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Bioterrorism Hardening: An Exploratory Study Of Emts Preparedness And Practices, Ndubuisi Chinemerem Ejike

Walden Dissertations and Doctoral Studies

The 2001 anthrax attacks heightened awareness of the possibility of weaponizing biological agents such as Ebola, anthrax, and smallpox and hence, the Bioterrorism Act of 2002 to prevent biological attacks and reduce bioterrorism threats and vulnerabilities. However, the 2014 Ebola epidemic raised concerns about unpreparedness for bioterrorism within the healthcare community and about secondary infections from healthcare workers. Using Kingdon's conceptualization of multiple streams as the foundation, the purpose of this case study was to explore the nature of bioterrorism threats and the level of preparedness of Emergency Medical Technicians (EMTs) who were involved in the 2014 Ebola epidemic in …

Prostate Cancer Screening Rates For Haitian Men Based On Demographic Characteristics, Wilgyms St-Hilaire

Walden Dissertations and Doctoral Studies

Cancer screening is useful for improving survival rates and treatment outcomes, which is why there are screening recommendations for the most prevalent types of cancer. Despite gains in the reduction of cancer-related mortality rate worldwide in the past few years, the Haitian community continues to experience high mortality rates due to cancer. The prevalence of prostate cancer in the Haitian population is among the highest worldwide at 767 per 100,000, with a mortality rate of 403 per 100,000. One of the causes may be the low prostate cancer screening rate in the Haitian community; however, no studies have been focused …

Comprehending Support Decisions Of Undergraduates Who Experienced Anxiety And Depression, David Vera

Walden Dissertations and Doctoral Studies

A West Coast university has had an increase of students who have experienced anxiety or depression over the last few years and have not sought professional assistance. Students have stated that multiple factors contributed to their anxiety or depression, including difficulty adjusting to their new college environment. This challenge has disrupted students' academic performances and often left them without professional help to deal with their anxiety or depression. The purpose of this qualitative narrative inquiry was to increase understanding of factors that lead undergraduate students to experience anxiety and depression and factors that led to their decision to seek or …

Patient Safety Problems, Procedures, And Systems Associated With Safety Reporting And Turnover, Grace Hilario

Walden Dissertations and Doctoral Studies

Research has shown that 400,000 people die every year due to preventable medical errors. Medical error reporting and safety is a responsibility of all members of a health care organization. Creating an environment that addresses and prevents potential or actual safety problems can help reduce the incidence of medical errors made by nurses in the workplace. The purpose of this quantitative research study was to determine if nurses' perceptions of safety problems and error-preventing procedures and systems affected their comfort in reporting safety problems and intent to leave. High-reliability theory was the theoretical foundation for this study. Data were obtained …

Strategies For Preventing Financial Fraud In Church Organizations In Ghana, Albert Rockson

Walden Dissertations and Doctoral Studies

Financial fraud in church organizations is increasing rapidly, which can affect the reputation, donation appeal, future funding, and ability of church organizations to meet their planned organizational goals. The purpose of this multiple case study was to explore strategies for preventing financial fraud in church organizations. The conceptual framework for the study was Cressey’s fraud triangle theory. Twenty participants who utilize strategies for preventing financial fraud in their organizations were purposively selected from 5 church organizations in Ghana. Data were collected through semistructured interviews and analysis of organizational financial policy documents. Interview data were transcribed, coded, and analyzed with Saldaña’s …

African American Parents' Perceptions Of Childhood Obesity In Broward County, Kenol Aris

Walden Dissertations and Doctoral Studies

Children may become overweight or obese for different reasons, and childhood obesity may have health consequences such as Type 2 diabetes and asthma. The purpose of this qualitative phenomenological study was to describe the perceptions of African American parents of elementary-age children with obesity living in Broward County, Florida about the causes and consequences of childhood obesity. The health belief model (HBM) guided this study. Interview data were gathered from 9 participants who met the criteria of being African American parents of elementary-age children with obesity living in Broward County, Florida. Moustakas- steps to analyze the data collected led to …

