Open Access. Powered by Scholars. Published by Universities.®
- Discipline
-
- Medicine and Health Sciences (1390)
- Public Health (832)
- Public Health Education and Promotion (576)
- Social and Behavioral Sciences (544)
- Nursing (442)
-
- Psychology (258)
- Education (251)
- Epidemiology (244)
- Public Affairs, Public Policy and Public Administration (139)
- Health and Medical Administration (123)
- Arts and Humanities (114)
- Public Policy (103)
- Life Sciences (86)
- Business (84)
- Sociology (77)
- Teacher Education and Professional Development (75)
- Educational Administration and Supervision (66)
- Race, Ethnicity and Post-Colonial Studies (57)
- African American Studies (49)
- Clinical Psychology (48)
- Public Administration (48)
- Nutrition (43)
- Human and Clinical Nutrition (40)
- Physical Sciences and Mathematics (39)
- Social Work (39)
- Feminist, Gender, and Sexuality Studies (36)
- Mental and Social Health (36)
- Pre-Elementary, Early Childhood, Kindergarten Teacher Education (36)
- Psychiatric and Mental Health (36)
- Women's Studies (32)
- Keyword
-
- Obesity (123)
- Diabetes (76)
- Education (51)
- African American (36)
- Depression (34)
-
- Nursing (31)
- Women (27)
- Breastfeeding (25)
- Stress (25)
- Nutrition (24)
- Health (22)
- Self-efficacy (22)
- Hypertension (21)
- Physical Activity (20)
- Type 2 Diabetes (20)
- African Americans (19)
- Knowledge (19)
- Nigeria (19)
- Overweight (18)
- Physical activity (18)
- Leadership (17)
- Adolescents (16)
- Mental Health (16)
- Poverty (16)
- Epidemiology (14)
- Prevention (14)
- Wellness (14)
- Barriers (13)
- COPD (13)
- Childhood obesity (13)
Articles 1441 - 1470 of 2220
Full-Text Articles in Entire DC Network
Efficacy Of A Va Residential Treatment Program For Co-Occurring Disorders, Kathrin Hohenstern
Efficacy Of A Va Residential Treatment Program For Co-Occurring Disorders, Kathrin Hohenstern
Walden Dissertations and Doctoral Studies
The problem of co-occurring substance abuse and mental health disorders among the veteran population can impact numerous aspects of a veteran's life, including self-esteem, relationships, employment, and legal issues. The Mental Health Residential Rehabilitation Treatment Program (MH RRTP) at the Saint Cloud, Minnesota VA Healthcare System is a program that provides residential treatment for this population. Identifying practical and beneficial treatment methods promotes better coping mechanisms for veterans and impacts social change by providing timely and cost-efficient care for veterans, while also leading the way for overall changes and improvements in other VA residential treatment programs. This study identified how …
Perceptions Of Barriers To Oral Care Among African American Families In Durham, North Carolina, Samuel Motto
Perceptions Of Barriers To Oral Care Among African American Families In Durham, North Carolina, Samuel Motto
Walden Dissertations and Doctoral Studies
Dental caries is one of the biggest issues of concern for healthcare providers in Durham, North Carolina due to the high prevalence of dental caries in African Americans. Many researchers have identified socio-economic, low income, poor education, psychological behavior, awareness, allied diseases, environment, unhealthy diet, obesity, type II diabetes, and inadequate health facilities as the possible reasons for its high prevalence, yet literature lacks information regarding how African Americans perceive the problem of oral health. Knowledge of the perceived factors may help to identify the actual cause of dental caries through the eyes of African Americans. The purpose of this …
Hazardous Waste Site Proximity And Type 2 Diabetes: From Youths To Adults, Theresa Ann Johnson
Hazardous Waste Site Proximity And Type 2 Diabetes: From Youths To Adults, Theresa Ann Johnson
Walden Dissertations and Doctoral Studies
Type 2 diabetes has reached epidemic proportions in adults and youths. Persistent organic pollutants and endocrine-disrupting chemicals (EDCs), such as pesticides, dioxins, and organochlorines, are omnipresent and persist in the environment with potential for human exposure via contaminated air, waterways, soil, and human food supply. EDCs have been correlated with diabetes incidence and risks. Residential proximity to hazardous waste sites (HWS) has been correlated with increased hospital admission rates for diabetes. The study used a sample population (N = 1,724), ages ≥ 12 years from the 2005-2012 Continuous NHANES and HWS data from the National Priorities List of Superfund Sites. …
Women's Empowerment By Group Sewing Training: A Microfinance Study In El Salvador, Sharleen Andrews
Women's Empowerment By Group Sewing Training: A Microfinance Study In El Salvador, Sharleen Andrews
Walden Dissertations and Doctoral Studies
