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Health Systems Predictors And Trends Of Access To Vaccinations In 9 Sub-Saharan African Countries, Mirfin Mpundu

Walden Dissertations and Doctoral Studies

The purpose of this ecological quantitative study was to examine the predictors of health systems building blocks and their interactions in improving access and uptake of immunizations in nine sub-Saharan African countries. Immunization rates in this region remain lower than global targets leading to preventable diseases and mortality. Using the systems approach, the study examined the relationships among five independent variables: quality of service delivery, governance, vaccine supply, health financing, socioeconomic factors and the dependent variable, access to immunizations. Datasets from the WHO and UNICEF were used. Analysis included a series of descriptive statistics, logistic and linear regression, and correlations. …

Evaluation Of A Shared Governance Model, Gorda Peters-Joseph

Walden Dissertations and Doctoral Studies

AbstractShared governance (SG) has been defined as a style of management in which frontline staff and managers work together to improve clinical practice. Guided by the PLAN-DO-STUDY-ACT cycle, the purpose of this project was to evaluate the implementation of the SG model for pediatric services in a US acute care hospital. The practice question explored whether the implementation of the SG model would demonstrate improvements in nurse satisfaction using the culture of safety survey, a change in nurse staff turnover reported as numbers hired, retired, resigned, or transferred, and changes in patient satisfaction measured by survey scores from the Hospital …

Advisors’ Perceptions Of Honors College Students’ Experiences Of Stress And Autonomy, Brandy Stanton Roye

Walden Dissertations and Doctoral Studies

Honors college students experience stress and anxiety, which has the potential to affect their psychological well-being. The advice of honors academic advisors may influence the psychological well-being of honors students through recommendations of college engagement that can assist in the development of autonomy and self-authorship. Baxter Magolda’s concepts of autonomy and self-authorship and Ryff’s scales of psychological well-being were the conceptual framework used to examine the perceptions of honors college advisors regarding how cocurricular opportunities influence the reduction of student stress and anxiety and the increase of student autonomy and self-authorship. Using a basic qualitative approach, interviews were conducted with …

Impact Of Nurse Education Program On 30-Day Readmissions Among Ischemic Stroke Patients, Mariana Tsucuneli

Walden Dissertations and Doctoral Studies

Unplanned 30-day readmissions among patients diagnosed with ischemic stroke (IS) is a significant public health problem in the United States. The Affordable Healthcare Act introduced financial penalties and incentives for facilities to encourage the adoption of care plans aimed at reducing 30-day readmissions rates for stroke and 5 other illnesses. Therefore, facilities with high rates of 30-day readmissions for IS patients are penalized by the Centers for Medicare and Medicaid services in addition to receiving poor scores on the quality of care they provide. This project was a staff education program aimed to improve postacute stroke transitional care and reduce …

Latino Caregivers Experiences With Transitioning Children From Pediatric To Adult Disability Services, Gloria Yvette Velazquez

Walden Dissertations and Doctoral Studies

Caregivers for children with disabilities may experience caregiver burden when transitioning their offspring to adult healthcare services. As the Latino population in the United States increases, so will the numbers of Latino caregivers of children with disabilities. This research described the experiences of Latino female caregivers who transitioned their children from pediatric to adult healthcare services. General systems theory was used to guide this research. The hermeneutical phenomenological approach was used to describe Latino female caregiver's experiences involving transitioning children with disabilities from pediatric to adult services. Bryman's 4 stages of data analysis were used to assist with thematic content …

Factors Affecting Electronic Banking Adoption In Barbados, Jacqueline Delores Bend

Walden Dissertations and Doctoral Studies

The low rate of customers' adoption of electronic banking services affects retail banks' profitability. The operating cost for a financial transaction performed by bank tellers averages US$1.07 compared to US$0.01 using electronic banking channels. It is paramount for retail banking leaders to understand the factors influencing customer adoption of electronic banking to sustain competitive advantage. Grounded in the technology acceptance model framework, the purpose of this quantitative correlational study was to examine the relationship between perceived usefulness (PU), perceived ease of use (PEOU), and customer adoption of electronic banking in Barbados. The validated technology acceptance model survey instrument was used …

