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Post-Pandemic Telebehavioral Health: Sustaining And Regulating Remote Mental Health Care As A Core Modality, Weiqiao Dong

Dartmouth College Master’s Theses

The United States continues to face a persistent mental health crisis after the COVID-19 pandemic, raising a policy question about the long-term role and regulation of telebehavioral health as a core modality of care. This thesis examines that question through a case study of New York State, an early center of the pandemic and a leader in telehealth policy reform.

Guided by the Health Policy Triangle framework, this thesis integrates longitudinal data from all 62 New York counties for 2010-2025 with a 2025 cross-sectional dataset covering 61 counties. Seventeen standardized indicators are organized into four dimensions: geographic, economic, demographic, and …

Artificial Intelligence-Assisted Retinal Imaging For Chronic Disease Detection, Prediction, And Screening, Shivani Gandhi

Master's Projects and Capstones

A retinal image may reveal more than eye disease; it may also show early signs of chronic illness elsewhere in the body. Diabetes, hypertension, cardiovascular disease, and chronic kidney disease can develop before symptoms become noticeable, making earlier detection an important public health goal. Advances in artificial intelligence have created new possibilities for using retinal images to identify patterns linked to these conditions. This scoping review examined how Artificial Intelligence -assisted retinal imaging has been used for chronic disease detection, prediction, and screening, along with the practical and health-equity factors that may influence its use.

To map the current evidence, …

The Experience Of Sleep And Academic Performance Among African American College Students: A Case Study, Jamean Alma Alexander

Walden Dissertations and Doctoral Studies

The transition to college presents significant challenges for African American college students, particularly in developing effective study habits and maintaining healthy sleep behaviors that support academic success. Despite growing evidence linking sleep and academic performance, limited research has explored how African American students attending historically Black colleges and universities (HBCUs) perceive these experiences. The purpose of this qualitative case study was to explore the perceptions and experiences of African American college students regarding sleep habits, study habits, and academic performance. Guided by three research questions, data were collected through semi structured interviews with 12 African American students attending HBCUs in …

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 …

Staff Education To Nurses On Trauma-Informed Care, Lorna Sackey

Walden Dissertations and Doctoral Studies

Many nurses receive little formal instruction about trauma-informed principles and their practical application in behavioral health settings. To address this practice gap, the project implemented a staff education program for staff at an intensive outpatient program (IOP) and a partial hospitalization program (PHP) located in a northeastern state. The aim was to increase staff knowledge and confidence in trauma-informed principles within clinical practice. The education program emphasized the relevance of trauma-informed care (TIC) in outpatient behavioral health settings, its principles, and its application in nursing assessments, therapeutic communication, and patient interactions. A pretest and posttest questionnaire consisted of 12 multiple-choice …

Understanding Relapse And The Correlation With Group Counseling Accountability, Attendance, And Attitudes, Willie Sanders

Walden Dissertations and Doctoral Studies

Substance abuse continues to create significant personal, family, and legal challenges, yet limited research exists on mandated clients receiving counseling within rural municipal court systems. Studying factors associated with relapse allows counselors and counselor educators to develop interventions to prevent relapse and improve treatment outcomes. The purpose of this quantitative study was to investigate the relationship between group counseling attributes of attendance, accountability, attitudes and the level of relapse rates among rural municipal court clients in Columbus, Mississippi, as measured by the DEF, Subtle, Face Valid Alcohol, Face Valid Other Drugs, and the OAT Scales of the SASSI-4 Assessment. Theoretical …

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 …

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 = …

Staff Education To Enhance Nurse Knowledge Of Standardized Sud Screening Using The Dast-10 In An Outpatient Psychiatric Setting, Peters Olugbemiga Adu

Walden Dissertations and Doctoral Studies

The utilization of substance use disorder (SUD) screening tools at the practice site was inconsistent, contributing to limited identification and diagnosis of SUDs. The project was conducted at a psychiatric outpatient clinic in an urban region of Maryland that serves many patients with co-occurring mental health and substance use disorders. The purpose of the project was to develop, implement, and evaluate a staff education program focused on the Drug Abuse Screening Test (DAST-10). The primary goal was to improve staff knowledge and understanding of the DAST-10 screening tool. A 14-item multiple-choice questionnaire was administered before and after the educational intervention …

