Date of Conferral

2015

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Mark White

Abstract

Over the past 13 years, the United States Army has been engaged in armed conflict within Afghanistan. Unfortunately, the United States Army has been forced to evacuate soldiers from the battlefield because of malaria, a parasitic disease that is endemic in Afghanistan. Even though the U.S. Army has adopted an effective chemoprophylaxis protocol, soldiers' adherence to their prescribed medication has been historically low. This research addressed a gap in literature regarding the adherence rates of U.S. Army enlisted soldiers to their prescribed oral malaria chemoprophylaxis. In addition, this research investigated self-reported reasons for soldiers' nonadherence to this medication. The study employed an experimental, correlational research design to aid in understanding the relationship between adherence to malaria chemoprophylaxis and age, gender, military rank, education level, and previous deployment experience. Ninety-four active-duty U.S. Army personnel deployed to Afghanistan participated in the study. The frequency distribution of responses to the 8-questions Morisky Medication Adherence Scale were presented and indicated that for almost all of the questions, the percentage of participants who answered yes was larger than the percentage who answered no, indicating low levels of adherence among the study participants. The findings indicated that age, gender, and perception of risk all significantly contributed to the models predicting medication adherence. With the scientific and medical advances of the 20th and 21st centuries, few if any military personnel should contract malaria. These findings contribute to a greater awareness of medication adherence, which directly supports positive social change within the Armed Forces of the United States.

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