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Severe Maternal Morbidity In Michigan: An Investigation Of Health Disparities, Laura Houdeshell-Putt

Walden Dissertations and Doctoral Studies

Severe maternal morbidity (SMM) rates in Michigan have increased over the past 20 years and continue to affect racial and ethnic women disproportionately. Women experiencing health conditions that complicate pregnancy outcomes have a greater risk of having poor obstetric outcomes that result in a SMM event. To evaluate the distribution of women experiencing health conditions that complicate pregnancy and a SMM event, geographic information systems were utilized in this study. The purpose of this study was to depict trends in the prevalence of 4 health conditions and SMM among women hospitalized for obstetric delivery in Michigan from 2016–2017. The 4 …

Impact Of Perceived Computed Tomography Radiation Risk And Benefit On Healthcare Decision-Making, Joseph Princewill

Walden Dissertations and Doctoral Studies

Patient-centered care is focused on healthcare consumers becoming more involved in their own health care decision-making. Research is needed to examine how those decisions are made in different settings. The purpose of this concurrent transformative design mixed method study was to evaluate how the perceived health risks and benefits of Computed Tomography (CT) influenced decision-making to accept or reject a hypothetical CT recommendation. One hundred thirty-four participants read 1 of 8 vignettes on how either “high” or “low” susceptibility to cancer risk, severity of exposure to radiation, and diagnostic benefits affected their decision-making. Using the health belief model as a …

Acculturative Experiences Of African American Military Wives In An Arctic Environment, Demetria Roshan White

Walden Dissertations and Doctoral Studies

United States military wives typically relocate every few years with their active-duty husbands. But little is known about the acculturative stress and stressors associated with relocating and reestablishing a military home in an Arctic environment. This qualitative research focused on African American women who were also military wives and the acculturative stress they encountered in relocating to an Arctic environment. Face to face interviews provided a platform for 10 military wives to share their personal experiences. The acculturative stress that African American military wives’ acculturative stress and stressors encountered in relocating from a non-Arctic to an Arctic environment are not …

Performance Evaluation Criteria For Project Managers, Nestor Briones Aquino

Walden Dissertations and Doctoral Studies

Supervisors of business project managers lack strategies to effectively evaluate the work of project managers, increasing the probability of project failure, and costing organizations billions of dollars in losses each year. Effective evaluation of the work of project managers is essential to avoid project failure. Grounded in Kaplan and Norton’s balanced scorecard theory, the purpose of this qualitative single case study was to explore strategies supervisors of business project managers use to evaluate the project managers’ work. The participants comprised 3 supervisors of project managers in the Rocky Mountain area of the United States with successful experience in evaluating the …

Improving Nursing Knowledge Of Heart Failure Discharge Self-Care Instructions, Maria Patricia Picar Deza

Walden Dissertations and Doctoral Studies

Patients with heart failure (HF) have recurrent symptoms that lead to frequent hospital readmissions. Moreover, HF is one of the leading causes of 30-day hospital readmissions. Evidence shows that patients with a high level of HF self-care have decreased readmissions. HF self-care education is commonly delivered by the nurse at hospital discharge, and the patient’s transition to self-care is a critical point in the continuum of care. However, nurses must be knowledgeable of patient self-care in HF to effectively convey this information to the patient upon discharge. Therefore, this staff education project question asked whether nursing knowledge of HF patient …

Impact Of Food Assistance Programs On Food Insecurity, Diet Quality And Obesity, Jessica Eileen Hill

Walden Dissertations and Doctoral Studies

Obesity remains a public health issue in the United States because it contributes to chronic diseases. The Supplemental Nutrition Assistance Program (SNAP) was designed to increase food security, alleviate hunger, and increase access to a healthful diet; however, it may have the opposite effect and contribute to obesity. The purpose of this study was to examine to what extent participation in SNAP impacts food insecurity, diet quality, and obesity in U.S. adults. The social-ecological model guided the study which was conducted using a quantitative a cross-sectional research design and secondary analyses of the 2013-2014 National Health and Nutrition Examination Survey …

