Digital Commons Network^™

Staff Education To Improve Behavioral Health Integration In Primary Care, Nelly Endah Atu

Walden Dissertations and Doctoral Studies

This staff education project addressed a persistent gap in the delivery of integrated physical and mental healthcare for patients with co-occurring conditions. Fragmented care in primary care contributes to untreated mental health needs, increased patient distress, higher costs, and poor outcomes. The aim of this project was to develop, deliver, and evaluate a staff education program equipping nurses, nurse practitioners, and interdisciplinary team members with the knowledge, skills, and practical strategies needed to improve behavioral health integration in primary care. The practice question was, among interdisciplinary staff in a community health setting, did the implementation of an evidence-based, ADDIE-designed staff …

Self-Care Behavior And Diabetes Knowledge In African American Women With Type 2 Diabetes, Rena Renee Barron

Walden Dissertations and Doctoral Studies

African American women experience a disproportionate burden of Type 2 diabetes, and limited evidence exists regarding the relationship between diabetes knowledge and self-care behaviors, particularly among African American female veterans. The purpose of this quantitative, cross-sectional study was to examine the relationship between diabetes knowledge and diabetes self-care among African American women with Type 2 diabetes, including a subsample of African American female veterans, and to evaluate whether the COVID-19 pandemic (2017–2019 vs. 2021–2023) moderated this relationship. Additional variables included age, marital status, physical health, and mental health. Guided by the social-ecological model, de-identified data from the Behavioral Risk Factor …

Relationship Between Hospital Case Management Leadership Style And Employee Engagement, Malinda Ellis

Walden Dissertations and Doctoral Studies

Employee engagement among hospital-based nurse case managers is important because these nurses support discharge planning, utilization management, care coordination, and safe patient transitions. Although leadership style has been studied in nursing, limited research has examined its relationship to engagement among nurse case managers. The purpose of this quantitative, nonexperimental, correlational study, using House’s path-goal theory, was to examine the relationship between transformational, transactional, and laissez-faire leadership styles and employee engagement among hospital-based nurse case managers. Data were collected from 89 registered nurse case managers in acute care settings in the United States, who completed the Multifactor Leadership Questionnaire, Short Form, …

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 …

Explicit Reading Comprehension Instruction: Developing An Evidence-Based Resource Guide For Upper Elementary Teachers, Amanda M. Moser

Masters Projects

Reading comprehension is a complex process that requires more than accurate decoding and word recognition. Many elementary students benefit from explicit instruction in the cognitive, linguistic, and metacognitive processes that support comprehension. The purpose of this project was to examine research on reading comprehension and develop evidence-based instructional resources for upper elementary teachers. The theoretical framework for this project draws on four perspectives: the Constructive-Integration Model (Kintsch, as discussed in Conner et al., 2016), Transactional Theory (Rosenblatt, 1978), Sociocultural Theory (Vygotsky, as discussed in Palincsar et al., 1987), and the Active View of Reading (Duke & Cartwright, 2021). Collectively, these …

Lightweight End-To-End Cryptographic Framework With Semantic Qos For Ar-Based Telesurgery, Pavan Kumar Satram

Masters Theses

This thesis presents the design, implementation, and evaluation of a lightweight end-to-end cryptographic framework integrated with a semantic quality-of-service classification system for augmented reality based telesurgery. Telesurgery can deliver expert surgical care to underserved populations, but adoption has been limited by unresolved cybersecurity, network performance, and resilience challenges. The core tension is that strong encryption adds latency that may exceed the clinical safety threshold, while unencrypted systems remain vulnerable to attacks that could endanger patients during live procedures.

