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Implementation Of A Standardized Social Determinants Of Health Screening And Documentation Workflow In Primary Care, Callistus Eze Okereh
Implementation Of A Standardized Social Determinants Of Health Screening And Documentation Workflow In Primary Care, Callistus Eze Okereh
Walden Dissertations and Doctoral Studies
The completed quality-improvement project addressed inconsistent screening and incomplete electronic health record (EHR) documentation of low-income, limited family support, and transportation barriers in a primary care clinic. The nursing practice problem can disrupt access, adherence, chronic disease management, and continuity of care. The practice-focused question examined whether an ADDIE-based education program would improve social determinants of health (SDOH) screening, EHR documentation, staff knowledge and confidence, and referral or follow-up documentation during a 6- to 8-week period. The project purpose was to develop, implement, and evaluate a role-based education program and standardized workflow for clinic staff. Evidence sources were drawn from …
Impact Of Employment Status And Housing Stability On Tuberculosis Treatment Adherence In Virginia, Samuel Deapeh Worgee
Impact Of Employment Status And Housing Stability On Tuberculosis Treatment Adherence In Virginia, Samuel Deapeh Worgee
Walden Dissertations and Doctoral Studies
Tuberculosis (TB) cases have resurged in Virginia, yet the structural determinants shaping treatment completion among socioeconomically marginalized populations remain unquantified locally, leaving public health programs without state-specific predictive evidence. Grounded in the World Health Organization's social determinants of health framework, this quantitative, ex post facto study examined how employment status, housing stability, and social risk factors predicted TB treatment completion. De-identified surveillance records for N = 898 adult TB cases reported from 2020 through 2024 were extracted from the Virginia Electronic Disease Surveillance System and analyzed using a multivariable binary logistic regression, controlling for age, sex, race/ethnicity, and radiographic severity …
Mental Well-Being Of Parents Who Have A Child With A Disability, Miracle Denae Adkins
Mental Well-Being Of Parents Who Have A Child With A Disability, Miracle Denae Adkins
Walden Dissertations and Doctoral Studies
Parents of children with developmental disabilities often experience elevated levels of stress and emotional burden associated with caregiving responsibilities, which can affect their mental health and overall well-being. The purpose of this generic qualitative study was to explore the perceptions, experiences, and decision-making processes of parents of children with developmental disabilities regarding the use of resources to support their own mental health. Data were collected through semistructured interviews, and data were analyzed using thematic analysis. The findings revealed that parents’ decisions to seek and use mental health resources were influenced by multiple factors, including accessibility and availability of services, financial …
Access And Utilization Of Counseling For People With Sexual Offense Histories, Darrell Antonio Jones Jr.
Access And Utilization Of Counseling For People With Sexual Offense Histories, Darrell Antonio Jones Jr.
Walden Dissertations and Doctoral Studies
There is a gap in understanding the low rate of utilization of mental health support services among adult men and women with criminal sex offense histories, which worsened mental health challenges for this population. The purpose of this qualitative action research study was to explore human services professionals’ perceptions and recommendations about access and utilization of mental health counseling for formerly incarcerated adults with sexual offense histories. Grounded in the good lives model of offender rehabilitation, the research question was: How do human services professionals perceive access to and utilization of mental health, holistic, and wellness counseling for formerly incarcerated …
Examining The Challenges Of Providing Mental Health Treatment In Female Correctional Facilities From The Perspective Of Mental Health Professionals, Lacretia Williams
Examining The Challenges Of Providing Mental Health Treatment In Female Correctional Facilities From The Perspective Of Mental Health Professionals, Lacretia Williams
Walden Dissertations and Doctoral Studies
Women in correctional settings frequently experience significant mental health issues that are linked to histories of trauma, abuse, and victimization. Despite increased attention to trauma-informed and gender-responsive approaches, numerous obstacles continue to affect the delivery of mental health treatment within female correctional facilities. Existing literature focuses on systemic and policy concerns, overlooking mental health professionals' experiences. Guided by general systems theory, this qualitative study examined the challenges encountered by providers, including how organizational, environmental, and institutional factors influence treatment implementation. Data collected through semistructured interviews with 10 mental health professionals revealed multiple barriers to effective service delivery, including the complex …
