Digital Commons Network^™

Timing Of Substance Use Initiation: Assessing The Role Of Trauma And Race, Rebecca Petrie

Walden Dissertations and Doctoral Studies

The purpose of this study was to examine the strength of the association between race, trauma, and the age of initiation for substance use, specifically tobacco, marijuana, alcohol among high school students aged 13-18 in the United States. This research is critical because prior research has shown that trauma and race led to higher rates of substance use in adulthood. Still, limited research has shown how these factors affect the age of substance use initiation. The theoretical foundation for this study was the general strain theory since the theory posits that exposure to stresses or strain leads to delinquency, which …

Nutritional Education Program Using The Dash Diet For African Americans, Angela B. Williams

Walden Dissertations and Doctoral Studies

Hypertension (HTN) is a serious yet common condition that can be prevented or

controlled. Complications of uncontrolled HTN can lead to cardiac failure, renal disease,

and stroke. In the United States, HTN is greater among African Americans than any other

ethnic group and is prevalent in the community in which this project was conducted. To

address the problem of HTN and its effect on members of the African American (AA)

population in the site community, a program of HTN self-management emphasizing

patient education and healthy behaviors for the AA community was developed. The

purpose of this project was to search …

Integrating Health Care Systems To Maintain Quality Care And To Manage Cost, Marilynn Noble

Walden Dissertations and Doctoral Studies

The rising cost of health care in the Philippines is a concern for the Department of Defense and TRICARE beneficiaries. The purpose of this quantitative cross-sectional research study was to determine the efficacy and acceptability of a different method to deliver health care to increase access to health care and decrease out-of-pocket costs while maintaining quality of care for TOP Standard beneficiaries who receive health care under the Philippine Demonstration. Secondary data was used to determine the acceptability of an alternative reimbursement methodology to decrease cost but maintain access to quality care. The Andersen's behavioral health care model and the …

Financing Post-2015 Development Goals: Shaping A New Policy Framework For Aid In Liberia, Apollos Ikechukwu Nwafor

Walden Dissertations and Doctoral Studies

Liberia, Africa's oldest democracy, has made several efforts in becoming a developed economy and ending poverty, but these efforts have been hampered by lack of appropriate financing mechanisms to achieve this goal. The most recent challenge which was the purpose of this study was to understand how Liberia can finance and achieve the sustainable development goals adopted by the United Nations in September 2015. Despite substantial external aid, Liberia was only able to meet 3 out of the 8 Millennium Development Goals, and more than 60% of the population remain extremely poor. The main research question was to understand what …

Impact Of Smoking Cessation Education On Workplace Wellness, Monica Coles

Walden Dissertations and Doctoral Studies

Guidelines and laws prohibit smoking in public places, and evidence supports the safety and effectiveness of workplace wellness programs in promoting healthy environments. A long-term care (LTC) facility selected as the focus for this project does not offer wellness programs and does not restrict on-site smoking by employees. The purpose of this project was to construct an evidence-based smoking cessation education program for delivery to employees at the LTC facility. The practice-focused question addressed whether a workplace wellness smoking cessation education program would increase employees' knowledge of the harmful effects of smoking and promote engagement in smoking cessation strategies. A …

The Relationship Between Workspace And Office Placement And Workforce Productivity And Wellbeing, Mladen Cvijanovic

Walden Dissertations and Doctoral Studies

The quality of the physical workspace environment has been widely debated in research and corporate communities. Inadequate workspace conditions have been associated with elevated levels of work-related stress, productivity, and job satisfaction. However, scholarly literature offers very little on the relationship between workspace and office placement, and workforce productivity and wellbeing. The purpose of this non-experimental quantitative study was to examine the impact of customized workspace and strategic office placement on work related stress, productivity, and job satisfaction. Optimal distinctiveness theory and cognitive-motivational-relational theory provided the theoretical framework for this study. Nine research questions in this study were designed to …

