Public Health Education and Promotion Commons^™

Changes In Operating Performance In Rural Hospitals From 2012 To 2019, Oluwaseyi Tami Young-Harry

Walden Dissertations and Doctoral Studies

Rural hospitals treat patients while dealing with the challenges of an inadequate workforce, limited financial resources, and an isolated geographic location, leading to difficulties in achieving financial viability. The purpose of this quantitative study was to analyze the operating performance of rural, general, medical and surgical hospitals in the United States and to determine if performance had changed from 2012 to 2019. Guided by x-efficiency theory, this study addressed whether hospital ownership explained variation in performance and if performance had changed from 2012 to 2019. A random sample of 394 rural hospitals was used, with data drawn from the American …

Barriers To Mental Health Services Related To Stigma In Northern California, Kandalena Ary

Walden Dissertations and Doctoral Studies

California Senate Bill 1041 recognized mental health as a contributing barrier for individuals struggling to achieve independence from aid through the California Work Opportunity and Responsibility to Kids (CalWORKs) program to meet the needs of the state's low-income families while reducing barriers to self-sufficiency. As mental health illnesses continue to increase, the engagement and utilization of services have not increased. The purpose of this study was to explore county policy infrastructure addresses making mental health services known, accessible, and increase participation to decrease barriers in utilization of available resources. The research questions were used to examine the effectiveness of processes …

Factors Associated With Flu Vaccination Status Among Older Hispanics In The United States, William Esteban Toledo Velazquez

Walden Dissertations and Doctoral Studies

AbstractOlder Hispanics in the United States are less likely to be vaccinated with the flu vaccine compared to older White Americans, despite being at higher risk of influenza-associated deaths and hospitalizations. A quantitative cross-sectional study based on the social ecological model was carried out to evaluate the influence of several sociodemographic and health factors on flu vaccination status among elderly Hispanic individuals in the United States. Logistic regression analyses were conducted using secondary data collected from 95,414 elderly Hispanic and White American 2018 Behavioral Risk Factor Surveillance System participants. Multivariate logistic regressions controlling for other variables revealed health care coverage …

Perceptions On Maternal Mortality Among The Ekpeye Community, Theresa Tenim Ogide-Alaeze

Walden Dissertations and Doctoral Studies

In Africa, especially Nigeria, maternal mortality is a public health issue among women of childbearing age (WCBA). WCBA living in the Ekpeye community located in Rivers state in Nigeria are at high risk of maternal deaths during pregnancy and labor or delivery. Data were obtained through key informant interviews with 9 relatives, friends, and health workers. The purpose of the key informant interviews was to identify perceived barriers that result in high maternal deaths and facilitators seen as promoters to reduce pregnancy-related deaths. The participants identified 11 core themes as contributors to maternal death: (a) postpartum death, (b) financial insecurity, …

Stroke Prevention Through Education, Laura Lee Ballance

Walden Dissertations and Doctoral Studies

AbstractThis project focused on two concepts: a need for a stroke prevention program and what should be included. The problem with early identification of stroke is not formally addressed at the project site, physician’s office. A physician’s office can play a beginning key role in minimizing the risk of stroke. The purpose of this project was to explore the evidence to support the need for and to determine ideal content for a stroke prevention education program. This program focused on early detection and identification of risk factors to prevent stroke occurrence. The theoretical framework of Pender’s health promotion model aligns …

Racial Differences In Hospital Readmission And Reimbursement Rates For Patients With Congestive Heart Failure, Catherine Talongwa

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is associated with a significant economic burden that includes frequent emergency department visits, hospitalizations, and readmissions. The purpose of this study was to examine the differences, if any, between hospital readmission rates and insurance reimbursement rates for non-Hispanic Black and White CHF patients in California. The theoretical framework was Bandura's social cognitive theory. Secondary data for this quantitative study were obtained from the Office of Statewide Health Planning and Development and State Inpatient Databases from Healthcare Cost and Utilization for calendar year 2014-2016. A t-test and Levene's test for equality of variance were conducted on a …

The Caregiver Advise Record And Enable (Care) Act And Compassion Fatigue In The United States, Karen Marie Johnson

