Public Health Education and Promotion Commons^™

Sociodemographic And Obstetric Predictors Of Cesarean Section In Ghana, Nana Mireku-Gyimah

Walden Dissertations and Doctoral Studies

The increasing cesarean section (CS) rate in Ghana has severe public health implications as it results in significant maternal and child morbidity and mortality. An assessment of the factors contributing to the increasing CS rate in different settings is imperative to guide the development of interventions. The purpose of this study was to identify the sociodemographic and obstetric predictors of CS in a major referral health facility in Accra, Ghana. This research was grounded in the systems thinking approach and involved the use of a case-control design whereby 2,704 pairs of cases (delivered by CS) and controls (delivered by vaginal …

Socioeconomic Factors And Comorbid Conditions In Children With Autism Spectrum Disorder, William Paris

Walden Dissertations and Doctoral Studies

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that impacts children and adults. Comorbid conditions such as anxiety, depression, behavioral issues, and low socioeconomic status negatively impact health care quality in children with ASD. Missing from the academic literature is the quantification of the relationship between parental education and employment and health insurance coverage on the prevalence of comorbid conditions in children with ASD. The purpose of this cross-sectional quantitative analysis was to examine and quantify the relationship between parental education and employment, health insurance coverage, and the reporting of comorbid conditions (anxiety, depression, behavioral issues) in a nationally representative …

Meaningful Use Criteria And Staff Accountability In An Office Setting, Marcia Ionie Pender

Walden Dissertations and Doctoral Studies

Proper documentation for meaningful use (MU) criteria within electronic health records (EHRs) was identified as an issue for office staff at a local primary care office in a metropolitan area of Central Florida. The project question addressed the local gap in knowledge about MU standards necessary to ensure correct documentation of EHRs. The purpose of this doctoral project was to provide an educational program for staff to ensure compliance with the HITECH Act of 2009. Lewin’s Change Theory and Knowles Theory of Adult learning were the conceptual foundations for the educational program. The project question was to determine whether a …

An Integrated Approach To Hand Hygiene, Tarsha Renee Stewart

Walden Dissertations and Doctoral Studies

AbstractHealthcare-associated infections (HCAIs) threaten the quality and safety of the services provided. HCAIs are infections that occur while a patient is receiving treatment for another condition in any type of healthcare. The Centers for Disease Control estimates that approximately one in every 20 inpatients will become infected with an HCAI during their hospital stay. Proper hand hygiene is the most significant intervention in preventing HCAIs. Despite hand hygiene's effectiveness, evidence suggests that only 50% of healthcare workers are compliant with proper hand hygiene techniques. The purpose of this project is to increase nurse’s knowledge the via education. Kotter's eight-step change …

Reproductive Health Factors And Maternal Mortality Of Internally Displaced Women In Nigeria, Fatima Mahmood Jibirilla

Walden Dissertations and Doctoral Studies

Approximately 529,000 women die from pregnancy-related causes every year, with 99% of these maternal deaths occurring in developing countries. Each year, about 59,000 maternal deaths occur in Nigeria, with a mortality rate of 576 deaths per 100,000 births. Women constitute about half of the 33.2 million internally displaced persons (IDPs) worldwide. The purpose of this retrospective cross-sectional study was to explore the association between the reproductive health factors and maternal mortality of internally displaced women in Borno state, Nigeria. McCarthy and Maine’s model for determinants of maternal mortality informed this study. A secondary dataset of 400 women (age 14-49 years) …

Age-Of-Consent Policies And Hiv Among Adolescents In Sub-Sahara Africa, Suzanne Marie King

Walden Dissertations and Doctoral Studies

Age of consent policies have recently been identified as a barrier to HIV testing among adolescents in HIV endemic Sub-Sahara Africa. Grounded in the modified social ecological model, the purpose of this study was to determine if these policies were related to HIV testing rates and prevalence. In this quantitative research secondary data sets from the Demographic Health Survey were used. This study included all sexually active respondents aged 18 years or below (N=37,015) and then was further limited by respondents that had HIV test results (N=25,107). Binary logistic regression showed that respondents with lower age of consent had higher …