Educators’ Perceptions Of The Challenges Of Reintegrating High School Students Returning From Suspension In A Western Suburban School District In Chicago, Rebecca Moss
Walden Dissertations and Doctoral Studies
The problem that was addressed through this study was that Grade 9–12 educators face challenges in implementing effective behavioral support systems for students returning to school after a suspension. Grounded in Bandura’s social cognitive theory, the purpose of this basic qualitative study was to investigate Grade 9–12 educators’ perceptions of the challenges they face and their recommendations when supporting students who return to school after a suspension in a western suburban Chicago district. Semistructured interviews were conducted with 11 purposely sampled Grade 9–12 educators including administrators, teachers, social workers, school counselors, and school psychologists. Through thematic analysis, four themes emerged. …
Staff Education To Improve Medication Adherence Knowledge In Schizophrenia Care, Richard Emereonye
Staff Education To Improve Medication Adherence Knowledge In Schizophrenia Care, Richard Emereonye
Walden Dissertations and Doctoral Studies
This staff education doctoral project addressed a documented gap in nursing competency, confidence, and documentation related to medication adherence counseling for adults with schizophrenia on an inpatient psychiatric unit. Nonadherence to antipsychotic medication affects an estimated 40% to 60% of adults with schizophrenia and contributes to relapse and avoidable rehospitalization. The practice-focused question was: In a psychiatric care facility, how does a competency-based staff education program on medication adherence strategies for schizophrenia affect nursing staff knowledge, confidence, and competency, as measured by pre- and post-education assessments? The intervention was developed using the analyze, design, develop, implement, and evaluate (ADDIE) model …
Perceptions Of Correctional Officers In Prison Environments And The Coping Mechanisms They Use To Support Work–Life Balance, Amiee C. Ruger
Perceptions Of Correctional Officers In Prison Environments And The Coping Mechanisms They Use To Support Work–Life Balance, Amiee C. Ruger
Walden Dissertations and Doctoral Studies
This qualitative study explored correctional officers’ lived experiences with occupational stress, coping strategies, work–life balance, and psychological well-being. The purpose of the study was to better understand correctional officers’ experiences working in high-stress correctional environments, including how they experienced and managed occupational stress, as well as the factors that influenced their psychological well-being. The Yerkes-Dodson law, Nixon’s human function curve, and the transactional model of stress and coping provided the theoretical framework for the study. Eight correctional officers were recruited using purposive and snowball sampling techniques. Semistructured interviews were conducted through the online meeting platform Zoom, and the data were …
Staff Education On Early Cpi-Based De-Escalation Strategies And Unit-Based Resources, Doris Onyenji Lerama
Staff Education On Early Cpi-Based De-Escalation Strategies And Unit-Based Resources, Doris Onyenji Lerama
Walden Dissertations and Doctoral Studies
This doctoral project was a staff education evidence-based practice initiative implemented at a state-operated adult inpatient psychiatric facility in California. The practice gap was inconsistent nursing staff knowledge of early Crisis Prevention Intervention-based de-escalation strategies and available unit-based resources despite an established crisis-prevention framework. The practice-focused question asked whether a standardized staff education activity would increase staff knowledge, as measured by anonymous pre-education and immediate post-education scores. The purpose was to develop, implement, and evaluate the education using staff knowledge change as the sole measurable outcome. The Johns Hopkins Evidence-Based Practice Model guided appraisal and synthesis of 11 evidence sources …
Strategic Planned Preventive Maintenance To Promote Sustainability In Acute Care Hospitals, Samuel Ngounou
Strategic Planned Preventive Maintenance To Promote Sustainability In Acute Care Hospitals, Samuel Ngounou
Walden Dissertations and Doctoral Studies
Despite advances in healthcare delivery, acute care hospitals often lack standardized strategic planned preventive maintenance (SPPM) protocols, resulting in equipment failures, higher costs, and disruptions to patient care. The purpose of this integrative review was to identify evidence-based best practices for implementing SPPM programs in acute care hospitals. The review question concerned the organizational practices and strategic approaches most effective for implementing an SPPM program. The Donabedian structure–process–outcome model represented the foundational framework for this review. The initial literature search yielded 110 articles. After further assessment, 27 studies were appraised using the Johns Hopkins Nursing evidence-based practice tools. Three low-quality …
