Public Health Education and Promotion Commons^™

County Health Leadership And Readiness For Noncommunicable Disease Services, Paul Wekesa Agunga

Walden Dissertations and Doctoral Studies

Premature mortality resulting from the growing global burden of noncommunicable diseases (NCDs) is a contemporary development challenge. Low-income and lower-middle-income countries are disproportionately affected, with the poorest in society considered the most vulnerable. A paucity of literature exists on how leadership practices at the implementation level relate to ensuring readiness for NCD services. The purpose of this study was to investigate whether any relationship exists between leadership practices at the county level and readiness for NCD services in Kenya. Path-goal and adaptive leadership theories were used to guide this quantitative correlational study, using secondary data from a 2013 Service Availability …

Implementation Of A Diabetic Resource Toolkit In A Veterans Administration Emergency Department, Caroline Hairston

Walden Dissertations and Doctoral Studies

Diabetes is the 7th leading cause of death in the United States. Uncontrolled diabetes and lack of self-care knowledge leads to increased emergency department (ED) visits, utilizing limited health care resources. The practice-focused question asked whether a patient-focused diabetic self-care toolkit could decrease the number of diabetes-related ED visits. The purpose of this project was to reduce the number of diabetes-related ED visits and was supported by the social cognitive theory. The sources of evidence included the facility's ED Information System (EDIS) data and a patient survey developed by the project lead. There were 149 participants (135 males and 14 …

Job Satisfaction And The Effects And Influences On Nurse Retention, Burke N. Kline

Walden Dissertations and Doctoral Studies

Researchers have predicted that by 2020 the United States will experience a severe shortage of registered nurses. The purpose of this correlation study, using the National Sample Survey of Registered Nurses 2008, was to investigate the relationship between nurse job satisfaction and its effect on nurse retention nationwide. Secondary data sets from the 2008 National Sample Survey of Registered Nurses and examining relationships between the variable of nurse retention and job satisfaction. Bivariate (correlation coefficient, chi squares, and simple linear regression) and multivariate (logistic regression) analyses identified and connected associations and examined measurement levels between the dependent and independent variables, …

Public Health Providers' Perceptions Of Electronic Health Records In A Disaster, Sherhonda Yvette Harper

Walden Dissertations and Doctoral Studies

The introduction of federal initiatives and incentives regarding health information technology fostered a movement towards the adoption of electronic health records (EHR). Implementation of EHRs sparked discussions among healthcare providers, patients, and others about the benefits or challenges of the move from the traditional paper method to the electronic version in healthcare settings. A knowledge gap in research involving the usefulness of EHRs and their impact to the delivery of care in other settings exists. The purpose of this qualitative study was to explore public health providers' perceptions of the meaningful use of EHRs in a disaster setting. Study participants …

Perceived Usefulness And Perceived Ease Of Use Impact On Patient Portal Use, Dasantila Sherifi

Walden Dissertations and Doctoral Studies

Patient portals are web-based tools that provide patients with access to their health records and enhance communication with providers. Despite the efforts in expanding their use and patients interest in using them, patient portal usage remains low. Higher use of portals is associated with greater patient engagement and better healthcare quality and outcomes. This study investigated the impact of perceived usefulness (PU) and perceived ease of use (PEU) on patient portal usage. The conceptual framework was based on the Technology Acceptance Model, which suggests that PU and PEU of a system affect attitude and behavioral intention toward using the system, …

Catheter-Associated Urinary Tract Infection In New York And North Carolina, Kehinde O. Abiodun

Walden Dissertations and Doctoral Studies

In the United States, many hospitalized patients with indwelling urinary catheters acquire catheter-associated urinary tract infections (CAUTI) during their hospital stay. CAUTI negatively affects peoples' health and quality of life and causes a financial burden to individuals and the nation. The purpose of this quantitative cross-sectional study was to explore the relationship between gender, age, and hospital types and CAUTI incidence in New York and North Carolina over a 3-year period. The theoretical framework of choice was the Donabedian model. Simple logistic regression and hierarchical multivariable logistic regression analysis were performed on archival data that was requested from Healthcare Cost …

