Digital Commons Network^™

Changes In Operating Performance In Rural Hospitals From 2012 To 2019, Oluwaseyi Tami Young-Harry

Walden Dissertations and Doctoral Studies

Rural hospitals treat patients while dealing with the challenges of an inadequate workforce, limited financial resources, and an isolated geographic location, leading to difficulties in achieving financial viability. The purpose of this quantitative study was to analyze the operating performance of rural, general, medical and surgical hospitals in the United States and to determine if performance had changed from 2012 to 2019. Guided by x-efficiency theory, this study addressed whether hospital ownership explained variation in performance and if performance had changed from 2012 to 2019. A random sample of 394 rural hospitals was used, with data drawn from the American …

Registered Nurse Engagement And Patient Falls In The Acute Care Setting, Jenna Zaliauskas

Walden Dissertations and Doctoral Studies

Falls are a critical problem for inpatient medical-surgical adult patients. Past research has indicated a link between nurse disengagement and unsafe care. The purpose of this study was to improve the understanding of the relationship between nurse engagement and patient falls with injury on medical surgical units in health care facilities in the United States using the National Database of Nursing Quality Indicators. Retrospective data were reviewed from 13 U.S. hospitals in the Midwest covering Q1 (2018) and Q2 (2018) on medical-surgical units related to nurse engagement and patient falls. A correlational and MANOVA design was used to determine the …

Impact Of Medicare Utilization On Mortality And Readmission Rates Of Heart Failure Patients 65 Years And Over, Joanna Alexander

Walden Dissertations and Doctoral Studies

Roughly 25% of individuals 65 years and over hospitalized with heart failure are readmitted within 30 days after discharge. Elderly individuals identified with heart failure possess a 5-year mortality approaching 50%. The purpose of this study was to determine if there is a relationship between Medicare-covered services for care, mortality rates, and readmission rates for beneficiaries 65 years and over with heart failure. To address this topic, the chosen approach was retrospective and quantitative. The theoretical foundation was the Chronic Care Model. The research questions sought to determine if there is a relationship between the Medicare-covered services for care and …

Countering Violent Extremism: U.S. Foreign Policy And The Trans-Sahara Counterterrorism Partnership, Jason S. Alexander

Walden Dissertations and Doctoral Studies

For over two decades, preventing and countering violent extremism (P/CVE) has proven a daunting challenge for foreign assistance policy makers and implementers. The challenges are rooted in its rapid emergence, continuous and uneven development, and lingering skepticism about its future and effectiveness. The purpose of this study is to provide policy makers and practitioners with a deeper understanding of how certain factors have driven the development of P/CVE policy. The research questions focused on the nature of policy alignment at all policy levels and the identification and nature of the factors that have driven rapid P/CVE policy change. The theoretical …

An Examination Of The Gestalt Group Process Using The Online Group Environment, Montrea Arndt-Verlander

Walden Dissertations and Doctoral Studies

Social media communications provides alternatives to healthcare by presenting a platform to the public, patients, and healthcare professionals as a way to communicate health issues that could improve health outcomes (Ramezanhani, Yadegarynia, Dorodgar & Arab-Mazar, 2019). These findings suggest that there is a need for studies regarding the psychological effects of taking part in social media platforms. This phenomenological study explored lived experience involving group member support received in the online environment and the opportunity that they were afforded to experiment with feedback to gain awareness of self via blogging. The conceptual framework was Beisser's paradoxical theory of change. The …

Faith, Medication Adherence, And Cardiovascular Disease Among African American Churchgoers, Linett Lorain Brice

Walden Dissertations and Doctoral Studies

Getting African Americans to adhere to medical management strategies to reduce negative health outcomes of cardiovascular disease (CVD) and CVD risk factors may be challenging. The purpose of this cross-sectional quantitative study was to examine whether levels of faith in God's healing, when it comes to taking medications, was associated with medication adherence to hypertension and/or diabetes mellitus type 2 (DMII) medications, and whether those factors were associated with prevalence of CVD and uncontrolled symptoms of CVD risk factors, namely hypertension and DMII. Social cognitive theory provided the framework for the study. Data were collected from surveys completed by 102 …