Georgia Government Leaders' Lived Experience Creating And Implementing Health Equity Policies, Tracy M. Clopton

Walden Dissertations and Doctoral Studies

Georgia’s racial and ethnic minority communities have a continual problem of disproportionately worse health outcomes, including higher chronic disease and behavioral risk factors, compared to their nonminority counterparts. The average cost per year for chronic disease between 2016 and 2030 could be $64.6 billion in medical costs and $26.8 billion in lost employee productivity for Georgia. The purpose of this study was to explore the lived experience of Georgia legislators and health program staff to determine policy solutions to reduce chronic disease and behavioral risk factor disparities in the racial and ethnic minority population. The theoretical lens for the study …

Advanced Practice Registered Nurses And Their Knowledge Regarding The Hindrance Of Obesity, Crystal Rainey

Walden Dissertations and Doctoral Studies

Advanced Practice Registered Nurses and Their Knowledge

Regarding the Hindrance of Obesity

by

Crystal N. Rainey

MSN, Walden University, 2014

BSN, University of Arkansas in Little Rock, 2011

AASN, Southeast Arkansas College, 2009

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

February 2020

Self Reported Cardiovascular Disease Risk Factors Among Deaf Users: A Communication Barrier, Dr. Jolene Ayres Ogunjirin

Walden Dissertations and Doctoral Studies

Cardiovascular disease (CVD) is the number one cause of mortality worldwide, and may disproportionately affect the Deaf and Hard of Hearing (DHOH) subpopulation in the United States. It has been suggested that communication barriers among the DHOH subpopulation contribute to the high prevalence of CVD risk factors. To assess this claim, this quantitative study utilized a cross-sectional data set of 400 DHOH and 400 non- DHOH participants taken from the National Health and Nutrition Examination Survey (NHANES) database. The differences of being told by a health professional of having specific CVD risk factors were assessed between the two groups and …

An Exploration Of Experiences Of Parents With Dependent Adult Children Expressed In Social Media, Lanora Lynn Elliston-Gittings

Walden Dissertations and Doctoral Studies

Many young adults lack independence and parents are supporting their children in into adulthood. There are parents who feel frustrated, taken for granted, and alone while providing for their dependent children. A lack of resources led a population of parents to find support through private social media groups. No research that examined the perception of the experiences of parents of dependent adults and the perceived benefits of online resources was found. The purpose of this generic qualitative study was to understand the parenting experiences of those who chose to join a private social media group and fill the literature gap …

Providers' Attitudes And Knowledge Of Motivational Interviewing With Opioid Dependent Clients, Katrina Agneauelle Gary-Forte'

Walden Dissertations and Doctoral Studies

Clients who suffer from opioid use disorders are at an increased risk of overdose and death. Researchers have indicated the need for studies that focus on ways to increase the use of evidenced-based practices (EBPs) in opioid use disorder treatments. Previous research suggests that motivational interviewing (MI) is an EBP that is effective in promoting behavioral change. The purpose of this study was to contribute to the research on MI by examining which variables predict mental health provider use of MI when treating opioid-dependent clients. The theory of planned behavior was the chosen theoretical framework for this study because it …

How Do Parenting Styles Influence The Academic Performance Of African-American College Students At An Hbcu On The East Coast, Chaka P. Smith

Walden Dissertations and Doctoral Studies

Various studies have shown that the style of parenting has a significant influence on the academic performance and success of students. Furthermore, these studies have shown this evidence on academic performance in different contexts, that is at different grade levels and in different countries. The dearth of literature on the relationship between African-American parenting styles and academic performances is important as there is no universally acknowledged best way of parenting. Thus, the purpose of this study was to determine the relationship between parenting styles and academic performance of African-American college students at historically black colleges and universities on the East …

