Public Health Education and Promotion Commons^™

Fall Safety Bundle, Baili Denise Campbell

Walden Dissertations and Doctoral Studies

The Centers for Medicare and Medicaid Services (CMS) report thousands of falls in hospitals each year. The CMS does not reimburse hospitals for fall related injuries, costing the hospital system organization for which this DNP project was designed millions of dollars each year. Framed within the Iowa model of evidence-based practice and using a team approach, the purpose of this project was to develop an evidence-based (EB) fall safety bundle for use by nursing staff and a curriculum to educate staff on prevention strategies. The components of the EB fall bundle kit were approved by the stakeholder committee. Evaluation of …

Perceptions Of Emergency Preparedness Among Immigrant Hispanics Living In Oklahoma City, Oklahoma, Rebekah Doyle

Walden Dissertations and Doctoral Studies

Tornadoes are occurring with increased frequency in Oklahoma. Emergency preparedness planning is essential to decreasing individuals' risks of injury or death from a tornado. Research on immigrant Hispanics' knowledge and perceptions of emergency preparedness is limited. The purpose of this study was to explore the perceptions and lived experiences of immigrant Hispanics who had experienced a tornado or other crisis weather conditions in Oklahoma during spring of 2013. The research questions explored their perceived risk for injury and knowledge of tornado preparedness planning. The health belief model provided the theoretical underpinnings for this qualitative phenomenological study. Semi structured interviews were …

Beliefs Among Mothers Of Adolescent Females On Cervical Cancer Vaccination, Aja Rochelle Gardner

Walden Dissertations and Doctoral Studies

Hispanic and African American women are infected with sexually transmitted diseases more often than are Caucasian women. This racial disparity is also seen in the incidence of human papillomavirus (HPV) and cervical cancer. The medical connection between HPV and cervical cancer is often unknown or misunderstood among women. This study addressed the beliefs and subsequent health decisions of minority parents regarding whether to get their daughters vaccinated against HPV. The theoretical framework for this study was Rosenstock's health belief model (HBM). The specific study design used was Husserl and Heidegher's theory on Phenomenology. This qualitative study utilized focus groups containing …

Influence Of Teacher Participation On Student Fitness And Student Participation In Physical Education, Whitney Morris

Walden Dissertations and Doctoral Studies

Physical activity plays a key role in the health of children. Childhood obesity is increasing in the United States, and children are spending less time being physically active. Active participation by a physical education (PE) teacher in physical activities has been suggested as a means of promoting student fitness. The purpose of this quasi-experimental quantitative study was to determine whether modeling of physical activity by a PE teacher would increase student participation and physical fitness. Bandura's social learning theory provided the theoretical framework for the study. Participants included 311 4th and 5th grade elementary students enrolled in physical education classes. …

Risk Of Maternal Smoking On Breastfed Infants And The Development Of Otitis Media, Judith C. Ogbonna

Walden Dissertations and Doctoral Studies

Despite advances in health promotion through efforts to reduce tobacco smoking, tobacco-related health conditions have continued to be significant. Exposure to secondhand smoke has been identified as a health risk also in addition to infant health risks related to maternal smoking. In contrast, breastfeeding has been found to promote infant health and is strongly encouraged. Despite literature supporting both of these statements, the combined effects of both breastfeeding and maternal smoking on infant wellbeing have not been delineated. Otitis media represents a common health problem among infants and young children. Tobacco exposure has been shown to increase its incidence while …

Hiv Knowledge, Intoxication, Risky Behaviors, And Sexual Communication Among Nigeria University Students, Johnpaul Chukwuemeka Ezeonyido

Walden Dissertations and Doctoral Studies

Poor sexual communication among Nigerian youth can create problems for health workers, medical practitioners, and the government in determining what is and is not working in their attempts to reduce sexually-related diseases. This quantitative study used self-administered questionnaires among 107 Nigerian university students, aged 18 to 35, to determine if a statistically significant predictive relationship existed between: (a) beliefs about alcohol, (b) HIV knowledge, (c) risk behaviors, (d) age, (e) religion, (f) gender, (g) sexual activity status, (h) dating status, (i) language, (j) sexual orientation, and (k) tribes of Nigerian university students and their sexual communication with partners. Previous studies …

