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Walden Dissertations and Doctoral Studies

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Leadership Strategies For Addressing U.S. Pharmaceutical Drug Shortages And Supply Chain Disruptions, Adrian Grant Scioli Jan 2017

Leadership Strategies For Addressing U.S. Pharmaceutical Drug Shortages And Supply Chain Disruptions, Adrian Grant Scioli

Walden Dissertations and Doctoral Studies

Health care providers in the United States expend more than $400 million in unnecessary direct costs annually managing the effects of widespread drug shortages. Based on the theory of complexity and complex adaptive systems, the purpose of this exploratory multiple case study was to identify the strategies that health care pharmaceutical procurement leaders from the Eastern region of the United States use to address widespread drug shortages. Data were collected from 5 semistructured interviews with pharmaceutical procurement leaders, recorded field notes, and a review of public documents from company websites. Data analysis included deductive and open coding techniques. Emergent themes …

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African American Pastors' Perspectives On Health Promotion Ministries, Brenda Ivy Watson Jan 2017

African American Pastors' Perspectives On Health Promotion Ministries, Brenda Ivy Watson

Walden Dissertations and Doctoral Studies

The centrality of the church in African American communities makes it a culturally compelling sponsor for health promotion activities targeting health disparities among the medically underserved. Pastoral support is critical in determining whether a church initiates or supports a health promotion agenda, but there is little understanding of the variables that influence this decision. The aim of the qualitative study was to investigate the perceptions of African American pastors regarding the decision to incorporate health promotion programs in their churches. This study was guided by the health belief model using a phenomenological approach. Data were collected using both semi-structured and …

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Children's Oncology Group Hospital Membership And Survival Of Pediatric Lymphoblastic Leukemia, Paul David Betts Jan 2017

Children's Oncology Group Hospital Membership And Survival Of Pediatric Lymphoblastic Leukemia, Paul David Betts

Walden Dissertations and Doctoral Studies

Acute lymphoblastic leukemia (ALL) predominates in children ages 0-14 years and has an excellent prognosis for cure with 5-year survival exceeding 90% in the United States. However, not all children experience such positive outcomes. The purpose of this quantitative, retrospective cohort study was to evaluate differences in survival of ALL among children who reside in the 32-county Texas-Mexico border region. While factors such as poverty and health insurance have been strongly associated with poorer cancer outcomes, additional factors such as geographic isolation and treatment disparities are not as well-documented in children. This study examined the association between use of Texas …

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College Health Clinic Population Health Improvement Plan Project, Kathryn M. Flynn Jan 2017

College Health Clinic Population Health Improvement Plan Project, Kathryn M. Flynn

Walden Dissertations and Doctoral Studies

A college community health improvement plan (CHIP) focusing on the indicators of nutrition and weight status, and physical activity and fitness is designed with the goal of reducing obesity risk, improving health, and preventing chronic disease. The precede proceed model, logic model, innovative care for chronic conditions model, self-care theory, and Bandura's social cognitive learning theory were used as a research design framework for assessing, planning, and managing sustainability through a two-year college health clinic. The research questions were: what are the current health promotion inputs and activities in terms of environment, ecology, education, and policy and what could be …

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Direct Care Provider Perceptions Of Factors Influencing Treatment Motivation Of Dual-Diagnosed Female Offenders, Cara Renee Tilbury Jan 2017

Direct Care Provider Perceptions Of Factors Influencing Treatment Motivation Of Dual-Diagnosed Female Offenders, Cara Renee Tilbury

Walden Dissertations and Doctoral Studies

Dual-diagnosed female offenders (DDFOs) present direct care providers with complex psychosocial needs and challenges that result in a serious lack of motivation to attain, sustain, and continue treatment after release from prison. Unsuccessful treatment of DDFOs represents a significant public health and safety risk including continuing criminal acts, increased health care costs, accidents related to substance abuse, and poor reintegration. Through in-depth semistructured interviews with direct care providers, this phenomenological study's focus was on examining the motivational facilitators associated with treatment adherence, barriers to treatment adherence, and approaches for enhancing treatment motivation. Nine major themes emerged from this research, including …

