Public Health Education and Promotion Commons^™

The Effects Of Vesico-Vaginal Fistula In The Lives Of Women In Southeastern Nigeria, Chioma Esther Amutaigwe

Walden Dissertations and Doctoral Studies

Vesico-vaginal fistula (VVF) is a maternal health problem faced by women in developing countries. VVF is one of the most devastating consequences of prolonged obstructed labor and is still prevalent in resource-poor countries like Nigeria where fertility is high, the status of women is low, and obstetric services are often inadequate. The objective of this study was to enrich our understanding of the effects of VVF as it relates to women’s experiences in southeastern Nigeria. I adopted the Transactional Model of Stress and Coping in this study; this theory posits that people, when contending with any kind of stressors, are …

Personal Hardiness As An Unexamined Component Of The Healthy Volunteer Effect, Angelique E. Blann

Walden Dissertations and Doctoral Studies

Clinical trials are the standard for approving medicines for public use. To conduct trials, researchers depend on a declining number of volunteers. The healthy volunteer effect, a phenomenon in which participants demonstrate better outcomes than their peers, limits the generalizability of trial outcomes. The healthy volunteer effect does not fully explain the outcome difference between volunteers and nonvolunteers. The purpose of this cross-sectional quantitative study was to examine personal hardiness as an unexplored component of the healthy volunteer effect and determine whether personal hardiness is associated with willingness to participate. Hardiness was a personality construct that represented resilience to stress. …

Implications Of Lgbtq Identity On Help-Seeking In College Students, Matthew T. Allen

Murray State Theses and Dissertations

LGBTQ individuals find themselves experiencing both mental and physical health concerns at disproportionate rates than cisgender and heterosexual individuals. However, LGBTQ individuals have been shown to seek help for these concerns. Studies examining this phenomenon on college campuses have focused predominantly on mental health concerns. This study hoped to look at both physical and mental health concerns and determine the implications of an LGBTQ identity on help-seeking behavior in college students. The study utilized quantitative research methods through targeted snowball sampling on social media and email. At the conclusion of the collection period, 61 participants completed a survey that included …

Association Of Income, Education, Employment And Covid-19 Mortality In Brazil, Marcelina Machado

Walden Dissertations and Doctoral Studies

The increased mortality rates from COVID-19 in Brazil have adversely affectedvulnerable populations and placed a severe burden on its public health system as compared to other nations. Focusing on socioeconomic status as a risk factor in this retrospective cohort study, I investigated the association between Brazilian COVID-19 mortality rate, income, school enrollment rate, and employment rate after controlling for the demographics and immunization rate. This is an important issue as an increase in incidence and mortality rates affects how governmental and public health leaders can effectively control and prevent disease spread. Using the fundamental causes of disease theory as the …

Comparative Study Of Risky Sexual Behaviors In African American Adolescents Who Use Drugs And Alcohol, Angela Matthew

Walden Dissertations and Doctoral Studies

Sexually transmitted infections (STIs) are a major public health problem in the United States. Adolescents are a high majority of these cases, with African American adolescents being affected disproportionally. Previous research has shown that risky sexual behaviors, such as non-condom use, multiple sexual partners, early initiation of sexual intercourse, and alcohol or marijuana use before sexual intercourse put adolescents at a higher risk of contracting an STI when they are sexually active. These behaviors can be observed through the theoretical framework of the problem behavior theory that describes the constructs of why individuals engage certain behaviors. How alcohol and drug …

Health Education Needs For Mortality Surveillance In Machakos County, Kenya, James S. Mwanza

Walden Dissertations and Doctoral Studies

Reporting mortality information is the primary data source from which evidence can be drawn to monitor disease trends and inform public health policy to improve population health. Still, only two-thirds of expected annual deaths are reported globally. Health education and promotion play a significant role in empowering communities to uptake public health services such as mortality surveillance. This qualitative descriptive study aimed to understand health workers’ (HWs’) perspectives regarding the need for health education to support mortality surveillance in Machakos County, Kenya. The capabilities, opportunities, and motivation for the behavior change model guided the study. Semi-structured interviews were used to …

Predictors Of Retention Among Individuals With Hiv Initiating Antiretroviral Therapy In Ghana, Ivy Ama Okae

