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Food Insecurity, Educational Attainment, And Type 2 Diabetes In African Americans In Rural Southern Us, Dana Elaine Lowe
Food Insecurity, Educational Attainment, And Type 2 Diabetes In African Americans In Rural Southern Us, Dana Elaine Lowe
Walden Dissertations and Doctoral Studies
Abstract Rural African Americans experience a higher prevalence of Type 2 diabetes compared to their White counterparts, yet little research has explored the roles of food insecurity and educational attainment in this disparity. The purpose of this quantitative, correlational study was to examine whether food insecurity and educational attainment were associated with the prevalence of Type 2 diabetes among African Americans aged 18 to 65 years in rural Southern United States, using the World Health Organization’s social determinants of health framework. Data from the 2019-2022 IPUMS National Health Interview Survey (N=793) were analyzed both descriptively and using multiple logistic regression …
Over Reliance On Antidepressant Medication In Long-Term Care Facilities: Rethinking Mental Health Approaches, Kaylene Elder
Over Reliance On Antidepressant Medication In Long-Term Care Facilities: Rethinking Mental Health Approaches, Kaylene Elder
Walden Dissertations and Doctoral Studies
Depression is a prevalent mental health condition among older adults in long-term care (LTC) facilities and is often managed primarily through antidepressant medications. While these medications can be effective, their overuse in elderly populations increases the risk of falls, sedation, cognitive decline, and adverse drug interactions. This project addresses the need for safer, evidence-based alternatives by promoting non-pharmacological interventions that support holistic well-being. The proposed approach integrates gratitude journaling, vitamin D testing to identify deficiencies, and vitamin D supplementation for residents experiencing mild to moderate depressive symptoms. Implementation is led by nursing staff and supported by the interdisciplinary care team, …
Staff Education Program To Improve Nurses' Knowledge Of Diabetes Self-Management Education (Dsme) Toward Reducing Readmissions, Vivian Adaora Okechukwu
Staff Education Program To Improve Nurses' Knowledge Of Diabetes Self-Management Education (Dsme) Toward Reducing Readmissions, Vivian Adaora Okechukwu
Walden Dissertations and Doctoral Studies
This project was a staff education program to enhance nurses' knowledge and skills in Diabetes Self-Management Education (DSME) in reducing hospital readmission. Diabetes mellitus is a chronic metabolic disorder that occurs as a direct result of the body's inability to produce enough insulin or the inability to utilize insulin in the bloodstream effectively, consequently accounting for life-threatening health complications. At the local organization, where diabetes is the third leading cause of hospitalization, evidence shows that it critically affects about 25% of the patient population. Also, some care providers at the organization do not have the distinctive competencies to give DSME …
Enhancing Patient Follow-Up: Creating And Evaluating Clinical Practice Guidelines On Appointment Reminders Using The Agree Ii Tool, Goretti Numfor
Enhancing Patient Follow-Up: Creating And Evaluating Clinical Practice Guidelines On Appointment Reminders Using The Agree Ii Tool, Goretti Numfor
Walden Dissertations and Doctoral Studies
This report presents the outcomes of a quality improvement (QI) DNP practicum project situated at an outpatient facility. The preparation for the practicum project included a situational assessment to determine feasible changes and an appropriate strategy of change leadership. The target practice problem is missed appointments. Keeping appointments is a defining element of plans for care for medical services that require regular assessments and updates. In psychiatric nursing, reminders dictate schedules for the nurse practitioners because they indicate expected encounters and commitments. At the same time, unplanned changes could demand a change of the appointments or rescheduling. Best practice guidelines …
A Comprehensive Framework To Enhance Holistic Care For Postpartum Single Mothers, Stephanie Dumas
A Comprehensive Framework To Enhance Holistic Care For Postpartum Single Mothers, Stephanie Dumas
Walden Dissertations and Doctoral Studies
Abstract Postpartum depression remains a significant challenge for single mothers who face emotional, financial, and social barriers with limited support. In Palm Beach County, Florida, where many households are led by single parents, existing services are often uncoordinated and lack trauma-informed approaches that address the realities of mothers during the postpartum period. The purpose of this qualitative action research study was to explore the perceptions of human services professionals regarding the trauma-informed and holistic care interventions needed to support single mothers experiencing postpartum depression. The Garbhasanskar holistic care framework, which emphasizes emotional well-being, mindfulness, and the creation of safe and …
