Digital Commons Network^™

Corporate Governance Strategies To Improve Organizational Performance In The Accounting Industry, Andress Walker

Walden Dissertations and Doctoral Studies

Corporate governance is a leading factor in organizational performance, financial reporting, and stakeholder satisfaction. The purpose of this multiple case study was to explore strategies that senior managers in the accounting industry implement to enforce corporate governance and improve organizational performance. The conceptual framework for the study was stakeholder theory. The population for this study included 3 senior managers of 3 different organizations in the accounting industry located in western United States. Data were collected through semistructured face-to-face interviews and from review of documented corporate governance strategies. The data analysis consisted of the following steps: compiling the data, disassembling the …

Ethical Decision-Making In Construction Engineering Projects, Monique Sidaross

Walden Dissertations and Doctoral Studies

Problems exist with ethical decision-making in U.S. construction engineering projects.

The purpose of this study was to explore factors that affect ethical decision-making in engineering construction in the United States. The general concepts of marketing ethics, Kohlberg's discussion of ethical and moral reasoning development, and Gillian's discussion of ethical care served as the basis of the conceptual framework. Factors that inhibit ethical decision making were addressed in the research questions. The resulting narrative framework included implementable initiatives based on these factors that could improve the quality of ethical decision-making and the impact of these initiatives on the cost and quality …

Development Of Patient-Centered Team-Based Care Certification, Stephanie Lynn Stewart

Walden Dissertations and Doctoral Studies

Accountable care units (ACU-?¢) provide a new model for integrated patient care. The ACU-?¢ promotes patient centeredness in nursing units as team members work collaboratively with physicians to improve patient outcomes and reduce unwarranted variations. A health system in the southeastern United States incorporated the ACU-?¢ as part of their care model. These units were held accountable for their clinical, service, and cost outcomes but lacked a validation process to demonstrate the effective utilization of their data. The purpose of this DNP project was to create a patient centered care (PCC) certification process, guided by the Donabedian model, that would …

Social Support And Psychotherapy For Asian And Pacific Islanders With Hiv/Aids, Venus Vacharakitja

Walden Dissertations and Doctoral Studies

HIV/AIDS rates among Asian and Pacific Islanders (APIs) have increased steadily in recent years. The Health Resources and Services Administration reported in 2011 that people living with HIV/AIDS experience psychiatric disorders at a rate 4 to 8 times higher than the general population, with as many as 60% experiencing depression. Studies show that short-term psychotherapy reduces depression and anxiety in people with HIV/AIDS, and studies have indicated that patients have better health outcomes when they receive psychotherapy in conjunction with medical treatment. It is not known how social support relates to psychotherapy attendance or health outcomes as measured by CD4 …

Childhood Lead Exposure And Adult Verbal Comprehension And Perceptual Reasoning, Carrie A. Wonderly

Walden Dissertations and Doctoral Studies

Lead neurotoxicity is considered a problem in young children and the long-term effects of lead exposure on them have yet to be determined. Studies have been completed to determine how lead exposure has affected children through their most important developmental stages. However, there is a lack of research to uncover any long-term effects lead may have as children enter adulthood. The purpose of this study was to determine long-term effects of lead exposure on IQ. The theoretical foundation for this study is the Cattell Horn Carroll theory of intelligence, which is based on fluid (novel experiences) and crystallized (previous experiences) …

Perceptions And Experiences Of Students Who Withdrew From College Prior To Degree Attainment, Enedine B. Andre

Walden Dissertations and Doctoral Studies

Nationally an estimated 41% of traditional students who begin seeking an undergraduate degree do not persist through degree attainment. Guided by Tinto's theory of student departure and the theory of social integration, the purpose of this study was to identify the reasons students withdrew from college prior to degree completion. A qualitative case-study design was implemented, and 13 former college enrollees were purposefully selected for individual semistructured interviews. The students graduated from one high school in the Southeastern United States. Data analysis was conducted using open coding procedures with iterative recategorization to identify key themes. Findings indicated that inadequate preparation, …