This case study explored the lived experiences of 8 participants in a microfinance sewing program in El Salvador. Numerous studies focused on empowering women by employing microfinance projects or programs in many countries; however, a lack of empirical data exists regarding Salvadoran women's perceptions about how a sewing program with teamwork affects women's empowerment. The purpose of this case study was to understand the women's personal stories, their obstacles as well as any factors they saw as empowering them. Guided by a constructionist framework, a sample of 8 participants: 5 who were sewing students and 3 who were employees, who …
The Influence Of Family History Of Type 2 Diabetes Mellitus On Positive Health Behavior Changes Among African Americans, Donny D. Ard
The Influence Of Family History Of Type 2 Diabetes Mellitus On Positive Health Behavior Changes Among African Americans, Donny D. Ard
Walden Dissertations and Doctoral Studies
Type 2 diabetes mellitus (T2DM) is a disease that affects the body's ability to metabolize glucose effectively. The disease is predicted to be prevalent in over 300 million people by the year 2030. African Americans (AA) have the highest prevalence rates in the United States. Lifestyle modification and awareness of risk factors, including family history, are important aspects for prevention of developing T2DM. The purpose of this study was to understand if a family history of T2DM played an influential role in individuals making positive health behavior changes for T2DM prevention. The phenomenological study was grounded in the health belief …
The Effect Of Income On Stroke Recovery In Urban Ghana, Ida Dawsome Amuah
The Effect Of Income On Stroke Recovery In Urban Ghana, Ida Dawsome Amuah
Walden Dissertations and Doctoral Studies
Stroke recovery is a crucial public health issue in Ghana due to the high rate of mortality and morbidity associated with stroke. The significant role income plays in the onset of stroke has been empirically proven using quantitative research. However, the in-depth insights on the role income plays in stroke recovery are less known and less appreciated, particularly, in middle-income countries such as Ghana. The phenomenological study was purposed to provide in-depth insight into the effect which might exist between income earned by Ghanaian-families and stroke recovery. The theoretical framework underlining this qualitative study was a combination of the Dahlgren-Whitehead …
Public Health Nurses’ Perceptions Of High School Dropout Rates As A Public Health Issue, Maria Wallace
Public Health Nurses’ Perceptions Of High School Dropout Rates As A Public Health Issue, Maria Wallace
Walden Dissertations and Doctoral Studies
Education is one of the strongest predictors of health, and well-being. Early termination of education can lead to poorer health, shorter lifespans, and increased stress on the healthcare system. Improving overall high school graduation rates has been debated and discussed by the Toronto District School Board (TDSB) and the Ministry of Education, however, there is a paucity of research on increased graduation rates as they relate to public health in the Canadian context. The purpose of this phenomenological qualitative study was to explore the perceptions of liaison public health nurses (PHNs) who worked directly with the TDSB regarding their roles …
Effect Of Access To Health Services On Neonatal Mortality In Uganda, Imelda Atai Madgalene Musana
Effect Of Access To Health Services On Neonatal Mortality In Uganda, Imelda Atai Madgalene Musana
Walden Dissertations and Doctoral Studies
Since 2006, Uganda has experienced a nonchanging neonatal mortality rate of 27 out of 1,000 live births, which is higher than the global average of 19 deaths for every 1,000 live births. The purpose of this retrospective cross-sectional study was to determine factors affecting access to health services and their impact on newborn deaths in Uganda. Mosley and Chen's model for child survival in developing nations provided the framework for the study. Secondary data from the 2016 demographic and health survey (UDHS) collected by the Uganda Bureau of Statistics (UBOs) was used. A total of 7,538 cases were used and …
Effectiveness Of Yoga Therapy On Pain And Related Depression, Anxiety, Perceived Stress, And Quality Of Life, Karen Romani
Effectiveness Of Yoga Therapy On Pain And Related Depression, Anxiety, Perceived Stress, And Quality Of Life, Karen Romani
Walden Dissertations and Doctoral Studies
Individuals are becoming more dependent on medication for conditions such as chronic-pain, anxiety, and depression. It is reported that patients are often overprescribed medication while health outcomes do not improve. The medicalization of society is distracting attention from the possibility of other therapies such as complementary or alternative medicine (CAMs) that can improve health outcomes if they were as supported as pharmacological research and better received by the medical community. Yoga and meditation, the components of Mindfulness Based Stress Reduction (MBSR) and yoga therapy, have been shown as effective CAMs for cases of anxiety and depression related to chronic illness …
