Digital Commons Network^™

Medical Marijuana Policy Conflicts Within The District Of Columbia Private Workplace, Robert B. Kennedy

Walden Dissertations and Doctoral Studies

The District of Colombia poses a unique challenge to private employers because the passage of a local medical marijuana policy was instituted in a federalized district that is obligated to abide by federal Schedule 1 narcotic laws. Using punctuated equilibrium as the theoretical foundation, the purpose of this case study was to understand how managers maintain compliance and address the conflict between different levels of government. Data were collected from interviews with 8 private industry hiring personnel who operate within the District of Columbia. These interviews were transcribed, inductively coded using a 2 cycle coding procedure, and then subjected to …

Socioeconomic Determinants Of Physical Activity Among Adult Arab Immigrants In Edmonton, Alberta, Samer Kobrosly

Walden Dissertations and Doctoral Studies

Little is known about leisure-time physical activity (LTPA) habits of Arab immigrants in Canada. Leisure-time physical activity has been linked to decreased risks for cancer, cardiovascular disease, and all causes mortality and increased life expectancy. Socioeconomic status has been recognized as a significant factor affecting health and wellbeing due to its impact on individuals’ attitudes, experiences, and exposure to several risk factors. The purpose of this cross-sectional descriptive study was to explore the levels of participation in LTPA among adult Arab immigrants in central Alberta, Canada, to examine the socioeconomic determinants of LTPA, and to investigate which individual, social, and …

Affordable Care Act And Racial Inequity In Breast Cancer Survival Rates, Nadine Terry-Lawrence

Walden Dissertations and Doctoral Studies

African American women are more likely than White women to be diagnosed with breast cancer after the disease has progressed to advanced stages. Further, African American women experience higher breast cancer mortality rates than White women at all stages of cancer diagnosis. The purpose of this quantitative comparative study was to examine differences between implementation of the Affordable Care Act (ACA) and 5-year breast cancer survival rates among African American and White women. The independent variable was African American women and White women who were survivors of breast cancer after the ACA implementation; the dependent variables were breast cancer survival …

Civility Promotion Actions And Decisions Of Prelicensure Baccalaureate Nurse Faculty, Brooke Stelle Russo

Walden Dissertations and Doctoral Studies

Acts of incivility in nursing education and practice settings are a growing concern. Previous research has indicated that uncivil behaviors, especially among nurses in the healthcare workplace, create toxic work environments and pose risks to patient safety. Uncivil behaviors among nurse educators and students were found to erode the learning environment and lead to poor program outcomes. Researchers provided evidence to show varied levels of incivility in academic and workplace environments and recommended solutions to improve civility, yet little evidence exists to show how nurse faculty approach civility promotion in their practices. This qualitative, descriptive study was designed to explore …

Parental Perception Of Physician Cultural Sensitivity And Adherence To Asthma Treatment, Narue Jaynelle Wright-Jegede

Walden Dissertations and Doctoral Studies

In the United States, asthma remains a major cause of frequent urgent care visits, hospitalizations, and preventable deaths among children. Nationwide, the chronic disease continues to fall disproportionately on minorities, mostly residing in urban localities. When a child is diagnosed with asthma, the parents are typically tasked with managing the child's condition. Establishing a collaborative partnership between parents and their child's primary physician is significant for improving asthma self-management among youth. Using the theory of reasoned action as a theoretical framework, this mixed-methods study examined whether a relationship exists between parental perceptions of physician cultural sensitivity and parental care in …

How People With Multiple Sclerosis Experience Web-Based Instructional Technologies, Gary Eugene Deroest

Walden Dissertations and Doctoral Studies

People with the autoimmune disease multiple sclerosis (MS) have few options for

educational activities. Although web-based instruction may be a viable option, little is known about how people with MS perceive this form of learning. The purpose of this qualitative study was to understand the experiences of people with MS regarding web- based instruction. The 3 learning structures--differentiated instruction, collaborative learning, and assistive technology--provided the conceptual framework for this research. Nine volunteers from the Pacific Northwest area of the United States who have MS were individually interviewed for this basic qualitative study. Transcripts were analyzed using open, axial, and selective …

