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Clinical Practice Guideline Development To Diagnose And Treat Adolescents With Obesity, Barbara Hunter Hudgens

Walden Dissertations and Doctoral Studies

Adolescent obesity is a worldwide multifaceted epidemic. This disease affects the medical, physical, psychosocial, and family aspects of adolescent life. Identification, diagnosis, and referrals to providers that can initiate early interventions that improve weight status have been recommended as critical steps in curtailing childhood obesity. This evidence-based clinical practice guideline (CPG) was developed for the healthcare providers at a rural clinic in Southwest Arkansas to provide consistency in the identification, diagnosis, and referral of adolescents. The health belief model (HBM) and the trans-theoretical model (TTM) were used to consider adolescents’ individual characteristics and beliefs as well as their readiness to …

Loneliness, Prosocial Relationships, And Recidivism In Long-Term Incarcerated Juveniles, Amy Rhoads Jozan

Walden Dissertations and Doctoral Studies

Prosocial bonds have been key in juvenile criminal desistance. Juvenile facility placement has resulted in deterioration of important prosocial supports and social isolation, increasing risk for recidivism. Loneliness has been increasingly prevalent in a facility setting, often leading to ongoing behavioral and health problems. Youth incarcerated longer than 1 year have experienced higher rates of physical and mental health challenges, lasting into adulthood. Lengthy juvenile incarceration impacts loneliness, postrelease prosocial relationships, and desistance implications have been underexplored. The purpose of this phenomenological study was to explore themes associated with reaffiliation motive, or lifelong problems resulting from loneliness, after experiencing youth …

Does Counselor Type Affect A Manualized Treatment?, Cynthia C. Kay

Walden Dissertations and Doctoral Studies

This quantitative study was to determine whether there are differences in client treatment outcomes based upon the type of counselor who conducted an empirically supported treatment called Seeking Safety for persons diagnosed with posttraumatic stress disorder and substance use disorder. Many studies show that counselors’ personal attributes impact treatment; however, this study added to the literature by focusing on a standardized treatment for the co-occurrence disorder of substance use and posttraumatic stress disorder. Archival data from an outpatient treatment facility was used. Clients were provided integrated services, which included psychological and substance use treatment. The participants/clients were men and women …

Mental Health Needs In Schools As Predictors Of Burnout In School Counselors, Sondra Junek

Walden Dissertations and Doctoral Studies

Researchers have found an increasing number of students with mental health issues, and

school counselors are often the first resource available to students. School counselors are

faced with many job duties including supporting students’ academic, career, and

emotional needs. Maintaining these duties of school counseling can increase stress and

lead to burnout. The purpose of this quantitative study was to examine mental health

needs, mental health knowledge, and mental health skills as predictors of each of the

three subscales of burnout (emotional exhaustion, depersonalization, and personal

accomplishment) among early, middle, and late career school counselors. Lazarus and

Folkman’s transactional theory …

Exploring Mid-Market Strategies For Big Data Governance, Kenneth Stanley Knapton Iii

Walden Dissertations and Doctoral Studies

Many data scientists are struggling to adopt effective data governance practices as they transition from traditional data analysis to big data analytics. Data governance of big data requires new strategies to deal with the volume, variety, and velocity attributes of big data. The purpose of this qualitative multiple case study was to explore big data governance strategies employed by data scientists to provide a holistic perspective of those data for making decisions. The participants were 10 data scientists employed in multiple mid-market companies in the greater Salt Lake City, Utah area who have strategies to govern big data. This study’s …

Integration Of Social Work Practices With Refugees: An Action Research Study, Avril Williams Knox

Walden Dissertations and Doctoral Studies

The United States is facing an increasing number of refugees and asylees who resettled and were forced to migrate from their countries of origin. In the United States, social service professionals and social workers of resettlement agencies are responsible for the program enrollment and follow-up with newly arrived refugees. Hence, there is a huge learning curve for these individuals. Although a substantial number of refugees are linked to appropriate resources, many are neglected and are unable to sustain themselves. This action research was based upon family systems theory. Integrative techniques used by social workers were explored. The information was subjective, …

Supervisor Experiences Mentoring Therapists-In-Training On Issues Related To Religion/Spirituality Among Lgbt Clients, Stephanie Kolhei

