Epidemiology Commons^™

Parents' And Health Professionals' Perceptions Of Asthma Medication Noncompliance Among Puerto Rican Children, Luz E. Nieves

Walden Dissertations and Doctoral Studies

Children of Hispanic origin have the highest prevalence of asthma of all ethnic groups in the United States, especially Puerto Rican children, who have a prevalence of 12.9%. Treatment nonadherence has been identified as one contributing factor. The purpose of this qualitative study was to explore the reasons for nonadherence to the asthma treatment regimen among Puerto Rican children. Parents and health care providers of asthmatic children were interviewed regarding their beliefs about asthma as a disease, its effect on the child's life, and their experience with asthma treatment. Two models served as the theoretical framework: the health belief model …

Hydraulic Fracturing And Cause-Specific Mortality: A Multicity Comparative Epidemiological Study, Uzoma C. Nduka

Walden Dissertations and Doctoral Studies

Cause-specific mortality (CSM), among other global health estimates, has garnered prominence in the contemporary public health field. CSM has been associated with several factors, however, research comparing CSM for prefracking versus postfracking periods is sparse. Hydraulic fracturing or fracking is a technique of extracting oil and gas from deep underground. The purpose of this study was to evaluate the difference among mean CSM scores from 1975 through 2015 in the available cities and counties of residence in Colorado and to determine the impact of gender, marital status, county of residence, and city of residence on CSM scores (prefracking period 1975-1977 …

The Influence Of Food Choices, Eating Habits, And Body Image Of African American Mothers On Childhood Obesity, Debrua Perniece Coleman

Walden Dissertations and Doctoral Studies

The food decisions, dietary patterns, physical activity, and weight-related convictions of African American mothers are affected by their self-perceptions and views of body weight. The gap in the literature regarding the impact of these perceptions on children's food choices, eating habits, and body image is significant. Using the health belief model as the theoretical foundation and a cross-sectional survey as the research design, this study assessed the potential relationship between mothers' and children's eating habits and whether mothers' perceptions of their children's body image were reliable indicators of childhood obesity. Eighty-six mothers provided demographic information and completed the Child Feeding …

Impact Of Social Influence On Willingness To Participate In Clinical Trials Among African Americans, Chika Okere

Walden Dissertations and Doctoral Studies

Global rate of participation in clinical trials is especially low among African Americans in the United States due to social factors identified by research, which adversely impact this group's willingness to participate in clinical trials. The purpose of this cross-sectional quantitative study was to evaluate the role of social influence in the decision-making patterns of African Americans as it relates to clinical trial participation. The theory of planned behavior was used as the theoretical framework to understand an individual's interaction with social factors and how it affects their willingness to participate in clinical trials. The participants in the study were …

Living Arrangements, Referral Source And Young Adult Admissions To Drug Treatment, Daniel Samaila

Walden Dissertations and Doctoral Studies

Abuse of painkiller drugs and non-medical use of drugs among young adults continues to be a public health crisis in the United States. Living arrangements and source of treatment referral were considered as the social context that could contribute to increased admissions to treatment for drug abuse. The purpose of this study was to examine the relationship between, independent living arrangement, the principal source of referral, and abuse of opioid, heroin, and cocaine. Steered by the conceptual framework of the biopsychosocial model, this study used the data from the 2015 Treatment Episode Data Set: Admissions managed by the Substance Abuse …

Oral Health Literacy And Oral Hygiene Habits In A Kentucky Appalachian Community, Katie D. Schill

Walden Dissertations and Doctoral Studies

This study sought to identify the level of oral health literacy held by people who live in transitional and distressed Kentucky Appalachian areas and if this effects how often they are using oral hygiene techniques. Data were also collected to describe the attitudes Kentucky Appalachian adults hold toward oral hygiene and oral health status. Current documentation shows that poor oral health remains a public health threat in this population despite efforts such as school-based sealant programs and increased dental insurance coverage. This study followed a quantitative design and 99 participants were polled using a survey specifically developed for this study's …

Late-Stage Breast Cancer Diagnosis Among Haitian Women In The United States, Marie-Hortence Prosper