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Breastfeeding Perceptions Of First-Time African American Mothers, Deborah Annmarie Jarrett Jan 2017

Breastfeeding Perceptions Of First-Time African American Mothers, Deborah Annmarie Jarrett

Walden Dissertations and Doctoral Studies

Breastfeeding is associated with numerous health and social benefits. Although support for breastfeeding is promoted globally, disparities in breastfeeding rates and support continue. African American mothers have lower breastfeeding rates than do Hispanic and Caucasian mothers. Several researchers have focused on the benefits of breastfeeding support, but no available research has explained any specific ethnic group perceptions of breastfeeding. This study explored 10 first-time African American mothers' perceptions of the breastfeeding support they received from physicians, nurses, midwives, and lactation consultants. The purposeful criterion sampling strategy was used to recruit participants, and data were collected through semistructured telephone interviews. The …

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Structured Physical Activity And Dietary Education Program For Obese Adolescents: An Evaluation Of A Quality Improvement Project At A Rural Primary Care Clinic, Andrietta Wright Barnett Jan 2017

Structured Physical Activity And Dietary Education Program For Obese Adolescents: An Evaluation Of A Quality Improvement Project At A Rural Primary Care Clinic, Andrietta Wright Barnett

Walden Dissertations and Doctoral Studies

Childhood obesity is a worldwide epidemic. In the United States, approximately 17% of adolescents are obese; and 13% of the general population is overweight. Obese adolescents are at threefold risk for developing chronic health conditions in adulthood, including type II diabetes, hypertension, and heart disease. The purpose of this project was to evaluate the results of a quality improvement program to reduce adolescent obesity as measured by BMI 5% over 18 months in a rural health primary care clinic. The health belief model and theory of planned behavior guided the project as adolescents need to first understand the risks associated …

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Hassles Of African Americans With Type 2 Diabetes, Sharon H. Murff Jan 2017

Hassles Of African Americans With Type 2 Diabetes, Sharon H. Murff

Walden Dissertations and Doctoral Studies

There has been a steady increase in the incidence of diabetes in the United States. The purpose of this study was to determine whether there was a difference in the daily hassles of African American adults with a self-reported diagnosis of type 2 diabetes compared to those of African American adults without a self-reported diagnosis of type 2 diabetes. The theoretical underpinning for this quantitative, descriptive study was the cognitive appraisal theory (CAT), but the concept of stress and the effects stress has on the body was the broad framework that connected all the variables. The CAT was used to …

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Food Waste Reduction Strategies In Supermarkets: The Lived Experiences Of Perishable Food Managers In Michigan, Kelly K. Zimmermann Jan 2017

Food Waste Reduction Strategies In Supermarkets: The Lived Experiences Of Perishable Food Managers In Michigan, Kelly K. Zimmermann

Walden Dissertations and Doctoral Studies

At the retail level, 25% of sellable food is wasted, and perishable foods account for 72% of food waste in the United States. The purpose of this qualitative phenomenological study was to explore the food waste reduction strategies used by supermarket perishable food department managers, which are covered under the Good Samaritan Food Donation Acts (state and federal). The participant population was comprised of 17 managers who are responsible for perishable foods departments (bakery, deli, meat, dairy, and produce) at local, regional, and national supermarkets in Midland, Michigan. Goal systems theory served as the conceptual framework lens for which the …

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The Chance Of Complications From Type 2 Diabetes As Perceived By Some Black Seventh-Day Adventists Who Follow A Plant-Based Diet., Charles Misori Jan 2017

The Chance Of Complications From Type 2 Diabetes As Perceived By Some Black Seventh-Day Adventists Who Follow A Plant-Based Diet., Charles Misori

