Digital Commons Network^™

Mindfulness-Based Interventions To Improve Anxiety And Depression Outcomes In Adult Patients, Eunice Onyinye Nsofor

Walden Dissertations and Doctoral Studies

Anxiety and depression are among the most prevalent mental health conditions and significantly affect quality of life, daily functioning, and healthcare utilization among adult patients. Despite strong evidence supporting mindfulness-based interventions (MBIs) as effective nonpharmacologic approaches for managing anxiety and depression, these interventions remain underutilized in many clinical settings due to limited staff knowledge and inconsistent referral practices. The purpose of this evidence-based practice (EBP) project was to implement and evaluate a structured staff education program designed to improve staff knowledge of mindfulness-based interventions for adult patients with anxiety and depression. The practice-focused question examined whether staff education on MBIs …

Therapists’ Perspectives On Female Patients’ Recovery From Sexual Violent Trauma Committed By Familiar Offenders, Lauren S. Doran

Walden Dissertations and Doctoral Studies

A mental health therapist is a licensed professional who is trained to identify any barriers or regression during the recovery process with their female patients’ psychological experiences from sexual violent trauma (SVT) perpetrated by a degree of familiar offenders. In this study, the therapists’ perceptions identified the impact of the SVT committed by a familiar offender toward the female victim’s recovery process. The theoretical foundation included betrayal trauma theory, moral injury, and victimology. The research question addressed how therapists described the psychological recovery of female patients who experienced sexual violence by a familiar offender. The research design was data collection …

Strategies Used By Software Leaders To Manage Technical Debt, Noel G. Alexander

Walden Dissertations and Doctoral Studies

A lack of effective strategies for managing software technical debt (TD) can negatively affect organizational performance. Software leaders are concerned that unmanaged TD threatens business growth and competitiveness. Grounded in bounded rationality theory, the purpose of this qualitative pragmatic inquiry was to explore effective strategies used by software leaders to reduce software TD. The participants were six senior software leaders from private software companies in the United States. Data were collected through semistructured interviews and the review of publicly available industry reports. Through thematic analysis, four themes were identified: (a) balancing product delivery and technical health; (b) leadership, stewardship, and …

Lived Experiences Of Black Counselor Educator Mothers: Intersecting Identities In Academic And Professional Spaces, Althea Genae Collins

Walden Dissertations and Doctoral Studies

Black counselor educator mothers navigate intersecting identities. Despite growing attention to women of color, scholarship remains limited on how Black counselor educator mothers manage caregiving and professional duties. This gap contributes to practices that overlook labor, taxation, and strains that affect retention and the ability to thrive. The purpose of this hermeneutic phenomenological study was to answer the question of what the lived experiences of Black counselor educator mothers are as they navigate the intersecting identities of race, gender, and motherhood in their personal and professional lives. This study also answered the question of what meaning Black counselor educator mothers …

A Grounded Theory Approach To Explaining Leadership And Leadership Processes Among Oncology Social Workers, Larmender Amia Davis

Walden Dissertations and Doctoral Studies

The absence of comprehensive field-specific leadership theories leaves oncology social work leaders insufficiently equipped to navigate organizational challenges such as policy shifts, financial pressures, and workforce dynamics. The purpose of this qualitative grounded theory study was to generate an explanatory theory of leadership grounded in the experiences of social work leaders practicing in oncology settings. The grounded theory and a conceptual framework on leadership processes, ethical identity, and organizational context guided this study. Data were collected through semistructured interviews with 12 oncology social work leaders in the United States. Five categories emerged and were analyzed using the constant comparative method: …

Perceived Influence Of Childhood Domestic Violence Exposure On Intimate Relationships Among Heterosexual African American Men, Ronnie Lyman

Walden Dissertations and Doctoral Studies

Childhood exposure to domestic violence (DV) remains a significant and underexplored issue within clinical social work, particularly as it pertains to African American men. This doctoral project involved addressing limited understanding of how heterosexual African American men who were exposed to DV in childhood perceived these early experiences in terms of shaping their emotional wellbeing and intimate partner relationships in adulthood. Guided by the intergenerational transmission of violence theory, this study involved exploring reflective narratives of men who experienced such exposure. Via a basic qualitative research design, data were collected through semi-structured interviews with seven purposefully selected participants who were …

