Digital Commons Network^™

Enhancing Surgical Team Readiness: Simulation Training For Power Failure Response In Robotic Procedures, Heather Marie Sorton

Walden Dissertations and Doctoral Studies

In this Doctor of Nursing Practice (DNP) project, I used a quality improvement design to implement and evaluate a simulation-based education aimed at improving perioperative staff knowledge related to robotic power-loss events. A practice gap was identified in staff preparedness for robotic system failures due to limited education on emergency protocols, communication, team roles, and Association of PeriOperative Registered Nurses (AORN)-aligned response processes, impacting patient safety during robotic-assisted procedures. I examined whether implementation of a simulation-based educational intervention improved staff knowledge related to robotic power-loss management. The purpose of the project was to improve staff knowledge and standardize responses to …

Medical Recommendations And Bmi Among Black And Hispanic Adolescent Females, Dorothea Polk

Walden Dissertations and Doctoral Studies

Adolescent obesity persists as a critical public health challenge in the United States, with Black and Hispanic adolescent females experiencing elevated rates. Adolescent obesity contributes to serious long-term health risks, but provider counseling may support body mass index (BMI) management. Guided by the social-ecological model, this study examined whether receiving medical recommendations to control or lose weight was associated with BMI among Black and Hispanic adolescent females aged 16–19 years and whether meal preparation habits and food security status moderated this association, controlling for age, household income, and race/ethnicity. This quantitative, cross-sectional secondary analysis used multiple linear regression analyses to …

Strategies For Effectively Socializing Remote Workers, Emily Dahlen

Walden Dissertations and Doctoral Studies

Improper socialization of remote workers into the organization can increase employee turnover and create an unstable remote workforce. Business leaders who fail to effectively socialize remote workers in ways that strengthen organizational identification and reduce turnover risk may create workforce instability that exposes the organization to additional business risks. Grounded in the theory of organizational socialization, the purpose of this qualitative pragmatic inquiry research project was to identify and explore the effective strategies some business leaders use to socialize remote workers and increase employee retention. The participants were eight business leaders who had implemented effective socialization strategies to remote employees. …

Staff Education To Address Medication Nonadherence Among Patients With Mental Health Challenges, Almena Ilis Huggins

Walden Dissertations and Doctoral Studies

Patients’ non-adherence to prescribed medication regimens remains a significant challenge in healthcare. Patients often misuse or skip their medications, which undermines treatment outcomes. This was evident at a mental health medical practice located in a suburban area of the southeastern coast. To address this problem, I developed, implemented, and evaluated a staff education program on evidence-based strategies to improve medication adherence among individuals with mental illness. The practice question focused on whether staff knowledge increased following participation in the education program. Four nursing staff participated in the 2-hour education program. Pre- and posttest questionnaires consisted of 15 multiple-choice questions. The …

A Dynamic Web Design Strategy For Increased Customer Engagement And Sales, Sherline Jones

Walden Dissertations and Doctoral Studies

Nonprofit organizations risk losing customers, revenue, and mission impact when leaders fail to adapt digital strategies to evolving customer expectations. Nonprofit leaders are concerned because digital strategy adoption is essential to strengthening sustainability and expanding mission-centered services. Grounded in the Baldrige Excellence Framework, the purpose of this qualitative single case study research project was to explore effective strategies nonprofit business leaders use to leverage technology to attract new customers, retain existing customers, and increase sales. The participants were two senior leaders from a Florida nonprofit organization in the southern United States. Data collection included semistructured interviews, internal archival data, and …

Reducing Psychotropic Polypharmacy In Outpatient Mental Health Settings, Roseline Onyebuchi Okafor

Walden Dissertations and Doctoral Studies

Psychotropic polypharmacy in outpatient mental health settings is associated with increased adverse drug events, reduced adherence, and higher healthcare utilization. This Doctor of Nursing Practice project developed and evaluated an evidence-based clinical practice guideline (CPG) to reduce inappropriate psychotropic polypharmacy among adults receiving outpatient psychiatric care. Guided by the Johns Hopkins Nursing Evidence-Based Practice model, a systematic literature review informed recommendations including structured medication reviews, standardized prescribing practices, interdisciplinary collaboration, and shared decision-making. The guideline was evaluated by a multidisciplinary expert panel using the AGREE II instrument. Mean domain scores ranged from 6.3 to 6.8 on a 7-point scale, indicating …

