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Articles 31 - 60 of 6363
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Meaning Of Mentoring For Puerto Rican Diaspora Professionals Seeking Career Advancement, Coralys M. Cedó Negrón
Meaning Of Mentoring For Puerto Rican Diaspora Professionals Seeking Career Advancement, Coralys M. Cedó Negrón
Walden Dissertations and Doctoral Studies
Hispanic/Latino professionals remain underrepresented in senior leadership positions across industries in the United States. Organizational leaders need to understand this concern as a critical indicator of factors that may shape leadership development and career advancement among underrepresented professionals. Grounded in the mentoring model, the purpose of this qualitative interpretative phenomenological analysis (IPA) study was to understand the meaning of mentoring for Puerto Rican diaspora professionals seeking career advancement in the United States. The participants comprised 10 Puerto Rican professionals living and working in the Washington, D.C. metropolitan area who had participated in formal or informal mentoring relationships. Data were collected …
The Association Of Age, Race, And Gender And Novel Interventions In The Prevention Of Catheter-Associated Urinary Tract Infection, In Washington State, Lamin Darboe
Walden Dissertations and Doctoral Studies
Delayed removal of indwelling urinary catheters (IUCs) contributes to catheter-associated urinary tract infections, a leading healthcare-associated infection. A dot/smart-phrase communication tool, guided by the Health Belief Model construct of cues to action, to promote timely IUC removal interventions was evaluated in this quantitative, cross-sectional study. Secondary data from N = 372 adult patients with acute urinary retention in acute and critical care settings in Washington State were analyzed using SPSS Version 30. Binary logistic regression examined relationships among demographic variables, intervention-related factors (adherence within 48 hours, cosignature within 24 hours, and secure chat communication), and clinical outcomes (IUC removal and/or …
Effective Employee Retention Strategies Used By Hair Salon Leaders To Sustain Business Operations, Taylor Bynum
Effective Employee Retention Strategies Used By Hair Salon Leaders To Sustain Business Operations, Taylor Bynum
Walden Dissertations and Doctoral Studies
Employee retention challenges continue to affect the operational sustainability of hair salons. Hair salon owners and leaders are concerned about employee retention because it directly affects their ability to sustain business operations. Grounded in Wayne McPhee’s sustainable activity model, the purpose of this qualitative pragmatic inquiry was to explore the strategies hair salon owners and leaders used to retain employees and sustain business operations. Participants included eight hair salon owners or leaders who had successfully retained employees and sustained business operations for at least 5 years. Data from semistructured interviews with the participants were analyzed using Braun and Clarke’s six-step …
Effective Strategies Human Resource Business Leaders Use To Decrease Employee Turnover, Dorothy Norton
Effective Strategies Human Resource Business Leaders Use To Decrease Employee Turnover, Dorothy Norton
Walden Dissertations and Doctoral Studies
Employee turnover continues to be a widespread organizational challenge because it increases recruitment and training costs, disrupts productivity, and negatively affects organizational performance and sustainability. The research problem was that some business leaders lack effective strategies to reduce employee turnover. The purpose of this qualitative pragmatic inquiry project was to explore strategies business leaders use to reduce employee turnover. Herzberg’s two-factor theory served as the conceptual framework for the study. The participants were six business leaders with responsibility for employee retention who successfully implemented employee retention strategies. Data were gathered through semistructured interviews and analyzed using Braun and Clarke’s reflexive …
Treatment Alternatives To Incarceration Program (Taip) Counselor’S Perceptions Of The Effectiveness Of Taip Within West Texas, Patricia Arenas
Treatment Alternatives To Incarceration Program (Taip) Counselor’S Perceptions Of The Effectiveness Of Taip Within West Texas, Patricia Arenas
Walden Dissertations and Doctoral Studies
Substance abuse remains a major challenge in the U.S. probation system, as recidivism persists despite specialized treatment programs such as the Treatment Alternatives to Incarceration Program (TAIP) available in Texas. This issue matters to policymakers, judges, community supervision officers, TAIP administrators, treatment providers, and local communities because decisions about funding, supervision, sanctions, coordination, and service delivery affect rehabilitation outcomes, public safety, and reoffending. This transcendental phenomenological study explored TAIP counselors’ perceptions of the program’s effectiveness in treating substance abuse offenders and reducing recidivism in West Texas. Guided by Husserl’s phenomenology, data were collected through semi structured interviews with four TAIP …
