Digital Commons Network^™

Ranking Small Business Resistance Criteria Toward The Affordable Care Act, Rakesh M K Gupta

Walden Dissertations and Doctoral Studies

Following the enactment of the Affordable Care Act (ACA) in 2010, politicians, media, and lobbyists rendered a number of conflicting and confusing interpretations of its merits and demerits. Such interpretations intensified the skepticism and concerns of small business enterprise (SBE) owners. The purpose of this study was to develop a representative, prioritized list of SBE owners' concerns or resistance factors. The goal was to create a useful guide for SBE owners who are seeking ways to reducing the adverse financial impact of the law. With social choice theory as the theoretical framework, 50 randomly selected SBE owners across 5 distinct …

Implementing Assistive Technology Through Program Planning, Shaune Lasheane Mckinney

Walden Dissertations and Doctoral Studies

Special education (SPED) service providers in the military are often underprepared to use the needed assistive technology (AT) in the classroom. This concurrent mixed-method study sought to explore the attitudes, skills, and quality indicators of assistive technology (QIAT) among 19 currently employed military SPED certified multidisciplinary team members. The conceptual framework of this study was based on the professional learning community model, which holds that the team members work collaboratively to educate the families it serves. All team members completed a quantitative QIAT survey and open-ended questionnaire, and individual qualitative interviews were conducted with a subsample of 8 volunteer staff. …

A Clinical Pathway Education Program For Pediatric Nurses, Lisa M. Scheiber-Case

Walden Dissertations and Doctoral Studies

Clinical pathways have been studied to promote best practices in nursing and enhance patient satisfaction. For 10 years a pediatric orthopedic surgical team at a Midwest hospital has not had a clinical pathway to treat or standardize care for adolescents following posterior spinal fusion surgery. Pain scores and patients' length of stay were collected using a retrospective chart review. This information was used to revise preoperative education materials and develop a visual poster. The purpose of this project was to identify and develop a way to educate the pediatric nursing staff on the use of the developed educational materials, poster, …

The Effectiveness Of Combining Simulation And Role Playing In Nursing Education, Shari Lynn Redden

Walden Dissertations and Doctoral Studies

The profession of nursing is affected by a nursing and nursing faculty shortage that is impacting the ability to produce adequate numbers of nurse graduates to address the healthcare needs of the future. Nursing schools are increasingly using simulation and/or role-playing to supplement the decreased number of nurse faculty and clinical sites in order to be able to continue to enroll nursing school applicants. The purpose of this phenomenological study was to examine the experiences of nursing students with role-playing and simulation and the extent to which role-playing with simulation is perceived by students as beneficial for learning within the …

The Disparity Of Racial Diversity In Counselor Education And Supervision, Sharon Hammett Webb

Walden Dissertations and Doctoral Studies

In general, doctoral programs in counselor education and supervision (CES) have low minority enrollments. Faculty members in clinical mental health counseling (CMHC) master's degree in science (MS) programs primarily come from CES doctoral programs; therefore, faculty members do not generally reflect the diversity of the MS student population. Using the theory of planned behavior and the bioecological model, the purpose of this research was to determine the extent to which age, gender, faculty support, income, level of parents' or primary caregivers' education, and the Council for Accreditation of Counseling and Related Educational Programs (CACREP) accreditation status predict White and racial …

The Effects Of Financial Literacy On Patient Engagement, Melanie Meyer

Walden Dissertations and Doctoral Studies

Health care reform has caused consumers to learn more about what it means to have health insurance and its costs. Patient engagement, a critical component of health care reform, reflects provider and consumer attention to shared decision making between patient and physician. The problem addressed in this study is that although researchers have studied patient engagement, there has been insufficient exploration of the relationship between financial literacy and patient engagement, which could negatively impact health outcomes not only for patients or consumers but for society as a whole. The purpose of this quantitative research was to determine if a relationship …

Use Of Flexible Work Arrangements By Race And Ethnicity: Examining The Mediating Role Of Organizational Diversity Climate Perceptions, Imani S. Owens