Walden Dissertations and Doctoral Studies

Abstract Managing HIV requires lifelong therapy. Retaining clients on lifelong therapeutic antiretroviral therapy (ART) ensures the suppression of viral replication and better health outcomes. The time of the start of ART management is also a factor in determining better health outcomes for persons living with HIV. This study examined the association between initiation criteria (treat all, Option B+, and CDC T-cell count < 500) and retention on ART at 12 months for 17,974 randomly selected clients in the Ghana Health Service's HIV patient electronic database. Analyses controlled for age, gender, educational status, alcohol use, treatment/adherence monitoring, and tuberculosis disease treatment. Bronfenbrenner's ecological systems theory guided the interpretation of the findings. Results shows that retention was positively associated with all treatment initiation criteria. Clients initiated with CD4 count ≤ 500 criteria seemed to be retained at 12 months on ART at a higher rate than initiation criteria based on Option B+ and treat all. The study results may contribute to positive social change by supporting CD4 testing for clients before initiation of ART to improve retention and ensure the availability and use of adherence counseling, no tuberculosis disease and its prevention, and low use of alcohol among people living with HIV. The results of this study may also provide opportunities for public health policy intervention efforts requiring a personalized, group-based approach to service delivery at the intrapersonal level, interconnected with interpersonal, meso, and meta factors at the community level.

Issues Encountered By Parents In Continuing School-Based Obesity Prevention Programs At Home, Prenu Skaria

Walden Dissertations and Doctoral Studies

Childhood obesity is a public health problem that can lead to various chronic health diseases such as cardiovascular disease and diabetes later in life. School-based obesity prevention programs are a public health recommendation to reduce and prevent obesity in schools through increased physical activity and better nutritional habits. This qualitative research involved exploring the reason for the discontinuation of school-based interventions at home using multi-theory model (MTM) constructs for health behavior change. A convenience sample of three focus groups of consenting parents whose children participated in the Wolf Pack Coaches Challenge (WPCC), a school-based obesity prevention program in Nevada, was …

Community Perceptions Of Syringe Service Programs In Charleston, West Virginia: A Qualitative Socioecological Perspective, Kenya M. Burton

Walden Dissertations and Doctoral Studies

In rural areas of the United States, people who inject drugs (PWID) experience an array of obstacles to accessing adequate healthcare. Locations with high rates of drug use normally offer more healthcare options, including needle exchange programs but, in some communities, there is resistance to providing this kind of care. This increases mortality, morbidity, cost, and adds to the stigma experienced by this vulnerable group. The experiences of people with substance dependency, including PWID, has been widely explored throughout studies that reflect a need for increased support. However, the perspectives of the community, especially in rural areas, though equally important, …

Internal Population Displacement And Vaccination Completion, Malnutrition, And Respiratory Infections Among Children In The Central African Republic, Francois Xavier Batalingaya

Walden Dissertations and Doctoral Studies

Forced displacement in fragile and conflict-affected countries has the potential to disrupt access to basic primary healthcare services such as immunization. The purpose of this study was to assess the association between internal population displacement and vaccination completion, malnutrition, and acute respiratory infections (ARIs) while controlling for maternal characteristics of wealth index, education level, and residence status in the Central African Republic. The socioecological model underpinned this cross-sectional study that used a secondary dataset collected in 2018 – 2019 and maintained by UNICEF. Descriptive statistics and logistic regression tests were used to analyze the data. The findings of this study …

Self-Care And Psychosocial Factors That Predict Sickle Cell Disease-Related Outcomes Among African Americans In The Usa, Datonye Agina-Obu

Walden Dissertations and Doctoral Studies

Existing beliefs and conceptions regarding sickle cell disease (SCD) have had a significant impact on the appropriate management of the condition, including self-care and psychosocial factors, particularly among African Americans. The aim of this study was to examine the influence of self-care and psychosocial factors on SCD-related outcomes among African Americans in the United States. The study was grounded in the self-care management theory and employed a cross-sectional, quantitative design. Regression analyses were conducted to explore the associations between self-care and psychosocial factors and SCD-related outcomes sample of 180 individuals. The results indicated three factors showed significant relationships for sickle …

Role Of Racially Concordant Patient-Physician Relationships In Health Outcomes Among African American Women, Joy Thomas

