Digital Commons Network^™

Disparities In The Lanterman Developmental Disabilities Services Act, Helen Grace Neri

Walden Dissertations and Doctoral Studies

Culturally and linguistically diverse populations in the developmental disability system suffer from socioeconomic and social services disparities. Efforts to address the disparities issue included enacting Welfare and Institutions Code 4519.5 § (e), (f), (g), and (h), also known as the Lanterman Developmental Disabilities Services Act or the disparities law. The law mandated monitoring of developmental disability system expenditures and allocated funding to the regional centers and community-based organizations to assist with implementing activities to address the disparity. Schneider and Ingram’s and Jun’s theories of social construction framed the inquiry as to how the law impacted considerations of the social construction …

Impact Of Religion On Mental Health Care Use Among African Immigrants In The United States, Mary Nganga

Walden Dissertations and Doctoral Studies

Mental health illnesses are the leading causes of disability worldwide with one in every five people suffering from mental illness in the United States. African Immigrants are the fastest growing immigrant group in the United States, yet their mental health care use remains relatively low. African immigrants face stressors that may lead them to be more prone to mental illness, yet they depend on religion and family support rather than formal mental health care. The purpose of this qualitative study was to understand the impact of religion on mental health care use among African immigrants in the United States. The …

Educating Nursing Staff Regarding African Immigrants And Mental Health Stigma, Kelly Ngenge

Walden Dissertations and Doctoral Studies

AbstractMental health stigma exists across multiple minority populations, especially among African immigrants in the United States. The purpose of this project was to increase staff knowledge at an outpatient mental health clinic by educating them on mental health stigma among African immigrants in the United States. The practice-focused question guiding this study was: Does nursing staff education on mental health stigmas among African immigrants increase knowledge? Two theories served as the theoretical framework for this doctoral project: social stigma theory and modified labeling theory. Seventeen staff members voluntarily participated in a 60-minute nursing staff education project based on the analysis, …

Health Awareness Of Hypertension In The African American Community, Rosemond Nunge Nguiffo

Walden Dissertations and Doctoral Studies

The practice problem this doctoral project addressed is the lack of clinical staff knowledge on self-care management of hypertension (HTN). Addressing this health crisis with current evidence-based patient education guidance that clinical staff can use to teach patient has the potential to increase nursing knowledge and confidence in providing patient education on self-care management of HTN. The purpose of this project was to explore the known nursing practice gap and answer the practiced-focused question to determine if an evidence-based, standardized health literacy teaching guide for nurses would improve nursing knowledge and confidence in applying health literacy and teach-back methodology in …

Socioeconomic And Health Impact Of Opioid Overuse On Working-Age Population In Minnesota, Colette Ngum Ngwa

Walden Dissertations and Doctoral Studies

Abstract The United States faces numerous challenges associated with the ongoing opioid crisis. Although the opioid epidemic is complex, opioid overuse affects users’ health and has a far-reaching impact on socioeconomic well-being. This study employed a quantitative cross-sectional design using secondary data from a 2018 national survey of working-age individuals ages 18 to 45. Multivariate regression analysis was used to examine the associations between opioid overuse and socioeconomic status, health status, and perceived need for substance abuse treatment. The addiction career concept and chronic illness model theory were used to analyze these correlations. The findings indicated that people with higher …

Perceived Stress Of Grandparents Parenting Their Grandchildren, Beverly Gale Nicholas

Walden Dissertations and Doctoral Studies

Parenthood responsibilities are changing in the United States. The overall research problem for this study was that grandparents are parenting their grandchildren when their adult children are incarcerated for alcohol abuse or use. The importance of this problem is that as adults age, they are taking on the responsibilities of being parents rather than grandparents. In this new role, grandparents may not have the coping strategies or social support to ensure that they have life satisfaction during their senior years. The purpose of this study was to assess the independent variables, age and perceived stress (low, medium, and high), as …

Small Business Strategies To Implement Product Diversification Effectively, Madeleine Solange Nouteya-Jackson

