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Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood

Walden Dissertations and Doctoral Studies

Inappropriate test utilization by physicians for clinical decision-making in patient care is a significant problem facing some healthcare leaders. Healthcare leaders are concerned about inappropriate test utilization because it can increase healthcare costs and degrade patient outcomes. Grounded in the complex adaptive system and Lean Six Sigma conceptual frameworks, the purpose of this qualitative single-case study was to identify strategies seven hospital leaders in Maryland and Washington, DC. who implemented successful test utilization strategies for physicians. Data were collected from semistructured virtual interviews and organizational reports and analyzed using Yin’s 5 step process. Five themes emerged: (a) continuing physician education, …

Help-Seeking Behavior Of African American And Non-African American Victims Of Elderly Abuse, Tesfaye Yigletu Wosene

Walden Dissertations and Doctoral Studies

Elderly abuse is a pervasive public health problem in the United States. Most abuse and neglect go unreported due to barriers including fear for safety, concerns about the consequences, culture, lack of knowledge about elder abuse, shame, and self-blame. However, there is limited research on how race and ethnicity impact help-seeking behaviors of the elderly. This cross-sectional quantitative study examined the difference in reporting and help-seeking behavior between African American and non-African American victims of elderly abuse. Applying the behavioral model of health services use, this study involved a secondary data analysis using the Nation Elderly Mistreatment Study Wave II …

Stakeholder Theory And Law Enforcement Strategy Creation, James Edward Wright

Walden Dissertations and Doctoral Studies

The study addressed the need for additional research on how people, groups, and communities influence the organizational process through agency and datedness of research on stakeholder theory. The purpose of this qualitative multiple case study was to explore how Southwestern Arizona law enforcement personnel create strategies to overcome the fear of proactive enforcement engagement and who is involved in their creation and implementation. The research questions addressed this purpose. The conceptual framework was based on stakeholder theory. Data were analyzed with ATLAS.ti using open coding to identify patterns and develop emerging themes from the multiple agencies and employee categories. Findings …

Association Between Psychosocial, Obstetric, And Lifestyle Factors And Antenatal Depression, Tomnema Xiong

Walden Dissertations and Doctoral Studies

Antenatal depression, or depression during pregnancy, is a mental health concern in the United States that impacts mothers and their infants. This study examined the associations between psychosocial, obstetric, lifestyle factors, and antenatal depression. This study was guided by social cognitive theory, specifically the reciprocal determinism construct. Secondary data from the 2007–2018 National Health and Nutritional Examination Survey (NHANES) were used in this quantitative cross-sectional study. Every participant of the NHANES completed the Patient Health Questionnaire-9 depression screening form. The study sample consisted of 274 women who were pregnant at the time of participating in the NHANES, approximately 28.8% of …

Strategies Dental Center Leaders Use To Improve Productivity Using Onsite 3d Printing, Edward Zamanian

Walden Dissertations and Doctoral Studies

Many dental centers are leveraging onsite 3D printing to increase their productivity and improve the quality of care they provide. However, dental center leaders lacking strategies to implement onsite 3D printing in their dental centers fail to take advantage of the substantial benefits of using this new technology. Grounded in the theory of disruptive innovation, the purpose of this qualitative multiple-case study was to explore strategies dental center leaders use to improve productivity using onsite 3D printing. The participants comprised five dental center leaders in the United States who successfully implemented strategies to improve productivity using onsite 3D printing. Data …

Variables Associated With Police Use Of Excessive Force In The United States, Leander Shane Zanders

Walden Dissertations and Doctoral Studies

AbstractA negative relationship persists among minority communities and law enforcement officers, including officers’ use of excessive force. Use of force researchers hold that a high percentage of African American men and boys can expect to die at the hands of police in the United States. Further, African American men are more likely than their White peers to die during an encounter with police. The purpose of this quantitative study was to examine the relationship between predictor variables and the use of excessive force against racial and ethnic minorities in the United States, controlling for race, gender, and household income. The …

