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A Staff Educational Initiative To Improve The Use Of Childhood Obesity Guideline Recommendations, Kris Kuhlmann Louque

Walden Dissertations and Doctoral Studies

Obesity affects one out every six children in the United States, which places them at risk for other chronic conditions such as cardiovascular disease, diabetes, and continued obesity into adulthood. Considering military children are more likely to enter the Armed Forces than their civilian counterparts, an increase in obesity among military families decreases the number of potential future military recruits who are physically eligible to serve. Despite this growing epidemic, providers report a lack of education and a low self-efficacy in the treatment of this condition. This doctorate of nursing practice study addresses this educational gap by attempting to improve …

Social Influences Of Suburban Black Residents Food Purchasing Decisions Using Snap Benefits, Carolyn Mccummings

Walden Dissertations and Doctoral Studies

In low-income, suburban Black communities, the prevalence of diet-related chronic illnesses is alarming. Various influences often increase diet-related illnesses among this population. One influence is the use of SNAP benefits to purchase food. In this study, the influences of SNAP as well as other influences affecting food purchase decisions among the study population was examined. A qualitative multicase study approach was used and, face-to-face interviews were conducted, to understand the experiences of 20 low-income, current recipients of SNAP who were Black and lived in suburban, New York. The data indicated the most significant influence, communicated by the participants, was that …

Perceptions Of Private Medical Practitioners Towards The Nigerian National Tuberculosis Treatment Guidelines, Chijioke Pius Osakwe

Walden Dissertations and Doctoral Studies

Tuberculosis (TB) is a major public health problem in many parts of the world. Nigeria is one of the 30 countries in the world that has the highest burden of TB. Private medical practitioners in Nigeria play an important role in health care delivery. Motivating them to adhere to TB treatment guidelines in managing persons suspected of having TB or diagnosed with the disease is one of the strategies employed by the National Tuberculosis Program to Reduce the Burden of TB. Few studies were identified which used qualitative study approaches to study the perceptions of these practitioners towards the TB …

Strategies For Retaining Employees In The Nonprofit Sector, George Parker

Walden Dissertations and Doctoral Studies

Voluntary employee turnover is a concern for nonprofit leaders due to human capital's strategic role in achieving performance excellence. The consequences of volunteer turnover include loss of profitability, productivity, knowledge, and financial stability. The purpose of this single-case study was to explore strategies used by 3 leaders of a nonprofit organization in the Washington, DC, area who have experience with the nonprofit's employee retention efforts. Data were collected from semistructured face-to-face interviews and organizational documentation and analyzed through the conceptual lens of Maslow's hierarchy of needs theory. Data gathered from interviews and analyses of organizational data and performance outcomes were …

Providers' Treatment For Overweight Navy Members And The Effect On Motivating Lifestyle Changes, Misty Scheel

Walden Dissertations and Doctoral Studies

In the military, excessive weight could put members at risk for training injuries, loss of potential career opportunities, and possible discharge from military service. This could increase cost to United States' national defense through increased injuries, decreased retention due to early discharge, cost of retraining, and lifelong chronic health conditions. The purpose of the study was to determine if there was a correlation or predictive value between active duty Navy members' perception of care provided for weight management and the active duty Navy member's motivation for weight management interventions. The social capital theory served as the theoretical framework for this …

The Relationship Between Attachment, Self-Regulation, And Resilience In Undergraduate Students' College Adjustment, Scott Tanner

Walden Dissertations and Doctoral Studies

Difficulty adjusting to college life is noted in nearly 20% of freshmen who fail to return to college. The purpose of this quantitative survey design study, grounded in attachment theory, was to investigate the best predictor (e.g., secure parental attachment, self-regulation, or resilience) of college adaptation, the combined contribution of the variables in predicting college adaptation, and whether a bivariate relationship existed between the variables and subcomponents of college adaptation. The Connor Davidson Resilience Scale Revised, Parental Attachment Questionnaire, Short Self-Regulation Questionnaire, and Student Adaptation to College Questionnaire were securely administered online to a sample of 68 full-time students from …

