Digital Commons Network^™

Leadership Strategies To Sustain Small Fitness Businesses, Jacqueline Renee Robertson

Walden Dissertations and Doctoral Studies

The development and sustainability of small businesses impact the U.S. economy. Owners of small businesses created 65.9% of new jobs between 2000 and 2017. Over 99.9% of known U.S. firms were small businesses. The purpose of this multiple case study was to explore the leadership strategies small fitness business owners implemented to sustain their businesses for longer than 5 years. The conceptual framework for this study was the servant leadership theory. The population for the study included 5 owners of small fitness businesses in the southeastern region of the U.S. who used leadership strategies to sustain their businesses for longer …

Assessment Of Cancer-Related Fatigue In Breast Cancer Survivors, Meagan Walker

Walden Dissertations and Doctoral Studies

Cancer-related fatigue (CRF) is a persistent and debilitating problem for many breast cancer survivors. Although many CRF measurement tools are available, no consensus exists on the most appropriate tool to use for breast cancer survivors. The purpose of this project was to identify the best method of assessing CRF in breast cancer survivors. The practice-focused question inquired about the most appropriate way to assess fatigue in breast cancer survivors. The central concepts of the project were CRF and cancer survivorship. This project was informed by the theory of health as expanding consciousness and Mishel's theory of uncertainty in illness. The …

Enhancing The Competitive Advantage Of U.S. Corporations By Incorporating A Foreign Trade Zones Strategy, Dino Adolfo Scott

Walden Dissertations and Doctoral Studies

Some leaders of U.S. companies fail to implement proper decision-making strategies to enact and execute strategies to realize the benefits provided by a foreign trade zone (FTZ). The purpose of this qualitative case study was to explore and to identify the proper decision-making strategies used in successfully implementing a FTZ. The target population consisted of 5 leaders, including a senior leader, a supply chain manager, and 3 department managers of a company located in the midwestern region of the United States that successfully implemented a FTZ. Porter's competitive advantage theory was the conceptual framework used for the study. Semistructured interviews …

The Role Of Advanced Practice Nurses In Advanced Care Planning For Cancer Patients, Sincere Mcmillan

Walden Dissertations and Doctoral Studies

In the United States, more than 75% of people will spend their last months of life in a health care facility. A key role for clinicians is to discuss care goals with the patients as part of a process called advanced care planning (ACP). As part of the oncology care team, advanced practice nurses (APNs) could help to increase the frequency of ACP discussions. The purpose of this project was to assess the knowledge and practice experiences of APNs regarding ACP at a National Cancer Institute designated cancer care hospital. Carper's patterns of knowing was the theoretical framework of this …

Weight Management Toolkit For Patients On Methadone, Bolaji Olugboja

Walden Dissertations and Doctoral Studies

Methadone is a mu-opioid agonist used in the treatment of patients with an opioid use disorder in an outpatient addiction treatment clinic. A recognized knowledge gap exists among nurses managing overweight and obese patients in an outpatient methadone treatment center in the northeastern United States. The goal of this project was to develop a weight management toolkit to assist nurses in the identification, evaluation, and management of overweight and obese patients receiving methadone treatment at the center. The evidence-based weight management toolkit incorporated practice guidelines from the American Heart Association, American Association of Clinical Endocrinologists, America College of Cardiology, and …

Hypertension Experience Of Foreign-Born West African Immigrant Women In The United States, Assumpta Onyinye Ude

Walden Dissertations and Doctoral Studies

Foreign-born African immigrants (FBAI) have a high rate of severe hypertension (HTN) and psychosocial-cultural factors have underlying roles in this, as in other chronic diseases. Literature lacks studies on FBAI women living with HTN. This study explored the HTN experience of FBAI women in the Washington Metropolitan area. This qualitative phenomenological study, was guided by a theoretical framework that included the Health Belief Model, Patient Centered Access to Health Care and the Transactional Model of Stress and Coping. Highly educated health care professional of 15 women participated in in-depth interviews. Thematic analysis was used for data analysis. Key findings included …

Social Support, Health Status, And Personality Factors In Coping Styles Of Gay Men, Mary Martin

Walden Dissertations and Doctoral Studies

Personality factors and coping styles may affect how individuals will respond to the lack of social support. The purpose of this descriptive design was to examine the relationship between social support and health risk implications in gay men, which is a population that is under-represented in the research literature in regard to this topic. The theoretical framework guiding this study was the social stress model, which posits that stress and support are related to mental health outcomes. A sample of 76 gay men were recruited from Craigslist ad to participate in this study. They completed self -report questionnaires anonymously online, …