Hypertension Awareness And Health Care Access/Use In Black Women With Hypertension, Marlène Trusiak

Walden Dissertations and Doctoral Studies

Black women in the United States have a high prevalence of hypertension and suffer the most complications of cardiovascular disease. Black women, though aware of the dangers associated with hypertension, have limited opportunity to access health care and or change their lifestyles. The purpose of this quantitative cross-sectional study was to test if there was a significant difference in hypertension awareness, health care access/use, and lifestyle modifications in Black women prior to and post implementation of The Patient Protection and Affordable Care Act, as compared to women of other races. The behavior modification theory guided this study. Secondary data from …

A Causal Layered Analysis Of Assistive Technology For The Cognitively Impaired Elderly, Dariusz J. Ropiak

Walden Dissertations and Doctoral Studies

Assistive technology may delay cognitively impaired elders' need for long-term institutionalization, and the promote independence. Its use is on the rise, yet the gap between the needs of the cognitive impaired elderly and what developers of the assistive technologies design, manufacture, and implement, remains to be filled. Using Inayatullah's 6-pillar approach, as the guide to the future of assistive technology, the purpose of this qualitative study was to explore how assistive technologies may fulfill the daily functional needs of the cognitively impaired elderly with Alzheimer's or other dementia by 2037. Data were collected from a focus group of 10 seniors …

Associations Between Substance Abuse And Mental Illness Among Sexual Minority Adults, Blanche O. Wright

Walden Dissertations and Doctoral Studies

Sexual minorities (lesbians, gays, and bisexuals) have a greater risk for substance abuse and mental illness than sexual majorities (heterosexuals). Associations between substance abuse and mental illness among sexual minority adults have not been widely studied. The purpose of this quantitative cross-sectional study was to use the 2015 National Survey on Drug Use and Health data from the Substance Abuse and Mental Health Administration to study the association of substance abuse (alcohol; hard drugs such as heroin, cocaine, methamphetamine; and hallucinogens), prescribed drugs (pain relievers, tranquilizers, sedatives, stimulants, psychotherapeutic, and inhalants, as well as marijuana) and mental illness (no past …

Evaluation Of The Effectiveness Of An Established Glycemic Monitoring Program In A High School Setting For Adolescents With Type I And Type Ii Diabetes Mellitus, Tabatha Lee Obeda

Walden Dissertations and Doctoral Studies

Adolescents with Type I and Type II diabetes need to monitor blood glucose and food intake, administer insulin, and participate in activities including physical education during school hours to maintain glycemic control. Glycemic management programs (GMPs) exist for the improvement of diabetes management during school hours. The purpose of this project was to evaluate a GMP in a school system in a rural area in the Southeastern United States. The goal was to determine if the existing GMP met objectives and to make recommendations for continuation, revision, or discontinuation of the GMP. The logic model provided the basic framework for …

Decreasing Acute Diabetes Complications Through Self-Management Education, Eugene O. Okafor

Walden Dissertations and Doctoral Studies

Diabetes mellitus is a chronic disease that affects millions of people in the United States. The purpose of this project was to develop a guideline to help clinical staff provide clear and concise diabetes self-management instructions to patients in a community setting. Orem's self-care deficit theory (SCD) and health belief model (HBM) provided a platform to assess how patients' self-care deficit contributes to illness and the effect of patients' perception of illness. SCD theory and the HBM provided the framework for the development of the guideline to decrease diabetes acute complications through self-management education. The practice-focused question was whether the …

Analysis Of Latent Tuberculosis Infection Treatment Adherence In An Inner-City Clinic, Yvonne Washington-Turay

Walden Dissertations and Doctoral Studies

More than 10 million people in the United States are known to have latent tuberculosis infection (LTBI), and more than 300,000 begin treatment for LTBI annually. However, many fail to adhere to therapy for numerous reasons. The purpose of this project was to evaluate the impact of a new guideline, Targeted Tuberculin Testing and the Treatment of Latent Tuberculosis, at inner-city tuberculosis (TB) control clinic in the United States. The practice-focused question for the project asked if the implementation of the clinical guideline using a shorter regimen improved LTBI treatment adherence. The health beliefs model was the framework used to …