Cultural Perspectives On Communication In Community Leadership, Abeer Anwar

Walden Dissertations and Doctoral Studies

Effective communication is important, particularly for the over 26 million immigrant workers with non-English speaking backgrounds who have entered the U.S. workforce. The research problem addressed the disillusion of non-English speakers in the workplace because of the communication gap. The purpose of this study was to explore and describe the experiences of non-English speaking immigrant workers in overcoming language and cultural communication challenges at work. The research question focused on how non-English speakers or English as a Second Language (ESL) speakers describe their communication experiences in the workplace. The theoretical framework was based on the cultural approach to organizations and …

Living With Muscular Dystrophy: Sexual Education, Leanne Beers

Walden Dissertations and Doctoral Studies

Sexual pleasure and intimacy are fundamental and innate human needs. Individuals with physical disabilities often find it difficult to meet these needs because of such factors as impaired mobility and lack of knowledge about sexual health. People with physical disabilities are often seen as asexual and not capable of having sex, and sexuality is often not considered a concern among this population. These misconceptions can result in individuals with physical disabilities not receiving basic sex education or advice and guidance when issues arise. Not receiving this attention may impede disabled individuals' sexual potential and personal relationships. This study's focus was …

Investigating Relationships Among Counselors' Gender, Race, Multicultural Competency When Counseling Sexual Minorities, Laverne Marie' Boone

Walden Dissertations and Doctoral Studies

Gay and lesbian individuals are marginalized, stigmatized, and can face bias in the counseling environment. There is a gap in the literature regarding research on gender, race, and multicultural competency and negative racial attitudes towards sexual minorities. This study examined whether multicultural competency (measured by the Multicultural Counseling Knowledge and Awareness Scale) moderates any associations of gender and race with attitudes towards sexual minorities (measured by Attitudes Towards Lesbians and Gay Men Scale) to examine if the role of multicultural competency differs across groups. The sample consisted of 20 White and 14 Non-White participants who were between 30-40 years of …

Metacognitive Reading Strategy And Emerging Reading Comprehension In Students With Intellectual Disabilities, Natasha Cox-Magno

Walden Dissertations and Doctoral Studies

Historically, students with intellectual disabilities (ID) have low reading comprehension skills that can impede their overall academic success. There is a gap in practice regarding the identification and effective use of evidence-based reading comprehension instructional strategies for students with ID. Guided by Piaget's and Vygotsky's constructivist theories, the purpose of this study was to test the effectiveness of a metacognitive reading strategy on the emerging reading comprehension (ERC) skills of kindergarten students with ID. A single-participant, multiple baseline design with graphical visual analysis was used across 4 kindergarten students with ID to illustrate the influence of the reading intervention. All …

Credit Recovery And Grade Point Average In An Alternative High School System, Antoinette Marie Cunningham

Walden Dissertations and Doctoral Studies

Abstract

The dropout rates of African American and Hispanic students in the United States are significantly higher than that of White students. Failure to obtain a high school diploma has adverse economic and social implications for these students and for society. The purpose of this study was to assess the relationship between a credit recovery program with key demographic variables and high school GPA, which is a graduation antecedent, for students in an alternative school. Knowles' framework of adult learning theory was used to examine how participation in the credit recovery process in a system of predominantly African American-serving alternative …

Impact Of Individualized Learning Plans On Educational Completion Among Incarcerated Youth, Laura Lee D'Anna

Walden Dissertations and Doctoral Studies

Interruptions to juvenile detainees' education often delay their progress toward high school completion. Implementing an individualized learning plan (ILP) has been suggested as a solution to this problem. The purpose of this case study was to explore how ILPs facilitate attainment of graduation among incarcerated youth. The study was guided by the Washington State legislative framework for individualized learning plans and the efforts of the Office of Juvenile Justice and Delinquency to increase educational opportunities. Three research questions were formulated to explore perceptions of local juvenile detention center educators and administrators regarding their experiences in the development, implementation, and effectiveness …

Small Business Restaurant Marketing Strategies For Sustainability, Lyle John Hubbard