Walden Dissertations and Doctoral Studies

Abstract There are gaps in the literature regarding how patient-physician racially concordant relationships affect African American women’s health. This quantitative study evaluated the effects of non-minority physician influence on the perceptions of medical mistrust, racial discrimination, and healthcare-specific racial discrimination on African American women. The behavioral model for vulnerable populations guided the study. Two research questions involved understanding the relationship between trust in the physician scale and medical mistrust and the association between racial discrimination and perceived healthcare-specific racial discrimination among African American women living in a Southern U.S. state. A stratified random sampling strategy was used to obtain a …

Physical Activity Promotion, Assessment, And Engagement In Clinical Settings In The United States, Kristin A. Grogg

Graduate Theses, Dissertations, and Problem Reports (ETD)

Physical inactivity is an important contributor to morbidity and all-cause mortality and the 2018 Physical Activity Guidelines Advisory Committee recommended that physicians increase their role in physical activity assessment and promotion to combat physical inactivity and related comorbidities. Healthcare providers are increasingly called upon to initiate physical activity promotion with their patients to manage conditions like obesity, diabetes, and cardiovascular diseases. Still, recent reports indicate that less than half of primary care visits include some type of physical activity promotion. Although the National Physical Activity Plan includes some recommendations for clinicians and the healthcare sector on physical activity promotion, it …

Association Between Childhood Obesity And Cerebral Palsy, Down Syndrome And Epilepsy Or Seizure Disorder, Stephanie Swanson

Walden Dissertations and Doctoral Studies

The purpose of this quantitative correlation study was to examine the association between childhood obesity (dependent variable) and cerebral palsy, Down Syndrome, and epilepsy and seizure disorders (independent variables), while controlling for the child’s age, race, and sex among United States children ages 0-17, as well as the guardian’s education and income levels. There are many studies related to childhood obesity; however, few focus on the independent variables in the current study in relation to overweight children. The Social Cognitive Theory (SCT) was used to understand and interpret the research findings. Secondary analysis of data was conducted using the National …

Assessment Of Factors That Affect Men’S Access And Utilization Of Tuberculosis Services In Zululand District In South Africa, Maureen Fatsani Tshabalala

Walden Dissertations and Doctoral Studies

Tuberculosis (TB) remains the leading cause of death in South Africa, with higher mortality rates among men compared to women, despite the availability of free TB services and a reduction in TB death rates. However, research on the factors influencing men's access to and utilization of TB services is limited. The purpose of this study was to assess the factors affecting men's geographical access and quality utilization of TB services in the Zululand district of KwaZulu Natal province, South Africa. A survey questionnaire was used to collect data from 200 men recruited from selected primary health care facilities. Andersen's model …

Lived Experience Of Women Veterans Navigating The Veteran Healthcare System, Candance Willett

Walden Dissertations and Doctoral Studies

Many women veterans who navigate the Veterans Affairs (VA) healthcare system across the United States have felt that their voices have not been heard regarding their input and lived experiences concerning inclusion to the quality-of-care delivery for their health needs. The purpose of this study was to explore the lived experiences of women veterans who were currently facing or had previously faced difficulty navigating the VA healthcare system. The framework used for this qualitative study was interpretive phenomenological analysis. The qualitative method used was hermeneutics which was designed by Edmund Husserl and Martin Heidegger. Semi structured interviews were of 12 …

Sun Exposure And Protective Behaviors Among U.S. Hispanic Farmworkers, Claudia Marie Delgado Cebollero

Walden Dissertations and Doctoral Studies

Sun exposure increases the risk of sun-related illnesses and skin cancer among U.S. Hispanic farmworkers. Reinforced by the health belief model, the purpose of this study was to determine the association between socio-demographic factors (i.e., age, educational attainment, gender, income, and marital status) and skin cancer with the level of sun exposure (sun’s effect on skin, sunburn reported) and protective behaviors (use of cap/visor, use of sunscreen) among adult Hispanic farmworkers in the United States. The study included Hispanic farmworkers aged 21 or older (N = 112) who responded to the 2015 National Health Interview Survey. Ordinal logistic regression showed …

Tuberculosis-Associated Knowledge, Stigma, And Health Seeking Behavior Among Traders In Onitsha Main Market, Anambra State, Nigeria, Benedeth N. Ezeosim