Walden Dissertations and Doctoral Studies

The transition from hospital to home can be complicated, leaving family caregivers in stressful situations that they may not know how to handle. The burden that is placed on these individuals has led researchers to focus on the public health implications of caregiving in hopes of identifying at-risk caregivers. This quantitative analysis identified what relationships exist between caregiver compassion fatigue among family caregivers and training or education received per the Caregiver Advise Record and Enable (CARE) Act and if education influences readmission rates. A purposive sample of 385 family caregivers participated in this study. The Care Transitions Measure (CTM-15), the …

Social Cognitive Theory Constructs That Predict Betel Nut Chewing Among Secondary Students, Lepani Waqatakirewa

Walden Dissertations and Doctoral Studies

After alcohol, tobacco, and caffeine, areca or betel nut is the 4th most common substance of abuse in the world, and its prevalence of use in the Solomon Islands is estimated at 68% in young people. Long-term use of betel nut can result in detrimental health outcomes such as oral cancers and metabolic syndrome. Guided by the social cognitive theory (SCT), the purpose of this quantitative cross-sectional study was to determine whether the constructs of SCT predict betel nut use in Year 12 secondary students in the Solomon Islands. Five SCT constructs of expectations (outcome expectations and outcome expectancies), self-efficacy, …

Predictors Of Intention To Use Health Literacy Strategies Among Physicians In Grenada, Arlette Wildman

Walden Dissertations and Doctoral Studies

Low health literacy is linked to poor health outcomes. Adequate health literacy depends on effective communication between patients and their healthcare providers, so it is important physicians use health literacy strategies. Grounded in the theory of planned behavior, the aim of this quantitative correlational study was to investigate the relationship between health literacy knowledge, health literacy experience, gender, the region of training, years of practice, and intentions to use health literacy strategies among physicians in Grenada. One hundred and eighteen physicians were sampled using a cross-sectional survey method. The results of the multiple linear regression analysis were significant, F(5, 112) …

Predictors Of The Health Effects Of Marijuana Use On The Hepatic Function, Makafui Kokou Gbogbo

Walden Dissertations and Doctoral Studies

The quantity of marijuana use, the length of time it was used, and the age of initiation of the drug are at the core of the discussions about the potential health effects of marijuana use on the liver. Results of recent studies regarding how the drug affects human health have resulted in a number of conflicting conclusions. Nevertheless, based on these findings, marijuana users are being denied liver transplants. The objective of this study was to identify predictors of the health effects of marijuana on the liver and provide guidance in the care management of marijuana users. To address the …

Behavioral, Demographic, And Clinical Determinants Of Hiv Serostatus In Zambian Women, Debebe Masresha Gebreyohannes

Walden Dissertations and Doctoral Studies

The rate of human immunodeficiency virus (HIV) infection shows a diminishing trend at the global level while it shows increasing in intensity of mortality, morbidity, and burden in Sub-Saharan Africa. The intertwined behavioral, demographic, and clinical determinants fueled the incidence of infections in Zambian women. The purpose of this study was to determine the association between demographic, behavioral, and clinical determinants with HIV serostatus in Zambian women. With the conceptual framework of the World Health Organization’s Commission for Social Determinants of Health (CSDH) and quantitative method of MANOVA, this study examined Zambian Demographic Health Survey data for Zambian women of …

Perceptions Of Physician Influence On Healthcare Accessibility, Samuel N. Jacobs-Abbey

Walden Dissertations and Doctoral Studies

A significant portion of the U.S. population across the country has limited access to quality healthcare; however, this situation is more pronounced in rural areas. One potential solution is for healthcare practitioners to move their services to underserved rural areas to improve healthcare coverage. No previous studies have explored the perceptions of practitioners regarding their influence on healthcare access, particularly the potential impact of moving healthcare services to underserved areas. Thus, the purpose of this research was to address this gap. A qualitative phenomenological approach was adopted. A sample of 24 participants was selected using purposive sampling, from the target …

Impact Of Race-Related Stress And Intraracial Microaggressions On Self-Efficacy Of African Descendants, Samina Long

