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Walden Dissertations and Doctoral Studies

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Best Practices For Controlling Tuberculosis - Training In Correctional Facilities: A Mixed Methods Evaluation, Ellen Reynolds Murray Jan 2016

Best Practices For Controlling Tuberculosis - Training In Correctional Facilities: A Mixed Methods Evaluation, Ellen Reynolds Murray

Walden Dissertations and Doctoral Studies

According to the literature, identifying and treating tuberculosis (TB) in correctional facilities have been problematic for the inmates and also for the communities into which inmates are released. The importance of training those who can identify this disease early into incarceration is vital to halt the transmission. Although some training has been done by public health authorities for corrections, there is little to no evaluation of such training. The aim of this mixed methods retrospective study was to evaluate the effectiveness of a training to control TB in correctional facilities. The Southeastern National Tuberculosis Center (SNTC) conducted 12 trainings between …


Experiences Of Heterosexual Couples Who Undergo Hiv Counseling And Testing In Nakuru-Kenya, Stephen Kinyua Mucheke Jan 2016

Experiences Of Heterosexual Couples Who Undergo Hiv Counseling And Testing In Nakuru-Kenya, Stephen Kinyua Mucheke

Walden Dissertations and Doctoral Studies

The increase in new human immunodeficiency virus (HIV) infections among heterosexual couples in Africa may reverse the gains made by HIV prevention programs. HIV screening among such couples remains low and understudied.This qualitative study focused on the motivations for HIV screening among heterosexual couples. The primary research goal was to examine the lived experiences of heterosexual couples who were screened for HIV and received their results in Nakuru-Kenya. The health belief model (HBM) served as the theoretical framework and as a basis for the secondary questions which sought to explore the participants' perceptions on HIV based on the constructs of …


Chronic Disease Management Of The Uninsured Patient At Ohio Free Clinics, James Benedict Jan 2016

Chronic Disease Management Of The Uninsured Patient At Ohio Free Clinics, James Benedict

Walden Dissertations and Doctoral Studies

Management of chronic disease requires a different service delivery model from that of acute illness. The uninsured population experience poorer health status and increased incidence of chronic disease than do the insured population. The purpose of this study was to identify the supports and barriers present in providing chronic disease management to patients at Ohio free clinics. Wagner's theory of chronic disease management served as the theoretical lens. The sequential, exploratory mixed methods study collected data from 13 free clinics belonging to the Ohio Association of Free Clinics (OAFC). Quantitative questions focused on processes in clinics with high and low …


Perceptions Of Infertility Among Arab Women In The U.S, Zena Hamdan Jan 2016

Perceptions Of Infertility Among Arab Women In The U.S, Zena Hamdan

Walden Dissertations and Doctoral Studies

Infertility is a serious public health issue. Infertile couples may perceive infertility differently based on their own cultural background. There is a paucity of literature about how infertility is perceived among Arab women living in the United States. The purpose of this study was to be able to understand how Arab women who live in Dearborn, Michigan feel about infertility and to understand their concerns and worries about their health status. The primary research questions asked Arab women how they perceive infertility and how infertility may impact their future. This qualitative case study was guided by the social support theory …


Videotaped Role-Play Simulation In Teaching Transcultural Self-Efficacy To Interprofessional Healthcare Students, Holldrid Aner Odreman Jan 2016

Videotaped Role-Play Simulation In Teaching Transcultural Self-Efficacy To Interprofessional Healthcare Students, Holldrid Aner Odreman

Walden Dissertations and Doctoral Studies

Increased demand for culturally sensitive healthcare services suggests that interprofessional beginning healthcare students need to gain the necessary cultural competency skills to be successful in delivering positive health outcomes for diverse patients. Bandura's theory of observational learning, Mezirow's theory of transformative learning, and Purnell's and Paulanka's model of cultural competence informed the framework for this research. The purpose of this quasi-experimental quantitative study was to determine the relationship between mode of instruction (observing role models in videotaped role-play simulation) and increased transcultural self-efficacy in cultural competence instruction. A convenience sample of 196 students enrolled in an interprofessional education (IPE) course …


