Digital Commons Network^™

Southeastern Michigan Firefighters’ Experiences With Their Organization’S Employee Assistance Program, Angela Patricia Johnson

Walden Dissertations and Doctoral Studies

Mental health challenges among first responders require coordinated stakeholder efforts. Although employee assistance programs (EAPs) are commonly offered as workplace benefits, little is known about firefighters’ experiences with these programs and how they can be tailored to meet their unique needs. Existing literature suggested that EAP utilization among firefighters is influenced by program awareness, confidentiality concerns, organizational support, stigma, and the extent to which services are tailored to first responders’ needs. Using a generic qualitative design and policy feedback theory, this study explored southeastern Michigan firefighters’ experiences with EAPs. Purposive sampling was used to recruit 11 firefighters for semi structured …

Self-Efficacy Mediators For Health-Seeking Behaviors In Women Of Childbearing Age Living With Polycystic Ovary Syndrome, Domenica Carrier

Walden Dissertations and Doctoral Studies

Polycystic ovary syndrome (PCOS) is an endocrine disorder leading to varied health complications, such as high blood pressure, Type 2 diabetes, infertility, and depression among women in the United States. Most studies have focused on managing the physical aspects of PCOS. Limited research to date has been conducted to determine the intrinsic and extrinsic motivation women living with PCOS harness to navigate the physical, psychosocial, and access to care in New Jersey, which are contributors to positive social change. This basic qualitative study utilized semistructured open-ended questions to determine the experiences and perspectives of women between the ages of 18 …

The Association Between The 24-Hour Activity Cycle And Academic Performance Of Online Graduate Students In The United States, Alia Ouali

Walden Dissertations and Doctoral Studies

Online graduate students are a growing population in higher education. Nevertheless, only a few studies have investigated the associations between their academic performance (AP) and movement behaviors—physical activity (PA), sedentary behavior (SB), and sleep quality (SQ). Guided by the 24‑hour activity cycle framework and social cognitive theory, the purpose of this quantitative cross‑sectional study was to explore these relationships among online graduate students in the United States and examine how self-efficacy (SE) and social determinants of health (SDOH) influence them. The online survey, which included validated scales for all constructs, yielded 403 complete responses. AP showed a significant positive association …

Exploring Elite Athletes’ Perceptions Of The Practice Of Mindfulness For Mental Health And Optimal Performance, Omar A. Sesay

Walden Dissertations and Doctoral Studies

Elite athletes experience physical, cognitive, and emotional demands that affect athletic performance and personal well-being, increasing the risk for anxiety, depression, burnout, attentional difficulties, and maladaptive coping strategies. Mindfulness-based stress reduction (MBSR) has been examined for its effect on attentional control, emotional regulation, cognitive flexibility, and stress resilience, but limited qualitative research has examined how elite athletes experience the practice of mindfulness. The purpose of this generic qualitative study was to explore elite athletes’ perceptions of the practice of mindfulness for mental health and optimal performance. The theoretical framework draws from mindfulness theory and MBSR principles. Semistructured interviews were conducted …

Mexican Women Caregivers’ Support For Family Members With Type 2 Diabetes, Andrea Mesa

Walden Dissertations and Doctoral Studies

Type 2 diabetes (T2D) is a persistent public health challenge in the United States, disproportionately affecting Hispanic populations. Mexican-origin women often serve as primary caregivers for relatives living with diabetes, yet their voices and lived experiences remain underrepresented in research. This study addressed the limited understanding of how cultural values and caregiving roles influence diabetes management within Hispanic families. The purpose of this qualitative phenomenological study was to explore the lived experiences of Mexican-origin women aged 40 to 60 who care for a family member with T2D. Guided by the theory of planned behavior and social cognitive theory, the study …

Retaining Teaching Hospital Nonacademic Nurse Educators: Addressing Burnout And Building Workforce Resilience, Walter Guevara

Walden Dissertations and Doctoral Studies

Burnout and high turnover intentions among nonacademic nurse educators (NANEs) in academic teaching hospitals pose a critical challenge for healthcare administration, threatening workforce stability, nursing education capacity, and healthcare outcomes. The purpose of the integrative review was to examine evidence-based strategies to reduce burnout and enhance resilience among NANEs, thereby improving retention, well-being, and workforce sustainability. An integrative literature review was conducted using the Johns Hopkins Evidence-Based Practice appraisal tools and 49 sources published between 2020 and 2025 were found to match criteria and quality for thematic analysis. Guided by Herzberg’s two-factor theory, a thematic analysis was used to synthesize …

