Public Health Education and Promotion Commons^™

Impact Of Race-Related Stress And Intraracial Microaggressions On Self-Efficacy Of African Descendants, Samina Long

Walden Dissertations and Doctoral Studies

Race-related stress such as ancestral trauma and experiences of out- and in-group microaggressions can be intergenerationally transmitted from parent to child. The current study was conducted to address the need for research on race-related trauma and out- and in-group discrimination by providing evidence-based research on whether African descendants experiencing and witnessing race-related stress and intraracial microaggressions results in low self-efficacy. The purpose of this quantitative, multiple regression design was to explore the relationships among race-related stress, intraracial microaggressions, and self-efficacy, which may provide clarity on the psychological impact of these stressors. This study addressed the question of whether race-related stress …

Practitioners’ Perceptions Of Medical Compliance Among Homeless Clients With Hiv And A Mental Health Diagnosis, Kyle Samuel Berkley

Walden Dissertations and Doctoral Studies

Previous research on HIV medical adherence has focused on incentive-based interventions, while previous research with the chronically homeless has focused on substance abuse, mental illness, and health disparities. This qualitative study focused on the experiences and perceptions of medical providers in a metropolitan area who work on medical adherence with homeless people living with HIV and mental illness. Ecological systems theory provided foundation to explore how medical providers form interventions based on clients’ ecosystems. The data were collected via audio-recorded, semi-structured interviews with 15 case managers, mental health therapists, nurses, and primary care physicians who worked at outpatient medical centers. …

Living With Multiple Sclerosis, William Witt

Walden Dissertations and Doctoral Studies

Background: Continuity of care is a crucial characteristic of high quality multiple sclerosis (MS) care. Nevertheless, experiences of MS patients with continuing care are currently understudied, particularly through in-depth methods, such as qualitative approaches. This is despite the significance of continuity of care in improving patient satisfaction and the quality of life of patients with chronic diseases.

Aim: To examine the experiences and perceptions of MS patients with continuity of care through a critical exploration of their lives following hospitalization for an exacerbation.

Design of the study: Qualitative using phenomenological approach.

Participants: Eight participants living with MS. All participants were …

Hiv/Sti Screening, Testing, And Prophylaxis Among Sexual Assault Survivors In U. S. Emergency Departments, Elizabeth A. Cita

Walden Dissertations and Doctoral Studies

Use of HIV screening/testing and prophylaxis has been found to be low in the general emergency department (ED) population. Less is known about the use of HIV/sexually transmitted infection (STI) screening, testing, and prophylaxis among sexual assault survivors who present to EDs. The main research questions asked whether there was a relationship between race, socioeconomic status (SES), geographic region, or age, HIV/STI, treatment, and prophylaxis among sexual assault survivors that present to U.S. EDs. This study was a secondary analysis of data collected in the NHAMCS years 2010 to 2016 and included 112 geographic primary sampling units, about 480 hospitals. …

Chronic Pain Management In The Primary Care Setting, Rebecca Ann Day

Walden Dissertations and Doctoral Studies

Chronic pain is pain that lasts longer than 12 weeks, affects an individual physically in some mental or psychological way, influences an individual’s job performance, and may create a social complication over time. Ensuring the best possible care for the patient’s pain with the least possible complications is the responsibility of the health care provider, including nurse practitioners. Providing a clinical practice guideline (CPG) for the management of chronic pain in the primary care setting was the focus of this project. The comfort theory model was used as a framework for this project as well as the basis of nursing …

Homelessness And Hiv Risk: Experiences, Perceptions, And Beliefs Of Transgender Youth, Darcia Bryden-Currie

Walden Dissertations and Doctoral Studies

Human ImmunodeficiencyVirus (HIV) continues to be a public health concern in the United States, with increased rates of infection among transgender youth. The phenomenon of homelessness is also a significant challenge for transgender youth. Gender expression often results in stigma, and discrimination, many trans youth experience poverty, rejection, and low self-esteem, which are precursors to homelessness. The purpose of this qualitative phenomenological study was to explore the influence that homelessness has on sexual risk associated behaviors in transgender youth. The theoretical framework that guided this study was Bandura’s social cognitive theory. The research questions sought to explore how this population …

