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A Phenomenological Study Of Digital Divide In Rural Philippines, Dennis Dizon
A Phenomenological Study Of Digital Divide In Rural Philippines, Dennis Dizon
Walden Dissertations and Doctoral Studies
The digital divide reflects policy relevant disparities in access to and effective use of internet based information resources, as experienced and interpreted by individuals navigating regulatory environments and governance conditions in the rural Philippines. Policymakers need to understand how the digital divide affects business owners and working-class people, with the impact of high costs and poor internet infrastructure in remote areas of the Philippines. Many of these business owners and working-class people lack access to the privileges and benefits of high-speed internet access. The purpose of this qualitative phenomenological study was to explore the lived experiences of these business owners …
Southeastern United States African American Business Leaders’ Effective Business Profitability Strategies, Maurice Chamblin
Southeastern United States African American Business Leaders’ Effective Business Profitability Strategies, Maurice Chamblin
Walden Dissertations and Doctoral Studies
African American business leaders in the United States experience persistent operational constraints that affect business sustainability and long-term profitability. These leaders face recurring challenges in accessing capital, securing managerial support, and effectively utilizing resources, which may hinder their ability to remain viable and competitive. Grounded in resource-based view theory, this qualitative pragmatic inquiry project aimed to identify and explore the practical strategies used by African American business leaders in the Southeastern United States to increase their business profitability over more than 5 years. The participants were six African American business leaders from the Southeastern United States who had grown their …
Experiences Of Maternal Care In The Gypsy, Roma, And Traveller Population In The United Kingdom: A Cultural Care Model, Sarah Englebert Crowson
Experiences Of Maternal Care In The Gypsy, Roma, And Traveller Population In The United Kingdom: A Cultural Care Model, Sarah Englebert Crowson
Walden Dissertations and Doctoral Studies
Gypsy, Roma, and Traveller women (GRT) in the United Kingdom face persistent maternal health disparities and show poor engagement with healthcare services. Exclusion, discrimination, and a lack of cultural competence from healthcare professionals contribute to poor health outcomes including preterm births; and GRT women have more babies born with congenital anomalies than non-GRT women in the United Kingdom. The purpose of this focused ethnographic qualitative study was to explore how self-identified GRT women living in the United Kingdom experienced maternal care and how cultural identity and social structures influenced their interactions with healthcare providers based on Madeleine Leininger’s cultural care …
Mapping Serial Killer Life Pathways With Behavior Sequence Analysis, Morgann Lynn Brafford
Mapping Serial Killer Life Pathways With Behavior Sequence Analysis, Morgann Lynn Brafford
Walden Dissertations and Doctoral Studies
Although adverse childhood experiences (ACEs) are known to influence criminal behavior in adulthood, their potential influence on serial killer actions has not been scrutinized. This study was an investigation of how ACEs might affect serial killer actions later in life. The trauma-control model provided a conceptual framework for the investigation. Marono et al.’s research featuring behavior sequence analysis (BSA) was broadened to examine the impact of psychological abuse, sexual abuse, physical abuse, violence against animals, head injury, and bullying serial killer behaviors like stalking or sexual assault. The participants were 364 anonymized male serial killers from the Radford/Florida Gulf Coast …
A Multilevel Analysis Of Prescriber-Reported Buprenorphine Induction Challenges In Fentanyl-Endemic Settings, Alyssa Vawn Long
A Multilevel Analysis Of Prescriber-Reported Buprenorphine Induction Challenges In Fentanyl-Endemic Settings, Alyssa Vawn Long
Walden Dissertations and Doctoral Studies
The emergence of illicitly manufactured fentanyl has increased clinical uncertainty during buprenorphine induction in medication-assisted treatment for opioid use disorder. The purpose of this quantitative, retrospective cohort study, guided by the Transtheoretical Model (TTM), was to examine whether prescriber-level buprenorphine induction practices and experiences with precipitated withdrawal were associated with reported buprenorphine induction challenges, and whether county-level fentanyl prevalence contributed to these challenges after accounting for geographic clustering. Secondary, de-identified archival data were obtained from the National Institute on Drug Abuse Clinical Trials Network study CTN-0134 and included 64 prescribers practicing in fentanyl-endemic settings. Buprenorphine induction challenges were operationalized as …
