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Walden Dissertations and Doctoral Studies

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Education To Increase Nurse Knowledge And Compliance With Social Determinants Of Health Screening, Bonnie Rieger Jan 2023

Education To Increase Nurse Knowledge And Compliance With Social Determinants Of Health Screening, Bonnie Rieger

Walden Dissertations and Doctoral Studies

To provide holistic care and ensure positive patient health outcomes, the social determinants of health (SDOH) must be addressed. Research demonstrates that while medical care is a contributor to wellness, the SDOH serve an influential role in patient health outcomes. There is limited literature describing how to best educate practicing nurses about SDOH concepts. The purpose of this DNP project was to provide an educational intervention to increase inpatient staff nursing knowledge of the SDOH. Sources of evidence used to create the education module included scholarly literature describing the SDOH concepts and their application to patient, community, and population health. …

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Perception Of Effective Leadership Concerning Nurse Satisfaction And Intent To Leave, Tina Marie Rose Jan 2023

Perception Of Effective Leadership Concerning Nurse Satisfaction And Intent To Leave, Tina Marie Rose

Walden Dissertations and Doctoral Studies

Nurses are an essential part of patient care, and improving retention is important to quality outcomes and the cost of care. An integral aspect of nurse retention is job satisfaction, which may relate to communication provided by organizational leadership. The purpose of this quantitative study was to determine if there was a relationship between perceived effective leadership, nurse job satisfaction, and nurse turnover intent. This potential relationship between leadership communication and nurse turnover was studied with the competing values framework as the theoretical structure. The two research questions addressed the independent variables of perceived effective leadership in a hospital setting …

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Relationship Between Nurse Managers’ Cultural Humility Practices And Nurse Retention, Jessica Scharfenberg Jan 2023

Relationship Between Nurse Managers’ Cultural Humility Practices And Nurse Retention, Jessica Scharfenberg

Walden Dissertations and Doctoral Studies

Some hospital administrators experience yearly loss of human capital, resulting in economic and noneconomic consequences that require resource reallocation to sustain operations. Grounded in the cultural humility theory, the purpose of this quantitative correlational study was to examine the relationship between nurses’ perceptions of their nurse managers’ (a) openness, (b) self-awareness, (c) egolessness, (d) self-reflection and critique, (e) supportive interaction, and nurse turnover intention. Participants included 142 registered nurses working in the Midwest United States. Data were collected using Foronda’s Cultural Humility Scale and the Michigan Organizational Assessment Questionnaire. Results of multiple regression analysis indicated the model could significantly predict …

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Clinical Research Principal Investigators’ Perspectives Of Improving The Diversity Of Clinical Research Participants, Nadine Hyacinth Spring Jan 2023

Clinical Research Principal Investigators’ Perspectives Of Improving The Diversity Of Clinical Research Participants, Nadine Hyacinth Spring

Walden Dissertations and Doctoral Studies

Clinical trials are needed to make new medications, devices, and diagnostic tools available. Participants in these clinical trials have historically come from a homogeneous group, and there is a recognized need for increased diversity and representation in these clinical research studies. The absence of diversity in clinical trials makes it difficult for clinicians and researchers to know which medications and devices are safe and effective for specific populations. This basic qualitative phenomenological study was conducted to explore the experiences of clinical research principal investigators regarding diversity in clinical research studies and how to improve it. The theoretical framework for this …

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Parents’ Perceptions Of The Traits, Characteristics, And Circumstances Of Modern-Day Mass Shooters, Matt Talbot Jan 2023

Parents’ Perceptions Of The Traits, Characteristics, And Circumstances Of Modern-Day Mass Shooters, Matt Talbot