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 …

Streamlining Hospital Administrative Procedures To Reduce Costs, Dr. Claret Onukogu

Walden Dissertations and Doctoral Studies

Americans spent nearly $2.6 trillion, or $8,000 per person for medical and administrative costs in 2010. By 2015, healthcare spending in the United States increased to 5.8% reaching $3.2 trillion or $9,990 per individual. By tackling healthcare administrative costs, it is estimated that healthcare providers could reduce these costs by $20 billion yearly. This case study explored strategies for streamlining hospital administrative procedures to reduce costs. The business process reengineering model formed the conceptual framework for this study. Data were gathered through semistructured face-to-face interviews guided by open-ended questions with a purposeful sample of 4 hospital managers in Atlanta, Georgia. …

Mental Hell, Jesenia De Moya, Hanaa' Tameez, Maritza Villela

Capstones

Mental Hell explores how difficult it is for low-income Latinos in New York City to access mental health care. Through explanations from experts and the personal stories of three Latinas New Yorkers who have gone through the process of trying to get the care they need, the story guides the reader through the many roadblocks this demographic encounters specifically under the insurance of Medicaid.

This is an extremely important topic that affects many New Yorkers, and we believe something needs to be done to make this type of healthcare more accessible for Latinos. New York City has a very high …

Six-Year Experience Of Influenza Vaccination As A Condition Of Employment For A Large Regional Health Care System, John R. Brill, Mark Hermanoff, Angela Tonozzi, Mary Jo Capodice, Jennifer Farrar, Zarina Dawoodbhai

Journal of Patient-Centered Research and Reviews

Background: Influenza remains a significant contributor to morbidity and mortality in the United States. Health care workers (HCW) can be both victims and vectors of influenza. Influenza vaccination of HCW is protective for both caregivers and patients, but voluntary programs generally fail to achieve rates recommended by the Centers for Disease Control and Prevention. Despite a complex, multifaceted influenza program initiated in 1996 that included significant education and promotion as well as free on-site vaccination, annual Aurora Health Care caregiver immunization rates remained in the mid-70s until adoption of a “condition of employment” strategy in 2011.

Purpose: Discuss the annual …

Challenges In Delivering Refugee Health Services, Thy Vo, Fabiana Kotovicz

Journal of Patient-Centered Research and Reviews

Background: Aurora Health Care is the major health care system providing care to refugees in Milwaukee, where half of Wisconsin’s refugee population resides. Like many other institutions caring for refugee patients, Aurora faces significant challenges when trying to address refugee health needs. Even with the assistance of medical interpreters, cultural differences, language barriers and limited patient health literacy, as well as lack of knowledge of refugee patients’ backgrounds, are major obstacles encountered by health care providers in this setting.

Purpose: This quality improvement study aims to assess Aurora providers’ perceptions of the benefits and barriers to working with refugee …

Refugee-Centered Medical Home:A New Approach To Care At The University Of Louisville Global Health Center, Rahel Bosson, Ruth M. Carrico, Anupama Raghuram, Paula Peyrani, William A. Mattingly, Rebecca Ford, Stephen P. Furmanek, Julio A. Ramirez

Journal of Refugee & Global Health

Refugees arrive to the United States with a full spectrum of health conditions, many of which involve intense case management requiring significant financial investments and use of healthcare resources. Kentucky receives more than 3,000 new refugees each year and ranked 10th in the nation for numbers of new arrivals resettled during 2015. These refugees arrive from diverse countries representing different cultures and speaking different languages. In addition, they arrive with diverse health conditions and medical needs. The aims of this paper are to share experiences from the University of Louisville Global Health Center regarding conceptualization, implementation and evaluation of a …

How Safe Is Healthcare? Perceptions Within The Healthcare Community And The General Public., Rodhan A. Khthir, Shahed Elhamdani, Ibrahim Hatab, Felyn Espina, Gerry Asuncion, Sutoidem Akpanudo

Marshall Journal of Medicine

Objectives: Complexity of health care is progressively increasing and with that the number of medical errors and adverse events are increasing to an alarming level. The purpose of this study is to assess the perception of healthcare safety within the healthcare community and the general public and examine the association between the perception regarding healthcare safety and the prior exposure to medical errors.

