Public Health Education and Promotion Commons^™

Adverse Childhood Events And Protective Health Behaviors Among Adults With Diabetes Or Diabetes With Comorbid Heart Disease, Ciara Michelle Rukse

Walden Dissertations and Doctoral Studies

Diabetes is a prevalent and costly chronic condition that can lead to other comorbid conditions such as heart disease. Disease management is essential but can be stressful and complicated, especially for individuals who have developed maladaptive behaviors in response to exposure to adverse childhood events (ACEs), which are chronic stressors that impact physiological and psychological development. There is limited research on the potential relationship between childhood adversity and engagement in protective health behaviors among U.S. populations with diabetes or diabetes with comorbid heart disease. The ACEs pyramid was the theoretical framework of this quantitative cross-sectional study concerning morbidity and early …

Effective Management Of Diabetes Mellitus Type Ii In A Military Treatment Facility, Jozy Merizier Smarth

Walden Dissertations and Doctoral Studies

In the United States, 34 million people have diabetes and 79 million have prediabetes. Currently, one in nine Americans are diagnosed with diabetes and it is projected that one in five will have diabetes by 2025 and one in three by 2050. The practice-focused question answered by this project addressed the question if implementing a staff education program improved staff’s knowledge about self-management education and intent for providers and staff to promote a formal diabetes self-management education (DSME) program in an overseas military treatment facility. The site has 47% of empaneled beneficiaries with diabetes mellitus Type II with an elevated …

California’S Urban And Rural Asthma Healthcare Access And Asthma Management During Covid-19 Pandemic, Stacey R. Varga

Walden Dissertations and Doctoral Studies

A lack of adequate healthcare access can negatively affect asthma management. The purpose of this study was to understand whether there was an association between source of care and asthma management. This study provides important insights concerning the changing landscape of how individuals receive asthma treatment and manage their asthma during a pandemic. Asthma management and asthma care have been studied; however, results have been inconclusive in relation to the barriers to health that are experienced among various adult age groups. Identifying additional subgroup characteristics could provide insight into where health practitioners, practice management, and policymakers direct healthcare resources. The …

Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo

Walden Dissertations and Doctoral Studies

Pharmacotherapy is a significant component of chronic disease management; its efficacy depends on long term, correct, and consistent use; however, medicine adherence rates remain low. The cost of medicines is considered a significant barrier to adherence, especially in low-income settings. This quantitative cross-sectional study was conducted using data from Cimas Medical Aid Society collected between 2015 and 2019. The purpose of the study was to determine the extent of the association between medicine adherence, complication development, and cost of care among diabetic and hypertensive patients while controlling for age and gender on a population that does not experience cost barriers …

Educating Nursing Staff On Clostridioides Difficle Infection Bundle Use, Amber Lee Winkis

Walden Dissertations and Doctoral Studies

Clostridioides difficile infection (CDI) is a local, national, and global issue impacting patient outcomes and healthcare organizations. CDI is costly to treat, painful, and at times deadly. Given an increase in CDI over the past year at the project site, the current gap in practice is the nonadherence of nursing staff to using a CDI bundle. This project addresses that gap. The practice-focused question targeted at nursing staff (N = 18) on an adult medical-surgical unit in an acute care hospital and asks whether education on use of a CDI bundle would result in a knowledge gain about the importance …

Let My People Go:Improving Nurses’ Knowledge To Decrease Physical Restraint Use, Trisha Marie Zehrung

Walden Dissertations and Doctoral Studies

Despite extensive research revealing the dangers of physical restraint use, it remains a common practice in critical care settings across the globe. Nurses stand at the forefront of clinical decision-making regarding the use of physical restraints but are doing so with a lack of education and evidence-based practices. The project addresses whether an evidence-based educational program regarding the use of physical restraints and alternative measures is an acceptable method for intensive care unit (ICU) nurse education according to six local subject matter experts (SMEs). The project’s purpose was to create an educational program outlining physical restraint evidence and alternative measures …

Comparative Effectiveness Study Of Acute Ischemic Stroke Care Between Stroke Belt And Non-Stroke Belt Hospitals Using The Get With The Guidelines-Stroke Program, Michael Earl Brown Jr