Evaluating Expert Opinions For Reducing Voluntary Employee Absenteeism In Trinidad And Tobago, Brian Anthony Brown

Walden Dissertations and Doctoral Studies

Organizational leaders in Trinidad and Tobago are ill prepared to manage voluntary employee absenteeism due to the ineffectiveness of traditional approaches to curtailing voluntary employee absenteeism. The lack of consensus on desirable, feasible, and important strategies for minimizing voluntary employee absenteeism in Trinidad and Tobago created a scholarly gap. The purpose of this qualitative modified Delphi study was to determine how a panel of 17 Caribbean and global human resources experts view the desirability, feasibility, and importance of 50 forward-looking strategies in 6 overarching elements for minimizing voluntary employee absenteeism in Trinidad and Tobago. The research questions addressed this purpose. …

Quantitative Analysis Of Public Perceptions Of Female Sex Offenders, Michael Buckley

Walden Dissertations and Doctoral Studies

Public perception may have formed a consensus belief regarding sex offending. Males have considerably outweighed females with offenses, which may have created a bias against males. This study was a quantitative examination and review of the public's perceptions of female sex offenders (FSOs) as it related to their crimes and differences in sentencing when compared to male sex offenders (MSOs). There may be many reasons why females sexually offend, but there is a lack of understanding of these reasons and how FSOs are viewed by the public and the sentencing by the judicial system. The theoretical framework for the study …

Enhancing Leadership Strategies To Reduce Stress On Employees For Organizational Success, Reginald Wayne Butler

Walden Dissertations and Doctoral Studies

Organizational leaders' inability to effectively manage complexity and implement leadership development strategies during intense situations creates work-related stress among employees. Stress contributes to emotional disorders, decreased job performance, high staff turnover that place the organization's health in jeopardy. Grounded in the expectancy theory of motivation, the purpose of this qualitative single case study was to explore key leadership strategies to reduce stress in the workplace. The face-to-face, semistructured interviews were conducted with 3 senior leaders from a financial institution in the southern United States who had successfully implemented strategies that reduced stress on employees and improved their job performance. Their …

Transgender Protection And Best Practices In The Prison Setting, Jessica Renee Byrd

Walden Dissertations and Doctoral Studies

While the importance of equal protection for all offenders has been established, prison officials often do not provide adequate protection for or effectively address the unique needs of transgender inmates. In this qualitative action research study, prison officials' perceptions regarding their responsibility to provide protection and equal treatment to transgender offenders were evaluated as well as to what extent they are congruent with those stated in policies and procedures. The expectation was that linkages could be drawn between prison officials' level of knowledge regarding their responsibilities and the various types of maltreatment that transgender offenders experience as well as the …

Impact Of Progress Toward Degree On Major Selection For Division I Historically'€¯Black'€¯College'€¯And University Student-Athletes, April Alicia Chestnut

Walden Dissertations and Doctoral Studies

National Collegiate Athletic Association (NCAA) Division I student-athletes select or may change their majors to maintain participation eligibility in sports rather than focus on their specific academic interests. The purpose of this study was to gain a better understanding of the impact of progress towards degree (PTD) on the degree choices and perceived academic value of the degree received by student-athletes attending HBCUs. The study used Sabatier's and Jenkins-Smith's advocacy coalition framework. The research questions focused on the perceptions and lived experiences of student-athletes, athletic advisors, and athletic administrators on the impact of PTD on major selection. A researcher-developed interview …

Resources Needed By Transitional Participants For Independent Living, Odell Jonathan Cole

Walden Dissertations and Doctoral Studies

A lack of resources for youth making the transition from foster care into independent living is a significant issue in the United States. However, this lack of resources may be overcome through successful career pathway programs. The purpose of this case study was to explore which career pathway strategies are useful for an organization attempting to help young people make a transition into independence. During the developmental planning stage of the program, plans were put in place for a program to help young people find guidance in a career field as they learn to live on their own and become …

Instructor Beliefs Related To Technology Use After Professional Development, Bethany Ann Croton

