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Articles 1081 - 1110 of 16767
Full-Text Articles in Entire DC Network
Assessing The Appropriateness Of Mental Health Patients For Telehealth Care, Jacquelyn Hamed
Assessing The Appropriateness Of Mental Health Patients For Telehealth Care, Jacquelyn Hamed
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) project developed an evidence-based clinical practice guideline (CPG) to address the inconsistent selection of patients for telepsychiatry services. Using the Johns Hopkins evidence-based practice model and evaluated through the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument, the project translated research findings into a practical tool for improving clinical decision-making. Telepsychiatry has been shown to produce outcomes comparable to in-person care for mild to moderate psychiatric conditions. However, without clear criteria, some patients with complex or high-acuity disorders are inappropriately scheduled for virtual visits, posing safety and quality risks. The CPG …
Telepsychiatry Follow-Up To Reduce Emergency Department Visits In Adults With Bipolar Disorder, Obianuju Tobechukwu Ibe
Telepsychiatry Follow-Up To Reduce Emergency Department Visits In Adults With Bipolar Disorder, Obianuju Tobechukwu Ibe
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) project involved the development of a clinical practice guideline (CPG) for implementing structured telepsychiatry follow-up visits to reduce relapse rates and emergency department (ED) use among adults with bipolar disorder. The project addressed the growing need for accessible, evidence-based psychiatric follow-up care, particularly for patients facing barriers to consistent in-person visits. The practice-focused question guiding this project was: In adults with bipolar disorder, how do structured telepsychiatry follow-up visits, compared with in-person visits, affect relapse rates and Ed utilization? A systematic review and critical appraisal of current evidence were conducted using the Johns Hopkins …
Enhancing Training For Law Enforcement In Mental Health Responses In The Community, Tiffany Raines
Enhancing Training For Law Enforcement In Mental Health Responses In The Community, Tiffany Raines
Walden Dissertations and Doctoral Studies
A significant issue in human services practice in Macon, Georgia, is law enforcement officers’ responding to individuals experiencing a mental health crisis in public. Many police officers are not equipped to handle situations involving individuals experiencing mental health events, leading to possible adverse outcomes such as injury, incarceration, or even fatalities. There are increasing rates of mental illness disorders, and therefore, the need for compassionate, informed approaches for human service professionals to respond to those in crisis. More training to improve responses can lead to better outcomes for individuals in crisis, foster community trust in law enforcement, and enhance overall …
Clinical Practice Guideline For Universal Anxiety Screening For Advanced Practice Providers, Kelechi Blanton
Clinical Practice Guideline For Universal Anxiety Screening For Advanced Practice Providers, Kelechi Blanton
Walden Dissertations and Doctoral Studies
This project was a clinical practice guideline (CPG) focused on anxiety screening in a primary care setting using the Generalized Anxiety Disorder (GAD-7) screening tool. The practice problem addressed general anxiety disorder and the need for standardized assessments for risk, as recently been recommended by the U.S. Prevention Service Task Force (USPSTF). Anxiety disorder is common but frequently untreated, due in part to low rates of screening. Lack of an evidence-based guideline for anxiety screening may contribute to delayed diagnosis and inconsistencies. The practice-focused question was, Does the evidence support development of an evidence-based CPG for universal anxiety screening in …
Experiences Of Loneliness And Belonging Among U.S.-Born Women During The Covid-19 Pandemic In Germany, Anna Sizorina
Experiences Of Loneliness And Belonging Among U.S.-Born Women During The Covid-19 Pandemic In Germany, Anna Sizorina
Walden Dissertations and Doctoral Studies
Existing literature indicates that the COVID-19 pandemic led to increased levels of loneliness, particularly among individuals with transnational ties. Travel and entry bans, along with social distancing, led to separation from family abroad and from people and communities in the countries of new residence. In this qualitative phenomenological study, experiences of loneliness and belonging among U.S.-born women during the COVID-19 Pandemic in Germany were explored. The transaction theory of stress guided the scientific enquiry, and the evolutionary theory of loneliness served as a conceptual framework for examining loneliness in the given context. Six adult female participants, born in the United …
Improving Blood Pressure Control In Home Care Patients Through Implementation Of Acc/Aha Hypertension Guidelines And Structured Blood Pressure Monitoring, Farrah Lynn Yuille