Walden Dissertations and Doctoral Studies

Race-related stress such as ancestral trauma and experiences of out- and in-group microaggressions can be intergenerationally transmitted from parent to child. The current study was conducted to address the need for research on race-related trauma and out- and in-group discrimination by providing evidence-based research on whether African descendants experiencing and witnessing race-related stress and intraracial microaggressions results in low self-efficacy. The purpose of this quantitative, multiple regression design was to explore the relationships among race-related stress, intraracial microaggressions, and self-efficacy, which may provide clarity on the psychological impact of these stressors. This study addressed the question of whether race-related stress …

Impact Of Education On Hiv Testing Among African American Women In The United States, Florence Matimbah Mbangowah

Walden Dissertations and Doctoral Studies

Improved and increased human immunodeficiency virus (HIV) testing among African American women in the United States could facilitate early detection of the virus. The purpose of this cross-sectional quantitative study was to determine if there was a significant association between HIV testing participation and education level (i.e., high school, college, post-college level) based on access to healthcare after accounting for insurance, income, employment, marital status, English language proficiency, and vision quality. The integrated theory of health behavior change, the theoretical framework used for this research, proposes that changes in health behavior can be improved by various factors such as fostering …

The Association Between Provider Cultural Competence And Type 2 Diabetes Health Behaviors, Bernadette Joyce Mejia-Tran

Walden Dissertations and Doctoral Studies

Provider cultural competence is poorly understood in relation to the outcome of Type 2 diabetes patient health behaviors. The purpose of this study was to examine the association between provider cultural competence and diabetes patient health behaviors. The chronic care model provided the conceptual framework for this study. The research questions were designed to determine whether 5 measures of provider cultural competence play a role in diabetes patient health behavior change. The research design of the study was a quantitative cross-sectional survey using the 2017 National Health Interview Survey. The 2,342 participants included in the study represent a national sample …

Prevention Practices And West Nile Virus Infection Among Ethnic Minorities, Texas, Bayabel Debebe Mengistu

Walden Dissertations and Doctoral Studies

Abstract

West Nile virus (WNV) is a major public health problem and the cause of nearly 25% of the world's economic burden of disease. While the risk factors for developing West Nile fever and West Nile disease from WNV infection have been identified, it is not known how knowledge, attitude, behavior (KAB), access to health care (AHC), and comorbidities are associated with prevention practices of WNV infection among ethnic minorities. The aim of this study was to examine the association between KAB, AHC, comorbidities, and prevention practices of WNV infection among ethnic minorities in Texas. KAB, AHC. Comorbidities were used …

Planned Behavior And Congolese Physicians’ Practice: Predicting Advanced Preventive Health Services Provision, Jean-Clément Milabu Mumbusi

Walden Dissertations and Doctoral Studies

The provision of preventive services, health promotion, and health maintenance has become the cornerstone of primary care practice in the United States and other Western countries to prevent morbidity and premature mortality and to increase the quality and years of a healthy life. Unfortunately, the delivery of these advanced preventive health services (APHS) has been sporadic in the Democratic Republic of Congo, a country with poor health indicators. The purpose of this cross-sectional mixed-method study was to apply Ajzen’s theory of planned behavior (TPB) to predict the intention of Congolese primary care physicians (PCPs) in the provision of APHS. Using …

The Relationship Between Practice Environment, Role Overload And Job Satisfaction Of Nurses In Canada, Olabisi Amao Olaniyan

Walden Dissertations and Doctoral Studies

Abstract

The shortage of nurses is a global phenomenon. The problem is particularly pronounced in rural areas and contributes to the health disparities experienced in the healthcare sector. Many factors had been shown to adversely impact the recruitment and retention of nurses, most especially in the rural areas. No study has examined how some factors such as the practice environment variation; geographical locations; and role overload impact job satisfaction of nurses. The Herzberg two-factor theory, with constructs of Motivation and Hygiene factors guided the study. In this quantitative, cross-sectional study, correlational approach was used to examine the association between the …

