Public Health Education and Promotion Commons^™

Risk Factors Associated With Childhood Vaccination Coverage In Afghanistan, Iqbal Mawani

Walden Dissertations and Doctoral Studies

Globally, vaccination is among the most successful and cost-effective public health practices in the prevention of infectious diseases. The purpose of this study was to examine the child, parental, and geographical risk factors that influence childhood vaccination coverage in Afghanistan. The health belief model and socio-ecological model was used in this study as the theoretical framework to examine the effects of these risk factors on vaccination coverage among children in Afghanistan. Univariate, bivariate, and multivariate tests were conducted within the secondary data analysis of the 2015 Afghanistan national Demographic and Health Survey dataset. Of the 32,420 children aged 0 to …

Demographic Characteristics And Response Preparedness Of Employed Adults To Ebola Virus Disease In Monrovia, Liberia, Beth Ann Sexton

Walden Dissertations and Doctoral Studies

AbstractEbola virus disease (EVD) is a deadly disease with no known cure and it caused an outbreak from 2014-2016 in Western Africa. Liberia had the highest morbidity and mortality; its capital city, Monrovia, was the focus of this study. The purpose of this research was to explore the association between sociodemographic and socioeconomic factors (gender, religion, age, occupation, education, and ward) and the use of preventative hygiene measures and understanding of EVD among working Monrovian adults. This population was chosen because 97% of the Monrovian population is employed, and thus serves as a good source for future public health campaigns. …

The Influence Of Community-Based Interventions On Behaviors Of Hiv+ Persons In Congo-Kinshasa, Max Ebengho Bokelo

Walden Dissertations and Doctoral Studies

AbstractSub-Saharan African communities bear the highest burden of HIV/AIDS in the world. Because of identifiable cultural links and local beliefs, people are more likely to engage in sexual mores that could negatively impact their lives. Starting in early 2000, Congolese HIV+ patients have undergone a variety of inputs designed to decrease HIV risk behaviors among people. The purpose of this inquiry was to understand the impact of those actions within the community. Data grounded on the socioecological model were collected regarding any changes in (1) behavioral rejection of condoms, (2) Kintwidi phenomenon, (3) levirate and (4) sororate marriage, (5) sexual …

Social Determinants Of Health Influence On Surgical Morbidity After Colorectal Surgery, Koianka J. Ivanova Trencheva

Walden Dissertations and Doctoral Studies

Decreasing surgical morbidity and improving surgical safety is a public health priority. With same-day or early hospital discharge after surgery, knowledge about social determinants of health (SDOH) impact on surgical morbidity is vital for surgical safety improvement. This study’s aim was to evaluate SDOH association with surgery-related morbidity after colorectal surgery in an adult population. This quantitative cross-sectional study used New York Statewide Planning and Research Cooperative System (SPARCS) secondary data from 2006 ⁠–2016 on 130,731 patients linked to SDOH. Dependent variables were anastomotic leak (AL), surgical site infection (SSI), Not SSI related, and overall complications (COMPL) within 30 days …

Diabetes Self-Management Of Adults With Diabetes In Grenada During The Covid-19, Pauline Smith

Walden Dissertations and Doctoral Studies

Diabetes self-management involves several behaviors to prevent complications and ensure a good quality of life. Several studies addressed how the COVID-19 lockdown impacted diabetes self-management practices worldwide, yet little was known about self-management experiences in Grenada and the Caribbean region. The purpose of this phenomenological and directed content analysis study was to gain insight into the lived diabetes self-management experiences during the COVID-19 lockdown in Grenada. The theory of planned behavior was used as the theoretical framework for this study. The research questions addressed lived self-management experiences and attitudes, subjective norms, and perceived behavioral control toward diabetes self-management. Semistructured interviews …

Developing A Clinical Practice Guideline For Colorectal Cancer Screening In Primary Care, Michelle Janise Berkley-Brown

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is the second leading cause of cancer deaths in the United States for both men and women combined. CRC screening is an effective way to reduce mortality and morbidity related to the disease. Practitioners within primary care practices can play an essential role in encouraging people to be screened. Yet, CRC screening rates remain low in primary care practices. Evidence-based strategies are available to help practitioners improve CRC screening activities and improve screening rates. The lack of a clinical practice guideline (CPG) with strategies to help improve CRC screening interventions was identified as a practice gap for …