Health Literacy Staff Education For Heart Failure Management, Ifeoma Onyeiwu

Walden Dissertations and Doctoral Studies

Heart failure (HF) is a chronic disease with progressive deterioration that occurs over years or decades. There is a need for individuals affected by HF to be educated regarding this complex disease. Health literacy, an integral part of health and wellness, is one's ability to understand and use health information. Ninety million adults in America have difficulty understanding and using health information, resulting in higher rates of hospitalization and use of emergency services among patients. Limited health literacy may lead to billions of dollars in avoidable healthcare costs. This DNP project addressed health literacy as it relates to medication adherence …

Medical Brain Drain And Its Effect On The Nigerian Healthcare Sector, Oluwakemi Osigbesan

Walden Dissertations and Doctoral Studies

Nigeria suffers from a huge brain drain issue across different sectors, particularly in the healthcare sector. The WHO assessed that there is a current shortage of 2.8 million physicians in the world A heuristic phenomenological method was used in this study to explore the lived experiences of 12 Nigerian healthcare practitioners that migrated to the United States. The push-pull theory served as the theoretical framework that grounded this study. The central research questions for this study focused primarily on the reasons healthcare practitioners are leaving Nigeria and what the impact of those decisions have on the Nigerian healthcare sector. Qualitative …

Misuse Of Prescription Pain Relievers Among Pregnant Women In The United States, Winnie Chebet Rono

Walden Dissertations and Doctoral Studies

The non-medical use of prescription pain relievers has increased remarkably, posing social and public health concerns particularly in developed countries such as the United States. The management of pain experienced by pregnant women poses a challenge to clinicians considering the effects of the regimen on unborn babies. Guided by the health belief model, which aims to predict health-related behavior in terms of certain health beliefs and explain change and behavior maintenance as well as to guide health behavior interventions, this cross-sectional study aimed to understand the associations between misusing pain relievers and social determinants of health such as education level …

Effects Of Trained Providers And Naloxone Distribution On Prescription Opioid Use Disorder, Samuel Sarpong

Walden Dissertations and Doctoral Studies

AbstractOpioid abuse and overdose are associated with substantial morbidity and mortality rates, as well as social and economic costs. The purpose of this study was to evaluate the independent and interactive effects of state-sponsored prescription drug monitoring program (PDMP) trained healthcare providers and community-based naloxone distribution program related factors in the states of Florida and Georgia for the prevention and reduction of prescription opioid use disorder, overdose, and deaths. The research theory adopted was the socio-ecological model with an emphasis on risk factors such as age. The study used secondary data from 2014 to 2018 from the Florida and Georgia …

Perspectives Of Key Court Personnel On The Prosecution Of Domestic Violence Cases, Crystal M. Schoeder

Walden Dissertations and Doctoral Studies

Domestic violence (DV) continues to be a public health and criminal justice problem. Several criminal justice system changes have been made to combat DV, such as mandatory arrest policies, no-drop prosecution policies, and specialized DV courts. Perspectives on these policies, DV, and the criminal justice system have been obtained from the victims, police officers, and victim advocates. However, perspectives from those within the criminal justice court system are missing. The purpose of this qualitative phenomenological study was to obtain the perspectives of key court personnel in small rural communities regarding the prosecution of DV cases. Narrative policy framework was used …

Issues Facing Community-Based Social Workers When Providing Female Offenders With Reunification Services, Karen N. Vertti

Walden Dissertations and Doctoral Studies

AbstractThe goal with this action research project was to understand how community-based social workers (CBSWs) could address female offenders’ and their children’s needs while striving to reintegrate them into the community of Central Los Angeles County, California. Postrelease female offenders with children suffer from a variety of issues related to housing, employment, and personal childhood trauma. The trauma exacerbates the risk of revictimization and recidivism. CBSWs play a pivotal role in helping female offenders overcome barriers to successful reentry and reunify with their children. This study incorporated Bronfenbrenner’s ecological systems theory which provided a systems lens to this project. The …

Social Determinants Of Health And Type 2 Diabetes Among Enrollees Of California Children’S Services Program In Fresno County, California, Daniela Marie Aghadjanian

