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Understanding Relapse And The Correlation With Group Counseling Accountability, Attendance, And Attitudes, Willie Sanders
Understanding Relapse And The Correlation With Group Counseling Accountability, Attendance, And Attitudes, Willie Sanders
Walden Dissertations and Doctoral Studies
Substance abuse continues to create significant personal, family, and legal challenges, yet limited research exists on mandated clients receiving counseling within rural municipal court systems. Studying factors associated with relapse allows counselors and counselor educators to develop interventions to prevent relapse and improve treatment outcomes. The purpose of this quantitative study was to investigate the relationship between group counseling attributes of attendance, accountability, attitudes and the level of relapse rates among rural municipal court clients in Columbus, Mississippi, as measured by the DEF, Subtle, Face Valid Alcohol, Face Valid Other Drugs, and the OAT Scales of the SASSI-4 Assessment. Theoretical …
Staff Education To Enhance Nurse Knowledge Of Standardized Sud Screening Using The Dast-10 In An Outpatient Psychiatric Setting, Peters Olugbemiga Adu
Staff Education To Enhance Nurse Knowledge Of Standardized Sud Screening Using The Dast-10 In An Outpatient Psychiatric Setting, Peters Olugbemiga Adu
Walden Dissertations and Doctoral Studies
The utilization of substance use disorder (SUD) screening tools at the practice site was inconsistent, contributing to limited identification and diagnosis of SUDs. The project was conducted at a psychiatric outpatient clinic in an urban region of Maryland that serves many patients with co-occurring mental health and substance use disorders. The purpose of the project was to develop, implement, and evaluate a staff education program focused on the Drug Abuse Screening Test (DAST-10). The primary goal was to improve staff knowledge and understanding of the DAST-10 screening tool. A 14-item multiple-choice questionnaire was administered before and after the educational intervention …
Licensed Counselors’ Meaning-Making Of Debriefing Experiences Following Client Crises In Community Mental Health Centers, Donna Howard
Licensed Counselors’ Meaning-Making Of Debriefing Experiences Following Client Crises In Community Mental Health Centers, Donna Howard
Walden Dissertations and Doctoral Studies
Licensed professional counselors working in community mental health centers (CMHCs) frequently respond to client crises; however, little was known about how they understand and make meaning of debriefing following those events. The purpose of this qualitative interpretative phenomenological analysis (IPA) study was to explore counselors’ meaning-making of debriefing following client crises in CMHCs. Guided by IPA and grounded in phenomenology and hermeneutics, data were collected through semistructured interviews with five licensed professional counselors who had at least 5 years of CMHC experience, participated in postcrisis debriefing, and graduated from programs accredited by the Council for the Accreditation of Counseling and …
Staff Education To Nurses On Trauma-Informed Care, Lorna Sackey
Staff Education To Nurses On Trauma-Informed Care, Lorna Sackey
Walden Dissertations and Doctoral Studies
Many nurses receive little formal instruction about trauma-informed principles and their practical application in behavioral health settings. To address this practice gap, the project implemented a staff education program for staff at an intensive outpatient program (IOP) and a partial hospitalization program (PHP) located in a northeastern state. The aim was to increase staff knowledge and confidence in trauma-informed principles within clinical practice. The education program emphasized the relevance of trauma-informed care (TIC) in outpatient behavioral health settings, its principles, and its application in nursing assessments, therapeutic communication, and patient interactions. A pretest and posttest questionnaire consisted of 12 multiple-choice …
Clinical Practice Guideline For Sepsis In Skilled Nursing Facility, Chinyere Okoroh
Clinical Practice Guideline For Sepsis In Skilled Nursing Facility, Chinyere Okoroh
Walden Dissertations and Doctoral Studies
Sepsis is a life-threatening condition that can rapidly lead to organ dysfunction, septic shock, and death if not recognized and treated early. Older adults in skilled nursing facilities (SNFs) are especially vulnerable because of age-related physiological changes, chronic conditions, weakened immunity, and increased exposure to infections. Consequently, sepsis remains a major cause of hospital readmissions, mortality, and healthcare utilization among SNF residents. The SNF serving as the site for this Doctor of Nursing Practice (DNP) project experienced increased hospital readmissions associated with recurrent sepsis, highlighting the need for a standardized, evidence-based approach to sepsis recognition and management. The practice-focused question …