Insecticide Treated Nets And Malaria Control Strategy In Sierra Leone, Henry Nk Biayemi

Walden Dissertations and Doctoral Studies

AbstractMalaria is a deadly disease and endemic in Sierra Leone. It is the leading cause of morbidity and mortality amongst children younger than five years in Sierra Leone. Insecticide treated nets (ITNs) are not used widely despite free distribution, low health risks, and proven ability to reduce malaria. The purpose of this quantitative crosssectional study was to investigate the association between a set of independent variables (parental education, parents' economic status, household size, and residence) and the use of ITNs among children under five years of age in Sierra Leone. The study used a secondary dataset from the Ministry of …

Strategies To Reduce Fall Rates In A Long-Term Care Facility, Kimberly H. Brewer

Walden Dissertations and Doctoral Studies

AbstractFalls among residents of long-term care facilities (LTCFs) pose significant threats to their health and quality of life, as falls often lead to life-threatening injuries such as traumatic brain injury and hip fractures. The etiology of the falls is multifactorial and complex; thus, interventions to reduce the falls typically combine two or more evidence-based interventions. The objective of this doctorate project was to develop an evidenced-based clinical practice guideline (CPG) outlining a multifaceted, evidenced-based bundled set of interventions for a fall prevention program to reduce falls for elderly patients living in the LTCFs. Lewin’s 3-step model of change was used …

The Importance Of Staff Education About Implementing Ketogenic Diet In Prediabetic Patients, Clarissa L. Dorsey

Walden Dissertations and Doctoral Studies

Diabetes, a chronic disease that can lead to many complications, is one of the leading causes of death. Obesity tends to increase the risk of diabetes. Nutritional therapy can not only control diabetes but also prevent it in some cases by decreasing weight. The ketogenic diet is a low-carbohydrate, high-fat diet that can prevent and control diabetes. The purpose of this study was to examine the recommendations of medical providers before and after the presentation of educational content on the ketogenic diet as nutritional therapy in prediabetic and diabetic patients. The practice-focused question addressed whether educating medical staff at a …

The Impact Of Midwifery On Infant And Maternal Outcomes Among Black Mothers, Joann Honoré

Walden Dissertations and Doctoral Studies

According to recent studies, disparities are prevalent in maternal and fetal outcomes between Black and White mothers in the United States. Researchers have established that using a midwife versus other healthcare practitioners can elicit positive maternal and fetal outcomes for Black mothers. However, no within-race research has been conducted exploring midwifery as an insulating factor against these disparities. The purpose of this quantitative retrospective cohort study was to explore the impact of midwifery on infant and maternal outcomes compared to outcomes associated with other prenatal care models/caregivers among Black mothers in California using secondary data. The ecological model was used …

Social Media And Physical Activity Among African American College Women, Carmen Brown

Walden Dissertations and Doctoral Studies

Among African American (AA) college women, physical activity (PA) is decreasing, with less than 20% participating in moderate-intensity cardio or aerobic exercise. Physical inactivity can lead to increased morbidity and mortality from chronic conditions. There is a need for more research on AA women’s health practices to develop interventions that can lead to sustainable behavior change among this population. More than 70% of AA college women reported using some form of social media (i.e., Facebook, Twitter, Instagram, TikTok, and Snapchat) daily. Social networking sites (SNS) in particular can provide health information, advice, and an open forum for individuals with health …

Developing A Lifestyle Modification Tool To Prevent And Manage Elevated Blood Pressure Among African Americans, Magdalene Oziwo

Walden Dissertations and Doctoral Studies

Hypertension is a national medical problem that has been predominantly seen amongst African Americans. Within this community, hypertension has been associated with obesity, a sedentary lifestyle, and poor nutrition. It is for this reason that lifestyle modifications can be used as applied tools in the field of nursing in the prevention and management of hypertension among African American patients. This doctoral project was conducted to address the gap in nursing practice that currently exists for the African American population with regards to hypertension. The project focused on a nursing staff education program with 10 participants to promote the implementation of …

The Association Between Teen Pregnancy And Academic Performance Among Schoolgirls In The Ivory Coast, Moussokoura Ouattara Epse Assoumou