Childcare Center Administrators’ Leadership Practices To Foster Childcare Worker Retention In Non-Residential Childcare Centers, Rebecca Dececco

Walden Dissertations and Doctoral Studies

Though staff retention is essential for children's stability and security in childcare settings, there remains a gap in knowledge about the leadership practices in childcare that have implications for retaining staff. The problem addressed in this study was the need for information about the influence of leadership practices on childcare teacher retention in the United States. Grounded in Bandura’s social cognitive theory, the purpose of this basic qualitative study was to explore the leadership practices of childcare center administrators who retain childcare staff. For this basic qualitative design, semistructured interviews were conducted with 12 childcare center administrators who worked directly …

Effective Strategies For Hospital Leaders To Increase Employee Retention, Lionso Gomez

Walden Dissertations and Doctoral Studies

Employee retention remains a critical challenge for hospital leaders because high turnover can contribute to workforce instability, increased organizational costs, and poor patient care quality. The purpose of this qualitative pragmatic inquiry research project was to identify and explore effective strategies that hospital leaders in Texas use to increase employee retention. The participants were six former hospital leaders in Texas's eastern and southern regions who had successfully implemented employee retention strategies. This research project was grounded in Herzberg’s two-factor theory. Data were collected through semistructured interviews and publicly available documents. The data were analyzed utilizing Braun and Clarke’s six-step thematic …

The Experiences Of Deaf American Muslims In Their Pursuit And Retention Of Employment, Shukry Mahmood

Walden Dissertations and Doctoral Studies

Deaf American Muslims in the United States face high levels of unemployment. They often experience compounded marginalization at the intersection of disability, religion, and cultural identity, which often leads to exclusion and underrepresentation in employment contexts. The purpose of the study was to explore the lived experiences while pursuing and retaining employment in the United States of deaf Muslims in United States workplaces. In this qualitative study, a self-designed, semistructured interview protocol with open-ended questions was used to explore these experiences. The sample of 12 participants was selected based on their self-identification as deaf American Muslims with at least 30 …

Staff Education In An Outpatient Psychiatric Setting Using The Teach-Back Method To Improve Staff Knowledge Toward The Ultimate Goal Of Improving Medication Adherence, Laura Assanga Eyong

Walden Dissertations and Doctoral Studies

For this doctoral project, I implemented a structured staff education intervention at an outpatient psychiatric clinic that required a practice change to address medication nonadherence among patients diagnosed with schizophrenia. The practice-focused question was: For staff in an outpatient psychiatric setting, will structured education on the use of the teach-back method improve staff knowledge toward the ultimate goal of improving medication adherence? The goal of this project was to conduct a rigorous education program using the analysis, design, development, implementation, and evaluation model to bridge the communication gap between staff and patients. Staff knowledge was evaluated via a pre-/posttest design …

Enhancing Chronic Kidney Disease Awareness And Early Identification Through Community Health Worker Education In Rural Arkansas, Samantha L.M. Smith

Walden Dissertations and Doctoral Studies

The doctoral project was focused on improving staff education and development to prevent chronic kidney disease (CKD) through community health worker (CHW) education. The practice problem was the delayed identification of CKD risk factors and late referral to nephrology services, particularly among rural and underserved populations. Because CKD often progresses without symptoms, early education and awareness are critical to improving outcomes and reducing disease progression. The purpose of the project was to develop and implement a structured CKD educational curriculum for CHWs to improve their confidence in kidney health, CKD risk factors, prevention strategies, early identification, and referral awareness. The …

Time Series Analysis Of Temperature And Pollen Exposure On Asthma Outcomes In Atlanta, Georgia, Victoria Okereke-Viktorsson

Walden Dissertations and Doctoral Studies

The effects of climate change contribute to volatile temperature changes, which coupled with pollen exposure pose a significant threat to asthmatic people, potentially impacting methods for asthma management. The purpose of this ecological time-series study was to use the carbon dioxide theory of climate change, Dutch hypothesis, and social ecological model to estimate the relationship between average temperature and average pollen concentrations on average asthma morbidity outcomes for adults living in metropolitan Atlanta from 2020 to 2022 (N = 37,913). Results varied in terms of years, socioeconomic status (SES) vulnerability, gender, and racial group. Overall, a linear regression model revealed …

Maintaining Excellence Under Pressure: The Stress–Performance Paradox In A Multi-Campus State University System, Rico D. De Asis Dr.

