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Walden Dissertations and Doctoral Studies

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The Link Between Disability And Suicide Ideation In Men Over 60, Cassandra Lawrence Aug 2025

The Link Between Disability And Suicide Ideation In Men Over 60, Cassandra Lawrence

Walden Dissertations and Doctoral Studies

The Centers for Disease Control and Prevention considers suicide and suicide ideation as a severe public health issue among older men and people with disabilities. The purpose of this study was to determine if there is a predictive relationship between the level of disability, type of disability (i.e., physical, visual, hearing), functional disability, (i.e., mobility, activities of daily living (ADLs), instrumental activities of daily living (iADLs), and having multiple disabilities on suicide ideation among men with a disability who are aged 60 years and older while controlling for age, depression, marital status and retirement status. The interpersonal-psychological theory of suicidal …


Nonprofit Organizational Effectiveness And Executive Leaders, Karen Renee Solomon Edwards Aug 2025

Nonprofit Organizational Effectiveness And Executive Leaders, Karen Renee Solomon Edwards

Walden Dissertations and Doctoral Studies

U.S. nonprofit organizations provide important services to society as an integral sector within the community. This necessitates organizational effectiveness. The problem explored in this research concerned how nonprofit executive leaders defined organizational effectiveness and perceived their role in creating and sustaining it within their organization. There was limited scholarly literature regarding a common understanding of how executive leaders defined organizational effectiveness within a nonprofit, and how they perceived their role in creating and maintaining it. The purpose of this basic qualitative study was to explore how nonprofit organization executive leaders defined organizational effectiveness and perceived their role in creating and …


Demographic And Clinical Predictors Of Metabolic Dysfunction-Associated Steatotic Liver Disease And Advanced Fibrosis In The United States, Gail Fernandes Aug 2025

Demographic And Clinical Predictors Of Metabolic Dysfunction-Associated Steatotic Liver Disease And Advanced Fibrosis In The United States, Gail Fernandes

Walden Dissertations and Doctoral Studies

Metabolic dysfunction-associated steatotic liver disease (MASLD; formerly nonalcoholic fatty liver disease-related liver fibrosis) is a growing public health problem in the United States. The purpose of this study was to assess the prevalence of MASLD-related advanced fibrosis in the United States and assess whether type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) were independent risk factors for MASLD-related advanced fibrosis. This study was a quantitative cross-sectional analysis of the National Health and Nutrition Examination Survey data from 2011 to 2020, grounded in the social ecological theory. Participants (N = 21,829) were included if they were ≥18 years, excluded if …


Staff Education On Blood Glucose Monitoring Protocols For Assisted Living Facility Staff, Musa Ahmed Mugenyi Aug 2025

Staff Education On Blood Glucose Monitoring Protocols For Assisted Living Facility Staff, Musa Ahmed Mugenyi

Walden Dissertations and Doctoral Studies

At the practice site, older residents face inconsistent and untimely blood sugar assessments, contributing to avoidable complications such as hypoglycemia, hyperglycemia, and hospitalizations. Many caregivers lack standardized training in blood glucose monitoring, which poses a significant risk to residents with diabetes or prediabetes. To address this practice problem, a staff education program on blood glucose monitoring protocols was initiated. The practice-focused question was the following: Will staff knowledge and confidence increase after participating in an education program on monitoring blood glucose levels? As part of the education program, staff received evidence-based instruction on proper techniques for blood glucose testing, recognizing …


A Toolkit For Treating Obesity In Children With Metabolic Syndrome, Karen Mayers-Scott Aug 2025

A Toolkit For Treating Obesity In Children With Metabolic Syndrome, Karen Mayers-Scott

Walden Dissertations and Doctoral Studies

This doctoral project seeks to bridge the existing knowledge gap in using Metformin to manage childhood obesity in patients with metabolic syndrome. The primary goal was to develop a complete toolkit to educate healthcare providers on utilizing Metformin in obese children with metabolic syndrome. Metabolic syndrome, characterized by higher triglycerides, decreased high-density lipoprotein cholesterol, increased blood pressure, elevated fasting plasma glucose, and increased waist circumference, offers considerable health hazards for children. The practice-focused question is, Is the toolkit deemed useful to providers for treating obesity in children with metabolic syndrome using metformin?” The project employed the theory of planned behavior, …


