Public Health Education and Promotion Commons^™

Association Of Landfall Atlantic Tropical Storms And Human Cases Of Locally Acquired West Nile Virus Infection In Florida, Jackson G. Mosley

Walden Dissertations and Doctoral Studies

West Nile virus (WNv) is the most widely distributed flavivirus and considered a vector-borne pathogen of global significance. During the study period from 2002 to 2018, WNv had the highest incidence of locally acquired human cases when compared to any other mosquito borne illness in Florida with 373 cases documented during the study period. The purpose of the study is to determine if there is an association between Florida landfall tropical storms (LTS) and the incidence of locally acquired human WNv cases from 2002 through 2018. The study used a retrospective ecological study design guided by the epidemiological triad model …

Population-Level Determinants Of Cholera Incidence In African Countries, Ngoy Nsenga

Walden Dissertations and Doctoral Studies

Cholera remains endemic in Africa, with limited access to safe drinking water and inadequate sanitation as 2 of the main drivers of its dissemination. Few studies have examined the impact of health system capacity, even though it plays an important role in prevention, early detection, and response to a cholera outbreak. Grounded in the ecosocial theory of infectious disease dissemination, this quantitative ecological study explored the effect of social vulnerability (as measured by access to safe drinking water and sanitation, rate of open defecation, poverty, income inequality, gender inequality, and adult literacy) and health system (as measured by health financing …

Hiv Knowledge And Behaviors Among Young People In Kenya And Lesotho, Beatrice Ochieng

Walden Dissertations and Doctoral Studies

Sub-Saharan Africa (SSA) has a great burden of human immunodeficiency virus (HIV) and high new HIV infection rates among youths age 15-24 years. Suboptimal practice of HIV risk-reducing sexual behaviors among youths threatens to reverse the gains made in preventing the spread of HIV in SSA. The purpose of this quantitative cross-sectional study was to investigate the effects of comprehensive knowledge of HIV transmission and prevention, on individuals’ attitude toward people living with HIV, and ability to obtain condoms (if needed) on practice of HIV risk-reducing sexual behaviors, in adolescents age 15-19 years and young adults age 20-24 years in …

Demographic Factors Associated With Childhood Obesity Among Women, Infants, Children (Wic) Participants In 2014, Olukayode Wisdom Oduwole

Walden Dissertations and Doctoral Studies

In the past few years, there has been an alarming increase in childhood obesity in the United States and worldwide, however there is little consensus around how to respond to the problem. What has now become an epidemic, was uncommon decades ago. This study assessed the demographic factors associated with childhood obesity among WIC participants in 2014. The study utilized demographic data from 3,011,119 participants in 2014 nationally representative National Health and Nutrition Examination Survey, and social cognitive theory (SCT) to understand the demographical factors associated with childhood obesity. Adjusted odds of obesity were calculated to assess association between males …

Hiv Positive African American Women’S Lived Experiences And Clinical Outcomes, Christie Olejemeh

Walden Dissertations and Doctoral Studies

African American (AA) women are disproportionately affected by HIV/AIDS. The infection rate for AA women continues to increase, and literature lacks information specifically on education for AA women regarding viral suppression at diagnosis. The purpose of the study was to understand the lived experiences of AA women living with HIV in the District of Columbia, particularly how they acquired knowledge of viral suppression. To understand their experiences with antiretroviral medications, viral suppression, discrimination, and stigma, this qualitative study applied a hermeneutic phenomenological approach. The theories of resilience and empowerment were applied. Ten HIV positive AA women living in the District …

Tuberculosis Diagnostics In Ethiopia: Assessment Of Laboratory Procedural Capabilities And Limitations, Yeshimebet Retta

Walden Dissertations and Doctoral Studies

Abstract

Tuberculosis (TB) is a curable and preventable disease; however, in 2015, 10.4 million people were diagnosed with TB, making it one of the top 10 causes of mortality. A major part of the TB disease burden is carried by low and middle-income countries. In Ethiopia, which ranks 15th among 22 countries with a high burden of TB and multidrug resistant TB (MDR-TB), important diagnostic and treatment gaps persist. This quantitative descriptive study was primarily aimed to determine levels of adherence to standardized TB laboratory procedures by calculating and reporting the number of sputum samples, and reporting valid and documented …