Recovering Illicit Substance Users' Perspective About Mandatory Drug Testing In Schools, Julie Bowser

Walden Dissertations and Doctoral Studies

The purpose of this exploratory qualitative study was to examine recovering substance

abusers' perceptions about the usefulness of mandatory drug testing in schools for adolescent substance abuse. Illegal substance abuse has reached epidemic proportions as more than half of U.S. adolescents, aged 12 to 17 years, have engaged in illicit drug use. Substance abuse information has been a part of school health education programs since the United States Drug Free Schools and Communities Act of 1986. Despite substance abuse education and school programs about the effects of drug use, many high school students abuse illicit drugs. Face-to-face interviews were conducted …

The Impact Of Dietary Intake On Mortality Risk In Colorectal Cancer Survivors, Ellen Chow

Walden Dissertations and Doctoral Studies

The colorectal cancer (CRC) survivor population is increasing in the United States. The lack of effective dietary recommendations in recurrence prevention undermines the health-related quality of life of survivors. Grounded in the socioecological model, dietary behavior is a personal-level risk factor that individuals may control. This study investigated the CRC-specific mortality risk as predicted by diet quality, dietary fiber intake, and dietary fat intake in hope of contributing to future dietary recommendations. A secondary analysis using data from 1,166 CRC survivors in the Multiethnic Cohort Study was analyzed via Cox proportional hazard regression models to estimate mortality risk. Results from …

Teachers' Perceptions Of Bullying And School Policy Enforcement, Angelena Elizabeth Clagon

Walden Dissertations and Doctoral Studies

Bullying has grown attention since the Columbine High School shooting; in April, 1999. Throughout the years, there has been an increase in aggressive behaviors including via the Internet across school districts in the United States. There was a gap in the literature regarding whether bullying-related school policies are enforced during school hours. The purpose of this qualitative study was to explore the perceptions of middle school teachers about bullying. This study was steered by Husserl's phenomenological theory. Five middle school teachers were interviewed to gather information regarding their experiences with and perceptions of bullying based on behaviors and school policy …

Voluntary Male Circumcision And Risk For Human Immunodeficiency Virus In Homa Bay, Kenya, George Obhai Gabriel

Walden Dissertations and Doctoral Studies

The role played by the belief about voluntary medical male circumcision (VMMC) in predicting HIV status has not been examined. The purpose of this study was to investigate whether there were any differences between belief about VMMC, unprotected sex, age, number of sexual partners, relationship status, and HIV status among circumcised males aged between 18-49 years in Homa Bay County, Kenya. Drawing from the health belief model and case-control study design, 936 men were recruited based on their HIV status (468 HIV cases and 468 controls). A bivariate logistic regression was applied, and the results indicated that unprotected sex, age, …

Self-Efficacy Of Older Homeless African American Men, Renee Carnithia Harvin

Walden Dissertations and Doctoral Studies

Older adults in the United States without permanent housing are witnessed living in shelters, cars, and on street corners in many urban centers and older adults now make up a third of the homeless population. There are stressors that may precede, or may result in homelessness, which may also affect older (i.e., age 50 or above) homeless adults' abilities to maintain their self-efficacy, a key to their self- management. This study further explored the lived experiences of self-efficacy among older homeless African American men. A descriptive phenomenological design and individual semi-structured interviews of 10 African American homeless men, aged 50 …

Collectivism And Uncertainty Avoidance In Narrative Oral Histories Of Resettled Syrian Refugees, Suzy S. Ismail

Walden Dissertations and Doctoral Studies

Emotional resilience among resettled refugees is an indicator of cultural integration and adaptation into a host country which in turn impacts schools, resettlement agencies, and refugee service organizations in how they can best meet the needs of refugees. The documented decline in emotional resilience among resettled Syrian refugees during the past decade is linked to the problem of cultural value disparities causing a resultant decline in mental health and socioemotional wellbeing. The purpose of this narrative qualitative study was to explore expressions of cultural value dimensions such as collectivism and uncertainty avoidance in oral histories of resettled Syrian refugees. Applying …

