Digital Commons Network^™

Diabetes Self Care Behaviors And Social Support Among African Americans In San Francisco, Liseli Inonge Mulala

Walden Dissertations and Doctoral Studies

Both Type 1 and Type 2 diabetes are significant public health issues that affect people of all races; Type 2 diabetes disproportionately affects African Americans with higher diagnosis, morbidity, and mortality than it affects Caucasians, and Type 1 has been increasing in incidence. Diabetes self-care activities (DSCAs) and social support have been shown to help in managing both types, which can reduce morbidity and mortality. African Americans with diabetes in San Francisco have higher rates of complications, hospitalizations, and emergency room visits secondary to diabetes. This study assessed whether a relationship exists between emotional support, practical support, affirmational support, informational …

Leadership Styles And Leadership Effectiveness Of Outpatient Physical Therapy Clinic Managers, Adedolapo Ibiyemi Oyefeso

Walden Dissertations and Doctoral Studies

Outpatient physical therapy clinics (OPTC), like many other healthcare organizations, face an array of challenges in meeting the needs of the growing elderly population. The leadership behavior of OPTC managers is a key component to secure employee loyalty, accommodate increased patient demand, and implement positive organizational change. The purpose of this nonexperimental quantitative survey designed study was to investigate the relationship between the leadership styles perceived by OPTC healthcare managers and nonmanagerial employees, as measured by the Multifactor Leadership Questionnaire Short. The primary research question examined the difference between the OPTC managers' self-perceived leadership style and the nonmanagerial subordinates' perceptions …

The Strategic Prevention Framework: Effectiveness Of Substance Abuse Prevention System, John Jinoh Park

Walden Dissertations and Doctoral Studies

The strategic prevention framework (SPF) is a data-driven operating system to assist designing evidence-based substance abuse prevention programs. The study performed here was to assess the effectiveness of the SPF as a prevention planning system. One purpose of this study was to determine the implementation fidelity of the programs that used the SPF process; the other purpose was to assess effectiveness of the SPF process. This study utilized a set of data collected by the national cross site evaluation team on all jurisdictions that implemented the SPF. A subset of communities collected and reported at least 2 pre-implementation and at …

Religiosity As A Predictor Of Hpv Awareness And Knowledge, Karen Adelheid Reiner

Walden Dissertations and Doctoral Studies

The Human Papillomavirus (HPV) is a common sexually transmitted infection (STI) and etiological agent of cervical cancer. It has been suggested that religiosity may promote a generalized disassociation between all STIs/STDs, including HPV, and personal relevance thus contributing to lower levels of HPV awareness and knowledge among certain groups. This study sought to identify the role of religiosity as a predictor of HPV awareness and knowledge among women in a Christian university. Religiosity was defined and measured using the Duke University Religion Index (DUREL). The schemata and social identity theories provided the theoretical framework for this study. A total of …

Standardized Communication At The Bedside: A Review For Reimplementation, Eunice Rosas

Walden Dissertations and Doctoral Studies

This paper discusses a developmental, interdisciplinary quality improvement project that seeks to improve healthcare communication by standardizing clinician communication across all levels of care. The purpose of this project was to develop an organizational policy and interdisciplinary practice guidelines to standardize the patient handoff at the bedside. The initiative intended to use processes already in place in the organization and to integrate the knowledge from a literature review to plan the implementation of bedside handoff procedures. The quality improvement project process included assembling an interdisciplinary committee; reviewing relevant peer-reviewed literature; and developing policy, relevant guidelines, as well as long-term plans …

Addressing Needs Of Intimate Partner Violence Survivors In The Emergency Department, Claudia F. Schenk

Walden Dissertations and Doctoral Studies

Intimate partner violence is a global epidemic and public health concern, including in the United States. The purpose of this descriptive, exploratory, nonexperimental, quantitative study was to determine to what extent intimate partner violence survivors avail themselves of offered resources and interventions in health care settings. The general systems foundation was used for the study's theoretical foundation. The research questions ascertained the proportion of intimate partner violence survivors who accepted mental health, law enforcement, and community outreach resources; the level of comprehensive intervention they received; and the associations, if any, between types of services. Retrospective data were collected from121 medical …