Exploration Of Black American Women's Lived Experiences With Structural Barriers In Human Resource Leadership Positions, Joyce Chimeziem Diala
Exploration Of Black American Women's Lived Experiences With Structural Barriers In Human Resource Leadership Positions, Joyce Chimeziem Diala
Walden Dissertations and Doctoral Studies
Black American women’s marginalization in leadership roles, including in human resources (HR), remains a significant concern in U.S. workplaces. Organizations need to understand this concern as a leading indicator of systemic workplace barriers that may restrict opportunities for leadership advancement for Black American women and hinder organizational diversity efforts. The specific research problem was the limited understanding of the lived experiences of Black American women who face structural barriers to advancement in HR leadership positions. The purpose of this qualitative interpretative phenomenological study was to explore the lived experiences of Black American women in HR leadership positions. This study was …
Impact Of Ownership Change, Administrator Turnover, And Registered Nurse Turnover On Operational Outcomes In Nursing Homes, Tanveer Dhaliwal
Impact Of Ownership Change, Administrator Turnover, And Registered Nurse Turnover On Operational Outcomes In Nursing Homes, Tanveer Dhaliwal
Walden Dissertations and Doctoral Studies
Nursing homes frequently experience leadership and structural disruptions that affect facility performance. The purpose of this quantitative correlational study using archival data was to examine the extent to which ownership change, administrator turnover, and registered nurse turnover predict operational outcomes in U.S. nursing homes. Four Centers for Medicare & Medicaid Services (CMS) measures represented indicators of operational outcomes: (a) staffing rating, (b) rating cycle 1 total health deficiencies, (c) number of fines, and (d) total weighted health survey score. Resource dependence theory and transaction cost economics served as the theoretical foundation. Data from July 2025 CMS public files (N = …
Assessing The Financial Impact Of Spoofing Attacks In Michigan’S Finance Industry, Shatarsha Smith
Assessing The Financial Impact Of Spoofing Attacks In Michigan’S Finance Industry, Shatarsha Smith
Walden Dissertations and Doctoral Studies
Spoofing attacks have become an increasingly significant cybersecurity threat, exposing organizations and customers to financial losses by impersonating trusted identities in digital environments. Cybersecurity leaders need a better understanding of how information security maturity and the selection of cybersecurity strategy relate to spoofing loss outcomes. Grounded in game theory, the purpose of this quantitative cross-sectional correlational study was to examine the relationships among information security maturity, cybersecurity strategy selection, and spoofing loss outcomes in the financial industry. Data were collected from approximately 90 IT professionals employed in a Michigan-based government office in the public finance sector with at least 5 …
How Adults With Fasd Describe Spiritual Experiences And Faith Formation, Emily Hargrove
How Adults With Fasd Describe Spiritual Experiences And Faith Formation, Emily Hargrove
Walden Dissertations and Doctoral Studies
Fetal alcohol spectrum disorder (FASD) has been extensively studied in childhood and, more recently, in adulthood. However, little is known about how adults with FASD experience faith formation and spirituality. Spirituality has been recognized as a coping resource that promotes resilience and psychological well-being, yet these experiences remain largely unexplored among adults with FASD. The purpose of this study was to explore how adults with FASD describe their faith formation and spiritual experiences. Two research questions guided the study: How do adults with FASD describe their faith formation? and How do adults with FASD describe their spiritual experiences? James Fowler's …
The Association Between The 24-Hour Activity Cycle And Academic Performance Of Online Graduate Students In The United States, Alia Ouali
Walden Dissertations and Doctoral Studies
Online graduate students are a growing population in higher education. Nevertheless, only a few studies have investigated the associations between their academic performance (AP) and movement behaviors—physical activity (PA), sedentary behavior (SB), and sleep quality (SQ). Guided by the 24‑hour activity cycle framework and social cognitive theory, the purpose of this quantitative cross‑sectional study was to explore these relationships among online graduate students in the United States and examine how self-efficacy (SE) and social determinants of health (SDOH) influence them. The online survey, which included validated scales for all constructs, yielded 403 complete responses. AP showed a significant positive association …
Effective Strategies To Sustain Small And Medium-Sized Businesses From Cybercrime For More Than 5 Years After Startup, Sumeet Singh