Walden Dissertations and Doctoral Studies

AbstractTeen pregnancy (TP) is a social and public health problem around the world. In developed nations, approximately 16 million girls from aged 15 to 19 years become pregnant each year, presenting health problems for the mother and fetus in addition to economic and social consequences for the communities in which they live. The purpose of this quantitative causal-comparative study, based on the theory of planned behavior, was to explore the association of academic performance and self-efficacy with TP. The research questions examined the association between the TP and the academic performance and self-efficacy while controlling for two covariates (socioeconomic status …

A Quality Improvement Evaluation Of A Hospitalist Telemedicine Program, Kelly Marie Awes

Walden Dissertations and Doctoral Studies

Critical access hospitals (CAHs) encounter unique challenges in terms of providingquality resources to their community, often lacking quality measures and continuity comparable to larger regional and tertiary hospitals. One CAH in rural Minnesota implemented an overnight hospitalist telemedicine service to address concerns with provider resources and quality practice. An evaluation of quality improvement implementation was completed to address data regarding ER transfers and inpatient length of stay (LOS). Following the triple aim framework to improve patient care, population health, and decrease costs, Donabedian’s model of quality improvement was utilized. Three months of pre and postimplementation data were collected one year …

Patient Perceptions Of Access To Chronic Pain Medications, Lauren Amy Durham

Walden Dissertations and Doctoral Studies

AbstractThe 2014 Drug Enforcement Administration’s reclassification of hydrocodone combination products caused significant unintentional consequences to patients with chronic pain. Although a few researchers have looked at the problems that resulted immediately following the reclassification, none have as yet repeated their studies, creating a knowledge gap. Additionally, previous researchers have shown that most of the current opioid restricting policies in place today were not created using a strong evidence-based or ethically inclusive approach. The purpose of this study was to assess whether common factors identified as issues impacting care for these patients immediately following the reclassification continue to affect care standards. …

Antenatal And Postnatal Care Services And Maternal Mortality In Nigeria, Lucy Evans

Walden Dissertations and Doctoral Studies

Nigeria has had a high maternal mortality rate per 100,000 live births since the 1990s. A possible contributing factor is that many Nigerian women are not aware of prenatal and postpartum pregnancy care-related services. The purpose of this study was to investigate the association between pregnancy-related care (access to antenatal services, maternal health education, and knowledge of prenatal and postpartum care) and maternal mortality in Nigeria. The theory of planned behavior forms the basis of this study. A cross-sectional quantitative study design was used to determine whether maternal mortality is influenced by pregnancy-related care. Secondary data collected by the Demographic …

Food Insecurity In Community College Students In The Central Valley Of California, Leah Carter

Walden Dissertations and Doctoral Studies

AbstractMany college students struggle with having enough money to pay for the costs of college and basic necessities, such as adequate food, which leads to food insecurity. Food insecurity results in a more challenging time focusing on studying and less success in school. This study addressed the lack of a profile of a food-insecure California community college student at Hiker’s Community College (HCC; pseudonym) in the Central Valley of California. The purpose of this quantitative study was to determine the profile of a food-insecure student and to determine relationships between food insecurity and ethnicity, gender, being a first-generation college student, …

Associations Between The Use Of Bed Nets And Malaria Infection On The School Performance Of Juveniles In Ghana, Ans Bumbokuri

Walden Dissertations and Doctoral Studies

Millions of malaria cases are reported yearly in sub-Saharan Africa, events which adversely influence children’s school performance. The purpose of this quantitative, cross-sectional study was to investigate the effectiveness of major malaria control policies in reducing malaria cases as a means of improving academic performance among school children in the greater Accra region of Ghana. A secondary data set was obtained from the 2014-2016 data from the Ghana Malaria Indicator Survey (GMIS). Findings indicated that bed net use and malarial episodes in children of participant recorded a p-value of 0.43 which is a significant association between the variables. The likelihood …

Experiences Of Spanish-Speaking Patients Using Interpreter Services With Their Physicians, Rafael Raul Caycho

Walden Dissertations and Doctoral Studies

In the United States, many patients cannot speak English well enough to communicate with their medical providers. Many of these patients use professional interpreter services offered by their medical organizations to help with communication, which can lead to miscommunication due to the translation process between patients, interpreters, and physicians, and to incorrect diagnosis and poor health outcomes for the patient. The purpose of this study was to explore the experiences of Spanish-speaking patients who used interpreter services with their physicians. The transmission model was the theoretical framework used to explore the experiences and outcomes for the participants. In this study, …