Strategies Restaurant Managers Use To Improve Brand Equity, Shamilleon Kechel Kelly-Payne

Walden Dissertations and Doctoral Studies

Failure to establish brand equity can adversely impact the sustainability of a business organization. Upscale full-service restaurant managers who fail to establish brand equity risk intricate assets to enhance shareholder value. Grounded in the brand equity theory, the purpose of this qualitative multiple case study was to explore customer retention strategies upscale full-service restaurant managers use to improve brand equity. The participants included 3 senior-level managers in 3 upscale full-service restaurants in the southeastern United States who successfully developed customer retention strategies to improve brand equity. Data were collected using (a) semistructured interviews with member checking follow-up interviews, (b) direct …

Calworks Participation And Poverty Rates In Multigenerational Families, Destiny Wray Lovato

Walden Dissertations and Doctoral Studies

The State of California aids more than a million individuals under the California Work Opportunity and Responsibility to Kids (CalWORKs) program at a cost of billions of dollars each year. Although adult recipients are given supportive services and offered various programs in a motivational attempt to achieve self-sufficiency, the needs of children, who are the highest population group living in poverty, are not currently addressed. The absence of programs and services targeted to children may perpetuate the generational cycle of poverty. Yet researchers have not yet examined the underlying reasons behind multiple generations receiving CalWORKs and the continuation of poverty …

Exploring Occupational Therapy Faculty Beliefs Related To Technology Acceptance Of High-Fidelity Simulation, Elisabeth Mcgee

Walden Dissertations and Doctoral Studies

High-fidelity simulation-based learning (SBL) is used in occupational therapy (OT) to immerse students in realistic clinical situations using advanced technology to better prepares health care professionals for the workplace. However, researchers have not explored OT graduate faculty technology acceptance using high-fidelity simulation (HFS) as a learning and instructional tool. The purpose of this basic qualitative study was to explore OT graduate faculty members' beliefs related to technology acceptance of high-fidelity SBL at a multicampus university. To accomplish this purpose, research questions were developed to examine faculty beliefs of high-fidelity SBL using Gu et al.'s four key constructs (outcome expectancy, task …

Obesity, Snoring, Sleep Apnea, And Coronary Heart Disease, Maryam Khalilah Muhammad

Walden Dissertations and Doctoral Studies

Coronary heart disease (CHD) is a significant public health issue that affects communities across all socioeconomic and demographic groups. Risk factors for CHD include sleep apnea and snoring. Obesity with short sleep duration also places individuals at higher risk for CHD. Although limited research has been conducted on CHD and its relationship to obesity, sleep apnea, and snoring as individual risk factors for CHD, a gap exists as these factors had not been studied as paired in this study. The purpose of this quantitative, cross sectional study was to determine if a significant relationship existed between obesity, snoring, sleep apnea, …

Factors Associated With Hepatitis B Vaccination Among Asian Adults (≥ 18 Years) In The United States., Naana Abena Ohemeng-Tinyase

Walden Dissertations and Doctoral Studies

In the United States, hepatitis B disproportionately affects Asian and Pacific Islanders (AAPIs). Hepatitis B related liver cancer is the leading cause of cancer deaths among Asian Americans. Despite the proven significant economic, health, and social effect of hepatitis B virus, immunization rates remain low. The purpose of this study is to examine the association between sociodemographic factors (age, marital status, gender, work experiences), health status factors (chronic disease, nonchronic disease), health behavior factors (smoking, alcohol intake, tobacco use, physical activity), and hepatitis B vaccination among Asian adults (≥ 18 years) in the United States. The main theory that frames …

Social Grants Transfer Program: The Role Of Policy Actors In Policy Implementation, David Quist

Walden Dissertations and Doctoral Studies

The scholarly literature lacks the knowledge to support the view that policy actor activities in policy streams were not limited to the 3 initial stages of the policy cycle. Finding evidence through a study to either back or refute this view among scholars was important to explain how policy implementation effort works to yield results. Thus, the purpose of this general qualitative and policy implementation research was to generate additional knowledge about the role of policy actors in policy implementation. The 5-stream framework theoretical lens for this study suggested that the policymaking process involved 5 streams with active policy actors …