Exploring Sub-Saharan African Immigrants’ Perceptions Of The American Criminal Justice System, Martin B. Kalala
Exploring Sub-Saharan African Immigrants’ Perceptions Of The American Criminal Justice System, Martin B. Kalala
Walden Dissertations and Doctoral Studies
This qualitative phenomenological study explored sub-Saharan African immigrants’ perceptions of the United States criminal justice system, including law enforcement, courts, and correctional institutions. Despite the significant and growing presence of sub-Saharan African immigrants in the United States, their perspectives remain underrepresented in criminal justice research. Grounded in critical race theory and informed by a narrative inquiry lens, this study sought to understand how race, immigrant status, and cultural background shape perceptions of fairness, trust, and legitimacy within the justice system. Data were collected through semi-structured interviews with 21 sub-Saharan African immigrants residing in the United States. The data were analyzed …
Strategic Effort For Employee Retention In The Financial Industry, Gail Nichole Flores
Strategic Effort For Employee Retention In The Financial Industry, Gail Nichole Flores
Walden Dissertations and Doctoral Studies
Failure to properly retain financial industry employees can cause a chain reaction of detrimental issues, including financial consequences, high turnover rates, and vulnerabilities to an organization’s overall health and success in the industry. Financial industry leaders may struggle to maintain an appealing organization for current and prospective employees, hindering their ability to retain talent profitably and sustainably and gain a competitive advantage in the financial industry. The purpose of this qualitative pragmatic inquiry project was to identify and explore effective strategies that financial industry leaders use to retain employees and remain profitable and sustainable. Using Herzberg’s two–factor theory of motivation, …
Staff Education To Improve 7-Day Post-Discharge Psychiatric Follow-Up, Michael Curtis Kwashie
Staff Education To Improve 7-Day Post-Discharge Psychiatric Follow-Up, Michael Curtis Kwashie
Walden Dissertations and Doctoral Studies
Too many psychiatric patients leave the hospital without a follow-up appointment, a gap that may cost lives. Research has consistently shown that the days immediately after discharge from psychiatric inpatient or emergency care are among the most dangerous in a patient’s trajectory, marked by elevated suicide risk, relapse, and avoidable readmission. Yet, across behavioral health settings, completion of outpatient follow-up within 7 days of discharge remains inconsistent; typically, standardized processes are often missing. This doctoral project in staff education was created to fill that gap and examined whether implementing a standardized discharge transition protocol, supported by targeted, interdisciplinary staff education, …
Staff Education To Improve Sleep Hygiene Knowledge And Competency Among Nursing Staff On An Inpatient Behavioral Health Unit, Jennings Ubadi Mekoba
Staff Education To Improve Sleep Hygiene Knowledge And Competency Among Nursing Staff On An Inpatient Behavioral Health Unit, Jennings Ubadi Mekoba
Walden Dissertations and Doctoral Studies
This staff education project addressed the gap in standardized knowledge and implementation of evidence-based sleep hygiene interventions among nursing staff on an inpatient behavioral health unit. Sleep disturbances affect 80%–90% of psychiatric patients and directly impact treatment outcomes and recovery. I developed the practice-focused question to consider whether an evidence-based sleep hygiene education program would enhance the awareness, knowledge, and practices of the nursing staff regarding sleep hygiene interventions. A thorough literature review of 23 high-quality sources formed the background for the development of a structured educational intervention that encompassed assessment methodologies, nonpharmacological interventions, environmental interventions, and patient education interventions. …
Implementation Of An Evidence-Based Multifactorial Fall-Prevention Staff Education Program In A Long-Term Care Facility., Peter Mufua Tumenta
Implementation Of An Evidence-Based Multifactorial Fall-Prevention Staff Education Program In A Long-Term Care Facility., Peter Mufua Tumenta
Walden Dissertations and Doctoral Studies
Walden University College of Nursing This is to certify that the doctoral study by Peter Mufua Tumenta has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Melanie Braswell, Committee Chairperson, Nursing Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2026 Executive Summary Falls are a significant patient safety concern among older adults in long-term care (LTC) facilities. This Doctor of Nursing Practice quality improvement project implemented and evaluated a standardized, evidence-based multifactorial fall-prevention staff education program to improve …
