This research investigated the connection between the Medicare star rating system and E-tags on emergency preparedness of nursing homes for disasters in Hampton Roads, Virginia. Emergency preparedness in nursing homes has been a topic of growing interest within the past decade. Hampton Roads, Virginia, has a history of natural disasters including hurricanes and flooding, which necessitates a proper and efficient emergency preparedness plan in nursing home facilities. The primary purpose of this research was to review the secondary Centers for Medicare and Medicaid Services (CMS) data regarding the star rating system and E-tag surveys of each of the 37 nursing facilities that were not connected to a hospital or part of a continuing care retirement community to find a correlation, if any, between emergency preparedness and CMS star rating. The theoretical foundation for the research was the diffusions of innovation theory, which addresses innovation that is communicated between members of a team or social group, inclusive of gaining knowledge of an innovation, persuading others to move toward that innovation, team decision making on the innovation, and implementation/confirmation of that innovation. The statistical analysis provided inconclusive answers to research questions. The potential social change from this study is it may inform nursing home administrators of the 4 most frequent E-tag deficiencies found in this research; and their nonlinear relationship to total bed count and variables such as individual Medicare star rating categories so that administrators can apply this new knowledge to their field in general and their facility in particular; to achieve better overall disaster preparedness coordination.

Management of hypertension and its complications requires health care providers to understand the reason for developing the disease. Complications of hypertension (HTN) are more prevalent when patient interventions are not consistently performed by staff. A gap in staff knowledge regarding the management of patients with HTN was noted at an outpatient clinic in the southwestern United States. A staff education project based on the Eighth Joint National Committee (JNC-8) guidelines for HTN management was developed to address the gap in knowledge. This DNP project sought to understand the impact of an evidence-based staff education program in improving the knowledge of nursing staff on HTN management. The health belief model and social cognitive theory guided the project. Three expert panelists evaluated the education program content and agreed that the content was relevant to clinical practice and would improve staff knowledge regarding management of HTN. Eight nurses participated in the education program, first completing a pretest questionnaire followed by educational program content in digital format. Participants reviewed the program for 1 week followed by a PowerPoint presentation at a staff meeting. Posttest questionnaires were completed by 7 participants using a 5-point Likert scale ranging from completely unaware to completely aware. Posttest results indicated that nursing staff knowledge increased to completely aware (100%) of the JNC-8 guidelines for HTN management compared with completely unaware before the program. The project emphasizes the potential for positive social change when translating evidence to practice through staff education to improve patient management and outcomes for the treatment of HTN.

According to the World Health Organization (WHO), people throughout the world become sick every year from consuming contaminated foods, which impacts countries’ socioeconomic development, straining their healthcare system, travel and tourism, and foreign trade markets. To help alleviate the impact foodborne illness (FBI) has on society, scholars suggest physicians incorporate food safety in their standard work practice. The purpose of this study was to determine if Harlem Hospital physicians utilized food safety knowledge in comprehensive patient care with a diagnosis of FBI, in addition to how physicians passed this food safety information onto the patient. A qualitative methodology using an interpretive description approach was used to determine 52 physicians' utilization of food safety accompanied by Slotnick four-stage theory of physician’s learning as the study’s theoretical foundation. The study found that Harlem Hospital medicine and ICU physicians were more knowledgeable in FBI than other hospital physicians, and even though physicians’ definitions of FBI were different, all physicians' answers corresponded with the behaviors of clean, separate cook and chill. The research concludes Harlem Hospital physicians know how to diagnose and treat patients with FBI, and physicians acquired their knowledge of food safety through multiple resources. The study also found the physicians do not always include food safety in comprehensive patient care. However, all physicians agreed patients should be educated in food safety to prevent its reoccurrence. When physicians provide education at the bedside, this may help increase patient awareness in food safety, reducing hospital readmission rates, leading to a positive social change.

Sex education through the public school system has been identified by the Centers for Disease Control and Prevention as an excellent vehicle by which HIV prevention education can be presented to students, thereby decreasing the rate of HIV infection among young men who have sex with men (YMSM). However, YMSM continue to be at high risk for HIV infection in the United States despite educational efforts to prevent infection. The purpose of this qualitative study using a phenomenological approach was to explore what impact school-based HIV prevention education had on YMSM in the past, and what effect that education has had on their current sexual behaviors. The theoretical foundation for this study was the health belief model. Individual 1-hour interviews were conducted with 13 YMSM (ages 21-35) who received HIV prevention education in California. Interviews were analyzed for common themes using a phenomenological approach. Results of this study suggest that participants were not utilizing safer techniques taught in the school HIV prevention education because there was a lack of curriculum consistency, LGBTQ content, and classroom management, and the impact of stigma and homophobia on YMSM. These results support the health belief model. Findings support that positive social change can be achieved by providing standardized, all-inclusive, non-judgmental, HIV prevention education program, in a classroom environment where it is safe to receive same-sex sexual information. This should decrease the number of HIV+ test results among YMSM.

Sarcopenia is a disease of muscle wasting primarily seen in older adults. Although this term was first coined over three decades ago, there is a lack of consensus on a definition, screening criteria, and treatment protocol for sarcopenia. The primary purpose of this study is to determine whether registered dietitian nutritionists (RDNs) in the United States (U.S.) screen for sarcopenia. Study participants were recruited through a randomized email list and included RDNs throughout the U.S. Respondents completed a survey questioning knowledge of sarcopenia, screening tools and company protocols in place, and the need and desire for sarcopenia education. Data revealed a lack of pre-existing protocols in place, a dissonance of validated and unvalidated screening tools used in practice, and substantial need for sarcopenia education.