Walden Dissertations and Doctoral Studies

The utilization of tuberculosis (TB) health care services in a Nigerian state has not been optimal. Many residents do not utilize available health care resources when they experience symptoms of TB. Although much is known about the determinants of health seeking behavior (HSB), there is a gap on how TB knowledge and TB related stigma among traders in one main market contribute to HSB. This study examined the effect of TB knowledge and TB related stigma on HSB among traders. The health stigma and discrimination and health belif models served as the theoretical foundation. A quantitative cross-sectional analytical survey design …

Experiences Of Women Faculty Using Meditative Practices Through Workplace Health Promotion In Ontario, Kelly Lynn Henley

Walden Dissertations and Doctoral Studies

Workplace stress is pervasive and changes to the postsecondary teaching and learning environment have contributed to stress among women faculty and adversely impacted their personal well-being. The purpose of this qualitative study was to understand how the constructs in the health belief model (HBM) play a role in the use of worksite wellness initiatives to manage stress and promote wellness among women postsecondary faculty in Ontario. The research questions were designed based on the HBM to examine the participants’ perceptions of severity and susceptibility to workplace stress, perceived benefits and barriers to participation, motivation to participate, and self-efficacy. Women faculty …

Predictors Of Psychoactive Substance Abuse Among Eastern Nigeran Youth, Kingsley Chidiebere Izuka

Walden Dissertations and Doctoral Studies

AbstractPsychoactive substance (PAS) abuse is a major public health problem leading to increased morbidity and mortality. In Nigeria, the incidence rate of PAS abuse has remained high, particularly in the youth population. The purpose of this study was to examine the influence of social factors and school enrollment status on PAS abuse in youth in Southeast Nigeria. The social ecological model and the theory of reasoned action were the theoretical frameworks used for this study; they were selected due to their focus on multiple levels of factors that influence behavior. A quantitative cross-sectional study design approach was used to determine …

The Effects Of Vesico-Vaginal Fistula In The Lives Of Women In Southeastern Nigeria, Chioma Esther Amutaigwe

Walden Dissertations and Doctoral Studies

Vesico-vaginal fistula (VVF) is a maternal health problem faced by women in developing countries. VVF is one of the most devastating consequences of prolonged obstructed labor and is still prevalent in resource-poor countries like Nigeria where fertility is high, the status of women is low, and obstetric services are often inadequate. The objective of this study was to enrich our understanding of the effects of VVF as it relates to women’s experiences in southeastern Nigeria. I adopted the Transactional Model of Stress and Coping in this study; this theory posits that people, when contending with any kind of stressors, are …

Food Insecurity On College Campuses: Addressing The Issue Through A Student-Centered Perspective, Thomas Ard

Theses and Dissertations--Kinesiology and Health Promotion

Research indicates food insecurity (FI) has become a consistent challenge for college students. However, more is needed regarding the students' lived experiences of food insecurity following the COVID-19 pandemic. Universities play a vital role in assisting students with food insecurity through food assistance programs, on-campus resources, and financial help, which impacts their physiological needs and academic performance. A better understanding of what influences students' perceptions and decisions about whether to engage in these resources is essential.

This dissertation's purpose was to explore how college students living with food insecurity experience engaging in food assistance programs (FAP). The study used a …

Risk Factors Associated With The Development Of Type Ii Diabetes-Related Complications, Jessica Danielle Lucas Williams

Walden Dissertations and Doctoral Studies

By 2040, it is estimated that 642 million people ages 20 to 79 will have Type II diabetes, thereby making it a heavily studied topic among scholars. As more people are diagnosed with Type II diabetes each year, the literature is slowly shifting to long-term complications. However, the many risk and protective factors that exist have created gaps in the literature. The purpose of this study was to determine the relationship between participation in diabetes self-management classes, mental health, physical health, BMI, smoking status, exercise, and possible diabetes complications (diabetes-related retinopathy and diabetes-related kidney disease). The gap in the literature …

Moderators Of Peripheral Neuropathy On Overall And Cardiovascular Mortality In People Without Diabetes, Adeoye Muideen Adenekan