Risk Factors Affecting Functional Outcomes Of Traumatic Brain Injury Patients During Long-Term Acute Care Hospital Rehabilitation, Arturo Olazabal
Risk Factors Affecting Functional Outcomes Of Traumatic Brain Injury Patients During Long-Term Acute Care Hospital Rehabilitation, Arturo Olazabal
Walden Dissertations and Doctoral Studies
Traumatic brain injury (TBI) is a major public health concern associated with long-term disability and high healthcare utilization. Evidence guiding post-acute rehabilitation for medically complex TBI populations remains limited, particularly in long-term acute care hospital (LTACH) settings serving medically unstable patients. This study examined clinical and system-level factors associated with functional rehabilitation outcomes among adults with moderate-to-severe TBI in LTACHs. Guided by the Socioecological Model, recovery was conceptualized as interactions across individual, clinical, and organizational levels. This dissertation included three manuscripts using cross-sectional logistic regression and CMS Section GG measures. In Manuscript 1, longer time from injury to LTACH admission …
Exploring How Long-Term Residents Influence Environmental Policy Decisions In The Takushara Settlement In Abuja, Nigeria, Agbanusi Uchechukwu Jonathan
Exploring How Long-Term Residents Influence Environmental Policy Decisions In The Takushara Settlement In Abuja, Nigeria, Agbanusi Uchechukwu Jonathan
Walden Dissertations and Doctoral Studies
Rapid urbanization of Nigeria’s Federal Capital Territory (FCT) has increasingly marginalized indigenous communities, creating a significant disconnect between top-down environmental governance and how it affects residents. Previous research has found that this land swap displaces indigenous stewards and erodes their traditional ecological knowledge, endangering local livelihoods, food security, and sustainable management of natural resources. The purpose of this narrative qualitative study was to explore how long-term residents perceive and experience their influence in environmental policy decisions through the lens of the social-ecological systems framework and the theory of resilience. This study examined the systematic exclusion of long-term residents of the …
Exploring The Perceptions Of Black Nurse Educators Regarding Antiracist Pedagogy In Nursing Education, Deborah Ann Stallworth
Exploring The Perceptions Of Black Nurse Educators Regarding Antiracist Pedagogy In Nursing Education, Deborah Ann Stallworth
Walden Dissertations and Doctoral Studies
Racism remains a persistent issue in nursing, prompting calls to create more inclusive educational environments and confront racial disparities. Guided by an intersectionality and critical realism framework, this generic qualitative study examined how Black nursing educators perceive antiracist pedagogy, how they implement it, and what they believe is needed to strengthen its adoption in nursing education. Twelve Black undergraduate nursing educators participated in in‑depth, one‑on‑one interviews. Thematic analysis generated four themes: (a) implementing antiracist pedagogy in the classroom; (b) challenges and resistance within school environments; (c) racial marginalization norms in nursing education, and (d) advocacy and vision for institutional reform …
Foster Parents' Experiences Faced With Older Foster Children During Covid-19, Tisha S. Nicholson
Foster Parents' Experiences Faced With Older Foster Children During Covid-19, Tisha S. Nicholson
Walden Dissertations and Doctoral Studies
The COVID-19 virus was a new virus that caused a worldwide pandemic. There was not much information about what the virus was, what caused it, or how to stop its spread. Vulnerable populations such as those in foster care were especially affected because the foster children had no place to go. The purpose of this qualitative study was to explore the lived experiences of foster parents who had older foster children in their care during the COVID-19 pandemic. There was a lack of research specifically on foster parents and their personal lived experiences with the foster care system and foster …
Relationship Between Hepatitis B Virus Screening, Vaccination, And Spread In Sierra Leone, Muhammed Sarmodu Mansaray
Relationship Between Hepatitis B Virus Screening, Vaccination, And Spread In Sierra Leone, Muhammed Sarmodu Mansaray
Walden Dissertations and Doctoral Studies
Hepatitis B virus (HBV) presents a significant public health burden in Sierra Leone. Although the estimated prevalence was 8.7% in 2021, comprehensive statistical data has been limited in general. Programmatic interventions for HBV control such as systematic screening and vaccination have remained limited as well. The purpose of this quantitative cross-sectional study was to examine the relationship between screening and vaccination practices and HBV prevalence in Sierra Leone while controlling for age, sex, education and health care access. The theoretical framework incorporated the Integrated Screening Action model, which highlights screening as a critical disease prevention strategy, and the Social Ecological …