Perceptions Of Stroke Risks Among West African Male Immigrants In San Diego, Lawrence Agi Jan 2016

Perceptions Of Stroke Risks Among West African Male Immigrants In San Diego, Lawrence Agi

Walden Dissertations and Doctoral Studies

The incidence and knowledge of the risk factors of stroke across ethnic groups in the United States have been examined in multiple studies. However, it is not well known if the foreign-born African immigrants who constitute about 4% of the U.S. immigrant population are at a higher risk of the incidence of stroke than are other nonimmigrant population in the U. S. This ethnographic study explored the perceptions of Anglophone African male immigrants residing in San Diego on the risk factors of stroke. The theoretical framework for this study included the health belief model and the health promotion model. Data …


The Association Of Smoking With Low Back Pain In Adult Americans: Analysis Of The 2012 National Health Interview Survey, Bart Green Jan 2016

The Association Of Smoking With Low Back Pain In Adult Americans: Analysis Of The 2012 National Health Interview Survey, Bart Green

Walden Dissertations and Doctoral Studies

Back pain is a chronic disease epidemic and the most common chronic painful condition in Americans. It is associated with human suffering and enormous financial and social burdens. Smoking is a prevalent and harmful health behavior and is the greatest modifiable risk factor for many chronic diseases. Cigarette smoking is associated with back pain, but there is little research on this relationship among adults in the United States. Using biopsychosocial theory, this study examined (a) the prevalence of back pain (dependent variable) among smokers, former smokers, and never smokers (independent variable), and (b) the influence of age, sex, race, body …


Barriers To Breast Cancer Prevention And Screening Among African American Women, Abosede Francisca Obikunle Jan 2016

Barriers To Breast Cancer Prevention And Screening Among African American Women, Abosede Francisca Obikunle

Walden Dissertations and Doctoral Studies

Breast cancer is a serious illness that often has fatal consequences. Adherence to the recommendations for breast cancer surveillance is poorly practiced among African American women. The purpose of this phenomenological study was to seek individual professed barriers to breast cancer screening among African American women to better understand why breast cancer continues to be one of the principal basis of mortality among African American women. The theoretical framework for this study was the behavioral model of health services use. Purposeful selection was used to invite 14 African American women to participate in the in-depth interview process. Interview data were …


Human Trafficking: The Health Of Men Forced Into Labor Trafficking In The United States, Christina Omole Jan 2016

Human Trafficking: The Health Of Men Forced Into Labor Trafficking In The United States, Christina Omole

Walden Dissertations and Doctoral Studies

Human trafficking is a criminal act that occurs globally. It affects both women and men, but most studies have focused on female victims; few have explored trafficked men or their related health issues. Though there are many forms of trafficking, it is believed that most male victims are trafficked as forced labor. Using gender schema theory as a framework, this quantitative study examined archival data to identify the types of trafficking men are subjected to, their health ailments, and how these differ from the health ailments of trafficked women. Archival data from 124 individuals subjected to human trafficking in Florida …


Issues Affecting Sexual Decisions Among Black Women In The Era Of Hiv/Aids, Saecilia Jackson Jan 2016

Issues Affecting Sexual Decisions Among Black Women In The Era Of Hiv/Aids, Saecilia Jackson

Walden Dissertations and Doctoral Studies

HIV/AIDS became a significant concern in the United States (U.S.) during the 1980s and in recent years has increased the most among people living in underserved urban areas, particularly impacting Black women ages 24-35. Guided by the social learning theory, this phenomenological study explored the lived experiences and behaviors of Black women in the south in order to understand their sexual health decisions and how those decisions impact the spread of HIV/AIDS among this group. The central research question focused on understanding the sexual decision making of Black women in Georgia, from the perspective of the client and provider. Convenience …


Healthy Weight Maintenance: Narrative Analysis Of Weight Cycling In The Formerly Obese, Cheri Renee Lewis Jan 2016

