Digital Commons Network^™

Perceived Barriers To Health Care Access And Delivery Among Arkansas Medicaid Beneficiaries, Kimbra D. Butler

Walden Dissertations and Doctoral Studies

Arkansas has historically been one of the lowest ranking states in the United States in education, economy, opportunity, crime and corrections, and health care. Though more than 3 million Arkansans live in the state, nearly 1 million receive Medicaid-funded health insurance. This phenomenological study employed a constructivist paradigm and focused on the perceptions of underserved Arkansans regarding their health and their access to health care; additionally, within this study, the Health Belief Model shifted the study’s focus to individuals’ perspectives, perceptions, experiences, and opinions through interview responses. The research was intended to identify factors that may relate to the higher …

Professional Identity Within An Evolving Profession: Clinical Social Work In Puerto Rico, Lorna Betzaida Colon Gonzalez

Walden Dissertations and Doctoral Studies

More than three decades of data document the challenges of clinical social workers in establishing their professional identity within the social work profession in Puerto Rico. Less is known specifically about how they identify within interdisciplinary and multidisciplinary teams in the various clinical settings on the island. The purpose of this study was to explore the perceptions of clinical social workers in Puerto Rico regarding their professional identity as compared to generalist social workers. The generic qualitative study was based on the ecological system theory framework. Data were collected from semistructured interviews with a purposive sample of 10 clinical and …

Case Managers’ Perspectives Of Hospital Postdischarge Services For Patients Diagnosed With Coronary Artery Disease, Brian Alexander Grant

Walden Dissertations and Doctoral Studies

The United States lacks postdischarge services, which can negatively impact hospital readmissions within 30 days. It is important for case managers to effectively leverage outpatient services to enhance patient care and reduce readmission rates. Grounded in the practice change model framework, this qualitative single case study explores the perspectives of case managers involved with postdischarge services for patients diagnosed with coronary artery disease (CAD). Participants included 13 case managers from two metropolitan hospitals in Atlanta, Georgia. To address the research problem and study purpose, data collection techniques included semi-structured interviews, case management discharge summaries, and reflective journal notes. The thematic …

Diabetes, Obesity, Geographic Location Of The Patient And Clostridium Difficile Infection In The United States, Mary (Maribeth) Greenway

Walden Dissertations and Doctoral Studies

AbstractClostridium difficile infection (CDI) is a major nosocomial threat to be reckoned with in the current health care setting in the United States. Advancing age, underlying chronic disease associated with inflammation (including Diabetes Mellitus Type I ([DMI]), Diabetes Type II ([DMII]), and obesity), trauma, immunodeficiency and other factors that diminish the overall health of an individual, and increase an individual’s susceptibility to CDI. The ecological framework was used to determine the relationship between geographic, chronic diseases and the occurrence of infectious diseases. To continue enhancing knowledge related to CDI susceptibility this quantitative study used the 2010 National Hospital Discharge Survey …

The Experiences Of Teenage Mothers About The Socioeconomic Aspects Of Teen Pregnancy In A Low-Income Community, Sunday Kerobo

Walden Dissertations and Doctoral Studies

Teenage pregnancy has adverse social, economic, and health consequences for adolescents. Pregnancy in adolescence is linked to high school dropout, high unemployment, stigma, low income, financial hardships, anxiety, and depression.. The purpose of this phenomenological research study was to understand the socioeconomic factors that impact young mothers aged 17 years and younger in low-income communities. Schlossberg's transition theory guided this study. Fifteen young women ages 18 and 24 who were either pregnant or had given birth before age 17 years and under were recruited through purposive sampling and interviewed using in-depth key informant interviews. Audio recordings of interviews were transcribed, …

Head Start Teachers' Descriptions Of Inclusion, Lawanda Katrina Lovett-Cunningham

Walden Dissertations and Doctoral Studies

AbstractA Head Start program in Southeast Georgia, teachers were struggling to provide appropriate services to students with special needs (SWSN) in inclusive settings. The purpose of this study was to explore Head Start teacher descriptions of their roles and the barriers that inhibit implementation of inclusive education for SWSN. McKenzie and Zascavage’s model of inclusion formed the conceptual framework that guided this study. The research questions for this study addressed teacher descriptions of their roles and the barriers that inhibit the implementation of inclusive teaching strategies. A basic qualitative design was used to capture the insights of 12 purposefully selected …