Effect Of Hot Spot Policing On Reducing Officer Stress, Alfred Henry Hollie

Walden Dissertations and Doctoral Studies

Police officers endure various threats ranging from verbal abuse to physical attacks, which can escalate and lead to police officer stress. Despite the abundant research exploring the relationship between high-stress occupations and environmental health, adequate exploration of the relationship between officer stress and hot spot policing (HSP; area with an above-average level of crime) has yet to occur. The purpose of this correlational study was to use Cohen and McKay's conceptualization of the stress-buffering hypothesis to explore whether HSP mitigates the negative impact of job stress, leading to improved officer performance and ultimately improved relationships between the police and communities …

Strategies To Improve Small Business Sustainability, Tywon Guy

Walden Dissertations and Doctoral Studies

Small businesses are considered the backbone of the U.S. economy with significant contributions in the areas of job creation and economic development. However, 79% of small businesses fail within the first 5 years. This multiple case study aimed to explore strategies and knowledge of resources that owners of small businesses used to sustain business operations for longer than the first 5 years. The population included 5 minority owners of small businesses in Texas. Chaos theory formed the conceptual framework. The data collection process included semistructured interviews, member checks, field notes, company artifacts, and archival documents. Data were analyzed using Yin's …

Globalization Of Clinical Research And Assessment Of Global Access To Treatments Approved Between 2006-2015, Rafael Duncan Escandon

Walden Dissertations and Doctoral Studies

Globalization in clinical research and development has increased since the 1990s. Products approved in the United States (U.S.) and European Union (EU) include increasing numbers of research participants from low- and middle-income countries. The purposes of this quantitative correlational study were to investigate the lag time, or drug lag, between U.S. approval and the approval of selected drugs in all countries that hosted their pivotal clinical trials. The study population was limited to products approved first in the U.S. between 2006 and 2015. The health capability model and research for health justice framework were the theoretical frameworks for the study. …

Connecticut Primary Care Physicians And Chronic Lyme Disease, Yvette P. Ghannam

Walden Dissertations and Doctoral Studies

The prevalence of chronic Lyme disease (CLD) remains relatively unknown in Connecticut because there is not an agreement on what CLD is and how it should be diagnosed in addition to which pathological agent causes CLD. The aim of this quantitative study was to assess whether there were significant differences between two groups of primary care physicians (PCP) working in Connecticut from two different points in time regarding their knowledge in the diagnosis, treatment, and management of CLD. A knowledge, attitude, and practice model was used as the underlying theoretical framework for this study. A random cross-sectional survey was mailed …

Academic Accountability Between Charter And Public-School Principals In New Jersey, Nicole Goodman

Walden Dissertations and Doctoral Studies

The purpose of this study was to explore school principals' accountability with student academic performance. Charter and public-school principals are responsible for the learning process and academic development. Previously published literature did not reveal a clear understanding of the policies and practices that contributed in obtaining the desired student academic outcomes. Parsons's theory of action served as the foundation for analyzing principals' decisions to achieve accountability and comply with the policies established by the regulating authorities. A snowball sampling of school principals included a public charter school principal and 5 traditional public-school principals in the state of New Jersey. A …

An Ecological View Of Urban Kindergarten Reading Instructional Practices, Deborah Ann Clark

Walden Dissertations and Doctoral Studies

Kindergarten students who are identified as at risk in reading often enter school with deficiencies in early reading skills. Little research exists for this vulnerable population on reading instruction in large, urban, school systems. The purpose of this multiple case study, which was guided by Bronfenbrenner's ecological theory of human development, was to describe urban kindergarten teachers' beliefs about the environmental factors that contribute to students' at-risk reading status, instructional practices employed to remediate reading, and teacher reports about systems in place to support student reading development. The multiple case study design included (a) structured interviews, (b) observations of kindergarten …

Cardiovascular Exercise Participation And Obstructive Sleep Apnea Among Adults Over Normal Weight In The United States, Marytherese Agwara