The Association Between Unemployment, Income, Education, Healthcare Access, Mental Health And High-Risk Hiv Behavior In The United States, Tia Smith Aug 2025

The Association Between Unemployment, Income, Education, Healthcare Access, Mental Health And High-Risk Hiv Behavior In The United States, Tia Smith

Walden Dissertations and Doctoral Studies

High-risk HIV behavior remains a critical public health concern in the United States, particularly among socioeconomically and psychologically vulnerable populations. Despite extensive prevention efforts, a gap persists in understanding how structural and mental health factors jointly contribute to HIV risk. This study addresses that gap by examining the association between socioeconomic status (SES), including income, education, employment, and healthcare access, and mental health status (diagnosis of depression and days of poor mental health) on high-risk HIV behavior at the individual level. Guided by the social determinants of health (SDOH) theoretical framework, the study utilized secondary data for over 40,000 adults …


The Impact Of Socio-Emotional And Provider Support On Hiv Testing In Southern United States, Ijeoma Onyinyechi Nwazuruokeh Aug 2025

The Impact Of Socio-Emotional And Provider Support On Hiv Testing In Southern United States, Ijeoma Onyinyechi Nwazuruokeh

Walden Dissertations and Doctoral Studies

HIV was first diagnosed over 40 years ago in the United States; however, HIV remains an epidemic. An understanding of how socio-emotional support, social isolation, and support from an individual's provider influence HIV testing in the Southern United States can be a key to increasing testing rates and ultimately reducing the incidence and prevalence of HIV in the Southern United States. The purpose of this non-experimental quantitative study was to examine the relationship between HIV testing, socio-emotional support, and social isolation, and how these variables are further moderated by an individual having provider support in the Southern United States. The …


Improving Medication Adherence Among Patients With Anxiety, Abong Miyeh Aug 2025

Improving Medication Adherence Among Patients With Anxiety, Abong Miyeh

Walden Dissertations and Doctoral Studies

Addres+D14sing medication non-adherence among patients with anxiety disorders is crucial in nursing practice due to its significant impact on patient outcomes and healthcare costs. This doctoral project explores the effectiveness of staff education in enhancing nurses' skills in promoting medication adherence within this population. The practice-focused question for this project is "What evidence supports the effectiveness of a staff education program in increasing nursing staff knowledge about evidence-based strategies for improving medication adherence among patients with anxiety disorders?" The purpose of this doctoral project is to investigate the effectiveness of staff education interventions in improving medication adherence among individuals with …


Childhood Vaccination In Mozambique Pre- And Post-Covid-19 Pandemic, Remy Mwamba Aug 2025

Childhood Vaccination In Mozambique Pre- And Post-Covid-19 Pandemic, Remy Mwamba

Walden Dissertations and Doctoral Studies

In 2019, infectious diseases and other conditions claimed the lives of over 5 million children under 5. Global immunization coverage remains below prepandemic levels, leaving behind over 14 million zero-dose children in 2022, of whom 84% lived in low- and middle-income countries. This quantitative cross-sectional study aimed to examine, using two consecutive Demographic and Health Surveys, whether the most significant household characteristics and health service utilization risk factors associated with nonvaccination before the COVID-19 pandemic still hold postpandemic in Mozambique. Andersen's behavioral model of healthcare service utilization was the foundation for this investigation. The sample included N=2034 children aged 12-35 …


Non-Pharmacological Interventions For Attention Deficit Hyperactive Disorders And Anxiety, Alichia Lashawn Pecks Aug 2025

Non-Pharmacological Interventions For Attention Deficit Hyperactive Disorders And Anxiety, Alichia Lashawn Pecks

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project used a quality improvement approach to address the co-prescription of stimulants and benzodiazepines in patients with attention deficit hyperactivity disorder (ADHD) and anxiety in outpatient mental health settings. The project explored whether implementing a structured non-pharmacological staff education program for mental health staff could improve knowledge of safe, evidence-based treatment alternatives. The purpose of this staff education project was to improve provider knowledge of evidence-based, non-pharmacological treatment alternatives. To address this issue, a structured non-pharmacological staff education program was implemented to improve provider knowledge of safer, evidence-based treatment alternatives. Four participants completed pre- …