The research problem focused on the use of collaboration by managers, supervisors, consultants, and professional staff in a department of public education and health to address disparities in on-time high school completion rates. The purpose of the study was to examine the perspectives of individuals in these public sectors on the use of collaboration as a means to improve on-time high school completion rates for African American and Hispanic students. The theoretical foundation and conceptual framework for the study were John Rawls's theory of justice and Amartya Sen's capability approach. The key research question involved how individuals in the public education and health sectors viewed the use of collaboration to address a complex problem of low rate of on-time high school completion for African American and Hispanic students. The research design was a multiple case study. Seven individuals participated from a department of public education and 4 from a department of public health in the same state. Data were collected and analyzed from participant interviews. Themes were identified from categories and specific codes or words that described the content of the participants' responses. A major conclusion was collaboration between a public education department and public health department can be used as a means to improve on-time high school completion rates for African American and Hispanic students. The implications for social change may be to increase the awareness for a public education department and public health department to routinely work in collaboration to improve on-time high school completion rates of minority and other vulnerable students.

Background: Despite consensus guidelines, only about half of at-risk relatives in families with Hypertrophic Cardiomyopathy (HCM) undergo clinical screening and even fewer undergo predictive genetic testing, leaving those unscreened at risk for sudden cardiac death. The use of qualitative inquiry to examine family communication and complex factors influencing uptake of screening may inform interventions to increase uptake and prevent sudden cardiac death. Purpose: The purpose of this study was to describe the engagement of at-risk relatives in family screening for HCM. Specific Aims: The specific aims were to (1) Describe the experience of communication of genetic risk of HCM in families with a causative variant for HCM; (2) Use the Theory of Engagement to identify facilitators and barriers to family screening in families with a causative variant for HCM; and (3) Identify strategies to increase uptake of clinical screening and predictive genetic testing in families with a causative variant for HCM. Framework: The Theory of Engagement, adapted from McAllister, was used as an initial framework for the study. Methods: A qualitative descriptive design with purposive and snowball sampling was used and data were analyzed using qualitative content analysis. Results: The overarching theme of Bringing Genetic Risk to the Foreground was comprised of three major themes: Cues to Action, Preferences for Knowledge and Gateways to Screening, reflecting factors that affect engagement with genetic risk and family screening throughout the lifespan. Conclusions: Integrated longitudinal care and access to genetic specialists are needed for patients and families with a causative variant for HCM.

The purpose of this non-experimental quantitative correlational study was to investigate the relationship between academic achievement and health in a national sample of college students using quantitative data analysis. Specifically, the researcher analyzed the relationship between three health-promoting behaviors (physical activity, strength training, and fruit and vegetable consumption), three negative health behaviors (cigarette, e-cigarette, and opioid use) and obesity with GPA. Cross-sectional data on student health collected from the American College Health Association’s National College Health Assessment II (ACHA-NCHA-II) and completed by 426,650 college students from 650 U.S. colleges during the semesters between 2015 and 2019 formed the foundation for this research. Nine research questions were addressed using a series of chi square tests. Results showed there was a significant positive relationship between health behaviors and grade average. Students who met the recommendations for fruit and vegetable consumption, moderate activity and vigorous physical activity were more likely to have GPAs than those who did not. Students who used cigarettes, opioids, or were obese were more likely to have GPAs.

Opioid Use Disorder is defined by the NIH as “the chronic use of opioids that causes clinically significant distress or impairment.”1 Due to a number of factors, the overuse of opioids has become an epidemic in the United States. In recent years there have been a number of lawsuits against pharmaceutical companies and other parties who have benefitted from the proliferation of this issue. In most cases, it is up to the states or local governments who receive these funds to determine their best use. The purpose of this Thesis is to analyze the resources recommended by Ballad Health’s Community Health Needs Assessments, and five additional panels of experts in this field, and to compare these recommendations with available resources, along with making recommendations for the distribution and use of funds coming from a number of lawsuits and settlements.

Introduction & Background: Unhealthy diets and non-communicable diseases such as obesity are on the rise on a national and global scale, and there is an urgent need to initiate interventions. However, research suggests there is a lack of effective initiatives from major processed food manufacturers, which are a major contributor to the cause of these health issues. Thus, this study seeks to examine the role that food manufacturers have in contributing to the obesity epidemic and the strategies that they use to navigate around health policies. Purpose Statement Question: Is there evidence of a primary role that processed food manufacturers play in enabling the obesity rates nationally and worldwide through market strategies? Literature Review: A wide variety of databases within public health and medicine, such as PubMed, World Health Organization, and National Institutes of Health, were searched using keywords like “Big Food and obesity,” “marketing and obesity,” and “relationship between obesity and food corporations”. Studies that discussed the impact food manufacturers had on obesity and other non-communicable diseases or strategies that they used were selected. Findings: The different research studies analyzed provided evidence that processed food manufacturers, also known as “Big Food," play a significant role in contributing to public health issues, especially non-communicable diseases like obesity. The food industry uses old and new techniques to solidify its influence nationally while gaining power through global means and evading public policy restrictions Conclusions: There is a need for further research to identify these market strategies and effectively dismantle them.