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Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood
Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood
Walden Dissertations and Doctoral Studies
Inappropriate test utilization by physicians for clinical decision-making in patient care is a significant problem facing some healthcare leaders. Healthcare leaders are concerned about inappropriate test utilization because it can increase healthcare costs and degrade patient outcomes. Grounded in the complex adaptive system and Lean Six Sigma conceptual frameworks, the purpose of this qualitative single-case study was to identify strategies seven hospital leaders in Maryland and Washington, DC. who implemented successful test utilization strategies for physicians. Data were collected from semistructured virtual interviews and organizational reports and analyzed using Yin’s 5 step process. Five themes emerged: (a) continuing physician education, …
Examination Of The Association Between Poverty, Income, And Education Levels On Tuberculosis Prevalence In Nigeria: Rural Niger Delta Case Study, Nwinmene George Zarakpege
Examination Of The Association Between Poverty, Income, And Education Levels On Tuberculosis Prevalence In Nigeria: Rural Niger Delta Case Study, Nwinmene George Zarakpege
Walden Dissertations and Doctoral Studies
Despite the global decline in tuberculosis (TB) cases, the prevalence of TB in rural populations in Nigeria is rising. To date, poverty and low educational levels continue to affect treatment and other prevention strategies to eradicate the disease. The purpose of this cross-sectional study was to assess the association between poverty, educational levels, household structure and vaccination status on TB prevalence in rural Niger Delta, Nigeria. The theoretical framework for this study was the socio-ecological model. Data were obtained from residents of rural Niger Delta in Nigeria attending a teaching hospital in southern Nigeria. The relationship between the stated demographic …
Associations Between Depression, Social Support, And Sexual Risk-Taking Behaviors Among Hiv-Infected Adult Black Women In The Southeastern United States, Joy Ireri Kagendo
Associations Between Depression, Social Support, And Sexual Risk-Taking Behaviors Among Hiv-Infected Adult Black Women In The Southeastern United States, Joy Ireri Kagendo
Walden Dissertations and Doctoral Studies
African Americans continue to carry the burden of new HIV cases and sexually transmitted infections and other comorbidity health problems more than any other social group in the United States. Except for New York; Washington, DC; and Maryland, 65% of all new HIV cases are in the Southern states. The U.S. Southern states make up 38% of the U.S. population, yet approximately 51% of annual HIV diagnoses are from the Southern U.S. states. In the Southern states, AIDS is among the leading cause of death for African American women. A gap exists in the associations of depression, social support, and …
Stigma In Intimate Partner Relationships Among Ebola Survivors In Monrovia, Adam Monah Kyne
Stigma In Intimate Partner Relationships Among Ebola Survivors In Monrovia, Adam Monah Kyne
Walden Dissertations and Doctoral Studies
Stigmatization among Ebola survivors poses a growing problem in Monrovia, resulting in fractured relationships and broken marriages due to the fear of contracting Ebola during intimate moments. This study explores the lived experience of stigmatization in intimate partner relationships among Ebola virus disease (EVD) survivors in Monrovia, guided by stigma theory. By sharing the experiences of survivors, the study sheds light on the effects of stigmatization on their intimate relationships and provides a platform for expressing their personal experiences. It reveals the profound impact of the disease on survivors’ lives and their relationships with their partners. Using a qualitative approach, …
Covid-19 Social Isolation And Young Adult Mental Well-Being And Socioeconomic Status As A Moderator, Falescia Ware Matlock
Covid-19 Social Isolation And Young Adult Mental Well-Being And Socioeconomic Status As A Moderator, Falescia Ware Matlock
Walden Dissertations and Doctoral Studies
AbstractIt is not currently known how social distancing guidelines impact mental health for emerging adults and whether socioeconomic status moderates this relationship. The psychosocial development theory states that emerging adults experience a psychological conflict—intimacy versus isolation—where the goal is to seek connections. Without connection, emerging adults are likely to experience impaired psychological well-being, which was exacerbated by the COVID-19 pandemic. The purpose of this study was to examine the effects of perceived social distancing guidelines on the mental health of emerging adults and if this relationship is moderated by socioeconomic status. This study followed a quantitative comparative design of emerging …