Walden Dissertations and Doctoral Studies

Approximately 52% of food and accommodation businesses survive 5 years or more. Small business restaurant owners face greater challenges in marketing and sustainability than larger and well-established chain restaurants. The purpose of this multiple case study was to explore the successful marketing strategies of small business restaurant owners who sustained their businesses 5 years or more. The population was small business restaurant owners in Eugene, Oregon. The conceptual framework for this study was Porter's 5 forces. Data collection included semistructured interviews with 4 business owners, and data analysis consisted of coding and thematically analyzing interview data and data collected from …

Advanced Practice Nurse Intervention And Heart Failure Readmissions, Tanesha Kemble

Walden Dissertations and Doctoral Studies

Heart failure (HF) is one of the main reasons for hospitalizations and readmissions. A local hospital collaborated with a skilled nursing facility (SNF) in 2012 with the goal of reducing systolic HF readmissions. This collaboration consisted of having an Advanced Practice Nurse (APN) who specializes in cardiac care follow up with all patients discharged from the hospital to the SNF with a diagnosis of systolic HF. The practice-focused question for this project addressed whether early follow-up and continuity of care by a cardiac APN would decrease hospital readmission within 30 days in patients with systolic HF who are discharged to …

A Staff Educational Initiative To Improve The Use Of Childhood Obesity Guideline Recommendations, Kris Kuhlmann Louque

Walden Dissertations and Doctoral Studies

Obesity affects one out every six children in the United States, which places them at risk for other chronic conditions such as cardiovascular disease, diabetes, and continued obesity into adulthood. Considering military children are more likely to enter the Armed Forces than their civilian counterparts, an increase in obesity among military families decreases the number of potential future military recruits who are physically eligible to serve. Despite this growing epidemic, providers report a lack of education and a low self-efficacy in the treatment of this condition. This doctorate of nursing practice study addresses this educational gap by attempting to improve …

Social Influences Of Suburban Black Residents Food Purchasing Decisions Using Snap Benefits, Carolyn Mccummings

Walden Dissertations and Doctoral Studies

In low-income, suburban Black communities, the prevalence of diet-related chronic illnesses is alarming. Various influences often increase diet-related illnesses among this population. One influence is the use of SNAP benefits to purchase food. In this study, the influences of SNAP as well as other influences affecting food purchase decisions among the study population was examined. A qualitative multicase study approach was used and, face-to-face interviews were conducted, to understand the experiences of 20 low-income, current recipients of SNAP who were Black and lived in suburban, New York. The data indicated the most significant influence, communicated by the participants, was that …

Perceptions Of Private Medical Practitioners Towards The Nigerian National Tuberculosis Treatment Guidelines, Chijioke Pius Osakwe

Walden Dissertations and Doctoral Studies

Tuberculosis (TB) is a major public health problem in many parts of the world. Nigeria is one of the 30 countries in the world that has the highest burden of TB. Private medical practitioners in Nigeria play an important role in health care delivery. Motivating them to adhere to TB treatment guidelines in managing persons suspected of having TB or diagnosed with the disease is one of the strategies employed by the National Tuberculosis Program to Reduce the Burden of TB. Few studies were identified which used qualitative study approaches to study the perceptions of these practitioners towards the TB …

Strategies For Retaining Employees In The Nonprofit Sector, George Parker

Walden Dissertations and Doctoral Studies

Voluntary employee turnover is a concern for nonprofit leaders due to human capital's strategic role in achieving performance excellence. The consequences of volunteer turnover include loss of profitability, productivity, knowledge, and financial stability. The purpose of this single-case study was to explore strategies used by 3 leaders of a nonprofit organization in the Washington, DC, area who have experience with the nonprofit's employee retention efforts. Data were collected from semistructured face-to-face interviews and organizational documentation and analyzed through the conceptual lens of Maslow's hierarchy of needs theory. Data gathered from interviews and analyses of organizational data and performance outcomes were …

Providers' Treatment For Overweight Navy Members And The Effect On Motivating Lifestyle Changes, Misty Scheel