A Phenomenological Study Of Factors Influencing Senor Female United States Marine Corps Officer Retention Decisions, Angel Rae Smith

Walden Dissertations and Doctoral Studies

The study showed factors that influenced senior female U.S. Marine Corps' (USMC) officer retention decisions. The qualitative study was based on the interpretivism research philosophy and Mobley's model of turnover and employed a phenomenological research design to identify themes regarding participants' perceptions of their lived experiences involving their professions and factors that affected their mandates to remain on active duty. The study included 11 women volunteers who had either earned membership in General Officer (GO) ranks or were competitive for within the USMC as a colonel (CV); they were recruited through purposive sampling, and data were collected through interviews. Data …

The Perceptions And Experiences Of Clinical Caseworkers In Promoting Pregnancy Prevention In Foster Youth, Ruby Ann Stroman

Walden Dissertations and Doctoral Studies

Teen pregnancy prevention has been a focus for clinical and medical professionals for many years now, and it is an extensively documented social issue, especially in the foster care system. In an effort to promote pregnancy prevention, clinical caseworkers who work with foster youth educate at-risk youth in regards to the difficulties that can be experienced as a result of teen pregnancy. The purpose of this generic qualitative study was to explore the perceptions and experiences of clinical caseworkers as they promoted pregnancy prevention in foster care youth. The 6 purposefully selected respondents were all clinical caseworkers. The study used …

Project Management Strategies To Reduce Post-War Project Failure Rates In Liberia, Thomas Asafua Nketsia Wobill

Walden Dissertations and Doctoral Studies

Project managers working in post-war Liberia from 2006 to 2020 have been struggling to reduce project failure rates due to ineffective project management strategies. This case study included the Delphi technique to explore strategies that project managers working in post-war Liberia's Ministry of Education may use to reduce project failure rates. The study addressed use of knowledge management principles in post-war project management. The resource-based view and knowledge-based view of organizations provided the conceptual framework. The purposeful international sample consisted of 20 project managers working with international organizations registered with Liberia's Ministry of Finance and Development Planning and affiliated with …

Preservice Teachers' Perceptions Of Public School Violent Intruder Drills, Kati Oakes Pusey

Walden Dissertations and Doctoral Studies

Public schools in the United States are increasingly implementing violent intruder drills in response to school shootings; however, the impact these drills have on the well-being of preservice teachers is not fully understood. A lack of knowledge also exists as to how intruder drills contribute to preservice teachers’ motivation to enter the profession. The purpose of this qualitative study was to explore the perceptions of preservice teachers who have participated in violent intruder trainings and drills. Using prospect theory as the framework, the key research questions addressed preservice teachers’ perceptions of violent intruder incidents and drills as well as their …

Youth Leadership Development Program Evaluation, Loreley Lyn Smith

Walden Dissertations and Doctoral Studies

In competitive youth sports organizations, few organizational leaders focus on leadership development to prepare youth for life situations. Sports organizational leaders are concerned about youth leadership development, as development allows youth to build skills necessary to understand their strengths and weaknesses and recognize ways to overcome fears. Grounded in social learning theory, the purpose of this summative program evaluation was to determine the extent to which a competitive youth sports leadership development program aligned with the organization’s primary objective to provide skilled athletic training while providing lessons to prepare youth for adulthood. The participants comprised 40 key stakeholders, including participants …

Clinical Factors That Influence Nurse Responsiveness In Activating Rapid Response Services, James Bernard Tormey

Walden Dissertations and Doctoral Studies

This study advances the understanding of essential clinical knowledge skillsets that nurses need to identify and respond to early signs of patient deterioration. The identification of critical thinking and assessment skills that nurses require may support professional practice through improved nursing education curriculum or additions of necessary critical care skillsets. The purpose of this study, which was framed by Benner’s novice-to-expert model, was to identify and measure critical thinking skills that influence a nurse’s ability to detect deterioration in patients and call the rapid response system (RRS). The research questions addressed the relationship between a nurse’s clinical or reasoning skill …