Negative Appraisal Correlation To Ptsd Symptoms Among Law Enforcement Officers, Ginger Lee Jenkins

Walden Dissertations and Doctoral Studies

Law enforcement officers are exposed to traumatic events through their daily work responsibilities. Traumatic events have increased within recent decades and can have long-term and critical outcomes on officers such as health concerns, long-term psychological issues, social impairment, and work performance. Thus, this quantitative study was conducted to explore negative appraisals of cumulative traumatic events and their relation to post-traumatic stress disorder (PTSD) symptoms in law enforcement officers. Based on the theoretical framework for the study, Ehlers and Clark's cognitive model, negative appraisals involve how an individual interprets a situation, negative appraisals of traumatic events lead to maladaptive behavior and …

The Role Of The Physicians' Assistant In Trinidad And Tobago's Healthcare System, Martha Ann Pamponette

Walden Dissertations and Doctoral Studies

The profession of physicians' assistant was introduced in the 1960s to assist with physician shortages in the United States of America. Since then, some countries have introduced this profession to fill the gaps that exist in the physician shortages problem in their health care system. Yet, in many countries like Trinidad and Tobago, this role remains absent from the health care system. The objective of this study was to assess how professionalization supports the introduction of the physicians' assistant role in Trinidad and Tobago. Using the theory of profession as a theoretical framework, and through an evaluation of institutional, regulatory, …

Resilience Building In Biracial And Multiracial, Bisexual Adults: An Interpretative Phenomenological Analysis, Melissa Gale Swartz

Walden Dissertations and Doctoral Studies

Until recently, society and science often ignored, erased, and avoided bisexual women and men and individuals with biracial and multiracial identities, and rarely considered these identities simultaneously. Prior research has shown that some lesbians and gay people of color exhibit resilience against sexual minority stress due in part to an inoculating effect of exposure to racism earlier in life. However, little is known about the lived experience of thriving, resilient bisexual multiracial individuals. In the tradition of positive psychology and context of intersectionality theory, this qualitative study explored how multiracial bisexual individuals develop and maintain flourishing well-€being despite sociocultural factors …

Improving Interdepartmental Care Collaboration For Pregnant Patients, Michelle Anne Ott

Walden Dissertations and Doctoral Studies

Communication is vital to improve patient care outcomes, especially with high acuity patients. Pregnant patients differ from other patient populations because their care involves 2 entities: the patient (mother-to-be) and her unborn fetus. There has been a noted gap in communication and care collaboration between the emergency department (ED) and obstetric (OB) teams at the project site, resulting in delays for patients and lack of appropriate maternal/fetal assessment and contributing negatively to patients' experiences. Using transitions theory and the Rosswurm and Larrabee model, a clinical practice guideline (CPG) inclusive of an obstetrically focused algorithm was developed and presented for use …

The Coping Strategies Of Alpha-1 Deficient Patients And Their Family Caregivers, Nicolette Bruscino

Walden Dissertations and Doctoral Studies

Alpha-1 antitrypsin deficiency, for which there is no cure, is one of the most lethal genetic diseases among the European White population. Early and proper diagnosis is challenging, as understanding how both alpha-1 antitrypsin deficient patients and their family caregivers cope with their related stressors on a daily basis. This qualitative phenomenological study incorporated the biopsychosocial approach, the Bowen family systems theory, and the family systems model of illness to examine the experiences of Alpha-1 patients and their family caregivers related to living with the disease and coping strategies. Participants were recruited with the assistance of a national organization that …

Impact Of Temporary Assistance For Needy Families On Poverty Rates In Kansas, Carla Green

Walden Dissertations and Doctoral Studies

The impact of the length of time that Temporary Assistance for Needy Families (TANF) recipients receive benefits on their path out of poverty is not clear. The purpose of this qualitative study with a phenomenological design was to increase understanding of the comparative experiences of TANF recipients who reached their lifetime limit of 60 or 24 months to determine the impact of time limits on their path out of poverty and the fulfillment of the TANF goal and second purpose. Human capital theory provided the framework for the study. Using a purposive, homogenous sampling method, 6 social service professionals were …