Walden Dissertations and Doctoral Studies

This study investigated whether women of color faced additional challenges in using flexible work arrangements (FWAs) when workplaces lacked an affirming diversity climate. Researchers found that use of FWAs was associated with organizational climate, race was correlated with diversity climate perception, and diversity climate perceptions were associated with organizational outcomes such as job satisfaction and retention. Limited empirical evidence existed that demonstrated that race/ethnicity predicted use of FWAs or that diversity climate mediated this relationship. This quasi-experimental study examined the hypotheses that (a) race/ethnicity predicted diversity climate perceptions, (b) race/ethnicity predicted use of FWAs, and (c) diversity climate mediated the …

Are Associations Between Parenting Style And Academic Achievement Moderated By Ethnicity And Individualism-Collectivism?, Thiago L. De Oliveira

Walden Dissertations and Doctoral Studies

Researchers have long been concerned in documenting the nature of associations between parenting styles and academic achievement in adolescents. Social learning theory has shown how domains such as individualism, collectivism, and ethnicity are associated with parent behavior. Research suggests compatibility between individualism and authoritative parenting and collectivism with authoritarian parenting styles, which could have critical implications in the relationship between parenting styles and academic achievement. Despite the robust research on parenting styles, no research has investigated the moderating roles of individualism and collectivism. Thus, the purpose of this study was to determine the associations between parenting style and academic achievement …

Student Perceptions Of Biology Teachers' Interpersonal Teaching Behaviors And Student Achievement, Victor N. Madike

Walden Dissertations and Doctoral Studies

Inadequate student-teacher interactions in undergraduate courses have been linked to poor student performance. Researchers have noted that students' perceptions of student-teacher relationships may be an important factor related to student performance. The administration of a Mid-Atlantic community college prioritized increasing undergraduate biology student performance. The purpose of this quantitative study was to examine the relationship between students' biology achievement and their perceptions of interpersonal teaching behaviors and student-teacher interactions in introductory biology courses. Leary's theory on interpersonal communication and the systems communication theory of Watzlawick, Beavin, and Jackson served as the theoretical foundation. The Wubbel's Likert-scale questionnaire on student-teacher interactions …

African American Male Community College Completion And Mode Of Instruction, Lisa M. Harper

Walden Dissertations and Doctoral Studies

Despite innovative policy and pedagogical transformations, postsecondary achievement gaps continue to exist between African American males and other students. Low college credential completion rates by African American males have prevented an East Texas community college from meaningful participation in the President's 2020 postsecondary education attainment goal of increasing U.S. college graduates by 5 million. The purpose of this quantitative study was to investigate a hypothesized connection between the independent variable, mode of instruction, and the dependent variables, mathematics course completion and college completion by African American males. Guided by Ogbu's cultural-ecological theory of minority school performance, a chi-square test of …

Recent Graduates' Perspective On The Efficacy Of Nursing Simulation Laboratory Experiences, Holli Sowerby

Walden Dissertations and Doctoral Studies

It has become progressively difficult to find suitable clinical placement for nursing students. To help meet this need, local schools of nursing are turning to high-fidelity simulation manikins to substitute for clinical experience. There is a lack of research that explores recently graduated nurses' perceptions about the efficacy of simulation experiences. Guided by the constructivist theory, this qualitative case study identified how recent RN graduates viewed simulation experiences and whether associate's-degree RN program graduates and bachelor's-program RN graduates viewed simulation differently. Nine recent graduates participated in individual face-to-face interviews. The data were coded and grouped into 5 major themes in …

Effects Of Education On Victims Of Domestic Violence, Julette N. Anderson

Walden Dissertations and Doctoral Studies

The purpose of this project was to improve support for victims of domestic violence. To that end, this project developed an evidence-based program to provide information about domestic violence including safe and confidential ways to seek assistance, rights as cohabiting intimate partners, and the resources available to community members. Several approaches were used to develop, validate, and plan for implementation and evaluation of this program, which was developed for 3 sites in Broward and Miami-Dade counties where the project is situated. The program logic model and the social ecological model, including the individual, relationship, community, and societal levels, were used …