Amyotrophic Lateral Sclerosis Patients' Sociological Resilience, Self-Determination, And Decision-Making For Life-Sustaining Treatments, Jeremy Jon Van Tress

Walden Dissertations and Doctoral Studies

People with amyotrophic lateral sclerosis (ALS) suffer from a rare, progressive, untreatable, and fatal neuromuscular disease. Their decision-making for life-sustaining treatments may not be fully self-deterministic. While researchers have examined resilience and self-determination in people with mental health problems and chronic illness, none have researched these variables in ALS patients from a socioecological framework. The purpose of this study was to explore the relationships between people with ALS socioecological resilience, self-determination, and decision-making for life-sustaining treatments. A cross-sectional concurrent mixed-methods design was used, with online surveys completed by 197 people with ALS who were solicited through the National ALS Registry. …

Perceptions Of Novice Teachers’ Early Departure Decisions In A Southern Rural High School, Angela Marie Fortenberry

Walden Dissertations and Doctoral Studies

One significant issue in U.S. public schools is the need to determine the root cause of the early departure of novice teachers. The problem that was the focus of this study was the departure of novice teachers from a southern rural high school prior to completing 5 years in the profession. The purpose of this project study was to explore novice teachers’ perceptions about early departure from the local high school. Fishbein’s expectancy-value theory was used in this exploratory case study to gain insight on seven novice teachers’ perceptions related to their early departures. The research questions focused on perceived …

Factors That Influence Violence And Homicidal Ideation Among Serial Offenders, Jared Matthew Rogers

Walden Dissertations and Doctoral Studies

Many studies have been conducted to identify sources of violence in serial killers, including environmental, biological, and mental disposition factors. However, serial killers’ sexual fantasies had not been explored. The purpose of this qualitative descriptive phenomenological study was to understand how sexual fantasies influence serial killers’ violent behavior. The theoretical framework consisted of ecological systems theory and social learning theory. Data from previously conducted interviews, serial killers’ manifestos, and historical records were used to conduct a comparative analysis of the behaviors, techniques, and identification signatures of serial killers. Data were coded and categorized to identify the relationship between sexual fantasies …

Managing Brand Value For Increased Patronage, Victor Tiwalola Olufemi

Walden Dissertations and Doctoral Studies

Information technology service providers (ITSPs) with low customer patronage may not remain competitive and could fail. Business leaders of ITSPs need to implement successful brand marketing strategies to gain consumers' confidence and increase patronage for their organizations' long-term sustainability. Grounded in the brand equity model, the purpose of this qualitative multiple case study was to explore brand marketing strategies ITSPs implement to increase patronage. The participants included nine business leaders from three ITSPs in Lagos, Nigeria, who successfully implemented brand marketing strategies to increase patronage. Data were collected from semistructured interviews, reflective notes, and review of public documents obtained from …

Business Leader Strategies That Fulfill Corporate Social Responsibility, Franklyn Abraham

Walden Dissertations and Doctoral Studies

Ineffective corporate social responsibility (CSR) strategies harm the organizational brand, reputation, and financial growth. Business leaders who lack strategies to achieve CSR initiatives risk the profitability of their organizations. Grounded in stakeholder theory, the purpose of this qualitative multiple case study was to explore CSR strategies leaders of small and medium sized enterprises (SMEs) use to sustain profitability. Four SME leaders who implemented successful CSR strategies and improved profitability in Maryland and Virginia participated in semistructured interviews. Other data collected were company profit and loss statements. A thematic analysis was used to analyze the data. The 3 primary themes that …

Nitrous Oxide For Pain Management In The Emergency Department, Jagmohan Kaur Ghotra

Walden Dissertations and Doctoral Studies

The clinical practice problem addressed was pain control in emergency department (ED) patients. The purpose of this project was to establish situations when inhaled nitrous oxide (N2O) could be used to manage pain in the ED. Specifically, a systematic review provided answers to questions related to appropriate uses of N2O in acute pain management, the effectiveness of inhaled N2O in managing acute pain, and the benefits of and barriers to N2O use in the ED. The middle range nursing theory of acute pain management published by the Agency for Health Care Policy and Research served as the theoretical support for …