Health Care Leaders' Strategies To Reduce Nursing Turnover, John Clayton Phelps

Walden Dissertations and Doctoral Studies

Health care leaders who lack effective nurse turnover strategies can negatively affect patient quality of care, productivity, and profitability. The purpose of this single case study was to explore strategies health care leaders used to reduce nursing turnover in a health care organization. The conceptual framework for this study was Herzberg's 2-factor theory. Data were collected from semistructured interviews with 4 health care leaders in the West Texas region who had a history of reducing nurse turnover for a minimum of 5 years from the date of hire, and from review of organizational documents related to the strategies to reduce …

Juvenile Detention Center Effects On Futures Of At-Risk Youth, Jennifer Lynn Zitterkopf

Walden Dissertations and Doctoral Studies

Juvenile Detention Center Effects on Futures of At-Risk Youth

by

Jennifer L. Turner

MS, Walden University, 2014

BS, University of Maryland University College, 2011

Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Philosophy

Forensic Psychology

Walden University

August 2019

Many juvenile offenders return to the justice system after serving their incarceration sentences. Detaining youth has a negative impact on their mental health, education, employment, and ability to secede from a criminogenic life course. Identifying detention center effects on youths' futures can provide further insight on why the current approach does not successfully deter youth from …

The Impact Of Faith-Based Organizations On Schools And Families For Prevention Of Bullying And Youth Violence, Jason L. Groce

Walden Dissertations and Doctoral Studies

The lack of research regarding the potential relationship between the reduction of bullying through participation in faith-based organizations may have failed to expand available bullying intervention methods. Faith-based organizations could assist in reducing bullying via moral instruction, boundary-setting guidance, social engagement techniques, and understanding social engagement with the bully's parents. This study explored the relationship between bullying and involvement in faith-based activities through (a) discovering the association between the reduction of bullying incidence or inclinations and faith-based activities, and (b) identifying the mechanisms responsible for the suppression of bullying orientations and behaviors through faith-based activities. The theoretical construct of the …

Factors Associated With Prostate Cancer Screening Intentions Among Adult Men In Nigeria, Ifeanyi N. Malu

Walden Dissertations and Doctoral Studies

Timely detection of prostate cancer (PCA) with prostate-specific antigens (PSA) and digital rectal examinations (DRE) are essential in optimizing incidence, minimizing prevalence, and reducing mortality rates. Given the low levels of participation in cancer screening, this study was conducted to examine the factors men consider when deciding whether to screen for PCA in Nigeria. A cross-sectional, online-based survey of 180 consenting Nigerian men 50 years old and older was carried out. Logistic regression analysis and descriptive statistics were used to analyze the data. Based on the data, there was a moderate positive association between the health belief model constructs and …

Admission Predictors Of Student Success On The Physician Assistant National Certifying Exam, Thomas Frank Moore

Walden Dissertations and Doctoral Studies

In 2009, a local physician assistant (PA) program lost accreditation due to decreased success in licensure pass rates on the Physician Assistant National Certification Examination (PANCE). In response, the program's admissions committee required additional metrics for accepting quality candidates more likely to pass the licensure examination on the first attempt. The purpose of this study was to gain a better understanding of these metrics, specifically the relationship between demographics, prerequisite admission requirements, and PANCE success. The theoretical framework and conceptual model shaping this study was Bordage's illumination and magnify framework and Swail's geometric model of student persistence and achievement. The …

Addressing Human Papillomavirus Vaccination In Primary Care Pediatrics, Natasha Marie Subramaniam

Walden Dissertations and Doctoral Studies

Human papillomavirus (HPV) is the most common sexually transmitted disease in the United States. Despite most common transmission, HPV immunization in adolescents remains below target rates of 80% as outlined by Healthy People 2020 Objectives. Nearly all individuals will contract HPV during their lifetime. The purpose of this project was to educate providers on successfully promoting HPV immunization in adolescents utilizing evidence-based methods. The health belief model (HBM) was the theoretical underpinning utilized to teach providers on discussions about 9vHPV immunization with parents of adolescents. The practice focused question explored whether an education program using concepts from the HBM would …