Staff Education To Primary Care Staff About The Standardized Asthma Control Test, Paulina Asiedu
Staff Education To Primary Care Staff About The Standardized Asthma Control Test, Paulina Asiedu
Walden Dissertations and Doctoral Studies
Staff Education to Primary Care Staff About the Standardized Asthma Control Test by Paulina Asiedu Walden University, 2026. Background Inconsistent primary care asthma tracking leads to reactive management and avoidable emergency utilization. At a Minnesota community clinic, baseline electronic health record (EHR) audits revealed validated Asthma Control Test (ACT) scores were documented in only 5% of eligible encounters, driving a 12% emergency department utilization rate. Purpose & Methods This Doctor of Nursing Practice quality improvement project evaluated whether educating primary care staff on a standardized ACT protocol improved clinical knowledge, behavioral intent, and documentation compliance. Using ADDIE and ADKAR change …
Self-Efficacy Mediators For Health-Seeking Behaviors In Women Of Childbearing Age Living With Polycystic Ovary Syndrome, Domenica Carrier
Self-Efficacy Mediators For Health-Seeking Behaviors In Women Of Childbearing Age Living With Polycystic Ovary Syndrome, Domenica Carrier
Walden Dissertations and Doctoral Studies
Polycystic ovary syndrome (PCOS) is an endocrine disorder leading to varied health complications, such as high blood pressure, Type 2 diabetes, infertility, and depression among women in the United States. Most studies have focused on managing the physical aspects of PCOS. Limited research to date has been conducted to determine the intrinsic and extrinsic motivation women living with PCOS harness to navigate the physical, psychosocial, and access to care in New Jersey, which are contributors to positive social change. This basic qualitative study utilized semistructured open-ended questions to determine the experiences and perspectives of women between the ages of 18 …
Texas Teachers’ Perspectives On Work Experiences That Influenced Their Decision To Leave Their District Or Profession Following The Onset Of The Pandemic, Rose Pham Tran
Walden Dissertations and Doctoral Studies
The problem that was addressed through this study is the over 10% departure of K-12 teachers following the onset of the pandemic, contributing to widespread teacher shortages in the classrooms in Texas. Guided by Bakker and Demerouti’s job demands and resources framework, the purpose of this study was to explore K-12 teachers’ perspectives on the demands and responsibilities as well as their reasons to leave the district or profession following the onset of the pandemic. For this case study, semistructured interviews were conducted with 10 teachers from the same district who voluntarily left between 2020 and 2025. Additional data on …
Assessing The Financial Impact Of Spoofing Attacks In Michigan’S Finance Industry, Shatarsha Smith
Assessing The Financial Impact Of Spoofing Attacks In Michigan’S Finance Industry, Shatarsha Smith
Walden Dissertations and Doctoral Studies
Spoofing attacks have become an increasingly significant cybersecurity threat, exposing organizations and customers to financial losses by impersonating trusted identities in digital environments. Cybersecurity leaders need a better understanding of how information security maturity and the selection of cybersecurity strategy relate to spoofing loss outcomes. Grounded in game theory, the purpose of this quantitative cross-sectional correlational study was to examine the relationships among information security maturity, cybersecurity strategy selection, and spoofing loss outcomes in the financial industry. Data were collected from approximately 90 IT professionals employed in a Michigan-based government office in the public finance sector with at least 5 …
Implementing A Structured Lifestyle Counseling Program To Improve Weight Management In Obese Adults Ages 18–65 Within The Private Primary Care Setting, Ntoge Sone Penda
Implementing A Structured Lifestyle Counseling Program To Improve Weight Management In Obese Adults Ages 18–65 Within The Private Primary Care Setting, Ntoge Sone Penda
Walden Dissertations and Doctoral Studies
Obesity is a major public health concern that affects millions of adults. As a chronic, progressive disease, obesity increases the risk of developing several medical conditions. Although evidence-based clinical practice guidelines recommend comprehensive lifestyle modification as a first-line treatment, implementation of structured lifestyle counseling in primary care remains inconsistent. The practice-focused question guiding this Doctor of Nursing Practice (DNP) quality improvement project was: Among obese adults aged 18–65 years in a private primary care setting, does implementing a structured lifestyle counseling program improve body weight and body mass index (BMI) outcomes over an 11-week period? An organizational change process guided …