Walden Dissertations and Doctoral Studies

In the military, excessive weight could put members at risk for training injuries, loss of potential career opportunities, and possible discharge from military service. This could increase cost to United States' national defense through increased injuries, decreased retention due to early discharge, cost of retraining, and lifelong chronic health conditions. The purpose of the study was to determine if there was a correlation or predictive value between active duty Navy members' perception of care provided for weight management and the active duty Navy member's motivation for weight management interventions. The social capital theory served as the theoretical framework for this …

The Relationship Between Attachment, Self-Regulation, And Resilience In Undergraduate Students' College Adjustment, Scott Tanner

Walden Dissertations and Doctoral Studies

Difficulty adjusting to college life is noted in nearly 20% of freshmen who fail to return to college. The purpose of this quantitative survey design study, grounded in attachment theory, was to investigate the best predictor (e.g., secure parental attachment, self-regulation, or resilience) of college adaptation, the combined contribution of the variables in predicting college adaptation, and whether a bivariate relationship existed between the variables and subcomponents of college adaptation. The Connor Davidson Resilience Scale Revised, Parental Attachment Questionnaire, Short Self-Regulation Questionnaire, and Student Adaptation to College Questionnaire were securely administered online to a sample of 68 full-time students from …

Hospital Executive Succession Planning Strategies, Janet Tingling

Walden Dissertations and Doctoral Studies

Approximately 50% of New York City hospitals lack succession planning as baby boomers transition out of the workforce into retirement. The potential loss of knowledge capital could affect leadership development and corporate stability. Guided by the transformational leadership theory, the purpose of this single site case study was to explore successful strategies executive-level leaders used to facilitate succession planning within their hospital. Three hospital executive-level leaders from a single site location participated in a semistructured face-to-face interview and provided data that assisted the analysis. Four themes emerged from the data analysis through a word cloud format that showed the most …

Workplace Bullying From A Nurses Perspective, Dawn Reid White

Walden Dissertations and Doctoral Studies

Bullying has long been associated with school children. In recent years, however, more attention has been paid to the bullying that has reached beyond the playground and into the workforce. One population facing this problem is staff nurses. To date, no one has found an effective way to address workplace bullying in the healthcare field, nor have effective methods been found for retaining trained nurses affected by this problem. The focus of this dissertation was on understanding nurses' lived experiences and how nurses decided to remain in their current working position despite these problems. Taking a phenomenological approach and using …

Relationship Between Federal Compliance Complexities And Internal Control Infraction, Laurence Richard Brown

Walden Dissertations and Doctoral Studies

In the nonprofit industry, lapses in internal controls and low levels of accountability have resulted in many organizations becoming insolvent. Grounded in the agency theory, the purpose of this correlational study was to examine the relationship between federal compliance requirement, executive compensation, nonprofit size, nonprofit type, and internal control infraction. Archival data were collected from 144 nonprofit organizations in the southeast United States. The results of the multiple regression analyses indicated the model was able to predict the relationship between federal compliance requirement, executive compensation, nonprofit size, nonprofit type, and internal control infraction, F(7, 136) = 6.559, p < .001, R2 = .252, with non-profit type (hospitals), (β = -9.392, t = 7.191, p <0.050), accounting for a higher contribution to the model than executive compensation, (β = -0.049, t = 1.96, p <0.050). Federal compliance requirement and nonprofit size did not explain any significant variation in internal control infraction. The implications for positive social change included the potential for a better understanding by nonprofit managers of the importance of internal controls, leading to the effective and efficient provision of goods and services needed by members of society.

