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Walden Dissertations and Doctoral Studies

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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 …


Perceptions Of Nonclinical Healthcare Executives On Advancing Physical Therapists Into Executive Healthcare Leadership Positions, Lindsey Johnston Aug 2025

Perceptions Of Nonclinical Healthcare Executives On Advancing Physical Therapists Into Executive Healthcare Leadership Positions, Lindsey Johnston

Walden Dissertations and Doctoral Studies

Healthcare professionals often aspire to transition beyond clinical roles into organizational leadership. In particular, physical therapists may seek executive leadership opportunities beyond rehabilitation departments. However, there is limited understanding of how nonclinical healthcare executives perceive physical therapists advancing into these roles. This qualitative study aimed to understand nonclinical healthcare executives' perceptions regarding physical therapists’ advancement to executive healthcare leadership positions. The study was guided by new institutional theory and Level 5 leadership theory and addressed four research questions to explore these perceptions in depth. A general qualitative methodology was employed, with data collected through semistructured, virtual interviews with eight nonclinical …


Enhancing Nursing Knowledge Of Sud Screening Tools In Va Primary Care, Marlene Joan Margerum Aug 2025

Enhancing Nursing Knowledge Of Sud Screening Tools In Va Primary Care, Marlene Joan Margerum

Walden Dissertations and Doctoral Studies

Substance use disorders (SUDs) are a persistent public health concern among veterans. A recognized knowledge gap exists among Veterans Affairs (VA) primary care nurses regarding validated SUD screening tools—the Alcohol Use Disorders Identification Test–Consumption (AUDIT-C), Drug Abuse Screening Test (DAST-10), and Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST)—limiting opportunities for early identification and coordination of care. This Doctor of Nursing Practice (DNP) project evaluated if a structured staff education intervention improved primary care nurses’ knowledge, confidence, and preparedness to support interdisciplinary SUD screening practices. Guided by Patricia Benner’s novice to expert model and the analysis, design, development, implementation, and …


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 …


Staff Education To Improve Knowledge Of The Patient Health Questionnaire-9 Assessment, Josie Weber Aug 2025

Staff Education To Improve Knowledge Of The Patient Health Questionnaire-9 Assessment, Josie Weber

Walden Dissertations and Doctoral Studies

This doctoral project was focused on a staff education initiative to enhance the proper use of the Patient Health Questionnaire-9 (PHQ-9), a validated depression screening tool, in an outpatient behavioral health (OBH) clinic. Despite its clinical utility, the PHQ-9 is often underused or inconsistently applied due to knowledge gaps among nursing staff. Inconsistent screening can delay diagnosis and treatment, negatively affecting patient outcomes. I conducted this project to address these gaps by implementing structured training to promote high-quality, patient-centered care. The practice-focused question was: Does a structured PHQ-9 training session improve staff knowledge in an outpatient behavioral health clinic, as …


Leadership Self-Efficacy: Exploring Social Workers’ Perceived Ability To Serve On School Boards, Jessica Zavalza Aug 2025

Leadership Self-Efficacy: Exploring Social Workers’ Perceived Ability To Serve On School Boards, Jessica Zavalza

Walden Dissertations and Doctoral Studies

The low representation of social workers serving on school boards is a social work practice problem because it limits their leadership ability to advocate for student mental health and influence policy change at the local and state levels of education. Therefore, addressing this practice problem within the context of clinical social work is crucial for improving student mental health outcomes and overall student well-being. Guided by Bandura’s self-efficacy theory, this qualitative study was conducted to explore the connection between social workers’ leadership self-efficacy and their willingness to pursue policymaking roles at the local and state school board levels. With the …


Socioecological Factors And Age Of Diagnosis For Autism Spectrum Disorder Among U.S. Children, Richline Wilson Aug 2025

Socioecological Factors And Age Of Diagnosis For Autism Spectrum Disorder Among U.S. Children, Richline Wilson