Staff Education On Type 2 Diabetes Mellitus, Joan P. Williams

Walden Dissertations and Doctoral Studies

Diabetes mellitus is a major health concern that affects the physical and financial facets of communities. During the past 4 years, a multidisciplinary health care clinic in a northern state reported an increase in the number of type 2 diabetes (T2D) patients. Forty-three percent (43%) of adults with T2D had an elevated glycated hemoglobin A1c of 7.5% or higher. Yet, the staff at the clinic lacked current knowledge of T2D, quality of care, and prevention strategies for patients with T2D. This resulted in increased serious health care issues, associated costs, and increased complications of the patients with T2D. The purpose …

Practitioners’ Perceptions Of Medical Compliance Among Homeless Clients With Hiv And A Mental Health Diagnosis, Kyle Samuel Berkley

Walden Dissertations and Doctoral Studies

Previous research on HIV medical adherence has focused on incentive-based interventions, while previous research with the chronically homeless has focused on substance abuse, mental illness, and health disparities. This qualitative study focused on the experiences and perceptions of medical providers in a metropolitan area who work on medical adherence with homeless people living with HIV and mental illness. Ecological systems theory provided foundation to explore how medical providers form interventions based on clients’ ecosystems. The data were collected via audio-recorded, semi-structured interviews with 15 case managers, mental health therapists, nurses, and primary care physicians who worked at outpatient medical centers. …

Medical Skepticism And Diabetes Management In African Americans, Pamela Bouyer

Walden Dissertations and Doctoral Studies

Type 2 diabetes (T2DM) in African Americans is a manageable disease, and self-management interventions reduce complications and hospital stays. However, in the African American population, traditional T2DM self-management interventions do not produce long-term effects on lifestyle and behavior changes. Researchers have analyzed the barriers and interventions associated with the disease, but the problem still exists. Medical skepticism may influence T2DM management and health outcomes in African Americans. However, there is scarce literature addressing the relationship between medical skepticism and health outcomes (eye and kidney problems). The purpose of the study is to assess the relationship between medical skepticism and outcomes …

Health Literacy And Health Beliefs With Adherence To Antihypertensive Medications In An Urban African American Cohort, Karen Ranae Dukes

Walden Dissertations and Doctoral Studies

African Americans aged 40 to 65 are more likely to be diagnosed with hypertension, and adherence to prescribed antihypertensive medication regimens is important in controlling their blood pressure levels. The purpose of this quantitative study was to examine the relationship between health literacy and sociodemographic and clinical factors with adherence to antihypertensive medications among African American adults. The theoretical framework for this study was the health belief model. A quantitative research design was used with participants recruited from churches with African American congregations in the city of Detroit. A convenience sampling method was used to obtain a sample of 79 …

Social And Ecological Determinants Of Physical Activity For Youth With Cerebral Palsy, George E. Gorton

Walden Dissertations and Doctoral Studies

Physical inactivity is a leading cause of morbidity and mortality, increasing risk for noncommunicable disease and compromised physical, social, and mental health. However, fewer than 20% of U.S. youth meet physical activity guidelines; youth with disabilities are even less active. Physical activity is influenced by personal, family, social, organizational, community, and environmental factors acting within a social-ecological framework. To what extent is not well understood. The purpose of this study was to determine the extent to which social and ecological factors are associated with participation of youth with cerebral palsy in physical activity. The research design was a cross-sectional, quantitative …

Clostridium Difficile Incidence In Acute Care Hospitals: Patient And Hospital Characteristics, Angela Nwachuku

Walden Dissertations and Doctoral Studies

Hospital acquired infections (HAIs) calls for the attention of public research because it allows for investigation of the health practices, resources, and barriers of different health facilities and their surrounding communities. This research study examined the relationship between hospital acquired clostridium difficile infection (CDI) and patient, socioeconomic, and hospital characteristics in the state of New Mexico to determine their correlation with the increased incidence of CDI between 2013 and 2015 and if significant differences exist. The research questions were explored with the implication of the fundamental cause model and the pathways model. New Mexico patients over the age of 18 …

Men’S Knowledge And Perceptions Of Cervical Cancer: Influence Upon Increase In Cervical Cancer Screening In Rural Kenya, Lydia Oriko