Maternal And Infant Birth Characteristics As Predictors Of Sudden Unexpected Infant Death, Betty Jean Ezell

Walden Dissertations and Doctoral Studies

Sudden Unexpected Infant Death (SUID) is a public health issue recognized by the United States Centers for Disease Control and Prevention (CDC) as the sudden and unexpected death of a baby less than 1 year old, often during sleep, with no obvious cause. Despite known SUID risk factors for infants and mothers, there is limited research on combinations of infant birth characteristics and mother demographics that could be indicative of a higher risk of infant death. The purpose of this cross-sectional quantitative study was to examine the extent to which infant birth characteristics, delivery characteristics, month prenatal care began, and …

Guidelines For Chronic Back Pain: An Education Module For Health Providers, Ron Pascual

Walden Dissertations and Doctoral Studies

Effective chronic back pain management and patient self-care guidelines are necessary for healthcare providers treating patients with complaints of low back pain (LBP). The purpose of this doctoral project was to provide an evidence-based educational program aimed at improving the knowledge and skills of healthcare professionals regarding the Center for Disease Control (CDC) and American Chronic Pain Association (ACPA) guidelines, emphasizing alternative pain management treatments. The staff education project was supported by the biomedical pain model and chronic care model. A panel of 3 experts including the clinic’s board-certified anesthesiologist and pain management specialist, clinical manager, and leading medical director …

Attitudes And Beliefs Related To Risk Of Sexually Transmitted Infection In Swingers Who Do Not Use Condoms, Deborah Brown

Walden Dissertations and Doctoral Studies

Sexually transmitted infection (STI) affects the public as a hidden epidemic of contagious disease with significant economic and health impacts. There are 110 million living with STI in the United States, with 20 million new infections annually. Condom use can reduce STI, but some people have sex without condoms, with risk for contracting or transmitting STI increasing when a person is in the same sexual network. Swingers are a growing sexual network and are a group at high risk of developing and spreading STI. The purpose of this generic qualitative study was to develop an understanding of the attitudes and …

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 …

African American Maternal Mortality In The United States: A Quantitative Analysis Of Chronic Disease And Maternal Deaths, Glory Inyang

Walden Dissertations and Doctoral Studies

African American women have higher rates of chronic disease including diabetes and cardiovascular related disease compared to White women and are 3 to 4 times more likely to die during childbirth, more than any other ethnic group in the United States. . When African American women become pregnant these conditions may influence their maternal health outcomes. This study aimed to determine difference in pregnancy related death associated with chronic conditions between African American women and White women. Based on secondary/archival data from the Center for Disease Control and Preventions' 2017 National Center for Health Statistics Mortality Multiple Cause Files a …

Factors Associated With Flu Vaccination Status Among Older Hispanics In The United States, William Esteban Toledo Velazquez

Walden Dissertations and Doctoral Studies

AbstractOlder Hispanics in the United States are less likely to be vaccinated with the flu vaccine compared to older White Americans, despite being at higher risk of influenza-associated deaths and hospitalizations. A quantitative cross-sectional study based on the social ecological model was carried out to evaluate the influence of several sociodemographic and health factors on flu vaccination status among elderly Hispanic individuals in the United States. Logistic regression analyses were conducted using secondary data collected from 95,414 elderly Hispanic and White American 2018 Behavioral Risk Factor Surveillance System participants. Multivariate logistic regressions controlling for other variables revealed health care coverage …

Factors Associated With Prostate Cancer Screening Among African American Men In California, Frank Ibe Agodi

Walden Dissertations and Doctoral Studies

In Los Angeles County, California, prostate cancer (PC) is the second primary cause of cancer-related death in men. Previous studies have focused on sociodemographic factors influencing racial and ethnic inequalities in health in the United States. However, research was lacking regarding if and to what extent social-ecological factors predict PC screening, specifically among African American men residing in Los Angeles County. The purpose of this quantitative study, using a cross-sectional design, was to identify the factors that may align with PC screening among African American men living in Los Angeles. African American men aged 45 and older were the targeted …