Staff Education For Improved Diabetes Management: Enhancing Knowledge And Patient Outcomes, Carissa Martine Bolden Aug 2025

Staff Education For Improved Diabetes Management: Enhancing Knowledge And Patient Outcomes, Carissa Martine Bolden

Walden Dissertations and Doctoral Studies

An increase in patients’ hemoglobin A1c levels in a South Mississippi organization suggests that inadequate type 2 diabetes (T2DM) knowledge among the staff hindered them from delivering competent care. The gap in practice at the site revealed a deficiency in knowledge in nutrition education for healthcare providers and staff, which led to the practice question: Does educating providers and staff on nutrition for adults with type 2 diabetes improve knowledge, as evidenced by pre- and post-surveys? This educational initiative employed the analysis, design, development, implementation, and evaluation (ADDIE) model, the John Hopkins evidence-based practice (JHEBP) model, the Walden University Doctor …


Patient Engagement Strategies In Weight-Loss Programs, Olufunmilayo M. Bishop Aug 2025

Patient Engagement Strategies In Weight-Loss Programs, Olufunmilayo M. Bishop

Walden Dissertations and Doctoral Studies

Weight regain after pharmacological weight-loss interventions remains a pervasive challenge in primary care, with over 70% of patients reverting to baseline weight within six months. This quality improvement project aimed to enhance healthcare providers’ patient engagement skills to improve retention and long-term outcomes in weight-loss programs. A structured staff training program focusing on motivational interviewing, goal-setting, and barrier recognition was implemented among a multidisciplinary team. The program’s effectiveness was evaluated through a mixed-methods approach, incorporating quantitative pre- and post-assessment scores and qualitative staff satisfaction surveys. Results demonstrated a significant increase in staff knowledge, with average scores rising from 68% to …


The Challenges Faced By Postrelease Offenders In Rural Mississippi, Whitney Starks Aug 2025

The Challenges Faced By Postrelease Offenders In Rural Mississippi, Whitney Starks

Walden Dissertations and Doctoral Studies

Reintegration after incarceration has long been a subject of scholarly inquiry, particularly regarding barriers to employment, housing, and mental health services. However, limited research addresses the reintegration experiences of postrelease offenders in rural regions, where access to essential resources is often restricted. This qualitative single case study is an exploration of the challenges and service needs of formerly incarcerated individuals living in rural Mississippi. Using purposive and snowball sampling, six participants were selected based on residency in rural counties, a nonviolent criminal history, and at least one year of successful community reentry. The conceptual framework was guided by the assess, …


Staff Education To Same Day Surgery Nurses, Katherine Lutman Aug 2025

Staff Education To Same Day Surgery Nurses, Katherine Lutman

Walden Dissertations and Doctoral Studies

The aim of this doctor of nursing practice staff education project was to provide a staff education program to the same day surgery staff at the practicum site on the Enhanced Recovery After Surgery (ERAS) evidence-based approach to surgical care to improve patient outcomes. ERAS includes multiple modalities designed to optimize a patient’s condition before, during, and after surgery. When implemented correctly, ERAS can reduce the need for narcotics, shorten recovery time, and improve surgical outcomes. The practice gap identified was that the only ERAS modality being actively implemented and tracked was nutrition in colorectal surgical patients and that the …


Postpartum Experiences Of Arab Women And The Educational Role Of The Mother, Diana Ikki Jul 2025

Postpartum Experiences Of Arab Women And The Educational Role Of The Mother, Diana Ikki

Walden Dissertations and Doctoral Studies

Women in the Arab world traditionally observe a 40-day postpartum rest period, during which they rest, follow specific rituals, and learn to care for their newborn under the guidance and care of a family matriarch, typically their mother. Despite the prevalence of this practice, there is limited empirical research exploring the educational role of Arab mothers during their daughters' postpartum period; this qualitative study addressed this gap. Foundational to this study’s theoretical framework was Ramona Mercer’s theory of maternal role attainment. The study addressed two research questions: how Arab women describe their postpartum experiences and the educational role their mothers …


Association Between Sociocultural Factors, Obesity, And Depression In The Hispanic/Latino Population, Maia Junco Jul 2025