Exploring Counselor Perspectives On The Role Of Ecotherapy In Mental Health Treatment: A Qualitative Study, Kimberly Seid
Exploring Counselor Perspectives On The Role Of Ecotherapy In Mental Health Treatment: A Qualitative Study, Kimberly Seid
Walden Dissertations and Doctoral Studies
This grounded qualitative study explored the common themes of ecotherapy in practice. The research problem was the limited understanding of how counselors implement ecotherapy in clinical practice, hindering the field’s ability to fully integrate nature-based approaches into mental health treatment. The purpose of this grounded theory study was to explore counselor perspectives on ecotherapy using the biophilia hypothesis and Swarbrick’s wellness model. The research questions focused on how licensed mental health counselors understood, implemented, and evaluated the impact of ecotherapy. Qualitative data were collected through an online survey with open-ended questions from 15 licensed counselors across the United States who …
Understanding The Barriers And Challenges Of Spanish-Speaking Latinos Who Received Calaim Initiative Social Support Services, Jessica De Lara Vallejo
Understanding The Barriers And Challenges Of Spanish-Speaking Latinos Who Received Calaim Initiative Social Support Services, Jessica De Lara Vallejo
Walden Dissertations and Doctoral Studies
Spanish-speaking Latinos continue to face significant barriers when attempting to access social support services through healthcare initiatives such as California Advancing and Innovating Medi-Cal (CalAIM). Despite previous efforts to address this issue, this population continues to encounter barriers such as systemic discrimination, language barriers, and limited access to culturally responsive care. This qualitative study was guided by the consolidated framework for implementation research and used an interpretative phenomenological analysis approach to explore the lived experiences of Spanish-speaking Latino parents whose children received CalAIM asthma home remediation (AHR) services. The purpose of this study was to understand the barriers and challenges …
Perceptions Of Academic Success Among African American Male High School Graduates In Urban Areas, Anthony Bourne
Perceptions Of Academic Success Among African American Male High School Graduates In Urban Areas, Anthony Bourne
Walden Dissertations and Doctoral Studies
African American males encounter more severe penalties, academic under-performance, and lower graduation rates compared to their Caucasian male counterparts. Numerous studies have delved into and elucidated the schooling experiences of African American male students from various perspectives, encompassing cultural, structural, racial, community, family, and school viewpoints. However, there remains a scarcity of voices documenting the experiences of African American males who have successfully completed high school in urban settings. The purpose of this descriptive qualitative study was to examine the schooling experiences of African American males who graduated from high schools located in urban settings. The Critical Race Theory and …
Executive Summary: Organization Change Process Initiative Usability And Integration Of A Nutrition Screening Tool In Outpatient Mental Health Care, Jennifer Marie Ross
Executive Summary: Organization Change Process Initiative Usability And Integration Of A Nutrition Screening Tool In Outpatient Mental Health Care, Jennifer Marie Ross
Walden Dissertations and Doctoral Studies
Summary This doctoral, practice-focused quality improvement project used a mixed-methods design to evaluate the usability, acceptability, and clinical integration of a nutrition screening tool in a mental health outpatient clinic. The project addresses a key practice gap, the lack of evaluation of the implementation of a systematic nutrition screening for individuals with severe mental illness (SMI), which contributes to worsening psychiatric symptoms and delayed recovery. Aligning with nursing’s holistic and patient-centered framework, the initiative aimed to strengthen interprofessional collaboration and preventive care. The guiding practice-focused questions addressed: How usable and acceptable is the clinical practice guideline (CPG) tool among clinic …
Dialysis Social Workers' Perceptions Of Strategies To Address Biopsychosocial-Spiritual Barriers To End-Of-Life Planning With Black Dialysis Patients, Annette Carol Kestner
Dialysis Social Workers' Perceptions Of Strategies To Address Biopsychosocial-Spiritual Barriers To End-Of-Life Planning With Black Dialysis Patients, Annette Carol Kestner