Access To Healthcare For American Indians Residing In The Northeast United States, Kristine D. Thomas-Jones

Walden Dissertations and Doctoral Studies

Urban American Indians/Alaskan Natives (AIs/ANs) have limited access to health care in comparison to non-Hispanic Whites (NHWs), which furthers health disparities for indigenous communities. The purpose of this quantitative, nonexperimental study, which was guided by the socioecological model, was to examine the relationship between access to health care and healthcare utilization among urban AIs/ANs and urban NHWs in the Northeast United States. The research questions addressed the difference in access to healthcare based on health insurance, difference in healthcare utilization, and whether there is an association between health care access and health care utilization for AIs in the Northeast United …

Barriers To Mental Health Services Related To Stigma In Northern California, Kandalena Ary

Walden Dissertations and Doctoral Studies

California Senate Bill 1041 recognized mental health as a contributing barrier for individuals struggling to achieve independence from aid through the California Work Opportunity and Responsibility to Kids (CalWORKs) program to meet the needs of the state's low-income families while reducing barriers to self-sufficiency. As mental health illnesses continue to increase, the engagement and utilization of services have not increased. The purpose of this study was to explore county policy infrastructure addresses making mental health services known, accessible, and increase participation to decrease barriers in utilization of available resources. The research questions were used to examine the effectiveness of processes …

Predictors Of Use Of Pap Tests Among Ghanaian Immigrant Women In Ohio, Baaba Forson

Walden Dissertations and Doctoral Studies

In the United States, cervical cancer disproportionately affects members of ethnic minorities, including immigrant women from Ghana. Overall cervical cancer incidence and mortality rates have declined in the United States due to opportunistic screening with Pap tests; however, rates have not declined for Black women and immigrant women, who continue to experience higher than average mortality rates. Immigrant women, including Ghanaian women, use screening less than nonimmigrant women. Several factors including poor acculturation, low educational level, certain personal attitudes, and lack of health insurance are known to reduce participation in screening. Using the theory of planned behavior as a guide, …

Primary Care Physicians’ Knowledge And Perception Of The Impact Of Health Literacy On Patient Care, Lutrisha S. King

Walden Dissertations and Doctoral Studies

Until recently, many health literacy studies were completed from the patient and nurse perspective, while few focused on the physician perspective, specifically the primary care physician. The purpose of this study was to provide insight into the health literacy knowledge and education of primary care physicians and determine the association, if any, between physicians’ perceptions of patients’ limited health literacy and physicians’ use of health literacy communication techniques. The knowledge, attitudes, and practice (KAP) framework directed this study. This framework posits that knowledge informs or influences attitudes, which leads to practices. The KAP framework was employed to answer the research …

Microvascular Disease And Chronic Kidney Disease In Persons With Diabetes In Grenada, Jennifer Elizabeth Lewis

Walden Dissertations and Doctoral Studies

Chronic kidney disease (CKD) is a set of pathophysiological reactions that impact the functionality of the kidney. The association between microvascular disease (MVD) and CKD as it relates to diabetes is important to the evaluation of organizational effectiveness in-hospital services planning as well as improving health outcomes. The purpose of this quantitative, cross-sectional study was to determine if there is an association between MVD and CKD severity in persons with diabetes. Using the socioecological model, the association between gender, age group, cigarette smoke, cigarette smoke frequency, alcoholic drink, alcoholic drink frequency, hypertension, albumin-to-creatinine ratio (ACR) severity, cholesterol, sickling (i.e. persons …

Levels Of Albuterol Inhaler With And Without Spacers In Children With Asthma, Jefferson Libed Pambid

Walden Dissertations and Doctoral Studies

Children with asthma remain a problem in public health because asthma drastically impacts children’s daily activities, increases absenteeism in school, and causes difficulties in sleeping. Researchers have demonstrated that poor asthma management is due to a lack of education about the correct inhaler technique, and the appropriate doses are not inhaled. Researchers have yet established whether asthma symptoms improve based on the doses inhaled with or without a spacer and whether children are most likely to experience fewer asthma episodes or attacks if they receive professional instruction. The purpose of this study was to fully understand the influence of an …

