Digital Commons Network^™

Risk Factors Of Human Papillomavirus Positive Oropharyngeal Cancer In Men, Kentress Davison

Walden Dissertations and Doctoral Studies

The human papillomavirus (HPV) is a leading domestic and global sexually transmitted disease. The purpose of this secondary quantitative, cross-sectional study is to investigate if there is an relationship between the rate of oral HPV-oropharyngeal squamous cell carcinoma (OPSCC) and race, exposure to smoking cigarettes (tobacco), risky sexual behavior, and participation in oral sex of male-to-male contact vs. male-to-female contact. The social cognitive theory grounded this study. The University of Alabama at Birmingham cancer database population supplied the study’s sample size of 337 males greater than 18 years of age with a diagnosis of OPSCC. I conducted descriptive analyses using …

Strategic Leadership Steps For New Certified Community Behavioral Health Clinics, Keisha Stacy-Ann Davis

Walden Dissertations and Doctoral Studies

States grapple with how to address the opioid epidemic and the growing need for behavioral health (BH) services. Certified Community Behavioral Health Centers (CCBHCs) are a new industry solution to address the need for integrated and coordinated physical and BH care. New CCBHCs are funded by the Federal 223 Substance Abuse and Mental Health Services Administration’s (SAMHSA) grant. However, they must be certified by states to meet the SAMHSA criteria for continued funding. This qualitative study presents a single-case study of a Southern state’s behavioral health department’s (SSBHD) leadership strategy for certifying the CCBHCs in its state and creating a …

Identifying And Examining Key Themes Emanating From The U.S. Legislative Tobacco Policy Subsystem, Arnon Dayak

Walden Dissertations and Doctoral Studies

Americans’ continuously increasing tobacco use in the form of smoking presents an ongoing and rising negative health impact on this leading cause of preventable death. Despite existing U.S. federal level tobacco regulation through the Family Smoking Prevention and Tobacco Control Act (FSPTCA), U.S. tobacco use remains ubiquitous demonstrating existent ineffectiveness of tobacco control legislation. Unknown underlying attributing factors present critical information gaps which, when exposed, could improve tobacco regulation. Using a case study approach, the question, “What key themes are aligned with legislative subsystem actors when voting on the FSPTCA” was examined. Multi-source data streams using existing secondary datasets including …

Elementary Administrators' Perspectives And Experiences Of Supporting Students Through Nature-Based Learning, Amanda Marie Shelley Degoede

Walden Dissertations and Doctoral Studies

Although nature-based learning (NBL) contributes to the development of students, itsinclusion in elementary schools is inconsistent. Researchers have established the benefits of nature to learning and child development, yet there is a gap in the literature on elementary administrators’ perspectives of and experiences with NBL. The purpose of this qualitative study was to explore elementary administrators’ perspectives of and experiences with NBL, its support of elementary student development, and its inclusion in elementary schools’ curricula and design. The research questions addressed elementary administrators’ perspectives of and experiences with NBL, how NBL supports student development, and how NBL is included in …

Student Physical Therapy Supervision And Physical Therapy Productivity In Skilled Nursing Facilities, Dionne Degrande

Walden Dissertations and Doctoral Studies

Physical therapy (PT) educational programs are faced with the problem of securing thenecessary clinical experiences for their students, particularly in long-term care settings. Student physical therapists (SPTs) must complete clinical education requirements to graduate and transition from learner to entry-level practitioner. Clinical instructors (CIs) provide SPT supervision and are responsible for meeting industry-standard productivity expectations. There is the notion that SPTs negatively impact PT productivity, creating a reluctance for organizations to host SPTs for clinical experiences. This quantitative pilot study aimed to determine if there was a statistically significant difference between PT productivity with and without SPTs in skilled nursing …

Implementing Corporate Social Responsibility Strategies To Enhance The Profitability Of Firms, Franklin Alexander De La Rosa