Walden Dissertations and Doctoral Studies

As autism spectrum disorder (autism/ASD) diagnoses rise, understanding the influence of socioecological factors on the age of diagnosis among children in the United States is critical for timely intervention and improved quality of life. The purpose of this study was to examine how socioecological factors influence the age at which children are diagnosed with autism/ASD. The quantitative causal-comparative design, which was informed by Bronfenbrenner’s socioecological model, involved analysis of secondary data from the 2021 National Survey of Children’s Health (N=1416). Ordinal logistic regression analysis revealed that race and ethnicity moderated the relationship between socioeconomic status (caregiver educational and employment status …


Effective Strategies For Mitigating Skills Gaps Postpandemic In The Automotive Industry, Neil Shah Aug 2025

Effective Strategies For Mitigating Skills Gaps Postpandemic In The Automotive Industry, Neil Shah

Walden Dissertations and Doctoral Studies

Inadequate approaches to filling employee skill gaps can seriously weaken workforce stability and organizational performance. Canadian automotive sector leaders are concerned about the risk of persistent employment shortages, high employee turnover, and decreased productivity. Grounded in Alderfer's existence, relatedness, and growth theory, the purpose of this qualitative pragmatic inquiry was to identify and explore the strategies employed by Canadian auto manufacturers to address skill shortages in their workforce in the wake of the pandemic and subsequent digitalization. Six senior executives from Canadian auto manufacturers who led successful skill-development and retention initiatives participated in semistructured interviews, complemented by a review of …


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 …


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- …


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 …


African American Men's Perceptions Of Law Enforcement, Dr. Dedrie Reshell Leonard-Francis Aug 2025

African American Men's Perceptions Of Law Enforcement, Dr. Dedrie Reshell Leonard-Francis

Walden Dissertations and Doctoral Studies

African American Black men are more likely to report unreasonable, unnecessary, and unwarranted experiences with U.S. law enforcement than men of other racial groups, and they higher mistrust toward law enforcement than any other racial group. These experiences have been described as unjustifiable due to the level of force used by police. In some cases, excessive force by law enforcement has resulted in the death of Black men. The purpose of this phenomenological study was to explore Black men’s perceptions of law enforcement and to understand their distrust. The study centered on the facilitators and barriers to Black men trusting …


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 …


Educational Leaders’ Perceptions Of Disproportionality In The Identification Of Elementary Gifted Students, Vincent Corrigan Aug 2025

Educational Leaders’ Perceptions Of Disproportionality In The Identification Of Elementary Gifted Students, Vincent Corrigan

Walden Dissertations and Doctoral Studies

Despite years of research on best practices in gifted program identification, racially diverse, linguistically diverse, and socioeconomically disadvantaged student populations continue to be underrepresented in elementary gifted programs. Guided by Renzulli’s three-ring conception of giftedness and practical system for identifying gifted and talented students, the purpose of this qualitative study was to explore local educational leaders’ perceptions of disproportionality in the identification of students for elementary gifted programs in a large public school system in the Eastern United States. For this basic qualitative design, data were collected through semistructured interviews with 18 educational leaders from the local elementary principal population. …


Staff Education On Depression Screening In Young Adults, Irene Micere Njeru Aug 2025

Staff Education On Depression Screening In Young Adults, Irene Micere Njeru

Walden Dissertations and Doctoral Studies

Summary This doctoral project was on staff education. The practice problem was a knowledge deficit regarding depression screening by staff nurses at a local acute inpatient psychiatric facility. The practice-focused question was as follows: Will education on depression screening for young adults (18-to-28-year-olds) increase knowledge on the use of evidence-based depression screening tools by nursing staff in an inpatient psychiatric crisis facility? The purpose of the doctoral project was to educate staff nurses at a local acute inpatient psychiatric facility on the PHQ-9 depression screening tool for individuals aged 18 to 28 years. The project included a PowerPoint presentation, a …


