Public Health Education and Promotion Commons^™

Lived Experiences Of African American Females With Breast Cancer Treatment Access, Tamika Chantey Smith

Walden Dissertations and Doctoral Studies

Breast cancer (BC) is a significant condition that can result in devastating outcomes without treatment. The purpose of this phenomenological study was to explore barriers to health care disparities among young African American females. The findings of this study may help to address gaps in knowledge, obtain insights in treatments, and comprehend lived experiences with BC. The theoretical framework for this study was Bronfenbrenner's social ecological theory. Data were collected from face-to-face interviews with 10 African American women ages 20 to 40. Data were then transcribed and coded. The findings of the study indicated that women required treatment plans, informative …

Association Of Health Facility Delivery And Risk Of Infant Mortality In Nigeria, Susan Adaku Ukwu

Walden Dissertations and Doctoral Studies

Infant mortality (IM) incidence in health facility systems during or after infant delivery is

substantially high in Nigeria. In this quantitative, cross-sectional study, the effects of skill

birth attendants (SBAs), prenatal care, and providers of prenatal care on IM in health

facility delivery centers were examined. The Mosley and Chen theoretical framework

informed this study and was used to explain the relationship between SBAs, prenatal

care, and providers of prenatal care and IM. One hundred and sixty infant deaths were

examined among mothers who used an SBA versus those who did not, mothers who had

prenatal care versus those without, …

Trends In Prevalence And Predictors Of Undernutrition Among Children In South Central, Monica Kabahimba Zikusooka

Walden Dissertations and Doctoral Studies

Undernutrition is a global public health challenge. In Somalia, undernutrition is chronic with the situation often graded for emergency response. The purpose of this study was to provide contextual evidence regarding trends of prevalence and predictors of undernutrition in South Central Somalia. Following the UNICEF conceptual framework of determinants of undernutrition, the study examined which individual, household, and society factors were associated with undernutrition. Using secondary data from cross-sectional nutritional surveys implemented by the Somalia Food Security and Nutrition Analysis Unit from 2007 to 2012, a sample of 75,756 and 60,856 children aged 6-59 months was used in analyzing trends …

Simulated Clinical Experience: An Investigation Of Emotion Understanding And Management, Neena White Jones

Walden Dissertations and Doctoral Studies

Many investigators have documented that lack of emotional intelligence (EI) in professional nursing correlates with patient dissatisfaction, negative patient outcomes, and litigation. However, much less information is available to nurse educators for an effective instructional strategy to increase EI skills, specifically emotion understanding and management (the most influential branches of EI) in nursing students. Grounded in the theory of EI and the theory of simulation, the purpose of this quantitative quasi experimental study was to introduce educational technology as a useful strategy for influencing EI in a convenience sample of 88 second semester students in a baccalaureate program. Research questions …

Adherence To Art Among Hiv Infected Female Sex Workers In Nigeria, Abass Babatunde Yusuf

Walden Dissertations and Doctoral Studies

A lack of adherence to antiretroviral therapy (ART) increases the risk of onward human immunodeficiency virus (HIV) transmission and mortality. The purpose of this cross-sectional study based on Andersen's conceptual framework was to test the associations between age, marital status, job/occupational status, education, membership in a peer support group, community, and facility ARV drug refill and alcohol and substance use, and adherence to ART among female sex workers (FSWs) who are 15 years and older in Rivers and Cross Rivers states Nigeria. Data were abstracted from existing program data collected between January 2015 and December 2017 by Heartland Alliance International, …

The Influence Of Food Insecurity, Low-Income, And Race On Diabetes Self-Management Practices Among Women With Diabetes, Jill La Capria

Walden Dissertations and Doctoral Studies

Diabetes is a chronic condition affecting more than 30 million adults living in the United States. Diabetes self-management (DSM) can prevent or delay the complications of diabetes and improve clinical outcomes; however, data show that low-income, food insecurity, female gender, and race contribute to challenges performing effective DSM. The health belief model was the theoretical framework for this cross-sectional study, which examined how food insecurity, low-income, and race affect DSM activities in women with diabetes. The sample population from the 2017 Behavioral Risk Factor Surveillance System survey consisted of 1,842 women with diabetes who were 18 years of age or …