Walden Dissertations and Doctoral Studies

Business leaders who lack an understanding of the proper strategies to successfully implement product diversification risk decreasing competitive advantage, causing loss of economy constancy and organizational profitability. Grounded in Porter’s five forces of competitive advantage, the purpose of this qualitative multiple case study was to explore strategies small business leaders used to effectively diversify their products to achieve and sustain a competitive advantage. Participants included three retail business leaders who employed fewer than 15 employees and have successfully used product diversification strategies to sustain and maintain a competitive advantage in the District of Columbia, Maryland, and Virginia areas. Data were …

The Relationship Between Housing/Living Arrangement And Admission To Drug Treatment Centers In Virginia, Odessa Ochoa

Walden Dissertations and Doctoral Studies

Homeless veterans with substance use disorders are among the most vulnerable and inaccessible populations in Virginia, which is evident by the lack of state and local resources. This cross-sectional study was conducted to present a retrospective assessment of the Treatment Episode Data Set (TEDS) to develop an understanding of the impact of housing arrangements on admission to long-term drug treatment centers among veterans in Virginia. To guide the study, the socioecological model was selected as the theoretical framework to better examine and understand the relationship between housing/living arrangement and admission to drug treatment centers among Virginia veterans. The aim of …

Effects Of The Hospital Readmissions Reduction Program On Copd Readmissions And Costs., Heather O'Connell

Walden Dissertations and Doctoral Studies

Readmissions for chronic obstructive pulmonary disease (COPD) are a major contributor to healthcare costs and patient outcomes. The Hospital Readmissions Reduction Program (HRRP) by the Centers of Medicare and Medicaid was implemented to decrease high rates of readmissions for serious medical problems, including COPD. The purpose of this study was to determine whether HRRP resulted in reductions in readmissions and costs for COPD patients. The Donabedian model was used as the theoretical framework to investigate three research questions concerning whether there are statistically significant differences in terms of readmission rates, total charges, and primary type of insurance payment before and …

Second Victims In Nursing, Ofelia O'Donnell

Walden Dissertations and Doctoral Studies

Nurses involved with an unexpected adverse patient event can experience guilt, depression, stress, and anxiety and relive the incident, known as the second victim phenomenon. Nurses would benefit from education on the topic of the second victim. The project holds significance for nursing practice as implementing second-victim education increased knowledge and awareness while promoting a just culture that fosters a psychologically safe environment focused on process and system improvement. Use of the analysis design development implementation evaluation (ADDIE) model and the Walden Manual for Education guided the project planning and implementation. The sources of evidence were obtained through a combination …

Diabetes Distress Among Adults Living In Texas, Jenny Chinedu Ogadi

Walden Dissertations and Doctoral Studies

About 34.2 million Americans (approximately 10.5% of the total U.S. population) live with diabetes. African Americans are twice as likely to be diagnosed with diabetes and more likely to be less compliant with treatment medication regimens and suffer from related complications, compared to non-Hispanic Whites. Such disparities brought attention to the need to investigate and understand better the diabetes distress of diverse groups of diabetics. The purpose of this cross-sectional study was to examine the relationships between demographic factors (race, age, gender, and educational level), diabetes education, diabetes management, and diabetes distress of adult diabetics in Texas. The theory of …

Challenges Of Digital Privacy In Banking Organizations, Okechukwu Innocent Ogudebe

Walden Dissertations and Doctoral Studies

As the information and technology age becomes more advanced, digital privacy flaws have become more challenging. Information technology (IT) security managers, chief information security officers, and other stakeholders in banks are concerned with identity-based authentication attacks because identity-theft attacks cause data breaches. Grounded in the protection motivation theory, the purpose of this qualitative pragmatic study was to examine strategies IT security professionals working on internet banking platforms use to mitigate identity-based authentication attacks. The study participants comprised five IT security professionals currently working in the online banking industry from the northeastern United States with at least 5 years of experience …

Risk Factors Associated With Type 2 Diabetes Among Adults In Alabama, Peter Okeke

Walden Dissertations and Doctoral Studies

In the 21stcentury Diabetes mellitus is recognized as one of the most important public

health challenges that carry a substantial individual and community burden.