Staff Education To Improve Knowledge Of Standardized Scheduling In A Certified Home Health Agency, Roger Nounamo Kamkoumeu

Walden Dissertations and Doctoral Studies

In this staff education project, I addressed the concerning rate of missed patient visits in home healthcare settings. At the practicum site, there has been no education program addressing scheduling and communication best practices for staff. The practice-focused question guiding this project was: Among nursing staff in a home health agency, does implementation of a staff education program on a standardized scheduling and reminder protocol, improve staff knowledge of missed visit reduction practices? The purpose of the project was to evaluate the effectiveness of the staff training on staff knowledge of scheduling, communication, and reminder protocols for the reduction of …

Relationship Between Sociodemographic Factors And Opioid Overdose Mortality In Milwaukee County, 2020-2021, Elizabeth David

Walden Dissertations and Doctoral Studies

Opioid overdose deaths increased significantly from 2020 to 2021, with Milwaukee County experiencing higher rates than the national and state averages. African American and Hispanic residents faced disproportionately high fatal overdose rates. The purpose of this quantitative retrospective cross-sectional study was to examine the associations among socioeconomic status, race, age, access to treatment (measured by emergency medical services [EMS] naloxone administration), and opioid overdose mortality among underserved minority populations in Milwaukee County. Guided by the social-ecological model, the study analyzed data from the Milwaukee Health Department and the Milwaukee County Medical Examiner's Office across 34 ZIP codes. Inclusion criteria for …

African American Experiences Accessing Mental Health Services In Rural Communities, Danielle O. Keith-Alexandre

Walden Dissertations and Doctoral Studies

African American communities have exhibited greater vulnerability in psychological functioning and well-being, and usage of mental health services for evaluation and treatment are lower than for other groups, due to a range of barriers, including geographic location and lack of access. There is a lack of research on the difficulties African Americans face in accessing mental health services in U.S. rural communities. The purpose of this qualitative study was to explore, from a phenomenological approach, the lived experiences of African American adults residing in rural Pennsylvania mid-U.S. Eastern Coastal communities in regard to accessing mental health services. The social-ecological model …

Self-Care Behavior And Diabetes Knowledge In African American Women With Type 2 Diabetes, Rena Renee Barron

Walden Dissertations and Doctoral Studies

African American women experience a disproportionate burden of Type 2 diabetes, and limited evidence exists regarding the relationship between diabetes knowledge and self-care behaviors, particularly among African American female veterans. The purpose of this quantitative, cross-sectional study was to examine the relationship between diabetes knowledge and diabetes self-care among African American women with Type 2 diabetes, including a subsample of African American female veterans, and to evaluate whether the COVID-19 pandemic (2017–2019 vs. 2021–2023) moderated this relationship. Additional variables included age, marital status, physical health, and mental health. Guided by the social-ecological model, de-identified data from the Behavioral Risk Factor …

Relationship Between Hospital Case Management Leadership Style And Employee Engagement, Malinda Ellis

Walden Dissertations and Doctoral Studies

Employee engagement among hospital-based nurse case managers is important because these nurses support discharge planning, utilization management, care coordination, and safe patient transitions. Although leadership style has been studied in nursing, limited research has examined its relationship to engagement among nurse case managers. The purpose of this quantitative, nonexperimental, correlational study, using House’s path-goal theory, was to examine the relationship between transformational, transactional, and laissez-faire leadership styles and employee engagement among hospital-based nurse case managers. Data were collected from 89 registered nurse case managers in acute care settings in the United States, who completed the Multifactor Leadership Questionnaire, Short Form, …

Social Workers’ Perceptions Of Pediatric Hiv Disclosure Process, Colleen Myrie

Walden Dissertations and Doctoral Studies

Although the social problem of pediatric HIV disclosure has been studied by researchers internationally, there remains a gap in the experiences of social workers in facilitating this process. The purpose of this generic qualitative study was to explore the experiences and perceptions of social workers in the United States regarding the disclosure process for HIV positive children. This study was grounded in Rosenstock’s health belief model, which posits that an individual will take necessary action to prevent or manage a disease based on their perceptions of health. This model was effective in helping to identify what social workers think about …

