Digital Commons Network^™

Predictors Of Cyberbullying And Help-Seeking Behaviors In Rural Midwestern Schools: A Multilevel Modeling Analysis, Ashley M. Harrison-Pavlik

Dissertations

Cyberbullying is a significant problem throughout the United States. Many risk factors have been identified for cyberbullying victimization, including experiencing traditional bullying victimization, social media usage, gender, and underrepresented racial/ethnic status, although the results are inconclusive. In response to cyberbullying, youth may choose to engage in or avoid help-seeking behaviors. Individual characteristics such as age, gender, frequency of victimization, race and ethnicity, and student perceptions of school staff can influence whether a youth seeks help. School level variables, including anti-bullying policies and teacher awareness and perceptions of cyberbullying may also impact help-seeking behaviors. However, few studies have empirically assessed their …

Understanding The Experiences And Perceptions Of Faculty Supporting Undergraduate Students With Mental Health Challenges, Jenna Ranee Parbati Jamieson

Dissertations

College is a big adjustment for students, and it doesn't come without its challenges, including being in a new place with new responsibilities. This is a stressful time that presents new obstacles and frustrations that can lead to increased stress, anxiety, depression, and mental health challenges that may cause faculty to engage and support undergraduate students with mental health challenges. As students adjust and transition to college, it is vital for university faculty to feel confident and comfortable supporting students from diverse backgrounds with varying levels of distress. By interviewing faculty, a better understanding of their lived experiences and perceptions …

Too Big To Fail? Using Microsatellites To Examine The Population Genetics Of Flathead Catfish (Pylodictis Olivaris) In Missouri Impoundments, Aaron Krolow

Dissertations

Flathead Catfish (Pylodictis olivaris) is a popular sportfish managed for recreational and commercial uses. Currently, managers in Missouri have implemented various reservoir-specific bag and length limits for P. olivaris to create sustainable populations of quality-sized individuals available for anglers to capture. In conjunction with field studies to estimate growth rates and size/age distributions, I developed and scored 15 microsatellite markers to estimate the effective population (Ne) and population structure within 10 Missouri reservoirs. I assessed the power of the markers to get acceptably precise estimates of Ne using NEoGen assuming life-history parameters (e.g., age at maturity, longevity and fecundity) estimated …

Spatial Distributions And Occupancy Dynamics Of Carnivores In A Central Hardwood Forest, Maximillian Larreur

Dissertations

Extirpation of apex predators, caused primarily by anthropogenic alterations to natural environments and persecution, has led to mesocarnivore release in these areas. Mesocarnivore release is an ecological phenomenon in which mesocarnivores thrive in the absence of apex predator dominance within the carnivore hierarchy. Mesopredators fill this dominant role on the landscape as de facto apex predators, however, this can lead to changes in inter-guild species space use, predator-prey dynamics, activity patterns, and interspecific competition. Understanding patterns in wildlife spatial distributions, which indicate variability in habitat space use across spatiotemporal scales, is critical for developing effective management and conservation plans and …

Degrees Of Freedom: How Project Rebound Facilitates Access To Higher Education For Adjudicated Adults, Elizabeth Regina Wirtz

Dissertations

Marginalized students are recommended for suspension and expulsion at higher rates than non dis/abled White peers. Exclusionary discipline contributes to the school-to-prison pipeline and recidivism rates in adults. Educational programs have been effective ways to support adjudicated adults as they transition back to their life after serving their sentences. The CSU program Project Rebound is a highly successful rehabilitation tool for adults seeking higher educational opportunities with an effective 0 percent recidivism rate. To learn about this organization a mixed methods study was conducted. The goal of this study was to capture quantitative and qualitative data about the experiences of …

Perceptions Of Department Chairs And Program Directors Of Ethnic Studies In The California State University System: A Convergent Parallel Mixed Methods Study, Christopher Jarrett Cox

Dissertations

The purpose of this dissertation study is to explore the conditions of Ethnic Studies departments and programs in the California State University (CSU) system nine years after the release of the CSU Ethnic Studies Task Force report released in 2016. Using a convergent parallel mixed methods analysis, this dissertation revisits several questions from the original CSU survey to assess the effectiveness of Ethnic Studies units in the CSU. Respondents to the survey included 13 of the 58 recognized department chairs and program directors for Ethnic Studies units among the 23 campuses of the CSU system, and interview participants included 5 …