It is necessary to do a detailed search regarding DM2 from adolescence till adulthood is in

Alabama which should aim to provide recent information. T2D is influenced by a many

factors including demographics including age, sex, income level, educational, BMI,

physical activities, etc. Identification of the associated risk factors is very important to

inform decision making by concerned bodies and T2D management. The study aimed to

examine the risk factors associated with T2D in adults aged …

The Experience And Perception Of Contraceptive Use Among Teenage Girls Living In Lagos, Nigeria, Kikelomo Omotoso

Walden Dissertations and Doctoral Studies

AbstractThere is a low level of contraceptive use among Nigerian teenagers, leading to unwanted pregnancies and subsequently unsafe abortions. Sexual activities among teenagers in Lagos, Nigeria, are a major public health problem. The principal factors leading to this health problem are poverty, peer pressure among university students leading to involvement in the sex trade, and early marriage in some cultures. There are myths and perceptions about the use of contraception in society, especially concerning the use of condoms, which Nigerian teenagers believe do not make intercourse interesting or satisfying; these ideas can lead to unwanted pregnancies, sexually transmitted infections (STIs), …

Relationship Between Cost, Schedule Overruns, And Project Success In The Nuclear Construction Industry In The United Kingdom, Adesegun Francis Osadare

Walden Dissertations and Doctoral Studies

Failure to achieve project success due to cost and schedule overruns may negatively affect an organization's financial strength, profitability, and competitive advantage. Organizational leaders must constantly monitor and control projects throughout the life cycle to reduce the impact of cost and schedule overruns and ensure project success. Grounded in the triple constraint model, the purpose of this quantitative correlational study was to examine the relationship between cost, schedule overruns, and project success. Data were collected from 66 project managers, project directors, project control, delivery integration managers, and construction project planners. The multiple linear regression analysis results were significant, F (2,63) …

Successful Recruitment And Retention Strategies Used By Logistics Hiring Managers, Anna Ouattara

Walden Dissertations and Doctoral Studies

Employee turnover results in increased employers’ costs and a decrease in profitability. Transportation hiring managers who lack strategies to recruit and retain employees risk higher employee turnover, resulting in reduced profitability. Grounded in Herzberg’s two factory theory, the purpose of this qualitative multiple case study was to explore strategies transportation hiring managers use to recruit and retain employees to reduce employee turnover and improve profitability. The participants were three transportation hiring managers from three transportation companies in Eagan, Minnesota, who successfully implemented strategies resulting in employee retention. Data were collected using semi-structured interviews and a review of company documents. Data …

Non-Disclosure Of Child Sexual Abuse: The Lived Experience Of Victims In South Africa, Chima Obiora Ozor

Walden Dissertations and Doctoral Studies

Child sexual assault (CSA) has been reported all over the world. Studies indicated that South Africa has one of the highest incidences with far reaching social, physical and emotional consequences. However, non-disclosure is common, which increases the risk of revictimization. Understanding the complexities surrounding the low reporting and non-disclosure will provide guidance for better intervention of CSA in South Africa. This study explored the past experiences of adults who were sexually abused as minors, and how their experiences and outcomes may have been influenced by factors at the micro, meso, macro, and chrono-system levels of Bronfenbrenner’s social ecological model. The …

Reducing Racial Disparity Of Youths Referred To The Juvenile Center, Kimberly Paige

Walden Dissertations and Doctoral Studies

In 2018, The Juvenile Center in St. Louis, Missouri acknowledged that they needed to decrease the racial disparity in the numbers and percentages of Black youths who were overrepresented compared to White youths at the front-end intake step of the facility. The purpose of this qualitative study was to gain insight as to whether there were alternative actions for police officers after they arrested the youths but before they referred them to the front-end intake step of The Juvenile Center. The main method of collecting data was an ethnographic interview in the form of a questionnaire to gather the community …