Examination Of The Association Between Poverty, Income, And Education Levels On Tuberculosis Prevalence In Nigeria: Rural Niger Delta Case Study, Nwinmene George Zarakpege

Walden Dissertations and Doctoral Studies

Despite the global decline in tuberculosis (TB) cases, the prevalence of TB in rural populations in Nigeria is rising. To date, poverty and low educational levels continue to affect treatment and other prevention strategies to eradicate the disease. The purpose of this cross-sectional study was to assess the association between poverty, educational levels, household structure and vaccination status on TB prevalence in rural Niger Delta, Nigeria. The theoretical framework for this study was the socio-ecological model. Data were obtained from residents of rural Niger Delta in Nigeria attending a teaching hospital in southern Nigeria. The relationship between the stated demographic …

Experiences Of Elementary School Counselors Treating Anger Issues In Elementary School-Aged Foster Children, Dr. Clarissa Y. Alderman

Walden Dissertations and Doctoral Studies

The purpose of this study was to examine in detail the experiences of school counselors with treating anger issues in school-age children from foster care homes. In particular, the study determined the counselors’ experiences using cognitive behavioral therapy (CBT) to treat anger and whether the interventions were effective. The aim was to shape policy regarding handling children in foster care and overall child social services. Using two methods, the study employed a generic qualitative research design to cover the topic. One method was the narrative literature review, and the other was collecting data using interviews with five counselors adept at …

How Black Americans Accessed And Used Mental Health Services During The Covid-19 Pandemic, John K. Anderson

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic created barriers to accessing mental health services for the general population, but for Black Americans, it exacerbated systemic barriers that have historically influenced help-seeking behaviors. Drawing from the concept of obstructed use, this qualitative study explored those barriers and, using a narrative approach, explored how Black Americans described their experiences of accessing mental health services during the COVID-19 pandemic The participants included six men and two women who identified as U.S.-born Black American adults who sought mental health services during the COVID-19 pandemic. Narrative data were analyzed through thematic analysis, identifying themes and subthemes of the participants' …

Strategies That Reduce Nurse Turnover, Trueman Chukwuemeka Atughonu

Walden Dissertations and Doctoral Studies

Nurse turnover is a significant problem that hospital managers and administrators face in delivering high-quality patient care while ensuring organizational profitability. In the United States, the average cost of replacing a nurse ranges from $40,000 to $100,000. Hospital managers are significantly challenged to reduce nurse turnover and keep costs down. Grounded in the Herzberg’s two-factor theory, the purpose of this qualitative multiple-case study was to explore the strategies hospital managers use to reduce nurse turnover. The participants included five hospital managers at five medical centers in Arizona with successful experience in reducing nurse turnover. Data were collected from semistructured interviews …

Achieving An Organizational Culture To Increase Female Leadership In Technology Organizations, Kikelomo Lina Awodogan

Walden Dissertations and Doctoral Studies

The nonexistence of organizational culture to increase female leadership in technology organizations impacts organizations’ performance. Leaders of technology organizations who do not create an organizational culture to increase female leadership may experience innovation gaps reducing their competitive advantage. Grounded in the gendered organization theory, the purpose of this multiple case study was to explore strategies that leaders of technology organizations use to create a culture-friendly environment and adequate support that allows women to occupy leadership positions for improving business performance. The participants were three technology leaders located in the United States. Data were collected via semistructured interviews and publicly available …

How Behavioral Health Leaders Overcome Barriers To Perinatal Mental And Psychoeducation, Jaime Lorraine Bailey

Walden Dissertations and Doctoral Studies

Behavioral health supportive services are increasingly becoming integrated into primary care settings. This study focused on strategies to strengthen the knowledge of behavioral health leaders and address the barriers to perinatal mental health support in primary care. A case study was designed to explore the obstacles behavioral health leaders faced managing the limited access to perinatal mental health care, along with the lack of provider psychoeducation on perinatal mental health, in integrated care settings in primary care. This study sought to provide options for better access and quality of care to perinatal patients and increase provider psychoeducation on perinatal mental …