Effective Strategies To Sustain Small And Medium-Sized Businesses From Cybercrime For More Than 5 Years After Startup, Sumeet Singh
Walden Dissertations and Doctoral Studies
Cybercrime and data breaches pose a serious threat to the long‑term sustainability of small and medium‑sized enterprises (SMEs), especially those with limited cybersecurity capabilities. Leaders of these firms recognize that inadequate cybersecurity resources significantly increase the risk of instability and reduce the likelihood that their businesses will survive beyond the first 5 years. Grounded in Schumpeter’s entrepreneurship theory and Keynesian economic theory, the purpose of this qualitative multiple case study was to identify and explore effective strategies that SME owners used to protect their businesses against cybercrime and data breaches to sustain their businesses beyond the first 5 years of …
Antiterrorism Policies And Curbing Youth Involvement In Violent Extremism In Nigeria, Timothy Melaye
Antiterrorism Policies And Curbing Youth Involvement In Violent Extremism In Nigeria, Timothy Melaye
Walden Dissertations and Doctoral Studies
Nigeria continues to face significant challenges from extremist groups such as Boko Haram, unidentified militia groups, and bandits. The radicalization of youths has played a central role in the country's ongoing violent extremism and general insecurity. Efforts to curb youth radicalization remain largely unsuccessful and pose a major challenge in the country. The existing literature on curbing youth violent extremism focuses on the use of force, while other scholars argue for a complex interplay among economic, social, political, and environmental factors. They also considered that high illiteracy, lack of religious understanding, poverty, unemployment, psychological factors, and unstable family environments contribute …
Local Farming Sustainability Nongovernment Organization’S Perceived Driving Forces For A Crisis Management Plan, Nthonoki Cynthia Tsepe
Local Farming Sustainability Nongovernment Organization’S Perceived Driving Forces For A Crisis Management Plan, Nthonoki Cynthia Tsepe
Walden Dissertations and Doctoral Studies
Nongovernmental organizations (NGOs) operate in increasingly volatile environments characterized by financial uncertainty, political pressures, and climate-related disruptions; however, many lack formalized crisis management systems. The absence of structured crisis governance exposes organizations to operational instability, financial risk, and reputational damage. The purpose of this qualitative force field analysis study was to explore a local farming sustainability NGO’s perceived driving and restraining forces for developing a formal crisis management plan. Guided by Burnett’s crisis management model and Lewin’s force field analysis framework, data were collected from nine organizational leaders involved in governance and operational decision making. Round 1 included open-ended online …
Social Workers’ Perceptions Of Pediatric Hiv Disclosure Process, Colleen Myrie
Social Workers’ Perceptions Of Pediatric Hiv Disclosure Process, Colleen Myrie
Walden Dissertations and Doctoral Studies
Although the social problem of pediatric HIV disclosure has been studied by researchers internationally, there remains a gap in the experiences of social workers in facilitating this process. The purpose of this generic qualitative study was to explore the experiences and perceptions of social workers in the United States regarding the disclosure process for HIV positive children. This study was grounded in Rosenstock’s health belief model, which posits that an individual will take necessary action to prevent or manage a disease based on their perceptions of health. This model was effective in helping to identify what social workers think about …
Teachers’ Perspectives About Early-Career Implementation Of Culturally Responsive Teaching Practices In Secondary Science Classrooms, Nicole D. Wilson-Pringle
Teachers’ Perspectives About Early-Career Implementation Of Culturally Responsive Teaching Practices In Secondary Science Classrooms, Nicole D. Wilson-Pringle
Walden Dissertations and Doctoral Studies
The problem that was addressed through this study was that little was known about how secondary science teachers use their training to implement culturally responsive teaching practices (CRTPs) during their early careers in classrooms with diverse student populations. Grounded in the culturally relevant pedagogy and the teacher identity development frameworks, the purpose of this basic qualitative study was to explore secondary science teachers’ perspectives on the use of their training to implement CRTPs during their early careers in classrooms with diverse student populations. Data were collected through semistructured interviews with 10 middle and high school science teachers who received certification …
Exploring The Experiences And Support Needs Of African Immigrant Families Raising Children With Autism Spectrum Disorder In Ohio, Linda Nkoumba Eteki