Walden Dissertations and Doctoral Studies

Despite extensive study in adults, Type 2 diabetes (T2D) has been the subject of little research concerning young adults or children. Doctors believed T2D to develop only in a person’s later years until health care providers found younger individuals developing this disease. The purpose of this cross-sectional quantitative analysis was to determine correlations between T2D and social determinants of health in Fresno County, California, based on children and adolescents. The 2017-19 data came from the Fresno County Department of Public Health. The theoretical foundation for the study was the socio-ecological framework focusing on individuals’ traits having a bidirectional impact on …

Inhaled Insulin, Afrezza, Educational Module For Health Care Providers, Sara Lynn Doolin-Thompson

Walden Dissertations and Doctoral Studies

Abstract Inhaled Insulin, Afrezza, Educational Module for Health Care Providers

bySara Doolin-Thompson

MSN, Walden University, 2014 BSN, University of Phoenix, 2004 ASN, Kentucky Wesleyan College, 1994

Project Submitted in Partial Fulfillmentof the Requirements for the Degree of Doctor of Nursing Practice

Walden University August 2021 Abstract Diabetes is on a global rise and there is a definite gap in providing care for the diabetic population. Two of the largest contributors to this gap in care are the lack of collaboration between health care professionals and the lack of education for health care providers on the evolution of diabetes treatment plans. …

Breastfeeding Information And Breastfeeding Duration Among African American Women With A Family History Of Breast Or Ovarian Cancer, Aleatha Johnson

Walden Dissertations and Doctoral Studies

Decades of research supports the notion that breastfeeding may help prevent breast and ovarian cancer in women. Women with a family history of these cancers are at greater risk. African American women have the lowest breastfeeding rates, yet the highest breast and ovarian cancer mortality rates. No studies have been conducted exploring the impact of being informed about breastfeeding from health care providers, breastfeeding support services, or family and friends and the relationship between their knowledge of family history of breast or ovarian cancer and breastfeeding duration for African American women. The purpose of this quantitative study was to determine …

Impact Of Out-Of-Pocket Fees On Under-5 Infant Mortality In Cameroon, Amelie Olga Mafotsing Fopoussi

Walden Dissertations and Doctoral Studies

Health facilities in Cameroon charge fees for treatment and services, which can affect health outcomes for those unable to pay for services. Some studies have shown that the removal of user fees had a positive impact on child health outcomes in selected African countries. The aim of this quantitative, cross-sectional study was to understand whether there is a link between out-of-pocket expenses and under-5 mortality in Cameron. The study was guided by the social ecological framework. Secondary data from the 2011 Cameroon Demographic Health Survey were used in the study. Chi-square, binary logistic regression, and multicollinearity analyses were used to …

Effectiveness Of Cancer Survivorship Plans On The Emotional, Psychosocial, And Physical Well-Being Of Breast Cancer Survivors, Amber Renee Purdie

Walden Dissertations and Doctoral Studies

AbstractCancer survivorship is essential for the longevity of all cancer survivors, and breast cancer survivorship has become the focus of public health organizations to help address the unmet needs of breast cancer survivors. This quantitative cross-sectional study explored the impact on the Quality of Life (QoL) and health outcomes of female breast cancer survivors in cancer survivorship programs or tertiary care. The ages of the survivors in the study sample ranged from 18 to 80, and all participants were at least 6 months into their cancer survivorship journey. Surveys used were the European Organization for Research and Treatment of Cancer’s …

Disparities In The Use Of Radiation Therapy For Postlumpectomy Breast Cancer, Deborah Rothley

Walden Dissertations and Doctoral Studies

Early-stage breast cancer can be highly curable when properly treated using national standards of care. However, disparities in treatment, including radiation therapy after lumpectomy, may result in disproportional mortality rates in African American women. The purpose of this study was to add to the body of research to help determine the reasons for an underutilization of radiation therapy among African American women and whether the disparity has continued by analyzing recent patient data. Anderson’s behavioral model was used to frame the study and help determine the associations between the predisposing and enabling independent variables of race, age, health insurance status, …