Walden Dissertations and Doctoral Studies

Obstructive sleep apnea (OSA) is a type of sleep apnea that is common, complicated, and a major contributor to cardiovascular diseases, neurocognitive impairment, and mortality. This disease has additional negative impacts on patients' lives by contributing to daytime sleepiness and low productivity at work as well as absenteeism and work-related injuries. Several studies have been conducted to assess the relationship between cardiovascular exercises and OSA; however, a definite conclusion is lacking. The purpose of this quantitative cross-sectional study was to assess the relationship between cardiovascular exercise participation and OSA by examining the relationship between total cardiovascular exercise participation per week …

Effects Of Canines On Humans' Physiological And Perceived Stress, Beth Marie Bowin

Walden Dissertations and Doctoral Studies

The bond between pet and owner has been shown to decrease stress-related physical, mental, and emotional disorders by lowering blood pressure and heart rate. The purpose of this study was to examine whether a nonpet canine would have the same effect in reducing physical symptoms of stress as a known dog. Human-animal bond theory, Human pressor test. Data were analyzed using repeated measures, analyses of variance, and t tests. Results indicated that interaction with a strange dog lowered heart rate and blood pressure significantly faster in the experimental group than in the control group. The positive social change implications of …

Exploring The Ethical Leadership Of Bank Managers, Jeannette Devine

Walden Dissertations and Doctoral Studies

Ethical dilemmas in banks have resulted in financial losses. A bank manager's ethical leadership strategy can affect the direction, success, operations, and profits of banks. The purpose of this multiple case study was to explore the ethical leadership strategies of bank managers that promoted profitability. This study's conceptual framework was Bandura's social learning theory. Data were collected from semistructured, face-to-face interviews with a sample of 2 bank managers from different Maryland banks and a review of these banks' documents. Member checking was conducted to verify the trustworthiness of the findings. Data were analyzed using Yin's 5-step approach. Themes that emerged …

Characteristics Of Young People Seen In The Emergency Department For Assault-Related Injuries, Robyn Coons

Walden Dissertations and Doctoral Studies

Violence is among the most serious threats to the health and safety of young people between the ages of 10 and 24 in the United States. The purpose of this cross-sectional quantitative study using secondary data from the CDC's 2015 National Hospital Ambulatory Medical Care Survey (NHAMCS) data set was to examine the characteristics (age, sex, race and ethnicity, insurance or payer source, and housing status) of young people between the ages of 10 and 24 who seek medical care for assault-related injuries through the emergency department (ED). The social ecological model was used to examine the complex interplay between …

Development Of A Standardized Oral Care Staff Education Program, Katrina Detoye

Walden Dissertations and Doctoral Studies

Hospital-acquired infections such as nonventilated hospital-acquired pneumonia (NV-HAP) are significant patient safety concerns. The lack of oral care in the nonventilated acute care patient population is a major contributor to NV-HAP. Nursing staff are on the frontline in the provision of oral care to hospitalized patients, but a lack of knowledge regarding the relationship between oral care and NV-HAP was identified as a gap in practice at the project site. The purpose of the project was to develop a staff education program on oral care of the nonventilated patient population. The practice-focused question addressed whether an evidence-based education for nurses …

The Experiences Of Witnesses To Prison Sexual Violence: A Case Study, Edyth Zada Hendricks

Walden Dissertations and Doctoral Studies

Prison sexual violence is prevalent and impacts the witnesses to it. Previous literature has fully discussed the victims of prison sexual violence; however there remains an important gap in the current literature regarding the experiences of witnesses. The purpose of the present qualitative case study was to explore the lived experiences of witnesses to prison sexual violence. The theoretical foundation of this study was the self-categorization theory linked to the prison code of silence. Four ex-inmates answered semi structured interview questions. Transcripts were coded and themes developed. Five themes that emerged were exposure (to prison sexual violence), ineffective guards, avoidance …

Perceptions Of Online Cheating: Impact Of Age, Gender, And Sexual Preference, Rosanna Helen Kallay

