Digital Commons Network^™

Small Business Restaurant Marketing Strategies For Sustainability, Lyle John Hubbard

Walden Dissertations and Doctoral Studies

Approximately 52% of food and accommodation businesses survive 5 years or more. Small business restaurant owners face greater challenges in marketing and sustainability than larger and well-established chain restaurants. The purpose of this multiple case study was to explore the successful marketing strategies of small business restaurant owners who sustained their businesses 5 years or more. The population was small business restaurant owners in Eugene, Oregon. The conceptual framework for this study was Porter's 5 forces. Data collection included semistructured interviews with 4 business owners, and data analysis consisted of coding and thematically analyzing interview data and data collected from …

A Staff Educational Initiative To Improve The Use Of Childhood Obesity Guideline Recommendations, Kris Kuhlmann Louque

Walden Dissertations and Doctoral Studies

Obesity affects one out every six children in the United States, which places them at risk for other chronic conditions such as cardiovascular disease, diabetes, and continued obesity into adulthood. Considering military children are more likely to enter the Armed Forces than their civilian counterparts, an increase in obesity among military families decreases the number of potential future military recruits who are physically eligible to serve. Despite this growing epidemic, providers report a lack of education and a low self-efficacy in the treatment of this condition. This doctorate of nursing practice study addresses this educational gap by attempting to improve …

Social Influences Of Suburban Black Residents Food Purchasing Decisions Using Snap Benefits, Carolyn Mccummings

Walden Dissertations and Doctoral Studies

In low-income, suburban Black communities, the prevalence of diet-related chronic illnesses is alarming. Various influences often increase diet-related illnesses among this population. One influence is the use of SNAP benefits to purchase food. In this study, the influences of SNAP as well as other influences affecting food purchase decisions among the study population was examined. A qualitative multicase study approach was used and, face-to-face interviews were conducted, to understand the experiences of 20 low-income, current recipients of SNAP who were Black and lived in suburban, New York. The data indicated the most significant influence, communicated by the participants, was that …

Providers' Treatment For Overweight Navy Members And The Effect On Motivating Lifestyle Changes, Misty Scheel

Walden Dissertations and Doctoral Studies

In the military, excessive weight could put members at risk for training injuries, loss of potential career opportunities, and possible discharge from military service. This could increase cost to United States' national defense through increased injuries, decreased retention due to early discharge, cost of retraining, and lifelong chronic health conditions. The purpose of the study was to determine if there was a correlation or predictive value between active duty Navy members' perception of care provided for weight management and the active duty Navy member's motivation for weight management interventions. The social capital theory served as the theoretical framework for this …

Exploring Peace Education For Consensual Peace Building In Nigeria, Agada John Elachi

Walden Dissertations and Doctoral Studies

Violence, insurgency, and terrorism have been a recurring problem in Nigeria. Efforts to address these challenges through the use of force have proved ineffective. The purpose of this study was to explore the application of peace education in the educational curriculum with a view to promoting consensual peace building in Kafanchan Town, Jema'a Local Government Area of Kaduna State, Nigeria. Although peace education has been applied in some countries, this approach has not been applied to these challenges plaguing Nigeria. This study adopts the survey research method and utilizes the tripodal theoretical framework of ethnic conflict theory, enemy system theory, …

Implementing A Healthy Diet In The Intellectual Disability Residential Community, Stephanie Michelle Shelton

Walden Dissertations and Doctoral Studies

The problem addressed in this study was how staff working in a residential agency for individuals with an intellectual disability (IID) make decisions about how to implement a healthy diet. The purpose of this study was to identify the influences on decisions made by staff on the meals they provided to their clients with an IID. The theory of planned was used to study the influences of attitude, subjective norms, and perceived behavior control on the meals provided for IID. The key research question explored how staff members make decisions. A qualitative case study design was used. The 12 participants …

The Effectiveness Of Screening For Comorbid Depression Among Outpatients With Chronic Diseases In Maryland, Linda Hasssan Allibalogun