"Are You My Counselor?" A Call To Action How Latinx General Counselors Can Support Latinx Student Retention Rates At California Community College Hispanic-Serving Institutions, Valentín García Cabrera

Dissertations

Latinx students comprise the largest population within the California Community College (CCC) system, but experience disproportionately lower retention rates. This dissertation used a phenomenological qualitative design and testimonios collected from Latinx general counselors to explore factors influencing Latinx student retention. Sixteen tenured Latinx general counselors from ten Northern California Hispanic-serving community colleges served as participants. Guided by two research questions, the study explored counselors’ perspectives on the factors influencing Latinx community college students’ retention and the counseling strategies, services, and resources that General Counseling Departments should provide to support Latinx student retention. Grounded in Latinx Critical Race Theory, the study …

Cultura Y Corazón: Latina Elementary School Principals Leading Schools, Mariana M. Alvarez

Dissertations

This qualitative participatory study focused on understanding the experiences of Latina elementary school principals on their pathway to school leadership and how cultural intuition and community cultural wealth influence their approaches to school leadership. Chicana Feminist Epistemology (CFE) and Latino Critical Race Theory (LatCrit) framed the study, while testimonio y pláticas served as the methodological framework. The concept of Community Cultural Wealth served as an analytical framework. Students of color often feel their histories, experiences, and languages are undervalued in education. Participants in this study shared challenges in navigating school, coming from families that valued education but faced barriers. Their …

Healing Circulos(Circles): Putting Our Educator's Mask First, Janet Martinez-Angeles

Dissertations

Educators play a pivotal role in supporting students throughout their educational journeys. In addition to academic instruction, they provide vital guidance for students' social, emotional, and personal development. They work tirelessly to help students navigate the complexities of education and life, often while shouldering multiple responsibilities and roles beyond the classroom. This dynamic contributes to high attrition rates and weakens the educational system. Much like the familiar safety instructions on an airplane, where passengers are reminded to put on their oxygen masks before assisting others, educators must be given the space, resources, and support to tend to their well-being before …

Early Care And Education Systems In The United States Of America: Voices Of The Past, Present, And Future, Timothy Harper

Dissertations

This mixed-methods study centers the voices, knowledge, and leadership of Black and Indigenous women working in Early Care and Education (ECE) while tracing how racism, sexism, and classism have shaped the field from colonization to the present day. Twenty in-depth interviews with sixteen Black and Indigenous educators across the United States are paired with secondary analyses of national workforce data to create a multilayered portrait of their professional realities. Grounded in Black feminist thought and Indigenous desire-based inquiry, the analysis surfaces six inter-locking themes: (a) enduring structural barriers that depress wages and limit advancement, (b) the day-to-day resilience that sustains …

Engagement Of Secondary History Social Science Teachers With Professional Development: A Phenomenological Study, Suzanne Paulazzo

Dissertations

Secondary social science teachers tend to feel disengaged and frustrated with their professional development (PD) experiences. They also feel that recommended meaningful practices appear to be time-consuming, require extra hours of preparation, and rely heavily on collaboration. Using phenomenological methodology, the dissertation research investigated secondary social science teachers' perceptions of their roles as educators, their professional growth, and their motivations for engaging in professional development opportunities. Nine male and one female teacher participants from a History-Social-Science Department in an urban public school in Northern California participated in an interview. This study addressed the following research questions: How do teachers perceive …

Teacher Workplace Bullying: Victim And Bystander Perspectives, Abigail R. Smurr

Dissertations

Workplace bullying is a phenomenon that is addressed within a broad context. This study focuses on teacher experiences of bullying. The focus will examine the impacts horizontal and vertical bullying can have on teacher victims and bystanders within K-12th within California. The purpose of this study is to give administrators awareness of these issues from the victim and bystanders’ lens. The study implemented a mixed methods design to give insight to teacher perceptions on the impacts it can have on their teacher efficacy, teacher retention, and their emotional well-being. By looking at how often PK-12th grade teachers experience workplace bullying, …