Readiness Of Stakeholders To Adopt Community Paramedicine Programs In Tennessee, Roger Lloyd Ritchie

Walden Dissertations and Doctoral Studies

Abstract

Community paramedicine is an emerging model of care that promulgates EMS in a more community-based and integrated role within the broader health care system. A hallmark characteristic of community paramedicine is that programs are designed to meet the specific needs of a given community, rendering programs unique but perplexing. A need for research aimed at exploring possible barriers that may impede the adoption and implementation of community paramedicine programs has been identified by the National EMS Advisory Board, the North Central EMS Institute, and the Joint Committee on Rural Emergency Care. The purpose of this study was to explore …

Sex Differences In Lyme Disease Symptomatology In The Northeast United States, Jeanine Scotti

Walden Dissertations and Doctoral Studies

Guided by the gender-analysis-matrix theoretical framework, 3 key areas of research inquiries focused on the relationship between sex and Lyme disease, symptoms of Lyme disease and sex, and severity of Lyme disease symptoms on sex. A quantitative secondary data analysis was used to address the research questions. A clinician specializing in caring for individuals with Lyme disease provided the dataset, containing responses to the Horowitz Multiple Systemic Infectious Disease Syndrome Questionnaire for Lyme disease. A cross-sectional, comparative research design incorporating 2 statistical techniques for analysis—the independent samples t test and multivariable regression analyses—was used to examine symptom counts and the …

Analysis Of The Impact Of Family Structure And Type 2 Diabetes Among Adolescents, Danny Lee Self

Walden Dissertations and Doctoral Studies

Type 2 diabetes (T2D) has increased among the adolescent population in the United States within the past 30 years. While the increase in T2D is linked to obesity and a lack of physical activity, it lacks contextual analysis within the structure of the non-traditional family unit. The purpose of this quantitative study was to examine family structure and prevalence of T2D among adolescents. Krieger’s ecosocial theory guided the study. The research questions were designed to investigate whether family structure directly impacts T2D prevalence or indirectly through socioeconomic status. The research design was quantitative with cross-sectional analysis of secondary data. The …

Factors Affecting Adherence To Diabetes Management Recommendations Among Afro-Caribbean Farm Workers, Aretha Meritian Townsend

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus (T2DM) is a global epidemic, impacting the economy and quality of life of affected individuals. The treatment and management of the disease often rely heavily on self-efficacy and provider guidance. Adherence to provider treatment regimens can help to prevent T2DM-related complications. However, non-adherence to T2DM regimens is a growing concern among minority populations, where T2DM is highly prevalent. Limited research is available for the Afro-Caribbean migrant farmworker (ACMF) with high rates of diabetes and an alarmingly high rate of non-adherence to treatment recommendations which is further complicated by low literacy, common cultural practices, and poor diets. …

Evidence-Based Strategies For Improving Medication Adherence Among Psychiatric Patients: A Systematic Review, Omah S. Tsikada

Walden Dissertations and Doctoral Studies

Nonadherence to psychotropic medications among patients with serious and persistent psychiatric disorders, including bipolar disorder and schizophrenia, is approximately 70%. Nonadherence is a common barrier to the treatment of individuals with mental health disorders. However, there is limited awareness of evidence-based interventions and strategies to address this problem. Therefore, the question for this project asks whether a systematic review can identify strategies to improve adherence of psychotropic medications among individuals with serious and persistent mental illness. The purpose of this systematic review was to explore the evidence-based strategies that can aid in increasing medication adherence in patients with mental health …

Sociodemographic Factors Associated With Abortion Rates Among Black Women In The United States, Lincoln Don Washington

Walden Dissertations and Doctoral Studies

Abortion has been a public health issue since the procedure became legal 47 years ago and, clinicians have performed 60,069,971 abortions from 1973 to 2017 in the United States. In 2014, a significant decline in abortion rates has been recorded in almost every state, as well as across different subpopulations when segregated by age, race/ethnicity, education, income, or geographic locations. However, abortion rates were still significantly higher among Black women relative to the U.S. average, prompting the need to examine the causes of this disparity. The main purpose of this quantitative study was to investigate and determine the sociodemographic causing …