Local Nongovernmental Organization Intervention Approaches In Nigeria's Communities Experiencing Continuous Trauma, Rashid Babalola Raji
Local Nongovernmental Organization Intervention Approaches In Nigeria's Communities Experiencing Continuous Trauma, Rashid Babalola Raji
Walden Dissertations and Doctoral Studies
Researchers have found an overlap of psychological symptoms in victims of Post-Traumatic Stress Disorder and Continuous Traumatic Stress. Although the circumstances inducing the psychological reactions are different, the symptoms mimic one another without a clear cut demarcation, calling for practitioners to be cautious of contexts inducing psychopathology that is triggered through re-experiencing of past trauma when they are assessing and intervening with ongoing trauma-exposed communities. This study explored the subjective experiences of 15 local Non-Governmental Organization (NGO) administrators in Nigeria across 5 states, including the federal capital Abuja, about the intersectionality of their clients' persistent trauma experiences and their program …
Adaptation Of Heart Failure Education Materials For The Middle Eastern Population, Nadine A. Williams
Adaptation Of Heart Failure Education Materials For The Middle Eastern Population, Nadine A. Williams
Walden Dissertations and Doctoral Studies
Cardiovascular disease, including heart failure, is the leading cause of death among male and female Middle Eastern Americans. In 2016, a medical center located in the northeastern region of the United States had an estimated 35% of heart failure patients readmitted within 30 days of discharge, 10% of these readmitted patients belonged to the local Middle Eastern community. The gap in nursing practice noted by nursing staff, patients, and their families was that the patient education materials on heart failure were not tailored to the cultural beliefs and customs of this high-risk population. The purpose of this project was to …
Achieving Improved Glycemic Control Among Hispanic Type 2 Diabetic Adults, Morenike Oyegbami
Achieving Improved Glycemic Control Among Hispanic Type 2 Diabetic Adults, Morenike Oyegbami
Walden Dissertations and Doctoral Studies
Type 2 diabetes is a major chronic health disease in the United States. A main concern of clinicians treating patients with Type 2 diabetes is poor glycemic control. The goal of this project was to improve glycemic control in Type 2 diabetic Hispanic adult patients in a private family practice clinic through the implementation of biweekly telephonic intervention focused on diabetes management by an advanced practice nurse/nurse practitioner. The project was guided by the chronic care model as a framework. The intervention was conducted over a 12-week period with 50 patients, ages 18 to 65. Data were collected from chart …
African American Parents' Perceptions Of Childhood Obesity In Broward County, Kenol Aris
African American Parents' Perceptions Of Childhood Obesity In Broward County, Kenol Aris
Walden Dissertations and Doctoral Studies
Children may become overweight or obese for different reasons, and childhood obesity may have health consequences such as Type 2 diabetes and asthma. The purpose of this qualitative phenomenological study was to describe the perceptions of African American parents of elementary-age children with obesity living in Broward County, Florida about the causes and consequences of childhood obesity. The health belief model (HBM) guided this study. Interview data were gathered from 9 participants who met the criteria of being African American parents of elementary-age children with obesity living in Broward County, Florida. Moustakas- steps to analyze the data collected led to …
The Coping Strategies Of Alpha-1 Deficient Patients And Their Family Caregivers, Nicolette Bruscino
The Coping Strategies Of Alpha-1 Deficient Patients And Their Family Caregivers, Nicolette Bruscino
Walden Dissertations and Doctoral Studies
Alpha-1 antitrypsin deficiency, for which there is no cure, is one of the most lethal genetic diseases among the European White population. Early and proper diagnosis is challenging, as understanding how both alpha-1 antitrypsin deficient patients and their family caregivers cope with their related stressors on a daily basis. This qualitative phenomenological study incorporated the biopsychosocial approach, the Bowen family systems theory, and the family systems model of illness to examine the experiences of Alpha-1 patients and their family caregivers related to living with the disease and coping strategies. Participants were recruited with the assistance of a national organization that …
Funding Strategies For Smallholder Rice Farmers In Afadzato South District, Ghana, Faith S. Ababio-Twi