Health-Related Quality Of Life Of Women With Polycystic Ovary Syndrome In Malaysia, Stephanie Yang

Walden Dissertations and Doctoral Studies

Polycystic ovarian syndrome (PCOS) is the most prevalent endocrine condition among women of reproductive age. PCOS is known to be a chronic disease that presents significant physical and body image issues, which in turn are associated with lowered emotional and health-related quality of life. Previous studies point to widespread dissatisfaction and delays with the diagnosis of PCOS and a lack of information provided by doctors. This phenomenological study was guided by Wilson and Cleary’s model of health-related quality of life to explore the health-related quality of life in Malaysian women with PCOS. Seven Malaysian women aged 29 to 50 years …

Strategies To Improve Diversity In Leadership And The Representation Of Black Women Within An Integrated Nonprofit Health Care System, Dominique Clark

Walden Dissertations and Doctoral Studies

Black women have been underrepresented in health care leadership, specifically at the senior level. The purpose of this integrative review was to identify strategies that could be implemented to increase representation for Black women in health care leadership, with emphasis on senior leadership. The review question centered on sustainable strategies and best practices that support an increased representation of Black women in health care leadership. Relational leadership theory (RLT) served as the theoretical framework, demonstrating that leadership advancement is influenced by relational networks. A comprehensive literature review identified 50 articles that were critically appraised using the John Hopskins evidence tools, …

Staff Education To Improve Culturally Responsive Mental Health Care For African Immigrants, Martha Eseh

Walden Dissertations and Doctoral Studies

Mental health disparities among African immigrant populations are often influenced by cultural stigma, limited mental health literacy, and providers’ insufficient understanding of culturally specific beliefs and help-seeking behaviors. In outpatient psychiatric settings, these gaps can negatively affect engagement, diagnosis, and treatment outcomes. The purpose of this quality improvement project was to evaluate whether a structured staff education program could improve provider knowledge of culturally responsive care for African immigrant patients. Guided by the Johns Hopkins Evidence-Based Practice model, a pretest–posttest design was implemented with 13 interprofessional staff members, including psychiatric providers, therapists, and support staff, in an outpatient mental health …

Staff Education On The Implementation Of Walking Interventions, Cynthia Ononobi

Walden Dissertations and Doctoral Studies

The doctoral project was a staff education project aimed at improving the knowledge of psychiatric nurses on the use of structured walking interventions to manage depression. The practice problem was related to the lack of consistency in the application of walking as a treatment for depression. This gap was significant to address because psychiatric nurses are in the center of behavioral activation, and insufficient knowledge may deny patients the right to potentially valuable, affordable, and nonpharmacological treatment. The practice-based question was: Among psychiatric nursing staff does education on structured walking intervention, compared to standard care, improve staff knowledge and skills …

Student Perspectives On Title Ix Policy Across North Texas College Campuses, Felicia Chism

Walden Dissertations and Doctoral Studies

This qualitative phenomenological study examined how North Texas higher education students’ lived experiences with Title IX (TIX) shaped their perceptions of the policy’s fairness, accessibility, and implementation. The study addressed the problem that experiential perspectives of TIX remain underexplored, despite their importance for understanding institutional accountability and student trust. Guided by the social ecological model and organizational justice theory, the research investigated how individual, relational, institutional, and societal factors influenced students’ interpretations of TIX processes. Eight students from North Texas public universities who had direct involvement in a closed TIX case participated in semi‑structured interviews. Data were analyzed using Moustakas’s …

Strategies For Integrated Primary Care Clinics To Improve Administrative Costs Due To Medication Nonadherence, Michael A. Watkins

Walden Dissertations and Doctoral Studies

Medication non-adherence is a pervasive issue that drives up administrative costs for integrated primary care clinics. Total administrative costs for medication non-adherence account for one-quarter of U.S. healthcare expenditures. The purpose of this integrative review was to identify cost-reduction strategies that integrated primary care clinic administrators can implement to offset costs associated with medication nonadherence. The theoretical framework for this integrative review was Bertalanffy’s general systems theory. The review question was to identify strategies that primary care clinics could implement to reduce administrative costs associated with patient medication nonadherence. A comprehensive literature search yielded 1,892 potential articles. A quality analysis …