How Adults With Fasd Describe Spiritual Experiences And Faith Formation, Emily Hargrove
How Adults With Fasd Describe Spiritual Experiences And Faith Formation, Emily Hargrove
Walden Dissertations and Doctoral Studies
Fetal alcohol spectrum disorder (FASD) has been extensively studied in childhood and, more recently, in adulthood. However, little is known about how adults with FASD experience faith formation and spirituality. Spirituality has been recognized as a coping resource that promotes resilience and psychological well-being, yet these experiences remain largely unexplored among adults with FASD. The purpose of this study was to explore how adults with FASD describe their faith formation and spiritual experiences. Two research questions guided the study: How do adults with FASD describe their faith formation? and How do adults with FASD describe their spiritual experiences? James Fowler's …
Food Insecurity Among Freshman Male Collegiate Athletes At A Historically Black University In Maryland, Petita Cue Rentz
Food Insecurity Among Freshman Male Collegiate Athletes At A Historically Black University In Maryland, Petita Cue Rentz
Walden Dissertations and Doctoral Studies
Food insecurity is an emerging public health issue impacting collegiate student-athletes enrolled at Historically Black Universities (HBUs). Recent research revealed that 63% of football players have reported some form of food insecurity which disproportionately impacts Black athletes at higher rates. The purpose of this qualitative study was to explore the lived experiences and dietary behaviors of freshman male collegiate student-athletes who lacked access to food despite receiving athletic scholarships in a publicly funded HBU in Maryland. The research questions for this qualitative study focused on exploring the lived experiencing of Black male athletes who were experiencing food insecurity at an …
The Association Between The 24-Hour Activity Cycle And Academic Performance Of Online Graduate Students In The United States, Alia Ouali
Walden Dissertations and Doctoral Studies
Online graduate students are a growing population in higher education. Nevertheless, only a few studies have investigated the associations between their academic performance (AP) and movement behaviors—physical activity (PA), sedentary behavior (SB), and sleep quality (SQ). Guided by the 24‑hour activity cycle framework and social cognitive theory, the purpose of this quantitative cross‑sectional study was to explore these relationships among online graduate students in the United States and examine how self-efficacy (SE) and social determinants of health (SDOH) influence them. The online survey, which included validated scales for all constructs, yielded 403 complete responses. AP showed a significant positive association …
Effective Strategies To Sustain Small And Medium-Sized Businesses From Cybercrime For More Than 5 Years After Startup, Sumeet Singh
Effective Strategies To Sustain Small And Medium-Sized Businesses From Cybercrime For More Than 5 Years After Startup, Sumeet Singh
Walden Dissertations and Doctoral Studies
Cybercrime and data breaches pose a serious threat to the long‑term sustainability of small and medium‑sized enterprises (SMEs), especially those with limited cybersecurity capabilities. Leaders of these firms recognize that inadequate cybersecurity resources significantly increase the risk of instability and reduce the likelihood that their businesses will survive beyond the first 5 years. Grounded in Schumpeter’s entrepreneurship theory and Keynesian economic theory, the purpose of this qualitative multiple case study was to identify and explore effective strategies that SME owners used to protect their businesses against cybercrime and data breaches to sustain their businesses beyond the first 5 years of …
Southeastern Michigan Firefighters’ Experiences With Their Organization’S Employee Assistance Program, Angela Patricia Johnson
Southeastern Michigan Firefighters’ Experiences With Their Organization’S Employee Assistance Program, Angela Patricia Johnson
Walden Dissertations and Doctoral Studies
Mental health challenges among first responders require coordinated stakeholder efforts. Although employee assistance programs (EAPs) are commonly offered as workplace benefits, little is known about firefighters’ experiences with these programs and how they can be tailored to meet their unique needs. Existing literature suggested that EAP utilization among firefighters is influenced by program awareness, confidentiality concerns, organizational support, stigma, and the extent to which services are tailored to first responders’ needs. Using a generic qualitative design and policy feedback theory, this study explored southeastern Michigan firefighters’ experiences with EAPs. Purposive sampling was used to recruit 11 firefighters for semi structured …