Relationships Between Sle Disease Activity And Damage, Depression And Work Productivity Impairment In The Georgians Organized Against Lupus Study, Karen Mancera-Cuevas

Walden Dissertations and Doctoral Studies

Systemic lupus erythematous (SLE) is an autoimmune and inflammatory disease that can affect all organs of the body. The purpose of this quantitative cross-sectional study was to examine SLE-related issues associated with depression and work-productivity impairment, and to assess if depression mediated the relationship between SLE disease activity and damage and work-productivity impairment. Participants were 257 residents of the state of Georgia in the United States with SLE and were recruited from the Georgians Organized Against Lupus study. Bandura'€™s social cognitive theory was the guiding theoretical framework of the study. Findings showed that the majority of participants worked full time …

Role Of Primary Care Providers And Integrated Disease Surveillance In Chad, Dhoud Stave Gischel Samba

Walden Dissertations and Doctoral Studies

In the Republic of Chad, primary care physicians play a central role in the detection and control of outbreaks and are critical actors in the integrated disease surveillance system through mandatory reporting. Feedback on such surveillance must reveal the needs and perceptions of these physicians. These needs and perceptions were examined using a questionnaire survey distributed to a sampling of 20 physicians in Chad. The purpose of this qualitative study was to investigate the role of primary care providers in the integrated disease surveillance to identify factors that impact complete, quality, and timely reporting. The theory of planned behavior was …

Mothers' Parenting Discipline Style And Their Early Puberty Daughters' Engagement In High-Risk Behaviors, Yvette C. White

Walden Dissertations and Doctoral Studies

Some early puberty girls engage in high-risk externalizing behaviors such as early sexual activity, delinquent behavior, and disruptive behaviors. Harsh parenting experienced by girls who develop early has been associated with delinquent and disruptive behaviors. The purpose of this quantitative correlational study was to examine predictive relationships between the style of parental discipline by mothers of early puberty girls and the likelihood and frequency of the girls' engagement in high-risk behaviors. Parenting style theory, including the authoritarian, authoritative, and permissive style of parenting, served as the theoretical foundation for the study. Survey data were collected from 28 mothers who identified …

A Geographic Study Of Lung And Bronchus Cancer Rates In Kentucky, Gabriel Njoh Dikong

Walden Dissertations and Doctoral Studies

The average age-adjusted incidence and mortality rates of lung and bronchus cancer is 55% and 56% higher in Kentucky than the national averages in the United States, respectively. Populations with low income and educational attainment, and those who live close to the mining regions across Kentucky are more affected by the high prevalence and resulting mortality rates of lung and bronchus cancer. This study was conducted because of the high incidence of lung and bronchus cancer and resulting mortality rates in the state of Kentucky that may not be caused solely by social and demographic factors. The theoretical foundation for …

Patient Awareness And Knowledge Of Medically Induced Radiation Exposure, Travis L. Mann

Walden Dissertations and Doctoral Studies

The level of knowledge and awareness among patients about the concepts and implications of medical radiation is unknown. The purpose of this qualitative, case study was to explore patients' awareness and knowledge of information regarding this topic from their perspectives. The health belief model provided the framework for the study. A total of 20 individuals were recruited using purposive sampling. All participants were above the age of 18 in central North Carolina and had undergone or are currently undergoing medical radiation exams. Data were collected using semistructured interviews and analyzed using Yin's 5-phased cycle, which involved compiling, disassembling, reassembling, interpreting, …

Smoking And Surgical Site Infection In Orthopedic Patients' Lower Extremity Arthroplasty, Alicia Y. Mingo

Walden Dissertations and Doctoral Studies

Cigarette smoking has been a public health concern for many years, and the possible impact of smoking on surgical site infection (SSI) has been studied broadly. However, a gap in understanding has persisted concerning whether there is an association between smoking tobacco and the development of SSI among patients who undergo lower extremity surgery, specifically total knee arthroplasty (TKA). The purpose of this study was to examine the association between smoking and lower extremity SSI. Andersen's behavioral model (BM) was used to understand the risk factors relevant to the interaction between smoking and SSI. Application of the BM categories of …

The Effect Of Maternity Care Practices On The Duration Of Breastfeeding, Lisette Rodriguez