Walden Dissertations and Doctoral Studies

Depression is a pervasive mental health disorder worldwide. Although being diagnosed with chronic illness exacerbates susceptibility to depression, detection and subsequent treatment of comorbid depression in primary care settings remain suboptimal because patients with chronic medical disorders are not commonly screened for depression. There is a need to initiate proactive measures by implementing routine screening in primary care settings. The plan-do-study-act (PDSA) model guided an intervention to establish a depression screening practice. This study aimed to determine if the implementation of evidence-based screening for depression using the Patient Health Questionnaire-9 (PHQ-9) tool could increase diagnosis of comorbid depression among patients …

Inpatient Rehabilitation, Diabetes, And The Risk Of Clostridium Difficile Infection, Kerry A. Flint

Walden Dissertations and Doctoral Studies

Clostridium difficile is a frequent cause of healthcare-associated infections (HAI) and is associated with increased risk of morbidity and mortality. Studies suggest environmental and host characteristics increase patient's susceptibility to C. difficile infection (CDI). However, few studies have examined the risk of CDI among those with diabetes or patients in the acute rehabilitation (AR) setting. A case-control study, using secondary data (n = 473), evaluated the relationship between CDI and diabetes and identified modifiable environmental exposures. An ecosocial framework was used to examine the relationship between these two complex diseases among hospitalized patients in an AR setting. Results of the …

A Nursing In-Service For Diabetes Education, Heidi Steiner

Walden Dissertations and Doctoral Studies

Nurses play a central role in preparing patients for discharge. Diabetes affects one-third of all hospitalized patients, with readmission rates 20% higher for patients with diabetes. Low health literacy affects patients' ability to understand education provided during a hospitalization, especially in diabetic patients who are required to perform complex self-care activities. The rehabilitation nurses within the practicum site struggled to provide adequate diabetes education, leading to patients' readmissions and frequent calls to the nursing unit post discharge. The purpose of this project was to educate nurses on an inpatient unit about survival skills and teach-back approaches to improve inpatient diabetes …

Relationship Between Health Literacy And End-Stage Renal Disease Among Type Ii Diabetics, Joelle M. Stolte

Walden Dissertations and Doctoral Studies

The progression of End Stage Renal Disease (ESRD) among type II diabetics is preventable, yet complications continue to plague many. Reports show that 29.1 million people (9.3%) in the United States have diabetes, and 40% of those individuals develop ESRD. Four research questions explored the relationship between ESRD, health literacy, and healthcare. Data from 2010-2015 from the National Institute of Health (NIH) was quantitatively analyzed. The conceptual framework was the revised health service utilization theory. The target population included 3939 diverse males and females between the ages of 20-75 diagnosed with type II Diabetes. Results from Chi-square, cross-tabulation, binary, and …

Increasing The Value Of Medicare Annual Wellness Visits For Patients And Providers, Stephanie Hope Turner

Walden Dissertations and Doctoral Studies

The Medicare Annual Wellness Visit (AWV) has been available to Medicare beneficiaries since 2005; however, most eligible individuals have not taken advantage of this benefit. The literature supports that patients are willing to schedule and complete an AWV if urged to do so by their primary care provider; however, providers are reluctant to advise patients to pursue the AWV due to the lack of perceived value and overall health benefit. The integrative theory of health behavior change was used as the theoretical framework for the project. By increasing patient self-management skills through education, engagement, and support, the project was designed …

Socioeconomic Characteristics Of Farmers And Agrochemical Use In Grenada, Lindonne Marcia Glasgow

Walden Dissertations and Doctoral Studies

The World Health Organization classified carbaryl, glyphosate, and paraquat as hazardous to human health. In the Agriculture Health Study in the United States, health problems were associated with the use of these 3 agrochemicals 12 or more times per year. These 3 agrochemicals were commonly used in Grenada. The purpose of this quantitative cross-sectional study was to investigate the relationship between the social and economic characteristics of the farmers who participated in the 2012 agriculture survey and the use of agrochemicals at frequencies that could pose health risks. Five constructs of the social cognitive theory were used as the premise …