Higher Learning Research Communications

Objectives: This study examines how multiple stress dimensions (levels, sources, effects, and coping mechanisms) relate to teaching performance in resource-constrained Southeast Asian public higher education, addressing the geographic concentration of faculty stress research in Western contexts.

Methods: Using multiple regression analysis with 80 permanent faculty members across three campuses of a state university system, I assessed relationships between stress factors and teaching performance. The study employed validated stress assessment instruments examining stress levels, sources (student, teacher, environment, work-related), effects (self, family, work), and coping mechanisms.

Results: Self effects of stress demonstrated the strongest negative relationship with teaching performance (R² …

Hospital-Acquired Infections Among Hispanic Diabetic Patients: Considering Geographic And Substance Use Factors In Southern Puerto Rico, Fabian A. Ramirez Rivera

Walden Dissertations and Doctoral Studies

Hospital-acquired infections (HAIs) remain a major cause of preventable morbidity, mortality, and healthcare utilization among hospitalized patients. Limited research has examined the relationship between diabetes and HAIs in Puerto Rican populations. The purpose of this quantitative cross-sectional study was to examine the prevalence of type 2 diabetes mellitus (T2DM) and its association with HAI characteristics and hospitalization outcomes among patients in southern Puerto Rico. The chronic care model provided a framework for evaluating whether diabetes status, geographic location, and substance use were associated with outcomes. Data were obtained through retrospective review of electronic health records from N = 846 patients …

Exploring Successful Change Strategies For Small Business Owners To Remain Competitive, Omari Akuamoah Boateng

Walden Dissertations and Doctoral Studies

Small businesses are vital to the U.S. economy but face significant challenges in implementing organizational change to remain competitive due to resource constraints. This problem is important to small business owners because ineffective change strategies limit growth, sustainability, and broader economic contribution. Grounded in the resource-based view of the firm and entrepreneurship theory, the purpose of this qualitative pragmatic inquiry project is to explore the evidence-based organizational change strategies used by some small business owners in the United States to achieve and sustain a competitive advantage. The participants were 6 leaders from small businesses with fewer than 100 employees located …

Global Humanitarian Aid Sector Leaders’ Perceptions Of Leadership Development Programs To Support Humanitarian Aid Workers, Stephen J. Thomspon

Walden Dissertations and Doctoral Studies

The problem addressed through this study is that current leadership development programs for global humanitarian aid sector (GHAS) leaders fail to adequately address the unique circumstances of humanitarian aid work. Grounded in trauma-informed care and adaptive leadership, the purpose of this basic qualitative study was to explore GHAS leaders' perceptions of the essential components and opportunities for improving leadership development programs, as well as their recommendations on how to address the unique contexts of humanitarian aid workers. Semistructured interviews with eight GHAS leaders who had at least 10 years of sector experience were conducted. Through qualitative content analysis with a …

Identifying Symbolic Modeling Of Grooming Precursors In Social Media, Heath Landress

Walden Dissertations and Doctoral Studies

Short-form video platforms such as TikTok and Instagram Reels increasingly circulate dating and lifestyle advice that may normalize coercive relational scripts. A key challenge for preventing technology-facilitated child sexual exploitation is that early grooming precursors can be communicated through audiovisual design choices, such as tone, pacing, setting, and editing, that make manipulative narratives appear benign. The purpose of this qualitative multimedia content analysis was to identify recurring observable patterns that provide a form of symbolic modeling, through which relational and boundary-shaping cues associated with early-stage sexualized grooming are framed as ordinary dating or lifestyle advice in public TikTok and Instagram …

Risk Factors For Metabolic Syndrome Among U.S.-Born And Non-U.S.-Born Hispanics In The United States, Banessa Maldonado

Walden Dissertations and Doctoral Studies

Current knowledge regarding risk factors for metabolic syndrome (METS) among Hispanic individuals of Mexican descent remains limited. Using data from NHANES 2017–2020, this study compared factors contributing to METS and included U.S.-born and non-U.S.-born Hispanic adults of Mexican descent aged ≥ 18 years living in the USA (N = 949) with assessed METS. Grounded in the social ecological model and social determinants of health, this research evaluated dietary habits, lifestyle patterns, and acculturation processes using multivariate logistic regression and stratified analyses. Educational attainment was associated with METS, but the association was not statistically significant in adjusted models p = 0.528. …