Walden Dissertations and Doctoral Studies

Type 2 diabetes has more than doubled in the past decade among Black Americans. Researchers have suggested that Black Seventh-day Adventists, who follow a plant-based diet, are concerned about preventing the complications from this disease. The purpose of this qualitative ethnographic study was to explore the chance and perceptions of complications from type 2 diabetes among 10 purposefully sampled Black Seventh-day Adventists. The health belief model (HBM) served as the conceptual framework. Two constructs, education and income, were chosen for this study. Education was chosen to increase understanding about the chronic nature of the disease, and income was chosen because …

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Role Of Midline Catheters In Patient Care, Tina K. Schlegel Jan 2017

Role Of Midline Catheters In Patient Care, Tina K. Schlegel

Walden Dissertations and Doctoral Studies

Central line-associated bloodstream infections (CLABSIs) are responsible for 100,000 patient deaths per year, creating a critical need for prevention of these deadly infections that occur with central venous lines (CVLs). Alternative forms of IV access such as midline catheters (MLCs) may offer lower rates of infection than those seen with CVLs. MLCs were implemented at the practice setting in 2016; however, no evaluation of their effectiveness had been conducted. The purpose of this project was to evaluate the effectiveness of MLCs using a retrospective, pre- post- comparison of CLABSI rates and device utilization rates (DUR) obtained from the practice setting …

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Perceptions Of Homeless Shelter Staff Workers On Chronic Homeless Individuals, Jimmy L. Griffith Jan 2017

Perceptions Of Homeless Shelter Staff Workers On Chronic Homeless Individuals, Jimmy L. Griffith

Walden Dissertations and Doctoral Studies

While researchers have identified the Housing First model of putting homeless persons into permanent housing as the best means of improving the quality of life for chronically homeless individuals, few studies have examined the perceptions of shelter staff workers on the barriers the homeless face in obtaining and maintaining long-term housing. This case study of 2 homeless shelters in New Jersey examined the relationship that fair and just democratic processes play in supporting or undermining Housing First. Data came from New Jersey's annual Point in Time counts of the number of homeless individuals and families and the causes and service …

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Program Evaluation Of Patient Safety And Risk Mitigation Educational Interventions For Medical Errors In Primary Care Settings By Patricia Rose Gould, Patricia Rose Gould Jan 2017

Program Evaluation Of Patient Safety And Risk Mitigation Educational Interventions For Medical Errors In Primary Care Settings By Patricia Rose Gould, Patricia Rose Gould

Walden Dissertations and Doctoral Studies

The Institute of Medicine reported in 2016 that medical errors are the 3rd leading cause of death in the United States. In the primary care setting, frequency and severity are unknown. Medical error research is limited related to evaluation of interventions conducted by medical professional liability (MPL) companies of risk mitigation strategies. The purpose of this program evaluation was to determine the impact of multifaceted patient safety and risk mitigation educational interventions conducted in primary care settings on patient safety, reporting, and liability. The program evaluation employed a retrospective secondary analysis of actuarial data from a MPL carrier's educational interventions …

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Examining The Relationship Between Communication Apprehension And Individual Innovativeness In Managers, Michelle Campagnola Jan 2017

Examining The Relationship Between Communication Apprehension And Individual Innovativeness In Managers, Michelle Campagnola

Walden Dissertations and Doctoral Studies

Communicative challenges that hinder managerial engagement in social networks can impede innovation adoption and thereby damage the financial performance and competitiveness of a firm. The purpose of this correlational study was to examine the relationship between communication apprehension (CA) and individual innovativeness in managers. The focus of the research questions was determining if a relationship exists between these variables before and after controlling for demographic characteristics. With diffusion of innovation theory as the theoretical framework, this research involved an attempt to address how adoption categories relate to varying degrees of CA. One hundred and five American-based owner-executives, senior managers, and …

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Theory Of Planned Behavior Analysis And Organic Food Consumption Of American Consumers, Marie Elizabeth Donahue Jan 2017

Theory Of Planned Behavior Analysis And Organic Food Consumption Of American Consumers, Marie Elizabeth Donahue