The Perception Of Gay Black Males Concerning Cultural Responsiveness Of Police Officer Use Of Force, Christopher M. Collier
The Perception Of Gay Black Males Concerning Cultural Responsiveness Of Police Officer Use Of Force, Christopher M. Collier
Walden Dissertations and Doctoral Studies
Police officers’ use of force on the public has been a popular topic of conversation over the last decade. Political campaigns, social media platforms, and neighborhood groups have expressed concerns about how police officers use force disproportionately within various communities. Suggestions have been made to increase police training, promote body-worn cameras, and foster greater transparency to hold police officers accountable for actions that may be unethical or illegal. This study sought to understand if cultural environments have an effect on law enforcement’s interaction with Black same gender loving males (BSGLM). Understanding the use of force was derived from BSGLMs’ perspectives …
Sociodemographic And Geographic Factors Underlying Breast Cancer Survival Disparities Among Women In The United States, Colletta Brabham-Orr
Sociodemographic And Geographic Factors Underlying Breast Cancer Survival Disparities Among Women In The United States, Colletta Brabham-Orr
Walden Dissertations and Doctoral Studies
Breast cancer-specific mortality in the United States remains higher among women in rural and socioeconomically disadvantaged areas, yet few population-based studies have been conducted to jointly scrutinize demographic and structural determinants of this disparity. Informed by the social determinants of health framework, this secondary data analysis, using records from the SEER Research Plus database, examined the association between age at diagnosis, race and ethnicity, rural/urban residence, county-level median household income, and breast cancer-specific mortality among U.S. women aged 18 and older diagnosed with malignant invasive breast cancer between 2010 and 2020 (N = 285,865). Bivariate chi-square tests and binary logistic …
Impact Of Sexual Orientation On Syphilis Diagnosis Among African American Men In Colorado, Emmanuel Bhatti
Impact Of Sexual Orientation On Syphilis Diagnosis Among African American Men In Colorado, Emmanuel Bhatti
Walden Dissertations and Doctoral Studies
Syphilis remains an ongoing public health concern among African American men. Elevated rates during the COVID-19 pandemic further underscored the need for focused attention on this population. The risk factors driving syphilis diagnosis among African American men during a pandemic like COVID-19 remain poorly understood. The purpose of this quantitative cross-sectional study was to examine the association between sexual orientation and syphilis diagnosis among African American men in Colorado. Social cognitive theory was applied to understand the interaction among sexual orientation, HIV status, age, and syphilis diagnosis. Sexual orientation categories include men who have sex with men (MSM), men who …
Standardized Screening And Monitoring Of Bioidentical Hormone Replacement Therapy In Women Ages 35–50, Amanda Ellen Hampton
Standardized Screening And Monitoring Of Bioidentical Hormone Replacement Therapy In Women Ages 35–50, Amanda Ellen Hampton
Walden Dissertations and Doctoral Studies
In this quality improvement project, I evaluated a pilot implementation of a standardized bioidentical hormone replacement therapy (BHRT) screening and monitoring tool embedded within the electronic health record (EHR) at an integrative medicine practice in the southeastern United States. Grounded in the Johns Hopkins evidence based practice (EBP) model, the project addressed a documented gap in consistent screening, initiation, and monitoring of hormone replacement therapy (HRT) for women ages 35 to 50 presenting with menopausal symptoms. The practice focused question examined whether a standardized, EHR embedded BHRT screening and monitoring tool could improve screening rate compliance, laboratory monitoring adherence, and …
Enhancing Hiv Knowledge And Resource Awareness Among Chief Nursing Officers, Susan Louise Cooper Bailey
Enhancing Hiv Knowledge And Resource Awareness Among Chief Nursing Officers, Susan Louise Cooper Bailey
Walden Dissertations and Doctoral Studies
Human immunodeficiency virus (HIV) remains a significant public health concern in rural communities, where limited specialty care, geographic isolation, transportation barriers, and stigma may delay testing and entry into care. The Texas Panhandle is a geographically expansive rural region served by rural hospitals with limited resources. Although area HIV services are available, they are inconsistently utilized. Although chief nursing officers (CNOs) influence practice and care coordination, knowledge gaps regarding HIV guidelines, prevention strategies, and regional resources may limit identification, referral, and continuity of care. The purpose of this doctor of nursing practice (DNP) project was to determine whether a targeted …