Beyond The Individual: Community Socioecological Correlates Of Mass Shootings In A Cross-Sectional Analysis, Barbara (Basia) E. Lopez Aug 2025

Beyond The Individual: Community Socioecological Correlates Of Mass Shootings In A Cross-Sectional Analysis, Barbara (Basia) E. Lopez

Walden Dissertations and Doctoral Studies

Mass shootings represent an urgent and persistent threat to public safety in the United States, yet most research has focused on individual-level characteristics, leaving community-level socioecological conditions comparatively underexamined. This study addressed this gap in knowledge through an examination of the statistical correlations between community-level characteristics and mass shooting incidence using Ostrom’s social-ecological systems theory as a guiding framework. A cross-sectional quantitative design was employed using secondary data from The Violence Project, the U.S. Census Bureau, Neighborhood Atlas National Data Archive, and publicly available law enforcement and policy records. Multiple regression analysis was performed to test both main and interaction …


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 …


Lived Experiences Of Police Officers With Vicarious Sexual Trauma, Resiliency, And Departmental Support, Joseph Schreiner Aug 2025

Lived Experiences Of Police Officers With Vicarious Sexual Trauma, Resiliency, And Departmental Support, Joseph Schreiner

Walden Dissertations and Doctoral Studies

This qualitative study involved addressing lived experiences of police officers who investigate sex crimes. Vicarious sexual trauma experienced by officers can lead to both short- and long-term issues for these individuals, particularly if they are left unaddressed. The constructivist self-development and resiliency theories were used to examine these experiences. Specifically, this study involved investigating how police officers perceived vicarious sexual trauma and viewed the accessibility and practicality of mental health and wellness resources provided by their departments. It was guided by two research questions, which were addressed through 12 semistructured interviews, which were thematically analyzed and interpreted. Five themes emerged …


How People With Borderline Personality Disorder Experience Addiction During The Process Of Treatment, Michael Paul Onesto Aug 2025

How People With Borderline Personality Disorder Experience Addiction During The Process Of Treatment, Michael Paul Onesto

Walden Dissertations and Doctoral Studies

This study explored the lived experience of Borderline Personality Disorder (BPD) and substance use as a maladaptive coping mechanism during recovery, raising the question of whether recovery itself fosters comorbidity. The study was grounded on several theories, including Linehan’s biosocial model, the Cox and Klinger alcohol motivation model, the affect regulation model, and the self-medication hypothesis. These theories argue that substance use arises from emotional vulnerability, invalidating environment, and affect regulation efforts. The study employed a phenomenological qualitative approach to guide data collection and analysis. Interviews from 20 BPD patients and mental health care providers were completed. The thematic analysis …


The Treatment Experiences Of Female Domestic Violence Offenders Who Have Completed Court-Mandated Counseling Programs, Chelsea S. King Aug 2025

The Treatment Experiences Of Female Domestic Violence Offenders Who Have Completed Court-Mandated Counseling Programs, Chelsea S. King

Walden Dissertations and Doctoral Studies

Domestic violence is a significant societal problem. However, aspects of domestic violence (DV) perpetrated by women are often overlooked or inadequately addressed in existing counseling and intervention programs, leaving counselor educators ill-equipped to effectively train counselors to treat this specific population. The research question addressed the treatment experiences of female DV offenders who completed court-mandated counseling programs. Given the limited current research on female domestic violence offender treatment, Heidegger’s hermeneutic phenomenological methodology was employed to further understand the perspectives of participants, potentially identifying areas of improvement and addressing the needs of female program participants. Semistructured interviews were completed with six …


The Lived Experience Of The Orgasm Gap In U.S. Cisgender Women In Heterosexual Relationships, Alina Beverly Vergara-Hegi Aug 2025

The Lived Experience Of The Orgasm Gap In U.S. Cisgender Women In Heterosexual Relationships, Alina Beverly Vergara-Hegi