Smoking And Surgical Site Infection In Orthopedic Patients' Lower Extremity Arthroplasty, Alicia Y. Mingo

Walden Dissertations and Doctoral Studies

Cigarette smoking has been a public health concern for many years, and the possible impact of smoking on surgical site infection (SSI) has been studied broadly. However, a gap in understanding has persisted concerning whether there is an association between smoking tobacco and the development of SSI among patients who undergo lower extremity surgery, specifically total knee arthroplasty (TKA). The purpose of this study was to examine the association between smoking and lower extremity SSI. Andersen's behavioral model (BM) was used to understand the risk factors relevant to the interaction between smoking and SSI. Application of the BM categories of …

Controlling Hypertension Among Young Black Men In America: A Prescription Medication Alternative, Winston Charles

Walden Dissertations and Doctoral Studies

Despite the evident improvements in the awareness of hypertension among the adult population in the United States, disparities remain in the burden of the disease, its treatment efficacy, and its control when data are compared along age, gender, and race. The purpose of this study was to determine the strength of the relationship between blood pressure control and prescription medication and lifestyle modification (smoking cessation, changes in eating habits, and weight loss). The target population were adult young Black men, and the control variables were age, low socioeconomic status (SES), and disparities in health care. A convenience sample of Black …

Public Health Implications Of Retailer Resale Of Returned Textile Clothing Merchandise, Antonette M. A. Francis-Shearer

Walden Dissertations and Doctoral Studies

Historically, 18th century anecdotal accounts of the decimation of several tribes of U.S. of the Native American population by trading of infected textile blankets alludes to the role of retail in the transmission of infectious disease. This study explores implications of the modern day retail organization practice of reselling returned clothing textiles from a public health infectious disease perspective. A qualitative multi-case study, utilized responses from 20 open-ended, unstructured interviews of retail employees assigned to the returns process. Additionally, several informal observations of select U.S.based, top-ranked clothing retail organizations, identified by the National Retail Federation were completed. Select federal, state, …

Obesity Epidemic In The Military: Implications For Veterans, Tracy Lewis

Walden Dissertations and Doctoral Studies

The purpose of this study was to examine the impact of overweight and obesity on veterans' careers. Obesity, once thought unproblematic for the military, is being recognized as a health concern that has expansive implications for the health and readiness of service men and women, as well as for veterans. There is an abundance of information on obesity within the general population, but research on the impact of obesity on military careers is limited. This quantitative, cross-sectional research study investigated how obesity is a challenge throughout a veteran's career, from enlistment to retirement, using an online survey to gather data …

Reducing Central Line-Associated Bloodstream Infections, Alexis Genarrian Whitfield

Walden Dissertations and Doctoral Studies

Central line-associated bloodstream infection (CLABSI) at the local healthcare setting exceeded the benchmark of 0 CLABSI. The Infection Prevention and Control (IPC) department determined that a role as CLABSI nurse champion would address the problem; however, no comprehensive education on CLABSI prevention and maintenance was available at the site. The purpose of this project was to develop a CLABSI prevention and maintenance education module using Knowles's adult learning theory and the chain of infection model. The practice-focused question asked whether a CLABSI educational module would provide the necessary information to educate nurse champions on CLABSI prevention and maintenance. The education …

Cybersecurity Strategies For Universities With Bring Your Own Device Programs, Hai Vu Nguyen

Walden Dissertations and Doctoral Studies

The bring your own device (BYOD) phenomenon has proliferated, making its way into different business and educational sectors and enabling multiple vectors of attack and vulnerability to protected data. The purpose of this multiple-case study was to explore the strategies information technology (IT) security professionals working in a university setting use to secure an environment to support BYOD in a university system. The study population was comprised of IT security professionals from the University of California campuses currently managing a network environment for at least 2 years where BYOD has been implemented. Protection motivation theory was the study's conceptual framework. …

Improving Nurse Well-Being Through A Mindfulness-Based Education Strategy, Sandra Dearholt

Walden Dissertations and Doctoral Studies

Abstract

An estimated 33% to 54% of hospital nurses exhibit signs of emotional stress and

decreased well-being, which is associated with a negative impact on nurses’ health, job

performance, patient care outcomes, and healthcare cost. This project sought to improve

nurse well-being by providing nurses with education on mindfulness-based practices.