Effects Of The Walters Criminal Lifestyle Program On Offenders' Criminal Thinking Styles, Alessandre Singher Singher

Walden Dissertations and Doctoral Studies

Researchers have documented the high prevalence of crime in society and the need for programs to assist in the reduction of crime. Social cognitive and criminal lifestyle theories were the two major theoretical frameworks applied to this study due to their focus on the influence of cognitive change on behavioral modifications. A lifestyle approach in such programs reshapes criminal thoughts and transforms criminal behaviors. The efficacy of a lifestyle program in a community correctional facility outside of federal prison walls, modified to run 3 months with parolees and probationers, lacks evidenced research. Using a 2x3 between groups factorial ANCOVA, archival …

Pediatric Emergence Delirium In The Postoperative Setting, Jennifer Miranda Snell

Walden Dissertations and Doctoral Studies

Emergence delirium (ED), also known as emergence agitation, is a postoperative condition characterized by aberrant cognitive and psychomotor behaviors following general anesthesia. The incidence of ED is 3 to 8 times higher in children 5 years of age or less. There is no standard of nursing practice for managing ED symptoms in the pediatric surgical population. The purpose of this quality improvement project was to address a gap in knowledge needed to inform clinical decision-making when managing ED in the postoperative setting. Using an educational presentation for post anesthesia care unit (PACU) nurses, this project introduced the use of non-pharmacological …

Leading A Multigenerational Workforce In The Public Sector, Cynthia A. Thompson

Walden Dissertations and Doctoral Studies

One of the demographic changes in the workplace is the presence of multiple generations working together. Some managers may find leading a multigenerational workforce a challenge, because the generational cohorts may have different work values and approaches to work. The purpose of this qualitative case study was to explore how generational characteristics manifest in the workplace, how managers perceive a multigenerational workforce, and whether macro-level descriptions of generations creates stereotypes or recognizable indicators of behavior in the workplace. Mannheim's theory of generations and diversity management theory provided the conceptual framework for the study. Data were collected through interviews and a …

Direct Care Provider Perceptions Of Factors Influencing Treatment Motivation Of Dual-Diagnosed Female Offenders, Cara Renee Tilbury

Walden Dissertations and Doctoral Studies

Dual-diagnosed female offenders (DDFOs) present direct care providers with complex psychosocial needs and challenges that result in a serious lack of motivation to attain, sustain, and continue treatment after release from prison. Unsuccessful treatment of DDFOs represents a significant public health and safety risk including continuing criminal acts, increased health care costs, accidents related to substance abuse, and poor reintegration. Through in-depth semistructured interviews with direct care providers, this phenomenological study's focus was on examining the motivational facilitators associated with treatment adherence, barriers to treatment adherence, and approaches for enhancing treatment motivation. Nine major themes emerged from this research, including …

Evaluation Of Math Block-Scheduling For Low Performing At-Risk And Economically- Disadvantaged Students, Toni Trice

Walden Dissertations and Doctoral Studies

Research shows a math achievement gap for at-risk and economically-disadvantaged students in the United States. To address this issue, a Texas school district implemented a 90-minute math block-scheduling program with 8th grade students. Shaped by the academic learning time and social justice theories, the purpose of this quantitative program evaluation was to determine if students in 3 key subgroups (low performing, low performing and at-risk, and low performing and economically-disadvantaged) who participated on the 90-minute block-schedule performed significantly better on the math state standardized assessment than did students in the same subgroups who remained on the traditional schedule. This retrospective …

U.S. Military Psychologists' Contemporary Lived Experiences Of Burnout, Rui Heng Babilonia

Walden Dissertations and Doctoral Studies

Currently, the high level of burnout among military psychologists resulting from contemporary military service is gaining attention. However, there is insufficient knowledge of their lived experiences of burnout. The purpose of this phenomenological study was to explore burnout, based on the military occupational mental health, military job demand-resources models, and biopsychosocial models. Eleven active duty and prior service military psychologists were recruited for interviews using snowball sampling. The first phase of data analysis employed NVivo software. The second and third phase used the 7-step modified version of the Van Kamm method, resulting in 7 themes and 1 discrepant case. The …