Walden Dissertations and Doctoral Studies
Black individuals with end-stage renal disease (ESRD) have an excessive risk of mortality and experience ongoing inequities in end-of-life (EOL) planning. This basic qualitative study, informed by Sulmasy's biopsychosocial-spiritual model, explored social workers' perspectives about approaches that consider the interplay of physical, psychological, social, and spiritual aspects for mitigating barriers to EOL planning among Black dialysis patients. Data were obtained from semi structured interviews with 10 licensed dialysis social workers in Virginia and Maryland. Thematic analysis with descriptive coding, reflexive journaling, and peer debriefing was employed to analyze qualitative data to ensure trustworthiness. Six themes were identified: (a) building trust …
Public Housing Professionals Perspectives On Mobile Food Unit Location And Accessibility For Children, Antoinette Lashurn Simpson
Public Housing Professionals Perspectives On Mobile Food Unit Location And Accessibility For Children, Antoinette Lashurn Simpson
Walden Dissertations and Doctoral Studies
Poor nutrition is a major contributor to death in the United States, and residents of public housing face disproportionate challenges in maintaining adequate nutrition. Public housing is the nation’s oldest housing subsidy program, providing more than one million units for millions of residents, many of whom are women, minorities, and unmarried individuals with incomes below the poverty line. The purpose of this generic qualitative study was to explore public housing professionals’ perspectives on using a mobile food unit located within housing communities to help reduce food insecurity. Feminist intersectionality theory provided the framework for this study, emphasizing how overlapping systems …
Enhancing Diabetes Self-Management Education And Support Knowledge And Awareness Among Nurses, Tamba Sam-Manimoi
Enhancing Diabetes Self-Management Education And Support Knowledge And Awareness Among Nurses, Tamba Sam-Manimoi
Walden Dissertations and Doctoral Studies
Diabetes mellitus (DM) affects 12% of the United States population at an annual cost of $412.9 billion. In the local clinic, 20% of the patient population has a diagnosis of DM. Despite the importance of diabetes self-management education and support (DSMES) in managing DM, patients are often not educated on this important strategy. Leadership identified that patients were reporting a lack of knowledge regarding DSMES practices and that the nurses lacked the necessary knowledge and awareness to educate patients in DSMES. Thus, the purpose of this DNP project was to determine if an educational intervention focused on DM and DSMES …
Staff Education To Improve Knowledge Of Venous Leg Ulcer Prevention, Bini John
Staff Education To Improve Knowledge Of Venous Leg Ulcer Prevention, Bini John
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) staff education project implemented a standardized program to strengthen knowledge, confidence, and adherence to venous stasis ulcer (VSU) prevention among staff in an outpatient vascular clinic. The practice problem was the lack of standardized staff education, leading to inconsistent patient teaching and recurrent ulceration. VSUs are a significant public health challenge, increasing morbidity, healthcare utilization, and reducing quality of life (He et al., 2024). The practice-focused question for this project was: In frontline medical staff at a vascular outpatient clinic, does a staff education program on a standardized approach to patient education for VSU …
Staff Education On Oral Health To Night Shift Staff, Uzoamaka Mbionwu
Staff Education On Oral Health To Night Shift Staff, Uzoamaka Mbionwu
Walden Dissertations and Doctoral Studies
Hospital-acquired pneumonia (HAP) remains the most common hospital-acquired infection in the United States, with nonventilated adult patients particularly at risk. This doctoral project focused on improving oral care practices among night shift nursing staff on a medical-surgical unit to reduce the risk of HAP. The practice gap identified was the inconsistent and inadequate delivery of oral hygiene during night shifts, primarily due to staff knowledge deficits, time constraints, and a lack of standardized procedures. The project was guided by the Johns Hopkins Evidence-Based Practice model and addressed the following question: In adult patients on a medical-surgical unit, will staff education …
Relationship Between Parent Demographics And Attitudes About Their Child’S Diabetes In Nigerian Parents Who Live In The United States, Vivian Obioma Nwankwo
Relationship Between Parent Demographics And Attitudes About Their Child’S Diabetes In Nigerian Parents Who Live In The United States, Vivian Obioma Nwankwo
Walden Dissertations and Doctoral Studies