Association Between Sociocultural Factors, Obesity, And Depression In The Hispanic/Latino Population, Maia Junco

Walden Dissertations and Doctoral Studies

The increasing prevalence of obesity and mental health disparities among Hispanic/Latino populations in the United States underscores the need to understand how sociocultural factors shape physical and psychological health. The purpose of this study was to examine how acculturation, diet quality, and fiber intake affect BMI and depressive symptoms over time. The study was guided by acculturation theory and the biopsychosocial model. The study used longitudinal secondary data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) with a sample of N=8,816, including adults who completed examination visits, 1 (2008–2011) and 2 (2014–2017). Path analysis was conducted to assess direct …


Relationship Between Participation In Employee Wellness Programs And Health-Related Quality Of Life Among Health Care Workers, Ana Williams Jul 2025

Relationship Between Participation In Employee Wellness Programs And Health-Related Quality Of Life Among Health Care Workers, Ana Williams

Walden Dissertations and Doctoral Studies

Employee wellness programs are available in many health care organizations but remain underutilized by health care workers. Low employee participation in these wellness programs can negatively impact employees’ health-related quality of life (HRQoL), which, in turn, may adversely influence patient care and overall health outcomes. Despite this, little is known about which factors, such as perceived barriers and benefits, job category, or work shift, are associated with participation. This study addressed that gap by exploring how these variables relate to employee engagement in wellness programs and their potential impact on HRQoL. Guided by the health belief model, this study examined …


Factors Associated With Maternal Health Care Utilization In Liberia, West Africa, Isaac Nyumah Yah Jul 2025

Factors Associated With Maternal Health Care Utilization In Liberia, West Africa, Isaac Nyumah Yah

Walden Dissertations and Doctoral Studies

Extant literature reports increased uptake of maternal health care utilization in Liberia in the era following the 14-year civil war that ended in 2004. The purpose of this secondary quantitative data analysis study was to examine the relationship between women’s place of residence, women’s earnings spending autonomy, and maternal health care utilization of women ages 15–49 in Liberia. Maternal health care utilization in this study is measured by women’s visits to government hospitals for antenatal care. Maternal health care utilization indicates whether women who were pregnant within the 3 years before the 2019–20 Demographic Health Survey in Liberia attended any …


Association Between Homelessness And Maternal Health Outcomes Among Non-Hispanic Black Women In Georgia, Miranda Weaver Jul 2025

Association Between Homelessness And Maternal Health Outcomes Among Non-Hispanic Black Women In Georgia, Miranda Weaver

Walden Dissertations and Doctoral Studies

Maternal health disparities among homeless non-Hispanic Black women in Georgia represent a critical public health concern, driven by inequitable access to care and elevated risks of adverse pregnancy outcomes. This study examined how homelessness influences perinatal care utilization (timing and frequency of prenatal visits and postpartum checkups) and pregnancy complications (gestational diabetes, hypertension, and depression), and whether these associations differ by geographic context (urban versus rural). Grounded in the Social Determinants of Health framework, the study used a quantitative cross-sectional design, analyzing secondary data (n = 1,540; weighted ≈ 203,571) from Phase 8 (2017–2021) of the Pregnancy Risk Assessment Monitoring …


The Covid-19 Lockdown And Diabetes Self-Management In Esan Northeast Area Of Edo State, Esther Ehivbaun Rapu Jul 2025

The Covid-19 Lockdown And Diabetes Self-Management In Esan Northeast Area Of Edo State, Esther Ehivbaun Rapu

Walden Dissertations and Doctoral Studies

The COVID-19 lockdown impacted chronic diseases care globally, but there is limited research on how individuals in rural Nigerian communities managed diabetes during this period. This qualitative phenomenological study explored the lived experiences of self-management with diabetes during the COVID-19 lockdown among adults in Esan Northeast. The socioecological model (SEM) served as the guiding conceptual framework, allowing for the exploration of the impact of individual, interpersonal, community, and institutional factors on self-care behaviors. The research explored how cultural, social and economic factors impacted how adults with diabetes in Esan Northeast managed their condition during the COVID-19 lockdown. Semi-structured interviews via …


Predicting Dietary Behavior In Obese Adult Diabetics Using Social Cognitive Theory, Precious Mueller Jul 2025