Funding Strategies For Smallholder Rice Farmers In Afadzato South District, Ghana, Faith S. Ababio-Twi
Walden Dissertations and Doctoral Studies
Agriculture revenue contributions to Ghana's gross domestic product have declined because of limited farm funding, which has constrained some smallholder rice farmers access credit to acquire necessary inputs, and to secure a stable market for their harvests. The purpose of this qualitative multiple case study was to explore successful strategies some smallholder rice farmers in the Afadzato South District of Ghana used in obtaining farm funding. Data collection included semistructured, face-to-face interviews with 9 smallholder rice farmers who successfully obtained farm funding. Previous research, reports, and policies of the Ghana Ministry of Food and Agriculture served as additional data collection …
Exploring The Mechanisms Of Racial Disparity In Infant Mortality: A Grounded Theory Approach, Barry Chukwugekwu Eneh
Exploring The Mechanisms Of Racial Disparity In Infant Mortality: A Grounded Theory Approach, Barry Chukwugekwu Eneh
Walden Dissertations and Doctoral Studies
Infant mortality (IM) is a critical health-disparity problem in the United States. Of the 23000 infants who die each year, the highest number occurs among African Americans. Previous studies implicated a mix of health determinants and risk factors, but no study has explored the mechanisms by which IM predictably persists among African Americans. This study uncovers the complex network of risk factors that underlies racial death disparities in infants. Two theoretical lenses chosen for this study were social systems theory (SST) and critical race theory (CRT). SST explains human behavior as an intersection of interrelated systems. CRT interrogates inherent social …
Patient Awareness And Knowledge Of Medically Induced Radiation Exposure, Travis L. Mann
Patient Awareness And Knowledge Of Medically Induced Radiation Exposure, Travis L. Mann
Walden Dissertations and Doctoral Studies
The level of knowledge and awareness among patients about the concepts and implications of medical radiation is unknown. The purpose of this qualitative, case study was to explore patients' awareness and knowledge of information regarding this topic from their perspectives. The health belief model provided the framework for the study. A total of 20 individuals were recruited using purposive sampling. All participants were above the age of 18 in central North Carolina and had undergone or are currently undergoing medical radiation exams. Data were collected using semistructured interviews and analyzed using Yin's 5-phased cycle, which involved compiling, disassembling, reassembling, interpreting, …
Mental Health Service Providers' Engagement Experiences Of Homeless Individuals, Tarsha Thomas-Richardson
Mental Health Service Providers' Engagement Experiences Of Homeless Individuals, Tarsha Thomas-Richardson
Walden Dissertations and Doctoral Studies
Limited literature exists regarding best engagement practices of mental health service providers in encouraging the homeless individuals to participate in clinical mental health services in New York City. New York City has a population of more than 8.5 million, and in 2017 more than 129,803 homeless individuals slept in shelters. The purpose of this phenomenological qualitative study was to gain more insight and knowledge about the best engagement practices and experiences of mental health service providers in encouraging homeless individuals to participate in clinical mental health services. The conceptual framework used to guide this study comes from Kearsley and Shneiderman's …
Timing Of Substance Use Initiation: Assessing The Role Of Trauma And Race, Rebecca Petrie
Timing Of Substance Use Initiation: Assessing The Role Of Trauma And Race, Rebecca Petrie
Walden Dissertations and Doctoral Studies
The purpose of this study was to examine the strength of the association between race, trauma, and the age of initiation for substance use, specifically tobacco, marijuana, alcohol among high school students aged 13-18 in the United States. This research is critical because prior research has shown that trauma and race led to higher rates of substance use in adulthood. Still, limited research has shown how these factors affect the age of substance use initiation. The theoretical foundation for this study was the general strain theory since the theory posits that exposure to stresses or strain leads to delinquency, which …
Role Of Primary Care Providers And Integrated Disease Surveillance In Chad, Dhoud Stave Gischel Samba
Role Of Primary Care Providers And Integrated Disease Surveillance In Chad, Dhoud Stave Gischel Samba
Walden Dissertations and Doctoral Studies