The framework addresses this tension through a dual-edge security middlebox that performs per-flow encryption using semantically selected ciphers: AES-128-GCM for latency-critical haptic …

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 …

Staff Education On Frailty And Senior Surgical Safety, Kimberly Buhay Gibu

Walden Dissertations and Doctoral Studies

This staff education doctoral project addressed a practice gap involving limited education on frailty assessment and senior surgical safety within the general surgery department of a large, integrated healthcare system. Frailty is associated with increased postoperative complications, hospitalizations, readmissions, and mortality among older adults, making early recognition essential to improving surgical outcomes. The practice-focused question project was: Does education on frailty screening and senior surgical safety improve the knowledge, confidence, and intent of general surgery staff in a large, integrated health system? The purpose was to develop, implement, and evaluate an evidence-based educational intervention. The project was guided by the …

Improving Hypertension Control Through Increased Follow-Up Frequency In Rural Adult Patients, Clarissa Renea King

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project centered on the implementation of an organizational change initiative to improve hypertension control among adults aged 18 years and older in a rural primary care setting, where barriers to healthcare contribute to poorer outcomes. The practice-focused question asked whether more frequent follow-up visits improve hypertension control rates in rural adults. Interventions included increased follow-up visits for uncontrolled hypertension, patient education, home blood pressure monitoring, and staff education on accurate blood pressure measurement techniques. The project involved a pre-/post- evaluation design and analysis of deidentified organizational quality data. Findings show that the baseline hypertension …

Staff Education To Improve Blood Pressure Reassessment And Referral Practices In An Urgent Care Setting, Carolyn Denise Kluttz

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was a staff education and quality improvement initiative designed to improve blood pressure (BP) reassessment and referral compliance among adult patients presenting with elevated BP readings in an urgent care setting. Elevated blood pressure is frequently identified during urgent care visits; however, provider responses and follow-up recommendations are often inconsistent, creating missed opportunities for early identification and intervention. The practice-focused question guiding this project was: In adult patients presenting to urgent care settings, how does implementing a standardized nurse-led hypertension screening and referral protocol, compared with usual care, affect the identification and follow-up …

Staff Education On Improving Medication Adherence, Oneil Dobgima Galega

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addressed a practice gap in an outpatient behavioral health setting involving inconsistent use of structured communication strategies to support medication adherence among psychiatric patients. Although nurses routinely provided medication instructions, approaches such as motivational interviewing and psychoeducation were underutilized, limiting patient engagement, understanding, and adherence, and ultimately affecting care continuity and outcomes. The purpose of the project was to improve psychiatric nurses’ knowledge and intent to use motivational interviewing and psychoeducation to enhance medication adherence. The guiding practice-focused question examined whether a structured educational intervention could strengthen nurses’ competencies in these communication strategies. …

Staff Education To Improve Nursing Knowledge On Pressure Injury Prevention, Kheeda Kimberly Gopaul

Walden Dissertations and Doctoral Studies

Staff education in this project was focused on improving nursing staff’s knowledge on pressure injury prevention, inspired by the persistent care quality gap. The gap in practice as of 2024 related to hospital-acquired pressure injury (HAPI) at the host health organization was reported to be approximately 0.2 per 1,000 discharges. It was apparent that education could benefit the nursing staff to improve their knowledge in pressure injury prevention. The education in service focused on continuous nursing skin assessments, to ensure over prolonged hospitalization, patients’ skin does not deteriorate with the development of pressure injuries or advancing of pre-existing pressure ulcers. …

Challenges Early Childhood Educators Encounter When Balancing Play-Based Learning With Preparation For Standardized Testing, Shanette Damar Mcbride

Walden Dissertations and Doctoral Studies

The problem addressed through this study was that emphasis is being placed on standardized testing, which is causing early childhood educators to feel pressured to eliminate or reduce playtime in their classrooms. Framed by Vygotsky’s theory of social development and Lave and Wenger’s situated learning framework, the purpose of this basic qualitative study was to explore the experiences of early childhood educators in a southcentral U.S. state regarding the challenges they face in balancing a play-based learning curriculum and the support they need, while emphasizing information about standardized testing. The data were collected from semistructured interviews with 12 certified kindergarten …

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 …

Staff Education To Improve Central Line Maintenance Documentation Compliance, Martha Danette Oglesby

Walden Dissertations and Doctoral Studies

This was a staff education quality improvement project aimed at improving compliance with central line maintenance documentation among nurses on a busy transitional care unit (TCU). The practice problem was inconsistent documentation of central line bundle documentation. Documentation is an important part of nursing care and is the most effective way to communicate the care provided. Effective documentation is a pivotal way of identifying evidence-based care to prevent central line-associated bloodstream infections (CLABSIs). The practice-focused question was, In nursing staff working on an inpatient TCU, what is the impact of targeted education on evidence-based central venous catheter bundle care documentation, …