Predicting Dietary Behavior In Obese Adult Diabetics Using Social Cognitive Theory, Precious Mueller

Walden Dissertations and Doctoral Studies

Predicting Dietary Behavior in Obese Adult Diabetics Using Social Cognitive Theory by Precious Mueller MA, University of Phoenix, 2009 BS, University of Iowa, 2006 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University November 2024 “ Diabetes mellitus Type II is a prevalent and serious condition affecting millions globally, particularly among obese adults. The association between dietary behaviors and diabetes management is critical, as it directly impacts health outcomes and quality of life for affected individuals. This study aims to identify the determinants of dietary behaviors that influence Type II …


Exploring Reciprocal Determinism, Behavior Capability, Observational Learning, And Self-Efficacy On Protective Behaviors For African American Millennial Women With Cardiovascular Disease And Depression, Ja’Sent Angelic Brown Jul 2025

Exploring Reciprocal Determinism, Behavior Capability, Observational Learning, And Self-Efficacy On Protective Behaviors For African American Millennial Women With Cardiovascular Disease And Depression, Ja’Sent Angelic Brown

Walden Dissertations and Doctoral Studies

Cardiovascular disease plays a significant role in the number of death and disabilities around the world. While there have been marginal gains in positive health outcomes for women who suffer from cardiovascular disease, African American women continue to fall behind compared to their White counterparts. There is a comorbidity of cardiovascular disease and depression in older African American women. The purpose of this qualitative study was to gain an in-depth understanding of how the comorbidity of cardiovascular disease and depression uniquely present in young African American women, how these two diseases influence cardiovascular health protective factors, and how components of …


Perspectives Of Childcare Center Directors Regarding Barriers To Naeyc Accreditation, Jessica Baffoe Jul 2025

Perspectives Of Childcare Center Directors Regarding Barriers To Naeyc Accreditation, Jessica Baffoe

Walden Dissertations and Doctoral Studies

NAEYC accreditation is a hallmark of quality in early learning and lack of accreditation suggested a gap in practice. The problem that was the focus of this research is that only 12% of early childhood center-based programs in the United States are accredited by the National Association for the Education of Young Children (NAEYC). The purpose of the study was to explore perspectives of childcare center directors regarding NAEYC accreditation. Knowles’s adult learning provided the conceptual framework for this study and guided 3 research questions about directors’ perspectives of barriers, benefits, and the necessary support they associated with NAEYC accreditation. …


The Impact Of The Covid-19 Pandemic And Race On Access To Maternal Healthcare Services For Patients Based On Insurance Status, Trishana Monlyn Jul 2025

The Impact Of The Covid-19 Pandemic And Race On Access To Maternal Healthcare Services For Patients Based On Insurance Status, Trishana Monlyn

Walden Dissertations and Doctoral Studies

Due to insurance status, COVID-19 has restricted how and when patients can access healthcare providers. In the health services community, examining obstetric care services during the coronavirus outbreak was important because it increased awareness about how changes to maternal healthcare access affect the health of the mother and unborn child during a pandemic. The theories and/or concepts that grounded this study include the intersectionality theory, which examined the connections between social groups and systems as individuals try to access health services based on health insurance reform, depending on their race. The purpose of this study was to determine if there …


Intersectionality Gaps Among Multiple Social Determinants In U.S. Infant And Maternal Mortality Rates, Mary D. Kirkley Jul 2025

Intersectionality Gaps Among Multiple Social Determinants In U.S. Infant And Maternal Mortality Rates, Mary D. Kirkley

Walden Dissertations and Doctoral Studies

The purpose of this quantitative, cross-sectional study was to examine whether social determinants interactively influence U.S. maternal and infant mortality rates. Grounded in the Social Ecological Model, this study analyzed secondary data from the Centers for Disease Control and Prevention’s National Vital Statistics System were analyzed using multivariable logistic regression. The final sample included 110,402 maternal deaths and 55,839 infant deaths, with inclusion criteria requiring complete data on race, education, age, marital status, gender (for infants), residency, and year of death. Exclusion criteria included non-U.S. resident deaths or missing demographic data. Results revealed statistically significant interaction effects: race/ethnicity with education …