Assessment Of Vitamin D Levels And Depression Among Adults In The United States, Troy Jean-Luc Owens

Walden Dissertations and Doctoral Studies

Vitamin D is essential to optimizing health; vitamin D deficiency (VDD) can increase risk of hypertension, cardiovascular disease, and insulin resistance. VDD occurs when individuals do not receive sufficient oral intake or obtain adequate sun exposure. Previous researchers indicated there is a relationship between VDD and depression, while others have indicated there is no relationship. The purpose of this study was to examine the relationship between vitamin D levels and depression, and how this relationship might be moderated by an individual's demographic characteristics (gender, age, smoking status, or marital status). This study was a quantitative data analysis of archival data …

Nurses Aides' Perspectives On Training, Joyce Young

Walden Dissertations and Doctoral Studies

In 2008, the Institute of Medicine recommended increasing CNA training programs to 120 hours of training. In accordance with that change, the Pennsylvania Department of Education recommended that the Pennsylvania's CNA training program of a required 80 hours be increased to 120 hours of training. This increase was intended to improve CNA job performance and job satisfaction, as well as the quality of patient care. The purpose of this phenomenological research study was to understand how Certified Nurse's Aide (CNA) graduates of 100-hours or fewer training programs in Lancaster, Pennsylvania, perceived their clinical training as related to effectively performing clinical …

Phenomenological Inquiry On Cigarette Smoking In Adults With Serious Mental Illness, Pedro R. Gabino

Walden Dissertations and Doctoral Studies

Cigarette smoking in adults with serious mental illness (SMI) has increased even when accounting for a decrease of smoking among the general population. Most of the research has focused on the prevalence, rates, and effects of smoking in adults with SMI. Little research has examined the motivations for smoking and experiences with smoking cessation among adults with SMI. Such an understanding may facilitate a reduction in smoking in this population. To address this gap in the literature, 12 adults with SMI who live in the southern Nevada area and smoke were selected through invitations distributed at a treatment facility and …

Spirituality, Religious Coping, And Depressive Symptoms In Hospice Patients: A Terror Management Perspective, Janine Siegel

Walden Dissertations and Doctoral Studies

Facing imminent death can be an unremitting problem for hospice patients who lack psychological support for existential concerns that contribute to depressive symptoms and suffering. According to terror management theory, spiritual and religious beliefs are a common means of coping with mortality at the end of life, and few studies have considered how hospice patients feel about their impending death. This was a quantitative, cross-sectional study that examined whether spirituality and religious coping moderated the relationship between imminent death concerns and depressive symptoms in 54 hospice patients. Participants completed a self-administered survey that included the Templer Death Anxiety scale, Brief …

The Association Between Exhaled Nitric Oxide In Exhaled Breath Condensate And Chronic Obstructive Pulmonary Disease, Colin Mitchell

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD), a progressive and nonreversible disease, is a leading cause of mortality and morbidity throughout the world. Detecting COPD early in the disease process will help in decreasing later stage COPD severity. Because airway inflammation is a hallmark of COPD, it has been proposed that measuring exhaled nitric oxide, a marker of inflammation, in exhaled breath condensate could prove to be an inexpensive and efficient method to detect COPD in outpatient settings. Using the hypothetico-deductive theory as a guideline, this study used secondary data from the National Health and Nutrition Examination Survey 2007 to 2010 to …

Technological Change And Employee Motivation In A Telecom Operations Team, Samuel Ogbonnaya Ude

Walden Dissertations and Doctoral Studies

Some managers view innovative product development and convenient service delivery as necessary to business survival. However, unmotivated employees might negate any gains from the use of innovation. The purpose of this correlational study, grounded in diffusion of innovation theory, was to assess the relationship between creativity and support for innovation, resistance to change, and organizational commitment and employee motivation. A random sample of 81 information technology (IT) professionals from telecom service centers completed an online survey. Simultaneous multiple linear regression was the statistical technique used to analyze these data. The results indicated a poor model with low R2 to significantly …