Social Support And Glycohemoglobin Level Among Older Adults, Emma O. Fakiya

Walden Dissertations and Doctoral Studies

Diabetes is a public health concern among older adults in the United States due to the increasing prevalence of diabetes among this age group and the associated long-term and financial impacts. Self-management is a key strategy in the control of diabetes. The purpose of this quantitative study was to examine the association between social support and glycohemoglobin level. The social cognitive theory was the conceptual framework for this study. The research questions were designed to determine whether social support played a role in diabetes management. Data were collected using a cross-sectional survey of secondary data from the 2007-2008 National Health …

Strategies Healthcare Managers Use To Reduce Hospital-Acquired Infections, Yohannes Debesai

Walden Dissertations and Doctoral Studies

Every year, 2 million patients in the United States suffer with at least 1 hospital-acquired infection resulting in an estimated 99,000 deaths annually. The purpose of this exploratory single case study was to explore strategies healthcare managers in U.S. hospitals used to reduce hospital-acquired infections. The study included face-to-face, semistructured interviews with 5 healthcare managers from a hospital in Maryland who were successful in reducing these infections. The conceptual framework was human capital theory. Field notes, hospital documents, and transcribed interviews were analyzed to identify themes regarding strategies used by healthcare managers. The data analysis and coding process resulted in …

Examining Fear Of Recurrence In Cancer Survivors, Christina L. Dixon

Walden Dissertations and Doctoral Studies

Improvements in the medical field have given many cancer patients and survivors better odds of long-term survival. As more patients become survivors, the demand for psychological treatment becomes greater. The most prevalent concern of survivors is getting help with a psychosocial condition known as fear of recurrence (FOR). Prior to this study, few researchers had explored how having a more aggressive cancer influences the development of FOR. The purpose of this quantitative study was to determine whether cancer stage and type (a measurement of severity) are predictive of FOR development in the high-risk cancer groups lung and bronchus and female …

A Systematic Review Of The Effectiveness Of The Nln Jeffries Simulation Framework, Angela Feeler

Walden Dissertations and Doctoral Studies

Simulation theoretical frameworks serve as guidelines for the development, planning, implementation, and evaluation phases during nursing simulation activities. Simulation frameworks provide a substantive foundation for research, education, and practices that contribute to the science of nursing education. The purpose of this systematic literature review was to evaluate and synthesize evidence-based research that can be used to recommend the National League for Nursing (NLN) simulation education framework for simulation activities. The Academic Center for Evidence-Based Practice star model of knowledge transformation and descriptive theory were used as frameworks to guide this systematic literature review. The practice question for this systematic literature …

Reducing Compassion Fatigue In Hospice Nurses Through Education, Gregory Daniel Friesz

Walden Dissertations and Doctoral Studies

Compassion fatigue is a secondary stress reaction that results from providing care to those undergoing traumatic life events. Frequent exposure to dying patients with complex medical concerns has been identified as a contributing factor to compassion fatigue and resultant turnover among hospice nurses. The purpose of this project was to assess whether the provision of education to hospice nurses regarding compassion fatigue resulted in a demonstrable improvement in their levels of compassion fatigue. Watson's theory of human caring and Roy's adaptation model provided the theoretical foundation for this project. The practice-focused question for this project asked whether a reduction in …

The Experience Of Older Homeless Females With Type 2 Diabetes, Joan Jacqueline Downes

Walden Dissertations and Doctoral Studies

The purpose of this phenomenological study was to explore the experience of older homeless females who have type 2 diabetes mellitus. Women who have stable housing often find it difficult to manage their diabetes; for those who are homeless, managing the disease is even more difficult. This chronic disease has impacted people all over the world and decreased their quality of life. However, people who are homeless may be at a higher risk of this stressful illness. Managing glycemic levels is a crucial factor in decreasing the adverse results in type 2 diabetes. In this study, face-to-face interviews were conducted …

Electronic Health Record Implementation Strategies For Decreasing Healthcare Costs, Christopher A. Foster