Walden Dissertations and Doctoral Studies

Breast cancer is the 2nd leading cause of death among women. While a significant amount of research has been done to understand the different disparities related to this disease, there is still more to learn about the relationship between a person's nationality and the staging of breast cancer. Using the Surveillance, Epidemiology, and End Results Program as the data source, this retrospective cohort study was aimed at assessing late-stage breast cancer among Caribbean immigrants, specifically comparing Haitian women with Americans and other immigrant populations in the United States. The research questions addressed the link between nationality and the likelihood of …

Measuring Effects Of Childhood Adversity On Resilience Level Of Army Veterans, Stephanie Rausch

Walden Dissertations and Doctoral Studies

Veteran suicide is a public health issue that requires more research to understand the multidimensional factors, such as resilience, that lead someone to suicide. Adverse childhood events (ACEs), such as poverty and abuse, have affected how resilience is developed. This study examined the association between childhood factors of socioeconomic status, parental discipline, and being a military child, and adult resiliency level. Dienstbier's theory of mental toughness framed the study, which posits that a child who experiences mild ACEs and has time to recover between events, will be more resilient than children who experience serious ACEs, and children who experience little …

Effects Of Maternal Obesity On Preterm Birth And Birthweight, La Tosha Headley

Walden Dissertations and Doctoral Studies

Obesity is one of the major risk factors for neonate low birthweight among reproductive women. The purpose of this quantitative study was to examine the association between 3 categories of obese status (moderate, severe, and very severe) and low neonate birthweight and preterm birth among women ages 18 to 39 years at all socioeconomic levels. Secondary data were obtained from 141,859 women ages 18-39 years living in the United States who had participated in the 2012-2015 Pregnancy Risk Assessment Monitoring System. Social-ecological theory was used to guide the study, and binary logistic regression was used for the analyses adjusting for …

Predictors And Risk Factors Of Ebola Virus Disease In Sierra Leone, Kandeh Kamara

Walden Dissertations and Doctoral Studies

Sierra Leone had the highest number of cases of Ebola virus disease in history during the 2014 Ebola epidemic. The purpose of this quantitative, cross-sectional study was to examine the relationship between sociocultural and behavioral risk factors and Ebola status among women and men ages 15 to 49 years in Sierra Leone. The ecological model served as the theoretical framework. Secondary data were collected from the Sierra Leone Ebola Disease Survey. Results of chi-square tests revealed that attending a funeral (p = .001), touching a dead body at a funeral (p = .023), contact with a sick person (p = …

Challenges Of Aging With The Hiv Virus And Comorbidities, Rommie Navylia Abele

Walden Dissertations and Doctoral Studies

Since the introduction of antiretroviral therapy, the survival rate of infected HIV patients has been on the rise with a predicted increase by 2030. The longer a person lives with the virus, the more prone to HIV-associated chronic diseases he or she becomes, but it is not clear whether these diseases are solely from aging with the virus or from long-term use of antiretroviral therapy. Scientists demonstrated that the introduction of antiretroviral therapy led to an increased life expectancy yet early onset of comorbidities; however, they failed to address the challenges that people 50 years old or older face, as …

Emergency Department Use For Nontraumatic Dental Conditions And Adult Oral Health, Cheryl Anne Lassiter-Edwards

Walden Dissertations and Doctoral Studies

Nontraumatic dental-related emergency department visits has resulted in a financial burden to hospitals across the United States. This study investigated whether there is a relationship between adult preventive dental care and emergency department visits for nontraumatic dental conditions by comparing specific states. Guided by Andersen's behavioral model of health services utilization, this retrospective quantitative study also investigated associations between state-specific community water fluoridation and dental-related emergency department visits. The population of interest was adult Medicaid enrollees who visited the emergency department for non-trauma-related dental conditions in the top 5 most populous states as identified in the 2012 NHAMCS survey. These …

Low Health Literacy And Hpv Vaccine Uptake Of African American And Hispanic American Women, Peter Ntiamoah

Walden Dissertations and Doctoral Studies

Cervical cancer incidence in the United States has declined for the past 40 years, yet the odds of developing cervical cancer is much higher among marginalized women, particularly African American and Hispanic American women. Although preventable through vaccination against the human papillomavirus (HPV) prior to infection, uptake and completion rates of the vaccine among African American and Hispanic American women are low. The purpose of the study was to determine if a significant relationship existed between the health literacy levels of African American and Hispanic American women, ages 18-26, and the low HPV vaccination uptake. The integrated behavioral model, which …