Staff Education On Frailty And Senior Surgical Safety, Kimberly Buhay Gibu

Walden Dissertations and Doctoral Studies

This staff education doctoral project addressed a practice gap involving limited education on frailty assessment and senior surgical safety within the general surgery department of a large, integrated healthcare system. Frailty is associated with increased postoperative complications, hospitalizations, readmissions, and mortality among older adults, making early recognition essential to improving surgical outcomes. The practice-focused question project was: Does education on frailty screening and senior surgical safety improve the knowledge, confidence, and intent of general surgery staff in a large, integrated health system? The purpose was to develop, implement, and evaluate an evidence-based educational intervention. The project was guided by the …

Staff Education To Improve Blood Pressure Reassessment And Referral Practices In An Urgent Care Setting, Carolyn Denise Kluttz

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was a staff education and quality improvement initiative designed to improve blood pressure (BP) reassessment and referral compliance among adult patients presenting with elevated BP readings in an urgent care setting. Elevated blood pressure is frequently identified during urgent care visits; however, provider responses and follow-up recommendations are often inconsistent, creating missed opportunities for early identification and intervention. The practice-focused question guiding this project was: In adult patients presenting to urgent care settings, how does implementing a standardized nurse-led hypertension screening and referral protocol, compared with usual care, affect the identification and follow-up …

Staff Education On Improving Medication Adherence, Oneil Dobgima Galega

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addressed a practice gap in an outpatient behavioral health setting involving inconsistent use of structured communication strategies to support medication adherence among psychiatric patients. Although nurses routinely provided medication instructions, approaches such as motivational interviewing and psychoeducation were underutilized, limiting patient engagement, understanding, and adherence, and ultimately affecting care continuity and outcomes. The purpose of the project was to improve psychiatric nurses’ knowledge and intent to use motivational interviewing and psychoeducation to enhance medication adherence. The guiding practice-focused question examined whether a structured educational intervention could strengthen nurses’ competencies in these communication strategies. …

Challenges Early Childhood Educators Encounter When Balancing Play-Based Learning With Preparation For Standardized Testing, Shanette Damar Mcbride

Walden Dissertations and Doctoral Studies

The problem addressed through this study was that emphasis is being placed on standardized testing, which is causing early childhood educators to feel pressured to eliminate or reduce playtime in their classrooms. Framed by Vygotsky’s theory of social development and Lave and Wenger’s situated learning framework, the purpose of this basic qualitative study was to explore the experiences of early childhood educators in a southcentral U.S. state regarding the challenges they face in balancing a play-based learning curriculum and the support they need, while emphasizing information about standardized testing. The data were collected from semistructured interviews with 12 certified kindergarten …

Exploring The Experiences And Support Needs Of African Immigrant Families Raising Children With Autism Spectrum Disorder In Ohio, Linda Nkoumba Eteki

Walden Dissertations and Doctoral Studies

Autism spectrum disorder (ASD) presents unique challenges for families; however, African immigrant parents raising children with ASD in Ohio experience additional difficulties related to cultural stigma, systemic inequities, and limited access to culturally responsive services. This social work practice problem is important because it reflects disparities in diagnosis, intervention, service access, and family support that align with social work’s commitment to equity, advocacy, and social justice. The purpose of this qualitative study was to explore the experiences of African immigrant families raising children with ASD in Ohio and to examine how they describe autism-related stigma, caregiving challenges, and interactions with …

Local Farming Sustainability Nongovernment Organization’S Perceived Driving Forces For A Crisis Management Plan, Nthonoki Cynthia Tsepe

Walden Dissertations and Doctoral Studies

Nongovernmental organizations (NGOs) operate in increasingly volatile environments characterized by financial uncertainty, political pressures, and climate-related disruptions; however, many lack formalized crisis management systems. The absence of structured crisis governance exposes organizations to operational instability, financial risk, and reputational damage. The purpose of this qualitative force field analysis study was to explore a local farming sustainability NGO’s perceived driving and restraining forces for developing a formal crisis management plan. Guided by Burnett’s crisis management model and Lewin’s force field analysis framework, data were collected from nine organizational leaders involved in governance and operational decision making. Round 1 included open-ended online …