Clinician Perceptions Of Female Sex Offender Treatment In Modern Society, Taylor J. Bryant

Walden Dissertations and Doctoral Studies

Clinicians are starting to see a higher population of female sex offenders enrolled in their treatment facilities. Current research indicates that both society and clinical professionals struggle with viewing women as sex offenders due to gender stereotypes and minimization of sex crimes committed by women. The purpose of this qualitative study was to examine clinician perceptions of female sex offender treatment and how these perceptions may impact clinician engagement. The theoretical frameworks utilized in this study were the attachment theory and psychoanalytical theory. Data included clinician experiences with treating female sex offenders, exposure to professional trainings on this population, and …

Teacher Self-Efficacy Beliefs Related To The Implementation Of A School-Wide Positive Behavioral Interventions And Support Program, Angela Burnell

Walden Dissertations and Doctoral Studies

Research supports that teacher self-efficacy beliefs influence instructional behaviors and the implementation of educational programs. Bandura, based on his social cognitive theory, described teacher self-efficacy beliefs as strong self-regulating factors that influence individual instructional practices. However, there is a lack of empirical information about the influence of these factors on implementation of school-wide positive behavioral interventions and supports (SWPBIS) programs to address student behaviors. The purpose of this quantitative study was to investigate the relationship between teacher self-efficacy beliefs and perceptions about the implementation of a SWPBIS program, and student outcomes. The research questions concerned whether teacher self-efficacy beliefs were …

Unvoiced Lgbt Individuals’ Perceptions And Experiences Of The School-To-Prison Pipeline, Dr. Deshaunt'e A. Burns

Walden Dissertations and Doctoral Studies

Studies have shown that lesbian, gay, bisexual, and transgender (LGBT) individuals face discrimination, harassment, and bullying by different education and criminal justice system entities because of their sexuality. Research has also indicated that when it comes to the school-to-prison pipeline (STPP), children of color are often mistreated and face harsher penalties, and research must be done to see how LGBT individuals are treated because they are considered abnormal because of their sexuality. Little is known about the perceptions and experiences of LGBT individuals when they are punished for violating minor infractions in school. This study addressed the critical race theory …

Kudumbashree Mission’S Community-Based Enterprise Strategies For Increasing Female Labor Force Participation, Deepak Chandran Chandran

Walden Dissertations and Doctoral Studies

Various facets of gender inequality continue to deter women from participating in the formal economy. Deployment of a significant level of capital from global sources and attention from the global academic community have not succeeded in addressing the persistence of economic marginalization of women. This study's purpose was to identify appropriate community-based enterprise (CBE) strategies for empowering women to overcome barriers and enter the labor force. The research questions addressed the study purpose and how the social capital and collective experiences of the community influenced the success of CBE strategies. Based on the CBE conceptual framework, this qualitative descriptive case …

Adverse Childhood Experiences, Internalized Homophobia, Alcohol Use, And Suicide Ideation And Attempts Among Sexual Minority Msm Of Color, Odion Clunis

Walden Dissertations and Doctoral Studies

Sexual minority men of color who engage in sexual activity with men (MSM) are twice as likely to experience a psychological episode contributing to suicide ideation or attempts when compared to White MSM. These MSM are underserved in health systems, underrepresented in research, and limited in their access to health care services and interventions. The purpose of this quantitative study was to examine relationships between adverse childhood experiences, internalized homophobia, alcohol use, and suicide ideation and attempts while controlling for age, income, education, and employment among sexual minority men of color (Asian, Black/African American, Hispanic/Latino, Middle Eastern, Native Hawaiian/Pacific islanders, …

Trauma-Informed Practices For Behavioral Health Leaders Serving Sex-Trafficking Survivors And Personnel, Evelyn Cordero Molina

Walden Dissertations and Doctoral Studies

Trauma-informed practices are essential to successful treatment outcomes and employee wellness in the context of sex trafficking clinical intervention. This single case study described the trauma-informed practices developed in a residential program for biologically-female sex trafficking survivors in the Southwest United States. The Baldrige excellence framework and the trauma-informed framework informed the study to comprehend organizational key factors and principles in the context of the residential program. Data were collected through semistructured interviews with four leaders at the senior and middle management levels, and internal documentation such as procedures, protocols, strategic plans, and yearly reports were included in the analysis. …