Methods: The study is a cross-sectional online survey. The online survey included basic demographics and a series of questions related to the knowledge and perception about healthcare safety and personal healthcare experience.

Results: 504 respondent …

Experiences Of Communication Barriers Between Physicians And Immigrant Patients: A Systematic Review And Thematic Synthesis, Salim Ahmed, Sonya Lee, Nusrat Shommu, Nahid Rumana, Tanvir Turin

Patient Experience Journal

Frequent immigration of peoples from outside often challenges various systems of any country; healthcare sector is the most confronted one. One of the most prominent reasons for this confrontation is communication gap between physicians and immigrant patients. In this systematic narrative review, we studied existing literature on physician-immigrant patient communication. We systematically searched the repositories of literature and followed some criteria to select literature. We selected 32 literatures for information extraction. Three themes emerged from the synthesis: Physicians’ viewpoint about communication barrier with their immigrant patients, Immigrant patients’ viewpoint about the communication barrier with their physicians, and Interpreter as a …

Healthcare Provider And Patient Knowledge, Attitudes And Practices (Kap) Regarding Zika Virus, Quinton Katler, Prachi Godiwala, Charles Macri, Beth Pineles, Aileen Chang, Homa Ahmadzia

GW Research Days 2016 - 2020

Introduction:

Zika virus emergence in the western hemisphere has prompted the critical need for tailored risk counseling. Our team created a KAP survey in order to assess provider and patient awareness of Zika virus symptoms, transmission, treatment, and current and future concerns in order to inform local risk counseling efforts.

Methods:

The cross-sectional survey was issued in Medical Faculty Associates (MFA) clinics and via online link to healthcare providers and community members. The REDCap Data Collection tool was used to capture responses with subsequent SAS data analysis.

Results:

A total of 172 responses were collected. Most respondents (97%) were aware …

Why Does Oral Health In Long-Term Care Residents Matter? Talking Points For Administrators, American Dental Association

Action for Dental Health

No abstract provided.

Engaging Parents To Promote Children’S Nutrition And Health: Providers’ Barriers And Strategies In Head Start And Child Care Centers, Dipti A. Dev, Courtney Byrd-Williams, Samantha Ramsay, Brent A. Mcbride, Deepa Srivastava, Ashleigh L. Murriel, Chrisa Arcan, Anna M. Adachi-Mejia

Department of Child, Youth, and Family Studies: Faculty Publications

Purpose: Using the Academy of Nutrition and Dietetics benchmarks as a framework, this study examined childcare providers’ (Head Start [HS], Child and Adult Care Food Program [CACFP] funded, and non-CACFP) perspectives regarding communicating with parents about nutrition to promote children’s health.

Design: Qualitative.

Setting: State-licensed center-based childcare programs.

Participants: Full-time childcare providers (n ¼ 18) caring for children 2 to 5 years old from varying childcare contexts (HS, CACFP funded, and non-CACFP), race, education, and years of experience.

Methods: In-person interviews using semi-structured interview protocol until saturation were achieved. Thematic analysis was conducted.

Results: Two overarching themes were barriers and …

Identifying Communication Barriers And Trust Issues Of Black Women Seeking Preventive Health Services In Houston, Texas, Melissa E. Shelton

Walden Dissertations and Doctoral Studies

Black women mortality rates are perceived to be impacted by communication barriers, trust issues, and the lack of quality preventive health services. The purpose of this phenomenological study was to explore communication barriers and trust issues perceived by Black women when seeking preventive health services. HMB was used to identify public attitudes around receiving preventive health services and to construct each question based on perceived susceptibility and perceived severity of communication barriers and trust issues. An ecological model of the communication process was used as a framework to identify fundamental relationships between the Black female patients and health care providers. …