Staff Education To Improve Confidence Of Triage Decision-Making In Hospice After-Hours Care, Kelly Hurst

Walden Dissertations and Doctoral Studies

A quality improvement project addressed variability in after-hours hospice telephone triage through implementation of structured communication and symptom-based decision-support tools. The practice-focused question examined hospice triage nurses’ perceived confidence following implementation of these tools. A descriptive quality improvement design was used. Five hospice triage nurses received education on the CALMER communication technique and symptom-specific decision-support guides for anxiety and dyspnea. Outcomes were evaluated through a postimplementation survey assessing confidence, tool utilization, intervention perceptions, and practice recommendations. Quantitative responses were summarized using descriptive statistics, and qualitative responses were reviewed for themes. All participants reported high baseline confidence in hospice telephone triage. …

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 …

Defining Quality Of Life: The Lived Experience Of Adults With Pulmonary Hypertension And The Impact Of Activity-Induced Respiratory Distress, Bethany Jean Adams

Walden Dissertations and Doctoral Studies

Pulmonary hypertension (PH) is a progressive, life-limiting disease that significantly affects quality-of-life (QoL). Limited research has explored lived experiences of individuals with PH. Guided by Parse’s human becoming theory, this qualitative descriptive phenomenological study explored the lived experiences of individuals affected by PH and examined how activity-induced respiratory distress affected QoL. The research Question was: How do individuals with PH describe the impact of activity-induced respiratory distress on their QoL. I conducted interviews with nine participants, including eight adults diagnosed with PH and one caregiver of an individual with PH. Data were analyzed using Saldaña's comparative coding framework to identify …

Licensed Counselors’ Meaning-Making Of Debriefing Experiences Following Client Crises In Community Mental Health Centers, Donna Howard

Walden Dissertations and Doctoral Studies

Licensed professional counselors working in community mental health centers (CMHCs) frequently respond to client crises; however, little was known about how they understand and make meaning of debriefing following those events. The purpose of this qualitative interpretative phenomenological analysis (IPA) study was to explore counselors’ meaning-making of debriefing following client crises in CMHCs. Guided by IPA and grounded in phenomenology and hermeneutics, data were collected through semistructured interviews with five licensed professional counselors who had at least 5 years of CMHC experience, participated in postcrisis debriefing, and graduated from programs accredited by the Council for the Accreditation of Counseling and …

Preschool Teachers' Perceptions In Supporting Students Experiencing Trauma, Ann F. Gorbett

Walden Dissertations and Doctoral Studies

Early childhood teachers are often the first to observe behaviors that could be a result of trauma. The problem that was addressed in this study is that preschool teachers are not adequately trained to effectively address the social, emotional, and academic needs of children who have experienced trauma. Framed by Bandura’s theory of self-efficacy, the purpose of this basic qualitative study was to explore preschool teachers’ preparedness and training needs to effectively respond to children who have experienced trauma. Data were collected through semistructured interviews with 10 general education preschool teachers, who have at least 2 years of teaching experience. …

Clinical Practice Guideline For Sepsis In Skilled Nursing Facility, Chinyere Okoroh

Walden Dissertations and Doctoral Studies

Sepsis is a life-threatening condition that can rapidly lead to organ dysfunction, septic shock, and death if not recognized and treated early. Older adults in skilled nursing facilities (SNFs) are especially vulnerable because of age-related physiological changes, chronic conditions, weakened immunity, and increased exposure to infections. Consequently, sepsis remains a major cause of hospital readmissions, mortality, and healthcare utilization among SNF residents. The SNF serving as the site for this Doctor of Nursing Practice (DNP) project experienced increased hospital readmissions associated with recurrent sepsis, highlighting the need for a standardized, evidence-based approach to sepsis recognition and management. The practice-focused question …

Digital Presence In Live Hybrid Performance, Luke Cargill

Dartmouth College Master’s Theses

This thesis examines how digital presence, the sense that a digital performer is socially and performatively "there," is designed and tested in live hybrid performance. Drawing on four practice-based projects (Vicarious, Voltage, Vicarious: Encore Edition, and SUPER BLOOM), the first phase identifies a recurring but empirically untested claim: that digital presence depends on interactivity and co-presence with live performers, though these factors were always entangled in practice.