Antiterrorism Policies And Curbing Youth Involvement In Violent Extremism In Nigeria, Timothy Melaye
Antiterrorism Policies And Curbing Youth Involvement In Violent Extremism In Nigeria, Timothy Melaye
Walden Dissertations and Doctoral Studies
Nigeria continues to face significant challenges from extremist groups such as Boko Haram, unidentified militia groups, and bandits. The radicalization of youths has played a central role in the country's ongoing violent extremism and general insecurity. Efforts to curb youth radicalization remain largely unsuccessful and pose a major challenge in the country. The existing literature on curbing youth violent extremism focuses on the use of force, while other scholars argue for a complex interplay among economic, social, political, and environmental factors. They also considered that high illiteracy, lack of religious understanding, poverty, unemployment, psychological factors, and unstable family environments contribute …
Exploring Elite Athletes’ Perceptions Of The Practice Of Mindfulness For Mental Health And Optimal Performance, Omar A. Sesay
Exploring Elite Athletes’ Perceptions Of The Practice Of Mindfulness For Mental Health And Optimal Performance, Omar A. Sesay
Walden Dissertations and Doctoral Studies
Elite athletes experience physical, cognitive, and emotional demands that affect athletic performance and personal well-being, increasing the risk for anxiety, depression, burnout, attentional difficulties, and maladaptive coping strategies. Mindfulness-based stress reduction (MBSR) has been examined for its effect on attentional control, emotional regulation, cognitive flexibility, and stress resilience, but limited qualitative research has examined how elite athletes experience the practice of mindfulness. The purpose of this generic qualitative study was to explore elite athletes’ perceptions of the practice of mindfulness for mental health and optimal performance. The theoretical framework draws from mindfulness theory and MBSR principles. Semistructured interviews were conducted …
Parents’ Perceptions Of Their Children With Disabilities’ Mental Health During The Rapid Transition To Online Learning At The Time Of The Covid-19 Pandemic, Arnell Rorie Footman
Parents’ Perceptions Of Their Children With Disabilities’ Mental Health During The Rapid Transition To Online Learning At The Time Of The Covid-19 Pandemic, Arnell Rorie Footman
Walden Dissertations and Doctoral Studies
The COVID-19 pandemic prompted an abrupt shift to online learning, raising significant concerns about the mental health of children with disabilities. Existing research highlights increased rates of anxiety, depression, and social isolation during due to the disruptions in structured routines and in-person support systems. This generic qualitative study, guided by Bronfenbrenner’s EST was conducted to explore parents’ perceptions of the mental health challenges experienced by their students with disabilities during the rapid transition to online learning at the time of COVID-19 pandemic. Data was obtained through semi-structured interviews in which parents voiced their perceptions and experiences concerning their children’s mental …
Staff Education On Frailty And Senior Surgical Safety, Kimberly Buhay Gibu
Staff Education On Frailty And Senior Surgical Safety, Kimberly Buhay Gibu
Walden Dissertations and Doctoral Studies
This staff education doctoral project addressed a practice gap involving limited education on frailty assessment and senior surgical safety within the general surgery department of a large, integrated healthcare system. Frailty is associated with increased postoperative complications, hospitalizations, readmissions, and mortality among older adults, making early recognition essential to improving surgical outcomes. The practice-focused question project was: Does education on frailty screening and senior surgical safety improve the knowledge, confidence, and intent of general surgery staff in a large, integrated health system? The purpose was to develop, implement, and evaluate an evidence-based educational intervention. The project was guided by the …
African American Experiences Accessing Mental Health Services In Rural Communities, Danielle O. Keith-Alexandre
African American Experiences Accessing Mental Health Services In Rural Communities, Danielle O. Keith-Alexandre
Walden Dissertations and Doctoral Studies