Walden Dissertations and Doctoral Studies

Ineffective corporate social responsibility (CSR) strategies can negatively impact a company’s competitive advantage. A lack of competitive advantage may lead a business leader to experience poor performance and lost profits. Grounded in the stakeholder theory, the purpose of this qualitative multiple case study was to explore strategies some commercial banking, loan, and savings association leaders used to ensure successful CSR programs to enhance profitability. Participants comprised four leaders in Puerto Rico who successfully established CSR strategies to improve organizational profitability. Data were collected from semistructured interviews and banking websites. Thematic analysis was used to analyze the data. Three themes emerged: …

Resiliency Perceptions Of Women In Organizational Management, Brandi Dehart

Walden Dissertations and Doctoral Studies

Exploring the perceptions of women managers involving effective strategies to remain within their roles is essential to further understand resiliency. A literature gap exists regarding the resilience strategies of women managers to stay in leadership roles. The purpose of this qualitative single case study with embedded units was to explore perceptions of women managers with at least five years of experience in management regarding how they remained resilient throughout their careers. The overarching research question was developed to address the purpose of this qualitative single case study with embedded units. Qualitative data were collected from semistructured interviews with nine women …

A Leadership Perspective On Preventing Counselor Burnout In A Behavioral Health Setting During Covid-19, Claudia P. De La Torre

Walden Dissertations and Doctoral Studies

During the COVID-19 pandemic, there was a high need for mental health services, which resulted in a shortage of mental health clinicians. This shortage of mental health clinicians then resulted in a high burnout rate due to client intake. This doctoral case study was grounded in the Baldrige Excellence Framework and focused on how a behavioral health organization in South Texas managed burnout in clinicians during the COVID-19 pandemic. This study aimed to help behavioral health leaders find a solution to preventing burnout during a high demand pandemic. This doctoral study had several data sources, including semistructured interviews with three …

Long-Term Psychological Adaptation Of U.S. Human Resource Personnel In Response To The Covid-19 Pandemic, Samantha Ann Denson

Walden Dissertations and Doctoral Studies

Previous research indicated that the COVID-19 pandemic negatively impacted employee psychological outcomes in various workforce sectors. Although research showed that U.S. human resource (HR) employees experienced unique occupational challenges during the pandemic, the literature did not explore pandemic-related psychological outcomes in this population. This quantitative survey-based study included a purposive sample of 294 U.S. HR professionals to explore the pandemic’s impact on their psychological well-being. The transactional model of stress and coping served as the theoretical framework to understand the independent effects of appraisal, meaning-based coping, and coping efforts on psychological well-being. A mediation analysis was used to understand the …

Call Center Managers’ Strategies To Address Employee Turnover, Kimberly Dickens

Walden Dissertations and Doctoral Studies

Employee turnover is a threat to call center sustainability. Call center leaders who lack strategies to reduce employee turnover have an increased risk of business failure. Grounded in Herzberg’s two-factor theory, the purpose of this qualitative multiple-case study was to explore strategies call center leaders use to reduce employee turnover in insurance call centers. The three participants were call center leaders from three different call centers in Raleigh, North Carolina, who implemented strategies to reduce employee turnover. Data were collected from semistructured interviews and reviews of public documents from participants’ company websites and analyzed using thematic analysis. Two themes emerged: …

Examining The Relationship Between Patient Care Quality, Patient Care Safety, And Socioeconomic Status In Chicago's Acute Care Hospitals, Theresa Ann Doby

Walden Dissertations and Doctoral Studies

AbstractEnsuring high quality and safe patient care are among the main goals of all acute care hospitals. This study found that quality of patient care is not consistent across all patient populations, which draws attention to the issue of disparity in access to safe and quality health care. The purpose research questions of this quantitative study examined if patient care quality and safety are related to hospitals’ socioeconomic status (SES) among Chicago’s acute care hospitals. Secondary data were derived from a sample of 20 acute care hospitals (i.e., 10 acute care hospitals of high SES and 10 of low SES) …

Thematic Analysis Of Online Predatory Grooming Behavior Among Male Offenders, Ryan Christopher Dronek