Prenatal Care Access And Pregnancy Outcomes Among Black Women Ages 15–44 In Cook County, Illinois, Deandrea Heggins

Walden Dissertations and Doctoral Studies

Maternal health disparities affecting Black women in the United States remain a persistent public health concern due to inequities in prenatal care access and adverse birth outcomes. Prior research has shown that socioeconomic conditions, insurance coverage, and systemic barriers influence prenatal care utilization and maternal outcomes; however, limited research has examined how Medicaid coverage, household income, preterm birth, and birth weight are collectively associated with prenatal care access among Black women in Cook County, Illinois. The purpose of this quantitative correlational study was to examine the relationships among these factors and access to prenatal care among Black women ages 15–44 …

Exercise Behavior Determinants Of The United States Military And Veterans, Ira Seth

Walden Dissertations and Doctoral Studies

Despite organizational policy and access to physical activity facilities, the U.S. Department of Defense has observed an increase in the prevalence of service members classified as overweight or obese. Guided by the social-ecological model, this quantitative study investigated the work-related exercise determinants within the U.S. military community. Voluntarily recruited current and former service members from Stars and Stripes completed the Office Exercise Behavior Determinant Scale and the International Physical Activity Questionnaire, along with demographic and biometric questions, to identify physical activity behavior and potential barriers. Findings revealed statistical significance related to exercise duration and military variables (e.g., occupation, race/ethnicity), as …

Executive Summary: Executive Leadership System Improvement Improving Depression Screening And Follow Up Processes, Rebecca Geneiveve Hidalgo Salomon

Walden Dissertations and Doctoral Studies

Depression remains a significant public health burden in the United States, contributing to disability, healthcare utilization, and economic cost. Internal 2024 audits at the project site identified variability in Patient Health Questionnaire 9 PHQ 9 screening and follow up processes, with 68% of screenings completed, 55% of follow ups timely, and disparities among patients with limited English proficiency. These findings indicate a systems level reliability and equity gap. This executive leadership system improvement project focused on developing a standardized, nurse led, electronic health record supported workflow to improve PHQ 9 completion and timely follow up. The practice focused question asked …

Lived Experiences Of Husbands Of Deployed Military Spouses, Timothy Lee Heath

Walden Dissertations and Doctoral Studies

The focus of this study was to explore the lived experiences of civilian husbands during the deployment of their active-duty spouses. Although there is plenty of information concerning the negative and demanding impacts of deployment on female spouses and children, more is needed to understand the lived experiences of husbands of deployed soldiers. Research has confirmed that husbands of deployed soldiers have distinctive gender-specific needs that have been inadequately addressed, leading to adverse psychosocial effects. The couple adaptation to traumatic stress model and gender role theory served as the frameworks for this study to identify the psychosocial issues faced by …

Human Service Professionals’ Perceptions Culturally Competent Resources For Transracial Adoption, Rachelle Tau-Stewart

Walden Dissertations and Doctoral Studies

Transracial adoption continues to increase in the United States, particularly in states with predominantly White populations; yet, culturally competent preparation and postadoption resources remain limited. The lack of structured cultural socialization and race-responsive supports places transracially adopted youth at increased risk for identity disruption, mental health challenges, and experiences of racism and microaggressions. The purpose of this qualitative action research study was to explore human service professionals’ perceptions of the services needed to provide culturally competent resources for transracial adoption in Washington State. Guided by the Transracial Adoption Parenting Series framework developed by the Coalition for Children, Youth, and Families, …

Occupational Stressors Correlated With Depression And Burnout Among Criminal Defense Attorneys, Fay Frances Spence

Walden Dissertations and Doctoral Studies

No prior studies have compared occupational stressors of criminal defense lawyers by practice setting (public defender, court-appointed, or retained). In this mixed-method study, the goal was to identify occupational stressors perceived by criminal defense lawyers in different settings and to determine if those stressors were correlated with depression, anxiety, and burnout, using Maslach’s burnout-engagement continuum as the theoretical framework. Based on stressors identified in semistructured interviews with 15 criminal defense lawyers, the Criminal Defender Stress Survey (CDSS) was created to measure the frequency and perceived intensity of identified stressors. The CDSS was incorporated into an online survey, along with the …

Bound By Belief: Exploring The Influence Of Internalized Rape Myths On Survivor Agency And Identity, Arika I. White