Walden Dissertations and Doctoral Studies

Faculty in higher education often see themselves as researchers and identify less as instructors. The problem is that nearly every profession has embraced technology in new ways, except in the world of education and students need 21st-century skills to be competitive in the workforce. The purpose of this qualitative phenomenological study was to explore instructors' lived experiences and beliefs regarding teaching and technology integration before, during, and after completion of a professional development program at a Midwestern Tier 1 research institute. The study was framed by Rogers's diffusion of innovation theory and the sustainability education academic development framework. The research …

The Relationship Between Spiritual Intelligence And Organizational Identification: A Correlational Research Study, Paschal L. Dawson

Walden Dissertations and Doctoral Studies

Employees who have lower levels of organizational identification (OID) can exhibit negative perceptions of leaders and managers within the organization. Lower levels of OID can lead to adverse employee attitudes and behaviors. Grounded in the social identity theory and spiritual intelligence (SQ) construct, the research questions for this quantitative correlation study were to investigate the relationship between SQ and OID. A simple random probability sampling design was used to sample midlevel supervisors and frontline managers using online self-report surveys. A total of 74 midlevel supervisors and 76 frontline managers completed the Spiritual Intelligence Self-Report Inventory and Mael and Ashforth's OID …

A Health Care Management Organization's Internal Controls Strategy For Managed Care, Elizabeth E. David

Walden Dissertations and Doctoral Studies

A lack of effective operational internal controls among health management organization (HMO) leaders could lead to poor operational practices, mismanagement of the government's health care funds, increased health care spending, and a negative impact on patient health outcomes. Grounded in transformational leadership theory, the purpose of this qualitative, single case study was to explore successful internal control strategies used by leaders at a southeastern Pennsylvania HMO. Data were collected from semistructured interviews with 5 participants who held positions of director or above within the organization for at least 3 years, had institutional knowledge, and had responsibility for overseeing the organization's …

Stability Vs. Change In Catholic Schools, Susan Theresa Diverio

Walden Dissertations and Doctoral Studies

This study was an investigation of innovative practices based upon organizational learning and the life cycle in Catholic elementary and high schools. Limited research exists in the role that these factors play in Catholic school sustainability. The purpose of this study was to examine the relationship of organizational learning, as measured by the Organizational Learning Scale, and life cycle, as measured by Organizational Life Cycle 5-Scale on organizational innovation, as measured by the Organizational Innovation Scale. Organizational design framework, life cycle theory, and transtheoretical model of behavior provided the theoretical framework to investigate the relationship between organizational learning, life cycle …

Perceptions Of Stress And Coping In The First Year Of Police Work, Scott David Eaton

Walden Dissertations and Doctoral Studies

The pressures associated with a career in law enforcement are considerable and often result in significant detriment to an officer's personality, behavior, and overall mental health, ultimately impacting job performance and work engagement. Although there is extensive research on the influence of stress encountered in police work, an understanding of those stressors and ways of coping in the first year of police work has yet to be fully explored. The purpose of this study was to describe the lived experiences of 5 police officers who have been subject to stress in their first year and to identify the coping skills, …

Exploring A Pathway Out Of Poverty Using The Welfare System, Cadarrall A. Eddings

Walden Dissertations and Doctoral Studies

Individuals dependent on Temporary Assistance for Needy Families (TANF) encounter

multiple contributors that impede economic empowerment and a pathway out of poverty

that leads to self '€“ sufficiency. Previous research has not been fully clarified as to why

TANF has not been successful in moving recipients out of dependency and into lasting

economic success. The purpose of this phenomenological qualitative study was to

conduct a comparative analysis between two administrations, namely the Obama and

Trump administrations, concerning welfare policies. The human capital theory provided

the theoretical framework for the study. This study explored the lived experiences of

TANF recipients related …

The Nature And Effectiveness Of Supplemental Nutrition Assistance Program Fraud Detection Strategies In Baltimore County, Keena Esemuede

Walden Dissertations and Doctoral Studies

The frequent occurrences of fraud over the life of the Supplemental Nutrition Assistance Program (SNAP) have indicated a need for robust fraud detection strategies. This qualitative study explores the nature and effectiveness of current fraud detection strategies for the SNAP in Baltimore County during 2008-2018 to understand what strategies can possibly reduce fraud within the program. The primary methods of fraud (conceptual framework) and social disorganization theory (theoretical framework) were used to collect the data for this study. The data included interviews with 1 administrator and 3 store managers who oversee the SNAP in Baltimore County, as well as 5 …