Walden Dissertations and Doctoral Studies

There are known issues related to religion and spirituality (R/S) among the lesbian, gay, bisexual, and transgender (LGBT) population, such as identity struggles, religious abuse, and internalized homonegativity. Many therapists are uncomfortable incorporating R/S into therapy, with poor training and supervision identified as a possible rationale. The purpose of this study was to explore supervisors’ experiences mentoring therapists-in-training on issues related to R/S among LGBT clients as well as supervisors’ level of preparation to mentor this area. The integrated affirmative supervision model (IAS) and multiple dimensions of cultural competence (MDCC) conceptual frameworks drove the development of this study. A generic …

Strategies To Implement A Material Management Information System For Medical Device Recalls, Paul Leo Lafrance

Walden Dissertations and Doctoral Studies

Health care business executives lack strategies to implement material management information systems (MMIS) related to medical device recalls. Lacking sufficient MMIS, health care business executives face insufficient product tracking related to medical devices affecting operational efficiency. Grounded in the conceptual frameworks of the technology acceptance model and diffusion of innovation, the purpose of this qualitative single case study was to explore health care business executives’ strategies for implementing an MMIS related to medical device recalls. The participants were 6 health care executives who implemented an MMIS in an urban hospital in the northeast region of the United States. Data were …

Foster Parents’ Perceptions Of Services Needed To Help Manage Foster Children’S Emotional And Behavioral Issues, Timothy A. Lance

Walden Dissertations and Doctoral Studies

Children entering the foster care system in the United States have higher rates of behavioral and emotional issues than children in the general population. Research has revealed that foster parents need to be trained in how to manage the emotional and behavioral problems of children placed in their care. However, there is a gap in knowledge regarding foster care providers’ perceptions of services they may need to assist them in managing their foster children’s behavioral and emotional problems. A generic qualitative approach was used to address the question: What are foster parents’ perceptions of services they need to effectively manage …

Relationship Between Pm2.5 Levels And Cancer Incidences In Interior Alaska, Sandra G. Lewis

Walden Dissertations and Doctoral Studies

Exposure to high levels of ambient air particulates < 2.5 microns in diameter (PM2.5) in the Fairbanks North Star Borough (FNSB) and the resulting impact on cancer incidence is the focus of this study. Climate, geography, and culture influence PM2.5 levels, particularly during the long cold season. While this study considers lung cancer incidences from PM2.5 exposure, the primary focus of the study is the incidences of all other types of cancers from exposure to PM2.5, because of the limited research done on this topic. This quantitative, retrospective, cohort study considered the incidences of new cancer diagnoses in the population during a 10-year period (January 1, 2008-December 31, 2017). The 2 FNSB Zip Codes, designated “hot spots,” frequently see spikes in PM2.5 during the long cold season. These areas are densely populated and contain the EPA-regulated air quality monitors. Cancer diagnoses in the hot spot Zip Codes were compared to cancer diagnoses in outlying Zip Codes (non-hot spots) that experience less PM2.5 and are more consistently within the EPA air quality guidelines. EPA monitors are not yet located in the non-hot spots. Cancer patient data were obtained from the Fairbanks Memorial Hospital Cancer Center. The results demonstrated that a strong association was found between PM2.5 exposure and non-lung cancers (OR = 1.37; RR = 1.36; p < 0.001); and between PM2.5 exposure and lung cancer (OR = 1.87; RR = 1.88; p < 0.001). These findings may be used to promote an increased awareness among FNSB residents of the potential impact on cancer diagnoses from inhaling high levels of PM2.5, so residents may change their behavior in favor of alternatives to biomass burning to improve air quality.