The Association Between Dietary Behavior Change And The Health Of Adult African Immigrants In The United States, Seyoum Abebe Jul 2025

The Association Between Dietary Behavior Change And The Health Of Adult African Immigrants In The United States, Seyoum Abebe

Walden Dissertations and Doctoral Studies

African immigrants represent one of the fastest-growing immigrant populations in the United States; yet, their health outcomes related to Type II diabetes remain understudied compared to other racial and ethnic groups. Grounded in the theoretical framework of the Health Belief Model, the purpose of this quantitative non-experimental study was to examine the relationship between dietary behavior changes and the diagnosis of Type 2 diabetes among African immigrants aged 20–80 residing in the United States. The research questions examined the association between getting meals prepared away from home and awareness of MyPlate nutritional guidelines, recommended by the U.S. Department of Agriculture, …


Jamaican Blue Mountain Coffee Farmers’ Effective Strategies For Achieving Profitability, Norman Washington Grant Jul 2025

Jamaican Blue Mountain Coffee Farmers’ Effective Strategies For Achieving Profitability, Norman Washington Grant

Walden Dissertations and Doctoral Studies

Jamaican Blue Mountain (JBM) coffee farmers often fail to improve production, which has the potential for adverse business outcomes. Farmers and business owners are concerned about the sustainability of their farm operations, which is essential for achieving profitability. Grounded in Hawley’s risk theory of profit, the purpose of this qualitative multiple case study was to identify and explore effective strategies that JBM coffee farmers used to achieve profitability. The participants were six JBM coffee farm owners in the Jamaican coffee industry who used effective strategies to achieve profitability. Data were collected using semistructured interviews and a review of organizational marketing …


Evaluating Nutrition, Exercise, And Education, On Mental Health And Quality Of Life In Menopause, Jill R. Stone Jul 2025

Evaluating Nutrition, Exercise, And Education, On Mental Health And Quality Of Life In Menopause, Jill R. Stone

Walden Dissertations and Doctoral Studies

Physical inactivity, poor nutrition, and a lack of understanding of menopause adversely affect mental health and quality of life in women entering menopause. Metabolic changes during this period can lead to an increase in visceral fat, loss of muscle mass, depression, and anxiety. These metabolic changes are linked to a higher risk for cardiovascular disease, type two diabetes, and metabolic syndrome. This cross-sectional quantitative study, guided by the health belief model, explored the contribution of adopting specific nutrition strategies, exercise, and education in women during menopause transition to help manage mental health (as measured by depression and tension), and quality …


Understanding Georgia Child Welfare Case Manager’S Perspective, Practicum Experience, And Retention, Takierra Dawson Jul 2025

Understanding Georgia Child Welfare Case Manager’S Perspective, Practicum Experience, And Retention, Takierra Dawson

Walden Dissertations and Doctoral Studies

Child welfare workers have high turnover rates and low retention rates. While there is well-documented research on reasons for turnover, no research was found on how a case manager's practicum experience impacts turnover rates. The purpose of this qualitative study was to explore child welfare case managers' perspectives on retention and to understand how their practicum and internship experiences influence retention. The theories that ground this research include systems theory by Bertalanffy and social constructivism by Vygotsky. The two research questions for this generic qualitative study were: What are the experiences of child welfare case managers during their internship and …


The Lived Mental Health Experiences Of African American/Black Mothers With An Infant In The Neonatal Intensive Care Unit During Covid-19, Dr. Shewonyui S. Lurker Jun 2025

The Lived Mental Health Experiences Of African American/Black Mothers With An Infant In The Neonatal Intensive Care Unit During Covid-19, Dr. Shewonyui S. Lurker

Walden Dissertations and Doctoral Studies

African American/Black (AA/B) women are more likely than other women in the United States to give birth prematurely. Experiencing premature birth and infant hospitalization in the neonatal intensive care unit (NICU) during the COVID-19 pandemic may have negatively affected AA/B mothers’ mental health and led them to experience elevated rates of increased posttraumatic stress disorders, depression, anxiety, and postpartum depression. The purpose of this study was to understand the lived mental health experiences of AA/B mothers of infants in the NICU during COVID-19. Feminist theory provided a lens for understanding intersectionality in the experiences of AA/B mothers. Semistructured interviews were …