Resilience In Crisis: How Bipoc Educators Navigated The Challenges Associated With Covid-19, Racial Awakening, And The Move To Online Learning, Jannet Galicia Castrejon

Dissertations

An unprecedented number of BIPOC teachers exited the profession since June 2020 largely due to the challenges posted by the COVID-19 pandemic (Doan et al., 2024). This study aimed to investigate ways these educators coped with the heavy toll of the converging pandemic(s) by asking what, if anything, sustained them? Participants provided individual and group testimonios and shared snapshots of what it was like to teach and exist during this time via the photovoice methodology and reflected on the challenges and sources of support. BIPOC teachers described the following challenges: difficulty connecting with kids, first-hand and vicarious trauma, increased workload, …

Development And Validation Of The Informal Safety Leadership Measure, Ashley L. Gill

Dissertations

This research develops and validates a measure of the emerging concept of informal safety leadership (ISL), which integrates elements of safety leadership and informal leadership to address a significant gap in organizational safety literature. Despite extensive research on formal safety leadership, there remains limited understanding of how non-managerial employees influence safety practices and culture within organizations. This dissertation develops and validates a comprehensive measure of informal safety leadership through a sequential mixed-methods approach incorporating a pilot study and two additional studies. First, a pilot study employed focus groups with health, safety, and environmental professionals to identify key dimensions of ISL. …

Screening For Bullying In A Middle School Setting, Paige Bernau

Dissertations

Problem: Bullied youth are two and a half times more likely to experience depression and three times more likely to experience anxiety and suicidal ideation than their peers (Li et al., 2024). Schools represent a key access point for mental health support and treatment for youth (Duong et al., 2020). Despite this, schools typically do not have formal bullying screening integrated into student support services.

Methods: This program evaluation used a descriptive, observational design to evaluate a bullying screening program in a suburban middle-school. This program used the California Bullying Victimization Scale (CBVS) to assess for bullying victimization (BV) followed …

Implementation Of An Evidence-Based Postpartum Depression Screening Tool In A Level Iv Neonatal Intensive Care Unit, Morgan A. Takacs

Dissertations

Problem: Postpartum depression (PPD) affects up to 40% of mothers with infants admitted to the Neonatal Intensive Care Unit (NICU), yet many remain undiagnosed due to the absence of standardized screening protocols. Early identification and referral to Perinatal Behavioral Health Services (PBHS) is critical to support maternal well-being and improve neonatal outcomes.

Methods: This evidence-based quality improvement project utilized a descriptive and correlational design to evaluate the impact of implementing the Patient Health Questionnaire-8 (PHQ-8) for PPD screening among mothers of infants born ≤ 32 weeks’ gestation in a Level IV NICU. A convenience sample of 29 mothers received the …

Evaluation Of A Behavioral Response Team To Decrease Use Of Violent Restraint, Katherine Skrade

Dissertations

Abstract Introduction: The purpose of this Quality Improvement project was to evaluate the implementation of the Behavioral Assessment and Response Team (BART) and evaluate its effect on occurrence and duration of violent restraints on non-psychiatric floors in a pediatric hospital. This QI project also aimed to correlate the use of the Broset Violence Checklist (BVC) to the utilization of the BART as a means of predicting patient escalation, as well as to assess the effect of booster education on the BVC and BART on bedside staff confidence in utilization of these resources.

Methods: Data was collected across three time periods: …

Implementing A Standardized Protocol To Screen For Depression In A Gastroenterology Outpatient Clinic, Catherine M. Karle

Dissertations

Problem: There is a lack of mental health screenings for depression taking place in outpatient gastrointestinal (GI) clinics. Outpatient gastrointestinal (GI) offices are not consistently screening patients for depression despite a rise in depression rates and the known adverse impact depression can have on the GI tract.