Walden Dissertations and Doctoral Studies

There is little research on parents’ perceptions about the traits, characteristics, and circumstances ascribed to mass shooters and the sources of information shaping these perceptions. Understanding parents’ beliefs about mass shooters and mass shootings can serve to inform approaches to training and education and recommendations for media reporting on such events. Evidence-based knowledge helps parents become more equipped to serve as early interventionists for those who may be moving along a pathway of violence. Application of Gerbner’s cultivation theory frames the process by which media sources shape perceptions. In this phenomenological qualitative study, semi structured interviews were conducted with 19 …

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Sub-Saharan African Immigrants’ Experiences In Utilizing Mental Health Services In Baltimore, Helen Tanwani Jan 2023

Sub-Saharan African Immigrants’ Experiences In Utilizing Mental Health Services In Baltimore, Helen Tanwani

Walden Dissertations and Doctoral Studies

AbstractMental illness is associated with poor quality of life evidenced by unemployment, homelessness, and substance abuse. Despite the adverse effects of mental illness, research has indicated that mental health-seeking behaviors and experiences in accessing mental health services among immigrants from sub-Saharan Africa are under-researched. The purpose of this qualitative study was to explore the experiences of sub-Saharan African immigrants in accessing mental health services in Baltimore, Maryland. To achieve the objective of this study, a descriptive research study was conducted utilizing semistructured one-on-one in-depth interviews with eight sub-Saharan African immigrants in Baltimore. Braun and Clarke’s six-step thematic data analysis approach …

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Role Of Racially Concordant Patient-Physician Relationships In Health Outcomes Among African American Women, Joy Thomas Jan 2023

Role Of Racially Concordant Patient-Physician Relationships In Health Outcomes Among African American Women, Joy Thomas

Walden Dissertations and Doctoral Studies

Abstract There are gaps in the literature regarding how patient-physician racially concordant relationships affect African American women’s health. This quantitative study evaluated the effects of non-minority physician influence on the perceptions of medical mistrust, racial discrimination, and healthcare-specific racial discrimination on African American women. The behavioral model for vulnerable populations guided the study. Two research questions involved understanding the relationship between trust in the physician scale and medical mistrust and the association between racial discrimination and perceived healthcare-specific racial discrimination among African American women living in a Southern U.S. state. A stratified random sampling strategy was used to obtain a …

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Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood Jan 2023

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

Walden Dissertations and Doctoral Studies

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

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Experience Of Established Mental Health Counselors Working With Adults Who Have Intellectual Disabilities, Margarete Denk Jan 2023

Experience Of Established Mental Health Counselors Working With Adults Who Have Intellectual Disabilities, Margarete Denk

Walden Dissertations and Doctoral Studies

Individuals with disabilities make up the largest minority population in the United States. Individuals with intellectual and developmental disabilities (I/DD) make up a significant portion of this population, yet there are limited studies addressing counseling with the I/DD population. The Council for Accreditation of Counseling and Related Educational Programs has addressed the need for disability competence in their upcoming 2024 standards. The purpose of the phenomenological study was to describe lived experiences of established counselors working with adult clients diagnosed with an I/DD. A descriptive phenomenological approach was used along with the social model of disability. The study involved six …

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Disparate Access To Medical Coverage Associated With Type 2 Diabetes Care In Low-Income And Rural Communities In Georgia, Crystal Alexis Symone Edwards Jan 2023

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 …

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Increasing Organizational Value Of A Private Healthcare Education Academy, Diana Skaff Jan 2023

Increasing Organizational Value Of A Private Healthcare Education Academy, Diana Skaff

Walden Dissertations and Doctoral Studies

Amid the dynamic changes and innovations of the healthcare field, healthcare providers seek educational activities that enhance their growth and decrease their knowledge gap. Healthcare education organizations responsible for providing high-quality healthcare education, have opportunities to differentiate their programs to acquire, attract, activate, and retain healthcare providers. Grounded in the five forces of competition and the value chain theories, this mixed method formative program evaluation aimed to improve the business development program by developing a differentiation by quality strategy that will increase its competitive advantage. Participants included three decision-makers and nine leaders in a healthcare education organization in the Kingdom …