Walden Dissertations and Doctoral Studies

Stroke is a leading cause of mortality in the United States, particularly in a cluster of states termed the stroke belt. This study examined the efficacy of the Get With The Guidelines (GWTG)-Stroke program in stroke belt hospitals (SBHs) compared to non-stroke belt hospitals (NSBHs) regarding disparities related to mortality and acute ischemic stroke (AIS) treatment (i.e., recombinant tissue-type plasminogen activator [r-tPA] rates, Door-to-Needle [DTN], Door-to-Imaging [DTI]). Use of the GWTG-Stroke program was assessed to determine if SBHs and NSBHs were quantitatively equivalent in terms of specific core stroke measures. This quantitative employed an equivalence study design with over 2.9 …

Preconception Protective Factors Associated With Preterm Birth In Black/African American And Non-Hispanic White Women In Nyc, Joyce Yvonne Hall

Walden Dissertations and Doctoral Studies

Racial disparities in preterm birth have persisted during the past two decades. Though studies have delineated the medical, behavioral, and social risk factors explaining racial disparities in preterm birth, less is known about protective factors. This quantitative, correlational study was conducted to examine the prevalence, association, and risk of preconception health protective factors and sociodemographic covariates between Black/African American and non-Hispanic White women with preterm birth in New York City (NYC). The maternal and child health (MCH) life course approach was the theoretical foundation. The NYC Pregnancy Risk Assessment Monitoring System 2016–2018 Phase 8 survey data, which included 2,161 women …

Five-Year Cervical Cancer Survival Rates By Stage At Diagnosis, Race, And Place Of Residence In Georgia, Usa, Layal Mansour

Walden Dissertations and Doctoral Studies

Despite breakthroughs and improvement in cervical cancer (cercancer) management strategies over the years, racial and geographical disparities on 5-year relative survival rates (RSRs) persist. Studies showed black women have higher mortality rates than white women with the majority of deaths occurring among women above age 45. The aim of this cross-sectional study was to investigate the predicting abilities of race and residence on 5-year RSRs by stage at diagnosis and the potential effect on survival probability in the early stage of cercancer for women above 45 years living in Georgia. Anderson's behavioral model for inequalities in healthcare was the theoretical …

Lifestyle Modifications To Reduce Hypertension In Obese Patients: A Clinical Practice Guideline, Tiffany Lynn Oates

Walden Dissertations and Doctoral Studies

In the United States, obesity affects almost 50% of the population with estimates of 60–70% of hypertension in adults attributable to adiposity. The practice gap addressed in this project is a lack of standardized patient education on lifestyle modifications aimed at reducing hypertension in the obese patient, which is the recommended first line of treatment for these patients. The practice focused questions were answered when evidence from the literature supported the implementation of a clinical practice guideline developed from evidence-based literature focused on patient education about lifestyle modification as the initial treatment for the reduction of hypertension in the obese …

Children's Body Mass Index Before And After Covid-19 Related Childcare Center Closures, Ericka L. Peterson

Walden Dissertations and Doctoral Studies

Prolonged childcare center closures due to COVID-19 restrictions have changed children’s health-related behaviors that may result in an increased risk in childhood obesity. Grounded in the social ecological model, the purpose of this study was to examine the differences in body mass index (BMI), physical activity, consumption of sugar-sweetened beverages (SSBs), and screen time among preschool aged children enrolled in the Merced County Office of Education Head Start program before and after COVID-19 related Head Start center closures. A quantitative, longitudinal study design using secondary data from ChildPlus was used. The paired t-test and Wilcoxon signed-rank test was used to …

Treatment Outcomes And Associated Factors In Tb/Hiv-Coinfected Patients In Namibia, Esland Shilongo

Walden Dissertations and Doctoral Studies

AbstractHIV and TB have merged into a deadly co-epidemic in Namibia. Currently, though, TB and HIV data at the national, regional, and district level might be underreported and insufficient to understand the full burden and outcome rates of TB and HIV. Targeting the TB outcomes rate among TB/HIV-coinfected individuals is an effective strategy for decreasing future TB burden and furthering the gains in the control of both diseases. The objective of this study was: to assess the outcomes of patients registered for anti-TB treatment in //Karas Region which has the largests burden of TB in Namibia. A 5-year retrospective cohort …