Healthy Weight Maintenance: Narrative Analysis Of Weight Cycling In The Formerly Obese, Cheri Renee Lewis

Walden Dissertations and Doctoral Studies

Medical and economic costs for obesity are estimated at $147 billion per year, yet less than 1/3 of overweight individuals successfully maintain weight loss. The literature is replete with descriptions of the problem and research on treatments, yet demonstrations of effective loss and maintenance are lacking. Missing is an understanding of the experiences of individuals who successfully maintained healthy weight loss, which could provide insights regarding effective psycho-social interventions. The purpose of this qualitative narrative study was to explore key events and experiences in the lives of former weight cyclers. The primary phenomena of interest included weight cycling and sustained …


An Ecological Approach To African American Adolescent Food Choices In Low Income Neighborhoods, Clarence E. Mcmillan Jan 2016

An Ecological Approach To African American Adolescent Food Choices In Low Income Neighborhoods, Clarence E. Mcmillan

Walden Dissertations and Doctoral Studies

Childhood obesity remains prevalent among African American (AA) adolescents in low income neighborhoods with limited access to a variety of foods from stores. Guided by the ecological framework, the purpose of this study was to examine the impact of neighborhood stores on food choices, and physical activity among AA adolescents in a low income neighborhood. A quantitative research design with cross sectional primary and secondary surveys was used. Participants included 176 high school students and 42 store merchants. Data sources were the 2011 New Jersey Student Health Survey with core questions from the Youth Risk Behavior Survey and the Hmong …


Insecticide Treated Nets As An Effective Malaria Control Strategy In Liberia, Taiyee Nelson Quenneh Jan 2016

Insecticide Treated Nets As An Effective Malaria Control Strategy In Liberia, Taiyee Nelson Quenneh

Walden Dissertations and Doctoral Studies

Malaria is a vector-borne disease that presents the most persistent and serious public health burden in Liberia. Numerous studies have examined the relationship between ITN use and malaria prevalence. However, little research has explored the effectiveness of ITNs in controlling malaria among children in postwar Liberia. The aim of this study was to examine the association between ITN ownership, parental economic status, ITN installation support, and malaria prevalence among children. This was a quantitative cross-sectional study guided by the health belief model. The study used secondary data from the 2011 Liberia Malaria Indicator Survey. Chi-square for association and Logistic regression …


Acculturation, Inflammation, And Depression Among Hispanic Adults In The United States, Kristin Marie Marano Jan 2016

Acculturation, Inflammation, And Depression Among Hispanic Adults In The United States, Kristin Marie Marano

Walden Dissertations and Doctoral Studies

Disparities exist in the recognition and treatment of depression among Hispanics in the United States, creating a social, ethical, economic, and public health burden. This study was designed to generate an improved understanding of the causes of and/or contributors to depression within this population. It was specifically designed to 1) assess the prevalence and severity of depression among Hispanic adults in the United States relative to adults of other race/ethnicities in the United States; 2) clarify the inconsistent results in the literature concerning the relationship between acculturation and depression among Hispanic adults in the United States; and 3) fill a …


Health System Predictors Of Antenatal Care Compliance Among Rural Congolese Women, Ngashi Ngongo Jan 2016

Health System Predictors Of Antenatal Care Compliance Among Rural Congolese Women, Ngashi Ngongo

Walden Dissertations and Doctoral Studies

Fewer rural Congolese women complete 4 antenatal care (ANC) visits than do urban women, despite high maternal and child mortality rates. This quantitative cross-sectional survey applied Andersen's behavioral model of service utilization to examine whether the ANC facility type, provider type, provider gender, time to ANC facility, cost, and number of services can predict ANC compliance among rural women. The study was a secondary analysis of the 2015 Maternal and Child Health (MCH) survey, which comprised 1,280 eligible women selected through stratified random sampling. The analysis included bivariate and multivariate logistic regressions. The findings showed that women seen in private …


Life Events, Initial Sexual Behaviors, And Teenage Pregnancy Among African American Females, Yonzetta Brook Tillman Jan 2016