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Sun Exposure And Protective Behaviors Among U.S. Hispanic Farmworkers, Claudia Marie Delgado Cebollero Jan 2023

Sun Exposure And Protective Behaviors Among U.S. Hispanic Farmworkers, Claudia Marie Delgado Cebollero

Walden Dissertations and Doctoral Studies

Sun exposure increases the risk of sun-related illnesses and skin cancer among U.S. Hispanic farmworkers. Reinforced by the health belief model, the purpose of this study was to determine the association between socio-demographic factors (i.e., age, educational attainment, gender, income, and marital status) and skin cancer with the level of sun exposure (sun’s effect on skin, sunburn reported) and protective behaviors (use of cap/visor, use of sunscreen) among adult Hispanic farmworkers in the United States. The study included Hispanic farmworkers aged 21 or older (N = 112) who responded to the 2015 National Health Interview Survey. Ordinal logistic regression showed …

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Improving Access To Diagnostic Medical Services For Children With Autism: Caregiver Perspective, John Nkemakolam Nkwocha Jan 2023

Improving Access To Diagnostic Medical Services For Children With Autism: Caregiver Perspective, John Nkemakolam Nkwocha

Walden Dissertations and Doctoral Studies

AbstractThe rising prevalence of autism among children in the United States has remained a challenge to caregivers, researchers, and healthcare providers. Medical diagnostic services struggled with inaccurate outcomes, misdiagnosis, inaccessibility, long waitlists, poor coordination, and a lack of expertise and knowledge for early intervention. There are limited studies on problems associated with diagnosing children with autism and the caregivers’ perspective on improving the services. In this qualitative phenomenological study, 10 caregivers’ perspectives on barriers to accessing medical diagnostic services, treatment, and management of children with autism and possible improvement of the services were explored. Resilience and health utilization models provided …

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Examining The U.S. Disaster Management Program: A Case Study Of The U.S. Virgin Islands Hurricanes Irma And Maria Evacuation, Victoria F. Vachon Jan 2023

Examining The U.S. Disaster Management Program: A Case Study Of The U.S. Virgin Islands Hurricanes Irma And Maria Evacuation, Victoria F. Vachon

Walden Dissertations and Doctoral Studies

AbstractWhether from natural or human causes, every global community is at risk for overwhelming, destabilizing incidents. Hurricanes Irma and Maria devastated the U.S. Virgin Islands in late August and early September 2017, necessitating the urgent evacuation of hemodialysis patients over 1000 miles to the U.S. mainland. Because the damage and response to the U.S. territory were unprecedented, the public health implications of the government’s strategies on the evacuated population subset were unexplored. However, available information suggested that some evacuees sustained avoidable harm while in the protracted care and custody of the government. This qualitative case study, conceptually framed by Bronfenbrenner’s …

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Organizational Strategies And Best Practices For Telehealth Delivery During Covid-19, Maria D. Mejia Jan 2023

Organizational Strategies And Best Practices For Telehealth Delivery During Covid-19, Maria D. Mejia

Walden Dissertations and Doctoral Studies

Organizational Strategies and Best Practices for Telehealth Delivery during COVID-19

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Impact Of Type 2 Diabetes And Hypertension On Allocation Of Grant Funds In Federally Qualified Health Centers, Rhonda Mullins Jan 2023

Impact Of Type 2 Diabetes And Hypertension On Allocation Of Grant Funds In Federally Qualified Health Centers, Rhonda Mullins

Walden Dissertations and Doctoral Studies

Limited resources exist for managing the increasing cases of hypertension and type 2 diabetes, which underlines the need to continuously review reimbursement plans to ensure care affordability for chronic illness. The purpose of this quantitative study was to determine whether a correlation existed between the number of patients with type 2 diabetes, hypertension, and demographic characteristics (independent variables) seen at Federally Qualified Health Centers (FQHCs) and the allocation of grant funds from Health Resources and Service Administration (HRSA) (dependent variable) from 2016 – 2020 among adults 18 years old and older in the United States. Guided by the Transaction Cost …