Addressing Cardiovascular Disease Among Populations Disproportionately Impacted In The United States, Michael Leron Sells

Walden Dissertations and Doctoral Studies

Cardiovascular disease (CVD) causes the most deaths in the United States and is disproportionately impacting certain groups more than others. A gap in the research exists when focusing on national data for those who bear the highest burden of CVD amongst people with hypertension when cardiovascular morbidity and mortality are examined. There is also a need to investigate the relationships between key indicators for CVD health disparities in people with hypertension. The purpose of this quantitative study is to investigate the cumulative effect of key health disparities indicators such as race, age, gender, education, and income using national-level surveillance data …

Translation And Validation Of The Hplp-Ii From English To Armenian, Zoya Minasyan, Leslie C. Hussey

Journal of Excellence in Nursing and Healthcare Practice

As the focus of healthcare shifts toward the social determinants of health, more information about health disparities between different ethnic communities is needed. The Health Promoting Lifestyle Profile II (HPLP-II) is an instrument that measures health promotion behavior across various cultural lines. This article describes the translation and validation of the HPLP-II from English to Armenian for the purpose of studying health promotion behavior among the hypertensive and normotensive Armenian American population and addressing health disparities among this community. Translating the HPLP-II required a multistep process to capture cultural linguistic adjustment. First, the researcher, a local bilingual professor, and a …

Nurses' Perceptions Of Patient Encounters During Bariatric Weight Loss Surgery Education, Traci Edwynne Cullins-Clark

Walden Dissertations and Doctoral Studies

Many researchers have suggested positive patient-health provider relationships can positively impact patient outcomes. A few focused explicitly on bariatric weight loss surgery (BWLS) professional-patient interactions. This study is significant because BWLS is a recommended tool to combat obesity. The purpose of this study was to analyze the perceptions of BWLS education nurses regarding their patient encounters. This mixed methods research study used an online survey combining quantitative Likert scale questions and open-ended qualitative questions, with social cognitive theory as the theoretical foundation. These explored viewpoints relate to their patient relations expressed by a health professional. Health professional beliefs incorporated into …

Interprofessional Intentional Empathy Centered Care (Ip-Iecc) In Healthcare Practice, Deepy Sur

Walden Dissertations and Doctoral Studies

Training interprofessional healthcare teams continues to advance practice for patient-centered care. Empathy research is also advancing and has been explored in social work, psychology, and other healthcare areas. In the absence of understanding empathy in an interprofessional setting, educators are limited in preparing teams to develop empathy as part of core competencies This grounded theory study explored for a theory of how interprofessional healthcare teams conceptualize and operationalize empathy in their practice. Azjen's theory of planned behavior and Barrett-Lennard's cyclical model of empathy framed the study. Data were collected using 6 focus groups and 24 semistructured interviews of varied healthcare …

Exploring Education Needs For Heart Failure Patients' Transition Of Care To Home, Michelle D. Williams

Walden Dissertations and Doctoral Studies

Transitions of care is a model designed to ensure that patients have resources needed to assist them to care for themselves at home after hospital discharge, which helps to decrease preventable adverse events. For people with heart failure (HF) to transition home from the hospital successfully, specific education is needed that is individualized to the disease process, but most patients' educational needs after discharge are unmet. The purpose of this qualitative study, guided by the Meleis middle range theory of transition, was to explore the perspectives of people with HF about their educational needs in order to gather data that …

Parental Perception Of Physician Cultural Sensitivity And Adherence To Asthma Treatment, Narue Jaynelle Wright-Jegede

Walden Dissertations and Doctoral Studies

In the United States, asthma remains a major cause of frequent urgent care visits, hospitalizations, and preventable deaths among children. Nationwide, the chronic disease continues to fall disproportionately on minorities, mostly residing in urban localities. When a child is diagnosed with asthma, the parents are typically tasked with managing the child's condition. Establishing a collaborative partnership between parents and their child's primary physician is significant for improving asthma self-management among youth. Using the theory of reasoned action as a theoretical framework, this mixed-methods study examined whether a relationship exists between parental perceptions of physician cultural sensitivity and parental care in …