Relationship Between Parent Demographics and Attitudes About Their Child’s Diabetes in Nigerian Parents who Live in the United States by Vivian Obioma Eluwa Nwankwo MA, Walden University, 2018 BA, University of Nigeria, 1992 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Human and Social Services Walden University August 2025
Mold Exposure And Cognitive Health During Menopausal Transitions: A Quantitative Analysis Using Secondary Data, Holly Jeannette Burns
Mold Exposure And Cognitive Health During Menopausal Transitions: A Quantitative Analysis Using Secondary Data, Holly Jeannette Burns
Walden Dissertations and Doctoral Studies
Mold exposure and menopausal transition have been independently linked to cognitive decline, yet their interaction among socioeconomically disadvantaged populations has not been well examined. This quantitative study is an exploration of how menopausal transition influences the relationship between mold exposure and cognitive health outcomes among women aged 40 to 60 living in low-income housing in the United States. Bronfenbrenner’s ecological systems theory was used to guide the cross-sectional design using secondary data from the 2005–2006 National Health and Nutrition Examination Survey (NHANES; N = 149). Weighted logistic regression and Hayes’ PROCESS (Models 2 and 4) were used to test associations …
Resources And Strategies Needed To Address The Problem Of Child Labor In Erbil, Kurdistan Region Of Iraq, Evan Faiq
Walden Dissertations and Doctoral Studies
Child labor is an international practice that has been on the rise in some parts of the world including Erbil, the Kurdistan region of Iraq. The purpose of this qualitative study was to explore the different resources needed but not available for the victims, how child labor has impacted the community, and how the criminal justice system can better approach the child labor issue and reduce it in Erbil, Kurdistan region of Iraq. Social conflict theory was used to guide the study. Data were collected from 15 interviews with individuals from different areas of the criminal justice department, local organizations …
Sociocultural Factors Influencing Excess Gestational Weight Gain In Pregnant Puerto Rican Women, Sonia O. Roselló Aponte
Sociocultural Factors Influencing Excess Gestational Weight Gain In Pregnant Puerto Rican Women, Sonia O. Roselló Aponte
Walden Dissertations and Doctoral Studies
More than 50% of women experience excessive weight gain during pregnancy or are overweight at the start of pregnancy, increasing their risk of short and long-term maternal and fetal complications. The literature highlights the relationship between sociocultural factors and excessive gestational weight gain (EGWG) and the need to explore these factors in ethnic subgroups. The purpose of this descriptive qualitative study, guided by Nola Pender’s health promotion model, was to explore the sociocultural factors that influence EGWG for pregnant women living in Puerto Rico. Semi-structured interviews were conducted with seven participants recruited from public and private prenatal clinics in Puerto …
Utilizing An Evidence-Based Educational Intervention To Assess Health Care Provider Knowledge And Confidence Of Weight Management Strategies In A Primary Care Setting, Fanny Ngwa Shu
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) project aimed to address a clinical gap in primary care by enhancing provider and staff knowledge and confidence in delivering weight management counseling. Despite the high prevalence of overweight and obesity, many healthcare providers feel inadequately prepared to initiate weight-related discussions due to factors such as limited training, cultural barriers, and a lack of understanding of social determinants of health (SDOH) that influence patient behaviors. This gap in care can hinder the effective management of chronic conditions like diabetes, hypertension, and cardiovascular disease. The practice-focused question guiding this project was: Can an educational session …
The Relationship Between Income And Race With The Utilization Of Oral Health Services Among Older Adults, Mishael Smith
The Relationship Between Income And Race With The Utilization Of Oral Health Services Among Older Adults, Mishael Smith
Walden Dissertations and Doctoral Studies
Oral health disparities continue to present a significant public health challenge for older adults in the United States, particularly among racial minority and low-income populations. Despite national discussions around healthcare equity, there remains limited empirical insight into how race and income influence dental service utilization among Medicare beneficiaries. In this quantitative, cross-sectional study, the extent to which these demographic factors predicted oral healthcare utilization, using nationally representative data from the 2021 Medicare Current Beneficiary Survey, was assessed. Guided by the social determinants of health framework, chi-square tests, binary logistic regression, and negative binomial regression were performed to analyze the data. …