Life Stress, Coping, Perceived Health, And Health Outcomes Among Eastern Orthodox, Athina-Eleni Goudanas Mavroudhis

Walden Dissertations and Doctoral Studies

Clergy exhibit higher stress and mortality rates in relation to their nonclergy counterparts. Despite current research on clergy stress and mortality rates, health perceptions and health outcomes of Western religious oriented clergy have been understudied. Even less is known about health perceptions and health outcomes of Eastern religious oriented clergy. The role of stress, coping, and health perceptions in predicting actual health outcomes is important to study in clerical populations because of the impact their health might have on serving their parishioners. The purpose of this nonexperimental correlational study was to determine the relative strength of life stress, coping styles, …

United States-Mexico Dual Resident's Perceptions Of Heritage And Acculturation, Alisia N. Muir

Walden Dissertations and Doctoral Studies

United States' policy makers have been challenged creating understandable nutrition labels and effective healthy food campaigns for consumers of mixed heritage. Previous studies explored the sociocultural factors that influence Hispanics' abilities to navigate consumer food education programs, but little was known about how Mexican culture impacts those programs. The purpose of this study was to better understand those factors. Research questions focused on the experiences of residents of a west Texas town regarding their food decision-making process about food choices and their understanding of food education information. The purpose of this phenomenological research was to explore how Mexican culture effected …

Predictive Relationship Between Treatment Adherence, Glycated Hemoglobin And Diabetic Complications Among Jamaicans, Christian Anaba Nwaukwa

Walden Dissertations and Doctoral Studies

Patient nonadherence to physicians' prescribed therapeutic regimen is the greatest challenge in the effective treatment of patients with diabetes worldwide. Scientific evidence has revealed that nonadherence to prescribed medication could result in diabetic complications such as cardiovascular disease, retinopathy, nephropathy, and neuropathic diabetic foot ulcers. The purpose of this study was to explore predictive relationships between levels of adherence to antidiabetic medications, patient HbA1c levels, and diabetic complications among Jamaicans, an understudied population. The research question that guided this study was: Do the patient level of adherence and HbA1c levels have any predictive relationship with the severity of diabetic complications …

An Evidence-Based Clinical Practice Guideline For Childhood Obesity, George Peterson

Walden Dissertations and Doctoral Studies

Childhood obesity is a national problem in the United States and has known implications as a potential cause of chronic illnesses as the child transitions into adulthood. A primary care clinic in the southwestern United States had a high percentage of obese Hispanic children within its population; therefore, the nurses and the pediatrician needed an evidence-based clinical practice guideline (CPG) to manage Hispanic children with a body mass index greater than the 95th percentile for their age. The purpose of the project was to develop a culturally competent CPG to manage childhood obesity in this primary care practice. The social …

Health Literacy And Hypertension Management In Haitian Immigrants, Suzie Jean

Walden Dissertations and Doctoral Studies

Patient compliance and health care communication are impacted by health literacy. Poor health choices, frequent hospital visits, noncompliance with health regimens, and higher health costs are all associated with low health literacy. The purpose of this cross-sectional study was to determine whether there was an association between health literacy as measured by primary language spoken in the home (Creole vs. English) and hypertension self-management as measured by regular use of medication and cutting down on foods high in salt, and whether there was an association between Haitian men, women, their education level, or level of poverty in relation to health …

A Qualitative Grounded Theory Approach To Reducing Breast Cancer Disparities In The Latina Population, Dbora Schrett

Walden Dissertations and Doctoral Studies

Breast cancer is the leading cause of death among Latinas. Several barriers persist when accessing health care and utilization of healthcare services such as annual mammograms, leading to a late-stage diagnosis or death related to breast cancer illness. Consequently, this study was important to further examine potential risk factors such as beliefs, cultural context, health insurance, and socioeconomic status for this population. Further, gaps in research provide limited evidence of risk factors adversely influencing high morbidity and mortality incidence. The purpose was to focus on disparities in breast cancer experiences within Latina communities in the United States. A qualitative foundation …