Strategic Organizational Growth In Nonprofit Organizations: A Swot-Based Change Management Analysis, Sharika Williams

Walden Dissertations and Doctoral Studies

Nonprofit organizations often face operational and sustainability challenges. This study examined a nonprofit serving individuals with intellectual and developmental disabilities that was experiencing increased service demands, communication challenges, and workforce shortages. The purpose of this generic qualitative study was to develop a sustainable strategic change management approach to strengthen workforce development, financial stability, stakeholder collaboration, and strategic planning. Guided by the research question, "How can the client nonprofit organization implement a sustainable change-management approach that addresses internal communication challenges and resource constraints while maintaining mission alignment?" the study used a SWOT analysis and Kotter’s eight-step change model. Data were collected …

Enhancing Staff Knowledge Of Prenatal Depression Screening And Follow-Up Protocols, Gladys Ajohmbu Esunji

Walden Dissertations and Doctoral Studies

This staff education project addressed inconsistent staff knowledge of prenatal depression screening and follow-up protocols in an outpatient behavioral health practice serving prenatal patients. Prenatal depression is a nursing practice concern because delayed identification and inconsistent follow-up may affect maternal well-being, infant outcomes, family functioning, and timely access to behavioral health support. The practice-focused question was: According to the evidence, among clinical staff in an outpatient maternal mental health setting, what is the impact of structured staff education on adherence to prenatal depression screening on follow-up protocol knowledge? The purpose was to improve clinical staff knowledge through a structured education …

Ai Vs. Licensed Psychologists: A Comparative Analysis Of Treatment Plan Quality For Treating Psychological Distress, Michael Edward Maloney

Walden Dissertations and Doctoral Studies

The study was conducted to investigate whether statistically significant differences exist in the quality of treatment plans developed by artificial intelligence (AI) platforms versus treatment plans generated by licensed psychologists, with a focus on intervention specificity and clinical appropriateness. Given the rapid proliferation of digital mental health technologies and the persistent shortage of licensed mental health professionals, empirical evaluation of AI-driven clinical tools has become a critical area of inquiry. Grounded in dual process theory (DPT), which conceptualizes decision making as the product of both intuitive and analytical cognitive systems, the study employed a quantitative, between-groups design. Sixty-six licensed psychologists …

Metropolitan Public School Counselors’ Perceptions On Implementing The Ohio K–3 Social And Emotional Learning Standards, Sharon Johnson

Walden Dissertations and Doctoral Studies

In 2019, the Ohio Department of Education adopted K–12 Social and Emotional Learning (SEL) standards to support students’ emotional, behavioral, and academic development; however, the problem is that implementation remains optional across districts, resulting in variability in school counselors’ access and consistency. Although SEL implementation has been examined in educational settings, there is a gap due to a lack of available research that have explored metropolitan K-3 public school counselors’ lived experiences implementing the Ohio K-3 SEL standards. The purpose of this transcendental phenomenological study was to explore metropolitan K-3 public school counselors lived experiences implementing the Ohio K-3 SEL …

Relationship Between Internet Use, Perceived Social Support, And Obesity Among African American Young Adults, Marketta Mccollough

Walden Dissertations and Doctoral Studies

The disproportionately high prevalence of obesity among African American young adults is a significant public health crisis rooted in systemic inequities. The purpose of this quantitative cross-sectional study was to examine the relationships between internet use for health information, perceived social support (online and offline), and obesity in this population. Grounded in the social cognitive theory (SCT), this study investigated how these behavioral and environmental factors interact to influence body mass index. Using secondary data from the 2021–2023 National Health and Nutrition Examination Survey, a complex samples logistic regression with a Bonferroni correction (α = .0125) was conducted on an …

Proposal For A Comprehensive Workplace Violence Program In An Acute Care Facility, Christin V. Timmons

Walden Dissertations and Doctoral Studies

Workplace violence (WPV) in healthcare is a growing threat to caregiver safety, workforce stability, and patient outcomes. At a newly opened acute care facility, the absence of a comprehensive WPV prevention program posed a gap in practice, creating safety risks and regulatory vulnerability. A literature search was conducted using CINAHL, PubMed/ MEDLINE, ProQuest Nursing & Allied Health collection, and Google Scholar. A total of 50 articles were identified with 11 articles meeting all inclusion criteria. Collectively, findings supported comprehensive, multicomponent WPV prevention programs to integrate leadership engagement, structured governance, staff education, environmental controls, and continuous data monitoring to improve safety …