Association Between Biopsychosocial Factors And Physical Activity Among U.S. Stroke Survivors, Claire Johnson

Walden Dissertations and Doctoral Studies

Stroke causes substantial morbidity and mortality, and physical activity can reduce the risk of stroke occurrence. The purpose of this study was to test the association between biopsychosocial factors and levels of physical activity and to develop a model to predict inactivity for US stroke survivors. A quantitative, cross-sectional analysis was performed of the 2013 National Health Interview Survey (NHIS), which is a representative sample of US households. Association for 1,077 stroke survivors was tested with chi-square between physical activity and independent variables: biological factors (age, sex, race, body mass index, musculoskeletal conditions, and cardiovascular diseases), psychological factors (mental distress, …

Facilitators And Barriers To Physical Activity Among People With Spinal Cord Injury, Laura Nicole Richardson-Smith

Walden Dissertations and Doctoral Studies

Research has shown that people with physical disabilities are at risk for developing secondary health conditions. Many of these secondary health conditions may be reduced by engaging in physical activity, yet people with physical disabilities are less likely to participate in physical activity. Information gaps remain regarding facilitators and barriers to physical activity. The purpose of this phenomenological study was to understand the experiences with physical activity among adults with a spinal cord injury (SCI). Research questions asked were about exercise experiences, barriers and facilitators, and the role of the natural and social environment. The theoretical framework used was the …

The Impact Of Free Healthcare On Hospital Deliveries In Sierra Leone, Salifu Salito Samura

Walden Dissertations and Doctoral Studies

Improving maternal health has been a challenge for developing nations with very high rates of maternal mortality. Sub-Saharan Africa, particularly Sierra Leone, has some of the highest maternal mortality rates in the world. In an attempt to improve on this, the Sierra Leonean government enacted free maternal healthcare services in 2010. The Sierra Leone Free Healthcare Initiative (SLFHCI) provides free healthcare for pregnant women, lactating mothers, and children under 5 years old. This research explored the impact of the free healthcare on hospital deliveries. The determinant of health model was used to evaluate the effectiveness of the SLFHCI program, and …

A Community's Perception Of Pregnancy And Sexually Transmitted Infections And Prevention Programs, Felecity Nicole Burns

Walden Dissertations and Doctoral Studies

The United States has the highest rates of teenage pregnancies, births, abortions, and sexually transmitted infections in the industrialized world. African American teen pregnancies and sexually transmitted infections are on the rise in many rural southwest school districts in the State of Georgia where the sex education curriculum is nonexistent or solely focuses on abstinence. Georgia ranked 4th in cases of primary and secondary syphilis, 6th in AIDS, 12th in gonorrhea, 14th in teen pregnancies, and 17th in chlamydia in the United States in 2012. The purpose of this qualitative study was to evaluate the perceptions of residents of a …

Social Demography Of Health Seeking Experiences Among Transgender African Americans, Alicia Cutrice Fritz

Walden Dissertations and Doctoral Studies

Access to and receipt of health care is an essential human right; however, transgender people often have negative health seeking experiences that give way to the many health disparities seen in the transgender community. Using the social ecological model, this study determined, through multiple logistic regressions, that correlations existed between socioeconomic, health behaviors, and sociocultural variables and 6 measures of health seeking experiences among transgender African Americans. Secondary data from the 2010 National Transgender Discrimination Survey were used, yielding a sample size of 253 transgender African Americans. Those in the African American transgender community at most risk for negative health …

Delaying First Pregnancies: Canadian Women's Knowledge And Perception Of The Consequences, Deborah Haynes