Demographic, Environmental, And Clinical Variables Associated With Dengue In Saint Lucia, Brendan Lee

Walden Dissertations and Doctoral Studies

Dengue is the most important arboviral disease of public health concern on the world stage. In Saint Lucia, the disease has been endemic for years. Little research has been published on the specific epidemiology of dengue in Saint Lucia, and this study sought to identify the risk factors associated with the disease specific to the island. This study was underpinned by ecological theory, which is used to explain the possible relationships between risk factors and the occurrence of dengue. This three-manuscript study was used to evaluate the relationship between demographic, environmental, and clinical variables and the occurrence of dengue as …

Perceived Obstacles For State-Facilitated Legal Recreational Cannabis, Robert A. Lino

Walden Dissertations and Doctoral Studies

U.S. states that facilitate the use of legal recreational cannabis face the threat of federal prosecution because cannabis remains illegal at the federal level. The purpose of this qualitative case study was to assess the perceived obstacles to the state-facilitated regulation and implementation of legal recreational cannabis. Collective action federalism theory provided the framework for the study. The data collection instrument was developed based on themes in the literature and was pilot tested to ensure accuracy. The final study included 22 participants who represented the cannabis industry in the United States. Descriptive coding and thematic analysis indicated that the federal …

Supporting Intervention For Adolescents Of Incarcerated Parents In Rural Areas, Jeanette Kathleen Loudy

Walden Dissertations and Doctoral Studies

This study was focused on the challenges experienced by children who had a parent incarcerated during their adolescence. The purpose of this qualitative phenomenological study was to explore the lived experiences of adult child survivors of parental incarceration in a rural community and to describe the impact that parental incarceration had on children during adolescence and into young adulthood. The research questions were designed to examine the perceived challenges facing adult children of parental incarceration in rural areas and policy intervention programs that would be most effective at supporting children of parental incarceration during adolescence and the transition into adulthood. …

Perceptions Of The Reentry Process Among African American Male Ex-Offenders With Multiple Incarcerations, Chanae Latrice Lumpkin

Walden Dissertations and Doctoral Studies

Within 3 years of their release from the criminal justice system, almost 7 out of 10 released African American males go back to. There is limited social science research into how these ex-offenders perceive their lived experiences after release. The research questions that guided this inquiry related to understanding the post-prison experiences of African American males with a history of multiple incarcerations. The conceptual framework was guided by Tajfel’s social identity theory and Becker’s social reaction theory. Interviews were conducted with a purposeful sample of 6 African American males with a history of multiple incarcerations who had been released from …

Preschool Teacher Perspectives Of Crisis Preparedness, Sara Ann Machado

Walden Dissertations and Doctoral Studies

The purpose of this study was to understand the perspectives of preschool teachers

regarding school-based emergency planning in independently funded childcare centers.

Current research has investigated perspectives of crisis preparedness by a variety of

school staff but has not yet included the extent to which preschool teachers feel prepared

to handle a school crisis event. This study was based on the integrated model of school

crisis preparedness and intervention proposed by Jimerson, Brock, and Pletcher. This

study examined how preschool teachers describe the effect of crisis preparedness drills

and training on their ability to handle school crisis events prior to, …

Mentoring Among Homosexual Male Managers: A Phenomenological Inquiry, Joseph Mannino

Walden Dissertations and Doctoral Studies

Homosexuality has become more accepted and recognized in the past 50 years by the public. Mentoring has been a key factor in employee engagement and job satisfaction of proteges. While past studies have investigated discrimination towards homosexual employees, there has been an absence of research about homosexual mentorship relationships between homosexual managers and employees in the workplace. The research question for this study inquired about the mentoring experiences of homosexual male managers in corporations. The purpose of this descriptive phenomenological investigation was to develop an understanding of the mentoring experiences of homosexual male mentors and proteges in corporate management. Leader-member …

Medication Reconciliation In An Outpatient Clinical Setting, Tilena Martin

Walden Dissertations and Doctoral Studies

Medication reconciliation is a fundamental step in the delivery of safe care, because if it is not done correctly, it can set the stage for medication errors. Medication reconciliation has been shown to alleviate safety issues that lead to mortality, falls, and adverse drug reactions. The project question examined how in-service training can improve the knowledge of nurse practitioners and medical assistants about medication reconciliation. The project was guided by Knowles’ theory of adult learning and Rosswurm and Larrabee’s health belief model. A 1-hour educational module was prepared, and all participants completed the training prior to a discussion period. Sources …

The Hospital Consumer Assessment Of Healthcare Providers And Systems And Readmissions, Sheri Matson

Walden Dissertations and Doctoral Studies

Patient perception of care has become a main priority in the delivery of high-quality health care. The creation of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey provided a nationally standardized method of evaluating patient perception to be incorporated in the reimbursement process defined by the Centers for Medicare and Medicaid Services (CMS). The purpose of this study was to examine the relationship between HCAHPS scores and readmission rates in 2 states in the South Atlantic region of the United States. Using social construction theory, this quantitative study utilized multiple regression analysis to analyze HCAHPS scores (independent …