Intimate Partner Violence Education In An Outpatient Setting, Juddy Morgan

Walden Dissertations and Doctoral Studies

Intimate partner violence/domestic violence (IPV/DV) has been a widely recognized yet preventable public health concern. Despite the increased attention to IPV/DV, there has been a lack of knowledge in recognizing its symptoms and referring victims to appropriate community services by staff in a mental health outpatient clinic. The purpose of this project was to provide the clinic staff with the knowledge to recognize symptoms of IPV/DV victims and refer them to appropriate services within the community. The educational intervention was designed to increase the clinic staff’s knowledge of recognizing victims of IPV/DV; becoming familiar with the Hurt, Insult, Threaten, Scream …

Staff Education For Obesity And An Evidence- Based Checklist To Manage Obesity, Veronica B. Nelson

Walden Dissertations and Doctoral Studies

AbstractObesity is a global problem that affects individuals of all ages. It results in a myriad of adverse health effects for children and adults. It is a preventable condition that can lead to a host of physical and psychological health conditions. Despite numerous attempts to decrease the incidence and prevalence of obesity, it continues to be a persistent problem. Efforts to decrease its incidence and prevalence are thus warranted within the nursing profession. Obesity management is inconsistent in clinical practice. This project aimed to deliver an education program to the staff of a pediatric clinic who serves many obese clients. …

Acculturation And Emotional Eating Among Arabic Middle Eastern Women In The United States, Sherri Alizz Roohi-Booroujeni

Walden Dissertations and Doctoral Studies

Obesity is a substantial problem that occurs worldwide and is highly associated with increased risks of chronic diseases such as Type II diabetes mellitus, cardiac-related diseases, hypertension, and some cancers. Middle Eastern cultures have one of the highest rates of overweight and obesity, estimated to be the second highest worldwide. The purpose of this study was to examine the relationship among stress, depression, emotional eating, and weight gain in Middle Eastern women, specifically Arabs, who have moved to the United States, using a quantitative approach. The theoretical foundation was psychosomatic theory, which explains the connection between psychological problems and emotional …

Lived Experiences Of Congenital Heart Defect Diagnosis In Adulthood, Jacklyn Sanders

Walden Dissertations and Doctoral Studies

Abstract

Congenital heart defects (CHD) are reported by the Centers for Disease Control and Prevention as the most common type of birth defect and can affect more than 30,000 infants each year. However, CHDs diagnosed in adulthood are becoming a growing public health concern. When the defect is not diagnosed in infancy or childhood, adult individuals may experience an array of signs and symptoms leading to the diagnosis of a CHD. CHDs that are undiagnosed until an individual reaches adulthood can cause many health complications. The purpose of this phenomenological study was to describe the lived experiences of adults diagnosed …

Reducing Hospital Noise Levels Through Nursing Staff Education, Althea Sanders

Walden Dissertations and Doctoral Studies

AbstractNoise levels can negatively affect a patient’s hospital experience. Increased noise levels in the hospital can trigger sleep disturbance and affect the length of recovery for patients; the increased noise levels can also cause increased anxiety and exhaustion for nursing staff members. Due to a gap in nursing practice related to nurses’ knowledge to safely reduce noise levels, this project addressed if nursing staff education on noise reduction could increase the knowledge among nursing staff members to use specific strategies to reduce noise levels in an intensive care unit (ICU) setting. The purpose of this project was to educate eight …

Speech-Language Pathologists’ Thoughts About Emotion Regulation Therapy To Improve Students’ Employability, Phyllis R. Scott

Walden Dissertations and Doctoral Studies

AbstractHigh school graduates with language deficits often have poor emotion regulation (ER), enter the workforce unprepared to meet the emotional demands, and experience workforce outcomes that lead to a poor quality of life. Speech-language pathologists (SLPs) teach ER, but little is known about ER-targeted speech-language therapy (ERSLT) for high schoolers with mild-to-moderate language impairments and ER deficits (MMLI/ER). This study was designed to explore SLPs’ views and decisions about providing ER-SLT to improve career readiness and employability for students with MMLI/ER. Several studies, the evidence-based practice (EBP) model, and a thematic analysis approach informed this integrative interpretive description design and …