Improving Blood Pressure Control In Home Care Patients Through Implementation Of Acc/Aha Hypertension Guidelines And Structured Blood Pressure Monitoring, Farrah Lynn Yuille
Walden Dissertations and Doctoral Studies
This clinical practice guideline addressed the practice problem of the lack of standardized and consistent hypertension management in the home setting. Addressing this practice problem is important within nursing practice, as uncontrolled blood pressure increased the risk of hospitalizations, emergency department visits, and long-term cardiovascular complications. The practice question focused on translating evidence-based hypertension guidelines into clinical practice and evaluating their impact on patient outcomes in the home care setting. The purpose of the project was to engage three voluntary participants in evaluating the clinical practice guideline per the American College of Cardiology and American Heart Association hypertension guidelines within …
Work-Life Balance And Occupational Stress: Moderating Factors Among African American Telecommunication Workers, Robert Charity
Work-Life Balance And Occupational Stress: Moderating Factors Among African American Telecommunication Workers, Robert Charity
Walden Dissertations and Doctoral Studies
After the COVID-19 pandemic, remote call center employees faced intensified challenges in maintaining work-life balance (WLB) while experiencing elevated occupational stress (OS) levels. The purpose of this quantitative correlational study was to investigate the relationship between WLB and OS among African American (AA) call center professionals employed in the telecommunications industry, moderated by resilience (RS), gender, and generational age (GenAge). The theoretical framework included boundary theory, the job demands-control model, and resilience theory. The participants comprised 103 AA telecommunications call center professionals aged 28 to 65 in the southwestern United States. They completed the work-life balance scale, perceived occupational stress …
Staff Education Using A Workplace Violence Reduction Bundle, Julla Panneh
Staff Education Using A Workplace Violence Reduction Bundle, Julla Panneh
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) quality improvement project addressed the ongoing issue of workplace violence (WPV) among medical-surgical nurses in an acute care setting. WPV poses significant risks to staff safety, psychological well-being, and the overall care environment. Guided by current evidence and professional guidelines, the project implemented a structured educational intervention focused on the Workplace Violence Reduction Bundle, incorporating the Broset Violence Checklist (BVC) and evidence-based de-escalation strategies. Medical-surgical nursing staff participated in tailored educational sessions; knowledge was assessed through pre- and post-intervention surveys, and program acceptability was evaluated through staff feedback. Data analysis revealed modest improvements in …
Impact Of Workplace Ostracism, Moderated By Personality Traits On Psychological Safety, Aniko Rastovac
Impact Of Workplace Ostracism, Moderated By Personality Traits On Psychological Safety, Aniko Rastovac
Walden Dissertations and Doctoral Studies
Psychological safety, an essential element for fostering collaboration, trust, and innovation, can be undermined by negative interactions in the workplace. Most importantly, a lack of psychological safety is a barrier to individual and organizational growth, development, and innovation, which is necessary for gaining a competitive organizational advantage. The present study examines the concept of workplace ostracism as a negative interaction in the workplace that affects psychological safety. Using the big five personality traits framework, Edmondson’s (1999) concept of psychological safety, and Tett et al.’s (2021) trait activation theory, this quantitative study examined how individual differences moderate the impact of workplace …
Psychiatric Nursing Staff Promoting The Use Of Long-Acting Injectables Antipsychotics, Yetunde Oloto
Psychiatric Nursing Staff Promoting The Use Of Long-Acting Injectables Antipsychotics, Yetunde Oloto
Walden Dissertations and Doctoral Studies
This project is a staff education aimed at improving psychiatric staff knowledge regarding the use of long-acting injectable (LAI) antipsychotics among patients with schizophrenia. The practice problem addressed was the limited use of LAIs among psychiatric nurses when treating schizophrenia patients, which contributes to medication non-adherence and subsequent relapse, hospitalization, increased healthcare costs, and diminished quality of life. In nursing practice, this problem is important because nurses are frontline practitioners who administer medications, provide education, and monitor patient adherence. The problem-focused question developed was “Among psychiatric nurses, does staff education on the use of long-acting injectable antipsychotics compared to oral …