Relationship Among Health Literacy Superstitious Beliefs And Self-Care Among Diabetic Patients In Warri, Nigeria, Nkemakolam Simpson Ukpabi

Walden Dissertations and Doctoral Studies

AbstractDiabetes imposes significant burdens in medical expenditures, medication use, outpatient visits, and treatment of its chronic complications. Self-care behaviors such as medication adherence and foot care have been shown to reduce hospitalizations and complications, and high health literacy levels have been positively associated with self-care adoption. However, the effect of superstition on this relationship has not been studied among diabetic patients in Warri, Nigeria. This study was conducted to determine the moderating effects of superstitious or cultural beliefs on the relationship between health literacy and self-care adoption among diabetes patients in Warri, Nigeria. A quantitative, observational, cross-sectional design guided this …

Workplace Bullying/Interpersonal Conflict, Job Stress, Coworker Support And Hypertension Among Women, Kia Williams

Walden Dissertations and Doctoral Studies

Interpersonal conflict in the workplace, such as workplace bullying, is recognized as a growing public health issue that could lead to poor health outcomes like hypertension among women workers. However, there is limited research on the role that interpersonal conflict, as well as other job-related factors such as job stress and coworker support, may collectively have on hypertensive outcomes among minority women workers, specifically in younger age groups. The purpose of this cross-sectional quantitative study was to examine the extent to which certain job risk factors (interpersonal conflict, job stress and coworker support) were associated with being treated for hypertension …

Access To Preventive Health Care Services And Effects On Health Outcomes For Hispanic Older Adults With Type 2 Diabetes, Shafa Al-Showk

Walden Dissertations and Doctoral Studies

Despite elevated prevalence of diabetes among Hispanic, Hispanic older adults face challenges in self-control and management of their glucose levels, and they have less access to preventive health care services. The purpose of this retrospective quantitative cross-sectional study was to examine the associations between access to preventive health care services and Type 2 diabetes outcomes among Hispanic adults aged 65 years and older. The social-ecological model provided the framework for the study. The research question for this study examined the extent to which doctor visits, diabetes education and blood sugar checks correlate with HbA1c levels. Data were collected from 566 …

Social Ecological Factors Affecting Marijuana Use Among Young Adults In The United States, Temple Oritsegbubemi Jagha

Walden Dissertations and Doctoral Studies

AbstractCurrent knowledge of young adults’ marijuana use centers around individual risk factors and negative health effects (i.e., mental disorder), with less focus on contextual circumstances. In this study, I examined the association between demographic (i.e., gender, race, education, employment, income, and population density), social (i.e., risk perception and religious beliefs influence), living context (i.e., difficulty getting marijuana, poverty level, and county metro status), and marijuana use among young adults. The social-ecological model guided this study. In this quantitative cross-sectional study, data from the 2019 U.S. National Survey on Drug Use and Health that included 14,226 young adults aged 18 to …

Diabetes Education For Nursing Staff In Primary Health Care, Artemio Pontejos

Walden Dissertations and Doctoral Studies

The nature of the DNP project was a staff education program for staff nurses and other clinic personnel on diabetes self-care management in a primary health care setting. The goal of this educational program was to improve and update the knowledge on self-care management of primary health care nurses. This education program followed the Walden University DNP Project Manual for Staff Education guidelines. The purpose of this continuing education of professional nurses was to improve nurses’ patient education on self-care management. After a 3-day face-to-face 90-minute lecture, improvement of knowledge was measured with a comparison of a pretest and a …

Association Between Modifiable Risk Factors And Stroke Among Hispanics, Shanice Williams

Walden Dissertations and Doctoral Studies

Stroke is a significant public health issue that impacts the health of Hispanic adults. Understanding the multiple risk factors of stroke is an essential strategy to control the disease among this population. The purpose of this study was to examine the association between modifiable risk factors and stroke among Hispanics. The public health prevention framework guided this study. The research questions were designed to determine whether an association exists between modifiable risk factors for stroke among Hispanics. A quantitative, cross-sectional research design was used to conduct secondary analysis of the pooled 2017–2019 Behavioral Risk Factor Surveillance System annual surveys. The …