Understanding The Barriers Of Lgbtq Youth Aging Out Of The Foster Care System, Quadasha Mcilwaine
Understanding The Barriers Of Lgbtq Youth Aging Out Of The Foster Care System, Quadasha Mcilwaine
Walden Dissertations and Doctoral Studies
Historically, there have been significant barriers experienced by youths aging out of the foster care system. A new area of focus highlights youths that identify as lesbian, gay, bisexual, transgender, and queer (LGBTQ). In this study, the opinions of LGBTQ youths who have aged out of the foster care system in North Carolina were explored and the barriers these youths may encounter as they transition into adulthood were illuminated. Bronfenbrenner’s ecological systems theory is the framework that was used to guide this study. A basic qualitative approach was used with semistructured interviews of 10 LGBTQ aged-out youths in North Carolina. …
Dietary Changes In Preventing Type Ii Diabetes Mellitus Among Young Hispanic Adults, Taiwo Onipede
Dietary Changes In Preventing Type Ii Diabetes Mellitus Among Young Hispanic Adults, Taiwo Onipede
Walden Dissertations and Doctoral Studies
Diabetes mellitus continues to be a major chronic disease affecting the global population today with more prevalence amongst minority groups in the United States. The genetic susceptibility to obesity and higher insulin resistance seen in the Hispanic population puts them at the highest risk for development of Type II Diabetes (T2DM). The alarming increase in young adult T2DM diagnosis led to the project question: How can teaching on dietary changes affect Type II Diabetes diagnosis in predisposed young Hispanic adults? The purpose of this project is to accomplish the goal of Healthy People 2020 towards improving the quality of life …
Perceptions Of Hiv-Positive Patients Towards Faith-Based Community Support In A Rural Setting, James D. Rollins
Perceptions Of Hiv-Positive Patients Towards Faith-Based Community Support In A Rural Setting, James D. Rollins
Walden Dissertations and Doctoral Studies
Studies have demonstrated different perspectives on faith-based organizations (FBOs). Various quantitative studies have been performed for many years; however, there is minimal qualitative research literature investigating the phenomenon of attitudes of HIV-positive patients in a faith-based structure. The purpose of this study was to examine the lived experiences of a sample of 7 participants aged 18-65 from rural areas of a southern U.S. state who have lived with HIV and have sought community support. The focus was on various interventions by rural religious community support programs. Patients’ perceptions and experiences regarding the possible improvement of their quality of life were …
Issues Encountered By Parents In Continuing School-Based Obesity Prevention Programs At Home, Prenu Skaria
Issues Encountered By Parents In Continuing School-Based Obesity Prevention Programs At Home, Prenu Skaria
Walden Dissertations and Doctoral Studies
Childhood obesity is a public health problem that can lead to various chronic health diseases such as cardiovascular disease and diabetes later in life. School-based obesity prevention programs are a public health recommendation to reduce and prevent obesity in schools through increased physical activity and better nutritional habits. This qualitative research involved exploring the reason for the discontinuation of school-based interventions at home using multi-theory model (MTM) constructs for health behavior change. A convenience sample of three focus groups of consenting parents whose children participated in the Wolf Pack Coaches Challenge (WPCC), a school-based obesity prevention program in Nevada, was …
Laboratory Practices And Antimicrobial Resistance In A Florida Hospital, Crispina Marie Sy-Trias
Laboratory Practices And Antimicrobial Resistance In A Florida Hospital, Crispina Marie Sy-Trias
Walden Dissertations and Doctoral Studies
Antibiotic resistance is a health threat affecting millions of Americans. Microorganisms develop resistance to antibiotics, rendering them useless for treating infections. The purpose of this quantitative study was to assess the associations between sample processing time and antibiotic resistance and is based on the health belief model. A retrospective specimen tracking activity of data from November 2019 to November 2020 was obtained by random sampling of 246 bacterial cultures. One hundred ninety-six (80%) samples were processed on time, and 50 (20%) were delayed; 167 (68%) samples were determined to have the presence of antimicrobial resistance (AMR), and 79 (32%) with …