Internet Use, Perceived Social Support, And Obesity Among African American Young Adults, Cynthia Adams

Walden Dissertations and Doctoral Studies

African Americans are disproportionately affected by obesity. Public health practitioners have an incomplete understanding of the social-environmental risk factors and how they affect obesity. The purpose of this quantitative, cross-sectional study was to explore whether internet use and perceived social support predicted obesity among African American young adults. The social cognitive theory guided this study. Secondary data were analyzed from the 2017 Behavioral Risk Factor Surveillance Survey. The sample consisted of 6,765 African American young adults age 18 to 34 and represented the U.S. population using weighted estimates. A Bonferroni correction was performed to reduce Type I error due to …

Perceived Health And Preventative Care In The Transgender Population, Gregory Page Carpenter

Walden Dissertations and Doctoral Studies

Historically, the transgender community has been treated and studied myopically, using the lens of psychological illness. As treatment and research efforts have expanded in the past decade, the transgender population is becoming better understood. The purpose of the study was to examine the relationship between perceived health and preventative care in the transgender community. The health belief model was the theoretical framework for this cross-sectional study, which included data from the 2014–2018 Behavioral Risk Factor Surveillance System Survey. Chi-square tests and binomial logistic regressions were performed to investigate associations between perceived health and preventative care in the transgender community. The …

Human Immunodeficiency Virus And Homelessness Among U.S.-Born And Foreign-Born Tuberculosis Cases In Georgia, Semra Ramosevac

Walden Dissertations and Doctoral Studies

According to the Centers for Disease Control and Prevention, tuberculosis (TB) is an infectious disease caused by bacteria and can easily spread in the U.S. and worldwide. TB infections in the U.S. have been much lower compared to other countries around the world in the last 40 years, but with the recent increase in an immigrant foreign-born population, there is a serious risk of the spread of TB. The goal of the study was to look into U.S.-born vs. foreign-born populations among TB/HIV/homeless cases in the state of GA from 2014 to 2018. The quantitative study was performed using secondary …

Perspectives Of Physicians Mandated To Complete Cultural Competence Education, Wayne Mccarthy Boatwright

Walden Dissertations and Doctoral Studies

Perspectives of Physicians Mandated to Complete Cultural Competence Educationby Wayne M. Boatwright

Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy in Health Services

Walden University May 2021 Abstract Studies show that ethnic and racial disparities continue to exist in health care delivery. The economics of today’s multicultural world along with changing demographics and persistence of inequality in healthcare have challenged healthcare professionals to consider cultural competency (CC) training to assist in eliminating health disparities. The purpose of this study was to identify the perspectives of physicians who were mandated to complete CC education. …

Cell Phone Use And Adolescent Weight Problems, Florence Kenkor Njang

Walden Dissertations and Doctoral Studies

AbstractOverweightinadolescenceincreasestheriskofobesityandmanyadversehealthoutcomeslaterinlife.The purpose of this quantitative cross-sectionalstudy was to investigatetheassociationbetweencell phoneuseandweightstatusinadolescents,ages14 17yearsold,livingintheUnitedStates.Thesocio-ecologicalmodel(SEM)wasusedtoexplainthelinkbetweencellphoneuseandoverweightamongadolescents.Threeresearchquestionswere used to explore(a)therelationshipbetweencellphoneuseandadolescentweightstatusaftercontrollingforage,gender,andrace;(b)the effectofcellphoneuseonoverweightandnormalweightstatusesamongadolescentsaged 14 17yearsaftercontrollingforage,gender,andphysicalactivity;and(c)themodifyingeffectofraceontherelationshipbetweencellphoneuseandadolescentoverweightaftercontrollingforageandgender.Secondary data from the2017YouthRiskBehavioralSurveillanceSystemwere analyzed usingbinarylogisticregressiontoanswer theresearchquestions.Highcellphoneusesignificantlyandpositivelypredictedoverweightinadolescentsaftercontrollingforage,gender,andrace(p<0.001).Afteraccountingforage,gender,andphysicalactivity,highcellphoneusewasasignificantpredictorofoverweight(p<0.001).Similarly,racehadasignificantmodifyingeffectonthepositiveassociationbetweenhighcelluseandoverweightamongadolescents(p<0.001).Thekeypositivesocialchange implication of this studyis the potentialtointegratehealthycellphoneusewithexistingobesitypublichealthinterventionsthatcanreduceoverweightandpositivelyimpactindividuals,families,andcommunities.