African American communities have exhibited greater vulnerability in psychological functioning and well-being, and usage of mental health services for evaluation and treatment are lower than for other groups, due to a range of barriers, including geographic location and lack of access. There is a lack of research on the difficulties African Americans face in accessing mental health services in U.S. rural communities. The purpose of this qualitative study was to explore, from a phenomenological approach, the lived experiences of African American adults residing in rural Pennsylvania mid-U.S. Eastern Coastal communities in regard to accessing mental health services. The social-ecological model …
African American Fathers’ Experiences Of Emotional Distress Within The Context Of Black Masculinity After Their Children’S Autism Diagnosis, John Notice
Walden Dissertations and Doctoral Studies
Although parental experiences following a child's autism spectrum disorder (ASD) diagnosis have been examined, mothers’ experiences have garnered the most exploration, with comparatively less attention given to fathers’ experiences. There was a gap in knowledge, in particular, on how African American (AA) fathers experience their children's ASD diagnoses while navigating emotional distress within the context of Black masculinity. The purpose of this generic qualitative study was to explore how AA fathers experienced their children's ASD diagnoses while navigating emotional distress within the context of Black masculinity. Crenshaw's intersectionality theory served as the conceptual framework. Data were collected by conducting semistructured …
Youth With Mental Illness Transitioning Into Adult Judicial Systems, Susan K. Beltran
Youth With Mental Illness Transitioning Into Adult Judicial Systems, Susan K. Beltran
Walden Dissertations and Doctoral Studies
Despite attempts to alleviate the issues of recidivism in juveniles, this issue continues to have a major impact on young adults suffering from mental health challenges. Criminal justice involvement continues to present significant challenges for individuals with behavioral health disorders, underscoring the need to identify factors associated with arrest to inform prevention and intervention efforts. The purpose of this quantitative study was to determine the relationship between recidivism and the age of first arrest, gender, and psychiatric diagnosis for youths in an adult facility. The current study used data from the Northwestern Juvenile Project, with a sample size of N=1829. …
Social Workers’ Perceptions Of Pediatric Hiv Disclosure Process, Colleen Myrie
Social Workers’ Perceptions Of Pediatric Hiv Disclosure Process, Colleen Myrie
Walden Dissertations and Doctoral Studies
Although the social problem of pediatric HIV disclosure has been studied by researchers internationally, there remains a gap in the experiences of social workers in facilitating this process. The purpose of this generic qualitative study was to explore the experiences and perceptions of social workers in the United States regarding the disclosure process for HIV positive children. This study was grounded in Rosenstock’s health belief model, which posits that an individual will take necessary action to prevent or manage a disease based on their perceptions of health. This model was effective in helping to identify what social workers think about …
Retaining Teaching Hospital Nonacademic Nurse Educators: Addressing Burnout And Building Workforce Resilience, Walter Guevara
Retaining Teaching Hospital Nonacademic Nurse Educators: Addressing Burnout And Building Workforce Resilience, Walter Guevara
Walden Dissertations and Doctoral Studies
Burnout and high turnover intentions among nonacademic nurse educators (NANEs) in academic teaching hospitals pose a critical challenge for healthcare administration, threatening workforce stability, nursing education capacity, and healthcare outcomes. The purpose of the integrative review was to examine evidence-based strategies to reduce burnout and enhance resilience among NANEs, thereby improving retention, well-being, and workforce sustainability. An integrative literature review was conducted using the Johns Hopkins Evidence-Based Practice appraisal tools and 49 sources published between 2020 and 2025 were found to match criteria and quality for thematic analysis. Guided by Herzberg’s two-factor theory, a thematic analysis was used to synthesize …
Relationship Between Sociodemographic Factors And Opioid Overdose Mortality In Milwaukee County, 2020-2021, Elizabeth David
Relationship Between Sociodemographic Factors And Opioid Overdose Mortality In Milwaukee County, 2020-2021, Elizabeth David
Walden Dissertations and Doctoral Studies