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Health Education Needs For Mortality Surveillance In Machakos County, Kenya, James S. Mwanza Jan 2023

Health Education Needs For Mortality Surveillance In Machakos County, Kenya, James S. Mwanza

Walden Dissertations and Doctoral Studies

Reporting mortality information is the primary data source from which evidence can be drawn to monitor disease trends and inform public health policy to improve population health. Still, only two-thirds of expected annual deaths are reported globally. Health education and promotion play a significant role in empowering communities to uptake public health services such as mortality surveillance. This qualitative descriptive study aimed to understand health workers’ (HWs’) perspectives regarding the need for health education to support mortality surveillance in Machakos County, Kenya. The capabilities, opportunities, and motivation for the behavior change model guided the study. Semi-structured interviews were used to …

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An Association Of The Transgenerational Implications Of Redlining And Obesity On Pediatric Type Ii Diabetes, Carlin Dexter Nelson Jan 2023

An Association Of The Transgenerational Implications Of Redlining And Obesity On Pediatric Type Ii Diabetes, Carlin Dexter Nelson

Walden Dissertations and Doctoral Studies

s the prevalence and incidence of childhood obesity has increased, so has the number of cases of pediatric Type 2 diabetes mellitus (T2DM). Although made unconstitutional in 1968, the transgenerational implications of redlining can be observed in disinvestments resulting in neighborhood detraction. Utilizing the 2019–2020 National Children’s Health Survey, the purpose of the study was to evaluate the relationship between obesity, T2DM, and neighborhood detraction elements as well as assessed indicators of T2DM in non-institutionalized children 6 through17 years of age (N = 34,725). The social determinants of health perspective served as the conceptual framework for the study. Results indicated …

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Educating Providers And Nurses On Human Trafficking, Valerie Smith Jan 2023

Educating Providers And Nurses On Human Trafficking, Valerie Smith

Walden Dissertations and Doctoral Studies

Human trafficking is a global public health problem. Victims of human trafficking experience higher rates of sexually transmitted diseases, reproductive damage, sexual violence, infertility, and mental and behavioral issues. To help end human trafficking, which is potentially deadly, raising awareness about this topic is essential for victim survival. A gap in practice among staff at a community health center regarding recognition of victims of human trafficking and procedures for potential victims was identified. An education program focused on increasing knowledge and awareness was developed to close this gap. Guided by Watson’s theory of human caring, a 30-minute educational session followed …

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Occupational Burnout Factors Among Correctional Mental Health Providers, Morgan Gruhot Jan 2023

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 …

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Occupational Risk Perceptions Among Foreign-Born Construction Workers In Central Florida, Matthew Edison Law Jan 2023

Occupational Risk Perceptions Among Foreign-Born Construction Workers In Central Florida, Matthew Edison Law

Walden Dissertations and Doctoral Studies

Hispanic and Latino foreign-born construction workers in the United States experience higher rates of serious injuries and fatalities in the workplace than their native-born peers. Previous research has pointed to specific vulnerabilities among this population, including birthplace, age of the worker, language barriers, and education level, but little to no research has examined addressable risk factors, such as occupational risk perceptions, among this population. The purpose of this quantitative study was to determine the relationship between birthplace, number of years working in the United States, and occupational risk perceptions while controlling for age of the worker, language barriers, and education …

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Non-Alcoholic Fatty Liver Disease And Metabolic Syndrome: The Role Of Gender Differences And Menopausal Status Of Women, Kimberly Kushner Jan 2023

Non-Alcoholic Fatty Liver Disease And Metabolic Syndrome: The Role Of Gender Differences And Menopausal Status Of Women, Kimberly Kushner