How Cyber Activity Influences Depression And Anxiety In Teenagers, Mary Fridah Gatwiri Muiruri

Walden Dissertations and Doctoral Studies

Both depression and anxiety have been a focus of scholars since their rates have recently skyrocketed from 5.4 % in 2003 to 20 % currently among teenagers in the United States. Although numerous studies have assessed the association between playing video games and depression, few studies have examined how cyberbullying and screen time contribute to depressive symptoms in teenagers. The purpose of this study was to analyze cyberbullying and screen time on depression in teens. . The exploration of associations between the dependent variable, depression, and the independent variables, screen time, video gaming, and cyberbullying, were guided by Bandura’s social …

Relationship Between Media Coverage And Child Measles Vaccination Uptake, Tanika Ward

Walden Dissertations and Doctoral Studies

Childhood vaccines have been a source of heated debates between both opponents and proponents of vaccination. Childhood immunizations have proven to be effective and save lives, but antivaccine movements continue. The purpose of this retrospective cross-sectional quantitative study was to determine if there was a significant difference in child measles vaccine uptake based on provider facility type and census region, after adjusting for age and education of mother, for the years 2003–2012, pre-and-post 2007 media coverage deeming vaccines unsafe, and for the years 2013–2017, pre-and-post exposure to measles at Disneyland in 2014–2015 for children aged 19–35 months. The social ecological …

Sociodemographic And Psychosocial Factors And Wellbeing Among Adults 65 And Older In England, Dainelle Clark

Walden Dissertations and Doctoral Studies

The increased number of older adults living longer parallels with the growth of public health concerns regarding the impact of sociodemographic and psychosocial factors (e.g., loneliness and social isolation) on older adults' wellbeing. The purpose of this quantitative study was to examine the association between loneliness, social isolation, the combined model of loneliness, and social isolation on wellbeing among older adults when accounting for age, gender, ethnicity, and social support. The socioecological model (SEM) was used to evaluate the multiple levels of environmental determinants for loneliness, social isolation, and wellbeing. The target population included older adults 65 years and older …

Social Determinants And Academic Success For Online Undergraduates Mediated By Mental Health, Jamie Michelle Claus Getz

Walden Dissertations and Doctoral Studies

AbstractSocial determinants of health (SDH) are social and economic systems that directly contribute to health disparities and inequalities. This study examined SDH and their relation to education, also an SDH. The relationship between SDH and online undergraduate achievement, as measured by grade-point average (GPA), was studied. Cumulative inequality is the theoretical framework that guided the study; it underscores the complexity of interaction between personal, social, and environmental stressors in relation to a student’s academic performance. The quantitative survey design allowed for potential relationships between variables to be observed and studied based on the survey responses per self-report from 212 online …

The Predictive Relationship Of Allostatic Load In Asthma, Mohamed Mustafa Hassan

Walden Dissertations and Doctoral Studies

Research on populations emphasizes the influence of allostatic overload, a marker of biophysical and biochemical stress, in driving adverse health outcomes. Unknown is the impact of allostatic load and its cardiovascular, metabolic, and inflammatory components as they pertain to asthma prevalence in U.S. populations. Specifically, there is a need to understand the nature of the relationship between allostatic load and asthma in light of confounders such as socioeconomic status, race, education, and gender. Using Bronfenbrenner’s bioecological model as a theoretical underpinning and binary logistic regression as a statistical modality, the predictive relationship between allostatic load and asthma was examined in …

Health Insurance Coverage, Sociodemographic Factors, And Treatment Completion For Opioid Abusers In Indiana, Ibrahim Samna

Walden Dissertations and Doctoral Studies

Many accidental deaths have recently occurred in Indiana due to opioid overdose. The current study sought to assess the association between sociodemographic factors, health insurance, and successful treatment completion for opioids abusers in Indiana based on the existing literature gap. In this study, the dependent variables considered were treatment completion status and opioid abuse. The independent variables included health insurance coverage and sociodemographic factors of education, marital status, employment status, race, gender, and age. I measured both dependent and independent variables as categorical. A cross-sectional and quantitative research approach was used by analyzing data from the 2017-Treatment Episode Data Set …