Accessibility To Vaping Products, Vaping, And Use Of Cigarettes Among Adolescents, Sherri Adeosun

Walden Dissertations and Doctoral Studies

There has been a continuous increase in the use of e-cigarettes among adolescents. The growth threatens to nullify the years of successfully reducing cigarette smoking among this age demographic. Additionally, the increase has been a concern for public healthcare workers due to the limited research on the effects of long-term use of e-cigarettes on adolescents. I investigated the possible side effects of exposure to e-cigarette advertisements and the use of e-cigarettes. Additionally, the study reviewed the relationship between the age e-cigarette use was initiated and the subsequent use of cigarettes. The conceptual framework was based on the multi-theory model and …

Hospital Readmission Reduction Penalties And Chronic Obstructive Pulmonary Disease Readmissions, Anthony Aduro

Walden Dissertations and Doctoral Studies

AbstractChronic obstructive pulmonary disease (COPD) is a serious disease that affects the respiratory system, creating poor patient outcomes. Additionally, persons with COPD have higher hospital readmission rates than other patient populations. Not only is hospital readmission indicative of poor patient outcomes, but hospital readmissions are costly to healthcare organizations as well. High readmission rates are associated with wasted resources and money, and negatively impact organizational performance. The Centers for Medicaid and Medicare Services (CMS) implemented the Hospital Readmissions Reduction Program (HRRP) to reduce the rate of avoidable hospital readmissions for diseases including COPD. However, how HRRP penalties have impacted readmission …

Not A Phase: Lgbtq+ Teens -- How We Can Save A Life, Jennifer Carner

Doctor of Nursing Practice Projects

This DNP project was conducted to address suicide and risk-taking behaviors of LGBTQ teens and how adults can improve the long-term outcomes of LGBTQ teens by being supportive adults. LGBTQ+ teens are at 4 times higher risk of suicide than their non-LGBTQ+ peers (The Trevor Project, 2021). The Suicide Prevention Resource Center, 2008, found a teen having one caring adult in their lives decreases the risk of suicide. The project's goal was to educate adults to increase their comfort levels in terminology, their understanding of the developmental stages of teens, and how to provide protective factors to help reduce the …

African American Women’S Body Image Perceptions And The Built Environment, Andrea Denise Smith

Walden Dissertations and Doctoral Studies

African American (AA) women have a 54.8% overall obesity rate in the United States. This quantitative cross-sectional study’s aim was to determine what factors may have an impact on body image perceptions of AA women in Alabama and New Jersey. A gap in research this study addressed is sociodemographic and geographic differences that may impact obesity rates among AA women. The theoretical framework used for this study was the social cognitive theory. Secondary data were obtained from the 2018 Behavioral Risk Factor Surveillance System. Linear regression (LR) analyses results showed that none of the sociodemographic variables (education level, employment status, …

Health Educators’ Perspectives On Black And Latin@ College Students’ Health Literacy, Desiree Williams Brown

Walden Dissertations and Doctoral Studies

AbstractEmerging adulthood is a critical life stage when participation in higher education can facilitate the transition of young individuals into adulthood and independence. The barriers associated with low health literacy levels are higher among racial or ethnic groups facing health inequalities, including those enrolled in higher education institutions. The purpose of this basic qualitative study was to explore how health educators promoted the health literacy of Black and Latino emerging adult college students. The theoretical framework was based on Bandura’s social cognitive theory. Eight health professionals who served to promote health literacy across diverse college campuses and different states in …

Effects Of Perpetrator Types And Gender-Based Violence On Condom Use Among Tanzanian Female Sex Workers, Lashonda Hall

Walden Dissertations and Doctoral Studies

HIV status among female sex workers (FSWs) continues to be a significant public health concern. Condom use is associated with HIV cases among FSWs. Gender-based violence (GBV) plays a role in FSWs HIV status. While studies have investigated the relationship between GBV and condom use, little is known about the impact of factors such as perpetrator type and substance use. I aimed to examine whether perpetrator type and substance use affect the relationship between GBV and condom use among FSWs in Tanzania. Secondary data analysis was performed on 1,502 FSWs extracted from the 2020 Tanzanian, John Hopkins Program for International …

