Digital Commons Network^™

Client-Centered Care Approach To Group Home Care, Peniel Mugo Wambugu

Walden Dissertations and Doctoral Studies

Scholars since the 19th century have focused on the provision of care in group homes and have demonstrated that structure (that is, the staff, facilities, and equipment), is critical in the delivery of care. The researchers, however, advocate doing for, rather than doing with the clients the activities that address the clients' welfare. The purpose of this study is to investigate how a client-centered approach would affect the quality of care delivered to the mentally challenged individuals (MCIs) in a group home. The study employed the quality-care framework in which the emphasis is on structure (skills), process (efficiency), and outcome …

Health Behaviors, Hardiness, And Burnout In Mental Health Workers, Jeremiah Brian Schimp

Walden Dissertations and Doctoral Studies

Burnout has emerged as a significant and costly issue in the modern workforce. Researchers have not fully explored the role of individual health behaviors and personality in burnout among mental health workers. The knowledge gap addressed in this study was the connection between health behaviors, what mental health workers do to take care of themselves, and hardiness, the characteristic way they perceive and interpret environmental challenges. The purpose of this study was to examine the influence of health behaviors and hardiness among mental health workers on the 3 dimensions of burnout as measured by the MBI-HSS: emotional exhaustion, depersonalization, and …

Centering Pregnancy Implementation And Its Effect On Preterm Birth And Low Birthweight, Carole Ann Moleti

Walden Dissertations and Doctoral Studies

Preterm birth (PTB) and low birthweight (LBW) babies are the source of a large burden of infant, neonatal, and childhood morbidity. The purpose of this project was to expand the use of the CenteringPregnancy^TM Group Prenatal Care Model as an evidence-based intervention for management of both medical and psychosocial risk in low-income, ethnic and racial minorities in New York City. The standardized model developed by Schindler Rising decreases the incidence of preterm birth and low birthweight and increases the rate of breastfeeding. A CenteringPregnancy^TM program implementation plan, customized to meet the needs of a multisite urban hospital system, …

Exploring Small Ghanaian And U.S. Banks' Efficiency During The 2007-2009 Financial Crisis, Reuben Ashitey Amarh

Walden Dissertations and Doctoral Studies

The adverse effect of small bank closures in the United States from 2007 to 2009 required $7 trillion from United States taxpayers to rescue the United States economy. This comparative case study explored the reasons that led to differences in efficiency in small banks in the United States and Ghana during the 2007 to 2009 period. This research was driven by the contingency theory, which states leaders perform well if they change their styles of leadership to suit the situation at hand. Semistructured interviews were employed to gather data from 20 senior and chief executives of small banks: 10 from …

Public Corruption In Liberian Government, Stephen H. Gobewole

Walden Dissertations and Doctoral Studies

There is a widespread public perception of corruption in Liberia's election process, yet there is little documentation on the characteristics of voters and their perceptions of electoral corruption. The purpose of this correlational study was to explore the relationship between gender, ethnicity, physical location, and perceptions about political activity during the 2005 national election. Roderick Chisolm's conceptualization of the internalist view of justification served as the theoretical construct. Data were acquired from the Afrobarometer survey (n = 1,200), which used a representative cross-sectional sample design, and were subjected to cross-tabulation analysis, a chi-square test, and a correlation analysis. The results …

Perceptions Of Home And Small Business Owners On Insurance In Accra, Ghana, Helen Stevens-Benefo

Walden Dissertations and Doctoral Studies

Insurance is a prudent option to mitigate business risk and property loss caused by natural disasters. The current study took place in Accra, Ghana, and was prompted by the low adoption of insurance and limited understanding by home and small business owners of its risk mitigation value. The purpose of this multiple-case study was to explore information insurance companies' need to motivate investment in weather-related insurance. The interview questions of the study served to explore the reasons business owners and homeowners purchase or decline insurance, including their understanding of and receptivity to insurance. The theoretical underpinning of this study included …

Beyond Elections: Ghana's Democracy From The Perspective Of The Citizenry, Ransford Osafo-Danso