Drug Court Graduation Rates Of African American Males Attending Habilitation Empowerment Accountability Therapy, Tierney President
Drug Court Graduation Rates Of African American Males Attending Habilitation Empowerment Accountability Therapy, Tierney President
Walden Dissertations and Doctoral Studies
African American males between the ages of 18 and 29 have lower rates of successful completion in drug court programs compared to other populations, increasing their risk of incarceration and recidivism. This study examined whether participation in the Habilitation Empowerment Accountability Therapy (HEAT) program, a culturally responsive intervention, was associated with improved drug court graduation outcomes among African American male participants. Guided by cognitive behavioral theory, a quantitative retrospective causal-comparative design was used to analyze archival data from 96 African American male participants enrolled in a drug treatment court program in Columbia, Missouri. A chi-square test of independence was conducted …
Practitioners’ Perceptions: Evidence-Based Practices And Evidence-Based Interventions To Reduce Burnout In Third-Sector Organizations, Elizabeth Riley
Practitioners’ Perceptions: Evidence-Based Practices And Evidence-Based Interventions To Reduce Burnout In Third-Sector Organizations, Elizabeth Riley
Walden Dissertations and Doctoral Studies
Third-sector organizations (TSOs) face challenges providing effective evidence in reducing stress and burnout for human services professionals (HSPs) to remain in the field. Burnout is a social phenomenon that has received much attention in the helping professions for the past 50 years, due to the nature of the work that HSPs perform. Researchers have confirmed that HSPs are at critical risk of burnout, which affects not only their health and work performance, but also their delivery of service. Current literature lacks studies on what supports HSPs’ need in TSOs to reduce their stress and burnout to remain in the field. …
Evaluation Of The Association Between School Prevention Programs And Adolescents’ Opioid Abuse In The United States, Lida Moazezi
Evaluation Of The Association Between School Prevention Programs And Adolescents’ Opioid Abuse In The United States, Lida Moazezi
Walden Dissertations and Doctoral Studies
This study examined adolescent opioid misuse in the United States and the role of school-based prevention. Guided by the health belief model, the purpose was to test whether participation in school-based drug prevention lessons was associated with past-year opioid misuse among adolescents ages 14–17 and whether race and gender moderated that association. This quantitative, cross-sectional, nonexperimental secondary analysis used the 2019 National Survey on Drug Use and Health (N = 8,965). Analyses included weighted descriptives, chi-square tests, and complex-samples logistic regression controlling for age and socioeconomic status. The sample included adolescents ages 14–17 with complete data on school-based prevention participation, …
Exploring Multicultural Competence Among Mental Health Workers When Providing Treatment To African American Males, Ashley Hightower
Exploring Multicultural Competence Among Mental Health Workers When Providing Treatment To African American Males, Ashley Hightower
Walden Dissertations and Doctoral Studies
African American men experience disproportionately low rates of mental health service utilization and often report negative perceptions of mental illness. Despite documented mental health disparities, limited research has explored how mental health workers understand and apply multicultural competence when providing treatment to African American men. Grounded in the theory of planned behavior and social identity theory, the purpose of this qualitative descriptive phenomenological study was to explore the lived experiences of mental health workers regarding multicultural competence in their work with African American men. Data were collected through semi-structured interviews with seven mental health workers recruited through purposive sampling. Interview …
Strategies General Practitioners Use To Effectively Communicate Patient Cases To Medical Specialists In Saudi Arabia, Alshraefarana Alharthi
Strategies General Practitioners Use To Effectively Communicate Patient Cases To Medical Specialists In Saudi Arabia, Alshraefarana Alharthi
Walden Dissertations and Doctoral Studies
Effective communication between general practitioners (GPs) and medical specialists is essential for reducing healthcare costs and improving continuity of care. Healthcare leaders are concerned that ineffective communication between GPs and specialists may contribute to delays in care, fragmented services, and inefficient use of healthcare resources. Grounded in relational coordination theory, the purpose of this qualitative pragmatic inquiry was to explore the effective communication strategies used by six GPs in Saudi Arabia when communicating patient cases to medical specialists to reduce healthcare costs and improve the quality of patient care. The participants were six GPs in Saudi Arabia. Data were collected …
