Public Health Education and Promotion Commons^™

Acculturation And Diabetes Among New York's Bangladeshi Immigrants, Renee Mehrra

Walden Dissertations and Doctoral Studies

There are more than 3.4 million South Asians in the United States. Among this subgroup, Bangladeshis in New York have a high prevalence of Type 2 diabetes ranging from 15 to 24% compared to the general population. This study examined the effect of acculturation through length of stay in the United States and understanding of the English language, and the role of gender on self-efficacy (SE) and diabetes self-management among 336 New York Bangladeshi immigrants between the ages of 21 and 75 who had been diagnosed with type 2 diabetes with A1C -‰¥ 6.5%, as verified by their medical record …

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, …

Predicting Outcomes Of American Youths' Shift Toward E-Cigarette Use, D J. Resendez

Walden Dissertations and Doctoral Studies

There has been a shift toward e-cigarette use and away from tobacco smoking among American youth. Despite effects of ongoing public health campaigns that bring attention to the harmful effects of tobacco and nicotine use generally, youths might not perceive e-cigarette use to be unhealthful in terms of psychological functioning. This study was an investigation of the impact of the method of tobacco use (cigarette or e-cigarette), past cessation attempts, cravings or needs to use tobacco, and serious cognitive difficulties, upon youths' intentions concerning future tobacco usage. The conceptual framework was based upon the self-medication hypothesis, biopsychosocial model, and social …

Risk Factors That Predict Asthma Among Adult, Foreign-Born African Americans In California, Alphajor Umaru Barrie

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to examine possible risk factors that predict asthma among adult, foreign-born African Americans in California. A total of 794 foreign-born African Americans (87 asthma cases) were included from the 2017-2018 California Health Interview Survey database. Data analysis included both descriptive and inferential statistical methods including chi-square analysis and multiple logistic regression techniques. The socioeclogical model was used to help understand and interpret the findings. The dependent variable was asthma status and the independent variables were the risk factors (tobacco smoking, alcohol use, health insurance, income level, and education level). Confounders included in the …

Ethnic Minority Young Adult Perspectives On Health Literacy Readiness For Adulthood, Selwyn A. B. Carrington

Walden Dissertations and Doctoral Studies

Health literacy is a social determinant of health and health disparity and low health literacy contributes to poor health outcomes in ethnic minority young adults (EMYAs). There is a gap in the literature regarding the health literacy readiness (HLR) of EMYAs transitioning to adulthood. The overarching research question concerned the perspectives of EMYAs on HLR for the transition to adulthood. A phenomenological study design was used with a theoretical framework that integrated concepts from the socioecological and health belief models. Twelve purposefully selected EMYAs ages 18-22 from a southern U.S. county participated in the study. Data were collected by telephone …

Care Intervention And Reduction Of Emergency Department Utilization In Medicaid Populations, Eno J. Rouse

Walden Dissertations and Doctoral Studies

Expansion of Medicaid and private health insurance coverage through passage of the Affordable Care Act of 2010 was expected to increase primary care access and reduce emergency department (ED) use by reducing financial burden and improving affordability of care. The aim of this study was to examine the differences in utilization patterns that exist among the Medicaid population that participated in an optimal level of care (OLC) intervention inclusive of appointments scheduled to primary care providers. Using the integrated behavior model as a theoretical framework, the key research question focused on determining if there was a difference in ED use …

The Relationship Between Parents' And Caregivers' Demographics And Their Knowledge About Congenital Heart Disease, Adeola Barakat Animasahun

Walden Dissertations and Doctoral Studies

The lack of knowledge regarding congenital heart disease (CHD) among the Lagos populace is leading to late presentation, late diagnosis and poor outcomes. The purpose of the research was to document the level of knowledge of parents and caregivers regarding CHD using the Leuven questionnaire for assessing knowledge of parents on CHD (LKQCHD). A quantitative correlational cross-sectional study, with purposeful convenience sampling strategy, was used. Health belief model was the theoretical framework used. Primary data of demographic information such as gender, age, the level of education, and the number of years of accessing care were obtained using a survey. The …

Evaluating The Frequencies Of Self-Reported Mental Health Conditions In Affluent Youth, Philip Bondurant

Walden Dissertations and Doctoral Studies

American youth are facing a mental health crisis. Rates of depression and suicide continue to rise among all children ages 12-17. While there is considerable research on the mental health of underserved children, much less is known about the mental health status of youth from affluent communities. The purpose of this study was to evaluate the effectiveness of community health assessment (CHA)-driven mental health interventions on the youth of affluent communities. Using a pre and post evaluation model, this study compared the frequencies of self-reported depression and suicide ideation for students in Grades 8, 10, and 12, and geographic location …