Improving Retention Strategies For Experienced Nurses, Kimberly M. Hollis

Walden Dissertations and Doctoral Studies

Experienced nurses depart the workforce in significant numbers; therefore, it is critical to understand how those departures affect patient care and safety. The focus of this systematic review included appraisal of recent research to provide an understanding of strategies used in acute care settings to retain experienced nurses. Guided by Benner's model of skill acquisition, the purpose of this systematic review was to identify factors that influence the decision of nurses with experience to leave or remain working in acute care work settings. The 19 articles selected for this review were limited to those pertaining to experienced registered nurses who …

Psychological Distress Among High-Risk Youths First-Year In Collegiate Sport, Cassidy Janay Jenkins

Walden Dissertations and Doctoral Studies

It is well documented that students from low socioeconomic backgrounds face a significant degree of deficiencies in college opportunity. Previous researchers have shown an estimated 1 in 5 student athletes given the opportunity to compete at the college level come from low socioeconomic backgrounds and encounter more adjustment issues than other students because of the psychological barriers they face. Using Pearlin's theory of psychological distress and Selye's GAS as the foundation, this study explored the extent to which the difference between the perceived time needed and actual time spent in both sports and academic commitment predict psychological distress in first-year …

Strategies Hospital Administrators Utilize To Optimize Patient Services, Vicente Njoku

Walden Dissertations and Doctoral Studies

Hospital administrators face challenges that arise from environmental factors or psychosocial factors, and lack resources to deliver valuable medical services to stakeholders, including patients and employees. A multicase study served to explore experiences and gain a broader perspective of hospital administrators' use of strategies to optimize patient services. Ten hospital administrators from acute care hospitals in Nevada and California were purposefully selected from the population of hospital managers with a minimum of 2 years of documented experience in successfully implementing management strategies to improve patient services. The conceptual framework was Drucker's management theory. Data were collected from semistructured interviews with …

Predictors Of Rapid Repeat Pregnancy In Zimbabwe, Thenjiwe Sisimayi

Walden Dissertations and Doctoral Studies

Rapid repeat pregnancy (RRP) is associated with adverse maternal and infant outcomes and a range of undesirable social and economic challenges for the mother, her baby, and society. Although the consequences of RRP are well known, Zimbabwe—a country with some of the poorest maternal health indicators—has not investigated or made efforts to directly address this problem. This is confirmed by the lack of targeted programs to curb RRP, the unavailability of documented evidence regarding RRP significant risk factors, and the lack of understanding of the extent of RRP in the country. Using social cognitive theory as the theoretical framework, an …

Breast Cancer Screening Knowledge And Beliefs Of Nigerian Women Living In The United States, Enobong Clement Utin

Walden Dissertations and Doctoral Studies

Breast cancer is one of the leading causes of death and disability globally. Although mammogram has been identified as a significant breast screening tool in the United States, researchers have indicated that African-born women in the United States are diagnosed with advanced stages of breast cancer because of underutilization of mammogram from diverse reasons. The purpose of this quantitative study was to determine the association of demographic factors, breast cancer knowledge, health beliefs, and the utilization of mammogram among Nigerian women, 40 years and older in the United States (N=200). The study was guided by the health belief model and …

Graduate Student Self-Efficacy During The Psychology Practicum Experience, Janice Baylor

Walden Dissertations and Doctoral Studies

There has been limited attention as to whether effective clinical supervisors help to build self-efficacy in clinical trainees by focusing on positive instances of their behavior during practicum. Trainees' may enter practicum with lower self-efficacy regarding their skills and having a supervisor that provides an experience that was positive would be expected to lead to higher self-efficacy. The purpose of this study was to quantitatively examine whether a relationship existed between self-efficacy and graduate students' experience in practicum training as measured by the role conflict subscale of the role conflict and role ambiguity inventory); working alliance inventory-supervisee; supervision evaluation questionnaire; …