Walden Dissertations and Doctoral Studies

There are few studies that investigate the association between non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS) predominantly in menopausal women. This quantitative study investigated the association between MetS and NAFLD while controlling for age, gender, ethnicity, and menopausal status of women. The theoretical framework that helps establish and guide the research was the diffusion of innovation (DOI). A multivariable logistic regression was conducted using secondary data from the National Health and Nutrition Examination Survey. There is a statistically significant association between MetS, and NAFLD after controlling for age (OR = 2.96, 95% CI = 2.319–3.778, p < 0.001). However, ethnicity was not statistically significant. After further controlling for gender, the relationship remained statistically significant and exhibited a decrease in risk for females compared to males (OR = -.734, 95%CI = .387–.596, p < 0.001). Lastly, focusing on women only, and further controlling for menopausal status, the association between MetS and NAFLD was still statistically significant (OR = 2.227, p < 0.001). Mexican Americans, other Hispanics, and Non-Hispanic Black women were at higher risk (95% CI 1.102–7.039, 1.321–5.351, and 1.255–3.013, respectively). Implications for positive social change include adopting proactive and preventative strategies that can improve the quality of life for vulnerable patients and reduce morbidity and mortality associated with MetS and NAFLD.

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Age, Race/Hispanic Origin, And Covid-19 Mortality Among Sickle Cell Disease Patients In The United States, Joe Lamont Ndula Jan 2023

Age, Race/Hispanic Origin, And Covid-19 Mortality Among Sickle Cell Disease Patients In The United States, Joe Lamont Ndula

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic remains a global health challenge, with 6.7 million deaths worldwide as of January 2023. It has illuminated the health iniquities in underserved communities and populations like those with sickle cell disease (SCD). Researchers have associated the COVID-19 outcome among SCD patients in other regions of the globe. The purpose of this retrospective cross-sectional observational study was to investigate the relationship between age, race/Hispanic origin, and COVID-19 mortality among persons with SCD in the United States from January 2020 to March 2021. The Krieger ecosocial theory of disease distribution framed the study. Data were drawn from an existing …

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Health Education Practices For Middle Eastern Women With Polycystic Ovary Syndrome, Walaa Daffaalla Jan 2023

Health Education Practices For Middle Eastern Women With Polycystic Ovary Syndrome, Walaa Daffaalla

Walden Dissertations and Doctoral Studies

Polycystic ovarian syndrome (PCOS) is a complex women’s health condition that reduces women’s quality of life, leading to health complications, such as menstruation issues, infertility, insulin resistance, risk of type 2 diabetes, depression, anxiety, emotional stress, being overweight or obese, and more. Research on PCOS has focused on the etiology and complications in women from different ethnicities. But limited research has explored the experiences and perspectives of Middle Eastern (ME) women in the United States with PCOS related to PCOS health education. The purpose of this qualitative study was to explore the perspectives and experiences of ME women of reproductive …

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Nursing Staff Education Program On Using The Ask Suicide-Screening Questions Tool Kit, Camarita Titang Jan 2023

Nursing Staff Education Program On Using The Ask Suicide-Screening Questions Tool Kit, Camarita Titang

Walden Dissertations and Doctoral Studies

The absence of adequate knowledge, skills, and competencies in screening for suicide risk in adolescent and young adult patients is a significant problem facing nurses in outpatient settings. An evaluation of the project site facility’s main performance metrics revealed shortcomings in locating patients who pose a serious risk of self-harm and suicide. Staff dealing with the patients may, as a result, overlook preemptive measures that could stop a suicide event. The project aimed to create a training program to introduce the ask suicide-screening questions (ASQ) tool kit, an evidence-based suicide screening tool, to ambulatory nurses. The goal of the project …

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Tuberculosis-Associated Knowledge, Stigma, And Health Seeking Behavior Among Traders In Onitsha Main Market, Anambra State, Nigeria, Benedeth N. Ezeosim Jan 2023

Tuberculosis-Associated Knowledge, Stigma, And Health Seeking Behavior Among Traders In Onitsha Main Market, Anambra State, Nigeria, Benedeth N. Ezeosim