Strategies That Black American Female Business Owners Use To Secure Government Contracts, Darrilyn Marie Brittian
Strategies That Black American Female Business Owners Use To Secure Government Contracts, Darrilyn Marie Brittian
Walden Dissertations and Doctoral Studies
Black American female business owners remain underrepresented in government contracting despite the availability of federal, state, and local procurement opportunities. Some Black American female business owners lack effective strategies to secure government contracts, which may limit business growth and profitability. Grounded in innovation and entrepreneurship theory, the purpose of this qualitative pragmatic inquiry was to identify and explore the strategies Black American female entrepreneurs use to secure government contracts. The participants were six Black American female entrepreneurs who had successfully secured government contracts and possessed experience navigating government procurement processes. Data were collected using semistructured interviews and organizational documents. Through …
Young Adults’ Perceptions Of Their Life Course Development After Their Parents Were Imprisoned For Violent Crimes, Selena Robinson
Young Adults’ Perceptions Of Their Life Course Development After Their Parents Were Imprisoned For Violent Crimes, Selena Robinson
Walden Dissertations and Doctoral Studies
Parental incarceration is an adverse childhood experience that can influence children’s emotional, educational, relational, and developmental outcomes into adulthood. Although previous research had examined the effects of parental incarceration on children, limited research had explored how young adults perceive their life course development when a parent was incarcerated for a violent crime. The purpose of this generic qualitative study was to explore the perceptions of young adults, age 18–25, regarding their life course development following parental incarceration for a violent crime. Elder’s life course development theory was the framework for this study. Data were collected through semistructured interviews with three …
Clinical Supervision In Local County Jails: The Descriptive Experiences Of Mental Health Supervisors, Vanessa Qualls
Clinical Supervision In Local County Jails: The Descriptive Experiences Of Mental Health Supervisors, Vanessa Qualls
Walden Dissertations and Doctoral Studies
The overrepresentation in correctional settings of persons who are seriously mentally ill and/or challenged with addiction has necessitated the presence of qualified mental health professionals. Implementation of quality mental health treatment in correctional settings has been met with various barriers, such as limited resources, physical space constraints, and safety concerns. While these barriers are present in most correctional settings, jails are more likely to encounter individuals who are experiencing acute symptoms related to mental illness and addiction, aggression, and crisis. Mental health counselors make up a significant portion of the mental health workforce in jail settings and may assume clinical …
Relationship Between Financial Performance And Healthcare Quality Outcomes, Ela C. Lena
Relationship Between Financial Performance And Healthcare Quality Outcomes, Ela C. Lena
Walden Dissertations and Doctoral Studies
Hospital leaders face increasing pressure to improve quality outcomes while controlling costs. The evidence is limited on whether hospital financial performance predicts overall quality star ratings. Grounded in the general contingency theory, this quantitative, correlational project examined the predictive relationship between operating margin, current ratio, and a composite of quality metrics represented by the overall hospital Quality Star Rating (QSR). Data included the population of acute care hospitals in Massachusetts with 25 or more beds, yielding a final analytic sample of 54. Four year-specific multiple linear regression models were performed from 2021 through 2024. The analyses did not indicate a …
Staff Education On Standardized Suicide Risk Assessment In An Outpatient Clinic For Behavioral Health, Fanta Haja Cabah
Staff Education On Standardized Suicide Risk Assessment In An Outpatient Clinic For Behavioral Health, Fanta Haja Cabah
Walden Dissertations and Doctoral Studies
Suicide risk assessment is a high-priority nursing safety responsibility in outpatient behavioral health. The practice gap was a variation in nurses’ knowledge of validated suicide screening, direct inquiry, risk escalation, referral, and related documentation expectations working in an outpatient behavioral health clinic located on the Eastern Atlantic Coast. To address this problem, I developed, implemented, and evaluated a staff education program on a standardized suicide risk assessment. The practice question focused on whether staff knowledge increased following participation in the education program. Ten nursing staff members participated in a 60-minute education program. Pretest and posttest questionnaires included 20 multiple-choice questions. …