Health Disparities Among Hispanic Americans With Type 2 Diabetes, Nelson Sitton

Walden Dissertations and Doctoral Studies

The ongoing increase in Type 2 diabetes among Hispanic Americans challenges the American public health system, particularly with health issues arising from not following appropriate health directives for the disease. This quantitative, cross-sectional, correlational study used primary data to assess the relationship between diabetes knowledge (as measured by the Diabetes Knowledge Questionnaire), health literacy level (as measured by the Short Assessment of Health Literacy-Spanish and English), education level, self-efficacy (as measured by the Diabetes Self-efficacy questionnaire), and self-reported diabetes self-care behaviors (as measured by the Summary of Diabetes Self-care Activities) among a sample of Hispanic Americans with Type 2 diabetes. …

Public Health Strategies For Strengthening Prehospital Injury Responses In St. Lucia, Delwin Oliver Ferguson

Walden Dissertations and Doctoral Studies

Traumatic injuries have steadily increased during the last two decades, affecting over 5.8 million persons annually and have become a global public health issue. Since 2008, 80% of all deaths from noncommunicable diseases and trauma, approximately 29 million occurred in developing countries. Sixteen thousand young adults worldwide have died due to traumatic injuries. Additionally, injuries account for over 15% of the global burden of diseases, with approximately 90% of these injuries occurring in developing countries like St. Lucia. The purpose of this qualitative descriptive study was to examine policy gaps in prehospital traumatic injury responses and explore implementing Essential Public …

Gender, Social Support, And Resiliency In Suicidal Ideation Among U.S. Army Soldiers, John Franklin Ambrose

Walden Dissertations and Doctoral Studies

Suicidal behaviors have continued to increase in the United States (U.S.) Army population since the beginning of the wars in Iraq and Afghanistan. Suicide rates are higher in men compared to women; yet, the rate of suicidal ideation is higher in women than men. The purpose of this study was to determine if there is a correlation between suicidal ideation and protective factors, if social support and resiliency are different for men and women within the U.S. Army population, and if gender acts as a moderating variable between suicidal ideation and protective factors. The interpersonal-psychological theory of suicidal behavior was …

Waterborne Disease Reduction Using Evidence-Based Microbiology Verification In Lower Nyakach, Kenya, Richard R. Blodgett

Walden Dissertations and Doctoral Studies

Waterborne diseases continue to plague the poorest people in low-income countries and are estimated to cause 4,600,000 acute incidents of diarrhea resulting in over 2,000 deaths daily. A major challenge is performing microbiology tests to monitor drinking water quality. Friends of the Old (FOTO) implemented a novel strategy using evidence-based microbiology to educate communities about the relationship between contaminated water and disease. Two commercially available tests for E.coli, adapted for fieldwork, provided easily interpreted results of contamination that correlate with WHO's disease risk categories. Simple and effective household water treatment options 'solar pasteurization and/or chlorination' were provided to all 14,400 …

Determinants Of Low Birth Weight In A Population-Based Sample Of Zimbabwe, Paul Nesara

Walden Dissertations and Doctoral Studies

Low birth weight (LBW) is a major public health concern globally. Despite its negative social and economic impact on the family and community at large, it has remained relatively unexplored at population level in Zimbabwe. The purpose of the study was to establish determinants of LBW using data from the 2015 Zimbabwe Demographic and Health Survey. The socioecological model was the conceptual framework for the study. A secondary analysis was conducted on 4,227 mother-infant dyads. Independent variables were duration of pregnancy, number of births within the past 5-year period, exposure to mass media, type of fuel used for cooking in …

Geographic Variations In Antenatal Care Services In Sierra Leone, Eunice Nyambura Chege