Exploring The Experiences And Support Needs Of African Immigrant Families Raising Children With Autism Spectrum Disorder In Ohio, Linda Nkoumba Eteki
Walden Dissertations and Doctoral Studies
Autism spectrum disorder (ASD) presents unique challenges for families; however, African immigrant parents raising children with ASD in Ohio experience additional difficulties related to cultural stigma, systemic inequities, and limited access to culturally responsive services. This social work practice problem is important because it reflects disparities in diagnosis, intervention, service access, and family support that align with social work’s commitment to equity, advocacy, and social justice. The purpose of this qualitative study was to explore the experiences of African immigrant families raising children with ASD in Ohio and to examine how they describe autism-related stigma, caregiving challenges, and interactions with …
Mexican Women Caregivers’ Support For Family Members With Type 2 Diabetes, Andrea Mesa
Mexican Women Caregivers’ Support For Family Members With Type 2 Diabetes, Andrea Mesa
Walden Dissertations and Doctoral Studies
Type 2 diabetes (T2D) is a persistent public health challenge in the United States, disproportionately affecting Hispanic populations. Mexican-origin women often serve as primary caregivers for relatives living with diabetes, yet their voices and lived experiences remain underrepresented in research. This study addressed the limited understanding of how cultural values and caregiving roles influence diabetes management within Hispanic families. The purpose of this qualitative phenomenological study was to explore the lived experiences of Mexican-origin women aged 40 to 60 who care for a family member with T2D. Guided by the theory of planned behavior and social cognitive theory, the study …
Openness To Experience And Creative Capacity Among Active First Responders, William Reagan
Openness To Experience And Creative Capacity Among Active First Responders, William Reagan
Walden Dissertations and Doctoral Studies
Because emergency services demand adaptive, creative problem-solving within procedurally rigid cultures, this study examined whether Openness to Experience predicted creative capacity among active first responders and whether age or tenure moderated that relationship. A cross-sectional design used N = 117 first responders from eight agencies. Openness was measured with the Big Five Inventory-2 (percentile ranks); creativity was assessed with the Divergent Association Task (DAT; n = 116) and the Consensual Assessment Technique (CAT; n = 111). Covariates were age, tenure, rank, gender, and, for 46 participants at one agency, a dispatch-derived operational exposure score. In the full sample, Openness did …
Completion Outcomes And Predictive Characteristics In Mandated Inpatient Substance Use Treatment, Tina Marie Moyer
Completion Outcomes And Predictive Characteristics In Mandated Inpatient Substance Use Treatment, Tina Marie Moyer
Walden Dissertations and Doctoral Studies
Treatment retention, specifically as it pertains to offenders who are mandated to receive substance use treatment rather than serve standard incarceration sentences, is receiving more scholarly attention. Although prior research indicates an association between substance use treatment and reduced criminal behavior, many studies have methodological limitations. The purpose of this quantitative non-experimental, comparative study was to compare treatment completion outcomes for mandated and non-mandated offenders and to examine individual predictors of treatment completion, thereby addressing gaps in the current research. Secondary data from adult offenders receiving treatment at an inpatient substance use rehabilitation facility were analyzed. The risk-needs-responsivity model was …
Effective Strategies For Implementing Artificial Intelligence To Improve Businesses’ Value Chains, Jehan Forsythe
Effective Strategies For Implementing Artificial Intelligence To Improve Businesses’ Value Chains, Jehan Forsythe
Walden Dissertations and Doctoral Studies
Organizational leaders are increasingly adopting artificial intelligence (AI) to improve business operations; however, leaders of small and medium enterprises (SMEs) continue to face challenges associated with AI adoption. Understanding strategies for effective AI integration may facilitate AI adoption in SMEs, helping to enhance organizational value and improve competitive positioning. Grounded in Porter’s value chain framework, the purpose of this qualitative pragmatic inquiry project was to identify and explore effective strategies that U.S. SME leaders use to integrate AI into their value chain to increase organizational value and gain a competitive advantage. The participants were six U.S. SME leaders who led …
Fellowship Graduates’ Perceptions Of The Professional Competencies Developed In A Local Orthopedic Manual Physical Therapy Program In The Southern United States, Margaret Elaine Lonnemann
Fellowship Graduates’ Perceptions Of The Professional Competencies Developed In A Local Orthopedic Manual Physical Therapy Program In The Southern United States, Margaret Elaine Lonnemann