Walden Dissertations and Doctoral Studies

Ghana's democracy has been hailed by scholars, practitioners, and the international community in recent years as a shining example in the West African subregion as a result of the country's record of organizing successive elections with minimal or no violence. However, the evaluation of Ghana's democracy has predominantly focused on the elections and disproportionately captures the views of the political elite; conspicuously missing is the perspective of the ordinary Ghanaian. This presents an incomplete picture of Ghana's democracy, given the relevance of citizens' participation in democratic societies. To address this gap in knowledge, this qualitative case study explored the practice …

The Distribution Of Type 1 Diabetes Onset In The United States By Demographic Factors, Margaret Beckstrand

Walden Dissertations and Doctoral Studies

Type 1 diabetes (T1D) is a chronic and lifelong condition, often diagnosed in childhood. Patients with T1D are at elevated risks of associated health complications, comorbidities, and mortality. Occurrence, clinical presentation, and complications related to T1D differ by age of onset, ethnicity, and gender. The last reported population-based estimates regarding the burden of T1D in children using the National Health and Nutrition Examination Survey (NHANES) were published in 2008, and these estimates were not well stratified by age of onset, ethnicity, and gender. The purpose of this study was to examine these demographics within the conceptual framework of the hygiene …

An Examination Of Tribal Nation Integration In Homeland Security National Preparedness, Donald J. Reed

Walden Dissertations and Doctoral Studies

Research has established that national homeland security policy requires a whole community or all-of-nation approach to national security preparedness. What is less clear is whether all stakeholders are integrated into or benefit from this collective effort. This narrative policy analysis examined the relationship between a federally-recognized group of Native American tribal nations and homeland security national preparedness to explore whether tribal nations are effectively integrated with the collective effort for national preparedness. The theoretical framework stemmed from a convergence of social contract theory and conflict theory. Interviews (n = 21) were conducted with preparedness authorities from government agencies, and from …

The Experiences Of Military Parents Homeschooling Using Online Teaching Resources, Georgia George Watters

Walden Dissertations and Doctoral Studies

U.S. military members and their families relocate from one duty station to another on average once every 3 years. Children in military families change schools often, introducing potential problems such as struggling to make new friends, having trouble adjusting to new teaching styles, and losing academic credits due to the transition from one school to the next. Homeschooling that incorporates online resources can provide instructional continuity, social interaction opportunities, and submission of required periodic assessments. The primary purpose of this phenomenological study was to examine the experiences of military parents involved in homeschooling their children using online resources. The research …

Hispanic Women Business Executives' Self-Perceptions Of Leadership Effectiveness, Daniel R. Dusch

Walden Dissertations and Doctoral Studies

Hispanics will become the majority ethnic group in the U.S. by 2060. The social and business cultural changes affected by these demographics are inevitable and will require leadership from academic and business communities in order to ensure clear direction for the future. Gender research in managerial and professional positions mostly includes White women and typically excludes those of other racial, ethnic, and cultural backgrounds. The research problem was that there is little known about the lived experiences of Hispanic women business executives. The purpose of this phenomenological study was to explore the self-perceptions of leadership effectiveness of Hispanic women business …

The United Nations Training Of The Liberia National Police: Effectiveness, Results, And Future Implications, Yarsuo Laezee Weh-Dorliae

Walden Dissertations and Doctoral Studies

After the United Nations' mission in Liberia (UNMIL) ends on September 30, 2015, effective policing will be a security concern for Liberians. Liberians have expressed fear that conflict could return if ongoing police training programs do not sustain public safety. The purpose of this mixed methods study was to understand how UNMIL's training affected public confidence in the Liberia National Police (LNP). The theoretical bases for this study included public choice theory and liberal democratic theory. Quantitative data were used to address impact of UNMIL's police training on the maintenance of law and order. These data were collected through a …

Systematic Review Of Retention Of Direct-Care Workers In Long-Term Care Facilities, Regina Evonne Goins