Association Between Childhood Exposure To Family Substance Abuse, Mental Health Issues, And Cervical Screening Among Women Ages 18-65 In South Carolina, Ashley Laine Hamm
Association Between Childhood Exposure To Family Substance Abuse, Mental Health Issues, And Cervical Screening Among Women Ages 18-65 In South Carolina, Ashley Laine Hamm
Walden Dissertations and Doctoral Studies
Adverse childhood experiences (ACEs) have been associated with adverse health outcomes in adulthood; however, less is known about their relationship with preventive health behaviors such as cervical cancer screening. The purpose of this quantitative, correlational study was to examine associations between selected ACEs and cervical cancer screening among women aged 18–65 in South Carolina. Data were drawn from the 2020 South Carolina Behavioral Risk Factor Surveillance System (BRFSS) and included 1,323 women. Binary logistic regression analyses were used to examine unadjusted and adjusted associations between ACE exposures and being up to date with Pap testing, controlling for age, race/ethnicity, income, …
Sociodemographic Factors And Dating Violence Among Adolescents Living In Rural Southern U.S. Communities, Kiara Patricia Sims-Thrasher
Sociodemographic Factors And Dating Violence Among Adolescents Living In Rural Southern U.S. Communities, Kiara Patricia Sims-Thrasher
Walden Dissertations and Doctoral Studies
Adolescent dating violence (ADV) is a significant public health issue that disproportionately affects youths in southern rural communities, yet these populations remain underrepresented in research. The purpose of this quantitative cross-sectional study was to examine the association between ADV and sociodemographic factors (gender, race, age, and education level), alcohol consumption, and bullying among adolescents in Alabama, Arkansas, and Mississippi using data from the 2021 Youth Risk Behavior Surveillance System. Guided by the social-ecological model, binary logistic regression analyses were conducted to assess relationships between ADV victimization and the selected predictors. Results indicated that females had significantly higher odds of reporting …
Strategies To Address Employee Shortages In Allied Health, John O. Delozier
Strategies To Address Employee Shortages In Allied Health, John O. Delozier
Walden Dissertations and Doctoral Studies
Continuing shortages of allied health (AH) workers have become a critical business challenge for health care organizations, driven by an aging population, rising service demand, and the lasting effects of the COVID 19 pandemic. AH leaders remain concerned about meeting essential staffing requirements, as persistent recruitment and retention difficulties threaten the delivery of high-quality health care. Grounded in Herzberg’s two-factor theory, the purpose of this qualitative pragmatic inquiry was to explore strategies successful health care leaders used to recruit and retain skilled AH employees. The participants were seven Maryland health care leaders with experience successfully implementing recruitment and retention strategies …
Fast-Food Consumption And Metabolic Syndrome Risk In African Children And Adolescents, Norkinsha Willis
Fast-Food Consumption And Metabolic Syndrome Risk In African Children And Adolescents, Norkinsha Willis
Walden Dissertations and Doctoral Studies
Childhood obesity and excessive fast-food intake represent a significant public health concern among African American children. Grounded in the social-ecological model, this quantitative, cross-sectional study examined whether frequency of fast-food or pizza meal consumption and reliance on low-cost food was associated with total cholesterol (mg/dL) and waist circumference among African American children and adolescents aged 6–15 years while controlling for key sociodemographic factors (age, gender, parental education status, and annual household income). Secondary data from the 2017–2018 National Health and Nutrition Examination Survey were analyzed (N=184). Descriptive statistics, nonparametric analyses, and a multiple linear regression model were used to analyze …
Psychosocial Experiences Of Custodial And Caregiving Grandparents With Adjudicated Violent Offending Grandchildren, Clifton George Burns Jr
Psychosocial Experiences Of Custodial And Caregiving Grandparents With Adjudicated Violent Offending Grandchildren, Clifton George Burns Jr
Walden Dissertations and Doctoral Studies
Primary caregivers of teenage violent offenders play a vital role in identifying and addressing safety concerns, providing emotional and financial support, and meeting individual developmental and psychosocial needs. As more grandparents assume the role of primary caregiver, the need for targeted interventions to support their emotional and psychosocial health continues to grow, emphasizing the increasing importance of population-specific support for grandparents caring for their grandchildren. Problems arise when grandparents take on this role without access to interventions or resources that are designed for caring for adjudicated teen violent offenders. This qualitative generic study involved exploring emotional challenges faced by custodial …