Walden Dissertations and Doctoral Studies

Some managers of primary care provider (PCP) facilities lack the strategies to implement electronic health records (EHRs), which could decrease healthcare costs and enhance the efficiency and quality of healthcare that patients receive. The purpose of this single-case study was to explore the strategies PCP managers used to implement EHRs to decrease healthcare costs. The population consisted of 5 primary care managers with responsibility for the administration, oversight, and direct working knowledge of EHRs in Central Florida. The conceptual framework was the technology acceptance model. Data were collected from semistructured face-to-face interviews and the review of company documents, including training …

Advisory Committee On Immunization Practices Recommendations, Socioeconomics, Demographics, And Influenza Vaccine Uptake, Jennifer Gadarowski

Walden Dissertations and Doctoral Studies

Seasonal influenza outbreaks are associated with morbidity and mortality in the United States. Though children are the most susceptible to influenza infection and are most likely to transmit the illness to others, many children are not vaccinated. The purpose of this study was to examine the relationship between seasonal influenza vaccination Advisory Committee on Immunization Practices (ACIP) recommendations, demographic characteristics, socioeconomic factors, and vaccine type among children over 3 consecutive flu seasons. This quantitative cross-sectional study was guided by the social ecology of health model. Secondary data from 3 consecutive flu seasons (2014-2015, 2015-2016, and 2016-2017) provided by the National …

Subjective Sleep Quality Of Isolated Sleep Paralysis: Fear Parameters And Psychosocial Correlates, Yudyahn Kushkituah

Walden Dissertations and Doctoral Studies

The bidirectional link between insufficient sleep and the distress related to a parasomnia known as isolated sleep paralysis (ISP) might lead to chronic health effects. The impact of fear-ridden hallucinations related to this REM sleep disorder can be both distressful and embarrassing for individuals often resulting in a reticence to seek help. This quantitative study was guided by a biopsychosocial approach with an integrated theoretical framework. One aim of the study was to determine if fear parameters of ISP (low and high) differ when considering psychosocial factors and sleep quality, based on the Dysfunctional Beliefs and Attitudes About Sleep Scale, …

Efficacy Of A Minnesota Statute Enacted To Reduce Inflicted Traumatic Brain Injuries, Jonathan K. James

Walden Dissertations and Doctoral Studies

This quantitative research is on the efficacy of Minnesota Statute 144.574 enacted in 2005 in response to the growing awareness of behavior leading to inflicted Traumatic Brain Injuries (iTBI) in infants and children. The model for this research is grounded in the Theory of Reasoned Action wherein the education of new parents which graphically explains the physiologic changes to the structural architecture of the brain post-trauma, paired with their signature on a social contract (SC), demonstrated a reduction in incidence. Because the enacted statute does not include the signing of a SC, nor does it require face-to-face education as in …

Sustainability Strategies Of Barber Salons, Kouassi Gilles Mevo

Walden Dissertations and Doctoral Studies

Many barber salons and other small businesses in the United States fail to succeed beyond the first 5 years. The factors responsible for the low survival rate of salons may include the limited training and education levels mandated by state certification requirements. The purpose of this multiple case study was to identify business strategies successful barber salon owners use to overcome the business management and staffing challenges associated with a small pool of skilled barbers and the high turnover in a low wage profession. The theory of transformational leadership served as the conceptual framework. The data collection included interviews of …

Blood Lead Testing Guideline Development For A Public Health Department, Becky Sue Johnson Himes

Walden Dissertations and Doctoral Studies

A lack of consistent, evidence-based practices for blood lead testing of children existed in a local public health department (LHD). No known blood lead level is safe, and toxicity can result in behavioral and cognitive impairments. The purpose of this project was to develop and analyze a clinical practice guideline to establish blood lead testing procedures in the LHD to improve testing procedures and enhance future testing within the jurisdiction. The RE-AIM framework was used to address the reach, effectiveness, adoption, implementation, and maintenance of the clinical practice guideline. Five experts evaluated the guideline using the Appraisal of Guidelines for …