Staff Education To Improving Patient Safety Outcomes Through Structured Staff Education, Imuetinyan Phillipa Ehondor
Staff Education To Improving Patient Safety Outcomes Through Structured Staff Education, Imuetinyan Phillipa Ehondor
Walden Dissertations and Doctoral Studies
This staff education doctoral project was implemented to address inconsistent staff knowledge of patient safety principles, disproportionate adherence to safety practices, and underutilization of standardized educational resources in an acute care clinic setting. It was important to address this issue in the context of nursing practice because patient safety is foundational to high-quality health care, directly influencing patient outcomes, regulatory compliance, organizational performance, and workforce morale. The practice-focused question was the following: In an acute care clinic, how does the implementation of a standardized safety protocol education program, compared to existing practices, impact staff knowledge regarding a culture of safety? …
Staff Education To Decrease Polypharmacy And Improve Medication Adherence In Older Adults In Primary Healthcare Settings, Nadine Pean Noel
Staff Education To Decrease Polypharmacy And Improve Medication Adherence In Older Adults In Primary Healthcare Settings, Nadine Pean Noel
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) project was a staff education initiative to address polypharmacy and increase medication adherence among older adults in a primary care setting. Polypharmacy is a prevalent and significant safety concern in older adults, increasing the risk for adverse drug events, medication nonadherence, hospitalizations, and decreased quality of life. The purpose of the project was to implement and evaluate a structured staff education focused on evidence-based strategies for medication review, deprescribing, and the integration of smartphone-based adherence tools. The practice-focused question guiding this project was as follows: Will an evidence-based staff education program focused on polypharmacy …
Staff Education To Nurses To Lmprove Routine Foot Examinations For Diabetic Patients, Sarah Abrefi
Staff Education To Nurses To Lmprove Routine Foot Examinations For Diabetic Patients, Sarah Abrefi
Walden Dissertations and Doctoral Studies
Diabetes-related foot complications remain a significant cause of morbidity, hospitalization, and lower-extremity amputation, despite strong evidence supporting routine preventive assessments. In many outpatient settings, variability in nursing knowledge, skill, and documentation practices contributes to inconsistent implementation of comprehensive diabetic foot examinations. The purpose of this practice-focused quality improvement project was to evaluate the effectiveness of a structured staff education program designed to improve nurses’ knowledge and competency in performing comprehensive diabetic foot assessments in an outpatient diabetes clinic.A pretest–posttest evaluative design was used to measure changes in knowledge following the educational intervention. Ten registered nurses participated in a structured educational …
Strategies To Engage Physicians In Reforming Healthcare Administrative Policies And Processes, Sara Hunt
Strategies To Engage Physicians In Reforming Healthcare Administrative Policies And Processes, Sara Hunt
Walden Dissertations and Doctoral Studies
A lack of physician engagement in healthcare reform initiatives is a persistent problem that can negatively affect hospital performance and patient care outcomes. Hospital leaders and healthcare administrators are concerned with low levels of physician engagement because of its association with reduced organizational effectiveness and quality of care. Grounded in the distributed leadership framework, the purpose of this qualitative single case study was to explore strategies hospital leaders used to engage physicians in reforming administrative policies and processes to improve patient service delivery. Semistructured interviews were conducted with five hospital leaders from one hospital in the southeastern United States who …
Depression, Education, And Quality Of Life In Women With Endometriosis, Ria N. Gajar
Depression, Education, And Quality Of Life In Women With Endometriosis, Ria N. Gajar
Walden Dissertations and Doctoral Studies
Endometriosis is a chronic gynecologic condition associated with substantial physical, psychological, and social burden, and depressive symptoms are consistently linked to poorer health-related quality of life (HRQoL) among affected women. However, limited population-based research has examined how depressive symptoms intersect with social factors. Guided by Engel’s biopsychosocial model, nationally representative data from the 2005–2006 National Health and Nutrition Examination Survey (NHANES)—the most recent cycle to include an item on endometriosis diagnosis—were analyzed among U.S. women with self-reported endometriosis (N = 4,137). Complex samples logistic regression models were used to examine associations between depressive symptoms and HRQoL across general, physical, and …