Effective Management Of Diabetes Mellitus Type Ii In A Military Treatment Facility, Jozy Merizier Smarth

Walden Dissertations and Doctoral Studies

In the United States, 34 million people have diabetes and 79 million have prediabetes. Currently, one in nine Americans are diagnosed with diabetes and it is projected that one in five will have diabetes by 2025 and one in three by 2050. The practice-focused question answered by this project addressed the question if implementing a staff education program improved staff’s knowledge about self-management education and intent for providers and staff to promote a formal diabetes self-management education (DSME) program in an overseas military treatment facility. The site has 47% of empaneled beneficiaries with diabetes mellitus Type II with an elevated …

Exploring Promotoras As Influencers Of Physical Activity And Diet Acceptability Among Latinas, Gladys Orock Tataw-Ayuketah

Walden Dissertations and Doctoral Studies

Promotoras are frontline community health workers who help link Latino community members to health and social services. Latino women have high rates of attrition and lack of participation in weight loss programs due to various barriers, and the promotora model is vital to address these concerns. The approach incorporates strong family support and influence to address health and social issues through interdependent ties of promotoras and families who live and work within the community they serve. The purpose of this qualitative study was to explore how promotoras influenced the acceptability of and participation in physical activity and dietary modification programs …

Evaluating The 2012 Vaccination Reporting Mandate: Applications To Adventist Health Network, May Abdalla

Walden Dissertations and Doctoral Studies

Influenza is a public health concern that claims up to 56,000 lives annually in the United States, though it is a vaccine-preventable disease. Influenza vaccination among health care personnel (HCP) is highly encouraged to prevent influenza transmission in health care settings. The objective of this study was to examine the relationship between mandatory reporting of HCP influenza vaccination rates (implemented in 2012) and HCP influenza vaccination intake in a health care network with 20 hospitals. The protection and motivation theory was used as the theoretical framework. Data collected from surveys of hospital administrators and archives of the Center for Medicare …

Whole Health Peer Pathway And Conventional Medicine To Promote Health In Diabetic Veterans, Delcina D Augustin Doreus

Walden Dissertations and Doctoral Studies

AbstractThe Veterans Health Administration has been one of the first to adopt the Whole Health approach in combination with therapeutic treatment, which is recommended to promote disease management and prevention of comorbidities associated with diabetes. However, this modality has not been adopted by the health care system. The purpose of this study was to examine the association between the veterans who have been in the Whole Health Program in combination with therapeutic treatment and those who have only been focusing on the therapeutic treatment regimen. The variables were A1C levels and adhering to medication renewal to determine whether veterans in …

Food Availability And Sanitation Conditions In Pademba Road Prisons, A Case Study, Santos Alimamy Bangura

Walden Dissertations and Doctoral Studies

Abstract Prisons generally suffer from poor sanitation and food shortages that undermine the health and overall quality of inmates’ lives. Focusing on Pademba Road Prison in Freetown, Sierra Leone, the purpose of this study was to provide policy recommendations that benefit the inmates by ensuring they receive nutritious meals and improved conditions of hygiene. The following research question shaped the study: What policies can be formulated that would give inmates access to adequate food and improved sanitation at Pademba Road Prison? This qualitative case study took place in single research setting and focused on the dilemma of the workers and …

A Staff Education Program To Improve Nurses’ Knowledge Of Managing Type 2 Diabetes, Steven Essien

Walden Dissertations and Doctoral Studies

AbstractOlder adults residing in long-term care facilities (LTCFs) have high prevalence rates of Type 2 diabetes (T2D). However, registered nurses practicing in these settings often lack the essential knowledge to manage the condition. The staff development activity developed for this project was to improve LTCF registered nurses' knowledge of understanding of the American Diabetes Association (ADA) position statement on the management of diabetes in LTCFs. The project was grounded in Knowles's adult learning theory. Lynn's content validity model was used to evaluate the staff development activity. The project's practice-focused questions concerned whether the educational sessions met Lynn's evaluation criteria and …