Life Events, Initial Sexual Behaviors, And Teenage Pregnancy Among African American Females, Yonzetta Brook Tillman

Walden Dissertations and Doctoral Studies

Teenage pregnancy is disproportionate between African American and Caucasian females. This disproportion is notable because African American teenagers are 3 times more likely to become pregnant than their Caucasian counterparts are. The purpose of this study was to determine whether a relationship exists among major life events, sexual behaviors, and resultant teenage pregnancy among African American females in the United States. The theoretical framework for this study was social learning theory. Three key research questions focused on relationships among (a) major life events and initial sexual behavior, (b) ethnicity, and (c) teenage pregnancy. Independent variables were life event and ethnicity, …


Relational Intelligence: A Framework To Enhance Interprofessional Collaborative Care, Elizabeth Ekole Jan 2016

Relational Intelligence: A Framework To Enhance Interprofessional Collaborative Care, Elizabeth Ekole

Walden Dissertations and Doctoral Studies

Many studies have reported that the training for practitioners does not stimulate reflexes that contribute to the tenets of teamwork and collaboration. No studies were found to investigate relational intelligence (RQ) in pharmacist-physician relationships as a catalyst for collaborative and hence cost effective quality care. This study addressed the role and potential opportunity to promote RQ as a critical leadership skill in the collaboration between pharmacists and physicians. Using RQ as the conceptual framework, this phenomenological study explored how pharmacists and physicians in a hospital setting perceive RQ as a leadership skill when working collaboratively. A total of 10 participants …


Analyzing Interrelationships Between Food Safety Practices And Inspections Among Food Staff In Manitoba, Kirandeep Kaur Brar Jan 2016

Analyzing Interrelationships Between Food Safety Practices And Inspections Among Food Staff In Manitoba, Kirandeep Kaur Brar

Walden Dissertations and Doctoral Studies

The incidence and prevalence of food safety practices among food staff working in food establishments in Manitoba is underrepresented and has not been adequately reviewed and researched. Uncertified food staff are at higher risk of not following food safety practices that can cause contamination of food and result in foodborne illness. The purpose of this quantitative study was to determine the prevalence of food safety practices among food staff in Manitoba and to determine the relationship between food safety certification and routine health inspections. Pender's health promotion model and Bandura's social cognitive theory were used to explain the relationships and …


Experiences Managing Type 1 Diabetes Mellitus Among Parents Of African-American Youth, Sonya T. Strider Jan 2016

Experiences Managing Type 1 Diabetes Mellitus Among Parents Of African-American Youth, Sonya T. Strider

Walden Dissertations and Doctoral Studies

Type 1 diabetes mellitus (T1DM) is one of the most frequently diagnosed endocrine and metabolic conditions that occur during childhood. This research study utilized a phenomenological study design to examine how the lived experiences of 20 African American (AA) parents of children with T1DM recruited using social media affects their management and control of the disease among AA youth age 5-17 years old. The interview questions were outlined in categories that tested key constructs of the health belief model (HBM) to determine the perceived barriers, seriousness, and susceptibility to maintaining good glycemic control for their children. Data from each interview …


Donor Coordination And Health Aid Effectiveness In The Nigerian Health Sector, Ifeoma Edna Uduji Jan 2016

Donor Coordination And Health Aid Effectiveness In The Nigerian Health Sector, Ifeoma Edna Uduji

Walden Dissertations and Doctoral Studies

Development partners and donors increasingly acknowledge the importance of coordinating their activities to achieve the outcome of the official development assistance to developing countries. Although stakeholders have recognized the importance of harmonizing donors and development partners' efforts in the Nigerian health sector, little research has addressed the influence of coordination on the health aid effectiveness. This qualitative case study determined the influence of coordination among the donors and development partners involved in the HIV/AIDS, malaria, and nutrition program on the outcome of these programs in Nigeria. Data were collected through interviews with 22 program officers participating in the health programs …