Problem Behavior Of A Child With Autism And Problem Behavior Of A Typically-Developing Sibling Moderated By Maternal Parenting Stress, Jennifer Torchetti

Walden Dissertations and Doctoral Studies

Drawing on Bowen's family systems theory, this study was designed to fill a gap in research regarding how raising a child with autism impacts the systemic functioning of a family unit, and provide evidence of the need for more comprehensive resources and support for families of children with autism. In this study, families of children with autism were invited to complete the Parenting Stress Index and the Strengths and Difficulties Questionnaire. These measures were used to determine the relationship between the level of problem behavior of a child with autism and the level of problem behavior of a typically-developing sibling …

Mindfulness Meditation: A Self-Awareness Approach To Weight Management, Michelle Brown

Walden Dissertations and Doctoral Studies

Obesity is a crucial health care issue that has a global effect on the health care industry. Not only does obesity decrease the patients' quality of life, it also places an astronomical burden on health care delivery systems. The purpose of this quality improvement project was to establish a weight management program derived from evidence-based research. The research question is can the utilization of mindfulness meditations and practices with traditional weight loss methodologies produce sustainable weight loss? Pender's health belief model was the conceptual framework utilized to guide and provides structure for this project. The health belief model has been …

Implementation Of A Diabetic Resource Toolkit In A Veterans Administration Emergency Department, Caroline Hairston

Walden Dissertations and Doctoral Studies

Diabetes is the 7th leading cause of death in the United States. Uncontrolled diabetes and lack of self-care knowledge leads to increased emergency department (ED) visits, utilizing limited health care resources. The practice-focused question asked whether a patient-focused diabetic self-care toolkit could decrease the number of diabetes-related ED visits. The purpose of this project was to reduce the number of diabetes-related ED visits and was supported by the social cognitive theory. The sources of evidence included the facility's ED Information System (EDIS) data and a patient survey developed by the project lead. There were 149 participants (135 males and 14 …

Effects Of Micronutrients On The Status Of Hiv-Infected African American Women, Veronica Alicia Graham

Walden Dissertations and Doctoral Studies

Weight loss among HIV-infected African American women (AAW), results in the fall of the cluster of differentiation (CD4) cell count and an increase in the viral load. There are 48,126 HIV-infected AAW who reported weight loss within the first year. AAW who report more than 10% weight loss within the first year progress to AIDS due to a deficiency in micronutrients and poor linkage to care. The phenomenon that occurs with individuals living with HIV does not necessarily occur among individuals who have cancer, heart disease, or some other life-threatening illness, and this phenomenon indicates a direct threat to the …

Diabetic Adult Access To Medical Care And Race And Ethnicity In Connecticut, Natacha Bertine Jerome

Walden Dissertations and Doctoral Studies

Diabetes is among the leading causes of death in Connecticut. An approximate of 330,000 adults in Connecticut have diabetes (diagnosed and undiagnosed). Those with diabetes have almost twice the risk of premature death throughout various age groups. The purpose of this cross-sectional study was to investigate whether disparities exist in access to medical care due to race and ethnicity; among adults with diabetes in the state of Connecticut. Furthermore, this study used the Andersen's behavioral model framework. Survey data from the behavioral risk factor surveillance system (BRFSS) were also analyzed. The research study covered 3 years (2013 to 2015) of …

Chronic Care Management Services At A Clinical Medical Group, Sharon Guccione

Walden Dissertations and Doctoral Studies

The purpose of this project was to design a chronic care plan using the chronic care management (CCM) framework to improve health services at lower healthcare costs. The practice-focused question explored whether the operationalization of the CCM model would impact progress toward the management of chronic illness for the target population of Medicare beneficiaries with 2 or more chronic illnesses in an urban acute care agency located in the western United States. The middle-range theory, logic rational plan model, Lewin’s change theory, and the CCM’s coordination care and collaborative care concepts were used to guide the project. Data were collected …