Walden Dissertations and Doctoral Studies

Social media sites, gaming platforms, and online communication tools have been integrated into children’s everyday lives. This has created a new avenue for child predators to identify, communicate, and victimize children. Just as the internet and the ability to communicate online have evolved, predatory grooming behavior has evolved as well. This qualitative study aimed to identify predatory grooming themes and the thematic stage progression for online male offenders who target child victims using online chat rooms. O’Connell’s typology of cyber sexploitation and online grooming practices was used to explore online child predators’ grooming themes and stage progression. Nine male Wisconsin …

Disparate Access To Medical Coverage Associated With Type 2 Diabetes Care In Low-Income And Rural Communities In Georgia, Crystal Alexis Symone Edwards

Walden Dissertations and Doctoral Studies

Disparate access to diabetes care in rural and low-income communities among older adults has been an ongoing issue among Americans. Type 2 diabetes in low-income and rural communities has continuously burdened many residents due to age, costs of care, income, geographic location, and education levels. Researchers have demonstrated that providing resources and tools to rural and low-income communities would assist in decreasing type 2 diabetes and increase education and awareness. The purpose of this quantitative cross-sectional study using secondary data was to examine the relationship between health insurance status and lack of access to health care resources and delay of …

Effect Of Treatment, Stage Of Lung Cancer, And Socioeconomic Status On Life Expectancy Within Marginalized Communities, Elsadig Ahmed Elsharif

Walden Dissertations and Doctoral Studies

Lung cancer is one of the most common cancers in the United States, and it accounts for 25% of cancer deaths. About 70% of cancer cases are diagnosed during late stages, leading to poor outcomes. An estimated 60% of cancer cases involve underserved and disadvantaged communities. However, there are limited studies had addressed effects of treatment, stage of lung cancer, and socioeconomic status on life expectancy within marginalized communities. Research questions examined effect of treatment, stage of lung cancer, and socioeconomic status on life expectancy of lung cancer patients between 2009 and 2019. This study was grounded in the deductive …

Clinical Social Workers’ Perceptions And Experiences Of Parental Alienation, Martinek Evans

Walden Dissertations and Doctoral Studies

This qualitative research study aimed to explore clinical social workers’ perceptions and experiences of parental alienation (PA). Using Bowen’s family system theory as the framework, the research questions examined the problem from multiple levels of practice, including individual, family, institutional, and systematic. The individual interview approach aligned with the study goal by allowing participants opportunities to share their perspectives and experiences working with PA. The study used a purposive and snowball sampling of eight participants who were licensed social workers in the United States. Individual interview responses were transcribed and coded. Thematic content analysis was also used to analyze the …

A Context-Sensitive Approach To The Implementation Of Performance Measurement Systems, Wisdom Eyoh

Walden Dissertations and Doctoral Studies

AbstractPerformance measurement systems (PMS) exist to help public managers assess and improve decision-making related to programs, policies, processes, and personnel. However, challenges in implementing PMS have resulted in underutilization in the public sector. While critical success factors for successful implementation are known, little research exists on how public organizations can successfully implement PMS in individual organizations. This qualitative case study aimed to explore participants' experiences dealing with PMS, using contingency and goal-setting theories to analyze the influence of organizational contexts on PMS design, adoption, and implementation. Data were collected from five staff and top-level management at a large state agency …

Improving Self-Efficacy Of Primary Care Providers With Assessment Of Diabetic Peripheral Neuropathy, Kimberly Paddock Farr

Walden Dissertations and Doctoral Studies

AbstractDiabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes. DPN contributes to significant pain, debility and injury to diabetic patients. The majority of diabetic patients are managed in the primary care practice (PCP) setting. A local chapter of a nurse practitioner association identified a lack of knowledge of current evidence-based guidelines for effective screening and assessment of DPN in the PCP environment. The practice-focused question for this project was to determine if an educational intervention on evidence-based screening and assessment would improve nurse practitioner’s knowledge with DPN screening and diagnosis in PCP. Mezirow’s transformative theory of …

Probationer Officer Experiences: Dual Role Decision-Making For Probationers With Mental Illness, Myra A. Fields