Nursing Home Caregivers’ Knowledge Of Decubitus Ulcer Prevention Strategies, Shola Akinfiresoye

Walden Dissertations and Doctoral Studies

Decubitus ulcers (DUs) were a constant concern among the residents of the nursing home in this project. Prolonged immobility, sensory impairment, and urinary incontinence are some of the factors found in the literature as the causes of the disease. However, the lack of useful knowledge regarding evidence-based practices (EBPs) to prevent and treat DUs also contributed to the higher incidence rates at the nursing home. The purpose of this DNP- project was to evaluate the caregivers’ knowledge of EBPs to prevent and treat DUs at the facility. The IOWA Model of Evidence-Based Practice, which healthcare practitioners use to guide clinical …

Sexual Behavior, Contraceptive Use, And Unmet Needs Among Unmarried Teenage Women In Uganda, Lawrence Were

Walden Dissertations and Doctoral Studies

At 25%, teenage pregnancy in Uganda is one of the highest in the world, and this has been mainly attributed to low contraceptive use and a high unmet need for modern contraceptives. Unmarried women aged 15 to 19 years in Uganda face unique cultural, ethical, financial, and legal barriers to the use of contraception. The purpose of this study was to investigate how sexual behavior, contraceptive use, and unmet needs among unmarried teenage women in Uganda aged 15 to 19 years are influenced by personal and environmental factors. Bandura’s social cognitive theory was used as a theoretical framework for this …

Nurse Practitioner Approach To Care For Peripheral Vascular Disease, Jessica R. Wozniak

Walden Dissertations and Doctoral Studies

The Amputation Coalition indicates that there were approximately 2 million people with limb loss in the United States primarily caused by peripheral vascular disease in 2019. Those with amputation related to vascular disease have a 5-year mortality rate. The gap in clinical practice at the facility used for this project is that there were no comprehensive program guidelines for nurse practitioners and other health care professionals working with people who are at risk for vascular intervention or limb loss. The practice-focused question was answered that an interprofessional team did develop a prototype for a comprehensive peripheral vascular program that serves …

Association Between Obesity, Socioeconomics, Mental Illness, And Education In Native American Communities, Darrell D. Wright

Walden Dissertations and Doctoral Studies

Obesity is a profound health epidemic that adversely affects the health of all ethnicities. This growing health crisis has been found to be linked to several chronic diseases such as stroke, diabetes, and several forms of cancer. As in Native American populations, increased morbidity and mortality rates associated with obesity prevalence in minority populations has been linked to variables such as income, education, mental illness, and age. The purpose of this research was to examine the association of obesity with socioeconomic status, education, mental illness, and age in Native American populations. The theoretical framework used in this study was based …

Changes In Operating Performance In Rural Hospitals From 2012 To 2019, Oluwaseyi Tami Young-Harry

Walden Dissertations and Doctoral Studies

Rural hospitals treat patients while dealing with the challenges of an inadequate workforce, limited financial resources, and an isolated geographic location, leading to difficulties in achieving financial viability. The purpose of this quantitative study was to analyze the operating performance of rural, general, medical and surgical hospitals in the United States and to determine if performance had changed from 2012 to 2019. Guided by x-efficiency theory, this study addressed whether hospital ownership explained variation in performance and if performance had changed from 2012 to 2019. A random sample of 394 rural hospitals was used, with data drawn from the American …

Impact Of Medicare Utilization On Mortality And Readmission Rates Of Heart Failure Patients 65 Years And Over, Joanna Alexander

Walden Dissertations and Doctoral Studies

Roughly 25% of individuals 65 years and over hospitalized with heart failure are readmitted within 30 days after discharge. Elderly individuals identified with heart failure possess a 5-year mortality approaching 50%. The purpose of this study was to determine if there is a relationship between Medicare-covered services for care, mortality rates, and readmission rates for beneficiaries 65 years and over with heart failure. To address this topic, the chosen approach was retrospective and quantitative. The theoretical foundation was the Chronic Care Model. The research questions sought to determine if there is a relationship between the Medicare-covered services for care and …