Pharmacists’ Responses To Medication Management Following Disasters, Rellamichelle W. Tyree

Walden Dissertations and Doctoral Studies

Disasters, both natural and human made, can cause emerging health threats in the United States and the Caribbean. The disasters that pharmacists experienced and reported for this study included hurricanes, snowstorms, ice storms, flooding, and a pandemic. The purpose of this research was to investigate the challenges and outcomes associated with pharmacists’ medication management practices during and following disasters. This generic qualitative study focused on pharmacists’ experiences and their responses to disaster planning and medication management activities. The ecological model of disaster management was the conceptual framework used to investigate the pharmacists and their responses and actions used to address …

The Impact Of Electronic Health Records Meaningful Use On Patient Safety And Satisfaction, Paulette Brown

Walden Dissertations and Doctoral Studies

AbstractThe widespread adoption of electronic health records (EHRs) is encouraged because of their potential to improve the quality of care provided. It was unknown to what extent the meaningful use of EHRs would impact patient safety and satisfaction in general and specialty hospitals. The researcher’s purpose for this quantitative correlational research was to examine the impact of meaningful EHR use of EHRs on patient safety and satisfaction outcomes in general and specialty hospitals in Philadelphia (PA). The constructs of the institutional theory guided the study. The hypotheses that guided the study included (a) Meaningful EHR use positively influences patient satisfaction …

Water/Sanitation, Hygiene, And Risk Factors Associated With Under-5 Mortality In Côte D’Ivoire, Ouda Kamagate

Walden Dissertations and Doctoral Studies

Despite remarkable progress in children’s survival since 1990, the global burden of the under-5 mortality rate (U5MR) remains immense. According to the World Health Organization, about 5.2 million children below 5 died in 2019, with 14,000 dying each day. Literature reveals that the lack and limitation of water, sanitation, and hygiene (WaSH) are linked to deaths in childhood. Cote d’Ivoire still lags behind expectations with 79 per 1000 live births in 2019 rather than 25 and below, so there is a need to uncover to what extent the U5MR is affected by WaSH. Through a cross-sectional design guided by the …

Overeating As A Coping Response To Workplace Gender Discrimination: The Role Of Resilience And Social Support, Rosemarie Charmain Mitchell

Walden Dissertations and Doctoral Studies

Gender discrimination in the workplace continues to be a persistent source of stress for women even after 5 decades of antidiscrimination legislation in the United States. Women are more likely than men to cope with stress by overeating, which is a risk factor for chronic illnesses and obesity. Much less is known about the protective factors that could weaken the association between perceived stress and overeating. The purpose of this quantitative study was to address this gap in the literature by examining whether resilience and social support are moderators of the overeating response for women who have experienced gender discrimination …

Understanding The Perspectives Of African American Gay And Bisexual Men Toward Hiv, Victor Onwezi , Ikechukwu Nwanguma

Walden Dissertations and Doctoral Studies

There is an urgent need to stop the HIV epidemic among African American gay and bisexual men in the United States. The purpose of this basic qualitative study was to identify the health issues responsible for the HIV epidemic among African gay and bisexual men. Two theoretical frameworks that guided the study were the transtheoretical model and the syndemic theory. The study's research involved understanding African American gay and bisexual men's perspective toward HIV infections and their understanding of possible reasons HIV rates appear to increase in their community. Semi-structured telephone interviews and field notes were used to collect primary …

Role Of Hypertension In Low-Birth-Weight Racial Disparities Among Virginian Women, Ashli Owen

Walden Dissertations and Doctoral Studies

Low birth weight (LBW) is a leading cause of infant mortality globally, but it disproportionately burdens the Black community in the United States, with a rate twice that of White women. Further, hypertensive disorders of pregnancy (HDsP) increase LBW incidence. The purpose of the study was to assess the association between HDsP and LBW, maternal race and LBW, and the moderation effect of HDsP on race and LBW on Black and White women in Virginia. The theoretical framework for this study was based on the lifecourse health development model, which states that health should be viewed as an outcome of …

Health Educator Experience: Recommendations For Physical Activity For Mental Health In Women, Patricia Schneider