Examining Predictors Of Birth Outcomes: Implications For Early Childhood Development And Policy, Cissy Lee Mattingly

Walden Dissertations and Doctoral Studies

While the infant mortality rate has improved significantly in the United States in recent years, a Black-White disparity persists. The problem is the high infant mortality rate in the state of Texas. The purpose of this quantitative multiple logistic regression study was to examine disparities in birth outcomes in the state of Texas by race, ethnicity, and other significant predictors related to socioeconomic status. The Mosley-Chen theoretical framework bridges the gap between social science and biomedicine to identify key predictors of infant mortality including socioeconomic factors for studies in child development. The 2 research questions examined if race and ethnicity …

Increasing Compliance With Sequential Compression Devices To Reduce Venous Thromboembolism, Randy Mcclain

Walden Dissertations and Doctoral Studies

Venous Thromboembolism (VTE) is a life-threatening complication. Approximately 900,000 people in the United States are affected by VTE with a mortality of 300,000 cases per year. Although potentially preventable, VTE remains the leading cause of hospital deaths in the U.S. The practice problem addressed in the Doctor of Nursing Practice (DNP) project was evidence of an increased incident of VTE events on a trauma surgical unit. The practice-focused question evaluated the extent to which a nurse-driven protocol for VTE prophylaxis could improve adherence to mechanical prophylaxis with sequential compression devices and compliance with nursing documentation. The purpose for the doctoral …

Systematic Review: Barriers To Primary Care For The Transgender Individual, Charles David Mccormick

Walden Dissertations and Doctoral Studies

Representing a diverse group, the transgender community defies conventional norms expected by society resulting in discrimination and denial of essential goods and services necessary to maintain personal health, safety, and well being. The identification of the barriers to primary care faced by the transgender individual has the potential to reduce healthcare disparities and improve the compliance with national screening and treatment guidelines. The purpose of this project was to examine available literature incorporating the systematic review method to determine the barriers to primary care faced by the transgender individual. Using Leininger’s transcultural nursing theory to guide the process to determine …

Healthcare Providers Perception Of Their Ability To Recognize Boys As Victims Of Human Sex Trafficking In A Pediatric Emergency Room, Deborah Susan Mican

Walden Dissertations and Doctoral Studies

The purpose of this dissertation was to explore the perceived barriers to pediatric emergency room (ER) providers’ identifying boys as victims of child sex trafficking (CST), to understand how providers working in a pediatric ER compared to a general ER believe they are better able to identify boys as CST victims, and to understand how the New Jersey-mandated human trafficking training affected the confidence of the healthcare providers’ to identify boys as CST victims using a grounded theory approach. In-depth interviews were conducted using a sample of 10 healthcare providers, including physicians, nurse practitioners, and physician assistants at a suburban …

Clinician Perspectives On Gender Bias In Diagnosis Of Borderline Personality Disorder, Carl N. Modeste

Walden Dissertations and Doctoral Studies

Healthcare systems across the globe strive to provide equal treatment for all patients irrespective of their status; nevertheless, disparities occur. Gender-based prejudices are present in many cultures and often affect clinicians’ diagnostic and treatment practices. Borderline personality disorder (BPD) patients represent a category that is more prone to gender biases. With a focus on Canada, this study was designed to contribute to currently limited evidence on BPD gender biases by addressing the knowledge gaps in clinical gender-based studies. The study was an exploration of forensic psychologists’ and psychiatrists’ methodology leading to making a diagnosis of BPD and the factors that …

Influence Of Implicit Racial Bias On Police Officers’ Decision To Use Force, Billy L. Moffett

Walden Dissertations and Doctoral Studies

U.S. police administrators have embraced the implicit racial bias model to minimize the racial bias in their officers’ use-of-force decisions amid a public outcry on excessive police force and racism against African Americans. Although researchers have investigated whether officers have an implicit racial bias, they have not analyzed implicit bias from a police officer’s naturalistic perspective. The purpose of this qualitative phenomenology study was to describe what implicit racial bias perceptions emerged from a small sample of experienced officers when the officers were confronted with a use-of-force decision during an encounter with an African American man. The implicit racial bias …