Walden Dissertations and Doctoral Studies

The majority of organic foods consumed by Americans are sourced internationally, which has global-reaching implications on health, economics, and sustainability. Current research findings show that environmental devastation and negative health outcomes have resulted from unsustainable, nonorganic agricultural practices; including herbicides, pesticides, and overcultivation. However, there is a lack of quantitative research on factors that motivate Americans to consume organic food. Based on the theory of planned behavior, this quantitative study employed an online survey to examine the role of attitudes, subjective norms, descriptive norms, and perceived behavioral control on the intention and behavior of American consumers to consume organic foods. …

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Perceived Barriers To Lifestyle Change In Obese, Low-Income Hispanic Women, Mariana Daniela Torchia Jan 2017

Perceived Barriers To Lifestyle Change In Obese, Low-Income Hispanic Women, Mariana Daniela Torchia

Walden Dissertations and Doctoral Studies

Low-income Hispanic women are the fastest growing minority population in the United States, and they have increased risks of obesity and secondary health issues, such as diabetes, related to their obesity. The purpose of this phenomenological study was to explore the barriers to lifestyle change among obese, low-income Hispanic women (OLHW). A health belief model lens was used. The study sample consisted of 15 OLHW who were clinic patients and ranged in age from 20-59. Recruitment occurred in a low-income, Southern California, outpatient clinic setting through volunteer participation from recruitment flyers. Fifteen women took part in 1-hour, in-depth interviews, which …

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Impact Of The Zambian Agricultural Policy On Grain Trade, Onesphore Karuho Jan 2017

Impact Of The Zambian Agricultural Policy On Grain Trade, Onesphore Karuho

Walden Dissertations and Doctoral Studies

The agricultural sector in Zambia is supported through the government use of public expenditure programs to spur the production and subsidize the consumption of key grains to stabilize prices. Previous research has documented the effects of public spending on agriculture in terms of food prices and food security. The effects of government spending on the trade of key grains, however, is not well understood. As such, there is a gap in knowledge regarding the impact of agricultural policy on the agricultural trade. The purpose of this study was to determine the impact of Zambian agricultural policy on grain trade. A …

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Treating Adult Women With Depression Through Videoconferencing, Irina Demidova Jan 2017

Treating Adult Women With Depression Through Videoconferencing, Irina Demidova

Walden Dissertations and Doctoral Studies

The occurrence of depression in the United States is steadily increasing. In every age group, women have a higher rate of depression than men, and U.S. women between the ages of 40 and 59 have a depression rate of 12%. Adult women living in rural areas experience physical and/or psychological impairment and lack access to mental health treatment. The purpose of this quantitative nonexperimental study was to examine participants' preferences for treatment delivery method based on patient perceptions of the clinical experience, patient satisfaction, and therapeutic bond. The working alliance theory provided the theoretical foundation. Data collection included survey responses …

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The Critical Role Of The Psychiatric Emergency Response Team In The Adoption Of A Violence Risk Assessment Tool., Angela Mackay Jan 2017

The Critical Role Of The Psychiatric Emergency Response Team In The Adoption Of A Violence Risk Assessment Tool., Angela Mackay

Walden Dissertations and Doctoral Studies

Workplace violence is a persistent problem in health care, and incidence rates have increased over the years. Traditional reporting systems, relying mostly on paper formats, are inadequate for developing effective predictive models for intervention and reducing acts of violence by patients to staff. The purpose of the development and deployment of the psychiatric emergency response team (PERT) was to provide effective intervention within the MIAHTAPS (Altered Mental status, Irritability, Agitation, History of Violence, Threatening, Attacking Objects, Pacing, and Staring) behavior prediction tool to reduce the severity and rates of violence in a hospital setting. Lewin's change theory was used to …

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Assessing For Awareness And Knowledge Regarding Diabetes In Pre-Diabetes Obese Patients, Remona Lysa Brown Jan 2017

Assessing For Awareness And Knowledge Regarding Diabetes In Pre-Diabetes Obese Patients, Remona Lysa Brown