Walden Dissertations and Doctoral Studies

Many women aged 20-30 are postponing their first pregnancies until their mid 30s and beyond, which has resulted in compressed childbearing years and/or infertility. Little is known about the knowledge and understanding that Canadian women of advanced age (age 35-45) possess of their reproductive capacity. This phenomenological study sought to explore these women's knowledge and perception of their reproductive capacity in relation to the timing of first pregnancy. Research questions using the constructs of Ajzen's theory of planned behavior were developed to explore how the behavioral, normative, and control beliefs of women's childbearing behaviors were based on their perceptions of …

Evaluation Of Low Immunization Coverage Among The Amish Population In Rural Ohio, Christine Marie Kettunen

Walden Dissertations and Doctoral Studies

Amish communities have persistently low childhood immunization rates. Prior to this study, reasons for low rates had not been clearly identified. Researchers have speculated that access to health care, religious factors, and fear might be reasons that Amish parents refuse childhood immunizations, but more empirical evidence was warranted.The purpose of this study was to gather that empirical evidence regarding the knowledge, attitudes, opinions, and beliefs of Amish parents residing in Ashtabula County Ohio, an additional purpose was to examine how these factors influence timely immunizations of Amish children. The theoretical framework was the PEN-3-Cultural Model, focusing on cultural influences, beliefs, …

Experiences Of Colorado Parents As They Recognized Their Child's Mental Illness, Lori Salgado

Walden Dissertations and Doctoral Studies

Mental illness is not only the leading cause of disability among adults, but there is also an emerging public health crisis in childhood mental illness. A majority of parents do not recognize symptoms of psychological disorder in their children, and current policies and programs for mental health service delivery are not sufficiently responsive to the early help-seeking dynamics of families. Using a concurrent mixed methods design, this study explored how parents in the Pikes Peak region of Colorado learned to recognize their child's mental illness. Phenomenological interviews, augmented by poetic inquiry and quantitative measurements, were used to discover factors that …

Perceived Barriers To Oral Health Care Access For Massachusetts' Underserved Parents, Doudelyne Cenafils-Brutus

Walden Dissertations and Doctoral Studies

Poor oral care is detrimental to the overall health of the population. In the United States, oral health diseases affect millions of individuals, especially children and adolescents. Guided by the health belief model, the purpose of this study was to identify parents' perceived barriers to oral health care access among their 5- to 10-year-old children. A phenomenological approach was used to gather data and thematically analyze interview data from 20 parents who were recruited from a health center in the northeastern United States. All participants had at least one child between 5-10 years old and all identified as under-served. Data …

History Of Pregnancy-Loss And Maternal Socioeconomic Factors As Predictors Of Under-Five Child Mortality, Henry Chukwunonso Debem

Walden Dissertations and Doctoral Studies

Nigeria is one of the countries with the highest Under-5 Mortality rates (U5M) estimated at 117 deaths/1000 live births. Despite public health control initiatives, no significant improvement in U5M has been demonstrated. The purpose of the study was to determine whether history of Adverse Pregnancy Outcomes (APO) and maternal socioeconomic factors could predict the death of children before their fifth birthday, using the life course health development and fetal programming theories. The study population was women in their reproductive age (15- 49 years). The study was a secondary data analysis of the datasets obtained from three Nigeria Demographic and Health …

African Americans' Understanding Of The Provisions Of The Affordable Care Act, Ewang Theo Epie-Alobwede

Walden Dissertations and Doctoral Studies

African Americans as a group tend to have numerous health issues, and by the time they seek healthcare, the conditions often advance into more serious ailments. Researchers have shown that cultural distrust of the U.S. healthcare system coupled with some discriminatory practices has hindered African Americans seeking care and taking full advantage of the healthcare system. With the introduction of the Patient Protection and Affordable Care Act (ACA), there is some confusion about the application of the law, resulting in many intended beneficiaries misinterpreting it, and not accessing quality healthcare. This interpretive phenomenological study explored how African Americans in the …

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 …

Influence Of Patient Engagement Protocol On Health Outcomes And Medication Adherence Of Patients With Metabolic Syndrome, Angela H. Mcconnell