Methods: This Quality Improvement (QI) study used a descriptive research design guided by the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Model. Its purpose was to implement a 10-week PHQ-2/PHQ-8 depression screening protocol at a large midwestern health center's gastroenterology outpatient clinic. The study used purposive sampling, including all GI outpatients aged 18+ with …

Palliative Care Beyond Cancer: The Use Of The P-Cares Tool, Breslin E. Meyer

Dissertations

Emergency Departments (EDs) often lack the necessary resources and protocols to provide comprehensive palliative care, resulting in inadequate pain and symptom management (Stoltenberg et al., 2022). This study investigates the potential transformative impact of a palliative care consultation on patients with advanced disease who screen positive using the validated P-CaRES tool. The PICOT questions: Will patients with end-stage COPD, CHF, and or other chronic conditions benefit from P-CaRES screening in the emergency department over nine weeks and receive more palliative care consultations from their primary care providers?

This project was conducted over 9 weeks, utilizing convenience sampling to select 20 …

Implementation Of Quantitative Blood Loss To Detect Postpartum Hemorrhage After Vaginal Birth, Raven S. Simpson

Dissertations

Problem: In the U.S., postpartum hemorrhage (PPH) is attributed to maternal morbidity and mortality, resulting in long-lasting effects of extended recoveries, surgical interventions, birth-related trauma, interruptions in mother-infant bonding, or death. Performing estimated blood loss (EBL) measurement methods postpartum is subjective and often associated with over- and underestimations of blood volume. The delay in recognition interferes with timely, efficient, and appropriate interventions, yielding a PPH (≥1000ml).

Methods: A quality improvement (QI) project was initiated with a descriptive, pre-implementation/post-implementation focus on a high-risk Labor and Delivery unit to explore the effects of Quantitative Blood Loss (QBL) measurements on the identification of …

Implementation Of A Nurse-Driven Process To Decrease Npo Times In A Geriatric Emergency Department, Luke D. Little

Dissertations

Prolonged nil per os (NPO) status for geriatric patients in the emergency department is a critical safety issue, leading to increased rates of delirium, hypoglycemia, and perioperative complications. A quality improvement project was designed to address this problem through a targeted, nurse-driven intervention. In geriatric patients (age ≥70) in a geriatric emergency department, this project aimed to determine if implementing an electronic health record (EHR)-prompted nursing workflow to obtain a diet order would reduce the length of time patients were kept NPO compared with standard practice. An EHR documentation tool was designed and implemented along with targeted nursing education sessions …

Motivational Interviewing For Weight Loss: A Review Of Evidence-Based Outcomes In Overweight And Obese Adults, Marian Dover

Dissertations

Obesity is a significant clinical problem affecting 41.9% of adults in the United States, with profound implications for individual health and healthcare economics. Standard weight loss interventions, often limited to pharmacological treatments and dietary guidance, frequently fail to achieve sustained adherence and meaningful longterm outcomes. This quality improvement (QI) project evaluated the integration of motivational interviewing (MI), a patient-centered counseling strategy, into routine clinical practice at Innovafusion, a medically supervised weight loss clinic in Aubrey, Texas. The aim was to enhance adherence to lifestyle modifications, promote intrinsic motivation, and improve weight loss outcomes among adults aged 18–65. Using a retrospective …

Screening For Depression And Anxiety In Women With Polycystic Ovarian Syndrome, Nicole M. Bondurant

Dissertations

Background: Polycystic Ovarian Syndrome (PCOS) is a multifaceted endocrine disorder that affects up to 20% of women of reproductive age and is associated with an increased prevalence of psychiatric conditions, particularly depression and anxiety. Despite international guidelines recommending routine screening for these mental health conditions in women with PCOS, consistent implementation in clinical practice remains limited.

Methods: This quality improvement (QI) pilot project aimed to address this gap by developing and implementing a standardized screening protocol for depression and anxiety within a suburban concierge OB-GYN clinic specializing in women’s reproductive and sexual health using validated tools—the Patient Health Questionnaire-8 (PHQ-8) …

Implementation Of Mindfulness-Based Interventions And Weekly Visits To Reduce Loneliness In Older Adults, Victoria E. Cobb

Dissertations

Implementation of Mindfulness-Based Interventions and Weekly Visits to Reduce Loneliness in Older Adults

Abstract:

Problem: Social isolation and loneliness have emerged as a significant public health issue for the older adult population. Loneliness has been linked to both physical and mental health effects. According to current literature, there is no standard intervention to treat loneliness in the older adult population.