Staff Education: Prediabetes Lifestyle Modification Toolkit, Vivian Elege

Walden Dissertations and Doctoral Studies

Prediabetes patients are at a high risk of developing Type 2 diabetes. The purpose of this project was to educate the medical staff of the project site clinic on lifestyle modifications that can help patients prevent prediabetes from progressing to Type 2 diabetes. The project took place at an outpatient clinic in the Southwestern United States. The clinic patient population is mostly African American, a population at risk for diabetes. The theoretical framework to support the project was the Iowa model of evidence-based practice. Staff education on patient diabetes prevention was the goal of the project. The project question focused …

Stroke Prevention Through Education, Laura Lee Ballance

Walden Dissertations and Doctoral Studies

AbstractThis project focused on two concepts: a need for a stroke prevention program and what should be included. The problem with early identification of stroke is not formally addressed at the project site, physician’s office. A physician’s office can play a beginning key role in minimizing the risk of stroke. The purpose of this project was to explore the evidence to support the need for and to determine ideal content for a stroke prevention education program. This program focused on early detection and identification of risk factors to prevent stroke occurrence. The theoretical framework of Pender’s health promotion model aligns …

Blended Learning Success In The Classroom, Alisanda Michelle Woods

Walden Dissertations and Doctoral Studies

An early elementary school in the Midwest, some economically disadvantaged students perform below grade level in math achievement. The blended learning model (BLM) is utilized within the district, however, there is a lack of data to support its effectiveness with underachieving, economically disadvantaged students. The purpose of this sequential mixed methods study was to investigate if there was a difference between the implementation of (BLM) and student achievement for economically disadvantaged students who are performing below grade level in math. The study was grounded in the technological, pedagogical, and content knowledge (TPCK) theoretical framework. Three quantitative research questions examined if …

Clinical Practice Guideline: Early Screening For Dementia In Diabetes Mellitus, Angelyn Levell-Smith

Walden Dissertations and Doctoral Studies

AbstractDiabetes mellitus (DM) is a recognized cognitive impairment risk factor. Even with hyperglycemia being a modifiable risk factor in dementia, primary care is without an evidence-based screening tool to screen patients with diabetes for cognitive abilities. Current literature supports developing an evidence-based standardized guideline for early screening for cognitive impairment in elderly patients with DM. The purpose of this doctor of nursing practice (DNP) clinical practice guideline (CPG) project was to develop an evidence-based CPG for early screening of dementia in patients with DM, providing a means for early recognition of cognitive decline in these patients, making early intervention more …

Guiding Nurses To A Healthier Lifestyle, Margaret Yvonne Garcia

Walden Dissertations and Doctoral Studies

AbstractNurses provide continuous patient care around the clock. Nurses who work outside of the 9:00 a.m. to 5:00 p.m. hours are susceptible to fatigue and sleep deprivation that impair their attention to detail, ability to remain focused, information processing, and problem solving. This is especially prevalent among those who work the night shift. Nurses also find that their memory, reaction time, motivation, communication, mood, and empathy are affected with fewer hours of sleep. This project explored the sleepiness that night shift nurses experience and provides nurses with strategies to improve these symptoms. Nurses were provided with a PowerPoint presentation to …

The Association Between Provider Cultural Competence And Type 2 Diabetes Health Behaviors, Bernadette Joyce Mejia-Tran

Walden Dissertations and Doctoral Studies

Provider cultural competence is poorly understood in relation to the outcome of Type 2 diabetes patient health behaviors. The purpose of this study was to examine the association between provider cultural competence and diabetes patient health behaviors. The chronic care model provided the conceptual framework for this study. The research questions were designed to determine whether 5 measures of provider cultural competence play a role in diabetes patient health behavior change. The research design of the study was a quantitative cross-sectional survey using the 2017 National Health Interview Survey. The 2,342 participants included in the study represent a national sample …

The Summer Treatment Program’S Effect On Behaviorally Challenged Orthodox Jewish Children, Dovid Rudomin