Walden Dissertations and Doctoral Studies

August 2016

Management of metabolic syndrome (MetS) may be enhanced by promoting patient engagement. Training health care providers in the conceptual and practical application of integrative patient centered care tools may promote patient lifestyle behaviors for better management of MetS. The purpose of this quantitative quasi-experimental study was to assess the impact of training providers in integrative patient centered care for patients with MetS. The biopsychosocial construct provided the conceptual framework for the study. Two groups of physicians were included; one received training in an integrative model (IM) while the second received no training and provided usual care (UC). Following …

Risk Factors Associated With Severe Acute Respiratory Infections Cases, Ryan Gatdula Ortiguerra

Walden Dissertations and Doctoral Studies

The close proximity of the United States to the Mexican border poses a concern for communicable diseases because of the high flow of population movement. The purpose of this retrospective, quantitative study was to identify risks associated with respiratory diseases using an analysis of archived data from the Severe Acute Respiratory Illness (SARI) surveillance program. Based on the epidemiologic triangle theory, demographic and etiologic factors were analyzed to examine any associations with SARI in this population. Between 2010 and 2012, 798 subjects enrolled in this program, with 336 (42.1%) testing positive for respiratory pathogens. Chi square analysis determined that age …

Association Between Haart And Metabolic Syndrome Components Among Hiv-Positive Adults In Southeastern Nigeria, Bridget Okiemute Amechi

Walden Dissertations and Doctoral Studies

Highly active antiretroviral therapy (HAART) contributes to metabolic disorders and the growing prevalence of metabolic syndrome (MetS) in human immunodeficiency virus (HIV)-infected patients. Hypertension, obesity, and hyperglycemia (components of MetS) are risk factors for cardiovascular disease. Studies have shown that HIV patients on HAART have a 2-fold risk of dying from MetS. There are no such studies in Umuahia; hence the need for this study to fill this gap. Using a sample size of 192 medical records of HIV-infected patients in Federal Medical Centre, Umuahia, and applying metabolic syndrome theory, this study examined the relationships among types of HAART regimen, …

Understanding Caregivers' Perceptions Of Childhood Immunization, Oliver Anyabolu

Walden Dissertations and Doctoral Studies

Low immunization in Nigeria is associated with high prevalence of childhood diseases. The purpose of this qualitative phenomenological study was to describe caregivers' perceptions of routine immunization of their children ages 24 to 36 months. Caregivers' attitudes, cultural beliefs, and knowledge regarding immunization were examined. The health belief model was used to guide study. Interviews were conducted with 5 caregivers of fully immunized and 5 caregivers of partially and nonimmunized children. Digital recordings were analyzed using NVivo 10 to identify themes and subthemes. Attitudes of caregivers with fully immunized children included both perceived barriers (distance to health center, lack of …

Preventive Health Education Media And Older Worker Health Literacy, Lori Michelle Williams-Johnson

Walden Dissertations and Doctoral Studies

The United States has experienced an increase in older workers as individuals born between 1946 and 1964 have remained in the labor force. Preventive health screening education, such as an immunization flyer, is necessary to avert preventable illness among older workers. Based on previous research, there is a gap regarding age-specific methods for educating the older worker about preventive health. Therefore, the purpose of this study was to explore the relationship between various media providing preventive health screening information and the assessed health literacy of the older worker. Based on the health belief model, a quantitative, cross-sectional method was used. …

Differences In Treatment-Seeking And Treatment-Adherence Factors For Tuberculosis In Armenian Versus Non-Armenian Populations Of Los Angeles County, Tanya Marie Ferguson

Walden Dissertations and Doctoral Studies

Tuberculosis (TB) is a deadly, yet curable, infectious disease that continues to be a global health threat. Armenia suffers from rising TB incidence and mortality rates. Armenians living in Los Angeles (LA) County, where TB incidence is higher than national averages, is the second largest Armenian community in the world; therefore implications are that many TB cases are attributed to this group. Using the social ecological model as a theoretical framework, this concurrent, mixed-methods study compared Armenians to non-Armenians in LA County about their knowledge of TB and perceived barriers to seeking and adhering to treatment. Bivariate chi-square analysis from …