Quality Of Nutrition Services For Children And Pregnant Women In Ntungamo District, Uganda, Church Tophill

Walden Dissertations and Doctoral Studies

Inadequate nutrition during infancy and early childhood seriously interferes with brain development, leading to neurological and behavioral disorders. Such effects are detrimental to children under 2 years of age. The purpose of this cross-sectional study was to better understand the quality of nutrition services offered to children and pregnant women in Ntungamo District in southwestern Uganda. The cross-sectional design facilitated comparison of different variables, using a research-question-driven approach, assessing existing secondary data from SPRING Uganda database. Stepwise, backward multiple logistic regression was used to identify the independent variables that influenced the provision of quality nutrition assessment, counseling, and support (NACS) …

Association Between Age Of Women When Diagnosed With Endometriosis And Infertility, Whitney Kennedy

Walden Dissertations and Doctoral Studies

Abstract

Because endometriosis is considered to be the primary cause of infertility in women and

the diagnosis is known to be delayed by many years, it is important to understand the

association between endometriosis and infertility. The purpose of this cross-sectional,

secondary data analysis study was to determine whether there was an association between

the age of women when diagnosed with endometriosis and infertility. Using the general

model of total patient delay (i.e., the Andersen model) as a theoretical foundation, data

for this study was collected by assessing patient medical records of women with

endometriosis at multiple OB-GYN clinics in …

Evidence-Based Pulmonary Rehabilitation Reduces Hospital Readmissions In Adults With Copd, Christiana Otuwa

Walden Dissertations and Doctoral Studies

Many patients are affected by chronic obstructive pulmonary disease (COPD), a progressive lung disease that obstructs air flow, resulting in dyspnea and inability to carry out daily activities. Despite optimal pharmacological management, COPD patients make frequent emergency room visits and are hospitalized due to exacerbations of COPD. Literature has suggested that pulmonary rehabilitation (PR), a nonpharmacological treatment, could help to decrease the symptoms that lead to illness exacerbation, hospital readmissions, and decreased quality of life in patients with COPD. The purpose of the project was to increase the quality of life and reduce admission rates for patients diagnosed with COPD …

Early Detection Of Neonatal Abstinence Syndrome By Neonatal Intensive Care Unit Nurses, Ebele Oraka

Walden Dissertations and Doctoral Studies

Neonatal abstinence syndrome (NAS) is a public health concern that is increasing in the United States due to the use of illicit drugs by pregnant women, which exposes the fetus to these substances. NAS results in increased infant morbidity and prolonged stay in the hospital, which can lead to increased cost of care. The inability of the nurses to care for at-risk infants can lead to inconsistent NAS scores, which can affect the infant's care treatment. The project examined the effectiveness of educating the neonatal intensive care unit (NICU) nurses on the correct use of the modified Finnegan Neonatal Abstinence …

Understanding Use Of Care For African Immigrants With Autistic Children, Leahnata Davies

Walden Dissertations and Doctoral Studies

The number of African immigrants in the United States is increasing. The incidence of children diagnosed with autism spectrum disorder in the United States is also on the rise. Despite these increases, little information exists about the adequacy of care for African immigrants with autistic children in the United States. The purpose of this grounded theory study was to understand the factors that affect use of care for African immigrants with autistic children in the United States. Using Aday-Anderson model of health care utilization framework, this study focused on African immigrants in the United States who had children with Autism …

Public Service Announcements To Promote Physical Activity, Jennifer Erickson

Walden Dissertations and Doctoral Studies

The World Health Organization (WHO) promotes physical activity as a primary way to maintain health, but many individuals do not participate in this health-promoting behavior. Despite the potential for public service announcements (PSAs) to communicate health information and promote behavioral change, no prior research on developing video PSAs to promote physical activity was found. The purpose of this quasi-experimental study was to examine how affective and information video PSAs for a public health campaign affect future levels of intention to engage in physical activity. The PSAs were developed and filmed specific for this study using the model of goal directed …