Involving Patient/Family Advisors And Advisory Councils With Patient And Family Engagement, Cortney D. Forward

Walden Dissertations and Doctoral Studies

Health care consumers are under-represented in literature when defining patient and family engagement. The proportion of people living longer is rapidly growing. Future research is needed to evaluate which strategies of patient and family engagement are most useful in real-world health care settings for patient and families. The purpose of this study was to describe the lived experiences of patient/family advisors working within patient family advisory councils at an academic medical center in the Midwestern United States. The conceptual framework is based on Greenleaf's servant leadership and Bass's transformational leadership. The research questions examined how patient/family advisors describe patient and …

Cancer Treatment Decision Making In Aging Minorities, Patrice Kemp

Walden Dissertations and Doctoral Studies

Cancer incidence is high for aging minority and underserved populations, yet research is limited about patient-provider communications with aging racial and ethnic minority populations. Achieving high-quality cancer care is crucial to reducing health disparities for this population. However, potential shortages in professional health personnel, the cost to treat cancer, a strained health care system, and large aging populations contribute to the problem. The purpose of this qualitative study was to understand the personal experiences of aging minorities during cancer treatment decision making when communicating with their cancer care providers. Purposive sampling methods were used to recruit 10 minority women and …

Geospatial Analysis Of Care And Mortality In The 2014 Liberia Ebola Outbreak, Marion Carlton Kinkade

Walden Dissertations and Doctoral Studies

The Ebola outbreak in West Africa in 2014 to 2016 had more than 28,000 suspected, probable, and confirmed cases. It was the largest Ebola outbreak in history. Of the 28,000 cases in the three Ebola-affected countries, Liberia had 10,000 cases with almost 5,000 deaths. The Ebola Virus Disease (EVD) entered Liberia along the border of Guinea and moved to the capital city of Monrovia where the virus spread. Ebola Treatment Units (ETUs) were constructed throughout the response in locations where there were available facilities versus distance to care challenges. This study examined the association of distance from villages to ETUs …

Pregnant African American Women Breastfeeding Intentions, Beliefs, Attitudes And Perspectives, Janelle S. Mcclain, Phd

Walden Dissertations and Doctoral Studies

Breastfeeding is the best infant feeding source of nutrition for infants in their early stages of development. However, there is a fundamental gap in the number of African American women that initiate breastfeeding compared to White, Asian, and Hispanic mothers. Social cognitive theory was used to explore the breastfeeding intentions, beliefs, perceived barriers, and perceptions on breastfeeding through a basic qualitative research method. To capture the essence of the lived experiences of African American pregnant women, a purposeful sample of 13 African American pregnant women were invited to participate in the study. Two focus groups discussions pertaining to breastfeeding intentions …

Parents' And Health Professionals' Perceptions Of Asthma Medication Noncompliance Among Puerto Rican Children, Luz E. Nieves

Walden Dissertations and Doctoral Studies

Children of Hispanic origin have the highest prevalence of asthma of all ethnic groups in the United States, especially Puerto Rican children, who have a prevalence of 12.9%. Treatment nonadherence has been identified as one contributing factor. The purpose of this qualitative study was to explore the reasons for nonadherence to the asthma treatment regimen among Puerto Rican children. Parents and health care providers of asthmatic children were interviewed regarding their beliefs about asthma as a disease, its effect on the child's life, and their experience with asthma treatment. Two models served as the theoretical framework: the health belief model …

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 …

Public Health Implications Of Retailer Resale Of Returned Textile Clothing Merchandise, Antonette M. A. Francis-Shearer

Walden Dissertations and Doctoral Studies

Historically, 18th century anecdotal accounts of the decimation of several tribes of U.S. of the Native American population by trading of infected textile blankets alludes to the role of retail in the transmission of infectious disease. This study explores implications of the modern day retail organization practice of reselling returned clothing textiles from a public health infectious disease perspective. A qualitative multi-case study, utilized responses from 20 open-ended, unstructured interviews of retail employees assigned to the returns process. Additionally, several informal observations of select U.S.based, top-ranked clothing retail organizations, identified by the National Retail Federation were completed. Select federal, state, …

Advisory Committee On Immunization Practices Recommendations, Socioeconomics, Demographics, And Influenza Vaccine Uptake, Jennifer Gadarowski

Walden Dissertations and Doctoral Studies

Seasonal influenza outbreaks are associated with morbidity and mortality in the United States. Though children are the most susceptible to influenza infection and are most likely to transmit the illness to others, many children are not vaccinated. The purpose of this study was to examine the relationship between seasonal influenza vaccination Advisory Committee on Immunization Practices (ACIP) recommendations, demographic characteristics, socioeconomic factors, and vaccine type among children over 3 consecutive flu seasons. This quantitative cross-sectional study was guided by the social ecology of health model. Secondary data from 3 consecutive flu seasons (2014-2015, 2015-2016, and 2016-2017) provided by the National …