Walden Dissertations and Doctoral Studies

The current quantitative study examined perceptions of online infidelity using ANCOVA calculations to determine if significant differences existed between variables of gender, age, orientation. The study considered the applicability of sexual strategy theory (SST) in today's culture and whether it remains relevant in current to today's relationships. SST and previous research suggested a clear trend in differences in perceptions of infidelity based on gender and age, with more mixed results in differences based on sexuality. This study expanded previous research by surveying 148 younger and older demographics, as well as men and women who are in opposite-sex and same-sex relationships. …

A Comparison Of Motivational Differences Among Older Marathon Runners And Their Injury Status, Marsha Renee Kaufman

Walden Dissertations and Doctoral Studies

Despite the high occurrence of running-related injuries, master level runners, those aged 40 years and older, account for 50% of all marathon finishers. What is not known is the common motive sustaining participation, especially among this age demographic. The self-determination theory was the theoretical framework to support how behavior is regulated by the individual. The purpose of this quantitative research was to identify a difference in the motives (psychological, physical, social, and achievement) and their subcategorical motives (health orientation, weight concern, affiliation, recognition, psychological coping, life meaning, self-esteem, competition, and personal goals) via the Motivations of Marathoners Scales by master …

Evaluation By Geospatial And Spatiotemporal Distribution Of Tularemia Cases In Arkansas, Toni Kathleen Beavers

Walden Dissertations and Doctoral Studies

Tularemia is a vector-borne disease of global concern with diverse regional foci. Arkansas is an endemic state with differences in case distribution and land suitability supporting host and vector sustainment. The aim of this study was to conduct a geospatial and spatiotemporal assessment of factors associated with case distribution and timeliness and completeness of public reporting. Guided with direction from spatial epidemiology and nidality, referring to the association of ecology, climate, and proximity of disease, analysis included secondary data collected from the Arkansas Department of Health between 1995 and 2018. Using Poisson-based software, 2 clusters were found: a high-risk cluster …

Extent, Correlates, And Consequences Of Careless And Inattentive Responding In Certification Job Analysis Surveys, Patricia M. Muenzen

Walden Dissertations and Doctoral Studies

Survey data quality is influenced by the care and attention that respondents take in answering questions. Careless and inattentive (CI) responding is a confound in survey data that can distort findings and lead to incorrect conclusions. This quantitative study explored CI responding in job analysis studies supporting occupational certification programs and its relationship to survey features, data quality measures, and test content validity. Satisficing theory served as the framework, and secondary analysis of 3 job analysis surveys was undertaken. Results indicated that 9-33% of respondents engaged in CI responding, with the rate differing by CI index used (Mahalanobis distance, long …

Pull And Push Factors That Influence A Student's Decision To Drop Out Of School, Monica Ruth Rouse

Walden Dissertations and Doctoral Studies

The high school dropout rate in the United States has historically been and continues to remain a persistent concern. The dropout epidemic has primarily been studied through a quantitative lens focused on the final decision to dropout rather than the complex sequence of events that factor into the dropout decision. The purpose of this study was to explore the pull/push factors that influenced a student's decision to drop out of high school. In this qualitative study, attention was given to both understanding how students described their reasons for dropping out of school and identification of any factors that could have …

The Impact Of Service Dogs On Combat Veterans With Posttraumatic Stress Disorder, Christine R. Hansen

Walden Dissertations and Doctoral Studies

Combat veterans with posttraumatic stress disorder (PTSD) related symptoms often require the use of complementary therapeutic aids, such as service dogs, to assist them in their recovery in addition to traditional evidence-based therapy. Anecdotal literature was available on the use of service dogs, but quantitative research has not been conducted to answer the question of what the impact was of the use of service dogs on reducing symptoms of PTSD among combat and non-combat veterans. Attachment theory was one of the most common theoretical frameworks for exploring the use of service dogs for treating combat PTSD. The theoretical framework for …

Strategies Outpatient Health Care Executives Use To Reduce Physician Turnover, Maureen A. Onyenacho