Walden Dissertations and Doctoral Studies

Over the past few decades, there has been an increase in prevalence of diabetes in the United States. Prevention of diabetes and improving patients' knowledge and awareness of diabetes are crucial for healthcare providers. Using the Health Belief Model (HBM) as a theoretical foundation, the student used the National Diabetes Prevention Program (NDPP) from the Centers for Disease Control and Prevention (CDC), to improve awareness and knowledge of diabetes among obese individuals with prediabetes. The key research question of this project was to determine whether the patients' diabetes knowledge and awareness improved after the NDPP program. A convenience sample of …

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The Experiences Of African American Women Participating In Church-Based Weight Loss Programs, Mangle L. Shanks Jan 2017

The Experiences Of African American Women Participating In Church-Based Weight Loss Programs, Mangle L. Shanks

Walden Dissertations and Doctoral Studies

While obesity is a nationwide phenomenon, African Americans - especially women - continue to be more severely affected than any other ethnic group. According to the Centers for Disease Control and Prevention, over 20% of African American women are obese compared to 15.6% of Caucasian women. The church is an important community center for many African Americans, and is often a site for health promotion programs, though little is known of the effectiveness of these programs. The purpose of this qualitative study was to study the experiences and attitudes of African American women who have gone through a church-based weight-loss …

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Serum Iron Concentration And Prostate Cancer In The United States, Aleeshaia Danner Raymonvil Jan 2017

Serum Iron Concentration And Prostate Cancer In The United States, Aleeshaia Danner Raymonvil

Walden Dissertations and Doctoral Studies

Over 2 million adult men in the United States have been diagnosed with prostate cancer, with nearly 200,000 new diagnoses each year. This type of cancer is the leading cause of mortality in U.S. men. One possible risk factor for prostate cancer is a high level of iron in the body, but the association has yet to be confirmed. This study was an investigation of the relationship between serum iron concentration and prostate cancer using data obtained from the 2009-2012 National Health and Nutrition Examination Surveys. This quantitative study involved 1,850 men in the U.S. aged 51 to 70 years. …

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Using Administrative Healthcare Records To Identify Determinants Of Amputee Residuum Outcomes, Judith Gail Walden Jan 2017

Using Administrative Healthcare Records To Identify Determinants Of Amputee Residuum Outcomes, Judith Gail Walden

Walden Dissertations and Doctoral Studies

In the United States, the number of major limb amputees is predicted to exceed several million in the coming decades. For those amputees using a prosthesis, their quality of life (QoL) is often modulated by residuum limb problems resultant from its use. Multiple factors preclude quality evidence-based medicine (EBM) research in the field of prosthetics, leading to greater health risk from prosthetic prescription ambiguity. Positive social change is integral to good QoL; studies support administrative healthcare (AHc) as useful to support such, especially in the absence of EBM. This study utilized Veterans Healthcare Administration (VHA) AHc data to discriminate determinants …

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Influences Of Provider-Patient Communication On Health Literacy And Public Policy Relevant Outcomes, Rachel Carla Cartwright-Vanzant Jan 2017

Influences Of Provider-Patient Communication On Health Literacy And Public Policy Relevant Outcomes, Rachel Carla Cartwright-Vanzant

Walden Dissertations and Doctoral Studies

Several artifacts of federal policy address the connection between health literacy of patients and health outcomes. These laws include The Plain Writing Act, Health Information Technology for Economic and Clinical Health, and the Health Insurance Portability and Accountability Act. Even with this policy structure, little is known about how nurses' knowledge of health literacy may influence patient understanding of medical information and health outcomes. Using Knowles' principles of effective communication, the purpose of this mixed-methods study was to concurrently examine the relationship between nurse knowledge of health literacy and communication techniques used by nurses to identify any causal relationships in …

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Improving Breastfeeding Knowledge Of Staff Nurses, Patience Sirri Mbonifor Jan 2017