Hospital Executive Succession Planning Strategies, Janet Tingling

Walden Dissertations and Doctoral Studies

Approximately 50% of New York City hospitals lack succession planning as baby boomers transition out of the workforce into retirement. The potential loss of knowledge capital could affect leadership development and corporate stability. Guided by the transformational leadership theory, the purpose of this single site case study was to explore successful strategies executive-level leaders used to facilitate succession planning within their hospital. Three hospital executive-level leaders from a single site location participated in a semistructured face-to-face interview and provided data that assisted the analysis. Four themes emerged from the data analysis through a word cloud format that showed the most …

Workplace Bullying From A Nurses Perspective, Dawn Reid White

Walden Dissertations and Doctoral Studies

Bullying has long been associated with school children. In recent years, however, more attention has been paid to the bullying that has reached beyond the playground and into the workforce. One population facing this problem is staff nurses. To date, no one has found an effective way to address workplace bullying in the healthcare field, nor have effective methods been found for retaining trained nurses affected by this problem. The focus of this dissertation was on understanding nurses' lived experiences and how nurses decided to remain in their current working position despite these problems. Taking a phenomenological approach and using …

Relationship Between Federal Compliance Complexities And Internal Control Infraction, Laurence Richard Brown

Walden Dissertations and Doctoral Studies

In the nonprofit industry, lapses in internal controls and low levels of accountability have resulted in many organizations becoming insolvent. Grounded in the agency theory, the purpose of this correlational study was to examine the relationship between federal compliance requirement, executive compensation, nonprofit size, nonprofit type, and internal control infraction. Archival data were collected from 144 nonprofit organizations in the southeast United States. The results of the multiple regression analyses indicated the model was able to predict the relationship between federal compliance requirement, executive compensation, nonprofit size, nonprofit type, and internal control infraction, F(7, 136) = 6.559, p < .001, R2 = .252, with non-profit type (hospitals), (β = -9.392, t = 7.191, p <0.050), accounting for a higher contribution to the model than executive compensation, (β = -0.049, t = 1.96, p <0.050). Federal compliance requirement and nonprofit size did not explain any significant variation in internal control infraction. The implications for positive social change included the potential for a better understanding by nonprofit managers of the importance of internal controls, leading to the effective and efficient provision of goods and services needed by members of society.

Success Strategies Of Small Business Owners, Lyndabelle Jakes

Walden Dissertations and Doctoral Studies

In the United States, 20% of newly established small businesses, including small

businesses in the life insurance industry, fail within 2 years, and over 50% of them fail during the first 5 years. The purpose of this multiple case study was to identify and explore the strategies that life insurance brokerage owners use to sustain business operations beyond 5 years. Porter's 5 forces model served as the conceptual framework for exploring this subject matter. Owners of 3 separate small life insurance brokerage firms in Texas, who sustained their businesses beyond 5 years, participated in semistructured interviews. A secondary source of …

Successful Strategies To Sustain Profits From Tourism Following A Hurricane, Kevin C. James

Walden Dissertations and Doctoral Studies

Hurricanes have caused billions of dollars in damage to the hotel industry in Florida, significantly affecting tourism flow. The unpredictable impact of hurricanes makes sustaining profits challenging. The purpose of this multiple case study was to explore strategies that hotel leaders use to sustain tourism profits following a hurricane. The theory of image restoration provided the conceptual framework for the study. Data were collected from company documents and semistructured interviews with 5 hotel leaders in Central Florida. Transcribed data were coded then validated using member checking during the data analysis, which revealed 5 themes: storm impact, accommodations, operations, communications, and …

Educational Module On Health Literacy For Hypertension In The Inmate Population, Pamela Mokoko

Walden Dissertations and Doctoral Studies

Hypertension is a major public health issue in the United States that affects approximately 70 million adults; the high blood pressure of nearly half is considered to be uncontrolled. Uncontrolled hypertension is especially true in the incarcerated population. Due to low health literacy on hypertension in the inmate population, there are recurrent hospital visits, an increase in the admission rate and an increased length of stay in hospitals, all of which may lead to an increase in the cost of healthcare. The purpose of this scholarly project was to develop an expertly reviewed, evidence-based, self-paced, computerized, educational module to promote …

