Public Health Education and Promotion Commons^™

Impact Of Hospital Closures On Families In Rural Communities, Onetha Dickerson

Walden Dissertations and Doctoral Studies

Closure of community hospitals directly impacts the health of rural populations and indirectly affects economic growth and access to medical services. The purpose of this doctoral project was to assess the causes and impacts of hospital closures on rural communities. The practice-focused question addressed the implications of hospital closures on individuals and families in rural communities. A systematic review of the literature, based on conflict theory, addressed populations that lack health care facility resources. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided the selection of 8 journal articles for review. The inclusion criteria for articles encompassed the impact …

Effect Of Physical Activity Frequency On Body Image Among Young Adult Women, Kristin Minter

Walden Dissertations and Doctoral Studies

Approximately half of all female adolescents and young adults suffer from body dissatisfaction and, in turn, body image-related health concerns. Poor body image can contribute to various negative health behaviors including low self-esteem, depression, anxiety, eating disorders, and suicide. Research indicates a positive relationship between physical activity and self-esteem, and between self-esteem and body image. However, a paucity of research examines the effect of physical activity frequency on the body image of young women with two-like body compositions, as measured by body mass index (BMI). Based on self-discrepancy theory, self-schema theory, and the health belief model, this quantitative study explored …

Religiosity As A Predictor Of Hpv Awareness And Knowledge, Karen Adelheid Reiner

Walden Dissertations and Doctoral Studies

The Human Papillomavirus (HPV) is a common sexually transmitted infection (STI) and etiological agent of cervical cancer. It has been suggested that religiosity may promote a generalized disassociation between all STIs/STDs, including HPV, and personal relevance thus contributing to lower levels of HPV awareness and knowledge among certain groups. This study sought to identify the role of religiosity as a predictor of HPV awareness and knowledge among women in a Christian university. Religiosity was defined and measured using the Duke University Religion Index (DUREL). The schemata and social identity theories provided the theoretical framework for this study. A total of …

Needs Assessment For A Lifestyle Intervention Weight Loss Program For Hospital Employees, Karen Baumann

Walden Dissertations and Doctoral Studies

The rate of obesity is increasing in the United States. In Florida, almost 60% of the population will be obese by 2030. This increase is expected to contribute to millions of cases of preventable chronic diseases costing the state an estimated $34 billion dollars. Employer-sponsored health programs can positively influence employees' lifestyle choices and support weight loss programs to reduce health-related costs to the employee and the employer. Guided by the transtheoretical model, the purpose of the project was to conduct an employee assessment to determine the need for, interest in, and readiness for a lifestyle intervention weight loss program. …

Understanding The Importance Of Culturally Appropriate Patient-Provider Communication In Diabetes Self-Management, Anita Mwalui

Walden Dissertations and Doctoral Studies

According to the Centers for Disease Control and Prevention, 29.1 million people in the United States have diabetes. Among those 29.1 million people, 21 million have been diagnosed, but 8.1 million have not. Changing demographics in the United States and the prevalence of diabetes are projected to be burdens on the health care system through 2050. Guided by the social cognitive theory, the purpose of this qualitative case study was to understand the importance of culturally appropriate patient-provider communication to the self-management of Type 2 diabetes by patients who are African immigrants. Culturally based health care has unique challenges when …

Contributing Factors Of Obesity Among Over-The-Road Truckers, Shari Weiss

Walden Dissertations and Doctoral Studies

Obesity among over-the-road truckers (OTRs) is an epidemic creating significant public health issues among this population. The consequences of obesity (hypertension, diabetes, heart disease) put both truckers' health and their medical clearance at significant risk. The purpose of this study was to examine the impact of gender, physical activity, diet, and sleep on obesity among OTRs. Through a socioecological lens, this study examined whether obesity is significantly impacted by gender, physical activity, nutrition, and sleep. This study also examined the impact of the trucking environment on obesity. The study used a quantitative research design and data were collected through a …

Nursing Student's Breast Cancer Knowledge And Breast- Self Examination Technique Confidence, Lydia E. Gaud