The Lived Experiences Of Those Bereaved By Suicide, Vincent Kinsey

Walden Dissertations and Doctoral Studies

This study sought to explore the lived experience of the bereaved-by-suicide and to provide a detailed description of their experience with the loss of a loved one. The study participants were 12 bereaved-by-suicide individuals between the ages of 21 and 65 who had experienced the loss of a loved one by suicide two or more years before the interviews. The research question was made up of three parts, "How do the bereaved-by-suicide describe their grief in personal, practical, and existential terms?" The theoretical framework for the study was derived from Neimeyer's meaning reconstruction theory. Data were collected via individual interview …

Progress On The Economic Empowerment Of Female Entrepreneurs In Kenya's 30% Preferential Public Procurement Policy, Rukaya Mohammed

Walden Dissertations and Doctoral Studies

In Kenya, a 2013 presidential directive reserved 30% of government procurement opportunities for enterprises owned by women, youth, and persons with disabilities to promote economic empowerment; however, as of 2016, female entrepreneurs continued to be outpaced by their male counterparts. The lack of policy evaluation from the female entrepreneur perspective limits the ability to assess progress and identify obstacles. Through purposeful sampling and semistructured interviews, this qualitative phenomenological study obtained the perceptions of the implementation and impact of Access to Government Procurement Opportunities (AGPO) on economic empowerment from the perspective of 20 female entrepreneurs in Kenya previously awarded procurement contracts. …

Funding Strategies For Smallholder Rice Farmers In Afadzato South District, Ghana, Faith S. Ababio-Twi

Walden Dissertations and Doctoral Studies

Agriculture revenue contributions to Ghana's gross domestic product have declined because of limited farm funding, which has constrained some smallholder rice farmers access credit to acquire necessary inputs, and to secure a stable market for their harvests. The purpose of this qualitative multiple case study was to explore successful strategies some smallholder rice farmers in the Afadzato South District of Ghana used in obtaining farm funding. Data collection included semistructured, face-to-face interviews with 9 smallholder rice farmers who successfully obtained farm funding. Previous research, reports, and policies of the Ghana Ministry of Food and Agriculture served as additional data collection …

Gifted Students In Poverty's Perceptions Of Blended Learning, Darren Chase Crutcher

Walden Dissertations and Doctoral Studies

Students who are raised in poverty and are not adapted to technology use have less positive learning experiences with technology usage than other students. The purpose of this qualitative study was to explore students' perceptions of blended learning among gifted students who are enrolled in the free and reduced lunch program in a public high school district in the southeastern United States. Davis's version of the technology acceptance model was used as the conceptual framework. The research questions explored the perceptions of these gifted students when they are taught using blended learning in terms of their attitudes, perceived usefulness, perceived …

Optimizing Green Supply Chain Management Strategies, Mark Derek De La Grandiere

Walden Dissertations and Doctoral Studies

Some business leaders in the manufacturing industry lack strategies to optimize green supply chain management strategies that increase profitability while reducing the carbon footprint. The lack of green supply chain strategies sub optimizes the use of resources business leaders use to meet their financial goals. The purpose of this qualitative single case study was to explore successful green supply chain strategies leaders used to increase profitability while reducing the carbon footprint. The participants were 7 business leaders in one manufacturing organization headquartered in Massachusetts who have sophisticated green supply chain strategies in place. The natural resource-based view theory was the …

A Geographic Study Of Lung And Bronchus Cancer Rates In Kentucky, Gabriel Njoh Dikong

Walden Dissertations and Doctoral Studies

The average age-adjusted incidence and mortality rates of lung and bronchus cancer is 55% and 56% higher in Kentucky than the national averages in the United States, respectively. Populations with low income and educational attainment, and those who live close to the mining regions across Kentucky are more affected by the high prevalence and resulting mortality rates of lung and bronchus cancer. This study was conducted because of the high incidence of lung and bronchus cancer and resulting mortality rates in the state of Kentucky that may not be caused solely by social and demographic factors. The theoretical foundation for …