Digital Commons Network^™

Strategies To Increase Service Utilization And Profitability In The Non-Emergency Medical Transportation Business, Ugochukwu Obidiugwu Onyemaobi

Walden Dissertations and Doctoral Studies

Underutilization of services is a concern for business managers because it reduces organizational profitability and efficiency. Business leaders in non-emergency medical transportation organizations are particularly affected by this issue due to its impact on operational sustainability. Grounded in change management and innovation theories, this qualitative pragmatic inquiry explores strategies managers use to mitigate service underutilization and increase profitability. The participants were six managers of non-emergency medical transportation businesses who implemented successful strategies to mitigate service underutilization and increase profitability. Data were collected using semi-structured interviews and publicly available documents. Through thematic analysis, six themes were identified: (a) optimizing scheduling efficiency, …

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 …

General Education Teacher Experiences With Implementing Inclusion In Middle School, Kelly Anne Bodkin

Walden Dissertations and Doctoral Studies

A state in the Pacific Northwest implemented an initiative to increase access to the general education setting for students with disabilities; however, students with disabilities continue to perform significantly below grade level standards despite the increase in inclusion. Guided by Bandura’s social cognitive theory of self-efficacy, the purpose of this basic qualitative study was to examine the perceptions of the challenges, successes, and necessary resources of eight general education teachers who teach students with disabilities in their classrooms. Semistructured interviews were conducted with eight general education teachers teaching students with disabilities in the general education setting. Thematic analysis using deductive …

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 …

Strategies To Improve Caregiver Satisfaction With Telehealth In Autism Care, Navid Dezhnabadi

Walden Dissertations and Doctoral Studies

The increasing use of telehealth in autism care has created opportunities to improve caregiver satisfaction as it remains a critical challenge in pediatric specialty settings. The purpose of this integrative review was to identify strategies that healthcare administrators can implement to improve caregiver satisfaction with telehealth platforms and optimize care delivery for autism patients. Using an integrative review methodology and viewed from the lens of the unified theory of acceptance and use of technology framework, evidence from 20 research and non-research sources published between 2018 and 2025 were analyzed, using the Johns Hopkins nursing evidence-based practice model and synthesized. The …

Narratives From Law Enforcement Officers Who Leave Policing, Hector Rene Matascastillo

Walden Dissertations and Doctoral Studies

Beginning in May 2020, a national exodus of law enforcement officers (LEOs) from the profession occurred. There has been speculation about the causes, including social unrest and trauma, while some claim that there has always been this level of attrition. The purpose of this study was to capture the narratives of LEOs regarding what motivated them to leave the profession after May 2020 and before achieving their retirement goals. The theoretical lens of general strain theory guided this study, as it posits that people under great strain resort to options that they would not usually consider, such as leaving the …

Effective Strategies For Onboarding Programs Mitigating Turnover Of Recently Separated Veterans, Jamie Reed

Walden Dissertations and Doctoral Studies

High rates of early turnover among recently separated veterans weaken workforce stability and disrupt both family and organizational outcomes. Employers, veteran service organizations, and families are concerned that without comprehensive onboarding programs, veterans’ adjustment and retention will suffer. Grounded in Schlossberg’s adult transition theory and the 4S transition model, the purpose of this qualitative pragmatic inquiry was to explore effective onboarding strategies to mitigate turnover among recently separated veterans. The participants were six business leaders with experience onboarding veterans in Department of Defense-contracted industries in the United States. Data were collected through semistructured interviews and publicly available documents. Through thematic …

Successful Strategies Business Leaders Use To Implement Artificial Intelligence For Achieving Financial Benefits, Swain C. Riley

Walden Dissertations and Doctoral Studies

Ineffective implementation of artificial intelligence (AI) strategies can erode organizational performance. Senior business leaders who struggle to integrate AI into core operations may find their organizations facing increased costs, reduced efficiency, and weakened competitiveness. Grounded in Lewin’s change management theory, the purpose of this qualitative pragmatic inquiry research project was to identify and explore effective strategies business leaders use to implement AI technologies to reduce costs and improve profitability. The participants were 10 senior business leaders who successfully implemented AI strategies within their organizations and were recruited via professional networking platforms. Data were collected through semistructured interviews and publicly available …

The Role Of Dollar Store Proliferation In Influencing Diabetes And Obesity Rates In West Virginia, Kelli L. Keith

Walden Dissertations and Doctoral Studies

Dollar stores are the fastest growing food retail format and are highly concentrated in rural, low-income communities including West Virginia, where diabetes and obesity prevalence rank among the highest in the United States. Although these retailers increase physical access to food, concerns remain about their limited healthier food options and potential contribution to chronic disease disparities. Guided by the socioecological model, this three-manuscript dissertation examined how dollar store density and healthier food availability related to county-level diabetes and obesity prevalence in West Virginia. Manuscript 1 used a cross-sectional ecological design with all 55 West Virginia counties, using data from USDA, …