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 …

Addressing Implicit Bias Toward Patients With Substance Use Disorders Through A Staff Education Quality Improvement Initiative, Jeanne Baleng Okuwobi

Walden Dissertations and Doctoral Studies

This doctoral project was a staff education quality improvement (QI) initiative designed to reduce implicit bias among healthcare providers toward patients with substance use disorder (SUD) at a community mental health center. Provider implicit bias toward patients with SUD contributes to stigma, inequitable care, reduced treatment engagement, and poorer health outcomes; addressing this bias is essential to advancing patient safety, health equity, and quality nursing care. The practice-focused question guiding this project asked whether a 9-week evidence-based staff education program incorporating didactic instruction and reflective practice would reduce provider implicit bias toward patients with SUD compared with current practice, which …

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 …

Strategies For Reducing Employee Turnover In Retail Business, Mia Bulger

Walden Dissertations and Doctoral Studies

Strategies for Reducing Employee Turnover in Retail Business by Mia S. Bulger MS, University of Phoenix, 2022 BS, Clark Atlanta University, 2005 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

African American Fathers’ Experiences Of Emotional Distress Within The Context Of Black Masculinity After Their Children’S Autism Diagnosis, John Notice

Walden Dissertations and Doctoral Studies

Although parental experiences following a child's autism spectrum disorder (ASD) diagnosis have been examined, mothers’ experiences have garnered the most exploration, with comparatively less attention given to fathers’ experiences. There was a gap in knowledge, in particular, on how African American (AA) fathers experience their children's ASD diagnoses while navigating emotional distress within the context of Black masculinity. The purpose of this generic qualitative study was to explore how AA fathers experienced their children's ASD diagnoses while navigating emotional distress within the context of Black masculinity. Crenshaw's intersectionality theory served as the conceptual framework. Data were collected by conducting semistructured …

Youth With Mental Illness Transitioning Into Adult Judicial Systems, Susan K. Beltran

Walden Dissertations and Doctoral Studies

Despite attempts to alleviate the issues of recidivism in juveniles, this issue continues to have a major impact on young adults suffering from mental health challenges. Criminal justice involvement continues to present significant challenges for individuals with behavioral health disorders, underscoring the need to identify factors associated with arrest to inform prevention and intervention efforts. The purpose of this quantitative study was to determine the relationship between recidivism and the age of first arrest, gender, and psychiatric diagnosis for youths in an adult facility. The current study used data from the Northwestern Juvenile Project, with a sample size of N=1829. …

Staff Education For Medication Adherence Among Adults With Major Depressive Disorder In A Private Outpatient Psychiatric And Mental Health Practice, Judith Timbui Eta

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project implemented a staff education initiative to improve medication adherence among adults with major depressive disorder (MDD) in a private outpatient psychiatric and mental health practice. Medication nonadherence remains a significant barrier to effective depression treatment and is associated with symptom relapse, increased healthcare utilization, and poorer patient outcomes. Evidence supports provider education as an effective strategy for improving adherence-related practices. The project examined whether a targeted educational intervention could improve staff knowledge and confidence in promoting medication adherence over a 12-week implementation period. Guided by the Johns Hopkins Evidence-Based Practice Model and the …

Lived Experiences And Competencies Of Mental Health Professionals Supporting Postpartum Mothers’ Mental Health And Well-Being, Shaynie Wolski

Walden Dissertations and Doctoral Studies

Perinatal mood and anxiety disorders (PMADs), including depression, anxiety, obsessive-compulsive disorder, posttraumatic stress disorder, and postpartum psychosis, affect postpartum individuals and their families. Limited research has examined the lived experiences and competencies of licensed mental health professionals who address PMADs, potentially limiting counselor educators’ ability to prepare counselors for postpartum mental health needs. Guided by hermeneutic phenomenology and informed by Ecological Systems Theory, the purpose of this qualitative study was to answer the guiding question: What are the lived experiences of licensed mental health professionals in recognizing, assessing, and treating PMADs among postpartum clients? Semi-structured interviews were conducted with eight …

Registered Nurses’ Knowledge, Self-Efficacy, And Willingness To Assess Near-Fatal Strangulation: Development Of The Near-Fatal Strangulation Self-Efficacy Scale, Morgan Kenady Mcmahon