Discovering Opportunities To Improve Profitability At A Federally Qualified Health Center, Robert Jackson Jackson

Walden Dissertations and Doctoral Studies

Federally Qualified Health Center (FQHC) organizations, which provide health care services to low-income, underserved patients, are underfunded. From 2000 to 2007, the cost of treating an FQHC patient increased by $146, while federal compensation to FQHCs increased by only $44 per patient. One FQHC organization in rural Alabama experienced financial losses from the fiscal year 2011 through 2014, jeopardizing services to approximately 6,000 low-income patients. The purpose of this qualitative case study was to analyze the subject organization and discover opportunities to improve financial performance. The research question pertained to the opportunities for improving profitability at the subject organization. The …

Attitudes Of Women Offenders Towards Medicaid Enrollment And Coverage Under The Affordable Care Act, Morrisa Barbara Rice

Walden Dissertations and Doctoral Studies

Although women offenders face barriers to successful reentry into their communities, as yet, no research has explored their experiences in accessing health care reentry services. Medicaid enrollment, the process of applying for Medicaid coverage, can be offered as a health care reentry service. Women offenders in jails have shorter sentencing times compared to those in prison, which presents Medicaid enrollment opportunities before release. The Second Chance Act provides the opportunity for reentry services, and the Affordable Care Act provides the opportunity for Medicaid coverage for women offenders. This phenomenological study explored the attitudes of women offenders about Medicaid enrollment and …

Narratives Of Men Living With Systemic Lupus Erythematosus, Kimberly Vandermark Lynch

Walden Dissertations and Doctoral Studies

While systemic lupus erythematosus (SLE) has been traditionally viewed as a woman's disease, SLE impacts men as well. Although most research on SLE has concentrated on how it affected women, little is known about how it impacts men. The purpose of this phenomenological study was to examine how men who live with SLE perceive its psychological impact. Using the lens of the biopsychological theory, common themes were examined pertaining to how men with SLE perceive the impact that SLE has on their cognitive and emotional functioning. Data were collected via interviews with 9 men with SLE, and the data were …

Influences Of Provider-Patient Communication On Health Literacy And Public Policy Relevant Outcomes, Rachel Carla Cartwright-Vanzant

Walden Dissertations and Doctoral Studies

Several artifacts of federal policy address the connection between health literacy of patients and health outcomes. These laws include The Plain Writing Act, Health Information Technology for Economic and Clinical Health, and the Health Insurance Portability and Accountability Act. Even with this policy structure, little is known about how nurses' knowledge of health literacy may influence patient understanding of medical information and health outcomes. Using Knowles' principles of effective communication, the purpose of this mixed-methods study was to concurrently examine the relationship between nurse knowledge of health literacy and communication techniques used by nurses to identify any causal relationships in …

Health Disparity In Preventive Care Among Nigerian Immigrants In The United States, Loveday E. Nwobilor

Walden Dissertations and Doctoral Studies

The roles of immigration status in preventive health care services among Nigerian immigrants in the United States were investigated in this quantitative, cross-sectional survey study. About 260,724 Nigerian immigrants reside in the Unites States, but many do not complete lifesaving preventive health services such as immunization and screening, a major factor contributing to the rise in the cost of healthcare resultant from their use of emergency room services. This study investigated the extent to which immigration status independently explains the relationship between health disparities and risks in non-completion of preventive health care among Nigerian immigrants in the United States by …

Barriers And Perceptions Of Black American Men About Prostate Cancer In Georgia, Martins M. Nnoko

Walden Dissertations and Doctoral Studies

In 2016, prostate cancer was the second leading cause of fatality in the United States. However, the population in this study 'Black American men, ages 40 and older, in selected counties in Fulton, DeKalb, Gwinnett, Clayton and Atlanta metropolitan areas' tended to underutilize prostate cancer care. The purpose of this quantitative, nonexperimental descriptive study was to determine whether socio-economic barriers and perceptions of Black American men about prostate cancer reduce their ability to access quality care in this county in Georgia. The Health Belief Model (HBM) was used to inform the predictive validity of perceptions, attitudes, and belief on individual …