Faith, Medication Adherence, And Cardiovascular Disease Among African American Churchgoers, Linett Lorain Brice

Walden Dissertations and Doctoral Studies

Getting African Americans to adhere to medical management strategies to reduce negative health outcomes of cardiovascular disease (CVD) and CVD risk factors may be challenging. The purpose of this cross-sectional quantitative study was to examine whether levels of faith in God's healing, when it comes to taking medications, was associated with medication adherence to hypertension and/or diabetes mellitus type 2 (DMII) medications, and whether those factors were associated with prevalence of CVD and uncontrolled symptoms of CVD risk factors, namely hypertension and DMII. Social cognitive theory provided the framework for the study. Data were collected from surveys completed by 102 …

Telehealth Efforts To Reduce Hospital Readmissions Of Congestive Heart Failure Patients, Sirfornia L. Deasfernandes

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is a chronic condition that affects millions of individuals in the United States. There is no cure for CHF, but medical interventions can help treat the symptoms and improve health outcomes. The purpose of this quantitative study was to determine if telehealth services help to reduce the readmission status of patients diagnosed with CHF. The theoretical framework used in this study was the individual and family self-management theory to help focus on self-management behaviors that contribute to improving the patients' health outcomes. The research questions were focused on addressing CHF patients receiving telehealth services and whether …

Bioterrorism: Exploring Factors For Improving Nurse Preparedness, Policies, And Practices, Leone Okey Tom-James

Walden Dissertations and Doctoral Studies

Ebola virus release/attack in New Jersey could go unnoticed but have immediate and long-lasting effects on the broader population and security. The risk underscores the need to prepare and enhance the state’s efforts to deal with a release and treat the confirmed cases. This descriptive single case research explored factors for improving nurses’ preparedness, policies, and practices for a bioterrorism release/attack. The epidemiological triangle conceptual framework was used descriptively in exploring, and developing a knowledge base of Ebola virus pathogenicity, characteristics, routes of transmission, and infection. The unit of analysis was Summit Ridge Genesis Healthcare Center. The theory of robust …

Social Cognitive Theory Constructs That Predict Betel Nut Chewing Among Secondary Students, Lepani Waqatakirewa

Walden Dissertations and Doctoral Studies

After alcohol, tobacco, and caffeine, areca or betel nut is the 4th most common substance of abuse in the world, and its prevalence of use in the Solomon Islands is estimated at 68% in young people. Long-term use of betel nut can result in detrimental health outcomes such as oral cancers and metabolic syndrome. Guided by the social cognitive theory (SCT), the purpose of this quantitative cross-sectional study was to determine whether the constructs of SCT predict betel nut use in Year 12 secondary students in the Solomon Islands. Five SCT constructs of expectations (outcome expectations and outcome expectancies), self-efficacy, …

Predictors Of Intention To Use Health Literacy Strategies Among Physicians In Grenada, Arlette Wildman

Walden Dissertations and Doctoral Studies

Low health literacy is linked to poor health outcomes. Adequate health literacy depends on effective communication between patients and their healthcare providers, so it is important physicians use health literacy strategies. Grounded in the theory of planned behavior, the aim of this quantitative correlational study was to investigate the relationship between health literacy knowledge, health literacy experience, gender, the region of training, years of practice, and intentions to use health literacy strategies among physicians in Grenada. One hundred and eighteen physicians were sampled using a cross-sectional survey method. The results of the multiple linear regression analysis were significant, F(5, 112) …

Association Of State Tobacco 21 Law With Tobacco Consumption Among Youth, Rebecca Adamson

Walden Dissertations and Doctoral Studies

The study is an investigation of the association between the Tobacco 21 Law and youth tobacco usage rates in Hawaii. Researchers have documented a gap in the research regarding the effectiveness of such laws. Several studies that have been conducted have shown mixed results. The purpose of this study was to better understand any association that may exist in Hawaii. The social ecological model (SEM) of health is the theoretical foundation for the study. The SEM of health includes five sources which influence health, and these consist of intrapersonal factors, interpersonal factors, institutional factors, community factors, and public policy. Tobacco …

