Awareness and Attitudes of Young Nigerian Immigrants in the United States to Sickle Cell Screening and Premarital Genetic Testing

Awareness and Attitudes of Young Nigerian Immigrants in the United States to Sickle Cell Screening and Premarital Genetic Testing by Timothy Atolagbe MS, Johns Hopkins University, 2001 MSc, University of Ibadan, 1987 BSc, University of Ibadan, 1985 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University February 2018 Abstract The carrier frequency for sickle cell anemia among Nigerians, who account for a high percentage of African immigrants in the United States, is high, according to the World Health Organization. Even though sickle cell disease contributes $2.4 billion annually to U.S. health care expenditures, ascertaining the number of affected individuals in the U.S. is difficult because sickle cell is not a reportable genetic disease. However, according to the Census Bureau, the number of African immigrants continues to grow at a steady pace among the foreign-born immigrant population in the U.S. There is a lack of research on the contribution of the immigrant population to the sickle cell incidence and mortality rates in the U.S. The purpose of this study was to examine the level of awareness and attitude of young Nigerian immigrants in the United States to sickle cell screening and premarital genetic testing. The health belief model constituted the study’s theoretical foundation. It was assumed that the level of awareness of sickle cell disease and the romantic choices among young Nigerian college and graduate students in the United States would have a direct relationship. A sample of undergraduate and graduate students of Nigerian origin completed an online survey developed for the study. The results from SPSS analyses indicated that even though this population sample has a high knowledge and awareness of sickle cell disease, they are non-committal about adapting and implementing such knowledge when making romantic choices. In order to continue to reduce the burden of sickle cell disease on healthcare delivery in the United States, public health education programs that address the adaptation and implementation of knowledge about sickle cell disease are needed.The carrier frequency for sickle cell anemia among Nigerians, who account for a high percentage of African immigrants in the United States, is high, according to the World Health Organization. Even though sickle cell disease contributes $2.4 billion annually to U.S. health care expenditures, ascertaining the number of affected individuals in the U.S. is difficult because sickle cell is not a reportable genetic disease. However, according to the Census Bureau, the number of African immigrants continues to grow at a steady pace among the foreign-born immigrant population in the U.S. There is a lack of research on the contribution of the immigrant population to the sickle cell incidence and mortality rates in the U.S. The purpose of this study was to examine the level of awareness and attitude of young Nigerian immigrants in the United States to sickle cell screening and premarital genetic testing. The health belief model constituted the study’s theoretical foundation. It was assumed that the level of awareness of sickle cell disease and the romantic choices among young Nigerian college and graduate students in the United States would have a direct relationship. A sample of undergraduate and graduate students of Nigerian origin completed an online survey developed for the study. The results from SPSS analyses indicated that even though this population sample has a high knowledge and awareness of sickle cell disease, they are non-committal about adapting and implementing such knowledge when making romantic choices. In order to continue to reduce the burden of sickle cell disease on healthcare delivery in the United States, public health education programs that address the adaptation and implementation of knowledge about sickle cell disease are needed. Awareness and Attitudes of Young Nigerian Immigrants in the United States to Sickle Cell Screening and Premarital Genetic Testing by Timothy Atolagbe MS, Johns Hopkins University, 2001 MSc, University of Ibadan, 1987 BSc, University of Ibadan, 1985 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University February 2018 Dedication This is work is dedicated to God for His amazing love for me, and to my wife Lidia, my son Ayomide and my daughter Ayodeji. I could not have done this without your support. Acknowledgments I have been enabled to see beyond the forest by standing on the shoulder of giants. Dr. Paige Wermuth, my dissertation chairperson, has been that giant along my dissertation journey. Her encouragement and guidance propelled me through many challenging stages. Thank you.