Strategies For Reducing Employee Turnover In Retail Business, Mia Bulger

Walden Dissertations and Doctoral Studies

Strategies for Reducing Employee Turnover in Retail Business by Mia S. Bulger MS, University of Phoenix, 2022 BS, Clark Atlanta University, 2005 Qualitative Pragmatic Inquiry Business Research Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Business Administration Walden University August 2026

African American Fathers’ Experiences Of Emotional Distress Within The Context Of Black Masculinity After Their Children’S Autism Diagnosis, John Notice

Walden Dissertations and Doctoral Studies

Although parental experiences following a child's autism spectrum disorder (ASD) diagnosis have been examined, mothers’ experiences have garnered the most exploration, with comparatively less attention given to fathers’ experiences. There was a gap in knowledge, in particular, on how African American (AA) fathers experience their children's ASD diagnoses while navigating emotional distress within the context of Black masculinity. The purpose of this generic qualitative study was to explore how AA fathers experienced their children's ASD diagnoses while navigating emotional distress within the context of Black masculinity. Crenshaw's intersectionality theory served as the conceptual framework. Data were collected by conducting semistructured …

Staff Education For Medication Adherence Among Adults With Major Depressive Disorder In A Private Outpatient Psychiatric And Mental Health Practice, Judith Timbui Eta

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project implemented a staff education initiative to improve medication adherence among adults with major depressive disorder (MDD) in a private outpatient psychiatric and mental health practice. Medication nonadherence remains a significant barrier to effective depression treatment and is associated with symptom relapse, increased healthcare utilization, and poorer patient outcomes. Evidence supports provider education as an effective strategy for improving adherence-related practices. The project examined whether a targeted educational intervention could improve staff knowledge and confidence in promoting medication adherence over a 12-week implementation period. Guided by the Johns Hopkins Evidence-Based Practice Model and the …

Teachers’ Perspectives About Early-Career Implementation Of Culturally Responsive Teaching Practices In Secondary Science Classrooms, Nicole D. Wilson-Pringle

Walden Dissertations and Doctoral Studies

The problem that was addressed through this study was that little was known about how secondary science teachers use their training to implement culturally responsive teaching practices (CRTPs) during their early careers in classrooms with diverse student populations. Grounded in the culturally relevant pedagogy and the teacher identity development frameworks, the purpose of this basic qualitative study was to explore secondary science teachers’ perspectives on the use of their training to implement CRTPs during their early careers in classrooms with diverse student populations. Data were collected through semistructured interviews with 10 middle and high school science teachers who received certification …

Strategies For Managing Change In Home Health Care Businesses, Halbert Brown

Walden Dissertations and Doctoral Studies

Home health care agencies may experience financial hardship when regulatory inspections result in deficiencies and administrative penalties. Home health company (HHC) leaders are concerned because ineffective change management strategies may contribute to ongoing regulatory deficiencies, penalties, and reduced business performance. Grounded in Lewin’s change management theory, the purpose of this qualitative pragmatic inquiry project was to explore change management strategies some HHC owners successfully implemented to reduce administrative deficiencies and penalties to augment business performance and profitability. The participants were six leaders from HHC firms in the southwestern region of the United States who had developed effective strategies to improve …

Staff Education To Improve Nursing Knowledge On Pressure Injury Prevention, Kheeda Kimberly Gopaul

Walden Dissertations and Doctoral Studies

Staff education in this project was focused on improving nursing staff’s knowledge on pressure injury prevention, inspired by the persistent care quality gap. The gap in practice as of 2024 related to hospital-acquired pressure injury (HAPI) at the host health organization was reported to be approximately 0.2 per 1,000 discharges. It was apparent that education could benefit the nursing staff to improve their knowledge in pressure injury prevention. The education in service focused on continuous nursing skin assessments, to ensure over prolonged hospitalization, patients’ skin does not deteriorate with the development of pressure injuries or advancing of pre-existing pressure ulcers. …

Sbirt Staff Education To Registered Nurses In The Emergency Department, Rosemary Thuet