Community Perceptions Of Syringe Service Programs In Charleston, West Virginia: A Qualitative Socioecological Perspective, Kenya M. Burton
Community Perceptions Of Syringe Service Programs In Charleston, West Virginia: A Qualitative Socioecological Perspective, Kenya M. Burton
Walden Dissertations and Doctoral Studies
In rural areas of the United States, people who inject drugs (PWID) experience an array of obstacles to accessing adequate healthcare. Locations with high rates of drug use normally offer more healthcare options, including needle exchange programs but, in some communities, there is resistance to providing this kind of care. This increases mortality, morbidity, cost, and adds to the stigma experienced by this vulnerable group. The experiences of people with substance dependency, including PWID, has been widely explored throughout studies that reflect a need for increased support. However, the perspectives of the community, especially in rural areas, though equally important, …
Doctoral Study Effects Of Mandatory Staffing Requirements On Quality Indicators In Long-Term Care, Melissa Reed
Doctoral Study Effects Of Mandatory Staffing Requirements On Quality Indicators In Long-Term Care, Melissa Reed
Walden Dissertations and Doctoral Studies
Long term care facilities continue to struggle to improve the quality of care, which affects publicly reported data and reimbursement. The purpose of this study was to evaluate if state-mandated staffing ratios affected Centers for Medicare and Medicaid Services (CMS) survey ratings for CMS Region 7, which consisted of Iowa, Kansas, Missouri, and Nebraska. The theoretical framework was grounded by Donabedian’s quality theory, which described quality is made up of the elements of structure, process, and outcomes. This study included two research questions evaluating if there was a correlation between minimum staffing ratios and quality of care in long-term care …
Improving Self-Efficacy Of Primary Care Providers With Assessment Of Diabetic Peripheral Neuropathy, Kimberly Paddock Farr
Improving Self-Efficacy Of Primary Care Providers With Assessment Of Diabetic Peripheral Neuropathy, Kimberly Paddock Farr
Walden Dissertations and Doctoral Studies
AbstractDiabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes. DPN contributes to significant pain, debility and injury to diabetic patients. The majority of diabetic patients are managed in the primary care practice (PCP) setting. A local chapter of a nurse practitioner association identified a lack of knowledge of current evidence-based guidelines for effective screening and assessment of DPN in the PCP environment. The practice-focused question for this project was to determine if an educational intervention on evidence-based screening and assessment would improve nurse practitioner’s knowledge with DPN screening and diagnosis in PCP. Mezirow’s transformative theory of …
Occupational Stress In Long Term Care In Georgia And Virginia During The Covid-19 Pandemic, Lacountess Renee Hooks
Occupational Stress In Long Term Care In Georgia And Virginia During The Covid-19 Pandemic, Lacountess Renee Hooks
Walden Dissertations and Doctoral Studies
Nursing staff working in long-term care settings experience high levels of occupational stress related to many factors that can lead to poor outcomes for the nursing staff and the residents. In 2020, the World Health Organization declared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, a pandemic which over the course of 3 years, has added an additional source of work-related stress for long-term care nursing staff. This quantitative cross-sectional study was guided by the job demand-control-support model to explore perceived stress and nursing stress among nursing staff working in the long-term care setting in Georgia and …
The Reconciliation Of Cognitive Dissonance Among Social Workers In Substance Use Treatment Settings, Miranda Ashley Kieler
The Reconciliation Of Cognitive Dissonance Among Social Workers In Substance Use Treatment Settings, Miranda Ashley Kieler
Walden Dissertations and Doctoral Studies
Although harm reduction (HR) and abstinence-based treatment approaches are both useful in addiction treatment, the former is less accepted and integrated into practice. Social workers who embrace an HR approach but who work at substance abuse treatment facilities that are abstinence based may experience cognitive dissonance because they perceive their work role to be incompatible with social work practice values and education. Little was known regarding how practitioners with a Master of Social Work (MSW) degree experience and reconcile cognitive dissonance related to their HR education and abstinence-only practice in substance use treatment centers. To address this gap in the …