Use Of Simulation For Tracheostomy Care, A Low Volume, High Risk Nursing Procedure, Vijaya Ramakrishnan

Walden Dissertations and Doctoral Studies

Often, education regarding low volume and high-risk procedures, like tracheostomy, are ignored. Lack of experience, skills, and human resources can lead to decreases in confidence levels, diminished quality of care, and potentially an adverse event. The purpose of this DNP project was to prepare simulation-based education on the tracheostomy procedure and provide hands-on education to bedside nurses. The project answered the question: To what extent will a simulation-based teaching method adequately prepare staff nurses in a post-acute surgical unit to perform this high risk low volume procedure? The Johns Hopkins evidence-based model method was used to assist in translation of …

Oral Care And The Connection To Adverse Events In Dentistry, Melissa A. Rhoney

Walden Dissertations and Doctoral Studies

As the healthcare industry continues to change, dental providers are concerned about the different types of adverse events that can occur if systemic diseases are not well understood when treating patients. The purpose of this study was to explore the level of understanding among dental care providers of the relationship between oral care and systemic diseases and how these are linked to adverse events. The theoretical foundation that was used for this study was the Swiss cheese model. The research questions were designed to address the level of understanding among dental care providers of the link between oral care and …

Implementing A Healthy Diet In The Intellectual Disability Residential Community, Stephanie Michelle Shelton

Walden Dissertations and Doctoral Studies

The problem addressed in this study was how staff working in a residential agency for individuals with an intellectual disability (IID) make decisions about how to implement a healthy diet. The purpose of this study was to identify the influences on decisions made by staff on the meals they provided to their clients with an IID. The theory of planned was used to study the influences of attitude, subjective norms, and perceived behavior control on the meals provided for IID. The key research question explored how staff members make decisions. A qualitative case study design was used. The 12 participants …

The Effectiveness Of Screening For Comorbid Depression Among Outpatients With Chronic Diseases In Maryland, Linda Hasssan Allibalogun

Walden Dissertations and Doctoral Studies

Depression is a pervasive mental health disorder worldwide. Although being diagnosed with chronic illness exacerbates susceptibility to depression, detection and subsequent treatment of comorbid depression in primary care settings remain suboptimal because patients with chronic medical disorders are not commonly screened for depression. There is a need to initiate proactive measures by implementing routine screening in primary care settings. The plan-do-study-act (PDSA) model guided an intervention to establish a depression screening practice. This study aimed to determine if the implementation of evidence-based screening for depression using the Patient Health Questionnaire-9 (PHQ-9) tool could increase diagnosis of comorbid depression among patients …

Strengthening Jamaica's Anticorruption Policy With An Independent Agency, Curt Brown

Walden Dissertations and Doctoral Studies

Corruption is a kind of behavior that undermines good governance. Current research has suggested that Jamaica's present anticorruption policy is ineffective, and needs strengthening. A civic organization in Jamaica has advocated for an independent anticorruption agency, with both investigative and prosecutorial powers to strengthen Jamaica's anticorruption policy. Little is known about the perspectives from the Jamaican business community on this concept. The purpose of this study was to discover and understand perspectives from the Jamaican business community on this concept. A framework included in this study is the principal-agent theory, which provides an understanding of the essence and relevance of …

Inpatient Rehabilitation, Diabetes, And The Risk Of Clostridium Difficile Infection, Kerry A. Flint

Walden Dissertations and Doctoral Studies

Clostridium difficile is a frequent cause of healthcare-associated infections (HAI) and is associated with increased risk of morbidity and mortality. Studies suggest environmental and host characteristics increase patient's susceptibility to C. difficile infection (CDI). However, few studies have examined the risk of CDI among those with diabetes or patients in the acute rehabilitation (AR) setting. A case-control study, using secondary data (n = 473), evaluated the relationship between CDI and diabetes and identified modifiable environmental exposures. An ecosocial framework was used to examine the relationship between these two complex diseases among hospitalized patients in an AR setting. Results of the …