Evaluating An Educational Initiative For Postsurgical Vascular Patients, Cynthia Ann Gillespie

Walden Dissertations and Doctoral Studies

The educational medium GetWellNetWork (GWNW) in a large magnet teaching facility offered few educational videos specific to vascular patients with a focus on leg elevation after lower extremity bypass surgery. Supplying patient-specific education has the potential for providing cost-effective nursing care to vascular patients and improving hospital reimbursement. Guided by the interactive care model, a storyboard was developed using best-practice evidence for vascular postoperative patients that could lead to the development of a video to address the educational needs of vascular patients upon discharge. The practice focused question asked if a video addressing the importance of leg elevation would improve …

Work-Life Balance Of Tenured And Tenure-Track Women Engineering Professors, Lily Giang-Tien Gossage

Walden Dissertations and Doctoral Studies

Balancing the needs of family with career ambitions is often challenging for women who pursue science, technology, engineering, or mathematics (STEM) careers, particularly in academia. In these male-dominated workplaces, few incentives exist for women who decide to manage both work and family. In this basic qualitative research study, a modified approach combining in-depth interviewing with life-history interviewing was used to examine the work-life balance experiences of 12 tenured and tenure-track women engineering faculty who have children. The research question addressed participants' perceptions of engineering academia and experiences regarding family formation, child-raising, and the tenure process. Data were analyzed using the …

Social Workers' Perceptions Of Barriers To Substance Abuse Treatment In Mississippi, Catherine Pacher

Walden Dissertations and Doctoral Studies

Addiction is a national problem in the United States that impacts public health and social and economic welfare. The purpose of this case study was to identify barriers that impede treatment and hinder the success of client recovery from addiction. The research question focused on social work clinicians' perceptions of barriers to effective treatment with substance abuse clients in Coastal South Mississippi. The theoretical framework for this research was the reasoned action theory. Data was collected from a focus group, personal interviews, and the review of literature. Purposeful sampling was used to select 13 social workers for interviews and for …

Exploring Public Sector Leadership Through Appreciative Inquiry, Wendy L. Morton

Walden Dissertations and Doctoral Studies

Leadership is an important part of creating effective public organizations. Effective leaders have the potential to produce social change through positive follower and organizational outcomes, the development of important policies, and efficiently implementing public policy. The scholarly literature lacks research concerning how leadership styles translate to the public sector. The theoretical framework used to guide and support this study was Cooperrider and Whitney's appreciative inquiry. The research question explored in what ways public sector leaders affect how followers perceive themselves as social change agents in a local city-county health department. For this phenomenological study, 10 followers employed by a local …

Promoting Nurses Management Of Night Shift Sleepiness, Sunday Iken Okundolor

Walden Dissertations and Doctoral Studies

Nurses are largely unaware of the problems of night-shift-nurse sleepiness and available strategies to manage night-shift sleepiness. The purpose of this project was to examine nurses' self-perception, awareness of sleepiness, and current strategies to manage this problem in the emergency medicine department of a major academic hospital in the western United States. The validated de-identified Karolinska Sleepiness Scale (KSS) was used to measure the prevalence and intensity of night shift nurses' sleepiness prior to the development of an educational program on strategies to manage sleepiness. Of the 164 registered nurses surveyed, 72 (43.9%) reported sleepiness greater than 7 on the …

Staff Education Program To Promote Breast Cancer Prevention Among African American Women, Vanessa Marie Palmer

Walden Dissertations and Doctoral Studies

African American women living in rural Ohio have a history of low mammogram

screening rates and a high incidence of breast cancer identification in the late stage of the

disease, leading to mortality rates exceeding those of Caucasian women. The purpose of

this doctoral project was to establish a breast health educational program for health

providers in a local mammography center that did not provide such a program

specifically targeted for African American women. Three theoretical frameworks, the

health belief model, Knowles's learning theory, and the PEN-3 model, guided the

development of a staff education program based on cultural appropriateness. …

Psychological And Contextual Antecedents To Student Engagement Profiles Of Ninth Grade Students, Wendy Ann Jones