Walden Dissertations and Doctoral Studies

Peripheral neuropathy (PN), a group of common heterogeneous disorders with varied etiologies, is associated with substantial morbidity and mortality. PN presents both as a diagnostic and therapeutic challenge to physicians and other healthcare providers. Socioeconomic moderators of PN in adults without diabetes in the United States have not been well studied. The consequences of PN can be devastating and include foot ulcers, amputations, a general decline in the quality of life, and death. The overall prevalence of PN in the United States is 13.5% in adults with diabetes and 11.6% in adults without diabetes. Clearly, these statistics indicate a public …

Risk Factors Influencing Poliomyelitis Seroprevalence In Polio High Risk Areas Of Afghanistan, Wasan Abdulaziz Al-Tamimi

Walden Dissertations and Doctoral Studies

Afghanistan is one of the remaining polio endemic countries in the world. Nearly one million children under 5 years of age have missed polio vaccination in Afghanistan from May 2018 until January 2021. This quantitative study used the socioecological model as the theoretical framework and secondary data analysis of the 2020 polio serosurvey (N = 1384) to investigate various risk factors such as gender, parental education, family origin (language/location), wealth, distance to nearest health facility, and number of polio vaccine doses on the level of antibodies (i.e., seroprevalence) against all three types of polioviruses in children of two age groups, …

Sexual Violence And University Campus Response To Sexual Violence, Jennifer Bivins

Walden Dissertations and Doctoral Studies

While anyone can be a victim of sexual violence, college-aged females between the ages of 18 and 21 are more likely to be victimized than any other group. Sexual violence continues to be a barrier to education, and colleges/universities make it challenging for students to report on campus. The purpose of this study is to explore the factors, intervention/prevention strategies, and policies/procedures used to address sexual violence on a university campus. The framework used was the ecological model, which focuses on factors and influences within the environment that affected individual behavior. The research questions focused on participants describing their experiences …

Association Between Psychosocial, Obstetric, And Lifestyle Factors And Antenatal Depression, Tomnema Xiong

Walden Dissertations and Doctoral Studies

Antenatal depression, or depression during pregnancy, is a mental health concern in the United States that impacts mothers and their infants. This study examined the associations between psychosocial, obstetric, lifestyle factors, and antenatal depression. This study was guided by social cognitive theory, specifically the reciprocal determinism construct. Secondary data from the 2007–2018 National Health and Nutritional Examination Survey (NHANES) were used in this quantitative cross-sectional study. Every participant of the NHANES completed the Patient Health Questionnaire-9 depression screening form. The study sample consisted of 274 women who were pregnant at the time of participating in the NHANES, approximately 28.8% of …

Help-Seeking Behavior Of African American And Non-African American Victims Of Elderly Abuse, Tesfaye Yigletu Wosene

Walden Dissertations and Doctoral Studies

Elderly abuse is a pervasive public health problem in the United States. Most abuse and neglect go unreported due to barriers including fear for safety, concerns about the consequences, culture, lack of knowledge about elder abuse, shame, and self-blame. However, there is limited research on how race and ethnicity impact help-seeking behaviors of the elderly. This cross-sectional quantitative study examined the difference in reporting and help-seeking behavior between African American and non-African American victims of elderly abuse. Applying the behavioral model of health services use, this study involved a secondary data analysis using the Nation Elderly Mistreatment Study Wave II …

Retention Of Foster Parents For At-Risk Youth In Tennessee, Marvin Amos

Walden Dissertations and Doctoral Studies

Federal legislation with the Family First Prevention Service Act (FFPSA) of 2017 required Tennessee to increase foster parent retention strategies. Tennessee does not have enough available foster homes for adolescents. The purpose of this generic qualitative study was to explore foster parent retention in Tennessee and to inform policymakers on how to adapt policy to increase the retention. The theoretical foundation for this study was based on the policy feedback theory, to identify the policy scope in Tennessee, and the two-factor theory, to guide the data analysis in the context of employee satisfaction and retention measures. Purposive sampling techniques were …

Health Literacy, Race, And Understanding Health Information Among Women, Adrienne Clark

Walden Dissertations and Doctoral Studies

Health literacy is a topic often referred to by public health professionals to help improve the health of a population. This study used a quantitative approach to understanding health information among women of different races, income levels, household sizes, and education levels within a specific age range. This study used the socio-ecological model for its framework. The overall goal of this study was to improve health disparities and improve health communication one population at a time. Women tend to be the pillar of communities. Having a better understanding of how women understand health information could improve public health outreach. The …