Walden Dissertations and Doctoral Studies

The natural practice of breastfeeding has been strongly noted as one of the most cost-effective, health promoting, disease-prevention strategies of the 21st century. Although primary health organizations recommend exclusive breastfeeding for the first 6 months of life with added complementary foods and continued breastfeeding up to 2 years of age or longer, many mothers do not breastfeed their infants for the recommendation length of time. Applied policies and health practices, such as those described under the 10 Steps to Successful Breastfeeding and The International Code of Marketing of Breast Milk Substitutes, have been noted as contributing factors that can considerably …

Unmet Support Needs Of Informal Caregivers Of Older Adults, Julie Ann Smith Hinders

Walden Dissertations and Doctoral Studies

Due to projected growth of the 65-and-older population and concerns of an impending care gap, reliance on informal caregivers is expected to increase. Improving support for informal caregivers is viewed as a national priority, yet research related to the unmet support needs of informal caregivers is limited. The purpose of this cross-sectional correlational study was to examine predictive relationships between contextual factors (caregiving relationship and type of illness) and environmental factors (rurality) and the unmet support needs (classes, service access, support groups, counseling, and respite) of informal caregivers of older adults. The theoretical framework was Bronfenbrenner's ecological systems theory. Archival …

Factors Contributing To High Readmissions For Congestive Heart Failure Among African Americans, Shavonda Caprice Devereaux

Walden Dissertations and Doctoral Studies

Abstract

African Americans are disproportionately affected by heart failure, with prevention and treatment of heart failure being a public health concern in the United States. The purpose of this retrospective quantitative study was to examine the primary variable race, specifically African Americans, and how this variable relates to 30-day readmission post discharge when controlled with geographic location (urban vs. rural), gender, and insurance status. The expanded chronic care model was used as a framework to shape health promotion, prevention efforts, and social determinants of health and to enhance community involvement related to chronic disease issues. The research questions were focused …

Connecticut Primary Care Physicians And Chronic Lyme Disease, Yvette P. Ghannam

Walden Dissertations and Doctoral Studies

The prevalence of chronic Lyme disease (CLD) remains relatively unknown in Connecticut because there is not an agreement on what CLD is and how it should be diagnosed in addition to which pathological agent causes CLD. The aim of this quantitative study was to assess whether there were significant differences between two groups of primary care physicians (PCP) working in Connecticut from two different points in time regarding their knowledge in the diagnosis, treatment, and management of CLD. A knowledge, attitude, and practice model was used as the underlying theoretical framework for this study. A random cross-sectional survey was mailed …

Cardiovascular Exercise Participation And Obstructive Sleep Apnea Among Adults Over Normal Weight In The United States, Marytherese Agwara

Walden Dissertations and Doctoral Studies

Obstructive sleep apnea (OSA) is a type of sleep apnea that is common, complicated, and a major contributor to cardiovascular diseases, neurocognitive impairment, and mortality. This disease has additional negative impacts on patients' lives by contributing to daytime sleepiness and low productivity at work as well as absenteeism and work-related injuries. Several studies have been conducted to assess the relationship between cardiovascular exercises and OSA; however, a definite conclusion is lacking. The purpose of this quantitative cross-sectional study was to assess the relationship between cardiovascular exercise participation and OSA by examining the relationship between total cardiovascular exercise participation per week …

Evaluation By Geospatial And Spatiotemporal Distribution Of Tularemia Cases In Arkansas, Toni Kathleen Beavers

Walden Dissertations and Doctoral Studies

Tularemia is a vector-borne disease of global concern with diverse regional foci. Arkansas is an endemic state with differences in case distribution and land suitability supporting host and vector sustainment. The aim of this study was to conduct a geospatial and spatiotemporal assessment of factors associated with case distribution and timeliness and completeness of public reporting. Guided with direction from spatial epidemiology and nidality, referring to the association of ecology, climate, and proximity of disease, analysis included secondary data collected from the Arkansas Department of Health between 1995 and 2018. Using Poisson-based software, 2 clusters were found: a high-risk cluster …

Strategies Hospital Administrators Utilize To Optimize Patient Services, Vicente Njoku