Association Between Diabetes Mellitus, Hypertension, Obesity, And Diagnosis Of Covid-19 In Puerto Rico, Julian Rene Rivera Rodriguez
Association Between Diabetes Mellitus, Hypertension, Obesity, And Diagnosis Of Covid-19 In Puerto Rico, Julian Rene Rivera Rodriguez
Walden Dissertations and Doctoral Studies
The population of Puerto Rico has been heavily affected by chronic diseases; however, data remains limited on the influence of diabetes mellitus (DM), hypertension, and obesity on the probability of COVID-19 diagnosis. The purpose of this quantitative study was to evaluate the association between non-communicable diseases that included DM, obesity, hypertension, and COVID-19 diagnosis, controlling for age and sex and person exposure in Puerto Rico. The sample consisted of 1,463 participants who underwent a polymerase chain reaction (PCR) test for COVID-19 from April 1, 2020, to March 31, 2021. Results from adjusted multivariable logistic regression analyses established that obesity OR …
Strategies That Clinical Research Site Managers Use To Minimize Employee Turnover, Christina Holston
Strategies That Clinical Research Site Managers Use To Minimize Employee Turnover, Christina Holston
Walden Dissertations and Doctoral Studies
High turnover rates among clinical research staff present a business problem that reduces continuity, quality, and cost-effectiveness of clinical trials. This problem is important to clinical research managers because employee stability is essential for participant retention, regulatory compliance, and operational success. Grounded in the job embeddedness and transformational leadership theories, the purpose of this qualitative pragmatic inquiry was to identify and explore the effective strategies that some clinical research site managers use to reduce employee turnover in the southeastern United States. Data were collected through semistructured interviews with six clinical research leaders and triangulated with publicly available documents. Using Yin’s …
Dieticians’ Perceptions Of Pediatric Obesity Education In Children’S Hospitals Located In Northeast Maryland, Constance Bartu
Dieticians’ Perceptions Of Pediatric Obesity Education In Children’S Hospitals Located In Northeast Maryland, Constance Bartu
Walden Dissertations and Doctoral Studies
Dieticians play a vital role in the fight against pediatric obesity in the United States. The purpose of this qualitative study was to explore dieticians’ perceptions of internal and external reinforcements and barriers to childhood obesity interventions in children’s hospitals within Northeast Maryland. The study was framed by the social cognitive theory described by Bandura. As applied to this study, the theory focuses on prevention and intervention strategies used by dieticians working in children’s hospitals while offering educational interventions and other health care services. Interviews were conducted with eight dieticians with a minimum of 4 years working in children’s hospitals …
Perceptions Of Whole Plant-Based Diets And Weight Among Hispanics In Miami, Florida, Zoraida Powell
Perceptions Of Whole Plant-Based Diets And Weight Among Hispanics In Miami, Florida, Zoraida Powell
Walden Dissertations and Doctoral Studies
Being overweight or obese poses major public health concerns and contributes to the development of chronic illnesses. While researchers have explored how a total plant-based diet impacts excess body weight or obesity, there is still a lack of clarity about how Hispanics living in Miami, FL, perceive or understand this diet concerning overweight and obesity. Using a generic qualitative approach, this study was conducted on how Hispanics in Miami, FL, understand and view a whole plant-based diet (WPBD) for preventing and reducing overweight and obesity. Through interviews with 14 diverse Hispanic participants, the study revealed that they see WPBD as …
Rurality’S Impact On Alaska Native Elders’ Levels Of Physical Activity And Obesity, Jessie Doherty
Rurality’S Impact On Alaska Native Elders’ Levels Of Physical Activity And Obesity, Jessie Doherty
Walden Dissertations and Doctoral Studies
While there have been studies on obesity levels and physical activity levels across many populations and age groups, few studies have focused on Alaska Native Elders. The purpose of this study was to examine rurality (urban vs. rural counties), physical activity, and obesity level while controlling for sex, self-reported loneliness, and self-reported stress. The theoretical foundation for this study was based on the socio-ecological model (SEM), and the research questions in this study explored how rurality impacted obesity levels and how rurality impacted physical activity levels in Alaska Native Elders. The methodology of this study was a quantitative cross-sectional design …