Experiences Of Rural Female Caregivers Of Loved Ones Diagnosed With Chronic Pain And Mental Health Care, Anne Banner Hatfield

Walden Dissertations and Doctoral Studies

AbstractThe complex diagnosis of chronic pain can include both physiological and psychological symptoms resulting in a need for caregivers to assist their loved ones and become involved in their mental health care treatment. As the aging population and the number of individuals diagnosed with chronic pain increases, the number of caregivers who assist them also increases. Critical to addressing the psychological symptoms of chronic pain is knowing how caregivers experience their involvement in mental health treatment. This research addressed the need for an understanding of caregivers’ experiences of caregiving and involvement with health care providers of mental health treatment for …

Exploring African American Women’S Experiences With Breastfeeding Support In Health Services, Jennifer Johnson

Walden Dissertations and Doctoral Studies

Breastfeeding provides complete nutrition to infants and reduces the risk of many chronic diseases among infants and their mothers, yet disparities exist. African American mothers have the lowest breastfeeding rates compared to other ethnic groups in the United States. There is limited qualitative research on health services support from the African American mother’s perspective. Understanding health behaviors may improve programming, reduce racial and ethnic disparities, and address social determinants of health. The purpose of this study was to explore African American women’s beliefs, experiences, perspectives, and opinions around breastfeeding support provided in healthcare settings by healthcare professionals. From a conceptual …

Coping Strategies Linked To African Americans With Chronic Kidney Disease, Gabrielle Lawrence

Walden Dissertations and Doctoral Studies

Chronic kidney disease (CKD) is a health problem that affects African Americans more often than Whites and other ethnic groups. Individuals with CKD need to develop strategies to help with the disease and life challenges. Social support, self-management, and self-efficacy are factors that may influence how individuals with CKD cope with the disease. This quantitative correlational study examined the relationships among self-management, self-efficacy, and coping behaviors in African Americans with CKD in Stages 3 or 4. In addition, the moderating effect of social support on the extent to which self-management and self-efficacy account for the variance of coping behaviors in …

Association Between Family Structure And Childhood Obesity In Essex County, Nj., Chima Tony Onyeagoro

Walden Dissertations and Doctoral Studies

Obesity is one of the most prevalent nutritional disorders in children in the United States. There are many factors associated with childhood obesity, but there is limited information about the association between family structure and childhood obesity. This quantitative retrospective cross-sectional study, guided by the Social Ecological Model, was carried out to identify the effect of family structure on childhood obesity. For this study, the 2017 National Survey of Children’s Health (NSCH) of children 6-13 years old residing in the state of New Jersey was analyzed. Binary logistic regression was used to determine the relationship between family structure and obesity, …

Children's Body Mass Index Before And After Covid-19 Related Childcare Center Closures, Ericka L. Peterson

Walden Dissertations and Doctoral Studies

Prolonged childcare center closures due to COVID-19 restrictions have changed children’s health-related behaviors that may result in an increased risk in childhood obesity. Grounded in the social ecological model, the purpose of this study was to examine the differences in body mass index (BMI), physical activity, consumption of sugar-sweetened beverages (SSBs), and screen time among preschool aged children enrolled in the Merced County Office of Education Head Start program before and after COVID-19 related Head Start center closures. A quantitative, longitudinal study design using secondary data from ChildPlus was used. The paired t-test and Wilcoxon signed-rank test was used to …

Influences Of 12-Hour Shifts On Unhealthy Eating Habits Of Acute Care Nurses, Ruth Sawdy

Walden Dissertations and Doctoral Studies

Shift work is a necessary part of a nurses’ work schedule to patients who need 24 hours of continuous care. Eating habits of nurses are influenced by working long hours, not having adequate time to take a meal break, and not having access to healthy food choices which can cause stress and exhaustion and results in weight gain and obesity. The purpose of this quantitative logistic regression analysis, guided by the health belief model and the theory of planned behavior, was to determine if there was a relationship between shift work and the unhealthy eating habits/obesity rates of acute care …

Mental Health Counselors’ Use Of Complementary And Alternative Approaches For Treating Individuals With Anxiety Disorders, Jane Rose Simmons