The practice question addressed whether implementing a mindfulness-based education

strategy for nurses improved nurse well-being. Three models informed this project: the

health promotion model, the andragogical model, and Kirkpatrick’s 4 levels of training

evaluation. Sources of evidence included the Maslach Burnout Inventory (MBI) and a

knowledge assessment administered to 10 …

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 …

Fruit And Vegetable Consumption, Physical Activity, And Colorectal Cancer Among African Americans, Stella Francoise Nanga Ndzana

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is a deadly and costly cancer, especially among African Americans. The purpose of this quantitative, retrospective, cross-sectional study was to examine African Americans' health behaviors that may have an association with CRC. The Health Belief Model was used to guide this study. The study addressed whether there is a statistical association between fruit intake, vegetable intake, and physical activity, and the occurrence of CRC while controlling for confounders, such as body mass index, smoking status, and income level. After conducting an overall analysis, the final research question examined if the association varied by race. In this study, …

Health Disparities In Females With Rheumatic Heart Disease In Central Afghanistan, Ruhina Najem

Walden Dissertations and Doctoral Studies

This study surveyed healthcare professionals and rheumatic heart disease (RHD) female participants in two hospitals located in central Afghanistan to examine the effects of communication among healthcare professionals, ethnicity and socioeconomic status, and the health quality of life. The social ecological models (SEM) of health promotion was utilized in the individual (communication between healthcare professionals), community (health quality of life), and societal factors (ethnicity and socioeconomic status). Three research questions were explored in this study: the significance of RHD healthcare professional's education to their RHD female patients ages 16 to 45 years; a correlation between ethnicity and socioeconomic status among …

Program Evaluation Of The Employee Health And Wellbeing Program, Alicia Carmen Marlena Perez

Walden Dissertations and Doctoral Studies

Health promotion and disease prevention are a focus of population health management. Without ongoing and rigorous evaluation, these programs may be in jeopardy of continuing. The purpose of this project was to conduct a descriptive population health- focused evaluation of a large-scale health system's employee health and wellbeing program. Guided by the Center for Disease Control and Prevention (CDC) framework for program evaluation in public health and National Center for Organization Development guidelines, a nurse-led evaluation was conducted using 5 specific data sets emphasizing organizational structure, employee health offerings, employee surveys, Pathway to Excellence survey, and program contributions. A descriptive …

Hospital-Acquired Pressure Ulcer Prevention, Druscilla Willis Jones

Walden Dissertations and Doctoral Studies

Hospital-acquired pressure ulcers (HAPUs) represent a significant challenge in the care provided for hospitalized patients. HAPUs impact morbidity, mortality, and quality of life. At the local practice site, the incidence of HAPUs increased in the perioperative setting. The practice-focused question for this project asked if an education program for staff nurses working in a perioperative care setting with high HAPU incidence can advance nurse knowledge regarding prevention, early assessment, symptoms, and treatment of HAPUs. The purpose of this educational project was to develop a pretest and posttest designed education program on HAPU prevention and care for perioperative nurses. The Iowa …

Prison Nurseries And Social Work Practice, Brooke Sheehan

Walden Dissertations and Doctoral Studies

This study sought to examine what gaps existed in practice through the perspectives of correctional social workers in terms of helping incarcerated mother–infant dyads bond. Additionally, it examined whether a prison nursery was viewed as a possible option within a smaller correctional facility. Theories used to guide this study included attachment theory and separation-individuation theory, which align with the research questions that sought to explore gaps in services, supports that could be established, and program feasibility. Action research, using an anonymous online survey, resulted in N = 6 social work participants who worked as prison social workers in the northeast …

Staff Education On Metabolic Syndrome In Patients Taking Antipsychotic Medications, Juliana Ifeoma Omile

Walden Dissertations and Doctoral Studies

Second-generation antipsychotics (SGAs) are prescribed for treatment of psychosis. A major side effect of SGAs is an increased risk of metabolic syndrome (MetS) with symptoms of hypertension, hyperlipidemia, hyperglycemia, and truncal obesity. A clinic in the northeastern United States was not screening patients for MetS when being treated with SGAs. The purpose of this project was to educate staff on MetS risk factors, signs, symptoms, and patient management with a goal to improve their knowledge of MetS. Lewin's change theory provided a conceptual framework for the project. The project question explored the development and evaluation of an educational module on …

Implementation Of A Transcultural Nursing Education Program To Improve Nurses' Cultural Competence, Ann Marie Elizabeth Edwards