Walden Dissertations and Doctoral Studies

Near-fatal strangulation (NFS) is a time-critical clinical presentation associated with elevated risk of stroke, delayed airway compromise, and future intimate partner homicide, yet no validated instrument existed to assess nurses' NFS-specific knowledge or self-efficacy. The purpose of this cross-sectional study, guided by Bandura's social cognitive theory and Benner's novice to expert theory, was to develop and pilot test the Nurses' Near-Fatal Strangulation Self-Efficacy Scale (NFS-SES) and to examine whether knowledge and self-efficacy predicted nurses' willingness to conduct an NFS assessment. A convenience sample of 150 registered nurses in emergency, labor and delivery, and obstetric emergency departments completed the NFS-SES, a …

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 …

Privacy And Security In The Age Of Digitalization: Addressing Data Vulnerabilities In Local Businesses, Shalanza Jones

Walden Dissertations and Doctoral Studies

Privacy and Security in the Age of Digitalization: Addressing Data Vulnerabilities in Local Businesses by Shalanza Jones MS, Kaplan University, 2012 BS, Bethel University, 2007 Doctoral Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Business Administration Walden University July 2026

Closing Boston's Pediatric Asthma Equity Gap Through Housing-Integrated Care, Valeria Miranda

Capstones

Asthma morbidity is disproportionately high for preschool-age children (2-5 years) in Roxbury, Dorchester, and Mattapan neighborhoods of Boston owing to poor housing conditions and a lack of coordination between housing remediation and healthcare systems. Data at the neighborhood level indicate rates of (0-17) emergency department visits as high as 144.1 per 10,000 in Mattapan, compared to 15.0 per 10,000 in West Roxbury, where Black children have emergency department visit rates that are 6.9 times more than the rates for White Children across the city (Boston Public Health Commission, 2023). Additionally, Community Health Worker (CHW)-led home visiting with environmental trigger remediation, …

Closing On The Cardiovascular Disparity Among Black Adults In Boston Through Church-Based Community Health Worker Intervention, Ana Porfirio

Capstones

Hypertension and cardiovascular disease disproportionately affect Black adults age 40 and older in Boston's Roxbury, Dorchester, and Mattapan neighborhoods, as heart disease mortality is three times higher among blacks than whites across Boston, and premature death rates are over twice as high in Dorchester and Roxbury as in richer neighborhoods. Historic redlining contributes to barriers in food access and is one factor behind Mattapan's highest age-adjusted mortality rate from heart disease in the city. These brief outlines a culturally concordant church-based Community Health Worker (CHW) intervention that includes a trained CHW who assists adults with uncontrolled hypertension in managing their …

Design And Characterization Of A 3d-Printed Dual Stacked Patch Antenna With Tunable Coupling For Uav Applications, Isabelle Lynn Brigman

Masters Theses

Antennas are a critical component of unmanned aerial vehicle (UAV) communication systems where compact size, light weight, and reliable operation across multiple frequency bands are critical. While microstrip patch antennas are attractive for UAV applications due to their low profile, low cost, and ease of fabrication, they are often limited by narrow bandwidth and fixed-frequency operation. To address these limitations, this thesis investigates a mechanically and electrically reconfigurable dual-stacked patch antenna fabricated using additive manufacturing techniques.

The proposed antenna consists of a slotted driven patch operating near 2.5 GHz with a second resonant mode near 5 GHz. A parasitic patch …

Electromagnetic Signatures Of Massive Binary Black Hole Systems, Kaitlyn Porter

Theses

(EM) radiation, with their observable signatures shaped by the complex interplay between orbital dynamics, gas dynamics, and radiative processes. The evolution of the surrounding accretion flow is governed by general relativistic magnetohydrodynamics (GRMHD) within a strongly curved, timedependent spacetime, making the prediction of observable EM signals a challenging computational problem. This dissertation presents the development of a general relativistic ray-tracing framework that post-processes numerical relativity GRMHD simulations of accreting SMBHB systems. The framework enables the calculation of predicted images, spectra, and light curves throughout the inspiral, merger, and early post-merger phases. In parallel, improvements are made to an analytical model …