Implementation Of A Transcultural Nursing Education Program To Improve Nurses' Cultural Competence, Ann Marie Elizabeth Edwards

Walden Dissertations and Doctoral Studies

The exponential growth of culturally diverse populations in the United States has led to a multicultural patient population while the nursing workforce remains predominantly White. At the project site, managers identified that staff nurses struggled to deliver culturally competent care. The purpose of this project was to improve the cultural competence of registered nurses (RNs) through a transcultural nursing education program. Leininger's transcultural nursing theory guided the project. Sources of evidence used to develop a face-to-face educational program included peer-reviewed journals, credible websites, and the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-R tool. Aggregate pretest and …

Antenatal Care And Maternal Sociocultural Determinants Of Childhood Immunization In Northern Nigeria, Amaka Tonia Okafor

Walden Dissertations and Doctoral Studies

Immunization has been recognized globally as a cost-effective public health intervention. However, despite its benefits, children in northern Nigeria are still adversely affected by the negative consequences of inadequate uptake of immunization. The purpose of this study was to assess antenatal care and maternal sociocultural determinants that influence childhood immunization within 2 months of birth in northern Nigeria. Constructs of social cognitive theory were applied to this retrospective correlational cross-sectional inquiry involving women 15-49 years old in northern Nigeria. Secondary data (the 2013 Nigeria Demographic and Health Survey) were analyzed using univariate, bivariate and multivariate logistic regression. Statistically significant (p < 0.05) predictors of uptake of childhood immunization within 2 months of birth were the person who delivered antenatal care, the number of antenatal care visits, the number of tetanus injections, maternal educational level, religion, wealth index, husband/partner educational level, and the person who decides on health care. Educated Christian women from middle-class or rich homes, whose husbands/partners were also educated and who jointly decided on health care, made numerous contacts with health care professionals, and received at least one tetanus injection during antenatal care, had a higher likelihood of immunizing their children within 2 months of birth. The positive social change implications for this study include providing evidence of deterrents to childhood immunization that could lead to relevant policies and interventions leading to healthier children, communities, and society.

Experiences And Perceptions Of Staff Providing Substance Use Disorder Treatment For Adolescents, Connie Jean Rendleman

Walden Dissertations and Doctoral Studies

Substance Use Disorder (SUD) is associated with high mortality rates and remains a public health concern in the United States. Although, numerous interventions are offered for adolescents struggling with substance misuse, minimal research is available on the effectiveness of treatments to reduce recidivism. Researching the most effective treatment offered to adolescents is crucial to treatment adherence and recovery. The purpose of this study is to determine the most effective SUD treatment for adolescent patients by exploring the perceptions and experiences of treatment therapists providing treatment. The trans-theoretical model was used with elements of the social cognitive theory as a guide …

The Relationship Between Limited Partner Availability, Masculine Ideologies, And Condom Use, Diakima Y. Thomas

Walden Dissertations and Doctoral Studies

One in every 4 people living with the Human Immunodeficiency Virus (HIV) are women. The leading cause of infection is heterosexual contact. The purpose of this quantitative, correlational study was to examine the relationship between gender ratio perception and masculine ideology and a woman's decision to use condoms during her sexual activity. The theory of gender and power and the theory of planned behavior served as the theoretical frameworks for this study. The perceptions of gender ratios, as measured by the Gender Ratio Imbalance Beliefs and Behaviors Scale (GRIBBS) subscale, GRIBeliefs, and masculine ideologies, as measured by the Gender Role …

Impact Of Community Factors On The Donor Quality Score In Liver Transplantation, Giovanna Saracino

Walden Dissertations and Doctoral Studies

An increasing prevalence of metabolic syndrome and obesity has been linked to the rise in transplant indication for cryptogenic cirrhosis and nonalcoholic fatty liver disease (NAFLD), creating a growing challenge to public health. NAFLD liver transplant (LT) candidates are listed with low priority, and their waiting mortality is high. The impact of community/geographic factors on donor risk models is unknown. The purpose of this study was to develop a parsimonious donor risk-adjusted model tailored to NAFLD recipients by assessing the impact of donor, recipient, transplant, and external factors on graft survival. The theoretical framework was the social ecological model. Secondary …