Transformational Leadership And Fiscal Sustainability In African American Churches, James Munford

Walden Dissertations and Doctoral Studies

African American church leaders often experience difficulty responding to financial crises, which ultimately increases their risk of organizational failure. Grounded in the transformational leadership theory, the purpose of this quantitative correlation study was to examine the relationship between transformational leadership and fiscal sustainability of African American churches in South Carolina, Pennsylvania, Delaware, New Jersey, Texas, North Carolina, Virginia, California, and the District of Columbia. Data were gathered from online surveys received from 92 adult church leaders who were responsible for the daily administration of their church’s duties and responsibilities. The results of the multiple regression analysis indicated the model significantly …

Challenges Of Human Resource Professionals Onboarding Generation Z Into The Federal Government, Flora Lawson Murphy

Walden Dissertations and Doctoral Studies

The U.S. labor market expects 83 million of the youngest generational cohort, known as Generation Z, to join the workforce with different attitudes towards work than previous generations. The methods used by human resource (HR) professionals to onboard Generation Z into organizational cultures are not well understood. The purpose of this qualitative single case study was to explore the challenges that federal HR professionals experience during the onboarding process for Generation Z employees. The data gathering and analysis were framed by Mannheim and Strauss-Howe’s theory on generational cohort and the conceptual framework developed by the Office of Personnel Management on …

Perceptions Of Probation Officers Placing Juvenile Sex Offenders In Rural South Carolina, Anthony Rochell Nelson Sr

Walden Dissertations and Doctoral Studies

In the western world, juveniles move through the criminal justice system by the hundreds of thousands. The probation services for many juveniles, however, are lacking due to the limited amount of psychological counseling, mental health facilities, and available mentors. Probation officers face accelerated challenges for juvenile sex offenders, particularly those residing in rural areas where resources are even more limited. Using the attribution theory, this qualitative case study explored the perceptions and decision-making challenges facing four juvenile intensive supervision officers in rural South Carolina when placing youthful offenders. Interviews were coded and analyzed using thematic content analysis. Results showed that …

Why Do Mentors Stay? Exploring Mentor Experiences, Perceptions And Motivations Within Mentorship Programs, Ann Murphy

Walden Dissertations and Doctoral Studies

Youth mentorship has captured the attention of policymakers as a method of addressing societal issues. A review of the literature highlighted challenges that mentorship programs face regarding mentor sustainability. The purpose of this study was to explore and differentiate the experiences, perceptions, and motivations among paid and volunteer mentors within formal youth mentorship programs. This phenomenological study informs public policymakers how funding should be allocated within the nonprofit sector in order to optimize mentor retention. Structural functionalism and Kingdon’s multiple streams approach composed the conceptual framework for this study. Data were collected utilizing 14 semistructured interview questions. An analysis of …

Understanding School Climate, Chronic Absenteeism, And Effective Practices For Improving Absenteeism At A Private High School, Tiffany Nerveza-Clark

Walden Dissertations and Doctoral Studies

Student absenteeism in high school continues to be a nationwide educational challenge. In manifestation of this problem, a private high school in Utah was identified as having a significant number of students with excessive absenteeism. Guided by Bronfenbrenner’s socio-ecological theory and Baumrind’s authoritative model, the purpose of this descriptive case study was to explore teacher and administrator perceptions about school climate and how to improve chronic absenteeism (CA). The research questions focused on how faculty perceived school climate, its effect on student absenteeism, and best practices being used to encourage attendance. The data collection included a) descriptive information from 13 …

Financial Management Strategies For Sustaining Small Entertainment Businesses, Michael Nana Nitto

Walden Dissertations and Doctoral Studies

Lack of effective financial management control strategies results in many small business entertainment owners (SBEOs) failing within their first 5 years of operations. Without strategies to develop and maintain adequate financial management controls, SBEOs may lose market share and potentially go bankrupt, which would result in the loss of jobs and income for employees. Grounded in the mental budgeting theory, the purpose of this qualitative multiple case study was to explore financial management strategies successful SBEOs use to improve productivity and profitability to sustain business operations beyond 5 years. The participants comprised 4 successful SBEOs in Northern Virginia who effectively …