Walden Dissertations and Doctoral Studies

Hospital administrators face challenges that arise from environmental factors or psychosocial factors, and lack resources to deliver valuable medical services to stakeholders, including patients and employees. A multicase study served to explore experiences and gain a broader perspective of hospital administrators' use of strategies to optimize patient services. Ten hospital administrators from acute care hospitals in Nevada and California were purposefully selected from the population of hospital managers with a minimum of 2 years of documented experience in successfully implementing management strategies to improve patient services. The conceptual framework was Drucker's management theory. Data were collected from semistructured interviews with …

Locus Of Control And Health Promotion For Marginalized Populations, Cara Stephenson-Hunter, Kathryn L. Dardeck

Journal of Social, Behavioral, and Health Sciences

Socioeconomic health disparities in the United States have remained largely unchanged for decades. This remains the case even for preventable illness and disease. Current health behavior theories and interventions rely on the perception of control over one’s fate to achieve desired behavior. In low-income and other marginalized populations, however, hopelessness and the perception of having limited control may make interventions less effective. The purpose of this quantitative study was to examine the role of the locus of control (LOC) as defined by the degree to which one believes outcomes are determined by external forces such as chance or authority figures …

Demographic, Behavioral, And Cultural Factors On Chlamydia Trachomatis Infection, Philis Grace Palmer

Walden Dissertations and Doctoral Studies

Chlamydia trachomatis is a sexually transmitted disease, and its incidence has been increasing in recent years in the U.S. population. Certain demographic factors have been identified as posing an increased risk to acquire this disease. The purpose of this mixed-methods research was to examine how population demographics (quantitative section) and cultural and behavioral factors (qualitative section) affect risk for contracting chlamydia trachomatis in the Miami-Dade, Florida area. The theory of reasoned behavior was the theoretical framework of the study. The quantitative component used secondary data from Jackson Health System (2012- 2018) pertaining to 333 Miami-Dade young adult individuals with incidents …

The Effects Of Sexual Education On Sexual Behaviors Of Adolescents In Rural Jamaica, Deborah Simmonds

Walden Dissertations and Doctoral Studies

Adolescent pregnancy and the sexual behaviors of adolescents continue to be robust public health and social problems in Caribbean countries such as Jamaica. Numerous researchers have conducted studies on the impact of sex education on sexual behaviors and pregnancy patterns among adolescents with mixed results (i.e., a lack of knowledge) especially in rural communities. The purpose of this study was to ascertain the impact of school- or home-based sex education on sexual behavior and pregnancy patterns of adolescents aged 15 —19 years in the rural community of St. Thomas, Jamaica. The parental expansion of the theory of planned behavior and …

Hispanic Parents' Perceptions Of Human Papillomavirus Vaccination For Male Children, Christy Dubuisson

Walden Dissertations and Doctoral Studies

Hispanic Americans experience a disparate burden of human papillomavirus vaccination (HPV)-related cancers. Despite vaccine availability, HPV vaccine uptake amid Hispanic American adolescent males in the United States is under the national goal. Furthermore, childhood vaccination compliance is driven by the parents; yet, there is little research on parents' perceptions of HPV vaccination of male children. The purpose of this phenomenological study was to explore the attitudes, beliefs, concerns, and decision- making factors of Hispanic American parents of male children aged 11- to 13- years-old surrounding HPV vaccination. The health belief model provided the framework for the study. Face-to-face interviews were …

Strategies For Patient Engagement In A Self-Management Program For Adults With Diabetes, Carolinee Jokotola Ogungbayi

Walden Dissertations and Doctoral Studies

Patients' lack of adherence to diabetes self-management education and support (DSMES) recommendations is a challenge for healthcare. One approach to addressing patient noncompliance with DSMES is through education of staff on current guidelines. In an outpatient facility in South Texas, staff training on current DSMES guidelines was recommended as one of the solutions to the problem of Type 2 diabetes mellitus (T2DM) complications observed among clinic patients. An educational module was created to increase staff knowledge on T2DM and to assist staff members in teaching patients to self-manage T2DM. The module was built on the self-management and health promotion models, …

Factors Associated With Maternal Mortality In Greater Accra Ghana 2016: Case-Control Study, Edmund Sekyi Eghan