Blood Lead Testing Guideline Development For A Public Health Department, Becky Sue Johnson Himes

Walden Dissertations and Doctoral Studies

A lack of consistent, evidence-based practices for blood lead testing of children existed in a local public health department (LHD). No known blood lead level is safe, and toxicity can result in behavioral and cognitive impairments. The purpose of this project was to develop and analyze a clinical practice guideline to establish blood lead testing procedures in the LHD to improve testing procedures and enhance future testing within the jurisdiction. The RE-AIM framework was used to address the reach, effectiveness, adoption, implementation, and maintenance of the clinical practice guideline. Five experts evaluated the guideline using the Appraisal of Guidelines for …

Barriers To Male Faculty In Nursing Education, Troy Jeffrey Palmer

Walden Dissertations and Doctoral Studies

Men are underrepresented among nursing faculty, providing few role models for male students who might benefit from interaction with male faculty. Male nursing faculty may face barriers similar to those faced by women in male-dominated professions. Diehl and Dzubinski's model of gender-based barriers served as the framework for this quantitative study conducted to identify disparities between male and female nursing faculty that may prevent men from entering, continuing, and advancing in nursing education. The association between the percentage of male nursing faculty with geographic region; institution type (i.e., public, private secular, or private religious); and 4 career variables (i.e., education …

Staff Education Program To Promote Breast Cancer Prevention Among African American Women, Vanessa Marie Palmer

Walden Dissertations and Doctoral Studies

African American women living in rural Ohio have a history of low mammogram

screening rates and a high incidence of breast cancer identification in the late stage of the

disease, leading to mortality rates exceeding those of Caucasian women. The purpose of

this doctoral project was to establish a breast health educational program for health

providers in a local mammography center that did not provide such a program

specifically targeted for African American women. Three theoretical frameworks, the

health belief model, Knowles's learning theory, and the PEN-3 model, guided the

development of a staff education program based on cultural appropriateness. …

Perceptions Of Female Genital Cutting Among Nigerian Immigrants In Portland, Oregon, Uche E. Ukachukwu

Walden Dissertations and Doctoral Studies

Female genital cutting (FGC) is the partial, or total excision of the female outer genitalia, or different forms of lacerations to the female genital organs for nonmedical reasons such as social, cultural, religious, or other nonmedical intentions. Many girls and women around the globe who have gone through FGC or are at the risk of being forced into it. The purpose of this qualitative case study was to explore the place of culture, religion, social beliefs, and men's views, attitudes, and knowledge regarding the FGC within the Nigerian immigrant community in the northwest US. The social convention theory served as …

Beliefs And Opinions Of Low-Income Residents Living In A Food Desert In A Gulf Coast State, Kimberly Lakeidra Willis

Walden Dissertations and Doctoral Studies

This study was an investigation of the access problem to fresh and affordable fruits and vegetables and how limited access influenced the beliefs and opinions of residents of a food desert as designated by United States Department of Agriculture. Many researchers have documented that price, availability, and transportation are barriers to fruit and vegetable consumption, particularly among low-income individuals. Researchers in other studies have concluded that these barriers are further exacerbated by an individual's distance from a supermarket or grocery store. However, much less information is available regarding the beliefs and opinions about life in a food desert and how …

Factors Associated With Pesticide Resistance In Culex Mosquitoes, Jude Akpan

Walden Dissertations and Doctoral Studies

In recent years mosquito-borne diseases have reemerged, largely because of pesticide resistance. The mosquitoes develop resistance to pesticides because of broad and repeated uses of pesticides. Preventing the development of pesticide resistance requires proper understanding of the environmental factors potentially associated with the development of the resistance. The purpose of this study was to investigate the environmental factors associated with the resistance to pesticides by the Culex mosquitoes. This correlational study included the analysis of archived data samples (N = 29,794) from the Field Cage Tests results conducted between 2013 and 2017 by a large county public health department. The …

Merging Pay-For-Performance And Technology To Impact Patient Outcomes, Daaiyah Nimat Akram

Walden Dissertations and Doctoral Studies

Pay-for-performance (P4P) programs improve the effectiveness, quality, and overall value of healthcare. In today's world of advanced technology and changing trends, physician organizations hesitate to adopt P4P program methodology. A gap in the literature was identified, as there were no guides found that explained how to implement P4P initiatives that improved quality of care. The purpose of this study was to gain a better understand-ing of P4P, and the phenomenology of practice theory was applied to obtain different perspectives about P4P programs and how incorporating technology improved quality of health provisions. Basic qualitative methodology was used, and semistructured telephone interviews …