Walden Dissertations and Doctoral Studies

Probation officers play a major role in maintaining public safety by balancing their dual roles of care and control. The number of individuals within the United States community corrections system is significantly growing. This has increased the need for probation officers to make decisions for probationers with mental illness. However, there is a gap in understanding how active-duty probation officers make decisions for probationers. This study examined how probation officers balance their dual roles while decision-making for probationers with mental illness. An interpretative phenomenological analysis design was used. Semi-structured interviews were conducted with six participants who met inclusion criteria to …

Teachers’ Perceptions Of Student Performance On The Advanced Placement English Language And Composition Exam In Department Of Defense Schools, Tracee Nichole Fisher

Walden Dissertations and Doctoral Studies

The problem that guided this study was the low proportion of students scoring 3 or more on the Advanced Placement English Language and Composition (APELC) exam at one Department of Defense (DoD) school. Moreover, the qualifying ratios were lower than students attending all DoD and U.S. schools. The need for teachers to examine the performance of military-connected students has become a critical element of high-stakes accountability in all schools, most importantly at military-connected schools. The aim of this research was to explore DoD teachers’ insights into the factors influencing military-connected students’ low scores on the APELC exam and the instructional …

Addressing Counterproductive Work Behaviors In A Behavioral Health Organization, Abigail Flores

Walden Dissertations and Doctoral Studies

Studies show that counterproductive workplace behaviors impact organizations financially and operationally. The focus of this case study was to explore reasons for counterproductive workplace behaviors and to determine the actions of leadership to address and mitigate them. The Baldrige framework was used to guide this case study of a nonprofit behavioral health organization in the northeastern United States. Data sources for this study included structured interviews with the organization’s executive director, personal communications via email with the executive director, the organization’s website, and a review of academic literature. Data were analyzed with NVivo qualitative analysis software. Findings indicated a lack …

African American Baby Boomers’ Lived Experiences In Skilled Nursing Facilities For Post-Acute Care Admissions, Dr. Charles A. Fraiser

Walden Dissertations and Doctoral Studies

AbstractPrevious studies have examined the quality of elderly healthcare offered in skilled nursing facilities (SNFs) among older adults, in general, but the studies have not emphasized ex-periences unique to African America baby boomers and the factors they consider when making SNF-related decisions for post-acute care. The purpose of the study was to exam-ine the lived experiences of African American baby boomers who are currently in or have been treated in SNFs for post-acute care to learn about their decisions to select an SNF. Andersen’s behavioral model of health services served as the conceptual framework. A descriptive phenomenological qualitative design was …

Lived Experiences Of Stress And Burnout Among Pediatric Home Care Nurses, Johane Garcon-Paul

Walden Dissertations and Doctoral Studies

Abstract

Research shows that healthcare providers encounter stress in their workplaces whether in a home or a healthcare facility that results in reduced job satisfaction, burnout, and inadequate care of patients. There is a gap in the literature regarding the lived experiences of nurses caring for children in all work settings, including the home care setting, regarding stress and burnout. The lived experiences of pediatric nurses working in home care settings were explored to discover conditions that contribute to their occupational stress and burnout. The occupational stress model with a major focus on the job demands-resources occupational stress model was …

Implementation Of Response To Intervention In An Urban Elementary School, Carla P. Graham

Walden Dissertations and Doctoral Studies

AbstractIn an urban Midwestern elementary school, the teachers and administrators were perplexed by the rise in special education referrals even with the implementation of response to intervention (RTI). The problem addressed in this study is the general education teachers’ implementation of RTI to identify if there were any gaps in practice and, if so, to create a plan that could correct those gaps and potentially decrease the number of special education referrals and students identified for special education services. The conceptual framework for this study was the multitiered system of support, of which RTI is one component. Four research questions …

Food Environment As A Moderator In The Relationship Between Ultra-Processed Food Intake And Mortality In The United States, Brandon Jerod Grandy

Walden Dissertations and Doctoral Studies

According to recent studies, the consumption of ultra-processed food is a major issue that leads to fatal outcomes within the United States, which is relevant because this type of food has become more accessible over the years. Using data from the National Health And Nutrition Examination Survey III (NHANES III), previous researchers found that frequent consumption of ultra-processed foods was associated with greater chances of all-cause mortality in U.S. adults, but little research has focused on factors that can impact ultra-processed food consumption, such as food environment. The purpose of this quantitative longitudinal study was to examine the effect of …