Walden Dissertations and Doctoral Studies

The Summer Treatment Program (STP) is an 8-week, research-based, behavior modification approach utilizing a unique point system that has been shown to improve the noncompliant behavior of children in a day camp setting. Due to religious reasons, the children of the Orthodox Jewish (OJ) community are unable to attend the original STP. Guided by behaviorism, the purpose of this research study was to assess whether a faith-based STP is effective in improving the noncompliant behavior of OJ behaviorally challenged children. In this study, the relationship between the completion of the STP and the behaviors of hyperactivity, aggression, conduct, anxiety, attention, …

Postpartum Depression Education And Screening In A Hospital Setting, Amanda Snyder

Walden Dissertations and Doctoral Studies

It is estimated that 24.3% of women in Florida who have recently given birth experience postpartum depression (PPD), which approximates the national percentage. Perinatal nurses are often not provided specific education relating to PPD nor provided reliable methods to screen patients in the hospital setting. The focus of this project was to increase the number of mothers identified as needing follow-up for PPD by formally educating perinatal staff members on the signs and symptoms of depression, while including validated methods of screening patients compared to the current practice of general assessment and verbal interviewing. The approach was supportive of the …

Impact Of District-Wide Free Lunch On Third-Grade Students’ Reading Comprehension, Rita A. Williams

Walden Dissertations and Doctoral Studies

Poverty has an enormous impact on children and their success in school. Children with low economic status often perform poorly in math and reading. Poor reading skills often lead to truancy, low rates of high school graduation, low-paying jobs, and cycles of illiteracy in generations of families. The fundamental cause theory was the theoretical lens used for this study. The purpose of this quantitative, comparative ANOVA quartile split study was to examine the impact of universal free and reduced lunch (FRL) policy changes on third grade reading normal curve equivalent (NCE) scores. The research design included data analysis for examining …

The Nature And Effectiveness Of Supplemental Nutrition Assistance Program Fraud Detection Strategies In Baltimore County, Keena Esemuede

Walden Dissertations and Doctoral Studies

The frequent occurrences of fraud over the life of the Supplemental Nutrition Assistance Program (SNAP) have indicated a need for robust fraud detection strategies. This qualitative study explores the nature and effectiveness of current fraud detection strategies for the SNAP in Baltimore County during 2008-2018 to understand what strategies can possibly reduce fraud within the program. The primary methods of fraud (conceptual framework) and social disorganization theory (theoretical framework) were used to collect the data for this study. The data included interviews with 1 administrator and 3 store managers who oversee the SNAP in Baltimore County, as well as 5 …

Experiences Of A Loss Of A Parent To Aids During Adolescence On Young Adults, Angela Thorpe-Moss

Walden Dissertations and Doctoral Studies

Acquired immunodeficiency syndrome (AIDS) continues to be a major healthcare issue for many countries, including the United States. Millions of adolescent children under the age of 18 have lost 1 or both parents to AIDS-related complications. The death of a parent to AIDS-related complications is severe; however, limited data describes how this type of death affects adolescents after they have become young adults. It is important to determine how these adolescents are affected by exploring their lived experiences of losing a parent to AIDS-related complications. The purpose of this qualitative phenomenological study was to understand the lived experiences associated with …

Area-Level Factors Linked To Obesity In African American And Caucasian Women In Michigan, Marjorie Arrey

Walden Dissertations and Doctoral Studies

Obesity is a major public health crisis, affecting every segment of the U.S. population. African American women have higher prevalence of obesity than all other subpopulations and are disproportionately burdened by the disease and its comorbidities. Despite this disparity, African American women are often underrepresented in obesity research. This research examined obesity-related risk factors specific to African American women compared to those for Caucasian women. The design was based on the socioecological model and social cognitive theory, both emphasizing the impact of social factors on health outcomes. The data set included only adult Michigan women from the NHANES study. Multiple …

Water Sustainability Leadership Fostering Stakeholder Engagement, Rosa Elena Bustillos Wong