Walden Dissertations and Doctoral Studies
Orthopedic manual physical therapy (OMPT) fellowship programs focus on improving clinical skills and professional development in physical therapy. OMPT fellowship programs are 1–3-year postprofessional subspecialty training programs in manual physical therapy requiring prior orthopedic clinical experience. The problem that was addressed in this study is that professional competencies are not adequately assessed after program completion of an OMPT fellowship in the Southern United States. Grounded in Dreyfus’s skill acquisition model, the purpose of this basic qualitative study was to explore OMPT fellowship graduates’ perceptions of the professional competencies developed and recommendations for assessing these competencies in future graduates. Data were …
Postsecondary Experiences And Impact On Career Choices And Employment Status For Cisgender Women With Autism, Maureen Bell
Postsecondary Experiences And Impact On Career Choices And Employment Status For Cisgender Women With Autism, Maureen Bell
Walden Dissertations and Doctoral Studies
Cisgender women with autism remain underrepresented in research on postsecondary education and career development despite experiencing distinct barriers within these systems. This qualitative study examined how cisgender women with autism perceived the impact of their postsecondary education experiences on career choices and employment navigation. Guided by the social model of disability and intersectionality theory, nine postsecondary participants formally diagnosed with autism and who self-identified as cisgender completed semistructured interviews exploring their educational and employment experiences. Thematic analysis identified seven interconnected themes. Findings indicated that academic success often masked significant internal distress, suggesting that performance did not reflect accessible environments. Participants …
Strategies To Reduce Staff Shortages In A Freestanding Dialysis Clinic In Rural Georgia, Shayla Daniell Sanders
Strategies To Reduce Staff Shortages In A Freestanding Dialysis Clinic In Rural Georgia, Shayla Daniell Sanders
Walden Dissertations and Doctoral Studies
Vacancy rates are a current problem in a freestanding outpatient dialysis clinic in rural communities. From an administrative perspective, vacancy rates increase costs associated with recruitment, onboarding, training, overtime and compromise the quality and safety of patient care. The purpose of this integrative review was to identify evidence-based strategies to decrease vacancy rates in rural Georgia dialysis clinics. Donabedian’s framework of structure, process, and outcome was used for this integrative review. The integrative review question explored evidence-based strategies that can decrease vacancy rates in dialysis clinics in rural Georgia. Out of 50 articles reviewed using the John Hopkins Evidence-Based Practice …
Public Defenders’ Challenges Representing Erroneous Prosecution Cases In The Black Community, Kayla Kristine Stephens
Public Defenders’ Challenges Representing Erroneous Prosecution Cases In The Black Community, Kayla Kristine Stephens
Walden Dissertations and Doctoral Studies
Public defenders in a southern state continue to face significant challenges when representing Black individuals in the criminal justice system, particularly in cases involving erroneous prosecution. These challenges are intensified by high caseloads, limited funding, and systemic inequities, which can be stressors affecting the prosecutors wellbeing and hinder the provision of adequate legal representation. Public defenders, appointed to represent indigent defendants, frequently navigate complex legal and social circumstances that intersect with racial disparities in the justice system. For this qualitative study the research question was, how do public defenders perceive and manage any stresses representing erroneous prosecution cases in the …
Recent Failures And Lessons In Self-Regulating Professions In Canada From A Historical Organization Perspective, Richard James Dixon
Recent Failures And Lessons In Self-Regulating Professions In Canada From A Historical Organization Perspective, Richard James Dixon
Walden Dissertations and Doctoral Studies
Canadian self-regulating professions govern the conduct of professionals through legislatively mandated organizations, yet the conditions under which their management fails, and self-regulatory authority is lost, remain poorly understood. Governing boards and provincial governments need to understand this concern as a leading indicator of governance failure, erosion of public confidence, and conditions that may precipitate the loss of self-regulatory authority. The purpose of this descriptive, historical, multiple-case study was to explore how recent management failures in three Canadian self-regulating professional organizations can guide decision-makers in choosing sustainable management practices and governance models. Freidson's professionalism framework, neo-institutional theory, and strategic management grounded …
Nursing Staff’S Perception Of The Implementation Of The Obstetric Emergency Code Pink, Mareena Johnson