An Ecological Perspective On Pertussis, Jody Ruth Goard Jan 2016

An Ecological Perspective On Pertussis, Jody Ruth Goard

Walden Dissertations and Doctoral Studies

In 2012, 48,277 cases of pertussis were diagnosed in the United States. Pertussis, otherwise known as whooping cough, is a highly contagious, often debilitating, sometimes deadly, vaccine-preventable disease with an increasing incidence and death rate in the U.S, which may be due to vaccine exemptions. The purpose of this project was to determine if a relationship exists between immunization policies and immunization exemption rates, immunization exemption rates and pertussis rates, and immunization policies and pertussis rates in each state. Bronfenbrenner's bio-ecological framework was used to guide the project. Publically available data from the Centers for Disease Control and Prevention (CDC), …


A Qualitative Examination Of Surviving Homeless In Alaska, Reynaldo Espera Jan 2016

A Qualitative Examination Of Surviving Homeless In Alaska, Reynaldo Espera

Walden Dissertations and Doctoral Studies

The homeless population in Anchorage, Alaska faces many unique challenges. Over the past several winters, a number of homeless individuals have succumbed to the effects of exposure despite available cold weather services. This study investigated individual experiences within the homeless population of Anchorage, Alaska during times of inclement winter weather. Self-determination theory was used to explore motivations of behaviors of the population and to uncover the reasons why this population does not use cold weather services offered by the Municipality of Anchorage. The research questions addressed participant awareness of available cold weather services, survival strategies during inclement winter weather, and …


Bone Health Education For Osteoporosis Risk Reduction In Premenopausal Women: A Quality Improvement Project, Gloria Nichols Nichols Jan 2016

Bone Health Education For Osteoporosis Risk Reduction In Premenopausal Women: A Quality Improvement Project, Gloria Nichols Nichols

Walden Dissertations and Doctoral Studies

In the United States, about 8.5 million women live with osteoporosis. Osteoporosis is a debilitating systemic skeletal disorder characterized by low bone mass and reduced bone mineral density that occurs with the loss of estrogen. The mortality rate for this group is about 3 to 4 times higher than other women and as many as 1 in 3 experience a fracture. Guided by the Health Belief Model, this project evaluated how a bone health fact sheet impacts knowledge about osteoporosis and self-efficacy for preventative behavioral change in premenopausal women (age 40-58 years). The project also evaluated if an electronic medical …


Effectiveness Of Cognitive Screening For Heart Failure Patients, Comfort Nkengla Jan 2016

Effectiveness Of Cognitive Screening For Heart Failure Patients, Comfort Nkengla

Walden Dissertations and Doctoral Studies

Cognitive impairment is commonly seen in the elderly population. It is unclear if cognitive deficit in heart failure (HF) patients is a primary factor for higher hospital readmission rates in this population. The Centers for Medicare and Medicaid Services have established strict guidelines for reimbursement on readmissions that occur within 30 days. It is imperative that organizations identify and rectify issues that impact readmissions. The aim of this project was to determine if there is a reduction in HF readmission after patients are screened for cognitive impairment. Orem's self-care model guided the project by providing a framework of inquiry regarding …


Relationship Between Nurse Training And Physical Restraints In Nursing Homes, Terah Tessier Jan 2016

Relationship Between Nurse Training And Physical Restraints In Nursing Homes, Terah Tessier

Walden Dissertations and Doctoral Studies

According to the Centers for Medicare and Medicaid Services (CMS), approximately 1.3 million U.S. residents are residing in nursing homes. CMS enforced regulations in the Nursing Home Reform Act. Training in the use of restraints in nursing homes is monitored through the CMS standards. The purpose of this study was to determine whether there was a correlation between training standards of health care practitioners and their use of restraints in nursing homes based on the patterns of citations by RNs and CNAs. Data were collected from Kansas, Louisiana, and Ohio within the CMS Nursing Home Data Compendium. The key research …


Prolonged Exposure To Non-School Related Media Use And Violence Among Urban Youth, Cindy Davis Jan 2016