Demographic Variables As Moderators Between Benevolent Sexism And Relationship Satisfaction, Dawna Jeanette Campbell

Walden Dissertations and Doctoral Studies

Romantic relationship satisfaction relates to better overall health, and identifying factors that affect relationship satisfaction could lead to better understanding of romantic relationships. This study examined the correlation between benevolent sexism, a subtle form of sexism resembling chivalry and relationship satisfaction; gender, age, ethnicity, religious beliefs, education, and length of time were also considered as moderators. The ambivalent sexism theory, which posits that sexism is ambivalent and ranges from hostile to benevolent sexism was the theoretical framework guiding this study. Previous research indicated benevolent sexism may predict relationship satisfaction. However, there remained an important gap in the literature; the demographic …

Why Leader-Member Exchange Is Important To Business Thinking, Linda Lou Coto

Walden Dissertations and Doctoral Studies

Leadership style affects the workforce and is one of many vital elements in business operations. Prior research suggests that leadership style can affect production outcomes and employee turnover ratios, yet scant evidence suggests the effect of leadership style on business thinking. This qualitative grounded theory study investigated the extent to which a leadership style known as LMX theory drives business thinking. The information gained from this study, including the effect on business thinking, may enhance how companies coach their leaders to interact with subordinates and improve production outcomes. Participants came from either private and public-sector companies or agencies. The sample …

Employee Retention Strategies In The Fast Food Industry, Darren Cross

Walden Dissertations and Doctoral Studies

Voluntary employee turnover in the fast-food industry is 50%. Employee turnover costs fast-food restaurants $10 billion annually. The purpose of this multiple case study was to examine the strategies of 5 fast-food restaurant managers in the Midwestern United States who achieved higher employee retention than did peers in their districts. The conceptual framework was the 8 motivational forces of voluntary employee turnover. Data were collected via semistructured, face-to-face interviews, recruiting materials, retention activities, policy manuals, and overall voluntary termination reports. Data were compiled, disassembled into groups, reassembled into patterns and themes, and interpreted for conclusions, revealing 3 themes that influenced …

Relationship Between Mental Health Facilities' Pre-Intake Practices And Children's First Appointment Attendance Rates, Christine Marie De Santis-Collis

Walden Dissertations and Doctoral Studies

Between 20% and 57% of patients at community mental health centers miss their first mental health appointment, resulting in wasted resources and longer wait times for other patients. To date, only one peer-reviewed quantitative study examined the relationship between appointment reminder practices and children's and adolescents' first appointment attendance rates for community mental health centers. The purpose of this quantitative study was to examine the relationship between first appointment wait times, electronic appointment reminders, phone appointment reminders, and first appointment attendance for U.S. community mental health centers, along with the potential moderating effects of age, ethnicity, and gender. Blumer's symbolic …

Screening For Opioid Misuse And Abuse In Chronic Pain Patients, Gloria Jean Farris

Walden Dissertations and Doctoral Studies

Abstract

In 2012, opioid prescriptions exceeded 250 million, which is equivalent to providing a prescription to every adult in the United States. Prescription opioids have contributed to over 100,000 deaths since the late 1990s with the greatest impact among adults 35 through 54 years of age. The purpose of this doctoral project was to introduce an evidence-based screening tool that will identify patients who are at risk of opioid misuse and aid in the development of the most effective treatment plan to manage chronic pain and avoid abuse. The Screener and Opioid Assessments for Patients with Pain (SOAPP), a screening …

Strategies For Reducing Employee Absenteeism For A Sustainable Future: A Bermuda Perspective, Allison Nicola Simone Forte

Walden Dissertations and Doctoral Studies

Employee absenteeism results in billions of dollars in revenue losses and lost productivity annually. Given the consequences that organizations could face resulting from high levels of work absences, executives should develop strategies to manage absenteeism to support organizational growth and sustainability. Grounded in the theory of planned behavior, the purpose of the single case study was to explore strategies managers in the private insurance industry used to reduce employee absenteeism. The population consisted of 3 managers located in Bermuda who implemented strategies to decrease employee absenteeism from a Bermuda perspective. Data included semistructured interviews, results of the company's 2016 engagement …