The second phase tests this claim directly. A new mini-performance, featuring the first fully AI-driven digital character in this line of work, was produced for controlled comparison. Using a 3 (intro type: AI-driven, …

Developing Field And Spaceflight Microscopy, Nikki Johnston

Dissertations and Theses

Designing for spaceflight favors the reduction of unnecessary features and cost-cutting, whether thisbe computation, hardware, or procedure. Resources are spent toward fortification and mission success over convenience. Such design goals paired with the relatively smaller budgets of academia lead us to do as much as we can in-house and use open-source as much as we can without compromising mission success. We also believe that thoroughly testing technology in extreme environments on earth is necessary for the success of a flight instrument. We focus on microscopy for life detection. I have spent my time here learning methods of hand-building microscopes to …

Toward Design-To-Fabrication Continuum For Open-Source Computational Robotic Ecologies In The Post-Anthropogenic Era, Celso Urroz

Electronic Theses and Dissertations

Computational design and robotic fabrication have expanded architecture’s capacity to coordinate geometry, material behavior, machine operation, and environmental performance. Yet many design-to-fabrication workflows remain structured by industrial logics of separation, standardization, and control. Design is often abstracted from material execution, fabrication is treated as a downstream phase, and robotic systems remain concentrated within specialized or proprietary infrastructures. This dissertation addresses this problem by proposing the design-to-fabrication continuum as an open, transferable, and ecologically situated framework in which computation mediates among design intent, matter, machine, environment, and shared technical knowledge.

The research uses a practice-based methodology combining computational workflow development, material …

Reading Comprehension Success For Multilingual Learners, Meilian Wang

Masters Projects

Multilingual learners (MLs) often struggle with reading comprehension as they simultaneously develop English language proficiency and learn grade-level academic content. Although research has identified effective instructional strategies for supporting ML reading comprehension, many general education teachers feel underprepared to implement these strategies effectively. This project examines the research-based approaches for supporting ML’s reading comprehension while addressing the need for sustained professional learning and instructional coaching for classroom teachers. The literature reviewed in this project focuses on sociocultural theory, translanguaging, culturally responsive pedagogy, and the Sheltered Instruction Observation Protocol (SIOP). There will be additional research-based instructional strategies such as explicit vocabulary …

Analysis Of Early Menopause And Endometriosis Genetics Merit In Use Of Polygenic Risk Assessments For Prediction, Emily Solomon

Graduate Student Dissertations, Theses, Capstones, and Portfolios

Endometriosis and Early Menopause are reproductive conditions that are under research in women's health. Both conditions impact a woman’s quality of life through severity of symptoms and associated risk factors and are influenced by genetic, hormonal and environmental elements. Both conditions have extensive and growing genetic knowledge that is being used to calculate either an increased or decreased risk of condition development. The array of genetic data shows promises in predicting risk for both conditions, as well as certain symptoms, to contribute to a personalized predictive tool to guide management of care. Endometriosis benefits from a potential polygenic risk assessment …

Exploring The Occupational Risks Among Human Service Professionals: A Trauma-Informed Approach To Caring For Others And Ourselves, Shaian Kong

Master of Arts in Human Services

It is known that human service practitioners are often expected to maintain empathy, compassion, emotional regulation, and professionalism during high-stress or uncertain situations. These experiences expose practitioners to a unique intersection of trauma. While helping others through their own trauma, practitioners may also experience symptoms such as intrusive thoughts, emotional exhaustion, sleep disturbances, hypervigilance, and avoidance despite not directly experiencing the traumatic events themselves. Current literature highlights these existing occupational risks that may hinder sustained career development, increased compassion fatigue, and affect workplace standards and support. With things like frequent increase in workloads, workforce shortages, and insufficient professional support, practitioners …

Strategies Health Care Leaders Use To Employ Ai-Supported Data-Driven Decision-Making To Increase Profitability, Lacurisia Harrison

Walden Dissertations and Doctoral Studies

Strategies Health Care Leaders Use to Employ AI-Supported Data-Driven Decision-Making to Increase Profitability by LaCurisia Harrison MS, Alabama A&M University, 2023 BS, Alabama A&M University, 2021 Qualitative Pragmatic Inquiry Business Research Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Business Administration Walden University August 2026