Walden Dissertations and Doctoral Studies

Maternal mortality is a critical area of concern globally, despite the availability of accessible preventive measures. The role of sociodemographic and service delivery factors in maternal mortality in the Accra Metropolitan Area of Ghana are important to examine. As part of the United Nations (UN) Millennium Campaign, the UN implemented 8 Millennium Development Goals (MDGs); maternal mortality reduction by 75% between 1990 and 2015 was among the fundamental MDGs to be achieved by 2015. The purpose of this case-control study was to use secondary data to assess the relationships between sociodemographic variables, service delivery factors, and maternal mortality among 8,171 …

Health System Access To Maternal And Child Health Services In Sierra Leone, Alhassan Fouard Kanu

Walden Dissertations and Doctoral Studies

The robustness and responsiveness of a country's health system predict access to a range of health services, including maternal and child health (MCH) services. The purpose of this cross-sectional study was to examine the influence of 5 health system characteristics on access to MCH services in Sierra Leone. This study was guided by Bryce, Victora, Boerma, Peters, and Black's framework for evaluating the scaleup to millennium development goals for maternal and child survival. The study was a secondary analysis of the Sierra Leone 2017 Service Availability and Readiness Assessment dataset, which comprised 100% (1, 284) of the country's health facilities. …

Predictors Of Rapid Repeat Pregnancy In Zimbabwe, Thenjiwe Sisimayi

Walden Dissertations and Doctoral Studies

Rapid repeat pregnancy (RRP) is associated with adverse maternal and infant outcomes and a range of undesirable social and economic challenges for the mother, her baby, and society. Although the consequences of RRP are well known, Zimbabwe—a country with some of the poorest maternal health indicators—has not investigated or made efforts to directly address this problem. This is confirmed by the lack of targeted programs to curb RRP, the unavailability of documented evidence regarding RRP significant risk factors, and the lack of understanding of the extent of RRP in the country. Using social cognitive theory as the theoretical framework, an …

Maintaining Confidentiality Among Hiv Infected Couples: Physicians' Patterns Of Decision In Nigeria, Francess Uju Ayaebene

Walden Dissertations and Doctoral Studies

Policies mandating HIV status disclosure to decrease incidence create ethical challenges for physicians on whether to breach or maintain infected patients' confidentiality. In Sub-Saharan Africa where HIV incidence is high, there is a need for clear guidelines/policies on making confidentiality decisions. The purpose of this quantitative quasi experiment was to determine whether the gender, gender orientation, and sexual relationship of an infected patient and physicians' demographics predicted physicians' decisions to breach confidentiality. In Plateau State, Nigeria, 222 physicians were given vignette questionnaires containing 6 different descriptions of gender, gender orientation, and sexual relationships of a hypothetical patient. Each physician decided …

Effect Of Access To Health Services On Neonatal Mortality In Uganda, Imelda Atai Madgalene Musana

Walden Dissertations and Doctoral Studies

Since 2006, Uganda has experienced a nonchanging neonatal mortality rate of 27 out of 1,000 live births, which is higher than the global average of 19 deaths for every 1,000 live births. The purpose of this retrospective cross-sectional study was to determine factors affecting access to health services and their impact on newborn deaths in Uganda. Mosley and Chen's model for child survival in developing nations provided the framework for the study. Secondary data from the 2016 demographic and health survey (UDHS) collected by the Uganda Bureau of Statistics (UBOs) was used. A total of 7,538 cases were used and …

Effects Of Nonadherence To Hiv/Aids Drugs On Hiv-Related Comorbidities In Eastern Nigeria, Chizomam Laura Ojukwu

Walden Dissertations and Doctoral Studies

Developing countries like Nigeria continue to have HIV epidemic challenge due to the scarcity of evidence-based information and lack of resources to boost HIV education. The study population, Owerri, is one of the states in Nigeria with a high incidence rate of HIV. The purpose of this phenomenological study was to explore the experiences of people living with HIV/AIDS regarding the effects of nonadherence to HIV/AIDS drugs. The integrated theory of health behavior model provided the framework for the study. I collected, transcribed, and analyzed interview data to identify clusters and themes. Results showed that various factors influenced and (e.g., …