Walden Dissertations and Doctoral Studies

Breast cancer is the second leading cause of cancer death in women in the United States. Several factors have been identified that interfere with women's breast cancer screening practices, including lack of knowledge and confidence in the breast self-examination (BSE) technique, and lack of information provided by health care provider. One of the reasons nurses do not teach breast cancer detection could be the little emphasis given to breast cancer examination in nursing schools. The BSE is a measure of significant value in detecting cancer of the breast. However, less than half of the women in the United States are …

Caregiver Burden And Emergency Room Utilization For Enhanced Recovery Surgery Cancer Patients, Mindy Sovel

Walden Dissertations and Doctoral Studies

Advances in surgical technique and medical management have led to fundamental changes in surgical care allowing for a paradigm shift from inpatient to outpatient surgery. Enhanced recovery pathways have moved surgical recovery from inpatient to outpatient settings requiring informal caregiver support. The purpose of this study was to determine the prevalence of caregiver burden in this patient population and to explore whether caregiver burden contributes to preventable use of emergency room services. The conceptual framework supporting this retrospective cross-sectional study was Andersen's behavioral model of health services utilization. Data collected from 28 urologic patient/caregiver pairs were analyzed using descriptive statistics …

Testing A Psychological Readiness Training Intervention On Ptsd, Depression, Anxiety, & Stress In First Responders, Renee Kosor

Walden Dissertations and Doctoral Studies

Exposure to traumatic events is rare for the general public but common for first responders. However, there is little proactive emotional health care occurring inside the first responder community. No preventive treatment for depression, anxiety, stress, and PTSD exists. The purpose of this study was to determine the efficacy of a psychological readiness training intervention on 361 police officers and firefighters in a medium-size Midwestern city. A combined positive psychological capital and cognitive behavior therapy approach was used to frame the study. This study used a pretest, posttest quasi-experimental design. The participants were a convenience sample of 119 volunteers from …

Predicting Weight Management Advice Behavior Using Social Cognitive Theory Among Psychiatry Professionals, Chidi Chima

Walden Dissertations and Doctoral Studies

Obesity remains a public health concern among persons with mental illness resulting from the interaction of a combination of factors such as genetic, medication, effects of their symptoms, social, and environmental factors. Obesity complications account for increased mortality and morbidity, reduced life expectancy, and quality of life in persons with mental illness. The management of obesity is challenging and predicting the ability of mental health professionals to advise patients on weight management behavior is important to improve patients' overall well-being. The social cognitive theory constructs knowledge, expectations, situational perception, self-efficacy, and goal setting were utilized in predicting Weight Management Advice …

The Lived Experiences Of School Nurses: Transitioning From Hospital To School Worksite, Irene Campbell

Walden Dissertations and Doctoral Studies

School nurses who transition from hospital or clinic-based settings to a school-based work environment often lack sufficient transitioning skills and orientation to cope with the roles and responsibilities of school-based nursing. The result is a high attrition rate among school-based nurses. School nurses may leave their positions due to experiences of marginalization, including isolation, role confusion, and barriers to practice. In this phenomenological study, the lived experiences of 12 school-based nurses who transitioned from hospital or clinical settings were explored. Bandura's self-efficacy and Spreitzer's psychological empowerment theories were used in interpreting the findings. Data were collected via face-to-face individual interviews …

A Secondary Analysis Of Survey Data Evaluating The Lifelines Suicide Prevention Program Among Middle School Students, Nicki Sullivan

DNP Projects

PURPOSE: The purpose of this study was to evaluate student feedback of the 2015 Lifelines Suicide Prevention Program at Jessie Clark Middle School. Student feedback was examined by assessing students’ knowledge of suicide, attitudes toward suicide, knowledge of when and from whom to seek help if feeling suicidal or told by a friend that they are suicidal, and impressions of the educational presentation following participation in the Lifelines Suicide Prevention Program.