Experiences Of Postpartum Women With Nurse-Delivered Education And Postpartum, Krystal Evans

Walden Dissertations and Doctoral Studies

Postpartum depression affects many women globally, yet largely remains underdiagnosed. It is thus important for nurses to have all available tools when delivering education and care to the postpartum patient. Yet, there is a lack of information on the experiences of postpartum women related to postpartum education and postpartum depression. The purposes of this quantitative study, for which Beck's postpartum theory was the framework, were to explore postpartum women's perceptions of education experiences and to determine if a correlation exists between the satisfaction with education and scores on the Edinburgh Postnatal Depression Scale. Sixty study participants who were 6-8 weeks …

Improving Rabies Aftercare By Educating Emergency Department Providers Of Care, Gloria Denise Evans

Walden Dissertations and Doctoral Studies

According to an evaluation completed by the local health department in the state where the project was conducted, patients were not returning to the emergency department (ED) for post-exposure prophylaxis (PEP) rabies vaccine as recommended. Educating the ED providers on care, who are usually the first point of contact after an animal bite with possible rabies virus transmission, is critical to improving patients' outcomes secondary to rabies postexposure. The focused for this project is educating ED personnel about rabies PEP administration after rabies virus exposure which will their increase knowledge regarding rabies follow-up care. Lewin's change theory provided the theoretical …

Strategies Small Business Leaders Implement For Outsourced It Solutions For Business Sustainability, Jessica A. Folkes

Walden Dissertations and Doctoral Studies

Small businesses in the United States have a high failure rate within their first 5 years of operation. Small business success is vital to the economy because it drives revenue, income, and job creation. Grounded in rational decision-making theory, the purpose of this qualitative multiple case study was to explore strategies small business owners and leaders implement for effective outsourced IT solutions for business sustainability. Data were collected from in-depth interviews with 10 purposefully selected business owners and leaders in the Houston, Texas, metro area and from a review of documentation from archival records. Yin's 5-step analysis guided the coding …

Formerly Incarcerated Students Returning To School, Robert Earl Gaines

Walden Dissertations and Doctoral Studies

Formerly incarcerated Grade 10'€“12 students in an urban high school in the Southern United States were dropping out at an elevated rate from August 2010 through May 2017. The purpose of this qualitative descriptive study was to gain an understanding of teacher, parent, and academic advisor perceptions of the challenges experienced by Grade 10'€“12 students who had been incarcerated and then returned to a traditional school environment and support services and resources needed to assist with these challenges. Hirschi's social control theory guided this study, which describes 4 elements missing from individuals participating in criminal activity: attachment, commitment, involvement, and …

An Interpretive Phenomenological Analysis Of Teachers' Perspectives Of Differentiated Instruction In K-3 Inclusion Classrooms, Julie Franklin

Walden Dissertations and Doctoral Studies

Researchers have addressed teachers' perspectives of differentiated instruction or teachers' perspectives on inclusion classrooms, but there was limited research on the combined topics of teachers' perspectives of differentiated instruction in inclusion classrooms. This interpretative phenomenological analysis used one to one interviews and reflective journals to explore nine teachers' perspectives of differentiated instruction in K-3 inclusion classrooms. The study's conceptual framework was comprised of Vygotsky's social constructivist theory and Piaget's theory of cognitive development. The research question and sub-questions asked about the challenges and successes teachers encountered in planning and implementing differentiated instruction in K-3 inclusion classrooms, and what teachers believed …

Stress And Wellness Among Municipal Law Enforcement Officers In Southeastern Virginia, Russell Morgan Granderson

Walden Dissertations and Doctoral Studies

Municipal law enforcement officers contend with unique occupational stressors. They must overcome stress from their employing agency and the pressures that arise from performing their basic enforcement duties. This study was designed to examine how municipal law enforcement officers in southeastern Virginia perceived their agency's wellness policy and to determine what recommendations they had to improve the effectiveness of the current wellness policy. Lazarus and Folkman's theory of cognitive appraisal and coping served as the theoretical framework for the study. Qualitative inquiry was used to examine the perceptions of 15 purposively sampled law enforcement officer participants. The data were then …