Understanding Law Enforcement Counterterrorism Information Sharing In Homegrown Violent Extremism Cases, Danielle Corry

Walden Dissertations and Doctoral Studies

Local law enforcement agencies are charged with the responsibility to prevent terrorist events in the United States, including the emerging threat of homegrown violent extremism. Without the use of the terrorism prevention tool of information sharing, with other applicable state and federal law enforcement agencies, there continues to be a breakdown in the ability to prevent terrorist events, especially those associated with homegrown violent extremists, in the United States. This qualitative case study explores the information sharing process in law enforcement agencies by examining the recent Boston Marathon Bombing in Boston, Massachusetts that occurred in 2013. Five themes emerged from …

The Effect Of Crime Drama Viewing Habits And Technology On Potential Jurors, Erin Marie Cosenza

Walden Dissertations and Doctoral Studies

Proponents of the “CSI effect” argue that viewers of fictional crime drama television programs are inappropriately influenced and have heightened expectations for the presentation of forensic evidence during jury trials and therefore cause jurors to incorrectly weigh the importance of the evidence on the outcome of the trial. Television programs make measurable contributions to viewers’ perceptions of reality and cultivate the way people learn about the world. Cultivation theory suggests that the ability to use critical thinking is inhibited in discerning truth from glamorized portrayals of evidence collection, analyses, and the timeframe with which criminal investigation storylines are concluded. The …

Latinx Parents’ Mental Health Advocacy Efforts In School Settings, Christine R. Durfee

Walden Dissertations and Doctoral Studies

Latinx parents want to participate in their child’s education plan but are faced with increased challenges since the 2016 anti-immigrant policies amplified the disparities in utilizing mental health services. Latinx parents want to collaborate with school psychologists and mental health providers to help their children but do not readily trust them based on their negative past experiences. Therefore, Latinx parents struggle to receive academic accommodations for their children with mental health challenges. The purpose of this phenomenological study was to address this gap and explore the lived experience of Latinx parents who advocate on behalf of their children with mental …

Strategies For Improving Performance Through Diversity And Inclusion In The Workplace, Satari Kay Durrah

Walden Dissertations and Doctoral Studies

A lack of diversity and inclusion policies can lead to the perception of exclusion in the workplace and cause some employee groups to underperform. Some hospital leaders lack strategies for developing and implementing effective diversity and inclusion policies to improve business performance. Grounded in transformation leadership theory, the purpose of this multiple case qualitative study was to explore strategies for improving performance through diversity and inclusion in the healthcare field. The participants included four leaders from hospitals located in the southeastern region of the United States. Data were collected using semistructured interviews and review of company documents. Data were analyzed …

Technology Manufacturing Leaders’ Innovation Strategies To Improve Users’ Choice Capabilities In A Fast-Changing Markets, Magnus Ekwunife

Walden Dissertations and Doctoral Studies

Some leaders of technology manufacturing organizations lack strategies to educate their users on how to make the optimal cloud technology selection decisions for their organizations during rapidly evolving innovation, resulting in significant risk of wrong choices and loss of customer loyalty. Grounded in resource-based view theory, the purpose of this qualitative single case study was to explore strategies technology manufacturing leaders use to educate users on how to make optimal cloud technology selection decisions for their organizations. The participants were six executive-level leaders of the strategic sales division of a multinational technology organization based in the western United States who …

Fostering Electricity Access In Cameroon: Impeding Factors And Cost-Effective Model, Jean-Jacques A. Enow