Strategies For Virtual Sales Leaders To Increase Productivity Of Remote Employees, Tamera Monai Gaines

Walden Dissertations and Doctoral Studies

An employee's contributions toward the success of organizational results and objectives are essential to how virtual sales leaders implement strategies to improve productivity. In 2014, 21% of virtual leaders received formal training to manage remote employees, and 17% of remote employees received formal training on how to work productively. The purpose of this single qualitative case study was to explore strategies virtual sales leaders used to improve remote sales employees' productivity. The population included 6 virtual sales leaders in 1 staffing organization located in Michigan. The conceptual framework for this study included the job demands-resources model. Data were collected through …

Using Calcaneal Heel Ultrasounds To Screen For Osteoporosis At Alaska Health Fairs, Heather Guess

Walden Dissertations and Doctoral Studies

Osteoporosis is a major health problem. The Alaska Department of Health and Social Services reports national rates of osteoporosis at 13-18% of women and 3-6% of men over age 50, but current evidence suggests that osteoporosis rates in Alaska are more equal between sexes. Known risk factors for osteoporosis that are very common among Alaskans include arthritis and low vitamin D and calcium levels. The U.S. Preventive Services Task Force (USPSTF) recommends dual-energy x-ray absorptiometry (DXA) scans of the hip and lumbar spine as the gold standard of screening for osteoporosis; however, DXA scans are expensive, not portable, and not …

A Nursing In-Service For Diabetes Education, Heidi Steiner

Walden Dissertations and Doctoral Studies

Nurses play a central role in preparing patients for discharge. Diabetes affects one-third of all hospitalized patients, with readmission rates 20% higher for patients with diabetes. Low health literacy affects patients' ability to understand education provided during a hospitalization, especially in diabetic patients who are required to perform complex self-care activities. The rehabilitation nurses within the practicum site struggled to provide adequate diabetes education, leading to patients' readmissions and frequent calls to the nursing unit post discharge. The purpose of this project was to educate nurses on an inpatient unit about survival skills and teach-back approaches to improve inpatient diabetes …

Relationship Between Health Literacy And End-Stage Renal Disease Among Type Ii Diabetics, Joelle M. Stolte

Walden Dissertations and Doctoral Studies

The progression of End Stage Renal Disease (ESRD) among type II diabetics is preventable, yet complications continue to plague many. Reports show that 29.1 million people (9.3%) in the United States have diabetes, and 40% of those individuals develop ESRD. Four research questions explored the relationship between ESRD, health literacy, and healthcare. Data from 2010-2015 from the National Institute of Health (NIH) was quantitatively analyzed. The conceptual framework was the revised health service utilization theory. The target population included 3939 diverse males and females between the ages of 20-75 diagnosed with type II Diabetes. Results from Chi-square, cross-tabulation, binary, and …

Increasing The Value Of Medicare Annual Wellness Visits For Patients And Providers, Stephanie Hope Turner

Walden Dissertations and Doctoral Studies

The Medicare Annual Wellness Visit (AWV) has been available to Medicare beneficiaries since 2005; however, most eligible individuals have not taken advantage of this benefit. The literature supports that patients are willing to schedule and complete an AWV if urged to do so by their primary care provider; however, providers are reluctant to advise patients to pursue the AWV due to the lack of perceived value and overall health benefit. The integrative theory of health behavior change was used as the theoretical framework for the project. By increasing patient self-management skills through education, engagement, and support, the project was designed …

Black Business Owners Overcoming Barriers In Texas, Henry Williams

Walden Dissertations and Doctoral Studies

Black entrepreneurs in the state of Texas reported that they did not achieve the same level of success as nonminority enterprises. Many Black entrepreneurs have obtained education from top tier institutions and have the managerial experiences, skills, and working knowledge that facilitate business success, but they are not able to sustain business growth. The purpose of this phenomenological study was to explore the lived experiences of Black Texan entrepreneurs. This research was established using the conceptual framework of human capital. The overarching research question concerned the lived experiences of Black Texas entrepreneurs who were not as successful in business as …