In the Republic of Chad, primary care physicians play a central role in the detection and control of outbreaks and are critical actors in the integrated disease surveillance system through mandatory reporting. Feedback on such surveillance must reveal the needs and perceptions of these physicians. These needs and perceptions were examined using a questionnaire survey distributed to a sampling of 20 physicians in Chad. The purpose of this qualitative study was to investigate the role of primary care providers in the integrated disease surveillance to identify factors that impact complete, quality, and timely reporting. The theory of planned behavior was …
Cameroonian Immigrants ' Behaviors, Beliefs And Knowledge Of Type 2 Diabetes: In Minnesota, Brendabell Ebanga Njee
Cameroonian Immigrants ' Behaviors, Beliefs And Knowledge Of Type 2 Diabetes: In Minnesota, Brendabell Ebanga Njee
Walden Dissertations and Doctoral Studies
Nondiabetic immigrants from Cameroon who migrate to Minnesota lack knowledge of risk factors associated with type 2 diabetes and face challenges accessing health care services. Nondiabetic immigrants from Cameroon lack culturally appropriate health care services and therefore find it difficult to follow providers' recommendations. This phenomenological study explored the perceptions and experiences of nondiabetic immigrants from Cameroon regarding access to affordable, quality health care services as well as their behaviors, beliefs, and knowledge of type 2 diabetes self-management. Bronfenbrenner's social ecological model provided the theoretical framework. Research questions addressed access to affordable health care services, knowledge, and perception of type …
Socioeconomic Status, Water, Sanitation, Hygiene, And Economic Cost Of Childhood Diarrheal Diseases In Uganda, Sarah Birungi Nahalamba
Socioeconomic Status, Water, Sanitation, Hygiene, And Economic Cost Of Childhood Diarrheal Diseases In Uganda, Sarah Birungi Nahalamba
Walden Dissertations and Doctoral Studies
Worldwide, diarrhea is the second leading cause of death in children aged under 5, yet it is both preventable and treatable. Several studies have established the effects of exposure to inadequate water, sanitation, and hygiene (WASH) on diarrhea prevalence, but little was known on how the interactions of socioeconomic status and WASH influence the economic cost of treatment of diarrhea. This retrospective cross-sectional survey study was focused on assessing the correlation between socioeconomic status, WASH, and household cost of treatment of diarrhea among children aged under 5 in Uganda using the multiple exposure-multiple effect model. Secondary data from the 2015/16 …
The Use Of Compassionate Release Policies For Elderly Offenders, Lindsey Martin
The Use Of Compassionate Release Policies For Elderly Offenders, Lindsey Martin
Walden Dissertations and Doctoral Studies
This research examined the use of compassionate release policy in response to the fastest-increasing segment of the prison population- elderly offenders. Though this policy is an approach to this problem, there was little available research regarding which correctional organizations in the United States adopt compassionate release and how it is used. The purpose of this nonexperimental comparative quantitative study was to examine the use of the policy in neighboring and distant state correctional systems relative to those organizations that used the policy more frequently to determine if the leader-laggard theory of policy diffusion was an effective policy-implementation framework. The research …
Mother Feeding Style And Health Outcomes Of Children, Marie Youngblood
Mother Feeding Style And Health Outcomes Of Children, Marie Youngblood
Walden Dissertations and Doctoral Studies
Childhood and adolescent obesity are pervasive among single mother households. Obesity causes many health risks including psychological/emotional illnesses. The purpose of this secondary analysis study was to examine the association between the parental feeding styles of single mothers and the degree that ethnicity moderates the rates of childhood obesity. Data from the National Longitudinal Survey of Youth were used with a total of 1,630 children in the study for a total of 842 minorities (African American and Hispanic American); 788 participates were not minorities (European American) with an average body mass indent of 15.9. Using the cross-sectional design, the quantitative …
Financing Post-2015 Development Goals: Shaping A New Policy Framework For Aid In Liberia, Apollos Ikechukwu Nwafor
Financing Post-2015 Development Goals: Shaping A New Policy Framework For Aid In Liberia, Apollos Ikechukwu Nwafor
Walden Dissertations and Doctoral Studies
Liberia, Africa's oldest democracy, has made several efforts in becoming a developed economy and ending poverty, but these efforts have been hampered by lack of appropriate financing mechanisms to achieve this goal. The most recent challenge which was the purpose of this study was to understand how Liberia can finance and achieve the sustainable development goals adopted by the United Nations in September 2015. Despite substantial external aid, Liberia was only able to meet 3 out of the 8 Millennium Development Goals, and more than 60% of the population remain extremely poor. The main research question was to understand what …