Effect Of Contemplative Pedagogy On The Ecoliteracy Of Undergraduate Public State University Students, Michael Vincent Lees

Walden Dissertations and Doctoral Studies

Undergraduate students lack the opportunity and environment to contemplate and develop ecoliteracy skills that serve to integrate subject matter into their everyday experiences. Ecoliteracy is grounded in Capra's web of life theoretical framework and represents students' capacities to read world systems objectively with their head, heart, hands, and spirit. Contemplative pedagogy provides educators with exercises that give students time to reflect on the integration of learning. Ecoliteracy and contemplative pedagogy research has shown little quantitative data pertaining to how contemplative pedagogy affects undergraduate student ecoliteracy. To address that gap, this causal-comparative study measured the use of contemplative pedagogy exercises relative …

The Development Of Narcissism Among Lawyers And Farmers: A Quantitative Study, Steve Murdock Murdock

Walden Dissertations and Doctoral Studies

Narcissism has been identified as a threat to society and the individual. Individuals with high levels of narcissism (narcissistic personality disorder) struggle to maintain jobs, stable relationships, and healthy life perspectives. Without knowledge about the origins of narcissism, mental health professionals may only be treating the symptoms of narcissism and not the factors that perpetuate its development. The purpose of this study was to measure narcissism in farming and law careers and to determine whether career is a factor in the development of narcissism. It was predicted that career would be an important developmental event and process that would have …

Structured Physical Activity And Dietary Education Program For Obese Adolescents: An Evaluation Of A Quality Improvement Project At A Rural Primary Care Clinic, Andrietta Wright Barnett

Walden Dissertations and Doctoral Studies

Childhood obesity is a worldwide epidemic. In the United States, approximately 17% of adolescents are obese; and 13% of the general population is overweight. Obese adolescents are at threefold risk for developing chronic health conditions in adulthood, including type II diabetes, hypertension, and heart disease. The purpose of this project was to evaluate the results of a quality improvement program to reduce adolescent obesity as measured by BMI 5% over 18 months in a rural health primary care clinic. The health belief model and theory of planned behavior guided the project as adolescents need to first understand the risks associated …

A Comparison Between Administrative Leadership In Higher Education And Change-Oriented Leadership In Banks, Glenn King Jr

Walden Dissertations and Doctoral Studies

Organizational environments continually change. Organizations that do not meet the demands for change do not survive. The required changes differ for banks versus universities, suggesting that leaders in each type of organization need to use unique styles to adapt to their unique environments. The purpose of this quantitative research study was to test a contingency theory of leadership that leaders of banks are change-oriented, whereas leaders of higher educational institutions are administrative in their style. The research questions dealt with differences in the uncertainty of internal operations and the external environment of banks versus universities, and the leadership style most …

Using An Apn-Led Transitional Care Program To Reduce 30-Day Hospital Readmissions, Miaozhen Li

Walden Dissertations and Doctoral Studies

Heart failure (HF) is a serious public health problem associated with high mortality rates, hospital readmissions, and health care costs. Transitional care has emerged as a disease management model used to reduce readmissions for hospital-discharged patients with HF. However, the efficacy of an advanced practice nurse (APN)-led transitional care program (TCP) in readmission reduction is under debate. The practice question for this project examined the extent to which an APN-led TCP was effective in reducing 30-day all-cause readmissions for hospital-discharged HF patients. The logic model was the framework guiding this program evaluation. An analysis of quality improvement HF data from …

Science Content Knowledge: A Component Of Teacher Effectiveness In A Primary School In Jamaica, Euphemia Sophia Robinson

Walden Dissertations and Doctoral Studies

Empirical evidence from the National Education Inspectorate suggested that teachers at the primary school in this study in an island country in the Caribbean have inadequate science content knowledge. Students' average performance on the science Grade Six Achievement Test (GSAT) has been below 40% for the last 5 years. The purpose of this bounded case study, guided by Shulman's conceptual framework, was to understand teachers' science subject matter knowledge (SMK). The guiding questions focused on teachers' abilities to demonstrate components of Shulman's SMK during science teaching and lesson planning and to gather their views on their abilities to meet the …