Improving Advance Care Planning Among Native Americans, Jasjit Kaur Pataria

Walden Dissertations and Doctoral Studies

A staff education project was created in a tribal health system of primary care clinics to improve advance care planning (ACP) conversations between care providers and Native American tribal patients. ACP conversations and advance directive documentation occurrences were found to be low or negligible in the project site despite primary care clinics being an ideal place to start these conversations. The purpose of the staff education project was to improve the knowledge and attitudes of providers toward initiating ACP conversations in a rural underserved community of Native Americans. The knowledge-to-action model was used to frame the project. Pretests and posttests …

Relationship Between Nursing Staffing Hours (Rns & Lpns) And Covid-19 Mortality In Indiana Nursing Homes, Chirag Chandrakant Patel

Walden Dissertations and Doctoral Studies

During the COVID-19 pandemic, many nursing homes struggled to meet the needed staffing levels, compromising service delivery in health institutions across the United States. The disproportionate effect of COVID-19 on various health care institutions and staff-patient ratios rejuvenated discussions on the longstanding workforce challenges on quality care and outcomes. The purpose of this quantitative study was to evaluate the relationship between registered nurse (RN) staffing hours and COVID-19 deaths in Indiana private and public nursing home residents based on the data obtained in the Care Compare database and Indiana Department of health COVID-19 portals. The independent study variables were RN …

Endarkened Joy: A Black Woman’S Critical Autoethnography Of (Re)Membering Self Through Generational Tales Of Spirituality, Social (In)Justice, And Education, Rhemma D. Payne

Walden Dissertations and Doctoral Studies

Counselor education lacks representation and visibility of Black women and women of color scholars and professionals despite ongoing efforts to promote cultural diversity and inclusion within the field. Researchers have explored the externalized stereotypes of identity for Black women; however, little is known about the internalized beliefs of these stereotypical identities and the impact on advocacy and (un)wellness in academic settings. The purpose of this critical autoethnography was to present an insider’s view of a Black woman’s nuanced experiences of internalization of stereotypes while completing a counselor education doctoral program. Using an endarkened feminist onto-epistemological framework to guide the research, …

Challenges And Opportunities For Implementing Sustainable Wind Strategies In The Dominican Republic, Virgil J. Perez

Walden Dissertations and Doctoral Studies

The difficulties utility managers in the Dominican Republic have implementing sustainable wind strategies threaten the ability to diversify the energy supply and reduce dependence on imported fuels. Grounded in Rogers’s diffusion of innovation theory, the purpose of this qualitative single case study was to explore strategies utility managers use to implement renewable wind energy in the Dominican Republic. The participants were five wind energy managers in the Dominican Republic. Data were collected using semistructured, face-to-face interviews and a review of company documents. Three themes emerged through thematic analysis: deconstructing the existing regulatory legal framework for renewable energy development, the fusion …

Perspectives Of Adult Esl Teachers On The Use Of Direct Vocabulary Instruction With Adult Ells, Erica N. Pettis

Walden Dissertations and Doctoral Studies

AbstractWith the growing number of non-native English speakers, improving communication through direct vocabulary instruction (DVI) is important. The problem investigated in this study was that English as a second language (ESL) teachers were not using the strategy DVI, in the ESL classroom. The purpose of this basic qualitative study was to explore ESL teachers’ perspectives about DVI for adult English language learners (ELLs) in a Midwestern state. The conceptual framework was drawn from Vygotsky’s constructivist theory because ESL teachers construct meaning from their experiences and what they have learned about vocabulary to improve reading comprehension for adult ELLs. The research …

Health Responsibility In Community College Students, Christine Phillips

Walden Dissertations and Doctoral Studies

Community college students are less healthy than 4-year college students, and they tend to have a higher allostatic load than their 4-year counterparts. Although research demonstrated that community college students are at greater risk for physical and mental illness, a better understanding of how community college students perceive their health responsibility was needed. A basic qualitative approach was employed to study how community college students experience health responsibility. Self-determination theory and the health belief model were used to guide the development of a semistructured interview and analysis plan. Thirteen adult credit-seeking students were interviewed. Data were analyzed using a top-down …