Walden Dissertations and Doctoral Studies

Women are not orgasming as often as men in heterosexual sexual encounters. Research has confirmed that sociocultural influences, gender differences, sexual perceptions, sexual miseducation, and relationship dynamics contribute to women’s negative sexual experiences. What has been missing is a better understanding of the experience of the orgasm gap and the role of gender ideology in women’s sexual experiences. This study explored the lived experience of the orgasm gap and gender ideology in nine cisgender women in long-term heterosexual relationships. Critical feminist theory was used as the lens to explore the meaning of sexual inequities in intimate long-term relationships. Using interpretative …


The Relationship Between Federal Employees' Viewpoints On Intrinsic Meaningful Work In The Extrinsic Work Unit Environment And Job Satisfaction., Sandra Kunz Aug 2025

The Relationship Between Federal Employees' Viewpoints On Intrinsic Meaningful Work In The Extrinsic Work Unit Environment And Job Satisfaction., Sandra Kunz

Walden Dissertations and Doctoral Studies

Managers are concerned with low job satisfaction since it is a prediction of decreased productivity and increased turnover. Framed within the two-factor theory, the purpose of this quantitative correlational post-facto study was to examine the relationship between intrinsic meaningful work in the extrinsic work unit environment and job satisfaction. The participants were 1,378 U.S. federal employees from the Office of Personnel Management who completed the Federal Employee Viewpoint Survey in 2023. The results of the multiple linear regression were significant, F(2, 1375) = 900.817, p < .001, R² = .567. Recommendations for managers include aligning employees with positions that reflect their skills and interests, enhancing communication regarding the significance of individual contributions, seeking out employee feedback, and resolving any work environment challenges to foster greater job satisfaction. The implications for positive social change include the possibility for managers to advance effective leadership and communication, thereby enhancing the work environment for employees and the quality of service to customers.


Staff Education To Enhance The Use Of Alternatives To Restrictive Interventions When Managing Aggressive Behaviors, Anthony Obinna Madu Aug 2025

Staff Education To Enhance The Use Of Alternatives To Restrictive Interventions When Managing Aggressive Behaviors, Anthony Obinna Madu

Walden Dissertations and Doctoral Studies

This is a DNP staff education project executive summary aimed at increasing staff knowledge on the use of alternatives to restrictive interventions when managing aggressive behaviors in an inpatient psychiatric unit.


Relationship Between Processing Speed And Perceptual Reasoning Index Scores In Contact Vs Noncontact Child Sex Offenders, Mylena Smith Aug 2025

Relationship Between Processing Speed And Perceptual Reasoning Index Scores In Contact Vs Noncontact Child Sex Offenders, Mylena Smith

Walden Dissertations and Doctoral Studies

Child sexual offending remains a critical societal issue with complex psychological and behavioral underpinnings. Although prior research has emphasized recidivism and risk assessment, there is limited information regarding neurocognitive functioning and its potential role in terms of differentiating contact versus noncontact offender subtypes. This quantitative cross-sectional study involved examining whether cognitive functioning, measured using the Processing Speed Index (PSI) and Perceptual Reasoning Index (PRI) via the Wechsler Adult Intelligence Scale predicted offender subtype among 90 adult males who completed psychosexual evaluations. Additionally, the study involved testing whether age moderated the relationship between cognitive indices and offender subtype classification. Guided by …


Minority Female Political Representation In Westchester County Politics: A View From Minority Female Elected Office Holders, Dwanita Michelle Crosby Aug 2025

Minority Female Political Representation In Westchester County Politics: A View From Minority Female Elected Office Holders, Dwanita Michelle Crosby

Walden Dissertations and Doctoral Studies

African American women have historically been underrepresented in political leadership, a disparity largely attributed to the persistent absence of structured support systems—particularly mentorship—that promote advancement across federal, state, and local levels. Existing literature highlights gender and racial disparities in political trajectories but often overlooked the specific role of mentorship in shaping leadership outcomes for African American women at the municipal level. This gap was particularly critical given the increasing civic engagement and influence of African American women in local governance. The purpose of this general qualitative study was to examine how mentorship shaped the political journeys of African American women …