The Association Between Leapfrog's Healthcare Organizational Grades And 30-Day Mortality Rates, Steven Michael Armstrong

Walden Dissertations and Doctoral Studies

U.S. healthcare consumers have access to various provider ratings from several organizations that are meant to assist in selecting their healthcare providers. Leapfrog Hospital Safety Grades is one such rating system that professes to allow consumers the ability to select the best hospital for their care. However, since consumers ranking mortality risk as their most important concern, it is essential to determine if Leapfrog grades align with consumer expectations. Andersen's Phase-4 behavioral model of healthcare utilization was used as the foundation for understanding healthcare consumer preferences. This study was designed to determine if Leapfrog grades are predictive of CMS 30-day …

Perceptions Of Economic, Health, And Environmental Effects Of Hydraulic Fracturing In Indiana, Juliana Bayowa

Walden Dissertations and Doctoral Studies

Effects of hydraulic fracturing (HF) have become a controversial public health issue in the United States. The purpose of this qualitative case study was to explore community members' perceptions of economic, health, and environmental effects of HF in Gibson County, Indiana. The conceptual framework was adapted from the health belief model and was named the HF health impact belief model (HFHIBM). Data were collected from stratified purposeful non-randomly selected 32 Gibson community members, using semi structured questionnaires, complete observations, and existing documents. Stratification was based on factors influencing perception, such as, gender, race, level of education, age or technology exposure, …

Logistical Resource Capability During A Mass Casualty Event In Washington State, Todd Devin Brauckmiller

Walden Dissertations and Doctoral Studies

The need for increasing efficiencies for medical resource delivery during a mass casualty incident/event is a paramount logistical planning factor that could mean life or death to the citizens affected by a disaster. As such, Washington State has prioritized emergency management and preparedness. Using the just-in-time system by way of Baghbanian' s complex adaptive decision-making theory as the foundation, gave purpose to this qualitative study. This was accomplished by analysis of emergency management professional responses, and to what degree, improvements can be made to the medical resource delivery system during a mass casualty incident/event. Data were collected through semi structured …

Preventing Obesity And Type 2 Diabetes In Immigrant Populations, Maxwell K. Chikuta

Walden Dissertations and Doctoral Studies

Obesity-related diseases have been increasing in African immigrants throughout the United States. Although research has been done to identify risk factors associated with many ethnic groups in the United States, only a few studies exist that explore obesity and type 2 diabetes diseases among Central African immigrants. The conceptual framework for this qualitative case study was social constructivism and the health belief model. The primary research question addressed the potential underlying causes for an increase in obesity and type 2 diabetes among Central African Immigrants. The secondary research questions explored how culture, illiteracy, and religion contribute to the problem of …

The Influence Of Food Choices, Eating Habits, And Body Image Of African American Mothers On Childhood Obesity, Debrua Perniece Coleman

Walden Dissertations and Doctoral Studies

The food decisions, dietary patterns, physical activity, and weight-related convictions of African American mothers are affected by their self-perceptions and views of body weight. The gap in the literature regarding the impact of these perceptions on children's food choices, eating habits, and body image is significant. Using the health belief model as the theoretical foundation and a cross-sectional survey as the research design, this study assessed the potential relationship between mothers' and children's eating habits and whether mothers' perceptions of their children's body image were reliable indicators of childhood obesity. Eighty-six mothers provided demographic information and completed the Child Feeding …

A Comparison Of The Safety And Efficacy Of Three Medical Abortion Protocols, Dhammika Perera

Walden Dissertations and Doctoral Studies

Unsafe abortions pose serious threats to women's health. Medical abortion provides safer abortion access to many. The lengthy interval between misoprostol and mifepristone creates multiple barriers for women and providers.

A paucity of research exists about medical abortion protocols that allow single day procedures. The efficacy and the safety of 3 medical abortion protocols of varying lengths were explored in this study.

A secondary data set of over 55,000 patients from the United Kingdom was retrospectively analyzed using binomial logistic regression. Efficacy results showed no significant difference between the conventional and the simultaneous protocols; when compared to those, the 6- …

Incentive Size Alignment With Accountable Care Organization Performance, Kristie D. Racca

Walden Dissertations and Doctoral Studies

Changes to the country's health care political landscape in 2012 resulted in the development of federal programs aimed at containing costs and improving the quality of care delivered. Accountable Care Organizations (ACO) emerged linking performance to rewards. Guided by Conrad's value-based performance incentive theory as the theoretical foundation, the purpose of this quantitative study was to determine the relationship between financial incentive size and ACO performance measures. The research questions examined the predictive relationship of incentive size and acute care readmission rates, emergency department (ED) visits, and per capita spending of the ACO Medicare Shared Savings Program population. The study …