Walden Dissertations and Doctoral Studies

Anxiety disorders are one of the most prevalent mental health disorders worldwide. Traditional counseling approaches do not address the evolving needs of individuals with anxiety disorders, and information is scarce regarding counselors’ use of complementary and alternative approaches in treating anxiety disorders. The purpose of this quantitative survey study was to investigate whether counselors’ knowledge, perceptions, intentional practices, and openness predicted their use of complementary and alternative approaches in counseling individuals with anxiety disorders. The integrative mental health model for the conceptual framework guided this study. The research questions examined how five variables—spirituality, specialization, types of anxiety disorders treated, training, …

Nursing Staff Education On The Use Of The American Diabetes Association Guidelines, Terrie Hattie Allen

Walden Dissertations and Doctoral Studies

AbstractDiabetes mellitus is a complex chronic condition that requires continuous care and management. Approximately 34 million Americans are diagnosed with diabetes and around 90%–95% suffer from Type 2 diabetes. The problem identified in this project was the need to follow the American Diabetes Association guidelines in place at the study site clinic but are not adhered to by the staff. Framed within the analysis, design, development, implementation, and evaluation model of instructional design, the purpose of this project was to plan, implement, and evaluate a nursing staff education program on the use of the American Diabetes Association Guidelines for diabetes. …

Psychosocial Complexities Of American Black Women’S Experiences With Weight Loss Or Obesity, Danielle Atkins

Walden Dissertations and Doctoral Studies

Weight loss and obesity among American Black women (including African American and Caribbean Black women) is a growing issue in the United States. However, a notable gap exists in the literature regarding research into this population’s lived experiences with weight loss or obesity, specifically regarding underlying psychosocial needs, such as cultural influences, self-care, and social networks, which are not being met to support them in making behavioral changes. A greater understanding of the impact of American Black women’s psychosocial underlying experiences may help mental health professionals support them in their efforts toward a healthier lifestyle. Using Bronfenbrenner’s ecological systems model …

Prophylactic Antimalarial Intermittent Preventive Therapy In Pregnancy And Birth Weight In Togo, Epiphane Awokou

Walden Dissertations and Doctoral Studies

In Togo, prophylactic antimalarial intermittent preventive therapy in pregnancy (IPTp) is provided to disrupt suboptimal pathways leading to the issue of low birth weight. However, there is a lack of nationally representative data on the determinants of this adverse birth outcome. The purpose of this quantitative cross-sectional study was to determine pregnancy-related determinants of low birth weight through a nationally representative dataset. Bronfenbrenner’s ecological systems model guided this study to explore potential associations between the covariates IPTp, utilization of long-lasting insecticidal bed nets, age of pregnant women, socioeconomic status of pregnant women, and gravidity type of pregnant women and the …

Economic Challenges Faced By African American Teenage Parents While Parenting During The Coronavirus Pandemic, Peace A. Barrigah

Walden Dissertations and Doctoral Studies

U.S. African American teenage parents are at a disproportionately high risk of experiencing stressors associated with the financial demands of parenting during the COVID-19 pandemic. The purpose of this qualitative descriptive study was to explore the socioeconomic challenges that African American teenage parents living in U.S. northeastern state face during events such the COVID-19 pandemic that limit the provision of human services, which the research question was designed to answer. The framework used in this study was social learning theory. A sample of 10 Black teenage parents residing in the northeastern United States were recruited. Data were collected through interviews …

Policy Sustainability Issues: Case Study Of Cassava Farmers In Ikorodu. Lagos, Nigeria, Medinat Oluwatoyin Adetunji

Walden Dissertations and Doctoral Studies

The inconsistency and lack of continuity of Nigeria's agricultural policies impact the cassava sector. Despite being the world's biggest producer, the country is yet to benefit from the advantage due to a lack of sustainable growth. The situation manifests in terms of low productivity, low production level, and poor income to the farmers. The purpose of this qualitative study was to investigate the experiences and perceptions of the cassava farmers on cassava policies and the effect on their income and livelihoods in the Ikorodu local government of Lagos State. This qualitative study adopted a case study research design using participatory …