Examination Of The Bureau Of Indian Affairs Public Policy Implementation In Support Of Sovereign Tribal Nations, Erna Mae Faber

Walden Dissertations and Doctoral Studies

Social and economic disparities in the Midwestern Reservation Community have persisted for more than five decades despite the enactment of federal Indian policy designed to address them. Based on the existing research, the Bureau of Indian Affairs’ (BIA’s) failure to effectively administer programs addressing health care, housing, and economic opportunity has perpetuated systemic inequities that disproportionately affect tribal nation members. The purpose of this generic qualitative study was to explore how members of the Midwestern Reservation Community viewed the implementation of BIA public policies intended to support tribal nations through the lens of the resource dependence theory, the narrative policy …

Food Insecurity Among Freshman Male Collegiate Athletes At A Historically Black University In Maryland, Petita Cue Rentz

Walden Dissertations and Doctoral Studies

Food insecurity is an emerging public health issue impacting collegiate student-athletes enrolled at Historically Black Universities (HBUs). Recent research revealed that 63% of football players have reported some form of food insecurity which disproportionately impacts Black athletes at higher rates. The purpose of this qualitative study was to explore the lived experiences and dietary behaviors of freshman male collegiate student-athletes who lacked access to food despite receiving athletic scholarships in a publicly funded HBU in Maryland. The research questions for this qualitative study focused on exploring the lived experiencing of Black male athletes who were experiencing food insecurity at an …

Guideline For Early Identification Of Chronic Kidney Disease In At-Risk Adults In Primary Care, Catherine Ugo

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project focused on developing and validating a clinical practice guideline (CPG) to improve the early identification of chronic kidney disease (CKD) among at-risk adults in a primary care practice. The project addressed a site-specific practice gap involving the inconsistent use of evidence-based CKD screening, particularly estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) testing, which may delay diagnosis and treatment (Kidney Disease: Improving Global Outcomes [KDIGO] CKD Work Group, 2024). The purpose of this project was to develop an evidence-based CPG and evaluate its quality using the Appraisal of Guidelines for Research and …

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 …

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 …

Workers Authoring Assessment: Play And Power In Early Childhood Education, Phoebe M. Gilpin

Theses and Dissertations

Researchers assert that play-based pedagogy is an effective approach to teaching young children, but there is less consensus on the specific methods of play-based teaching. This mixed-methodology exploratory case study investigated early childhood (EC) educators’ conceptualizations of play-based pedagogy in three phases: Phase 1’s quantitative measure testing found a mismatch between researchers’ conceptualization of play-based pedagogy and EC educators’ (n=183) understandings. In Phase 2, EC educators (n=3) articulated their perspectives about teaching through play and co-authored a new tool, the Teacher-Authored Play and Teaching Scale (TAPTS). Within Phase 3, EC educators (n=60) completed the TAPTS, which I interpreted through a …

Staff Education To Primary Care Staff About The Standardized Asthma Control Test, Paulina Asiedu

Walden Dissertations and Doctoral Studies

Staff Education to Primary Care Staff About the Standardized Asthma Control Test by Paulina Asiedu Walden University, 2026. Background Inconsistent primary care asthma tracking leads to reactive management and avoidable emergency utilization. At a Minnesota community clinic, baseline electronic health record (EHR) audits revealed validated Asthma Control Test (ACT) scores were documented in only 5% of eligible encounters, driving a 12% emergency department utilization rate. Purpose & Methods This Doctor of Nursing Practice quality improvement project evaluated whether educating primary care staff on a standardized ACT protocol improved clinical knowledge, behavioral intent, and documentation compliance. Using ADDIE and ADKAR change …

A Soft-Skilled Leadership Development Course For New Nurse Managers, Kiadrick Roshelle Hood

Walden Dissertations and Doctoral Studies

New nurse managers are stepping into leadership roles without structured training. While organizations offer various onboarding courses for managers transitioning into new management roles, few have implemented a structured, evidence-based program focused on leadership development, particularly in the soft leadership skills needed to lead a diverse workforce. I designed this staff education project to determine whether implementation of a leadership development course focused on time management, prioritization, and delegation would improve new nurse managers’ self-perception of these leadership skills. To address this gap, I developed a 1-day leadership development course to introduce tools to improve new nurse managers’ time management, …