Secondary Teachers' Perceptions Of The Implementation Of Response To Intervention, Patricia Denise Hampton

Walden Dissertations and Doctoral Studies

Teachers at a local high school in Alabama were struggling to implement the tiered interventions of the response to intervention (RTI) model. The purpose of this qualitative case study was to explore teachers' perceptions of the implementation of RTI at one high school to help teachers and administrators understand what professional development training, supports, and resources were needed to implement the model effectively. The concerns-based adoption model, which examines educators' concerns with new educational innovations, framed the study. The study's research questions focused on the teachers' perceptions, concerns, and required resources needed to implement the program as intended. The participants …

Autism Spectrum Disorder And The Impact Of Attachment Behavior Toward Therapeutic Staff Support, Karen Kotchik Hughes

Walden Dissertations and Doctoral Studies

Research has indicated that levels of attachment behavior by individuals with intellectual disability toward professional staff in a residential setting prevent dysregulated behavior. Although challenging behaviors are not part of the diagnostic criteria for an ASD, these behaviors are frequently observed in the forms of property destruction and disruptive/aggressive behaviors. The purpose of this study was to examine the attachment relationship of individuals diagnosed with an autism spectrum disorder (ASD) toward the therapeutic support staff (TSS) assigned to their case as indicated by the display of challenging behaviors (self-injurious, stereotypical and aggressive behavior). Levels of attachment were measured by the …

User Perception Of The U.S. Open Government Data Success Factors, Joy Alatta

Walden Dissertations and Doctoral Studies

This quantitative correlational study used the information systems success model to examine the relationship between the U.S. federal departments' open data users' perception of the system quality, perception of information quality, perception of service quality, and the intent to use open data from U.S. federal departments. A pre-existing information system success model survey instrument was used to collect data from 122 open data users. The result of the standard multiple linear regression was statistically significant to predict the intent to use the U.S. open government data F(3,99) = 6479.916, p <0.01 and accounted for 99% of the variance in the intent to use the U.S. open government data (R²= .995), adjusted R²= .995. The interdependent nature of information quality, system quality, and service quality may have contributed to the value of the R². Cronbach's alpha for this study is α=.99, and the value could be attributed to the fact that users of open data are not necessarily technical oriented, and were not able to distinguish the differences between the meanings of the variables. The result of this study confirmed that there is a relationship between the user's perception of the system quality, perception of information quality, perception of service quality, and the intent to use open data from U.S. federal departments. The findings from this study might contribute to positive social change by enabling the solving of problems in the healthcare, education, energy sector, research community, digitization, and preservation of e-government activities. Using study, the results of this study, IT software engineers in the US federal departments, may be able to improve the gathering of user specifications and requirements in information system design.

Posttraumatic Stress Disorder Rates Among Children In Foster Versus Family Kinship Care, Rashanda Allen

Walden Dissertations and Doctoral Studies

Children in foster care represent a highly traumatized population. However, trauma researchers studying this population have focused primarily on maltreatment rather than the full spectrum of posttraumatic stress disorder (PTSD) attributes and symptoms for children living in nonkinship foster homes versus kinship foster homes. The purpose of this study was to address this gap in the literature, as well as examine the benefits and limitations of children placed in kinship and nonkinship foster homes. Attachment theory was the theoretical framework. The research questions centered on the prevalence of specific types of posttraumatic stress symptoms for a sample of children living …

Financial Sustainability Strategies Of Religious Nonprofit Organizations, Erica Illauna Allen

Walden Dissertations and Doctoral Studies

The percent of religious nonprofit organizations (RNOs) facing uncertainty in operational capital and resources will rise as government funding diminishes. The RNOs that struggle to maintain a competitive advantage are at high risk of failure. Grounded in the resource-based view theory, the purpose of this qualitative multiple case study was to explore funding strategies leaders of RNOs use to achieve financial sustainability beyond the first 5 years of operation. Participants were 3 leaders of RNOs in Middle Tennessee with successful experience in applying funding strategies that increased revenue year-over-year while serving their constituencies. Data sources included face-to-face interviews and organizational …