Optimizing Workforce Planning To Reduce Outsourcing Of Clinical Roles In Physician Practices, Heidi Sontag
Optimizing Workforce Planning To Reduce Outsourcing Of Clinical Roles In Physician Practices, Heidi Sontag
Walden Dissertations and Doctoral Studies
The increasing reliance on outsourcing of clinical roles in physician practices has raised concerns regarding continuity of care, staff morale, and organizational control over service quality. While outsourcing may offer temporary financial relief, outsourcing often introduces inefficiencies and declines in patient satisfaction. In this integrative review, I identified workforce planning strategies that reduce outsourcing reliance while enhancing organizational efficiency and patient care outcomes. Using the Johns Hopkins evidence appraisal tools, I analyzed sources published between 2022 and 2025 grounded in resource dependency and Herzberg’s two-factor theories. Five thematic areas emerged: organizational efficiency, patient satisfaction, cost management, staff morale and engagement, …
Invisible Man: Mental Health Providers And How Implicit Bias Manifests When Treating African American Men, Jamila Kali Robinson
Invisible Man: Mental Health Providers And How Implicit Bias Manifests When Treating African American Men, Jamila Kali Robinson
Walden Dissertations and Doctoral Studies
African American men continue to face disproportionate barriers to engagement, accurate diagnosis, and equitable nonbiased treatment in mental health settings. The purpose of the qualitative narrative inquiry was to explore how implicit bias and sociocultural assumptions manifest among mental health providers who diagnose and treat African American men. Bronfenbrenner’s ecological systems theory, which considers the influences of all the systems that shape an individual’s lived experiences, was the study’s theoretical framework. Semi-structured interviews were conducted with five licensed mental health providers who worked in large hospital systems, private practice, or community-based clinics. The interview data were analyzed using Braun and …
Staff Education To Improve Rn Accountability In Interdisciplinary Rounds Using Qr Code Tracking, Jennifer L. Zimmerman
Staff Education To Improve Rn Accountability In Interdisciplinary Rounds Using Qr Code Tracking, Jennifer L. Zimmerman
Walden Dissertations and Doctoral Studies
Interdisciplinary rounding is essential for effective communication, coordinated care, and patient‑centered decision‑making; however, baseline observational audits on pediatric inpatient units at a large northeastern hospital revealed that nurses were present for only 54% of rounding opportunities, with no formal accountability process. This Doctor of Nursing Practice project aimed to improve registered nurse (RN) engagement and accountability in interdisciplinary rounds through a structured staff education intervention paired with a QR code–based tracking process. The practice‑focused question examined whether educating nursing staff on a QR code rounding system would increase nurses’ knowledge of rounding expectations and positively influence accountability behaviors. Fourteen RNs …
The Moderating Role Of Self-Esteem In The Relationship Between Perceived Gender Bias And Job Satisfaction Among Women In The Technology Industry, Roberta L. Minicola
The Moderating Role Of Self-Esteem In The Relationship Between Perceived Gender Bias And Job Satisfaction Among Women In The Technology Industry, Roberta L. Minicola
Walden Dissertations and Doctoral Studies
Women employed in the technology industry continue to experience gender-based bias that may adversely affect job satisfaction. Although the deleterious impact of gender bias on women’s job satisfaction has been well documented, the potential of self-esteem to mitigate this impact has not yet been examined. Informed by social dominance theory, the purpose of this quantitative, cross-sectional, correlational study was to examine the moderating effect of self-esteem on the relationship between perceived gender bias (i.e., insufficient support, devaluation, hostility) and job satisfaction among women working in the U.S. technology sector. Data were collected from 138 female technology professionals recruited through Amazon …
Staff Education On Preventing Benzodiazepines Related Falls In Older Adults, Dafnee Gilles
Staff Education On Preventing Benzodiazepines Related Falls In Older Adults, Dafnee Gilles
Walden Dissertations and Doctoral Studies
In geriatric psychiatric setting, falls rates are higher than general wards and could reach up to 13-25 falls per 1000 hospital days. High use of benzodiazepines in older adults is a major cause of increased falls despite recommendations to avoid its prescription to the population. This DNP staff education project focused on training nurses working in an 80 bed capacity geriatric psychiatric facility on best evidence based practice of preventing falls associated with use of BZDs. The identified practice issue was knowledge deficit on evidence based best practices to prevent falls in older adults under BZDs medications. The project aims …