Lived Experiences Of Shingles Vaccine-Hesitant Adults Over Age 50 In Riverside County, California, Michelle Beatrice Loomis
Lived Experiences Of Shingles Vaccine-Hesitant Adults Over Age 50 In Riverside County, California, Michelle Beatrice Loomis
Walden Dissertations and Doctoral Studies
Shingles (herpes zoster) causes substantial morbidity, especially among adults over age 50 in the United States. There is a need to better understand the reasons behind low vaccination rates among adults over age 50 given the associated risks for infection and adverse health outcomes that can reduce their quality of life. This qualitative interpretative phenomenological study explored how individuals’ perceptions of the benefits, barriers, susceptibility, and severity of shingles influence vaccine intentions and identified what factors influence vaccine uptake. The health belief model was used to guide the study. Data were collected from one-on-one semistructured virtual interviews with eight adults …
Evaluating The Relationship Between Vitamin D Supplementation, Lifestyle, Social Determinants Of Health, Asthma, And Respiratory Tract Infections, Yun O'Donnell
Walden Dissertations and Doctoral Studies
Hypovitaminosis D is a significant public health concern in the United States associated with inadequate sunlight exposure and insufficient dietary intake. Asthma is a chronic respiratory condition that progressively worsens over time. While asthma is typically managed through individual-level treatment approaches, population-level strategies such as vitamin D supplementation and food fortification policies have not been implemented. A five-tier Public Health Impact Pyramid theoretical foundation guided this nonexperimental quantitative cross-sectional study. Data from 2013-2014 and 2017-2018 NHANES (n = 1,456) was evaluated for relationships between vitamin D supplementation, duration of sunlight exposure, and food security index, with asthma, asthma exacerbation severity, …
Determining Factors Leading To Sobriety In Native American Graduates Of A Joint-Jurisdictional Court Program, Ryan Fisher
Determining Factors Leading To Sobriety In Native American Graduates Of A Joint-Jurisdictional Court Program, Ryan Fisher
Walden Dissertations and Doctoral Studies
The issue of driving under the influence (DUI) is a continuous problem in rural communities, especial those in Indian Country. Alcohol use and abuse has long been a health concern for these communities contributing to higher mortality rates and increased incarceration rates for American Indian / Alaskan Native (AIAN) populations. Wellness courts, using the problem-solving court model, have been successful in helping DUI offenders achieve sobriety and wellness. While the model has been successful, there remains a lack of qualitative research into why participants find success in these programs; especially marginalized populations such as AIAN. This phenomenological qualitative study was …
Coping Strategies, Barriers, And Supports Of Female Nurses And Veterans With A Work-Related Traumatic Exacerbation Of An Existing Respiratory Disorder, Joanna Lynn Phillips
Coping Strategies, Barriers, And Supports Of Female Nurses And Veterans With A Work-Related Traumatic Exacerbation Of An Existing Respiratory Disorder, Joanna Lynn Phillips
Walden Dissertations and Doctoral Studies
The United States Department of Defense and Bureau of Labor Statistics estimated that female veterans and nurses experience work-related trauma at rates of 51% or higher. While many studies have examined their mental health outcomes, posttraumatic worsening of physical health has been less studied in this population. This generic qualitative inquiry was conducted to gain a deeper understanding of the subjective lived experiences of female nurses and veterans' work-related traumatic exacerbation of an existing respiratory disorder. The coping strategies developed, the potential barriers they overcame, and the support systems used were examined. The theoretical framework that grounded this study was …
Exercise Effects On Decreased Levels Of Depression In Female Breast Cancer Patients, Dorothy Y. Spencer
Exercise Effects On Decreased Levels Of Depression In Female Breast Cancer Patients, Dorothy Y. Spencer
Walden Dissertations and Doctoral Studies
Breast cancer patients with major depressive disorder (MDD) are at a high risk of experiencing pain and fatigue, anxiety and substance use, poor quality of life, marital spouses with elevated depression, impaired sexual functioning, sleep disorders, poor immune system functioning, rapid progression of cancer, and higher mortality rates. Grounded in Fritz Heider’s attribution theory, the purpose of this quantitative quasi-experimental study was to examine the relationship between physical exercise and a decrease in MDD. The participants comprised of 15 female breast cancer patients, 18 years of age and older, who may have experienced depression. The participants completed the Beck Depression …