Walden Dissertations and Doctoral Studies

Abstract Due to irregularities and shortages in electricity generation and distribution, 95% of Cameroon’s population suffers from debilitating effects on national economic security, public health, education, safety, and quality of life. Cameroon needs a sustainable, efficient, and innovative electricity source and policy system. Failure to meet this demand forestalls the much-needed socio-economic and political development of the country. The purpose of the present study was to explore inadequacies of the current hydroelectric supply system in Cameroon, putting into perspective factors that impeded the development of a sustainable electricity supply system, strategies to alleviate these impediments, and the most cost-effective framework …

The Barriers Social Workers Face During The Discharge Of Hospital Patients, Nykke Flaum

Walden Dissertations and Doctoral Studies

This study investigated the psychosocial barriers hospital patients face that would delay their discharge. A delay in discharge can stop new patient admissions, cause further illness to the patient, and cost the hospital money, amongst other issues. Social workers are there as part of the multidisciplinary team to reduce the barriers and length of stay. One of the ways to do this is to detect the psychosocial issue early on in a patient’s admission so that it does not delay the discharge. Social workers investigate these issues during the discharge planning process and while conducting assessments. This study utilized structured …

A Community-Based Distribution Intervention For Family Planning Among Women In Northern Nigeria, Joy Matau Garba

Walden Dissertations and Doctoral Studies

In Northern Nigeria, inadequate information on family planning contributes to high mortality and morbidity rates in women of reproductive age due to multiple childbirths yearly. This study aimed to examine the relationship between the community-based distribution (CBD) strategy, religion, and attitudes toward family planning methods. Rosenstock’s health belief model, which can be an instrumental anchor for health promotion programs, was the theoretical framework for the quantitative cross-sectional study design. The data source was survey questionnaires administered by the U.S. Agency for International Development to 809 reproductive-age Nigerian women after implementing a CBD intervention. A multinomial logistics regression analysis showed that …

Deaf And Hard Of Hearing College Students’ Experiences With Alcohol And Related Consequences, Christine Lee Gannon

Walden Dissertations and Doctoral Studies

Alcohol misuse on college campuses has been shown to be the cause of physical, socio-emotional, and academic harm. Alcohol is also an issue at Gallaudet University, the only liberal arts university for the deaf, but there is a gap in the literature describing the phenomenon in the environment and how to address it. This qualitative case study explored the perceptions and experiences of alcohol use and alcohol-related consequences for deaf and hard of hearing college students through interviews with 50 students and staff at Gallaudet University. Alcohol misuse and related harms were explored through the framework of the social ecological …

Testimonios From Latinas In Community College Administration In Nuestra Comunidad, Yessika Milines Garcia-Guzman

Walden Dissertations and Doctoral Studies

It is not known why Latina community college administrators are disproportionally underrepresented in higher education. Of all full-time faculty in postsecondary institutions, 3% are Hispanic females; 1% or less of full-time professors are Hispanic females, and 3% are full-time assistant professors. The purpose of this qualitative study was to describe the experiences of Latina community college administrators in their journey as college students and how these experiences informed their understanding of the academic and student support systems that either hinder or support Latinas. Phinney’s theory of racial and ethnic development was the theoretical foundation for the study. The research questions …

Impact Of Resilience On Quality Of Life In Spinal Cord Injured Clients, Crystal D. Glover

Walden Dissertations and Doctoral Studies

Abstract Impact of Resilience on Quality of Life in Spinal Cord Injured Clients by Crystal D. Glover

MSM, Troy University, 2006BSN, University of North Carolina at Greensboro, 1995

Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health

Walden University August 2023

Co-Rumination In The Friendships Of Black And White Adolescents, Andrea Renee Gourdine

Walden Dissertations and Doctoral Studies

Co-rumination is the process of friends discussing challenges via a problem-focused dialogue that is excessive and involves dwelling on negative emotions. Co-rumination is related to higher friendship quality but also depression. The adjustment consequences of co-rumination have been studied, but racial differences in co-rumination have yet to be studied. The purpose of this non-experimental, correlational, quantitative study was to examine co-rumination among Black and White adolescents. Theoretical frameworks included the response styles theory and Africentric theory. Research questions included whether there were racial differences in the degree to which adolescents co-ruminate and in the relations of co-rumination with friendship quality …