Walden Dissertations and Doctoral Studies

Many facilities in Kendubay, Kenya offer cervical cancer screening and treatment services, yet many women in this rural community do not undergo screening. This lack of preventive care may be attributable to lack of support from men in the community. There exists a gap in the literature concerning the knowledge and perceptions of men about cervical cancer and related screening procedures. The purpose of this qualitative study was to describe the knowledge and perceptions of men in the community about cervical cancer and screening, and how men’s knowledge and perceptions influence women to undergo cervical cancer screening. The study used …

Process, Factors, Resources, And Health Consequences Of Burnout In Psychiatrists, Brittany Elise Plaven

Walden Dissertations and Doctoral Studies

Burnout among psychiatrists in the United States is prevalent; however, scholarly literature lacks studies exploring why psychiatrists are burnt out, what resources mitigate burnout, and the health implications of burnout, which is needed to improve health education programs for psychiatrists. Understanding the reasons for psychiatrist burnout, the resources that can mitigate burnout, and the health implications of burnout provided the purpose for this dissertation and foundation for the four research questions. The multidimensional theory of burnout, job demands-resource model, and the conservation of resources theory grounded the study. A qualitative, exploratory, multiple case study was conducted using data gathered from …

Breast Cancer Knowledge, Attitude, And Screening Practices Among Hispanic/Latino Women, Harrindra Seepersaud

Walden Dissertations and Doctoral Studies

Nearly 1 out of every 8 women will develop breast cancer during her lifetime, making breast cancer the most common noncutaneous malignancy in women, particularly among the Hispanic/Latino population. Hispanic/Latino women are more likely than non-Hispanic/Latino women to be diagnosed with breast cancer after the disease has progressed to a fatal stage. This quantitative study measured how knowledge, attitude, and screening practices affect the prevalence and outcomes of breast cancer cases among Hispanic/Latino women while controlling for socioeconomic status factors, using social cognitive theory as a framework. This research uses secondary data analysis of a cross-sectional survey study, the 2014 …

Sociodemographic Factors, Culture, And Suicide In Guyana, Kay Shako

Walden Dissertations and Doctoral Studies

Suicide in younger populations is a major public health concern and it significantly impacts third world countries like Guyana. Some challenges related to suicide are poor recording of suicide risk factors and customized prevention programs to address this significant issue. The purpose of this study was to examine which sociodemographic factors (age, gender, occupation, method of suicide, and region) are associated with suicide and method of suicide among people aged ≥ 15 years in Guyana. Also, because studies show that culture plays a pivotal role in suicide, this study investigated if there is a link between culture (ethnicity/race and religion) …

Childhood Obesity: The Healthy, Hunger-Free Kids Act And School-Aged Children, Frankie Jean Alstin-Brooks

Walden Dissertations and Doctoral Studies

Obesity among children in America is at an all time high, 57.3% of the nation’s children will be obese by the age of 35. The purpose of this study was to examine the effectiveness of the Healthy, Hunger-Free Kids Act (HHFKA) policy. The HHFKA modified the nutritional and physical policies in order to reduce the obesity rates by changing their expenditures. Schools in all 50 states that are subject to federal, state and local nutrition regulations were researched. This was a quantitative, non-experimental, correlation study that measured state compliance with the USDA guidelines and tested for an association between compliance …

Suicidal Ideation, Suicidality, And Hiv/Aids Infection Or Diagnosis Among Asian American Sexual Minorities, Francis Azih Ngene

Walden Dissertations and Doctoral Studies

Asian American men who have sex with men (MSM) are an understudied minority. They are particularly affected by HIV/AIDS and are also impacted by psychosocial and mental health factors of depression, substance use, drug use, and alcohol use/abuse, any of which may lead to suicidal ideation and suicidality. These associations have not been widely studied in this population. The purpose of this quantitative study was to use the 2015 National Survey on Drug Use and Health data to examine these psychosocial and mental health issues and their association with suicidal ideation, suicidality, and HIV/AIDS infection or diagnosis among Asian American …