Walden Dissertations and Doctoral Studies

The exponential growth of culturally diverse populations in the United States has led to a multicultural patient population while the nursing workforce remains predominantly White. At the project site, managers identified that staff nurses struggled to deliver culturally competent care. The purpose of this project was to improve the cultural competence of registered nurses (RNs) through a transcultural nursing education program. Leininger's transcultural nursing theory guided the project. Sources of evidence used to develop a face-to-face educational program included peer-reviewed journals, credible websites, and the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-R tool. Aggregate pretest and …

Lived Experiences With Social Networking Technology To Improve Physical Activity, Paula Nobles Eubanks

Walden Dissertations and Doctoral Studies

Research suggests that Black women living in the United States are not engaging in sufficient physical activity, which is a major factor negatively impacting their health outcomes. Black Girls Run (BGR) is a targeted national health movement using the capacity of social networking technology as a tool to interact with and inspire Black women to live healthy through running. Literature lacked the voice and perspective of Black women who were embracing the innovation of technology to positively improve their health behaviors. The purpose of this qualitative phenomenological study was to gain a better understanding of the composite experiences of women …

Beliefs And Opinions Of Low-Income Residents Living In A Food Desert In A Gulf Coast State, Kimberly Lakeidra Willis

Walden Dissertations and Doctoral Studies

This study was an investigation of the access problem to fresh and affordable fruits and vegetables and how limited access influenced the beliefs and opinions of residents of a food desert as designated by United States Department of Agriculture. Many researchers have documented that price, availability, and transportation are barriers to fruit and vegetable consumption, particularly among low-income individuals. Researchers in other studies have concluded that these barriers are further exacerbated by an individual's distance from a supermarket or grocery store. However, much less information is available regarding the beliefs and opinions about life in a food desert and how …

Factors Affecting Health Care Access And Utilization Among U.S. Migrant Farmworkers, Melinda R. Kelly

Walden Dissertations and Doctoral Studies

There are over 3 million seasonal and migrant farmworkers in the U.S. agricultural industry with a significant percentage of farmworkers documented or native to the United States. Migrant farmworkers live below the federal poverty levels at high rates and experience low health care access and utilization. Guided by the fundamental cause theory, the purpose of this phenomenological study was to examine the lived experiences of migrant farmworkers and identify the factors impacting their health care access and utilization. Face-to-face interviews were conducted with 12 migrant farmworkers who had worked in Southwest Texas agricultural stream. Data were analyzed and coded to …

Preventing Obesity And Type 2 Diabetes In Immigrant Populations, Maxwell K. Chikuta

Walden Dissertations and Doctoral Studies

Obesity-related diseases have been increasing in African immigrants throughout the United States. Although research has been done to identify risk factors associated with many ethnic groups in the United States, only a few studies exist that explore obesity and type 2 diabetes diseases among Central African immigrants. The conceptual framework for this qualitative case study was social constructivism and the health belief model. The primary research question addressed the potential underlying causes for an increase in obesity and type 2 diabetes among Central African Immigrants. The secondary research questions explored how culture, illiteracy, and religion contribute to the problem of …

Family Predictive Factors Of Rural Malaria Prevalence In Nsukka, Eastern Nigeria, Gabriel Ugwuja Ugwu

Walden Dissertations and Doctoral Studies

Children in early childhood are still suffering from burdens of malaria-related morbidity and mortality. There have been insufficient studies on how family-level factors may predict the prevalence of malaria (PoM), and negatively impact the control of malaria in rural areas, especially among children. In this study, potential family factors were explored to address the challenges associated with the increase in PoM among the children in rural areas of Nsukka. Socioecological framework guided this study at the interpersonal level. The quantitative cross-sectional study used secondary data from Demographic and Health Surveys (DHS) of 2015 in Nsukka rural communities. Data were analyzed …

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. …

Quality Improvement Initiative To Improve Patient Attendance In Diabetes Self-Management Education Classes, Charon Denise Randel

Walden Dissertations and Doctoral Studies

Diabetes self-management education (DSME) is a key resource in the battle against diabetes and its secondary effects. This quality improvement project was conducted to address the decreased attendance rates of DSME classes in a community health center in the southern United States. The practice question for this project explored process-related strategies to increase patient attendance in DSME classes. Based on review of patient reports of reasons for nonattendance and an evaluation of peer reviewed literature on improving attendance in DSME, the following strategies were implemented: (a) alternative solutions such as providing patients with the dates for a year of initial …

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 …