METHODS: In this secondary analysis, anonymous student responses (N=269) from a 2015 middle school survey were examined by using a mixed method design with the quantitative study measures being …

Knowledge And Use Of E-Cigarettes And Risk Perception In Brazil: Results From A Country With Strict Regulatory Requirements, Tânia Maria Vavalcante, André Salem Szklo, Cristina De Abreu Perez, James Thrasher Phd, Moyses Szklo, Janine Ouimet, Shannon Gravely, Geoffrey T. Fong, Liz Maria De Almeida

Faculty Publications

Due to uncertainties about the impact of electronic cigarettes on health, Brazil adopted, in 2009, a regulation that prohibited the sale, importation and advertising of these products until manufacturers can demonstrate that they are safe and/or effective in smoking cessation. The objective of the study was to analyze among Brazilian smokers: (1) knowledge about the existence of electronic cigarettes, lifetime use, and recent use; (2) risk perception of e-cigarettes compared to conventional cigarettes; and (3) factors correlated with knowledge and perception of risk. This is a cross-sectional study among Brazilian smokers (≥ 18 years old) using a replacement sample from …

Physician Burnout Is Better Conceptualised As Depression, Bianchi Renzo, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Ronald Epstein and Michael Privitera reported that burnout affects more than half of practising physicians. The authors additionally warned against confusing burnout with depression. For two reasons we are concerned with the validity of these conclusions. First, there is now robust evidence that burnout is a depressive condition. Second, the published estimates of burnout’s prevalence rely on clinically groundless criteria, cobbled together without any rationale.

Users' Experiences Of Wearable Activity Trackers: A Cross-Sectional Study, Carol Maher, Jillian Ryan, Christina Ambrosi, Sarah Edney

Research outputs 2014 to 2021

Background

Wearable activity trackers offer considerable promise for helping users to adopt healthier lifestyles. This study aimed to explore users’ experience of activity trackers, including usage patterns, sharing of data to social media, perceived behaviour change (physical activity, diet and sleep), and technical issues/barriers to use.

Methods

A cross-sectional online survey was developed and administered to Australian adults who were current or former activity tracker users. Results were analysed descriptively, with differences between current and former users and wearable brands explored using independent samples t-tests, Mann-Whitney, and chi square tests.

Results

Participants included 200 current and 37 former activity tracker …

Your Teaching Strategy Matters: How Engagement Impacts Application In Health Information Literacy Instruction, Heather A. Johnson, Laura C. Barrett

Dartmouth Scholarship

The purpose of this study was to compare two pedagogical methods, active learning and passive instruction, to determine which is more useful in helping students to achieve the learning outcomes in a one-hour research skills instructional session.

Effect Of Home Telemonitoring On Heart Failure Hospital Readmissions Among Adult Hispanics, Priscilla Liza Caban

Walden Dissertations and Doctoral Studies

Heart failure is ranked as one of the leading causes of hospitalizations and mortality among adults of all racial/ethnic groups in the United States. Telemonitoring, as a homecare intervention for heart failure management, has been used across all groups although the benefit for Hispanics not established. The purpose of this retrospective, quantitative study was to determine the differences in hospital readmission between Hispanic, non-Hispanic Black, and non-Hispanic White patients with heart failure disease who either received or did not receive home telemonitoring services from a homecare agency in Connecticut. The research questions for this study examined the effect of home …

Obstetric Fistula: The Experiences Of Patients And Medical Personnel In Sierra Leone, Sheku Samba

Walden Dissertations and Doctoral Studies

Women face great risks in pregnancy and childbirth, especially in developing countries where there are very few skilled birth attendants and negligible government investments in maternal health programs. As a result, obstetric fistula (OF), a potentially fatal but preventable and treatable condition, affects some 3 million women and girls globally. In Sierra Leone, the prevalence of OF is extremely high, but the absence of quality data to inform decision-making, both on prevalence and risk factors, is a barrier to creating an environment for OF prevention and care. The purpose of this phenomenological study was to explore and document the barriers …

The Influence Of Culture On Hiv Disclosure Among Gay Asian Males, David C. Doan

Walden Dissertations and Doctoral Studies

HIV-positive, Asian Pacific Islander (API) men who have sex with men (MSM) experience triple minority stigma including HIV, sexual orientation, and minority ethnicity. To date, there is no research that examines the influence of cultural factors, level of acculturation, social determinants of health, and other confounding variables (e.g., age, education, level of income, and length of time since diagnosis) on HIV-positive disclosure behaviors, attitudes, and intentions to casual sexual partners for API MSM. The theoretical framework for this study was based on Hofstede's original cultural values and Triandis's cultural dimensions. In this 2-phase, mixed methods, sequential explanatory study, 24 API …