Methods: This quality improvement (QI) project utilized a descriptive cohort design and the Visit-A-Bit screening assessment instrument. Undergraduate nursing students implemented mindfulness interventions during weekly visits over an eight-week period at an independent living facility located in the Midwest. Descriptive …

Implementing Behavioral Management And Social Skills Training For Pediatric Patients With Adhd And Their Caregivers, Meagan A. Conwell

Dissertations

Problem: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects 11.4% of children in the United States. Patients diagnosed with ADHD struggle with focus, hyperactivity, and impulsivity, resulting in executive and emotional dysfunction, poor social skills and quality of relationships, and poor school performance.

The American Academy of Pediatrics guidelines recommend that school-age children diagnosed with ADHD should receive both medication management and behavioral management training (BMT) for the best treatment outcomes. Research over the last decade has found that combining social skills training (SST) with BMT results in even better outcomes for these patients. Less than half of pediatric …

Improving Hpv Vaccination Decision-Making For Adolescents And Their Caregiver, Mary E. Hohman

Dissertations

Abstract

Problem: Human papillomavirus (HPV) is a viral infection associated with the development of certain cancers and is the most common sexually transmitted infection in the United States (U.S.) (Centers for Disease Control and Prevention [CDC], 2023). The CDC (2021) asserts that more than 90% of cancers caused by HPV infections could be prevented through the HPV vaccination. The CDC recommends the HPV vaccine series for children ages 11 or 12 years; however, this organization further submits that the HPV series could be initiated as early as 9 years of age through 26 years of age (CDC, 2024). Despite CDC …

Implementing A Turn Team Process To Reduce Hospital-Acquired Pressure Injuries On A Telemetry Unit At A Hospital In The Midwest, Sally Wang

Dissertations

Problem: Pressure injuries (PI) are localized wounds to the skin and soft tissues that typically result from sustained pressure on specific areas of the body (Zaidi & Sharma, 2024). Hospital-acquired pressure injury (HAPI) refers to pressure injuries that develop while a patient is in the hospital (Rondinelli et al., 2018). PI can cause patients to experience pain, decreased feelings of dignity, increased feelings of depression and anxiety, reduced levels of social activity, difficulty sleeping, and impaired cognitive function (Roussou et al., 2023). The Advanced Cardiac Care Unit (ACCU) at Missouri Baptist Medical Center experienced an increase in HAPI cases: …

The Psychological Impact Of Parenting Child Victims Of Trauma, Stephanie Faulkingham

Dissertations

Abstract

Research indicates that non-offending caregivers of traumatized children (NOC) is a population with an elevated risk for increased levels of depression and anxiety and are an underserved population for mental health services. The purpose of this quality improvement project was to determine if screening caregivers of traumatized children using the Patient Health Questionnaire (PHQ-8) and Generalized Anxiety Disorder (GAD-7) improves identification of depression and anxiety. Participants of this investigation were individuals enrolled in the Children’s Advocacy Services of Greater St. Louis’ 12-week parenting group, TASK (Trauma, Assessment, Skills, and Knowledge). Each participant was asked to complete the PHQ-8 and …

Depression Screening In The Adult Inpatient Oncology Population, Erica Bizub

Dissertations

Routinely screening oncology patients for depression is recommended due to the higher rates of depression in this population as well as the negative impact of untreated depression. The goal of this QI project is to implement a standard depression screening protocol for patients admitted to this hospital, where there is currently no standard screening protocol. There were 110 patients included in this study, and 67 (60.91%) of patients received a PHQ-9 screening. Of the patients who completed the PHQ-9, 21 (19.09%) had a positive screening, which was a score of seven or higher. While there were high rates of provider …

Care Coordination In Pediatric Primary Care, Alyssa K. Durzo

Dissertations

No central documentation of care plans exists for children with special healthcare needs (CSHCN) in the electronic health record (EHR). Providers of a large pediatric primary care office in St. Louis Missouri were asked to identify CSHCN in the practice. Clinic nurses completed a comprehensive chart review of the patients identified and constructed care coordination documents using a pre-established smart-text phrase. Subsequently, these were documented centrally in the EHR under the Problem List.

Likert score data was obtained from providers on the acceptability, appropriateness, and feasibility of the intervention through the verified tools: Acceptability of Intervention Measure (AIM), Intervention Appropriateness …