Walden Dissertations and Doctoral Studies

This qualitative study explored how internalized RMA impacts survivors’ cognitive processing, coping strategies, and psychological agency, as observed by licensed psychotherapists who treat sexual assault survivors. Despite extensive literature on the societal impacts of RMA, less attention has been given to understanding how these cultural myths are internalized by survivors and manifest intrapsychically, influencing self-perception, self-blame, and identity reconstruction following trauma. Using a phenomenological approach, semi-structured interviews with therapists provided meta-level insights into how survivors’ narratives reflect internalized cultural stigma and misogynistic beliefs. Thematic analysis was used to identify patterns of maladaptive coping, internalized misogyny, and diminished agency, revealing how …

Reducing College Dropout Rates Of People With Autism In Hillsborough County, Florida, Jennifer Warren

Selected Social Change Portfolios in Prevention, Intervention, and Consultation

Goal Statement

Significant barriers exist for neurodivergent individuals when they try to access higher education and these barriers continue to disrupt their ability to persist and obtain a college degree or secondary professional education. By implementing targeted academic supports and increasing authentic inclusive education practices on campuses and in online education spaces, barriers can be reduced or eliminated. With clear actionable steps and intentional buy in from institutions, barriers present for teens and young adults with autism are removed and higher education.

Significant Findings

College students with autism spectrum disorder (ASD) are a growing population in higher education, but they …

Neurodiverse Secondary School Educators Transitioning To Online Teaching During Covid-19 Pandemic, Leane Pupo

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic affected individuals, families, communities, and a variety of workplaces across the world. Many studies have addressed the impact of the emergency transition from on-ground to online on educators, students, and their families. However, while there is emerging literature on the impact of COVID-19 on neurodiverse individuals and on neurodiverse individuals in the workplace, there is little or no research on neurodiverse teachers. The purpose of this study was to explore the experiences of neurodiverse educators who transitioned from on-ground to online teaching during the COVID-19 pandemic. Bandura’s social cognitive theory of self-efficacy and Garmezy’s theory of resilience …

Open Education On Social Entrepreneurship: A Comparative Study Between Mexico And Bolivia To Scale Up Complex Thinking, Inés Alvarez-Icaza, Benito Javier Martinez-Briones, Liz Katherine Marco-Torrez, Evelyn Rondon-Jara

Higher Learning Research Communications

Objectives: This study examined the effectiveness of an open digital educational platform for developing complex thinking competencies through social entrepreneurship education among higher education students in Mexico and Bolivia. Specifically, it assessed changes in perceived systemic, scientific, critical, and innovative thinking and compared learning outcomes across both contexts.

Method: A quasi-experimental pre-post design was implemented with 601 participants (Mexico, n = 509; Bolivia, n = 92). Participants completed a validated 25-item, Likert-scale instrument assessing systemic, scientific, critical, and innovative thinking before and after engaging with the digital platform. Within- and between-group differences were analyzed using permutation-based statistical tests, complemented by …

K–8 Teachers' Perceptions Of The Barriers To Educating Chronically Absent Homeless Youth, Daniel James Pangrazio

Walden Dissertations and Doctoral Studies

Abstract The problem that was addressed through this study is that kindergarten through eighth-grade homeless students experience higher rates of chronic absenteeism and lower educational outcomes than their housed peers in California. Grounded in Bronfenbrenner’s ecological systems theory, the purpose of this study was to explore K–8 teachers’ perceptions of the barriers they face in educating chronically absent homeless youth. For this basic qualitative design, semistructured interviews were conducted with 10 K–8 teachers from one California school district. Creswell and Guetterman’s five-stage coding process was used for data analysis. Four themes emerged: Teachers discussed (a) barriers to addressing student academic …

Male Teachers' Experiences On The Gender Imbalance In Early Education, Erika White

Walden Dissertations and Doctoral Studies

Diversity in the ECE workforce has been shown to have a positive social and academic influence on children and families within the ECE setting. The problem addressed in this study was that in an urban eastern school district (UESD), there was an educator gender imbalance in early childhood education (ECE). Grounded in Smith’s rational choice theory, the purpose of this basic qualitative study was to explore the experiences of male preschool and kindergarten (P—K) teachers in UESD. Data were collected through semistructured interviews with 13 male P—K teachers working in the UESD. Thematic analysis using inductive coding indicated male educators: …