Beliefs, Costs, And Policies Influencing African American Men's Decisions On Psa Screening, Mary Frances Carter

Walden Dissertations and Doctoral Studies

Despite the growing concerns about routine prostate-specific antigen (PSA) screening in men, little is known about the societal and economic impact of screening among the African American population. The purpose of this qualitative case study was to explore beliefs among African American men about PSA screening, funding for screening, and the role of the United States Preventive Service Task Force in addressing the problem. Guided by rational choice theory, data collection consisted of completion of a health beliefs survey, face-to-face interviews, field notes taken during interview, and interview audio recording. The population for the study included African American men residing …

Decreasing Primary-Care-Related Emergency Department Visits In The Hispanic Population Using Patient Navigators, Arthur Dominguez Jr.

Walden Dissertations and Doctoral Studies

Primary-care-related emergency department (PCR-ED) visits by Hispanic patients enrolled in a not-for-profit Medi-Cal and Medicare health plan resulted in longer wait times in the emergency department (ED) at a regional medical center in Southern California. This congestion decreased access for those with true emergencies, created capacity issues, increased ED length of stay, and resulted in potential safety risks. This project focused on decreasing PCR-ED visits in the Hispanic population using patient navigators in Southern California. Applying the health belief model and Lippitt's theory of change, this doctoral project involved the creation and implementation of a culturally appropriate, population-specific patient navigator …

Assessment Of Anxiety And Depression Among Breast Cancer Patients Undergoing Treatment In Ghana, Kofi Adesi Kyei

Walden Dissertations and Doctoral Studies

Breast cancer patients undergoing radiotherapy often experience severe levels of anxiety and depression. There is a gap in the research literature from Africa, particularly from Ghana, with few studies focusing on the assessment of anxiety and depression among breast cancer patients undergoing radiation treatment. A better understanding was essential to promote efforts to help breast cancer patients cope with their diagnosis and treatment and increase their overall quality of life. This mixed method study examined breast cancer patients in Ghana undergoing radiotherapy and their responses related to anxiety and depression through a concurrent triangulation involving an interview with selected professional …

Type 2 Diabetes Mellitus And Colorectal Cancer Risk And Survival In Oman, Rose Ngozi Mafiana

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus (T2DM) and colorectal cancer (CRC) are 2 chronic diseases with common risk factors related to physical inactivity, obesity, and diet. Literature on T2DM as a risk factor for CRC development and survival in Oman is scarce. Using de-identified archival data provided by Sultan Qaboos University Hospital (SQUH) Oman, a retrospective, case-control, and time-to-event study designs were used to compare odds of developing CRC, and survival rates among adults with and without T2DM. The ecosocial theory provided the theoretical base for this research. Logistic regression was used to examine the odds of developing CRC among 114 cases …

Socioeconomic Challenges In The Household And The Prevalence Of Comorbidity Among Children With Attention-Deficit Hyperactivity Disorder, Randy Lee Perrin

Walden Dissertations and Doctoral Studies

Attention-deficit hyperactivity disorder (ADHD), the most commonly diagnosed childhood neurobehavioral disorder, is increasing annually at about 5% per year. ADHD has been diagnosed in approximately 6.4 billion children in the U.S., and it is estimated that 66% of those afflicted have 1 or more comorbid conditions. Children with ADHD are often from socioeconomically challenged households. What is unclear from the literature is the relationship between socioeconomic status (SES), defined as education, employment, and income and the reporting of comorbidities with ADHD. The problem is that children with ADHD from low SES households may be reporting a higher prevalence of comorbid …

Lived Experiences Of Individuals Quality Of Life On Prolonged Home Mechanical Ventilation, Munyaradzi Ephie Rwakonda

Walden Dissertations and Doctoral Studies

Improvements in technology have allowed people with tracheostomies to live at home on mechanical ventilation (HMV). Quality of life (QOL) for HMV users has been studied quantitatively, but few qualitative studies have been published. The purpose of this phenomenological study was to explore QOL for individuals with tracheostomies on prolonged HMV focusing on activities of daily living (ADLs) and the role of decision- making. The Roper, Logan, and Tierney activities of living theory were used to categorize activities. Ten participants, 18 years and older, with a tracheostomy and on HMV for at least 6 months were enrolled using purposive sampling. …