Influence Of Overweight, Obesity, Social Support, And Self-Efficacy On Breastfeeding Outcomes Among African-American Women, Elizabeth Hoo

Walden Dissertations and Doctoral Studies

Breastfeeding reduces morbidity and mortality among mothers and children, yet African-American women breastfeed at lower rates than women of other racial and ethnic groups do. Higher rates of overweight, obesity, and low socioeconomic status may be contributing factors in this population; however, limited research exists regarding the roles of maternal overweight and obesity on breastfeeding outcomes. The purpose of this study was to examine whether social support and self-efficacy positively influence breastfeeding outcomes among overweight and obese African American women. Self-efficacy and social support theories provided the theoretical framework for the study. Research questions examined whether (a) maternal overweight and …

African American Single Mothers' Perceptions Of Physical Activity, Sheryl Lynn Richard

Walden Dissertations and Doctoral Studies

Insufficient physical activity detracts from healthy living and has a disparate impact on African American women and their female children. The extensive body of prior research addressing preventable chronic disease and other consequences of insufficient physical activity includes limited information specific to African American single mothers. The purpose of this descriptive phenomenological study was to gain an understanding of African American single mothers' perceptions of physical activity. Specifically investigated were African American women's familial influences and potential effects of these influences on their children's health behaviors. The health belief model served as the theoretical framework for this study and provided …

Strategies Ontario Hospital Administrators Apply To Generate Non-Government Revenue To Remain Sustainable, Frank Pieter Martien Naus

Walden Dissertations and Doctoral Studies

Health care administrators in Ontario want to transform health care with a focus on improving efficiency and quality of care, yet they pay little attention to increasing revenue. The purpose of this qualitative case study was to explore strategies Ontario hospital administrators apply to generate nongovernment revenue to remain sustainable. The target study population consisted of 2 chief executive officers and 2 chief financial officers at Ontario academic research hospitals. The conceptual framework for this study included radical organizational change theory supported by complexity leadership theory, and grounded in an evidence-based approach. The researcher conducted open-ended semi-structured interviews and made …

Impact Of Simulation Training On Novice Nurses, Sheila Marjean Moore

Walden Dissertations and Doctoral Studies

In 1999, the Institute of Medicine released its report on building a safer health system. Since then, safety in patient care has become a paramount interest. Given the growing support for increasing patient safety, simulation training has become a common part of novice nurses' orientation program. This simulation training is designed to mimic situations in the acute care setting where novice nurses can practice in a patient safe environment. In this DNP project, a stroke simulation scenario and supporting patient chart was developed as an addition to a novice nurses' orientation program. The National League for Nursing simulation template was …

Characteristics Of Adult Icu Patients With Device Associated Nosocomial Infections, Doramarie Arocha

Walden Dissertations and Doctoral Studies

Nosocomial infections are a cause of concern for hospital patients and the incidence rates of these infections are greater in intensive care units (ICUs) due to the invasive nature of treatments, additional risk factors and comorbidities, and therapies used. Invasive devices, such as vascular central lines, Foley catheters, and mechanical ventilators pose a risk for critically ill patients in the ICUs to develop device-related, healthcare-associated infections (HAI). The purpose of this study was to describe the epidemiological characteristics of patients who developed device-related HAIs within 3 ICU units (medical-surgical, cardiovascular, and neurosurgical) of an academic medical facility. The ecosocial theory …

Community And Patient-Centered Medical Home In The Care Of Chronically Ill Patients, Victor A. Carrillo

Walden Dissertations and Doctoral Studies

Large portions of the US population live in poor inner-city communities. Health needs assessment data have shown that these communities have disproportionately high rates of chronic illnesses. The patient-centered medical home (PCMH) model was developed to address the gaps that exist in the primary care system, and emphasizes a redesign of primary care that is patient centered, utilizes multiple levels of healthcare professionals, information technology, and care coordination. However, little evidence exists on the value of this model which may explain why it has not gained wide acceptance by primary care providers. Therefore, this study was designed to examine the …