Exploring Marital Resilience Through The Lived Experiences And Perception Of Spousal Support During Events Of Shared Stressors, Prince-James Smith

Walden Dissertations and Doctoral Studies

Marital resilience during shared stressors remains insufficiently understood, particularly when both spouses are simultaneously affected by the same external stressor and must adapt together over time. The purpose of this qualitative phenomenological study was to explore marital resilience through the lived experiences and perceptions of spousal support during shared stressors among individuals who had been legally married for 10 years or more, with specific attention to how participants described the shift from solo coping to dyadic coping over time. Bowlby’s attachment theory provided the theoretical foundation, and Senge’s learning organization theory served as the conceptual framework. Participants included 18 legally …

Nurse Education On Nonpharmacological Management Of Knee Osteoarthritis, Toyin Mary Ajayi

Walden Dissertations and Doctoral Studies

The Doctor of Nursing Practice (DNP) project aims to fill the gaps in the management of knee osteoarthritis (OA) in adults aged 40 to 75 years in a primary care practice. Knee OA is a common chronic disease that significantly impacts pain, mobility, and quality of life. Although there is empirical evidence that nonpharmacological interventions, including exercise, weight control, and self-management education, are effective, these methods are not consistently used in clinical practice, and pharmacologic treatment continues to be used. The project was designed to inform healthcare personnel about evidence-based nonpharmacological strategies to improve patient outcomes and reduce reliance on …

Elected Sheriffs’ Election Process And How It Affects Their Behavior, Brian James Ardoin

Walden Dissertations and Doctoral Studies

Scholars have widely examined how electoral pressures influence the behavior of judges and prosecutors; however, less attention has been given to how elections affect law enforcement leaders. This quantitative study examined whether sheriff election cycles in Louisiana were associated with changes in law enforcement behavior. Louisiana parish sheriffs occupy a unique role as both elected officials and chief law enforcement executives, which may create incentives that influence enforcement priorities. Using secondary arrest data from the Federal Bureau of Investigation Uniform Crime Reporting program, this study analyzed parish-level arrest patterns from 2009 through 2019 to determine whether deputies’ arrest behavior differed …

The Effect Of Burnout On Intention To Resign Among Adult Protective Services Investigators, Derek Frank Wachter

Walden Dissertations and Doctoral Studies

Adult Protective Services (APS) workers play a crucial role in providing care, support, and services to older and adult clients with special needs. There was a lack of empirical data on the long-term retention of APS investigators and on how burnout affects their intentions to resign. Departments consistently rely on a cycle of using newer, less experienced investigators who may not know about community and state services or department policies and procedures to connect clients. The purpose of this quantitative correlational study was to examine the relationship between personal, work-related, and client-related burnout and APS investigators’ intention to resign. Data …

Perceptions Of Fourth-Year Undergraduate College Students With Attention Deficit Hyperactivity Disorder On Academic Success, Olympia Shante Jenkins

Walden Dissertations and Doctoral Studies

The problem addressed through this study is the low graduation rate of students with attention deficit hyperactivity disorder (ADHD) across the United States. Guided by Mezirow’s transformative learning theory, the purpose of this qualitative study was to explore the perceptions of fourth-year undergraduate college students with ADHD on the academic support or methods that contributed to their perseverance in college. For this basic qualitative design, semistructured interviews were conducted with 10 undergraduate college students who self-reported a diagnosis of ADHD and had successfully completed the first 3 years of their education. Through thematic analysis and open, inductive coding, the following …

Performance-Based Budgeting Implementation Strategies For Improving Financial Performance, Waleed Ibrahim Alsyaegh

Walden Dissertations and Doctoral Studies

The lack of effective strategies for allocating organizational financial resources can lead to adverse business outcomes. Business managers are concerned about the ineffective allocation of financial resources, as it can impede financial performance and sustainability.Grounded in stakeholder theory, the purpose of this qualitative single-case study was to explore the performance-based budgeting strategies that business managers use to sustain financial profitability. The participants were 10 business managers who oversee subsidiaries that successfully implemented performance-based budgeting.Data were collected through semistructured interviews and the review of organization documents. Through thematic analysis, four themes were identified: (a) traditional versus contemporary budgeting; (b) importance of …