Procurement Strategies In Nigerian Ceramics Manufacturing, Emmanuel Korede Alege

Walden Dissertations and Doctoral Studies

Some developing nations struggle with a diminishing manufacturing output market share because of a lack of appropriate procurement strategies. The purpose of this single case study was to explore the procurement strategies that managers successfully developed and deployed to improve company performance. The strategic alignment model was the conceptual framework for the study. Data were collected through semistructured interviews of 6 members of a Nigerian ceramics manufacturing company, as well as from a review of publicly available documents related to the performance of the company. A thematic analysis of the data was conducted to identify codes, extract subthemes and themes …

Early Radiation Therapy And Cervical Cancer Survival In The United States, Olufunmiso Oyetunde Asamu

Walden Dissertations and Doctoral Studies

A paucity of information exists on the benefits of using radiation therapy for treating women with early cervical cancer detection. The purpose of this cross-sectional study was to investigate the association between early versus late testing of Human papilloma virus (HPV), age, race, radiation therapy, and regions in United States, and survival rates among women diagnosed with early cervical cancer. The epidemiological triad of person, time, and space guided this study to explain the regional spread of cervical cancer, and the effect of early testing. Secondary data from Surveillance, Epidemiology, and End Results (SEER) were used (N= 520,153). Statistical analyses …

Emergency Room Nurse Perceptions Of Emotional Intelligence, Ingrid Astralaga

Walden Dissertations and Doctoral Studies

The delivery of quality care has been a priority for the health care industry in the United States. Researchers have established positive correlations between the levels of emotional intelligence of registered nurses and their clinical performances. However, new evidence suggests the need to enhance the use of emotional intelligence (EI) in high-risk clinical units. With the intent to understand the use of EI, a phenomenological research approach was used to identify the emergency room nurse's understanding of EI. The Four-branch Model of Emotional Intelligence was used as the theoretical framework, while the research question identified the emergency room nurse's perception …

Sexism, Just-World Beliefs, And Defensive Attribution: Relationship To Online Discourse And Child Sexual Abuse, Andrea M. Barbis

Walden Dissertations and Doctoral Studies

Research has shown that individuals' willingness to believe a disclosure of childhood sexual abuse (CSA) is related to just-world beliefs, ambivalent sexism, and defensive attribution. However, researchers do not know whether these variables relate to posts made in response to online articles describing CSA. Negative or disbelieving posts may impact not only the author, but also readers who view these comments via hindrance of disclosures, increased self-blame, and avoidance of help seeking. In this quantitative study, just-world, ambivalent sexism, and defensive attribution theories provided the theoretical basis used to determine whether just-world beliefs, ambivalent sexism, and defensive attribution influenced comments …

Measuring Skill Decay In Fire Ground Commanders, Joe Bonnell

Walden Dissertations and Doctoral Studies

Despite improved technology and equipment and a steady decline of structure fires, firefighter line-of-duty deaths and injury rates have increased over the past 10 years. Independent reports indicated poor decision-making by fire ground incident commanders (FGCs) as the primary cause of deaths and injuries. FGCs are vulnerable to skill decay given the expertise needed to manage an incident and limited opportunities to remain proficient. Guided by skill decay theory, the purpose of this quantitative study was to examine the relationship between skill decay among FGCs and experience, drilling and training opportunities (overlearning), years of experience, and time since initial training. …

Korean Immigrant Women's Perceptions Of Cervical Cancer Screening In Hawaii, Eurina Yujin Cha

Walden Dissertations and Doctoral Studies

Minority immigrant women are more likely to be diagnosed with and suffer from cervical cancer compared to other minority women in the United States. The purpose of this qualitative ethnographic study was to explore cultural health perceptions, behaviors, and barriers to cervical cancer prevention among Korean immigrant women (KIW) in Hawaii. The health belief model and the social-ecological model were used to guide the study. Data were collected using individual structured interviews with 20 KIW ages 21 to 65 who are first-generation KIW immigrant to Hawaii. Data were coded and analyzed to identify themes. Findings revealed that participants (a) prefer …