Adaptive Leadership And Employee Retention During Disruptive Times In Real Estate, Susej Koral Corrales Bethancourt Aug 2025

Adaptive Leadership And Employee Retention During Disruptive Times In Real Estate, Susej Koral Corrales Bethancourt

Walden Dissertations and Doctoral Studies

Some real estate agency owners in Panama lack adaptive leadership strategies to retain employees during market disruptions. The real estate industry and agency owners are especially vulnerable to financial fluctuations and market volatility, which can lead to increased employee turnover and decreased organizational performance. This qualitative pragmatic inquiry explored the adaptive leadership strategies used by Panamanian real estate agency owners to retain employees during disruptive periods. Guided by Heifetz and Linsky’s adaptive leadership theory, the project addressed the central research problem through semistructured interviews with six real estate owners and managers with at least 4 years of leadership experience. Participants …


Staff Education Program For Fall Prevention, Priya Sebastian Vadakkan Aug 2025

Staff Education Program For Fall Prevention, Priya Sebastian Vadakkan

Walden Dissertations and Doctoral Studies

Falls are the most common adverse events leading to increased injury, length of hospital stay, and costs among hospitalized patients. I developed a staff education project to address the identified practice problem of increased fall rates on the cardiac floor of the project site. The practice-focused question guiding this Doctor of Nursing Practice (DNP) project was whether a comprehensive staff education program on evidence-based fall prevention strategies could improve the nurses’ knowledge when compared to standard fall prevention practices. The purpose of this DNP project was to provide staff education to increase nurses’ knowledge about the early identification of fall …


The Experience Of Living With Infertility Among Women Of Color, Claudia Calvario Aug 2025

The Experience Of Living With Infertility Among Women Of Color, Claudia Calvario

Walden Dissertations and Doctoral Studies

Infertility affects individuals across all cultural and socioeconomic backgrounds; however, the lived experiences of women of color navigating infertility remain underrepresented in research, health care, and policy. The purpose of this interpretative phenomenological analysis (IPA) study was to explore the lived experiences of infertility among women of color. The specific aims of the study were to (a) understand the significance of cultural values in shaping these experiences, with a focus on cultural norms surrounding motherhood and fertility, and (b) gain insight on the ways in which women of color seek assistance. The conceptual framework integrated the biopsychosocial model, stress and …


Development Of A Clinical Practice Guideline For Trauma-Informed Care In Interprofessional Health Care Settings, Ngwi Rita Etiendem Aug 2025

Development Of A Clinical Practice Guideline For Trauma-Informed Care In Interprofessional Health Care Settings, Ngwi Rita Etiendem

Walden Dissertations and Doctoral Studies

Developing a standardized Clinical Practice Guideline for Trauma Informed Care was a central objective of this Doctor of Nursing project. This project followed an evidence-based, collaborative, and structured methodology that prioritized interdisciplinary input, organizational alignment, and rigorous appraisal using the AGREE II instrument.


Strategies To Reduce Waiting Times In A Hospital Emergency Department, Gillian Denise Browne-Farrell Aug 2025

Strategies To Reduce Waiting Times In A Hospital Emergency Department, Gillian Denise Browne-Farrell

Walden Dissertations and Doctoral Studies

Leaders of the emergency departments (EDs) globally, especially in the United States face persistent challenges addressing staffing issues in the ED and increased wait times. The purpose and review question for this integrative review was to investigate strategies and best practices to decrease waiting times in a hospital ED. The Theory of Constraints framework served as the theoretical foundation for this review. An examination of the literature published within the past five years identified 101 relevant articles. From these articles, 30 empirical and non-empirical articles were selected for further analysis using the Johns Hopkins evidence-based practice model and six major …