Relationship Between Modality And The Degree Of Knowledge Retention In Bioterrorism Training, Gaylon Rashun Crawford

Walden Dissertations and Doctoral Studies

A public health workforce must be trained to react quickly, especially in the case of terrorist attack. Political leaders and emergency management experts have often cited inadequate emergency training as a contributing factor in the public health system's failed preparations for a bioterrorist event. As a result of these failures, billions of dollars have been allocated towards correcting infrastructure deficiencies including training for public health nurses (PHNs), who are critical to a communitywide medical response. This quantitative study used Pearson's correlation and a multivariate regression analysis to evaluate the most effective modality of bioterrorism training (BTT) for PHNs working in …

Differences Between For-Profit And Nonprofit Hospitals: Perceived Quality And Access, Michael Ray Eiland

Walden Dissertations and Doctoral Studies

Despite a large body of literature addressing the issue, questions remain about whether nonprofit hospitals provide more community benefit than do for-profit hospitals. This lack of information impacts governments, hospitals, and the healthcare industry, as stakeholders attempt to generate requirements to which hospitals should adhere to maintain nonprofit status, and thus tax exemption. This study addressed this lack of information by examining U.S. hospitals through the lens of stewardship theory to determine whether nonprofits are better stewards of the public good than for-profits, and thus likely to provide higher quality and access. The study applied logistic regression to Centers for …

Psychosocial Predictors Of Successful Bariatric Surgery, Rodney D. Grim

Walden Dissertations and Doctoral Studies

Obesity is an epidemic that can lead to a wide range of physical and mental problems. When traditional weight-loss methods are not effective, bariatric surgery is a viable weight-loss option. While previous researchers have investigated the role of psychological factors in relation to obesity, few have investigated psychological factors as predictors of weight loss and complications after bariatric surgery. The purpose of this study was to determine the prevalence of psychological disorders/conditions (e.g., depression and abuse) in the study population, evaluate weight and psychosocial variables before and 6 months after weight-loss surgery, and identify psychosocial factors that are predictors of …

The Critical Success Factors Of Public Private Partnerships In Lagos State, Franca Igboka

Walden Dissertations and Doctoral Studies

In recent years, the Lagos State Government has attempted to adopt public private

partnerships (PPP) with little success, largely as a result of implementation barriers. The

purpose of this quantitative, ex-post facto design study was to evaluate which factors are

considered most predictive of success of PPP implementation in the state, whereby the

prescribed quality of products/services is achieved within a specified time frame and at

the agreed cost. Wood and Gray's theory of collaboration and the network and

collaborations theory by Kamensky and Burlin guided this study. A self-constructed and

validated structured questionnaire was utilized in the collection of …

Success Factors Of Small Business Owners Of Independent Financial Planning Firms, Joanne Snider

Walden Dissertations and Doctoral Studies

Small Business Administration statistics indicate that 20% of small businesses fail within the first 2 years and 50% fail within 5 years. The purpose of this case study was to explore the success factors and strategies of 12 small business owners of independent financial planning firms who achieved profitability beyond 5 years. A gap exists in the literature concerning such business owners, and their experiences provide valuable information to others desiring to start or maintain a financial planning business. The conceptual framework was entrepreneurship theory and Porter's 5 forces model of competitive strategy. The data were gathered via semistructured interviews …

Perceptions Of Middle School Bystanders To Bullying Incidences, Elizabeth Walden Beasley

Walden Dissertations and Doctoral Studies

Bullying permeates all grade levels in schools. Despite antibullying initiatives implemented in a Midwest school district, bullying continued to occur. One aspect of bullying that is not often examined is the perceptions of bystanders, especially at the middle school level. The purposes of this quantitative survey design study were to examine (a) the frequency and level of bullying by grade level, (b) the relationship between middle school bystanders' willingness to intervene and grade level, and (c) perceptions of bullying interventions and grade level. Latané and Darley's bystander effect theory was the theoretical framework for this study. Descriptive statistics and chi-square …