Walden Dissertations and Doctoral Studies

Mental health issues, specifically anxiety and depression, continue to be a public health crisis in the United States. Despite the established therapies of pharmacology and cognitive behavioral therapy, not all patients seek or find relief using these methods. Therefore, other treatment strategies need to be studied. The purpose of this basic qualitative study was to understand the experiences of health educators who use physical activity as a strategy for anxiety and depression management among middle-aged women as well as their own attitudes, norms, and perceived behavioral controls. The theory of planned behavior (TPB) was leveraged as the theoretical foundation for …

The Process And Case Study Approach To Implementing A Nutrition-Specific Dissemination And Implementation Science Training In Appalachia, Ayron E. Walker

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Nutrition professionals face implementation challenges due to their lack of knowledge to incorporate D&I science into intervention design. To improve intervention outcomes, nutrition professionals must be trained in D&I science, which are currently absent in the field.

Aims: To identify and assess nutrition educators and practitioners perceived motivations, self-efficacy, and attitudes in using D&I science to inform the educational design and strategies of a nutrition-specific D&I curriculum for nutrition educators. Then to test feasibility of the nutrition-specific curriculum in increasing knowledge, self-efficacy, and attitudes by a case study approach, pre/post intervention design.

Methods: First, scoping review methodology involved the …

Risk Factors Associated With Community-Onset Sepsis In Latino/Hispanic Adults, Joan Ivaska

Walden Dissertations and Doctoral Studies

Sepsis results in a significant public health burden globally, causing 20% of adult mortality worldwide and accounting for more than one third of deaths in hospitalized adults in the United States, making it one of the top 15 leading causes of death in the United States. Community-onset sepsis (COS) comprises nearly 80% of all sepsis cases occurring in the United States each year. Despite the widespread prevalence of COS, significant gaps in knowledge exist regarding the risk factors that lead to COS and sepsis mortality in Latino/Hispanic adults in the United States. The purpose of this secondary data study was …

Perceptions Of Implicit Bias In New York City Healthcare System During Covid-19, Kiesha Jackson

Walden Dissertations and Doctoral Studies

Implicit bias has been identified as a significant problem that hinders effective healthcare delivery. The purpose of this qualitative exploratory phenomenological study was to examine whether implicit bias influenced healthcare services for African Americans with comorbidities aged 30 and over living in New York City during the COVID-19 pandemic. Current studies show healthcare disparities, revealing barriers with healthcare delivery; however, they do not disclose a patient’s lived experience qualitatively, which constituted a gap in the literature. The frameworks of the behavioral model of health services use, and social construction and policy design guided this study. Research questions addressed (a) whether …

Appraisal Of Institutional Antimicrobial Stewardship In Selected Public Health Facilities In Nigeria, Joshua Olusegun Obasanya

Walden Dissertations and Doctoral Studies

The misuse of antimicrobials (AM) constitutes a huge problem in developing countries, including Nigeria, posing severe public health threats to the populace’s health. Misuse contributes to the high consumption of AM, driving the emergence and spread of antimicrobial resistance (AMR). Establishing functional antimicrobial stewardship (AMS) programs at the health facility levels is recognized as an effective and efficient strategies to tackle AMR. Literature is replete with evidence of poor prescription practices, but few studies assessing the factors contributing to inappropriate use of AM in Nigeria exist. The purpose of this study was to improve the understanding of AMS practice at …

Association Between Parental Socioeconomic Status And Childhood Obesity In The Southwest Geopolitical Zone Of Nigeria, Omatsola Aboyowa Sifo

Walden Dissertations and Doctoral Studies

AbstractGlobally, childhood obesity is a major social and public health concern characterized by complications such as high cholesterol and high blood pressure. The purpose of this quantitative cross-sectional study was to examine the association between childhood obesity in children age 6–12 years and the socioeconomic status of their parents in the Southwest geopolitical zone of Nigeria. Social cognitive theory served as the theoretical framework for the study. Questionnaire data were collected from 384 parents/guardians of children age 6–12 years across three states in the Southwest geopolitical zone of Nigeria. Data were analyzed using descriptive statistics and multiple logistic regression at …