Success Strategies Of Small Business Owners, Lyndabelle Jakes

Walden Dissertations and Doctoral Studies

In the United States, 20% of newly established small businesses, including small

businesses in the life insurance industry, fail within 2 years, and over 50% of them fail during the first 5 years. The purpose of this multiple case study was to identify and explore the strategies that life insurance brokerage owners use to sustain business operations beyond 5 years. Porter's 5 forces model served as the conceptual framework for exploring this subject matter. Owners of 3 separate small life insurance brokerage firms in Texas, who sustained their businesses beyond 5 years, participated in semistructured interviews. A secondary source of …

Successful Strategies To Sustain Profits From Tourism Following A Hurricane, Kevin C. James

Walden Dissertations and Doctoral Studies

Hurricanes have caused billions of dollars in damage to the hotel industry in Florida, significantly affecting tourism flow. The unpredictable impact of hurricanes makes sustaining profits challenging. The purpose of this multiple case study was to explore strategies that hotel leaders use to sustain tourism profits following a hurricane. The theory of image restoration provided the conceptual framework for the study. Data were collected from company documents and semistructured interviews with 5 hotel leaders in Central Florida. Transcribed data were coded then validated using member checking during the data analysis, which revealed 5 themes: storm impact, accommodations, operations, communications, and …

Educational Module On Health Literacy For Hypertension In The Inmate Population, Pamela Mokoko

Walden Dissertations and Doctoral Studies

Hypertension is a major public health issue in the United States that affects approximately 70 million adults; the high blood pressure of nearly half is considered to be uncontrolled. Uncontrolled hypertension is especially true in the incarcerated population. Due to low health literacy on hypertension in the inmate population, there are recurrent hospital visits, an increase in the admission rate and an increased length of stay in hospitals, all of which may lead to an increase in the cost of healthcare. The purpose of this scholarly project was to develop an expertly reviewed, evidence-based, self-paced, computerized, educational module to promote …

Use Of Simulation For Tracheostomy Care, A Low Volume, High Risk Nursing Procedure, Vijaya Ramakrishnan

Walden Dissertations and Doctoral Studies

Often, education regarding low volume and high-risk procedures, like tracheostomy, are ignored. Lack of experience, skills, and human resources can lead to decreases in confidence levels, diminished quality of care, and potentially an adverse event. The purpose of this DNP project was to prepare simulation-based education on the tracheostomy procedure and provide hands-on education to bedside nurses. The project answered the question: To what extent will a simulation-based teaching method adequately prepare staff nurses in a post-acute surgical unit to perform this high risk low volume procedure? The Johns Hopkins evidence-based model method was used to assist in translation of …

Oral Care And The Connection To Adverse Events In Dentistry, Melissa A. Rhoney

Walden Dissertations and Doctoral Studies

As the healthcare industry continues to change, dental providers are concerned about the different types of adverse events that can occur if systemic diseases are not well understood when treating patients. The purpose of this study was to explore the level of understanding among dental care providers of the relationship between oral care and systemic diseases and how these are linked to adverse events. The theoretical foundation that was used for this study was the Swiss cheese model. The research questions were designed to address the level of understanding among dental care providers of the link between oral care and …

Implementing A Healthy Diet In The Intellectual Disability Residential Community, Stephanie Michelle Shelton

Walden Dissertations and Doctoral Studies

The problem addressed in this study was how staff working in a residential agency for individuals with an intellectual disability (IID) make decisions about how to implement a healthy diet. The purpose of this study was to identify the influences on decisions made by staff on the meals they provided to their clients with an IID. The theory of planned was used to study the influences of attitude, subjective norms, and perceived behavior control on the meals provided for IID. The key research question explored how staff members make decisions. A qualitative case study design was used. The 12 participants …

The Effectiveness Of Screening For Comorbid Depression Among Outpatients With Chronic Diseases In Maryland, Linda Hasssan Allibalogun

Walden Dissertations and Doctoral Studies

Depression is a pervasive mental health disorder worldwide. Although being diagnosed with chronic illness exacerbates susceptibility to depression, detection and subsequent treatment of comorbid depression in primary care settings remain suboptimal because patients with chronic medical disorders are not commonly screened for depression. There is a need to initiate proactive measures by implementing routine screening in primary care settings. The plan-do-study-act (PDSA) model guided an intervention to establish a depression screening practice. This study aimed to determine if the implementation of evidence-based screening for depression using the Patient Health Questionnaire-9 (PHQ-9) tool could increase diagnosis of comorbid depression among patients …