Lived Experiences Of Obese Women In Mississippi Concerning The Role Of Psychosocial Factors In The Development Of Obesity, Temitope Olabode
Lived Experiences Of Obese Women In Mississippi Concerning The Role Of Psychosocial Factors In The Development Of Obesity, Temitope Olabode
Walden Dissertations and Doctoral Studies
One of the highest rates of obesity in the United States is in Mississippi, where middle- aged obese women deal with a variety of social, cultural, and personal issues, including shame, discrimination, and stigma based on weight, mental anguish, cultural norms, financial limitations, and restricted access to healthcare. This study investigated the psychosocial factors that contribute to obesity in women aged 40- 60 years, and the effects of obesity on body image, self-esteem, health behaviors, and quality of life. A qualitative phenomenological study using the social ecological model (SEM) framework looked at the individual, interpersonal, and policy levels of the …
Staff Education Program To Increase Staff Knowledge On Evidence-Based Practices To Reduce Falls, Ariella Carrenan
Staff Education Program To Increase Staff Knowledge On Evidence-Based Practices To Reduce Falls, Ariella Carrenan
Walden Dissertations and Doctoral Studies
Falls among older adults in long-term care facilities constitute a pressing concern, affecting 30% to 40% of residents each year due to physiological changes associated with aging. Such incidents precipitated injuries, extended hospitalizations, elevated healthcare costs, and increased the potential for legal liabilities. This project investigated the effect of a structured educational intervention on nursing staff knowledge of fall prevention strategies in a long-term care facility where the fall rate of 3.4% exceeded the state average of 2.5% and the national average of 3.3%. The project explored the question: In a long-term care facility, does staff education increase staff knowledge …
Native Hawaiian Culturally Appropriate Substance Use Disorders Formative Program Evaluation, Kelly J. Penn
Native Hawaiian Culturally Appropriate Substance Use Disorders Formative Program Evaluation, Kelly J. Penn
Walden Dissertations and Doctoral Studies
Substance use disorders (SUDs) disproportionately affects Native Hawaiians, yet conventional treatments often overlook the cultural, spiritual, and relational foundations of well-being for Native Hawaiians. This gap represents a human services problem, as it perpetuates health disparities, limits recovery, and slows social change within Native Hawaiian communities. The purpose of this qualitative single case study was to identify culturally relevant components for an SUD treatment program tailored to Native Hawaiians. The research question guiding this study was, what are culturally appropriate components for a SUD program for Native Hawaiians. The Nā Pou Kihi framework grounded the exploration of Indigenous approaches to …
Fathers’ Lived Experiences After Their Children Experienced Child Sexual Abuse, Joan Michelle Lucien
Fathers’ Lived Experiences After Their Children Experienced Child Sexual Abuse, Joan Michelle Lucien
Walden Dissertations and Doctoral Studies
Child sexual abuse (CSA) is a global health crisis with deleterious consequences that violates children’s safety worldwide. Exact rates of CSA prevalence vary, as most cases of CSA are not disclosed. Survivors delayed or nondisclosure impedes early interventions to alleviate documented adverse effects of CSA. CSA survivors have an increased risk of suicidal ideation. This phenomenological study involved examining the lived experiences of adult fathers after their children experienced CSA. Finkelhor and Browne’s traumagenic dynamics framework guided this study. Traumagenic dynamics influence children’s cognitive and emotional functioning and distort their self-esteem, identity, worldview, and affective capacities. Stigmatization has been associated …
Improving Staff Knowledge On Hourly Rounding Using The 4ps To Reduce The Fall Rate, Chukwuemeka Igboanugo
Improving Staff Knowledge On Hourly Rounding Using The 4ps To Reduce The Fall Rate, Chukwuemeka Igboanugo
Walden Dissertations and Doctoral Studies
I designed this Doctor of Nursing Practice (DNP) project to develop an educational program that increases staff knowledge of hourly rounding using an evidence-based approach, specifically pain, position, potty, and possession (the 4Ps), to prevent falls among residents in a long-term care facility. According to facility leadership, the observed gap in practice was the nursing staff members’ lack of knowledge in performing hourly rounding. The facility’s fall records for the lockdown units indicated a surge in fall rate, with 32 falls among 62 residents per month, reflecting a need for action. The practice-focused question guiding the project was: For staff …