Walden Dissertations and Doctoral Studies

Despite antenatal care presenting opportunities to identify and monitor women at risk, use of recommended antenatal care services remains. Barriers preventing use of antenatal services vary between countries, and limited knowledge exists about the link between geographical settings and antenatal service use. The objective of this cross-sectional quantitative study was to explore geographical variations and investigate how social demographic characteristics affect use of antenatal care for women in Sierra Leone using the Andersen behavioral model. The data used were from the 2016 maternal death surveillance report of the whole counrty (N =706). Logistic regression analysis was used to determine the …

Racial/Ethnic Differences In The Treatment Of Elderly Non-Small Cell Lung Cancer Patients, Cheryl Mokrzecky

Walden Dissertations and Doctoral Studies

Racial and ethnic disparities related to lung cancer treatments and outcomes are not fully understood but may be due to individual or institutional factors. Following established national cancer treatment guidelines may improve patients' quality of life, outcome to treatment, and facilitate the eradication of lung cancer. There are limited data on the real-world treatment of racial/ethnic groups with non-small cell lung cancer (NSCLC) according to clinical practice guidelines, therefore this population-based cohort study examined the receipt of first line treatment for advanced or metastatic NSCLC according to the National Comprehensive Cancer Network (NCCN) practice guidelines. The Social Cognitive Theory served …

Adherence To Antiretroviral Medicines Among Adolescents And Young Adults In Benue State, Nigeria, Amom Tor-Anyiin

Walden Dissertations and Doctoral Studies

Adherence to ARV medicines is essential to halt HIV progression, increase CD4 counts, decrease virologic impact, and improve quality of life for the infected people. However, sustaining good adherence among adolescents and young adults (AYA) has been a challenge caused by various problems such as distance to clinic, improved CD4 count which lead to complacency in adherence, and the nature of the environment. This was a quantitative, retrospective, correlational, cross-sectional study anchored by the transtheoretical model, which was used to understand how adherence rate among the study population was impacted by the predictive factors. Secondary data was collected from patient's …

The Impact Of Parental Education Level, Wealth Status, And Location On Female Genital Mutilation Prevalence In Northwestern Liberia, Sando Adetunji

Walden Dissertations and Doctoral Studies

Walden University

College of Health Sciences

This is to certify that the doctoral dissertation by

Sando Adetunji

has been found to be complete and satisfactory in all respects,

and that any and all revisions required by

the review committee have been made.

Review Committee

Dr. Chinaro Kennedy, Committee Chairperson, Public Health Faculty

Dr. Adebowale Awosika-Olumo, Committee Member, Public Health Faculty

Dr. James Rohrer, University Reviewer, Public Health Faculty

Chief Academic Officer

Eric Riedel, Ph.D.

Walden University

2018

Female genital mutilation has been a public health issue in many countries. As a result, researchers across the globe have conducted numerous studies …

Knowledge, Beliefs, And Perceptions About Tuberculosis Among Haitian Immigrants And Haitian Americans Living In Miami-Dade County, Florida, Leslie Barbour

Walden Dissertations and Doctoral Studies

Tuberculosis (TB) kills 1.7 million people each year, and 1/3rd of the world's population is estimated to have latent TB. It was once the deadliest disease in the United States but is now relatively rare and, if treated properly, it is curable. Migrants from TB-endemic countries, such as Haiti, are one source of TB transmission to the US, and the prevalence of TB remains high and is increasing in Little Haiti, Florida. Data on the knowledge and perceptions of Haitian immigrants and Haitian Americans about TB is inadequate. The purpose of this qualitative research was to study the TB-related knowledge, …

Factors Influencing Alzheimer's Disease Healthcare Utilization Patterns In Puerto Rico, Carlamarie Noboa

Walden Dissertations and Doctoral Studies

Alzheimer's disease (AD) is associated with substantial healthcare utilization costs, resulting in a public health priority. In this study, the relationship between the demographic characteristics of age, gender, and type of health insurance; the presence of comorbidities of older Puerto Rican residents diagnosed with AD; and their healthcare utilization patterns (i.e., medical office and emergency room visits and hospital admissions) was examined using Andersen's behavioral model. Data from the 2013 Puerto Rico Health Study was used in this retrospective cohort design study. All AD cases aged -?¥ 60 years were extracted using systematic random sampling. One-way ANOVA-WELCH, Mann-Whitney U test, …