The Effects Of Nursing Education On Decreasing Catheter Associated Urinary Tract Infection Rates, Pamela R. Gordon

Walden Dissertations and Doctoral Studies

Catheter-associated urinary tract infections (CAUTIs) account for 40% of all nosocomial infections in the United States, affecting nearly 900,000 patients per year. The indwelling urinary catheter (IUC) is a widely utilized device in modern hospital environments, yet they are not always used appropriately in hospital settings and can result in prolonged use and improper management, increasing risk of infections and length of stay. Nurses are the primary champions to promote preventative measures, provide patient education, and evaluate evidence-based practice (EBP) strategies to decrease CAUTIs. The purpose of this study was to determine if nursing education on EBP guidelines could decrease …

Teacher Perceptions Of Administrative Involvement In Transfer Of Training, Stephanie Michelle Heflin

Walden Dissertations and Doctoral Studies

This study district provides ongoing professional development for teachers; however, there was little evidence that transfer of training was occurring and it was unclear whether the administrator role could improve the implementation of learning from professional development. The purpose of the study was to examine teachers' perceptions of administrative involvement in professional development in order to identify indicators that could strengthen nonevaluative, collaborative relationships leading to higher rates of transfer. The central research question focused on teachers' perceptions of the roles of administrator-as-evaluator and administrator-as-collaborator and whether collaboration might influence transfer of training for teachers as they strive to improve …

The Relationship Between Information Technology And Organizational Effectiveness As Perceived By Health Care Providers, Christian Chikwem Ukaga

Walden Dissertations and Doctoral Studies

The U.S. Congress has made health information technology a central component of the national quest to improve health care delivery. The problem addressed in this study was the uncertainty among healthcare providers regarding the benefits of health care information technology adoption relative to healthcare delivery processes and outcomes. The purpose of the study was to understand the effectiveness of information technology as perceived by healthcare providers. The research questions were designed to investigate the relationship between health information technology and organizational effectiveness, exchange of information, organizational process, organizational productivity, and direct personal care. Sociotechnical systems theory and Donabedian's framework for …

Challenges Of Child Trauma On Adoptive Families' Social And Emotional System, Jacqueline Yvonne Ford

Walden Dissertations and Doctoral Studies

Adoption-focused psychoeducation is deemed essential in maintaining the permanency of traumatized children within a new family unit. However, adoptive parents of traumatized children struggle to find training to address their unique concerns. Guided by the lens of psychodynamic theory, the purpose of this study was to investigate the challenges faced by adoptive families of traumatized children. Special focus was placed on the social and emotional relationships of the adoptive parents of traumatized children, to identify the realistic expectations towards attachment from the families' perspectives. Fifteen families were randomly selected to participate in this study from a group of 30 parents …

A Phenomenological Examination: African American Women And Low Cervical Cancer Screening Attendance, Leslie G. Matthews

Walden Dissertations and Doctoral Studies

African American women tend to have lower attendance rates at cervical cancer screenings compared to the attendance rates of women from other ethnic groups. The purpose of this research project was to understand how perceptions of African American women affects attendance of future cervical cancer screenings. The goal was to understand what contributes to low attendance. Previous research did not focus on factors contributing or interfering with appointment attendance among African American women, aged 30-65. The conceptual framework was based on individual health behavior. The research questions examined lived experiences affecting attendance of cervical cancer screenings, attendance of future screenings, …

Care Transition Gaps: Risk Identification And Intervention, Michael Howard Jongsma

Walden Dissertations and Doctoral Studies

Hospital readmissions related to chronic heart failure (CHF) are costly, widespread, and often avoidable. Patient education that includes diagnosis, causes, medications, diet, exercise, and exacerbation warning signs has been shown to reduce the number of CHF readmissions. The purpose of this study was to use risk stratification to identify CHF patients at high risk for 30-day readmission. Once a high-risk CHF patient was identified, nursing interventions would be triggered to reduce readmissions and close the gaps in the continuum of care following acute care admission. Transitions of care theory was used as the framework for this project. The methodology had …