Stressors And Depression Among Adolescents With Co-Rumination As A Moderator, Angela Grosso-Burke

Walden Dissertations and Doctoral Studies

Stress, depression, and co-rumination have been a focus of scholars in recent years. Although studies have considered the relationship among stressors, depression, and co-rumination, little is known about the moderating effects of co-rumination. This study aimed to address the gap in the literature by examining moderating effects of co-rumination on relations between stressors and depression, along with further moderating effects of sex, race, and grade. The current study examined mean-level race, sex, and grade differences in the relation among stressors (total, family, peer, physical appearance, sport/physical activity, school) and depressive symptoms in adolescents. Analyses were conducted to determine the relationship …

Occupational Burnout Factors Among Correctional Mental Health Providers, Morgan Gruhot

Walden Dissertations and Doctoral Studies

Burnout rates of correctional employees are higher than employees in the general public. The purpose of this study was to identify how occupational factors impact burnout rates among correctional mental health workers. Grounded in the job-demands theoretical model, this study compared burnout rates among mental health staff within county jails and state prisons. Burnout was measured using the Maslach Burnout Inventory and Occupational factors were measured using the Areas of Work life Survey and Pandemic Experience and Perception Survey. Data was analyzed using IBM SSPS software to address multiple a priori directional research questions. Research questions considered how occupational factors …

Filipino Americans’ Attitudes And Experiences With Mental Health And Help-Seeking Behaviors, Kelsey Guerrero

Walden Dissertations and Doctoral Studies

Filipino Americans suffer from mental illness at an alarming rate and have a low rate of seeking mental health treatment. Because Filipino Americans are underrepresented in social science research, psychologists do not understand how to resolve this issue within the Filipino American population. The purpose of this generic qualitative study was to describe the experiences with mental health and treatment of Filipino Americans. Bronfenbrenner’s ecological model theory and Latane’s social impact theory served as the theoretical foundation for the study. A sample of 12 Filipino Americans was interviewed using a semistructured interview design. Participants were asked 10 questions addressing their …

The Experiences Of Women Executive Leaders In A Leadership Development Program, Angela Ivy Gustus

Walden Dissertations and Doctoral Studies

The host organization is a nonprofit that has a mission of supporting the work of 19 other separate organizations, 47% of which are run by women. The problem addressed in this research is the host organization’s lack of knowledge related to how to create a leadership development program that will maintain or increase the current gender diversity. The purpose of this research was to gather information about the current leaders to inform the creation of a leadership development program for the host organization based on research conducted at Harvard University. The aim was to understand the experiences of the women …

The Effect Of Public Budgeting Decisions And Tuition Costs On Student Graduation Outcomes In Michigan, Travis Charles Hadden

Walden Dissertations and Doctoral Studies

AbstractTuition costs for U.S. public universities have steadily risen in response to decreased state funding in the aftermath of the 2008 Great Recession. Researchers have studied the relationship between public budgeting and higher education but have not established the direct effects of budgeting decisions on student graduation outcomes. The purpose of this quantitative study was to understand why state funding has not kept up with tuition prices and how that affects student graduation rates. The effect of (a) tuition costs and (b) Michigan state funding for public universities on student outcomes was examined. Punctuated equilibrium theory and policy feedback theory, …

Social Work's Unremitting Identity Crisis: Can The Dsw Provide Answers?, Debra Joyce Hall

Walden Dissertations and Doctoral Studies

AbstractThis study is centered on a long-standing professional identity dilemma that poses potential problems for the future of the field of social work. Current literature points to specific shortcomings in the field that threaten the future of the profession. Some researchers also suggest that the reemergence of the Doctorate of Social Work (DSW) may be used to solve some of the identity concerns with the profession. The study further asserts that practicing licensed clinical social workers (LCSW) have not been a part of the conversation regarding the identity issues or the remedies that the field is considering. Using both a …