The Relative Strength Of Social Media Motives, Perceived Race Relations, And The Centrality Of Black Identity In Predicting Black Community Activism, Johnnie Gordon

Walden Dissertations and Doctoral Studies

As social media has become a central context for identity development, sociopolitical awareness, and civic engagement among Black emerging adults, exposure to racialized content, experiences of online discrimination, and competing narratives regarding racial progress may heighten awareness of systemic inequities and strengthen collective racial identity. To date, the potential of these experiences to motivate engagement in Black community activism to advocate for community empowerment has not been investigated. Informed by social identity theory, this quantitative study assessed the relative importance of motives for social media use, perceived racial progress, and Black identity centrality in predicting Black community activism among emerging …

Lived Experiences Of Emotional Competence Development Among Online Doctoral Clinical Psychology Students During Clinical Training, Michelle Davis

Walden Dissertations and Doctoral Studies

Emotional competence is essential for effective clinical practice, professional development, and client care. However, limited research has examined how emotional competence develops among students in fully online doctoral clinical psychology programs. This qualitative descriptive phenomenological study explored how students enrolled in online doctoral clinical psychology programs experience the development of emotional competence during clinical field training. Guided by Goleman’s emotional competence framework, the lived experiences of doctoral students as they developed emotional awareness, emotional regulation, empathy, and relationship management skills was examined. Data were collected through semistructured interviews with 10 purposively selected participants enrolled in online doctoral clinical psychology programs …

Association Between Resource Availability And Wellbeing Of Autism Patients In Ghana, Kwabena Aduse-Poku

Walden Dissertations and Doctoral Studies

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that presents significant challenges for children and families in Ghana, where resources remain limited. Grounded in the social ecological model, this quantitative cross-sectional study examined the associations between autism management programs and wellbeing, defined briefly as independent functioning in daily life and learning of autism patients enrolled in selected institutions in Accra and Kumasi, Ghana. Data were collected from N=122 autism patients using structured questionnaires that were completed by caregivers and program staff. Binary logistic regression analyses were conducted to assess relationships between program type, regional location, and years of enrollment and …

Association Between Opioids And Leukemia/Lymphoma In Adults Living In The United States, Brenda Sue Newberry-Colasanti

Walden Dissertations and Doctoral Studies

Opioid prescribing rates and opioid misuse remain high throughout the United States. Exposure to opioids has been positively associated with various cancers; however, research evaluating associations between opioid exposure and hematologic cancers like leukemia and lymphoma is limited. Using the Socio- Ecological Model as a foundation, this quantitative cross-sectional study aimed to analyze the association between medicinal opioid use, opioid misuse, and leukemia/lymphoma while exploring how selected social determinants of health (SDOH) may modify that relationship. Secondary data were pooled from the 2015–20-year United States National Survey on Drug Use and Health (NSDUH). One thousand three hundred and twenty binary …

Effective Work-Life Balance Strategies That Small Business Owners Use To Increase Personal And Organizational Resilience, Anquinett Pope

Walden Dissertations and Doctoral Studies

Small business owners frequently sustain their businesses at the cost of their personal health, which poses long-term threats to both organizational sustainability and resilience. The sustainability of a small business is often inseparable from the health, well-being, and decision-making capacity of its owner. The purpose of this qualitative single case study was to identify and explore effective strategies employed by some small business owners to balance personal and professional obligations to enhance business sustainability. The study was focused on one small business owner from a consulting firm based in the United Kingdom. The project was grounded in the Baldrige excellence …

Health Literacy And Diabetes Self-Care Behavior, Eucharia Amaefule

Walden Dissertations and Doctoral Studies

Limited health literacy is a significant barrier to effective diabetes self-management among adults with type 2 diabetes mellitus (T2DM), yet nationally representative evidence using comprehensive health literacy measures remains limited. Guided by the health belief model, the purpose of this quantitative, secondary data analysis using cross-sectional data was to examine the relationship between health literacy and diabetes self-care behaviors among U.S. adults with T2DM and determine whether education level moderated this relationship. Data from the 2016 Behavioral Risk Factor Surveillance System were analyzed for U.S. adults (N = 9, 535) with self-reported T2DM. Diabetes self-care behaviors included blood glucose monitoring, …