Walden Dissertations and Doctoral Studies

Turnover among direct-care workers in long-term care (LTC) facilities is high, and has a significant impact on residents, leaders, and owners of LTC facilities. The overall turnover costs are also substantial and constitute a significant financial burden in LTC facilities. This systematic review of the literature examined, retention strategies for direct-care workers in the LTC workforce. The information may be used to develop and provide practice recommendations that will help improve retention rates among direct-care workers in LTC facilities. The project design involved a systematic examination of English-only studies from 2001-2004, retrieved from 3 major databases: CINAHL with Medline simultaneous, …

Building Resilience And Coping Effectiveness (Brace): A Program For Military Families, Linda Pauline Zarrett

Walden Dissertations and Doctoral Studies

Building Resiliency and Coping Effectiveness (BRACE): A Program for Military Families

by

Linda Zarrett

MSN, University of Cincinnati, 2012

BSN, Minnesota State University, Moorhead, 1985

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

August 2015

Veterans returning from combat report significant family strain and Post Traumatic Stress Symptoms (PTSS) yet have limited access to care resources. Family members, including children, report very similar symptoms to those of veterans and have yet fewer health care resources. The purpose of this project was to apply principles from existing research on post-traumatic stress …

Inflammatory Markers Associated With Disease Progression Of Cardiorenal Syndrome, Srikanta Banerjee

Walden Dissertations and Doctoral Studies

An increase in cellular inflammatory biomarkers directly increases the risk of cardiovascular disease (CVD). Using the social ecological and biomedical theories, the study examined quantitatively how specific inflammatory biomarkers are associated with cardiorenal syndrome (CRS), a potential complication of hypertension and diabetes, and how sociodemographic factors modify this association in the U.S. adult population. A retrospective secondary data analysis of the data collected from National Health and Nutrition Examination Survey (NHANES) 1999-2010 was utilized to evaluate these hypotheses. High sensitivity C-reactive protein, homocysteine (hcy), and fibrinogen had a modifying effect on Type 4 (chronic reno-cardiac etiology), Type 2 CRS (chronic …

Perceptions Of Value-Stream Costing And The Effect On Lean-Accounting Implementation, Patricia Hart Timm

Walden Dissertations and Doctoral Studies

In response to the competitive global economy, lean manufacturing has become more prevalent in the United States. Manufacturing has changed, but cost accounting has not. Lean manufacturing has the potential to change the U.S. manufacturing economy, resulting in positive economic social change, yet it requires lean accounting to increase successful implementations. This study addressed the problem of lack of adoption of lean-accounting techniques like value-stream costing in lean-manufacturing enterprises. The purpose of this nonexperimental explanatory study was to investigate factors that influence the adoption of lean accounting. Using the technology acceptance model (TAM), based on the theory of reasoned action …

Predictors Of Cervical Cancer Screening Among Hispanic Women In The United States, Benedicta Ngozi Ilouno

Walden Dissertations and Doctoral Studies

Minority women groups in the United States have the highest incidence and mortality rates of cervical cancer. Hispanic women have the highest incidence rate and the second highest mortality rate of the disease. Researchers have examined the lower rates of cervical cancer screening among Hispanic women, as compared to other groups of U.S. women, but researchers have not examined the extent to which socioeconomic status, acculturation, and sexual activity impact Hispanic women's compliance with screening. The purpose of this study was to examine the association between compliance with cervical cancer screening and acculturation, socioeconomic status, and sexual activity among U.S. …

A Mixed Method Study Of Diagnostic And Adaptive Functioning Challenges In African American Preschool-Aged Children With Autism Spectrum Disorders, Douglene Jackson

Walden Dissertations and Doctoral Studies

Children with Autism Spectrum Disorder (ASD) are known to experience performance and participation challenges, with early diagnosis being critical for improved outcomes. Children from ethnic minority backgrounds tend to receive their diagnoses later, even when symptomatology is similar. This mixed methods study explored symptom severity, functional difficulties, and age at diagnosis for ASD and to describe the functional challenges encountered by preschool-aged children with ASD of African American descent. The International Classification of Functioning, Disability, and Health along with the Model of Human Occupation were the theories used for this study to conceptualize functional challenges and other potential factors. Research …

Examining The Impact Of Accreditation On A Primary Healthcare Organization In Qatar, Alia Ghareeb