Walden Dissertations and Doctoral Studies

Student engagement is a determinant for students' academic success, readiness for higher education, and social agency. The purpose of this qualitative, case study was to explore ninth grade students' perceptions of the contextual and psychological factors that influence the development of student engagement profiles. The ecological systems theory was used as the framework for the study. Through purposive sampling, 15 participants were selected, and 5 groups of 3 were formed based on participants' engagement profiles as identified by cooperating teachers' categorization and the results of the Student Engagement Instrument. Using semi structured interviews, data were gathered for the 4 research …

The Role Of Advanced Practice Nurses In Advanced Care Planning For Cancer Patients, Sincere Mcmillan

Walden Dissertations and Doctoral Studies

In the United States, more than 75% of people will spend their last months of life in a health care facility. A key role for clinicians is to discuss care goals with the patients as part of a process called advanced care planning (ACP). As part of the oncology care team, advanced practice nurses (APNs) could help to increase the frequency of ACP discussions. The purpose of this project was to assess the knowledge and practice experiences of APNs regarding ACP at a National Cancer Institute designated cancer care hospital. Carper's patterns of knowing was the theoretical framework of this …

The Post-9/11 Gi Bill And Its Role In For-Profit University Enrollment, Irma Paul

Walden Dissertations and Doctoral Studies

There is limited research on the Post-9/11 Veterans Educational Assistance Act of 2008, known as the 9/11 GI Bill, which provides educational benefits to veterans who have served in the United States military on active duty for 90 days. While outcomes for public and nonprofit universities are well known, less is known about whether proprietary universities are successful in recruitment and enrollment of veterans under the 9/11 GI Bill. The purpose of this phenomenological study was to examine the experiences that veterans who were Post 9/11 Bill beneficiaries had with recruitment strategies and institutional public policy practices from for-profit institutions. …

Public Health Implications Of Retailer Resale Of Returned Textile Clothing Merchandise, Antonette M. A. Francis-Shearer

Walden Dissertations and Doctoral Studies

Historically, 18th century anecdotal accounts of the decimation of several tribes of U.S. of the Native American population by trading of infected textile blankets alludes to the role of retail in the transmission of infectious disease. This study explores implications of the modern day retail organization practice of reselling returned clothing textiles from a public health infectious disease perspective. A qualitative multi-case study, utilized responses from 20 open-ended, unstructured interviews of retail employees assigned to the returns process. Additionally, several informal observations of select U.S.based, top-ranked clothing retail organizations, identified by the National Retail Federation were completed. Select federal, state, …

Teacher Perceptions Of Math Professional Development In A Small Vocational School, Nisha Woody

Walden Dissertations and Doctoral Studies

Abstract The vocational math teachers at a vocational secondary school lack the adequate skills needed to be effective in math classrooms. The vocational teachers who teach math at the local vocational school have been identified as noncertified teachers based on their certification with the state department of education. The purpose of this project study was to determine the best professional development sessions needed to improve the instructional practice of untrained math teachers at the school. Their work is critical to the academic and career development of students. The social development theory of Vygotsky, which states that social interaction has an …

Factors Associated With Pesticide Resistance In Culex Mosquitoes, Jude Akpan

Walden Dissertations and Doctoral Studies

In recent years mosquito-borne diseases have reemerged, largely because of pesticide resistance. The mosquitoes develop resistance to pesticides because of broad and repeated uses of pesticides. Preventing the development of pesticide resistance requires proper understanding of the environmental factors potentially associated with the development of the resistance. The purpose of this study was to investigate the environmental factors associated with the resistance to pesticides by the Culex mosquitoes. This correlational study included the analysis of archived data samples (N = 29,794) from the Field Cage Tests results conducted between 2013 and 2017 by a large county public health department. The …