Resilience Of Former Offenders Released From A Halfway House, Tasha Andrea Pritchett

Walden Dissertations and Doctoral Studies

Former offenders confront a myriad of obstacles that often lead to re-offending and return to prison. Re-offending also creates financial and social burdens for taxpayers. There is some evidence that the consequences of incarceration for offenders can be buffered through resilience. Factors that promote resilience can be personal (internal) and environmental (external), and may directly or indirectly affect offenders’ adaptation, well-being, and development as they transition out of prison. The purpose of the study was to explore the narratives of resilience in adult males who have transitioned from halfway houses to mainstream society. Richardson’s metatheory of resilience and resiliency was …

Stories Of Adults Experiencing Overweight Or Obesity With Histories Of Childhood Adversities, Megan Propps

Walden Dissertations and Doctoral Studies

More than half the population in and outside of the United States experience childhood adversity, which is associated with the risk of developing obesity and overweight problems across the life span. In the United States, overweight affects 73.6% of adults, obesity affects 42.5% of adults, and both are considered a major public health concern. With this qualitative study, 18 adults with early life adversities were explored as to how experience weight loss treatment within their primary care. This narrative inquiry was designed to answer the research questions intended to explore physical health, mental health, and socio-environmental aspects of their stories, …

Beliefs, Skill Sets, And Behaviors Of Police Officers Regarding Mental Health Treatment, Kareem C. Puranda

Walden Dissertations and Doctoral Studies

Current law enforcement training assumes that police officers can manage their mental health with minimal support. This cultural attitude creates a fear of being unfit if police officers seek assistance for their mental health. Law enforcement suicide rates have outnumbered duty-related deaths in recent years. Statistics show that police officers are twice as likely to die by suicide for reasons related to stress. Mental health treatment is the ideal solution, but research has shown that police officers often reject treatment due to stigma. This qualitative study aimed to examine factors that hindered law enforcement officers from obtaining mental health treatment. …

The Experiences Of Female Survivors Of Sexual Assault When They Make A Police Report, Tracy L. Rainey

Walden Dissertations and Doctoral Studies

Nearly 20% of all women will be the victim of an attempted or completed sexual assault within the United States, yet less than one quarter of victims will report their experienced crime to law enforcement (LE). Many survivors of sexual violence experience apprehension about reporting sexual assault, due to fear of social consequences, relational consequences, and fear of the reprisal from LE officers. The purpose of this interpretive descriptive qualitative study was to describe and interpret the experiences of adult, female sexual assault survivors when they make a LE report about their victimization. Resilience theory, which is the study of …

Staff Nurses Lack Of Knowledge And Opioid Use At The Veteran Administration, Cathy J. Ramey

Walden Dissertations and Doctoral Studies

AbstractStaff Nurses’ Lack of Knowledge and Opioid Use at the Veteran Administration By Cathy Ramey

MS, University of Phoenix, 2014BS, Chamberlain University, 2008

Dissertation Submitted in Partial Fulfillment Of the Requirements for the Degree of Doctor of Nursing Practice

Walden University November 2022

Abstract Opioids are often prescribed for pain management, which may have led to high rates of opioid addiction among veteran populations. The problem identified in this DNP project was the nurses’ lack of knowledge regarding pain management and the use of opioids in the veteran’s (VA) hospital where the project commenced. Using the Analyse, Design, Develop, Implement, …

The Relationship Between Work Engagement, Burnout, And Employee Turnover Intention, Lannita J. Randle

Walden Dissertations and Doctoral Studies

Employee turnover can cost an organization 30% to 250% of a worker’s annual compensation to replace and train an employee. Understanding employee intent to leave is vital for human resource managers in the field service industry to help reduce turnover. Grounded in Alderfer’s Existence, Relatedness, and Growth (ERG) theory, the purpose of this quantitative correlation study was to examine the relationship between work engagement, employee burnout, and employee turnover intention in the field service industry. The participants were 169 full-time service repair employees residing in the metropolitan Houston, Texas area who completed the Utrecht Work Engagement Scale, Maslach Burnout Inventory, …