Walden Dissertations and Doctoral Studies

Although a modest body of literature exists on accreditation, little research was conducted on the impact of accreditation on primary healthcare organizations in the Middle East. This study assessed the changes resulting from the integration of Accreditation Canada International's accreditation program in a primary healthcare organization in the State of Qatar. The study also investigated how accreditation helped introduce organizational changes through promoting organizational learning as well as quality improvement initiatives. Pomey's Dimension of Change framework and questionnaire was used to measure the effect of Accreditation Canada International standards on the perceived quality performance and the progress towards organizational learning. …

Examining Biopsychosocial Factors In The Drive For Muscularity And Muscle Dysmorphia Among Personal Trainers, Beau J. Diehl

Walden Dissertations and Doctoral Studies

This cross-sectional quantitative study was conducted to assess the presence of muscle dysmorphia (MD) and a drive for muscularity (DFM) in 1,039 personal trainers using the Muscle Dysmorphia Inventory (MDI) and the Drive for Muscularity Scale (DMS). Muscle dysmorphia is considered a subtype of body dysmorphic disorder that can be exacerbated by an intense DFM, which may in turn lead to negative psychobehavioral outcomes. Because personal trainers are an unresearched population with regard to these 2 constructs, a multidisciplinary framework was used to ground the present research study. Independent variables were structured using a biopsychosocial foundation where the biological dimension …

A Client-Vendor Relationship Perspective Of Cultural Differences On Cross-Border Information Technology Outsourcing, John Kennedy Bosire

Walden Dissertations and Doctoral Studies

Cross-border information technology (IT) outsourcing continues to rise due to the demand for business process outsourcing. Issues such as miscommunication and management problems have emerged because of cross-cultural disparities between clients and vendors across national borders. The theoretical framework of this study was based on the organizational culture model studies of Meek, Spradley, Smith, and Draft for examining and understanding complex organizational practices. The purpose of this mixed-methods explanatory sequential case study was to qualitatively identify and quantitatively determine the management approaches that are effective in managing cross-cultural differences and the constitution of the elements of global adjustment, motivation, mindset, …

The Design, Implementation, And Evaluation Of A Professional Development Program, Ellen Riina Hirsch

Walden Dissertations and Doctoral Studies

Ineffective professional development is a longstanding problem in education. Locally, the school district in the study lacked a comprehensive system for evaluating their secondary level professional development programs. The purpose of this case study was to investigate the district's professional development program, specifically examining its perceived strengths and weaknesses. The conceptual framework of the study was systems theory and the adaptive schools reform model. The research questions examined the perceptions of various school personnel on their experiences with the current professional development program at the study district's high school. Individual interviews were conducted with a purposeful sample of 3 teachers, …

Social Inequality: Cultural Racism As A Predictor Of Collegiate Academic Success, Natasha L. Ball

Walden Dissertations and Doctoral Studies

The economic sustainability of an area is largely dependent on the education level of its population, yet little is known about the role cultural racism may play in academic success. The purpose of this correlational study was to evaluate the theory of cultural racism, defined as, the establishment of cultural institutions by whites/Europeans to the detriment of non-white people, as it relates to academic success at the college level. Data were collected from 100 participants from 3 predominately African American high schools in the Atlanta, Georgia area to explore whether the presence of cultural racism existed from the perspective of …

The Impact Of Leadership On The Governance Of Infrastructure Development In Nigeria, Michael Oziegbe Onolememen

Walden Dissertations and Doctoral Studies

Research literature has documented Nigeria's leadership crisis since its independence from Great Britain in 1960. This crisis corresponds with political instability and infrastructure weaknesses, which have resulted in crime, corruption, poverty, lack of social cohesion and personal freedoms, environmental degradation, gender inequities, and deteriorating conditions of public works. No literature was located that addressed the impact of leadership on the governance and development of infrastructure in Nigeria. The purpose of this qualitative case study was to investigate this phenomenon in Nigeria between 1960 and 2010. The theoretical framework comprised Burns' and Bass' theories of transformational leadership, and Davis' and Toikka's …