The Correlation Of Beer, Wine, And Liquor Excise Tax With Alcohol-Impaired Traffic-Related Deaths In All 50 U.S. States, Paul R. Amigh Ii

Walden Dissertations and Doctoral Studies

Alcohol-impaired driving remains a persistent public health and safety problem in the United States, resulting in thousands of preventable deaths each year and substantial societal costs. Policymakers frequently rely on alcohol excise taxes as a deterrence strategy; however, evidence regarding the effectiveness of taxation alone in reducing alcohol-impaired traffic fatalities remains mixed. The purpose of this quantitative, correlational study, grounded in economic deterrence theory, was to assess relationships between state-level beer, wine, and liquor excise tax rates and alcohol-impaired traffic fatality rates per 100,000 population in 2019. A cross-sectional design used secondary data from all 50 U.S. states and the …

The Association Between Racial Discrimination And Pregnancy-Related Hypertension Among Department Of Health And Human Services Regions Between 2016 And 2022, Emily Chew

Walden Dissertations and Doctoral Studies

This quantitative study examined the association between racial discrimination and pregnancy-related hypertension among women age 18–40 in the United States, and how this relationship is modified by age and the Department of Health and Human Services (HHS) regions (states). Guided by the social ecological model, this research measured whether race, place, and lived experiences of discrimination contributed to disparities in maternal health outcomes. The study utilized the Centers for Disease Control and Prevention’s Pregnancy Risk Assessment Monitoring System data set (2016–2022) which represented 81% of United States live births (n=249,970). The independent variable was self-reported racial discrimination during pregnancy, delivery, …

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 …

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 …

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 …

Information Security Strategies To Thwart Cybersecurity Attacks In The Financial Services Industry, Donovan Anthony Miles

Walden Dissertations and Doctoral Studies

Financial markets and industries are vulnerable to ransomware attacks. Information technology (IT) security subject matter experts (SMEs) are concerned about ransomware cyberattacks on critical infrastructure that threaten their customers’ financial privacy and the institution’s reputation, causing severe financial losses and diminishing productivity. Grounded in the diffusion of innovation theory, the purpose of this qualitative pragmatic inquiry was to explore strategies IT security SMEs use to increase the implementation of existing solutions to thwart cybersecurity attacks in the financial services sector. The participants were six IT security SMEs in the financial industry in the Northeast United States who were responsible for …

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 …

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 …

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 …

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 …

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 …

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, …

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 …

Healthcare Institutions’ Influences On Health Literacy Levels In Mothers In Greensboro, North Carolina, Wole Ajala

Walden Dissertations and Doctoral Studies

Immigrant populations experience persistent challenges within the U.S. healthcare system, including marginalization, discrimination, and limited access to understandable health information, which contribute to health disparities. Factors such as low income, cultural differences, and intersecting identities related to gender and race further compound these challenges. This qualitative phenomenological study examined how these social determinants of health influenced the health literacy experiences of African immigrant mothers in Greensboro, North Carolina. Data were collected through encrypted WhatsApp audio interviews with eight African immigrant mothers who had used healthcare services in the United States. Interview recordings were transcribed verbatim and analyzed using inductive thematic …

Strategies To Reduce Diagnostic Wait Times In Vha Facilities, Frankie Loadz Odlens Beaubrun

Walden Dissertations and Doctoral Studies

The Veterans Health Administration (VHA) is the largest integrated healthcare system in the United States, providing care to millions of veterans annually. Diagnostic service wait times affect veteran access to timely diagnoses and subsequent eligibility for disability benefits, vocational rehabilitation, and social services. The purpose of this integrative review was to identify evidence-based strategies to reduce diagnostic wait time within the VHA. The guiding review question addressed what strategies VA medical centers can use to reduce diagnostic wait times. Guided by Donabedian’s structure-process-outcome framework, a comprehensive literature search initially identified 487 sources across multiple databases. Subsequently, systematic screening and application …

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 …

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 …

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 …

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 …

Strategies Of It Leaders For Deploying Cloud-Native Applications In Emerging Markets, Peter Ekhator

Walden Dissertations and Doctoral Studies

Cloud-native applications are transforming organizational information technology (IT) operations by enabling scalability, flexibility, and cost efficiency. However, some IT leaders in emerging markets lack evidence-based strategies for successfully deploying cloud-native applications. IT leaders and organizational decision-makers are concerned because ineffective deployment limits the ability to leverage cloud technologies for innovation, operational resilience, and sustained competitiveness. Grounded in the technology–organization–environment (TOE) framework, the purpose of this qualitative pragmatic inquiry was to explore strategies IT leaders use to deploy cloud-native applications in emerging-market contexts. Data were collected using semistructured interviews from 10 IT leaders with experience deploying cloud-native applications and were supplemented …

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 …