Fetal/Infant Mortality: Understanding Race And Ethnicity, Birthing Location, And Prenatal Care, Chelsea Collum

Walden Dissertations and Doctoral Studies

This study addressed whether race and ethnicity, birthing location, the month the mother begins prenatal care, and pregnancy risk level impact fetal/infant mortality. Infant mortality is a gauge by which the efficacy of the healthcare system and the overall health of the country is measured. The United States falls behind most other developed countries in terms of infant mortality rates. The ecological perspective was used as the theoretical framework. The study design was a cross-sectional cohort design using a sample of births and infant deaths from U.S. Vital Statistics data. Binomial logistic regression analyses were carried out to calculate odds …

Experiences In An Online Learning Community, Michelle Potthoff Wylie

Walden Dissertations and Doctoral Studies

Master of public health online programs have been experiencing issues with retention and problems related to inconsistent implementation of online learning communities. This basic qualitative study aimed to understand the efficacy of online programs and the perceived impact of the implantation of online learning communities. The conceptual framework for this study is Siemens’s connectivism theory supporting different types of learning in the online environment. Two research questions guided the study: (a) How do graduate students in an online Master of Public Health program perceive the efficacy of online learning communities and (b) Which components of online learning communities do graduate …

African American Females And Herpes Simplex Virus 2: A Basic Interpretive Qualitative Study, Cherlisa Jackson

Walden Dissertations and Doctoral Studies

According to recent studies, African American females are most susceptible to HSV-2 and are often asymptomatically diagnosed. Yet, the perceived benefit of discussing sexual health as well as recognizing a need to discuss HSV-2 with a healthcare provider was an identified gap in the existing research and current study findings. The purpose of this qualitative interpretive study was to understand the experiences of African American females who received an asymptomatic HSV-2 diagnosis. The health belief model constructs guided this study. Outlined through semi-structured interviews were the experiences of seven African American females diagnosed with HSV-2 in Fulton County, GA, as …

Predictors Of Stunting In Children Under 5 Years Of Age In Zimbabwe, Ranganai Matema

Walden Dissertations and Doctoral Studies

Stunting is the most common form of undernutrition globally and is a major public health concern. Child stunting has both short-term negative effects on children’s health and long-term negative effects on adult health and human capital. Zimbabwe has a high prevalence of stunting, 27% in 2015. Although some of the factors associated with stunting are known, there is a gap on comprehensive evidence on the significant factors associated with persistent high levels of child stunting. The UNICEF conceptual framework for malnutrition was used to guide a cross-sectional study using the 2015 Zimbabwe Demographic and Health Survey data to identify and …

Social Determinants Of Maternal And Neonatal Birth Outcomes Among Syrian Refugees In Lebanon, Mona Charbel Kiwan

Walden Dissertations and Doctoral Studies

Neonatal and maternal health indicators have been impacted due to Syrian refugees’ displacement in Lebanon and an increase in child marriage rates from 13% in pre-conflict Syria to 41%. Using the causal continuum framework, the retrospective cross-sectional study’s purpose was to examine whether there is a statistically significant association between adverse maternal and birth health outcomes among Syrian refugees in Lebanon and social determinants of health. The sample size drawn from UNHCR database included 48,083 maternal and 4,288 neonatal refugees admitted to the secondary health care in 2018. Pearson chi-square and binomial logistic regression results showed that employed, newcomers mothers …

The Impact Of Socioeconomic Status And Ethnicity On Chronic Obstructive Pulmonary Disease Patients, Donald Garret Abshier

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD) is a progressive and debilitating respiratory condition that leads to significant medial and financial burdens. For many patients with COPD, multiple socioeconomic factors contribute to health disparities, including income, education, employment status, and race/ethnicity. The purpose of this study was to examine the impact of SES and race/ethnicity on COPD patients. For this cross-sectional study, using secondary data analysis, the Social-Ecological Model (SEM), which discusses five levels of influence, was utilized. Data from over 3,222 participants aged 18 and over, living in Nevada were obtained from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) study. …