Prolonged Exposure To Non-School Related Media Use And Violence Among Urban Youth, Cindy Davis

Walden Dissertations and Doctoral Studies

Youth violence is a pervasive and ongoing public health concern. Based on the paradigm of resilience, the purpose of this quantitative study was to test the relationship between prolonged (3 or more hours) of non-school related media use and youth violence. Secondary data from the Centers for Disease Control and Prevention (CDC) were utilized for this study. Logistic and multiple regression models were used to test whether exposure to prolonged non-school related media (video games and TV) use was associated with violent behavior, and whether there was a relationship between prolonged exposure to non-school related media use and electronic bullying …


Improving Self-Management In Patients With Chronic Conditions, Jeryl Yvette Horton Jan 2016

Improving Self-Management In Patients With Chronic Conditions, Jeryl Yvette Horton

Walden Dissertations and Doctoral Studies

Care Coordination Home Telehealth (CCHT) maintains a positive impact on the delivery of patient care in the primary care clinic at the Department of Veterans Administration Medical Center (VAMC). This quality improvement initiative targets patients with chronic conditions such as diabetes, hypertension, heart failure, and chronic obstructive pulmonary disease. These patient are frequently seen in the emergency room, and are often admitted to the hospital, where they saturate the outpatient clinics' waiting room with multiple walk-ins. CCHT has, to some extent, reduced walk-ins, emergency room visits, and hospitalization while minimizing the strain on access to care at the VAMC. Sustaining …


Diagnosing Fibromyalgia: Using A Diagnostic Screening Tool In Primary Care, Lilo Fink Jan 2016

Diagnosing Fibromyalgia: Using A Diagnostic Screening Tool In Primary Care, Lilo Fink

Walden Dissertations and Doctoral Studies

Fibromyalgia (FMS) goes undiagnosed in as many as 3 out of 4 people who have the disease. Primary care providers (PCPs) are the first to evaluate patients; therefore, PCPs need to be able to recognize FMS, implement initial treatment, and refer for further consultation. The Fibromyalgia Diagnostic Screening Tool (FDST), a validated instrument to identify FMS, can improve the speed and accuracy of FMS diagnosis. The purpose of this project was to familiarize PCPS with the FDST, evaluate their receptiveness to the tool, and train them in its use. The Leventhal, Diefenbach, and Levanthal, common sense model of illness provided …


Socioeconomic Responsibility And Its Effect On Hypertension Among West African Immigrants In The United States, Chryss Arekhandia Okonofua Jan 2016

Socioeconomic Responsibility And Its Effect On Hypertension Among West African Immigrants In The United States, Chryss Arekhandia Okonofua

Walden Dissertations and Doctoral Studies

Native-born African Americans (NBAA) bear a disproportionate burden of the effect of hypertension (HTN) in comparison to other racial groups in the United States. West African immigrants (Foreign-born African Americans) appear to carry a heavier burden than the NBAA in the United States. Using the social support theory as a guide, this study examined the association between the need to meet socioeconomic responsibility of financial and familial obligations (SERFFO) and perceived stress and the increased likelihood of HTN among West African immigrants, aged 25-54 years, in the United States. In this quantitative, cross-sectional design, self-reported data were collected from a …


Childhood Attention Deficit Hyperactivity Disorder: A Stress Factor For African Immigrant Mothers, Helen Agatha Awatefe Jan 2016

Childhood Attention Deficit Hyperactivity Disorder: A Stress Factor For African Immigrant Mothers, Helen Agatha Awatefe

Walden Dissertations and Doctoral Studies

Children between the ages of 6-17 years suffering from childhood attention deficit hyperactivity disorder (ADHD) need constant attention as they are more likely to be accident proned, hospitalized, disruptive, and educationally challenged. The constant attention required for children with ADHD may impose stress on mothers and primary caregivers, yet this stress has not been sufficiently studied. The objective of this study was to fill a gap in literature by studying the stress experienced by African immigrant mothers living in the United States who are living with and caring for a child with ADHD, and then comparing the level of stress …