Risk Factors Influencing Poliomyelitis Seroprevalence In Polio High Risk Areas Of Afghanistan, Wasan Abdulaziz Al-Tamimi
Risk Factors Influencing Poliomyelitis Seroprevalence In Polio High Risk Areas Of Afghanistan, Wasan Abdulaziz Al-Tamimi
Walden Dissertations and Doctoral Studies
Afghanistan is one of the remaining polio endemic countries in the world. Nearly one million children under 5 years of age have missed polio vaccination in Afghanistan from May 2018 until January 2021. This quantitative study used the socioecological model as the theoretical framework and secondary data analysis of the 2020 polio serosurvey (N = 1384) to investigate various risk factors such as gender, parental education, family origin (language/location), wealth, distance to nearest health facility, and number of polio vaccine doses on the level of antibodies (i.e., seroprevalence) against all three types of polioviruses in children of two age groups, …
Strategies To Mitigate Nurse Turnover, James Edward Cooper Jr
Strategies To Mitigate Nurse Turnover, James Edward Cooper Jr
Walden Dissertations and Doctoral Studies
Registered nurse turnover is a severe problem for all healthcare organizations because it negatively affects financial growth, patient care, and reputation, ultimately resulting in financial losses. Grounded in Herzberg’ two-factor theory, the purpose of this qualitative multiple-case study was to explore strategies hospital leaders use to mitigate RN turnover. The participants included three hospital leaders from three different hospitals in the southeastern United States who mitigated RN turnover. Data were collected from semistructured interviews and company documents and analyzed using Yin’s five-phase data analysis process. Three themes emerged: nurse engagement, job satisfaction, and trust in leadership mitigated RN turnover. A …
Influences On Influenza Vaccine Uptake Among Older Lebanese Adults, Doha D'Agostini
Influences On Influenza Vaccine Uptake Among Older Lebanese Adults, Doha D'Agostini
Walden Dissertations and Doctoral Studies
Influenza is a viral infection that is globally transmitted and that increases the risk for infectious diseases, hospitalization, and morbidity and mortality, especially among the older adult population. Although influenza vaccines are recommended in several countries, influenza vaccine hesitancy remains a challenge. In Lebanon, there is minimal research related to older adults’ attitudes and perceptions associated with influenza vaccination. To explore older Lebanese adults’ vaccination experiences and perceptions of the factors that affect their influenza vaccine uptake, a qualitative investigation was conducted. The theory of planned behaviors served as the theoretical framework for the study. A thematic analysis was conducted …
A Leadership Perspective On Preventing Counselor Burnout In A Behavioral Health Setting During Covid-19, Claudia P. De La Torre
A Leadership Perspective On Preventing Counselor Burnout In A Behavioral Health Setting During Covid-19, Claudia P. De La Torre
Walden Dissertations and Doctoral Studies
During the COVID-19 pandemic, there was a high need for mental health services, which resulted in a shortage of mental health clinicians. This shortage of mental health clinicians then resulted in a high burnout rate due to client intake. This doctoral case study was grounded in the Baldrige Excellence Framework and focused on how a behavioral health organization in South Texas managed burnout in clinicians during the COVID-19 pandemic. This study aimed to help behavioral health leaders find a solution to preventing burnout during a high demand pandemic. This doctoral study had several data sources, including semistructured interviews with three …
Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood
Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood
Walden Dissertations and Doctoral Studies
Inappropriate test utilization by physicians for clinical decision-making in patient care is a significant problem facing some healthcare leaders. Healthcare leaders are concerned about inappropriate test utilization because it can increase healthcare costs and degrade patient outcomes. Grounded in the complex adaptive system and Lean Six Sigma conceptual frameworks, the purpose of this qualitative single-case study was to identify strategies seven hospital leaders in Maryland and Washington, DC. who implemented successful test utilization strategies for physicians. Data were collected from semistructured virtual interviews and organizational reports and analyzed using Yin’s 5 step process. Five themes emerged: (a) continuing physician education, …