The Implementation Of The Anti-Bullying Bill Of Rights Act: New Jersey High School Educators' Perceptions, Stacey Zaremba

Walden Dissertations and Doctoral Studies

New Jersey's high school teachers have many responsibilities to their students: they must educate them, work to mold their strength of character, and protect them from harming each other. The Anti-Bullying Bill of Rights Act (ABR), legally fortified these goals by protecting students from harassment, intimidation, and bullying (HIB), at the state level. Previous research has indicated that incident rates for these negative behaviors are growing globally. This reality has driven the need for intervention and prevention programming; however, few instances of successful implementation exist. An important gap remains in the current literature, as there is still a need to …

Culturally Competent Nutrition Counseling And Health Outcomes Of Patients On Emergency Dialysis, Edlyn Geraldine Bustamante

Walden Dissertations and Doctoral Studies

Undocumented end stage renal disease (ESRD) patients in the United States only have access to emergency dialysis. To compensate for the lack of regular dialysis these patients must follow strict renal dietary restrictions. However, nutrition counseling by a dietitian is not part of the renal management of patients on emergency dialysis. The purpose of this quantitative quasi-experimental treatment-control study was to assess how the application of nutritional counseling that is both culturally and linguistically competent affects dialysis frequency and biochemical lab values such as serum potassium, phosphorus, and vitamin D of patients in emergency dialysis. The study was grounded on …

Predicting Success Of Developmental Math Students, Isaac Martinez

Walden Dissertations and Doctoral Studies

Addressing the needs of developmental math students has been one of the most challenging problems in higher education. Administrators at a private university were concerned about poor academic performance of math-deficient students and sought to identify factors that influenced students' successful progression from developmental to college-level coursework. The purpose of this retrospective prediction study was to determine which of 7 variables (enrollment in a college success course, math placement results, frequency of use of the developmental resource center, source of tuition payment, student's age, gender, and race/ethnicity) would be predictive of success in developmental math as defined by a final …

Quality Improvement Initiative About Patient Engagement With Clinicians In A Community Hospital, Cheryl Simpson

Walden Dissertations and Doctoral Studies

Chronic kidney disease (CKD) is a global health problem and efforts are needed to improve the care of individuals affected by the disease. A recent strategy for improving care within the healthcare system is patient engagement. Nurses and other health care clinicians can apply patient engagement into their clinical practice to improve the care they provide to their patients. Therefore, the purpose of this project was to increase the knowledge and awareness of patient engagement among clinicians who work with CKD patients. This quality improvement project used Lewin's force field analysis to analyze driving and restraining forces to help develop …

Communication Training And Nonemergency Transportation Driver Perception Of Challenging Behavior, Priscilla Wright

Walden Dissertations and Doctoral Studies

Nonemergency transportation drivers play a critical role in helping individuals with Intellectual Disabilities (ID) gain access to community integration opportunities. Challenging behaviors can limit access to enrichment opportunities and possibly increase the likelihood that individuals with ID will be isolated from community enrichment activities. The purpose of this study was to determine if positive behavior support training improved nonemergency transportation drivers' perceptions of challenging behaviors displayed by individuals with ID. For purposes of this study, perception was defined as staff (driver) beliefs about the causes of challenging behavior. A convenience sample of 52 nonemergency transportation drivers was chosen from a …

Vicarious Trauma Coping And Self-Care Practices Among Trauma Therapists., Annette Zaccari

Walden Dissertations and Doctoral Studies

Therapists who specialize in trauma therapy are indirectly exposed traumatic events presented by clients within the therapeutic relationship. The potential consequences for trauma therapists may be the risk of vicarious trauma. Effective coping and self-care are essential in the practice of trauma work. The research question for this study is: Do coping skills and self-care practices in trauma therapists moderate the disruptive effect of vicarious trauma on the fulfillment of their psychological needs (trust/dependence and control)? The purpose of this research study was to examine quantitatively, the role of trauma therapists' beliefs in the effectiveness of coping skills and time …