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Socioecological Factors And Age Of Diagnosis For Autism Spectrum Disorder Among U.S. Children, Richline Wilson
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 …
Staff Education For Improved Diabetes Management: Enhancing Knowledge And Patient Outcomes, Carissa Martine Bolden
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 …
Effective Strategies For Mitigating Skills Gaps Postpandemic In The Automotive Industry, Neil Shah
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 …
Patient Engagement Strategies In Weight-Loss Programs, Olufunmilayo M. Bishop
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 …
Educational Leaders’ Perceptions Of Disproportionality In The Identification Of Elementary Gifted Students, Vincent Corrigan
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. …
Non-Pharmacological Interventions For Attention Deficit Hyperactive Disorders And Anxiety, Alichia Lashawn Pecks
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- …
African American Men's Perceptions Of Law Enforcement, Dr. Dedrie Reshell Leonard-Francis
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
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 …
Development Of A Clinical Practice Guideline For Trauma-Informed Care In Interprofessional Health Care Settings, Ngwi Rita Etiendem
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.
Staff Education On Depression Screening In Young Adults, Irene Micere Njeru
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 …
Strategies To Reduce Waiting Times In A Hospital Emergency Department, Gillian Denise Browne-Farrell
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 …
Staff Education To Same Day Surgery Nurses, Katherine Lutman
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 …
Beyond The Individual: Community Socioecological Correlates Of Mass Shootings In A Cross-Sectional Analysis, Barbara (Basia) E. Lopez
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 …
The Treatment Experiences Of Female Domestic Violence Offenders Who Have Completed Court-Mandated Counseling Programs, Chelsea S. King
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 …
Adaptive Leadership And Employee Retention During Disruptive Times In Real Estate, Susej Koral Corrales Bethancourt
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 …
The Lived Experience Of The Orgasm Gap In U.S. Cisgender Women In Heterosexual Relationships, Alina Beverly Vergara-Hegi
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 Experience Of Living With Infertility Among Women Of Color, Claudia Calvario
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 …
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
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
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 …
How People With Borderline Personality Disorder Experience Addiction During The Process Of Treatment, Michael Paul Onesto
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 …
Minority Female Political Representation In Westchester County Politics: A View From Minority Female Elected Office Holders, Dwanita Michelle Crosby
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 …
Relationship Between Doctor Communication And Patient Satisfaction In Inpatient Units In California, Sandra Viehoever
Relationship Between Doctor Communication And Patient Satisfaction In Inpatient Units In California, Sandra Viehoever
Walden Dissertations and Doctoral Studies
Effective doctor communication is an important determinant of patient satisfaction in inpatient units. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey measures patient satisfaction and influences reimbursement rates under the Hospital Value-Based Purchasing Program. The purpose of this retrospective quasi-experimental quantitative study was to examine the possible relationship between doctor communication and patient satisfaction in inpatient units in California. The Donabedian framework provided the theoretical framework to examine possible relationships between the variables. Publicly available data were collected from 290 hospitals in California that participated in the HCAHPS survey between July 2022 and June 2023. Results of …
The Challenges Faced By Postrelease Offenders In Rural Mississippi, Whitney Starks
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, …
Lived Experiences Of Police Officers With Vicarious Sexual Trauma, Resiliency, And Departmental Support, Joseph Schreiner
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 …
Staff Education Program For Fall Prevention, Priya Sebastian Vadakkan
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 …
Enhancing Communication Among New Nurses Using Scenario-Based Education, Anita Clark Chambers
Enhancing Communication Among New Nurses Using Scenario-Based Education, Anita Clark Chambers
Walden Dissertations and Doctoral Studies
This staff education project was designed to enhance communication among new nurses with 2 years or less of experience in a Level One trauma center emergency department (ED). The aim of this project initiative was to enhance learners’ communication strategy knowledge and confidence by using scenario-based education via a web-based format. When ineffective communication exchanges occur with healthcare personnel, such as with new nurses, negative patient care outcomes can occur such as sentinel events. Transitional challenges such as lack of prioritization, clinical decision-making skills and low confidence can affect the new nurse’s ability to appropriate effective communication strategies into their …
The Problem With Consumer Affordability Of Prescription Medications In The United States, Valerie E. Bell
The Problem With Consumer Affordability Of Prescription Medications In The United States, Valerie E. Bell
Walden Dissertations and Doctoral Studies
Consumer affordability of prescription drugs is an ongoing problem in the United States. This study was undertaken to research the financial, physical, and economic effects of drug prices on consumers and the methods used by consumers to address such effects. Rational choice and power and politics theories were used to explain the decisions consumers make when they could not afford their medications and the role policies and politics play in drug pricing. The research questions concerned the relationship between consumers’ perceptions of drug pricing and their ability to purchase medications. The quantitative nonexperimental study involved the administration of a survey …
Associations Between School-Based Arrests And High School Graduation Status Of African American Female Students In Florida, Rannisha Missick
Associations Between School-Based Arrests And High School Graduation Status Of African American Female Students In Florida, Rannisha Missick
Walden Dissertations and Doctoral Studies
Zero tolerance school discipline policies, originally intended to address serious threats such as weapon and drug possession, have increasingly been applied to minor behavioral infractions, disproportionately affecting African American students, particularly females. These exclusionary practices, including school-based arrests, have been linked to adverse educational outcomes. The purpose of this quantitative correlational study was to examine associations between school-based arrests due to zero tolerance policy violations and high school graduation status of African American female students in Florida. The study was guided by the intersectionality theory, which posits individuals who belong to multiple marginalized groups experience compounded forms of discrimination. Archival …
A Qualitative Case Study Exploring The Decision-Making Criteria Of Policymakers In The State Of Michigan To Reinstate A Universal Helmet Law, Eberley Nicole Adams
A Qualitative Case Study Exploring The Decision-Making Criteria Of Policymakers In The State Of Michigan To Reinstate A Universal Helmet Law, Eberley Nicole Adams
Walden Dissertations and Doctoral Studies
Policymakers are elected to create, amend, or repeal legislation that impacts public welfare; however, little is known about the specific criteria used when making public health and safety decisions, particularly regarding motorcycle helmet laws. In 2012, Michigan repealed its universal helmet law (UHL) after 35 years, replacing it with a partial helmet law specifying requirements for helmetless riding. Despite an increase in unhelmeted fatalities, the UHL has not been reinstated, raising questions about the legislative decision-making process. Prior research has found that factors such as budgeting, statistical data, interest groups, education, income, political stability, and public opinion may guide these …