Gender Dynamics In The Management Care Of Internally Displaced Persons: The Boko Haram Insurgency, Evelyn Kikelomo Ikuenobe Otaigbe
Gender Dynamics In The Management Care Of Internally Displaced Persons: The Boko Haram Insurgency, Evelyn Kikelomo Ikuenobe Otaigbe
Walden Dissertations and Doctoral Studies
The Boko Haram asymmetric insurgency and warfare have decimated the Northeastern region of Nigeria and its neighboring environs of Chad, Niger, and Benin. The purpose of this study was to explore the peculiar socioethnic and cultural challenges encountered by female victims of Boko Haram terrorism at internally displaced persons camps in Abuja, Nigeria, including challenges in functioning, relocating, and acclimating back into society. A phenomenological approach was applied to understand participants’ lived experiences. Data collection occurred through interviews and observation. Data analysis involved the synthesis of narratives, and generation of themes. Among the emergent themes were poor feeding; lack of …
Organizational Strategies And Best Practices For Telehealth Delivery During Covid-19, Maria D. Mejia
Organizational Strategies And Best Practices For Telehealth Delivery During Covid-19, Maria D. Mejia
Walden Dissertations and Doctoral Studies
Organizational Strategies and Best Practices for Telehealth Delivery during COVID-19
An Association Of The Transgenerational Implications Of Redlining And Obesity On Pediatric Type Ii Diabetes, Carlin Dexter Nelson
An Association Of The Transgenerational Implications Of Redlining And Obesity On Pediatric Type Ii Diabetes, Carlin Dexter Nelson
Walden Dissertations and Doctoral Studies
s the prevalence and incidence of childhood obesity has increased, so has the number of cases of pediatric Type 2 diabetes mellitus (T2DM). Although made unconstitutional in 1968, the transgenerational implications of redlining can be observed in disinvestments resulting in neighborhood detraction. Utilizing the 2019–2020 National Children’s Health Survey, the purpose of the study was to evaluate the relationship between obesity, T2DM, and neighborhood detraction elements as well as assessed indicators of T2DM in non-institutionalized children 6 through17 years of age (N = 34,725). The social determinants of health perspective served as the conceptual framework for the study. Results indicated …
Age, Race/Hispanic Origin, And Covid-19 Mortality Among Sickle Cell Disease Patients In The United States, Joe Lamont Ndula
Age, Race/Hispanic Origin, And Covid-19 Mortality Among Sickle Cell Disease Patients In The United States, Joe Lamont Ndula
Walden Dissertations and Doctoral Studies
The COVID-19 pandemic remains a global health challenge, with 6.7 million deaths worldwide as of January 2023. It has illuminated the health iniquities in underserved communities and populations like those with sickle cell disease (SCD). Researchers have associated the COVID-19 outcome among SCD patients in other regions of the globe. The purpose of this retrospective cross-sectional observational study was to investigate the relationship between age, race/Hispanic origin, and COVID-19 mortality among persons with SCD in the United States from January 2020 to March 2021. The Krieger ecosocial theory of disease distribution framed the study. Data were drawn from an existing …
Tuberculosis-Associated Knowledge, Stigma, And Health Seeking Behavior Among Traders In Onitsha Main Market, Anambra State, Nigeria, Benedeth N. Ezeosim
Tuberculosis-Associated Knowledge, Stigma, And Health Seeking Behavior Among Traders In Onitsha Main Market, Anambra State, Nigeria, Benedeth N. Ezeosim
Walden Dissertations and Doctoral Studies
The utilization of tuberculosis (TB) health care services in a Nigerian state has not been optimal. Many residents do not utilize available health care resources when they experience symptoms of TB. Although much is known about the determinants of health seeking behavior (HSB), there is a gap on how TB knowledge and TB related stigma among traders in one main market contribute to HSB. This study examined the effect of TB knowledge and TB related stigma on HSB among traders. The health stigma and discrimination and health belif models served as the theoretical foundation. A quantitative cross-sectional analytical survey design …
Relationship Between Homelessness, Substance Use, Employment, Living On A Reservation And Tuberculosis Among Northern Plains Native Americans, Darla Mccloskey
Relationship Between Homelessness, Substance Use, Employment, Living On A Reservation And Tuberculosis Among Northern Plains Native Americans, Darla Mccloskey