The Impact Of Transmission Mode On Hiv/Aids Medication Adherence, Lindsey Wilde

Walden Dissertations and Doctoral Studies

Medication adherence amongst HIV/AIDS infected individuals can be challenging for many reasons. I examined whether there was an association between mode of HIV transmission, such as sexual intercourse, mother to child, or IV drug use, and medication adherence among HIV+ individuals 18 years and older living in New York City. The theoretical base for this study was the Social Ecological Systems Theory. Logistic regression analyses were conducted on field data obtained from the New York State Medicaid Agency from 2015. Results indicated that transmission mode, age, race, and poverty level all have statistically significant associations with the dependent variable of …

Using Social Cognitive Theory To Predict Obesity Behaviors In Hispanic American Children, Augustina Anyikwa

Walden Dissertations and Doctoral Studies

Childhood obesity is a growing challenge in the U.S. Hispanic American population. There is a need for evidence-based approaches to combat this problem. Social Cognitive Theory (SCT) is one such approach. The purpose of this study was to examine the extent to which selected constructs of SCT (expectations, self-efficacy, self-efficacy in overcoming barriers and self-control) could predict five childhood obesity prevention behaviors, namely time spent on television watching, time spent on physical activities, water consumption, consumption of fruits and vegetables, and meal portion size among Hispanic American children. A quantitative cross-sectional research design was employed for this study. Data were …

Relationship Between Health Literacy And End-Stage Renal Disease Among Type Ii Diabetics, Joelle M. Stolte

Walden Dissertations and Doctoral Studies

The progression of End Stage Renal Disease (ESRD) among type II diabetics is preventable, yet complications continue to plague many. Reports show that 29.1 million people (9.3%) in the United States have diabetes, and 40% of those individuals develop ESRD. Four research questions explored the relationship between ESRD, health literacy, and healthcare. Data from 2010-2015 from the National Institute of Health (NIH) was quantitatively analyzed. The conceptual framework was the revised health service utilization theory. The target population included 3939 diverse males and females between the ages of 20-75 diagnosed with type II Diabetes. Results from Chi-square, cross-tabulation, binary, and …

Effects Of Menafrivac® Introduction In The African Meningitis Belt, 2010-2017, Andre Arsene Bita Fouda

Walden Dissertations and Doctoral Studies

Meningococcal meningitis is a burden in the African meningitis belt. Before 2010, Neisseria meningitidis serogroup A (N. meningitidis A) was the predominant pathogen causing deathly epidemics. MenAfriVac® vaccine protects against N. meningitidis A. It was introduced in 2010 into highest meningitis risk health districts. There was limited data on the effects of MenAfriVac®, mainly on the degree of relationship between N. meningitidis A and the MenAfriVac® immunization. The social ecological model was used as a theoretical framework for this study. The purpose of this quantitative study was to assess the effectiveness of MenAfriVac® from 2010 to 2017 in 21 out …

Health Promoting Behaviors Of Young Adults With Chronic Lyme Disease, Patricia D. Bolivar

Walden Dissertations and Doctoral Studies

Lyme disease is the most prevalent arthropod-borne (tick) disease in North America. The disease is more prevalent in some Eastern and Central states than in Western states. The general problem is that, in southern California especially in Los Angeles County, both patients and practitioners fail to recognize the disease, resulting in misdiagnosis and delayed treatment. Consequently, the patient may develop the long-term, chronic Lyme disease (CLD). The purpose of this phenomenological study was to explore the impact of CLD on the health-promoting behaviors of ethnically diverse young adults from similar educational and socioeconomic backgrounds based on their lived experiences. The …

Association Between Age Of Women When Diagnosed With Endometriosis And Infertility, Whitney Kennedy

Walden Dissertations and Doctoral Studies

Abstract

Because endometriosis is considered to be the primary cause of infertility in women and

the diagnosis is known to be delayed by many years, it is important to understand the

association between endometriosis and infertility. The purpose of this cross-sectional,

secondary data analysis study was to determine whether there was an association between

the age of women when diagnosed with endometriosis and infertility. Using the general

model of total patient delay (i.e., the Andersen model) as a theoretical foundation, data

for this study was collected by assessing patient medical records of women with

endometriosis at multiple OB-GYN clinics in …