Walden Dissertations and Doctoral Studies

The utilization of tuberculosis (TB) health care services in a Nigerian state has not been optimal. Many residents do not utilize available health care resources when they experience symptoms of TB. Although much is known about the determinants of health seeking behavior (HSB), there is a gap on how TB knowledge and TB related stigma among traders in one main market contribute to HSB. This study examined the effect of TB knowledge and TB related stigma on HSB among traders. The health stigma and discrimination and health belif models served as the theoretical foundation. A quantitative cross-sectional analytical survey design …

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Consideration Of Mindfulness Intervention For Hispanic Adolescents In A School Setting, Kierra Mcshine Gregory Jan 2023

Consideration Of Mindfulness Intervention For Hispanic Adolescents In A School Setting, Kierra Mcshine Gregory

Walden Dissertations and Doctoral Studies

Hispanic adolescents’ accessibility to treatment options for depression is met with limitations associated with financial barriers and cultural misalignment. This research study aimed to bring to light an alternative psychotherapy treatment through the foundations of mindfulness interventions. The goal was to understand the experience of Hispanic adolescents when engaging in mindfulness in a school setting. The purpose of this study was to gather information about the experiences of Hispanic adolescents using mindfulness to support mental health practitioners, school counselors, and behavioral interventionists to provide treatment options that are accessible and meet the needs of this culture group. This explanatory case …

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Strategies To Reduce Turnover Among Black Home Healthcare Aides, Diane Allen Tate Jan 2023

Strategies To Reduce Turnover Among Black Home Healthcare Aides, Diane Allen Tate

Walden Dissertations and Doctoral Studies

Many individuals prefer to remain in their homes as they age instead of entering a long-term care facility. As the proportion of older Americans rapidly grows, the demand for delivery of nonmedical services by home healthcare aides (HHAs) is expected to increase. However, the national and local supply of HHAs is insufficient and must be rectified to meet a projected increase of older Americans by 2050. This research study involved exploring this problem for one small home healthcare organization in the Maryland suburbs outside of Washington, DC with an HHA workforce that was comprised predominantly of Black/African American and African …

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The Effects Of Vesico-Vaginal Fistula In The Lives Of Women In Southeastern Nigeria, Chioma Esther Amutaigwe Jan 2023

The Effects Of Vesico-Vaginal Fistula In The Lives Of Women In Southeastern Nigeria, Chioma Esther Amutaigwe

Walden Dissertations and Doctoral Studies

Vesico-vaginal fistula (VVF) is a maternal health problem faced by women in developing countries. VVF is one of the most devastating consequences of prolonged obstructed labor and is still prevalent in resource-poor countries like Nigeria where fertility is high, the status of women is low, and obstetric services are often inadequate. The objective of this study was to enrich our understanding of the effects of VVF as it relates to women’s experiences in southeastern Nigeria. I adopted the Transactional Model of Stress and Coping in this study; this theory posits that people, when contending with any kind of stressors, are …

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Relationship Between Homelessness, Substance Use, Employment, Living On A Reservation And Tuberculosis Among Northern Plains Native Americans, Darla Mccloskey Jan 2023

Relationship Between Homelessness, Substance Use, Employment, Living On A Reservation And Tuberculosis Among Northern Plains Native Americans, Darla Mccloskey

Walden Dissertations and Doctoral Studies

Native Americans in the Northern Plains have a long history of tuberculosis (TB) infections. There is limited research on the causes of latent TB infections (LTBI) and TB in this population. The purpose of this quantitative study was to assess the relationship between latent TB and factors of homelessness, substance use, employment, living on a reservation, and active or latent TB among this population using the eco-social theory as the theoretical framework. Data from 146 TB cases of Native Americans living in the Northern Plains and diagnosed with TB from 1999 to 2019 were analyzed using chi-square tests that showed …

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