Quality Of Life, Physical Activity, And Weight Status For A Sample Of Online Students, Walaa Awad

Walden Dissertations and Doctoral Studies

Obesity has been identified as a global health problem and a risk factor for many chronic diseases. While previous studies discussed the weight status and factors associated with overweight and obesity among adults enrolled in traditional universities, few studies have yet estimated the obesity rate among adults who choose online education. Guided by the social cognitive theory, this descriptive exploratory quantitative study used a survey to collect primary data from adult online students of three higher educational institutions. The survey examined the effect of quality of life and physical activity level on the weight status of the participants; taking into …

Sexual Education, Sexual Initiation, And Contraceptive Use Among African American Young Women, Kineka J. Hull

Walden Dissertations and Doctoral Studies

Unintended pregnancy is associated with adverse social, economic, and health outcomes making it a public health concern. African American (AA) women aged 18–24 are at higher risk of unintended pregnancy due to earlier sexual initiation and non-use, inconsistent, or improper use of contraceptive methods (CM). The purpose of this study was to investigate the extent to which receipt of formal sexual health education (FSHE) impacts age of sexual initiation and contraceptive use and selection of more effective CMs (ECMs) among AA women aged 18–24 (N = 242) who have sex with men. Driven by the reasoned action approach, 2015–2017 National …

Socioeconomic And Health-Related Factors Affecting Congestive Heart Failure Readmissions, Jollibyrd Miguel Gusto

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) readmissions are frequent and costly, but preventable. These readmissions not only contribute to rising healthcare cost but also affect the quality of life of these individuals and their loved ones. Guided by the social ecology model for health for health promotion, the purpose of this study was to analyze the socioeconomic and health-related factors of CHF readmissions. The main hypothesis of this study was that there was a relationship between 30-day readmissions of individuals with CHF and their payer status, race, ethnicity, primary language spoken, living arrangement, and comorbidities in the dataset as identified in their …

Predicting Behavior To Engage In Fall Prevention Practices: The Role Of Interests And Basic Psychological Needs, Jan Fay Kress

Walden Dissertations and Doctoral Studies

AbstractA fall is associated with adverse outcomes that include occupational, physical, cognitive, and psychological decline together with economic and caregiving burden. Despite the continued increase in prevalence of falls globally, most studies address the well-known risk factors of falls but exclude the behavioral risk factors associated with human actions, emotions, and everyday choices. Following the theory of self-determination and person object of interest framework, this quantitative, nonexperimental study was conducted using face-to-face and web surveys to examine the relationship between motivational, relational, and sociodemographic/medical conditions to predict engagement in fall prevention practices in a sample of 75 community dwellers, 65 …

Risk Factors Of Infant Mortality Disparity In Indian River County, Florida, Cecilia Miguelina Escorbore

Walden Dissertations and Doctoral Studies

Infant mortality in the United States is a great concern to families, communities, and professionals in the public health field. More concerning is the infant mortality racial disparity, prevalent throughout the United States. The purpose of this study was to explore risk factors of infant mortality disparity in Indian River County (IRC), Florida. Using socioecological theory as the theoretical framework, this study explored whether there is an association between infant mortality among Black infants and geographic location as well as measures of socioeconomic status (age, educational level, health insurance status, and marital status) associated with infant mortality among Black infants …

The Relationship Between Mental Illness And Mass Shooting, Priscilla Ngozi Chukwueke

Walden Dissertations and Doctoral Studies

AbstractWhenever a mass shooting occurs, it impacts the immediate families of the perpetrator, victims, and the whole nation: emotionally and financially. The research on the association between mental illness (MI) and mass shooting fatalities is limited. The purpose of this quantitative, cross-sectional study was to explore the association between MI and mass shooting using the archival data of the Stanford University database of mass shootings in America from 2000 to 2016. The theoretical framework was based on Bronfenbrenner’s social-ecological theory and the cognitive-behavioral theory to explain socio-environmental factors that impact human growth and development. The results showed that the proportion …