Effective Teaching In Higher Education For The 21st Century Adult Learner, Denise Murchison Payton

Walden Dissertations and Doctoral Studies

Abstract

As college populations are becoming increasingly diverse, institutions must find ways to meet the needs of their nontraditional students. Nontraditional adult learners are self-directed, ready to learn, and are internally motivated to engage in problem-centered learning. The purpose of this study was to expand and refine an active learning seminar in a higher education setting to improve the quality of teaching, student engagement, and retention rates. The site of the study was a Historically Black College and University (HBCU) in which adult students over 25 constituted 49% of the population. The faculty members at this site predominantly employed traditional …

Effects Of Successmakers Math As An Intervention For Students, Jennifer Lee Calcut

Walden Dissertations and Doctoral Studies

Schools throughout the United States use the IQ-achievement discrepancy method to

identify children with learning disabilities. This current method allows many students to fall behind in the regular education setting. In 2004, the Individuals with Disabilities Education Act was reauthorized to provide states with the option of using a response to intervention (RtI) model in lieu of or in conjunction with the IQ-achievement discrepancy model. The purpose of this quasi-experimental, single subject, pre/posttest design study was to determine the impact of a Tier II intervention using SuccesMakers Math, a learning system that adapts to the unique needs of the individual …

Program For Healthcare Personnel To Improve Anti-Hypertensive Medication Adherence In Black Adults, Verena D. Johnson

Walden Dissertations and Doctoral Studies

Medication nonadherence is a healthcare problem that costs the United States billions of dollars annually. The purpose of this project was to propose an evidence-based program for healthcare personnel to increase the rate of medication adherence in hypertensive Black adults who require daily, oral medication. The transtheoretical model of change was used to explain the process of change and to identify approaches to changing non-adherent behaviors related to medications. Motivational interviewing was used to explain the process that nurse-educators would use to guide patients through the stages of change. In the initial step of this quality improvement program, a convenience …

A Mindfulness-Based Stress Reduction Psychoeducational Program In Postpartum Support Groups, Marina Pesserl

Walden Dissertations and Doctoral Studies

Postpartum Depression (PPD) affects 15% of women after childbirth. Its etiology includes psychoneuroimmunologic factors with long-lasting postpartum stressors that lead to allostatic overload. Using mindfulness-based stress reduction (MBSR) for PPD has not yet been studied. Addressing this literature gap, the potential benefits of including an 8-week MBSR component based on Beck's theory of PPD at support groups were examined in this phenomenological study based on a sample of 10 women and 2 group facilitators. Purposes of the study included describing the experience of PPD and the MBSR program, identifying the stage of behavioral change of the participants, and describing the …

Complementary Alternative Medicine: Awareness And Perceptions Of Health Care Providers Who Provide Systemic Lupus Care, Carmen Ionie Bartley

Walden Dissertations and Doctoral Studies

The purpose of this study was to explore healthcare providers' awareness and perceptions of complementary and alternative medicine (CAM) use in providing systemic lupus erythematosus (SLE) care. This phenomenolgical study was built upon existing research indicating SLE patients' need to foster better communication about CAM use. Participants were recruited from the Long Island Rheumalogical Clinic in the State of New York. Individual in-depth semistructered interviews were conducted to explore the awareness and perceptions of a purposive sample of 10 healthcare providers who care for patients with SLE. Transcripts were analyzed, and categorical themes were developed. Guided by the use of …

Health-Related Beliefs Among Low-Income African American Women And Their Perceptions About Obesity, Cenora Kimberly Akhidenor

Walden Dissertations and Doctoral Studies

The aim of this study was to explore the health-related beliefs and perceptions of low-income African American women regarding obesity. Phenomenology served as the conceptual framework for this study. African American women, especially those in low-income brackets, have been shown to weigh more than women of other racial/ethnic groups. The consequences of these high rates are increased risks of developing chronic health disorders, such as type II diabetes and cardiovascular disease. The study sample consisted of 7 low-income obese African American women, ranging in age from 20 to 62, who resided in the Pacific Northwest. Recruitment for participation occurred via …