Examining Predictors For Surgical Site Infection Following Abdominal Hysterectomy Among Women In New York, Nicole Henry
Examining Predictors For Surgical Site Infection Following Abdominal Hysterectomy Among Women In New York, Nicole Henry
Walden Dissertations and Doctoral Studies
Surgical site infections (SSIs) remain one of the most frequent and preventable complications following abdominal hysterectomy. Existing literature has focused on clinical and procedural risk factors, while less is known about how social conditions shape surgical outcomes. This gap is especially concerning for women in New York State (NYS) where differences in income, marital status, primary payer, rurality, and county-level food insecurity may influence postoperative outcomes and subsequent care. The socioecological model provided the foundation for this retrospective cohort study by examining how social drivers of health (SDoH) are associated with SSI incidence following abdominal hysterectomy, and whether food insecurity …
Exploring The Lived Experiences Of African American Women In Counseling For Body Dysmorphia, Sitonja Valenzuela
Exploring The Lived Experiences Of African American Women In Counseling For Body Dysmorphia, Sitonja Valenzuela
Walden Dissertations and Doctoral Studies
African American women may experience body dysmorphia differently due to cultural, racial, and societal influences that shape their body perceptions and counseling experiences. Guided by a Heideggerian theoretical foundation, this hermeneutic phenomenological study aimed to explore how African American women experience receiving counseling for body dysmorphia in the United States. The guiding research question was: How do African American women with body dysmorphia experience receiving help in counseling? Eight African American women participated in in-depth, semi-structured interviews, and data analytic procedures were analyzed using the hermeneutic circle. Key findings revealed body dysmorphia as a persistent, embodied experience shaped by racialized …
Transitions Of Growth And Partner Responsiveness In Late Adolescent Marriage, Terrell Ka-Seem Pugh
Transitions Of Growth And Partner Responsiveness In Late Adolescent Marriage, Terrell Ka-Seem Pugh
Walden Dissertations and Doctoral Studies
During the stage of late adolescence, marriage presents unique challenges, with partners navigating several developmental tasks in tandem with forming and maintaining marital relationships. Partner responsiveness has been consistently identified as a key factor for personal wellbeing and relationship satisfaction. Limited research has explored how late adolescent married individuals describe this dynamic. The purpose of this qualitative transcendental phenomenological study was to explore lived experiences of late adolescent married individuals between 18 and 20 who described their experiences with partner responsiveness during this transitional period. This study was grounded in Bronfenbrenner’s ecological systems theory in order to explore how relational …
Decision Making Processes Of Adolescent Women About Entering Intimate, Long-Term Romantic Relationships, Jeannie Miller
Decision Making Processes Of Adolescent Women About Entering Intimate, Long-Term Romantic Relationships, Jeannie Miller
Walden Dissertations and Doctoral Studies
There is a high rate of women in their late 20s and early 30s that are in destructive relationships, many because of decisions that were made during adolescence . Little research has focused on understanding the decision making process of entering intimate, long-term romantic relationships from the viewpoint of adult women in their late 20s through 30s who made that decision during adolescence. This phenomenological study allowed for a greater understanding of adolescent decision making, specifically about entering intimate, long-term romantic relationships. The research questions were (a) What are the lived experiences of young women as they enter intimate, long-term …
Opioid Overdose Associations In The United States Among Pregnant And Postpartum Women During 2019-2023, Permecia Winston-Dixon
Opioid Overdose Associations In The United States Among Pregnant And Postpartum Women During 2019-2023, Permecia Winston-Dixon
Walden Dissertations and Doctoral Studies
The rising trend of opioid-involved overdose deaths among pregnant and postpartum women in the United States from 2019 to 2023 represents a pressing public health issue. This population faces increasing risk due to opioid use and co-occurring mental health conditions, yet remains underrepresented in research. The purpose of this quantitative study was to examine the association between opioid involvement among pregnancy-associated overdose deaths, while controlling for pandemic periods (pre-COVID: 2019, peak COVID: 2020–2021, post-peak COVID: 2022–2023). Grounded in the syndemic theory, this study addressed two research questions Grounded in syndemic theory, this study addressed two research questions focused on opioid-involved …