Walden Dissertations and Doctoral Studies
Native Americans in the Northern Plains have a long history of tuberculosis (TB) infections. There is limited research on the causes of latent TB infections (LTBI) and TB in this population. The purpose of this quantitative study was to assess the relationship between latent TB and factors of homelessness, substance use, employment, living on a reservation, and active or latent TB among this population using the eco-social theory as the theoretical framework. Data from 146 TB cases of Native Americans living in the Northern Plains and diagnosed with TB from 1999 to 2019 were analyzed using chi-square tests that showed …
Poverty Implications Of Covid-19 And Government Social Protection Programmes In Nigeria, Adeponle Adeoye, John Lola Okunola, Sunday Fakunle
Poverty Implications Of Covid-19 And Government Social Protection Programmes In Nigeria, Adeponle Adeoye, John Lola Okunola, Sunday Fakunle
Journal of Social, Behavioral, and Health Sciences
The sole objective of this paper was to investigate the poverty implications of COVID-19 on Nigerians, relative to the effectiveness of the government’s social protection programs in mitigating the socioeconomic strain caused by the pandemic. The paper used documentary analysis to assess the impact of COVID-19 on Nigerians’ socioeconomic lives and the government’s policy response to the situation. The review found that COVID-19 exacerbated the existing poverty in Nigeria, and most of the government policy programs were not effective in mitigating the effects. We concluded that government policy responses to the socioeconomic strain caused by the pandemic were ineffective due …
The Lived Social Experience Of Covid-19 Survivors In Southwestern Nigeria, Endurance Uzobo, Ijeoma Nwanwene, Tolulope Funmilola Ojo
The Lived Social Experience Of Covid-19 Survivors In Southwestern Nigeria, Endurance Uzobo, Ijeoma Nwanwene, Tolulope Funmilola Ojo
Journal of Social, Behavioral, and Health Sciences
The traditional perceptions of disease causation often reinforce the feelings of stigmatization and discrimination towards individuals who have recovered from an illness. This study investigated the existing social practices with regard to stigmatization and discrimination against COVID-19 survivors in Southwest Nigeria. Using the Psychoanalytic Theory, this phenomenological qualitative study utilized the snowball sampling method and an in-depth interview to sample 25 COVID-19 survivors in Southwest Nigeria. Collected data for this study were analyzed thematically, using content analysis with the aid of the ATLAS.ti software. Findings from the study indicated that COVID-19 survivors generally experience sympathy, hostility, mockery, and social exclusion. …
Barriers To Blood Availability Within The New Orleans Area, Tishawn Francis
Barriers To Blood Availability Within The New Orleans Area, Tishawn Francis
Walden Dissertations and Doctoral Studies
An adequate and reliable supply of blood and blood components is becoming an increasing public health concern. Over the past decade, researchers have indicated a continued decline in the collection of blood products. An insufficient blood supply may present a risk to both patients and reserves for emergencies and disasters. The purpose of this quantitative, cross-sectional study was to determine whether gender, age group, ethnicity, year, serological tests, and discard factors were associated with the availability of the donated blood supply throughout the New Orleans region. The donated blood supply chain model guided this study. Secondary data were retrieved from …
Sources Of Information About Covid-19 Among Older Adults In Ghana, 2019-2021, Samuel Adu-Gyamfi, Emmanuel Akwasi Asante
Sources Of Information About Covid-19 Among Older Adults In Ghana, 2019-2021, Samuel Adu-Gyamfi, Emmanuel Akwasi Asante
Journal of Social, Behavioral, and Health Sciences
The COVID-19 pandemic sparked a worldwide search for information. Information about COVID-19 is crucial and it could be the first step toward designing practical disease-control strategies. Misinformation amid the widespread information about COVID-19 has undoubtedly caused psychological distress, especially among older adults. We present an empirical and descriptive study of the sources of information among older adults and how they perceived the COVID-19 pandemic. A total of 58 participants were recruited and interviewed using an in-depth semi-structured interview and structured questionnaire for our study. The study participants were recruited using purposive and convenience sampling in their respective homes from Mallam, …