Walden Dissertations and Doctoral Studies

Water conservation management and water use behaviors of U.S. citizens are critical to secure water for future generations. An American citizen consumes approximately 88 gallons of water per day. On a local scale, a Florida citizen uses 134 gallons per day and wastes 71% of the total municipal drinking water provision in landscape activities. The problem addressed in this study was that administrators working on water conservation programs undergo difficulty fostering stakeholder engagement to advocate a water use behavioral change. The purpose of this qualitative exploratory multiple case study was to understand how citizen water use behaviors influence stakeholder water …

Developing An Indicator System For A Healthy City: Taking An Urban Area As A Pilot, Tingting Li, Yong Fang, Dewei Zeng, Zumin Shi, Manoj Sharma, Huan Zeng, Yong Zhao

Walden Faculty and Staff Publications

Purpose: The Healthy Cities Project is an important strategy for global health. This study aimed to develop a scientific and appropriate indicator system for the evaluation of a Healthy City in Chongqing, China. Methods: Data were collected via a review of government documents, focus group discussions, and in-depth interviews. A total of 34 government documents were reviewed to build the indicator database based on our previous studies. The first round of focus group discussions, which involved eight health-related experts, was conducted to form the indicator system framework. In-depth interviews with 15 experts from government departments were conducted to design …

How Do They Feel About It? Testing A New Mixed Methods Survey Tool To Assess Collective Emotional Status, Michael Schwab

Walden Faculty and Staff Publications

Emotions are now widely accepted as important elements of qualitative research, in studies of individuals and communities. However, collective emotional status—what a community feels about a given situation or proposition—can be challenging to assess. In this study, we examined the validity and acceptability of a new mixed methods survey tool, primarily qualitative, to address this challenge—the Assessment of Collective Emotional Status (ACES). The tool begins with an adjustable set of questions about emotion, to draw respondents’ attention to their own feelings. These are followed by an emotional self-assessment, in which respondents select and prioritize five emotional responses to a standardized …

Treatment Plans For Diabetes Management During Hurricane Maria In Puerto Rico, Joel De La Cruz Oller

Walden Dissertations and Doctoral Studies

The purpose of this study was to evaluate the health outcomes of diabetic patients in Puerto Rico, before, during, and after Hurricane Maria, in 2017. The Department of Health in Puerto Rico provided the secondary data for the variables low-density lipoproteins (LDL) cholesterol, hemoglobin A1C (HbA1c), mortality, and consumer price index (CPI). The inclusion criteria were participants for whom electronic data were available before, during, and after Hurricane Maria; the sample size was 450. The theoretical framework for this investigation was the health outcomes and impact assessment. The data were analyzed by univariate and analysis of variance (ANOVA) to compare …

Gratitude Among Mothers Raising A Child With Special Health Care Needs, Keli Jean Kleindorfer

Walden Dissertations and Doctoral Studies

For a mother raising a child with special health care needs (CSHCN), maintaining positive feelings of gratitude can become challenging because of the stress associated with caregiving, as well as the consequences of unmanaged stress, which include decreases in both physical and psychological health and well-being. Chronic, unmanaged stress has been associated with various health issues that can be severe and potentially life-threatening. The purpose of this phenomenological study was to examine how mothers raising a CSHCN experience gratitude. A secondary purpose was to identify possible barriers to experiencing gratitude, which, when implemented as a coping style, may decrease the …

Improving Nursing Knowledge Of Heart Failure Discharge Self-Care Instructions, Maria Patricia Picar Deza

Walden Dissertations and Doctoral Studies

Patients with heart failure (HF) have recurrent symptoms that lead to frequent hospital readmissions. Moreover, HF is one of the leading causes of 30-day hospital readmissions. Evidence shows that patients with a high level of HF self-care have decreased readmissions. HF self-care education is commonly delivered by the nurse at hospital discharge, and the patient’s transition to self-care is a critical point in the continuum of care. However, nurses must be knowledgeable of patient self-care in HF to effectively convey this information to the patient upon discharge. Therefore, this staff education project question asked whether nursing knowledge of HF patient …