Nursing Staff’S Perception Of The Implementation Of The Obstetric Emergency Code Pink, Mareena Johnson
Walden Dissertations and Doctoral Studies
The local nursing practice problem addressed by this DNP doctoral project was the inconsistent and uneven response to obstetric emergencies within the health care setting. The purpose of this project was to evaluate the current implementation of the Code Pink protocol, identify any gaps or barriers in its effectiveness, and gather insights from nursing staff to propose refinements that would enhance its reliability and impact., The perception of nursing staff regarding obstetric emergency codes represents a critical dimension in the domain of maternal and neonatal health care, significantly influencing the efficacy of emergency responses and patient outcomes. Obstetric emergencies, such …
Hospital Operational Strategies For Reducing 30-Day Acute Myocardial Infarction Readmissions In The Southeast United States, Heather Smith
Hospital Operational Strategies For Reducing 30-Day Acute Myocardial Infarction Readmissions In The Southeast United States, Heather Smith
Walden Dissertations and Doctoral Studies
Thirty-day readmissions following acute myocardial infarction (AMI) remain a significant challenge for health care organizations due to increased health care utilization, costs, and adverse patient outcomes. The purpose of this integrative review was to identify effective operational strategies for reducing 30-day readmissions among patients with AMI in the Southeast United States. An integrative review of literature published between 2019 and 2026 was conducted using Cumulative Index to Nursing and Allied Health Literature, MEDLINE/PubMed, UAB Lister Hill Library, Walden Library, Scopus, American Heart Association, and Google Scholar. Twenty-five articles were appraised using the Johns Hopkins appraisal process, and 15 studies meeting …
K–3 Teachers’ Perspectives Regarding Learnable Intelligence As A Developmental Target And Their Advocacy For Students’ Cognitive Capabilities, Eleanor Nkechi Maduako
K–3 Teachers’ Perspectives Regarding Learnable Intelligence As A Developmental Target And Their Advocacy For Students’ Cognitive Capabilities, Eleanor Nkechi Maduako
Walden Dissertations and Doctoral Studies
Extensive research shows the brain is malleable and, with experience and knowledge, intelligence can grow. The research problem addressed through this study was that the extent of early childhood educators' knowledge of learnable intelligence and their advocacy for advancement of children’s cognitive capabilities as a developmental goal were unknown. Guided by Perkins’s theory of learnable intelligence, the purpose of this basic qualitative study was to explore K–3 teachers’ perspectives on learnable intelligence as a developmental target and how they advocate for children’s cognitive capabilities in their classrooms. In vivo and axial coding of data from semistructured interviews with 12 participants …
Effective Strategies To Implement Energy-Efficient Practices In Enterprise Cloud Data Centers: A Qualitative Pragmatic Inquiry, Joshua Tremayne Campbell
Effective Strategies To Implement Energy-Efficient Practices In Enterprise Cloud Data Centers: A Qualitative Pragmatic Inquiry, Joshua Tremayne Campbell
Walden Dissertations and Doctoral Studies
Cloud computing has increased electricity use in data centers, leading to higher costs and a larger carbon footprint. Information Technology (IT) leaders need to address this, as such inefficiencies will increase operational costs, undermine sustainability commitments, and leave companies unprepared for future regulatory pressures. Energy-efficient technologies can reduce data center energy consumption by 40-60%, yet few studies examine the qualitative processes behind IT leaders' practices. The specific IT problem is that some IT leaders lack effective strategies to implement energy-efficient practices in enterprise cloud data centers. Grounded in the technology-organization-environment (TOE) framework, the purpose of this qualitative pragmatic inquiry was …
Prenatal Health Factors Of Pregnant People Associated With Second Degree Postpartum Hemorrhage Across The United States, Elizabeth Simpler
Prenatal Health Factors Of Pregnant People Associated With Second Degree Postpartum Hemorrhage Across The United States, Elizabeth Simpler
Walden Dissertations and Doctoral Studies
Secondary postpartum hemorrhage (SPPH) is a significant contributor to maternal morbidity in the United States and occurs after hospital discharge during the postpartum period. Persistent disparities in terms of maternal outcomes suggest access to prenatal care alone may not adequately address clinical and social factors associated with SPPH. Guided by the Social Ecological Model, which recognizes that health outcomes are influenced by a collective approach to examining health. The purpose of this study was to examine associations between SPPH, prenatal care access, and social determinants of health from 2019 to 2022 while controlling for maternal age, race, and delivery type. …