Walden Dissertations and Doctoral Studies

Summary The project hospitals have, on average, 2,400 emergency department (ED) visits a month. Although patients receive a social screening, there are no specific assessments to determine if the person is at risk for alcohol use disorder (AUD). The lack of screening is a missed opportunity to provide a Screening, Brief Intervention and Referral to Treatment (SBIRT) assessment of over 2,400 patients a month or 48,000 people annually. Although several screening tools could be used for an SBIRT assessment, the recommendation of ED nursing leadership is to implement the tool known as the CAGE Questionnaire (Cut down, Annoyed, Guilty, and …

Youth With Mental Illness Transitioning Into Adult Judicial Systems, Susan K. Beltran

Walden Dissertations and Doctoral Studies

Despite attempts to alleviate the issues of recidivism in juveniles, this issue continues to have a major impact on young adults suffering from mental health challenges. Criminal justice involvement continues to present significant challenges for individuals with behavioral health disorders, underscoring the need to identify factors associated with arrest to inform prevention and intervention efforts. The purpose of this quantitative study was to determine the relationship between recidivism and the age of first arrest, gender, and psychiatric diagnosis for youths in an adult facility. The current study used data from the Northwestern Juvenile Project, with a sample size of N=1829. …

Lived Experiences And Competencies Of Mental Health Professionals Supporting Postpartum Mothers’ Mental Health And Well-Being, Shaynie Wolski

Walden Dissertations and Doctoral Studies

Perinatal mood and anxiety disorders (PMADs), including depression, anxiety, obsessive-compulsive disorder, posttraumatic stress disorder, and postpartum psychosis, affect postpartum individuals and their families. Limited research has examined the lived experiences and competencies of licensed mental health professionals who address PMADs, potentially limiting counselor educators’ ability to prepare counselors for postpartum mental health needs. Guided by hermeneutic phenomenology and informed by Ecological Systems Theory, the purpose of this qualitative study was to answer the guiding question: What are the lived experiences of licensed mental health professionals in recognizing, assessing, and treating PMADs among postpartum clients? Semi-structured interviews were conducted with eight …

The Nexus Between Social Media Use And Mental Health Among Tertiary Students, Claretah Makuvire, Pinias Chikuvadze, Sekai Kamba

Journal of Social, Behavioral, and Health Sciences

This study examines the connection between social media use and mental health among tertiary education students. The study was motivated by growing concerns about psychological well-being in digitally-connected educational environments and the need for evidence-based interventions in Zimbabwean contexts. The researchers used a mixed-methods case study design, and the participants consisted of 85 students from Seke Teachers College. The researchers employed questionnaires, semi-structured interviews, focus group discussions, and observations to generate data. The research revealed that students use social media intensively. Usage averaged 6.45 hours daily with 100% WhatsApp penetration. The data revealed that 67.1% of participants experienced depressive symptoms, …

The Application Of Knowledge Graphs In Education: A Bibliometric Analysis, Rui Yin, Jundi Teng, Ningwei Sun, Huimin Li, Ting Cheng

Journal of Educational Research and Practice

With the rapid advancement of artificial intelligence (AI) technologies such as ChatGPT, the use of knowledge graphs (KGs) has increased substantially in educational applications. As a technology for knowledge representation and management in AI, KGs play a pivotal role in personalized learning, educational resource integration and management, and learning performance prediction. Their scalability and semantic interpretability were particularly evident in online education during the coronavirus disease 2019 (COVID-19) pandemic. However, systematic reviews of their application in education remain limited.

To address this gap, our study analyzed data from the Web of Science (WOS) Core Collection (high-quality Social Sciences Citation Index …

Staff Education To Improve Hand Hygiene And Personal Protective Equipment Compliance, Suliat Oluwa

Walden Dissertations and Doctoral Studies

This doctoral project is a staff education initiative designed to strengthen hand hygiene and personal protective equipment (PPE) practices among interdisciplinary staff in a long-term care (LTC) facility. The practice problem addressed inconsistent hand hygiene and PPE use across shifts and departments, contributing to healthcare-associated infections (HAIs). Because LTC residents are highly vulnerable due to advanced age, multiple comorbidities, and shared living environments, improving adherence to infection prevention practices is essential for enhancing resident safety, reducing preventable infections, and supporting compliance with Centers for Disease Control and Prevention (CDC) and Centers for Medicare & Medicaid Services (CMS) infection prevention standards. …