Opioid overdose deaths increased significantly from 2020 to 2021, with Milwaukee County experiencing higher rates than the national and state averages. African American and Hispanic residents faced disproportionately high fatal overdose rates. The purpose of this quantitative retrospective cross-sectional study was to examine the associations among socioeconomic status, race, age, access to treatment (measured by emergency medical services [EMS] naloxone administration), and opioid overdose mortality among underserved minority populations in Milwaukee County. Guided by the social-ecological model, the study analyzed data from the Milwaukee Health Department and the Milwaukee County Medical Examiner's Office across 34 ZIP codes. Inclusion criteria for …
Self-Care Behavior And Diabetes Knowledge In African American Women With Type 2 Diabetes, Rena Renee Barron
Self-Care Behavior And Diabetes Knowledge In African American Women With Type 2 Diabetes, Rena Renee Barron
Walden Dissertations and Doctoral Studies
African American women experience a disproportionate burden of Type 2 diabetes, and limited evidence exists regarding the relationship between diabetes knowledge and self-care behaviors, particularly among African American female veterans. The purpose of this quantitative, cross-sectional study was to examine the relationship between diabetes knowledge and diabetes self-care among African American women with Type 2 diabetes, including a subsample of African American female veterans, and to evaluate whether the COVID-19 pandemic (2017–2019 vs. 2021–2023) moderated this relationship. Additional variables included age, marital status, physical health, and mental health. Guided by the social-ecological model, de-identified data from the Behavioral Risk Factor …
Challenges Early Childhood Educators Encounter When Balancing Play-Based Learning With Preparation For Standardized Testing, Shanette Damar Mcbride
Challenges Early Childhood Educators Encounter When Balancing Play-Based Learning With Preparation For Standardized Testing, Shanette Damar Mcbride
Walden Dissertations and Doctoral Studies
The problem addressed through this study was that emphasis is being placed on standardized testing, which is causing early childhood educators to feel pressured to eliminate or reduce playtime in their classrooms. Framed by Vygotsky’s theory of social development and Lave and Wenger’s situated learning framework, the purpose of this basic qualitative study was to explore the experiences of early childhood educators in a southcentral U.S. state regarding the challenges they face in balancing a play-based learning curriculum and the support they need, while emphasizing information about standardized testing. The data were collected from semistructured interviews with 12 certified kindergarten …
Strategies For Reducing Employee Turnover In Retail Business, Mia Bulger
Strategies For Reducing Employee Turnover In Retail Business, Mia Bulger
Walden Dissertations and Doctoral Studies
Strategies for Reducing Employee Turnover in Retail Business by Mia S. Bulger MS, University of Phoenix, 2022 BS, Clark Atlanta University, 2005 Qualitative Pragmatic Inquiry Business Research Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Business Administration Walden University August 2026
Strategies For Managing Change In Home Health Care Businesses, Halbert Brown
Strategies For Managing Change In Home Health Care Businesses, Halbert Brown
Walden Dissertations and Doctoral Studies
Home health care agencies may experience financial hardship when regulatory inspections result in deficiencies and administrative penalties. Home health company (HHC) leaders are concerned because ineffective change management strategies may contribute to ongoing regulatory deficiencies, penalties, and reduced business performance. Grounded in Lewin’s change management theory, the purpose of this qualitative pragmatic inquiry project was to explore change management strategies some HHC owners successfully implemented to reduce administrative deficiencies and penalties to augment business performance and profitability. The participants were six leaders from HHC firms in the southwestern region of the United States who had developed effective strategies to improve …
Mexican Women Caregivers’ Support For Family Members With Type 2 Diabetes, Andrea Mesa
Mexican Women Caregivers’ Support For Family Members With Type 2 Diabetes, Andrea Mesa
Walden Dissertations and Doctoral Studies
Type 2 diabetes (T2D) is a persistent public health challenge in the United States, disproportionately affecting Hispanic populations. Mexican-origin women often serve as primary caregivers for relatives living with diabetes, yet their voices and lived experiences remain underrepresented in research. This study addressed the limited understanding of how cultural values and caregiving roles influence diabetes management within Hispanic families. The purpose of this qualitative phenomenological study was to explore the lived experiences of Mexican-origin women aged 40 to 60 who care for a family member with T2D. Guided by the theory of planned behavior and social cognitive theory, the study …