Staff Education Project Staff Education To Integrate Nutrition Into Mental Health Care In An Acute Medical Setting, Yolene Auguste
Staff Education Project Staff Education To Integrate Nutrition Into Mental Health Care In An Acute Medical Setting, Yolene Auguste
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) project was a staff education initiative designed to support the implementation of a protocol that integrates nutrition and mental health screening in an acute medical setting. The practice problem addressed inconsistent identification of nutrition-related needs and mental health concerns, along with variable follow-through on referral pathways, limiting holistic care and contributing to unmet needs during and after hospitalization. Nutrition and mental health are bidirectionally related, with dietary quality and lifestyle factors influencing mental health outcomes and overall well-being (Dubois & Giroux, 2025). The practice-focused question guiding this project was: In adult patients receiving care …
Teachers And Administrators' Perceptions Of School Resource Officers, Shameka J. Duncan
Teachers And Administrators' Perceptions Of School Resource Officers, Shameka J. Duncan
Walden Dissertations and Doctoral Studies
School Resource Officers (SROs) play a significant role in middle and high schools in Metro Atlanta; however little research has included the perceptions of school administrators and teachers about their roles. The purpose of this descriptive qualitative study was to explore the perceptions of teachers and administrators regarding the roles of SROs and their perspectives on the practices that could enhance collaboration among these stakeholders in ensuring school safety. Informed by Gregory’s theory of perception, the study investigated how educators and administrators described their interactions with SROs. Data was gathered via semi-structured interviews with three teachers and three administrators and …
Exploring Strategies For Leadership In Small Businesses, Edward B. King
Exploring Strategies For Leadership In Small Businesses, Edward B. King
Walden Dissertations and Doctoral Studies
Small businesses face challenges in maintaining leadership continuity. Unstable leadership transitions can jeopardize business survival. Business leaders are concerned with selecting qualified succession leadership to avoid increased business costs and operational disruptions. Grounded in replacement planning theory, the purpose of this qualitative pragmatic inquiry project was to identify and explore successful strategies used by business leaders in small Oklahoma enterprises to select qualified leadership successors. The participants were six leaders of small businesses in the U.S. state of Oklahoma who had successful strategies for selecting qualified leadership successors. Data were sourced from semistructured interviews and publicly available organizational documents. Thematic …
Improving Nursing Knowledge Of Medication Adherence In Bipolar Disorder, Abisola Omobolanle Disu
Improving Nursing Knowledge Of Medication Adherence In Bipolar Disorder, Abisola Omobolanle Disu
Walden Dissertations and Doctoral Studies
The purpose of the project was to improve staff knowledge using a structured educational intervention. The project was guided by the Johns Hopkins evidence-based practice model. Approximately 30 relevant articles were identified, with 20 meeting inclusion criteria and levels of evidence ranging from Level I to V, indicating moderate overall strength of evidence. The educational intervention consisted of a single, in-person, staff education session delivered to 11 outpatient mental health staff members. I administered a project-developed pre- and postknowledge assessment to evaluate participants’ knowledge change. De-identified data were analyzed using descriptive statistics. Results demonstrated increased staff knowledge, with mean scores …
North Dakota Emergency Medical Personnel’S Perceptions Of Human Trafficking, Jessica Evans
North Dakota Emergency Medical Personnel’S Perceptions Of Human Trafficking, Jessica Evans
Walden Dissertations and Doctoral Studies
Human trafficking is an abhorrent human rights violation, and victims experience a myriad of health disturbances while being exploited. Victims often seek emergency medical care, but research consistently shows that emergency medical personnel (EMP) are largely unprepared to screen, identify, and respond to them. However, there has been no research exploring their preparedness to screen, identify, and respond to victims of human trafficking, the barriers and challenges to identification of human trafficking victims, and training needs to improve screening, identification, and response to human trafficking victims in North Dakota. This study employed a generic qualitative approach grounded in constructivism. The …
Determinants Of Clinical Supervisor Self-Efficacy In Substance Use Disorder Counseling, Victoria A. Nagel