Walden Dissertations and Doctoral Studies

Some outpatient health care executives experience high physician turnover leading to increased costs. To retain highly productive physicians, outpatient health care executives need to understand the best strategies for reducing physician turnover. Grounded in Herzberg 2-factor theory as the conceptual framework, the purpose of this multiple case study was to explore the strategies outpatient health care executives used to reduce physician turnover. Data were collected from semistructured interviews of 4 outpatient health care executives and the review of proprietary documents from 2 outpatient health care facilities in the Southern California metropolitan area. Data analysis comprised compiling and disassembling the data …

Adult Character Strength Use And Its Relationship To Physical And Mental Health, Angela Beth Bergen

Walden Dissertations and Doctoral Studies

In this study, the use of human character strengths was evaluated as a component of mental and physical health. The majority of previous character strengths research has been limited to monotonic use of character strengths. This study evaluated subjective outcomes based on a new measure of how much adults reported underusing, optimally using, and overusing their character strengths. This exploratory study was theoretically grounded in the upward spiral model of lifestyle change. The underuse, optimal use, and overuse of character strengths were evaluated as predictors of physical and mental health status, health behaviors, and emotions. Using a convenience sample of …

Survey Of U.S. Undergraduate Self-Reported Opioid Diversion And Heroin Use, Motives, Sources, And Collective Efficacy As Mediating Factors, Mark Francis Plaushin

Walden Dissertations and Doctoral Studies

Epic morbidity and mortality, and intractability make prescription opioid diversion a wicked problem. Meanwhile, college undergraduates are vulnerable to opioid misuse and its consequences. The purpose of this quantitative study was to assess U.S. undergraduate students' opioid misuse and the relationship between mediating factors. The study's theoretical framework rested on Wakeland's et al. opioid system model and Shaw and McKay's social disorganization theory. This study bridged the gap, measuring collective efficacy and testing its relationship to undergraduate decisions to regulate misuse. Thus, research questions focused on gauging the problem's scope and assessing relationships between factors that drive or potentially regulate …

Relationship Between Novice Counselors' Supervisory Attachments And Boundary Practices And Perceptions, Glenda Hill Nanna

Walden Dissertations and Doctoral Studies

Novice counselors may struggle to understand and follow ethical guidelines for boundary behaviors with clients. When counselors violate therapeutic boundaries, harmful consequences can result for clients and counselors. The purpose of this quantitative study was to examine the possible relationship between novice counselors' (NCs') attachment to supervisors and NCs' ethical perceptions and boundary practices. This study addressed the possible predictor variables of age, gender, relationship status, and practice setting. Bowlby's attachment theory provided the framework for the study. Survey data from 114 NCs were analyzed using descriptive statistics and hierarchical linear regression. Each regression analyzed predictors of age, gender, relationship …

A Quality Improvement Evaluation Of Patient Experience Through The Enhanced Recovery Program, Sarah Orozco

Walden Dissertations and Doctoral Studies

The purpose of this project was to evaluate the effectiveness of adopting clinical care bundles for the enhanced recovery program (ERP) at the project site. The practice-focused questions explored whether care bundles from the enhanced recovery program (ERP) would achieve positive postoperative patient care experiences when compared to the traditional surgical care pathways. The concepts, models, method, and theories used for this project include the Iowa model, the plan-do-study-act model, lean methodology, Donabedian's framework, and Watson's theory of caring. The sources of evidence included the facility site analysis report to evaluate surgical inpatient complications, morbidity, and mortality rates. Over 100 …

Organizational Strategies To Grow Mature Small Information Technology Businesses, Timothy L. Knox

Walden Dissertations and Doctoral Studies

Standard indicators of slow growth among small businesses are negative job creation and lower tax revenue. Small business success and growth is necessary for increasing productivity, profitability, and job creation. The purpose of this single case study was to explore growth strategies leaders of a mature small information technology (IT) business in the midwestern United States used to grow their organization beyond existing capacity. Data were collected from semistructured interviews and review of organizational documentation. The conceptual framework for the study was general systems theory. The study included a purposeful sample of 2 senior leaders of a mature small IT …