Demographic, Behavioral, And Cultural Factors On Chlamydia Trachomatis Infection, Philis Grace Palmer
Demographic, Behavioral, And Cultural Factors On Chlamydia Trachomatis Infection, Philis Grace Palmer
Walden Dissertations and Doctoral Studies
Chlamydia trachomatis is a sexually transmitted disease, and its incidence has been increasing in recent years in the U.S. population. Certain demographic factors have been identified as posing an increased risk to acquire this disease. The purpose of this mixed-methods research was to examine how population demographics (quantitative section) and cultural and behavioral factors (qualitative section) affect risk for contracting chlamydia trachomatis in the Miami-Dade, Florida area. The theory of reasoned behavior was the theoretical framework of the study. The quantitative component used secondary data from Jackson Health System (2012- 2018) pertaining to 333 Miami-Dade young adult individuals with incidents …
Lived Experience Of Tongans With Obesity And Diabetes, Gladys Adjei-Poku
Lived Experience Of Tongans With Obesity And Diabetes, Gladys Adjei-Poku
Walden Dissertations and Doctoral Studies
People of Pacific Island descent are afflicted by obesity and diabetes more than other populations. Although interventions have succeeded in reducing these conditions among other groups, they have been unsuccessful among Tongans and other Pacific Islanders. Furthermore, little is known about the cultural perspectives of this population with a high rate of obesity and diabetes. Accordingly, this descriptive phenomenological study was conducted to investigate the lived experiences of Tongans with obesity and diabetes in a western metropolitan area of the United States to understand their predisposition toward these conditions and suggest appropriate interventions. Purposive sampling was used to recruit 11 …
Caribbean Students' Experience Of Readiness For The Secondary Education Certificate Exam, Cleon Pauline Athill
Caribbean Students' Experience Of Readiness For The Secondary Education Certificate Exam, Cleon Pauline Athill
Walden Dissertations and Doctoral Studies
While there is general agreement about its importance, the construct of educational readiness is nebulous with much debate about what constitutes readiness. Readiness has been found to be a multidimensional psychological construct from a psychometric perspective. However, there is a growing awareness that this psychometric focus is lopsided, and that readiness does not only reside in the child. Further, there is an accompanying appreciation that readiness research may need to focus more on the subjective experience of individuals within the context of their environment. This phenomenological study, using Bronfenbrenner's social-ecological model, explored how Antigua and Barbudan students experienced readiness as …
Family Caregivers' Perspectives On Establishing Hospice Care In Belize, Rachael Florita Battle
Family Caregivers' Perspectives On Establishing Hospice Care In Belize, Rachael Florita Battle
Walden Dissertations and Doctoral Studies
End-of-life (EOL) care decisions present a challenge for family caregivers. Despite the increasing number of terminally ill patients in need of pain management and comfort care, there is limited qualitative data about how populations in the developing world can access culturally appropriate resources and EOL support. In this phenomenological study, 17 Garifuna family caregivers in southern Belize were interviewed about their experience caring for terminally family members. The conceptual frameworks were Kübler-Ross’s hospice approach and Watson’s theory of human caring. The two theories were selected based on their significance to this process: Kübler Ross’s hospice approach and its impact on …
Experiences And Challenges Of Social Workers Providing Services To Elderly Veterans, Maritza Rivera-Moret
Experiences And Challenges Of Social Workers Providing Services To Elderly Veterans, Maritza Rivera-Moret
Walden Dissertations and Doctoral Studies
The social work practice problem of this doctoral action research project was the unmet mental health needs of veterans 65 and older in Puerto Rico. This action research project explored the experiences and challenges of social workers when they offer mental health services to veterans 65 and older. This study was framed using social support theory, integrating the 3 core elements of tangible support, emotional support, and informational support. The data collection technique included a semistructured interview protocol used in a focus group setting. Purposive sampling was used to identify 9 participants who were licensed social workers in Puerto Rico. …