Determinants Of Clinical Supervisor Self-Efficacy In Substance Use Disorder Counseling, Victoria A. Nagel
Walden Dissertations and Doctoral Studies
Substance use disorder counselors face increasing challenges in responding to a growing and more severely affected population, often presenting with co-occurring mental health conditions and complex clinical needs. Clinical supervision plays a critical role in supporting counselor development, yet little is known about the factors that contribute to clinical supervisors’ self-efficacy in providing supervision for alcohol and drug counselors. The purpose of this quantitative correlational study was to examine whether years of counseling experience, years of substance use disorder (SUD) counseling experience, years as a clinical supervisor, professional counseling credentials, and supervisory credentials predicted self-efficacy among clinical supervisors. This study …
Association Between Environmental Exposures To Perfluoroalkyl And Polyfluoroalkyl Substances And Military Veterans Cancer Determination, Stephen A. Pereira Jr
Association Between Environmental Exposures To Perfluoroalkyl And Polyfluoroalkyl Substances And Military Veterans Cancer Determination, Stephen A. Pereira Jr
Walden Dissertations and Doctoral Studies
This study involved evaluating whether cumulative exposure to perfluoroalkyl and polyfluoroalkyl substances (PFAS) was associated with kidney cancer, bladder cancer, and adult leukemia among U.S. veterans. Pooled National Health and Nutrition Examination Survey (NHANES) data from 2005–2015 were analyzed for sample of 2,500 veterans with available serum PFAS measurements and physician-diagnosed cancer histories. This study employed a cross-sectional, correlational design grounded in a post-positivist paradigm. Inclusion required complete data for (a) serum PFAS concentrations, (b) kidney cancer, bladder cancer, and adult leukemia, and (c) covariates age, sex, race/ethnicity, smoking status, and body mass index. Cumulative PFAS was modeled as a …
Staff Education To Improve Antipsychotic Medication Adherence, Okikiola Oluwabunmi Ogunbunmi
Staff Education To Improve Antipsychotic Medication Adherence, Okikiola Oluwabunmi Ogunbunmi
Walden Dissertations and Doctoral Studies
Non-adherence to antipsychotic medication among patients with schizophrenia and other severe mental illnesses is a critical issue, contributing to high rates of relapse, rehospitalization, and increased healthcare costs. Despite the necessity of these treatments, patients often struggle with compliance due to lack of insight, side effects, or complex regimens. The project aimed to evaluate how structured staff education interventions increase knowledge and confidence among healthcare providers, regarding medication adherence strategies, including the use of Long Acting Injectable (LAI) antipsychotics and the “teach-back” methods. Staff education programs typically utilize evidence-based tools, pre-and post-intervention assessments, and training sessions to enhance knowledge on …
Survivors Of Sexual Trauma: Abortion Experiences Of Black Women In The Southern United States, Katie Grace Geter
Survivors Of Sexual Trauma: Abortion Experiences Of Black Women In The Southern United States, Katie Grace Geter
Walden Dissertations and Doctoral Studies
Women who experience both sexual trauma and abortion within their lifetime are highly likely to struggle with serious mental health symptoms; however, social work students and practitioners lack education and knowledge on how to serve these women. Recent events, including the uprising of gender and race related movements, COVID-19, heightened political division, and increased governmental control on abortion rights also impact social-work practice. Acknowledging intersectionality, the purpose of this qualitative study was to explore the experiences of abortion for Black women in the Southern United States who have a history of sexual trauma. The experiences of 6 Black women with …
The Relationship Between Medical Mistakes, Organizational Culture, And Patient Safety In South Florida Hospitals, Tachaumbi Lamaya Williams
The Relationship Between Medical Mistakes, Organizational Culture, And Patient Safety In South Florida Hospitals, Tachaumbi Lamaya Williams
Walden Dissertations and Doctoral Studies
The present study investigated the relationship between safety-promoting management structures and medical errors in South Florida hospitals. The purpose of the study was to determine if safety-promoting management frameworks reduce medical errors. Using Donabedian’s model, the main research question focused on whether specific organizational management systems are significantly associated with the frequency and severity of medical mistakes in these hospitals. Using a quantitative, cross-sectional research design, the study analyzed secondary data, initially collected by Leapfrog group. Data analysis involved descriptive statistics to profile the sample’s demographics and baseline characteristics, followed by inferential statistical tests to assess the primary hypothesis. Findings …