Improving Breastfeeding Knowledge Of Staff Nurses, Patience Sirri Mbonifor

Walden Dissertations and Doctoral Studies

The World Health Organization advocates that newborn babies require exclusive breastfeeding until 6 months of age to attain a desired level of growth. Despite this recommendation, exclusive breastfeeding rates continue to be at low levels globally. The purpose of this DNP project was to examine best practices for increasing the breastfeeding knowledge of health care workers, and to understand how breastfeeding is promoted in different healthcare systems. The Critical Appraisal Checklist and the Cochrane Handbook for Systematic Reviews framed this systematic literature review. Additionally, Melnyk's levels of evidence was used to evaluate each article. Articles for inclusion were limited to …

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Health Portal Functionality And The Use Of Patient-Centered Technology, Anita Joyce Simmons Jan 2017

Health Portal Functionality And The Use Of Patient-Centered Technology, Anita Joyce Simmons

Walden Dissertations and Doctoral Studies

Health portals are dedicated web pages for medical practices to provide patients access to their electronic health records. The problem identified in this quality improvement project was that the health portal in the urgent care setting had not been available to staff nor patients. To provide leadership with information related to opening the portal, the first purpose of the project was to assess staff and patients' perceived use, ease of use, attitude toward using, and intention to use the portal. The second purpose was to evaluate the portal education materials for the top 5 urgent care diagnoses: diabetes, hypertension, asthma, …

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American Indians' Perceptions Of Obesity And Its Effects On Healthy Lifestyles, Morgan J. Foster Jan 2017

American Indians' Perceptions Of Obesity And Its Effects On Healthy Lifestyles, Morgan J. Foster

Walden Dissertations and Doctoral Studies

A disproportionate number of American Indians are overweight or obese and have a higher risk of other health concerns compared to the general United States population. Researchers conducting anthropometric studies have found that American Indians have higher body mass indices and worse health than most of the general United States population. There is, however, a gap in the literature regarding American Indians' perceptions, beliefs, opinions, and attitudes of obesity and its effects on their health. The purpose of this qualitative study was to determine whether American Indians view obesity as a major health concern. Focus groups and key-informant interviews were …

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The Perceptions And Experiences Of African American Parents In The Management And Care Of Obese Children, Priscilla Ann Huggins Jan 2017

The Perceptions And Experiences Of African American Parents In The Management And Care Of Obese Children, Priscilla Ann Huggins

Walden Dissertations and Doctoral Studies

Childhood obesity is a global concern among all ethnic groups. Childhood obesity is a problem that continues into adulthood, exacerbating the incidence of diseases such as diabetes or heart disease. The purpose of this phenomenological study was to explore, understand, and describe the perceptions and experiences of African American parents in the management and care of their obese or overweight children. This study used the health-belief model (HBM) as its theoretical foundation, focusing on the constructs of perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy. This research study used an interview tool and an 8-item …

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Predictors Of Mastectomy In Male Breast Cancer, Esther Opara Jan 2017

Predictors Of Mastectomy In Male Breast Cancer, Esther Opara

Walden Dissertations and Doctoral Studies

Male breast cancer (MBC) is rare, and research on the predictors of MBC has been limited because of inadequate funding in and outside of the United States. One goal of this study was to eradicate the stereotyping of breast cancer as a female disease. The emergence of medical technology and education to benefit the public will help to ensure greater health awareness at the individual, community, and global levels. The purpose of this study was to understand the influence of the predictors of age; race (Black, White, and Other); and grade of cancer (I, II, or III) on the outcome …

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Leadership Style And Organizational Citizenship Behavior In Community-Based Mental Health Facilities, Paula Ann Lucey Jan 2017

Leadership Style And Organizational Citizenship Behavior In Community-Based Mental Health Facilities, Paula Ann Lucey

Walden Dissertations and Doctoral Studies

A dramatic and historic evolution has occurred as mental health care has shifted from institutional-based care to community-based care. Framed by the social exchange theory, the purpose of this study was to identify the correlation of the leadership style of supervisors in residential care facilities with the organizational citizenship behavior of the residential care workers. The research questions focused on the correlation between the leadership styles and organizational citizenship behavior (OCB) with a secondary focus specifically on transformational leadership. Residential care workers in 3 states working in 65 facilities within a single organization completed 2 surveys: the Multifactor Leadership Questionnaire …

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