Human Services Administrators’ Perceptions Of Youth In Acute Crisis Needs, Carey Alvord
Human Services Administrators’ Perceptions Of Youth In Acute Crisis Needs, Carey Alvord
Walden Dissertations and Doctoral Studies
There is a lack of acute crisis services for youth in the United States. In San Luis Obispo County, California, there are no designated facilities with crisis stabilization services near family homes for children in acute crisis. Grounded in Stroul et al.’s system of care approach for children and families, the purpose of this qualitative force field analysis study was to explore human service administrators’ perceptions of the services youth in acute crisis need to stabilize within San Luis Obispo County. Directors at youth human services county departments and nonprofits were contacted to help recruit a purposeful sample of 11 …
Social Determinants Of Health And Treatment Outcomes In Black And White Men With Early-Stage Prostate Cancer, Laurel Cannon
Social Determinants Of Health And Treatment Outcomes In Black And White Men With Early-Stage Prostate Cancer, Laurel Cannon
Walden Dissertations and Doctoral Studies
Black men are disproportionately affected in diagnosis and death rates from prostate cancer compared to White men. Although prior research established links between race, sociodemographic factors, and prostate cancer outcomes, longitudinal analyses examining multiple social determinants of health simultaneously were limited. The purpose of this quantitative study was to examine whether race, marital status, and education impact how long patients live who were diagnosed with early-stage prostate cancer. Social impact theory framed how social forces such as race, education, and marital status influence health outcomes. A non-experimental correlational design was employed, drawing on archival data from 4,407 participants in the …
Psychologists’ And Psychiatrists’ Views On Criminal Behavior, Fetal Alcohol Spectrum Disorder, And Federally Sentenced Indigenous Women In The Prairie Region And British Columbia, Rina Asghar
Walden Dissertations and Doctoral Studies
The overrepresentation of federally sentenced Indigenous women in Canada reflects longstanding structural and systemic injustices within the criminal justice system. Constituting approximately 5% of the female population, Indigenous female offenders are disproportionately represented, especially in maximum security facilities and structured intervention units. This qualitative study examined psychologists’ and psychiatrists’ perspectives on the potential role of fetal alcohol spectrum disorder (FASD) related neurocognitive impairments in increasing justice system involvement among Indigenous women in Western Canada. Guided by the multidimensional Indigenous developmental framework, which integrates historical trauma theory and attachment theory, nine psychologists and one psychiatrist were interviewed in semi-structured interviews. The …
Food Insecurity’S Influence On Obesity, Hypertension, And Diabetes In Rural Vermont And Adirondack New York, Lindsay Morse
Food Insecurity’S Influence On Obesity, Hypertension, And Diabetes In Rural Vermont And Adirondack New York, Lindsay Morse
Walden Dissertations and Doctoral Studies
Food insecurity (FI) is a persistent public health challenge in the United States and disproportionately affects rural communities. Guided by syndemic theory, this quantitative cross-sectional study examined associations between FI and chronic disease outcomes among rural residents of Vermont and the Adirondack region of New York. Social determinants of health screenings and electronic medical records from 35 rural primary care sites were analyzed. Secondary data from n = 72,505 adults were used to evaluate these relationships. Binary logistic regression models assessed obesity, hypertension (HTN), and diabetes (DM), and a multinomial logistic regression model evaluated the combined presence of obesity and …
Enhancing Staff Knowledge And Confidence In Depression Screening Using The Patient Health Questionnaire-9, Melkamzer Chari
Enhancing Staff Knowledge And Confidence In Depression Screening Using The Patient Health Questionnaire-9, Melkamzer Chari
Walden Dissertations and Doctoral Studies
Depression is a serious public health concern affecting over 280 million people globally and leading to significant morbidity and mortality if left undetected and untreated. At the local organization, leadership identified inconsistent depression screening as a practice problem among nursing staff. Thus, the purpose of this doctor in nursing practice (DNP) project was to determine if an educational intervention focused on depression, the importance of depression screening, and the use of the Patient Health Questionnaire-9 (PHQ-9) increased knowledge and confidence among nursing staff working in a local organization. Fifteen participants volunteered to participate in the project. The average age was …