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Psychiatric and Mental Health Nursing Commons™
Open Access. Powered by Scholars. Published by Universities.®
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Articles 181 - 210 of 316
Full-Text Articles in Psychiatric and Mental Health Nursing
Social Media Use And Mental Health: An Educational Intervention To Reduce Depression And Anxiety In Adolescents, Natalie Catlett
Social Media Use And Mental Health: An Educational Intervention To Reduce Depression And Anxiety In Adolescents, Natalie Catlett
DNP Projects
Background: Most adolescents spend a great deal of their time using various social media platforms. However, excessive and maladaptive social media use is correlated with worsening symptoms of depression and anxiety among adolescents.
Objective: This project aimed to determine whether an educational intervention could help decrease overall time spent using social media and improve mood and mental health outcomes among adolescents with depression or anxiety disorders.
Methods: This was a quasi-experiment with a pretest and posttest design. An educational intervention about the relationship between social media use and symptoms of depression and anxiety among adolescents and strategies to minimize risk …
The Effect Of Education On The Nida Modified Assist (Nmassist) Tool On Knowledge And Screening For Substance Use Disorder Among Clinicians, Victoria Page Arnold
The Effect Of Education On The Nida Modified Assist (Nmassist) Tool On Knowledge And Screening For Substance Use Disorder Among Clinicians, Victoria Page Arnold
DNP Projects
Background: Substance use disorder (SUD) is a disparity affecting nearly 24 million individuals in the U.S., nearly 10% of the total population. Oftentimes, the emergency department (ED) is the only medical care this population receives. There is often a lack of screening for SUD in ED’s, therefore referred care may be limited for these individuals. The National Institute on Drug Abuse Modified Assist (NMASSIST) is an evidence-based tool developed to educate and screen for SUD. This tool can be completed in a timely manner and aid in the recommended referral of care for this select population.
Purpose: The purpose of …
Anxiety And Depression Among Students Using Tobacco In A Selected College Of Sonitpur District, Assam: A Crosssectional Study, Monalisa Saikia, Nurnahar Ahmed, Arunjyoti Baruah
Anxiety And Depression Among Students Using Tobacco In A Selected College Of Sonitpur District, Assam: A Crosssectional Study, Monalisa Saikia, Nurnahar Ahmed, Arunjyoti Baruah
Manipal Journal of Nursing and Health Sciences
Introduction: Tobacco use is one of the major public health concerns around the world, accounting for many deaths and disabilities. The use of tobacco is linked to many physical and mental ailments. A large population of adolescents are enrolled in colleges and universities in India, making them a vulnerable population for the use and abuse of tobacco. Objective: The objective of this study is to assess the level of anxiety and symptoms of depression among college-going students who consume tobacco. Methods: A descriptive cross-sectional approach was selected for the study. The purposive sampling technique was used to select college students …
The Resilience Vaccine, Sara Horton-Deutch T. Duffy
The Resilience Vaccine, Sara Horton-Deutch T. Duffy
Master's Projects and Capstones
Healthcare workers have been working in unprecedented circumstances since the declaration of the COVID-19 pandemic. Caregivers have been taxed with burnout. A large healthcare organization’s 26-bed, medical-surgical, telemetry, COVID-19 overflow unit was significantly impacted. Many healthcare organizations have adopted advocacy for attaining joy in work as an extra dimension of the Institute for Health Improvement’s Triple Aim. Adding this fourth aim supports averting caregiver burnout (CBO) while promoting joy in work.
This quality improvement project examined nurse leaders’ interventions that address CBO, promote healthy work environments, and promote joy in work. From June through August 2021, an 8-week resilience program …
Implementing Evidence-Based Treatment Of Patients With Opioid Use Disorder In An Inpatient Addiction Treatment Center, Emily Ashley
Implementing Evidence-Based Treatment Of Patients With Opioid Use Disorder In An Inpatient Addiction Treatment Center, Emily Ashley
Doctor of Nursing Practice
Patients with opioid use disorder are at increased risk for overdose and death should they relapse due to reduced opioid tolerance after a period of abstinence. A retrospective chart review was performed at an inpatient drug and alcohol treatment center to identify areas in need of improvement. The global aim of this project was to promote patient adherence to treatment, as well as increase the prevention of patient overdose and death after inpatient treatment. Project objectives include improving provider management of opioid use disorder through standardizing patient education, increasing prescription of relapse prevention medication, initiating prescription of naloxone at discharge …
Implementation Of An Interprofessional Fall Prevention Program To Reduce Falls On An Older Adult Inpatient Psychiatric Unit, Teresa Woodson
Implementation Of An Interprofessional Fall Prevention Program To Reduce Falls On An Older Adult Inpatient Psychiatric Unit, Teresa Woodson
Doctor of Nursing Practice
Background. Falls are the most reported incidents in the hospital setting, especially among older adults. According to the National Database of Nursing Quality Indicators (NDNQI), the number of falls in inpatient psychiatric units is 13-25 per 1,000 patient days, compared to 4 per 1,000 days for medical-surgical units. This DNP project aims to implement an interprofessional fall risk team to reduce falls in an older adult inpatient psychiatric unit. Problem. The psychiatric inpatient units had a total of 31 falls, with 13 (40%) occurring on the older adult unit. Interventions. Education of nursing staff, providers, and physical therapy (PT) …
Implementing An Evidence-Based Practice Change For Alcohol Withdrawal In An Acute Care Hospital, Theresa Carroll
Implementing An Evidence-Based Practice Change For Alcohol Withdrawal In An Acute Care Hospital, Theresa Carroll
Student Scholarly Projects
Practice Problem: Alcohol Use Disorders (AUD) affects a significant portion of the population in the United States. When AUD is either unrecognized or inadequately treated in the acute care setting it can lead to medical complications, increased length or stay (LOS), increased healthcare expense, and increased patient mortality.
PICOT: In a population of adult patients admitted to an acute care hospital progressive care unit (P), how does applying an initial evidence-based screening tool to detect risk for moderate to severe alcohol withdrawal, the PAWSS (I), compare to no standard screening or assessment for potential alcohol withdrawal symptoms (C) affect the …
Medicated-Assisted Treatment And 12-Step Programs: Evaluating The Referral Process, Candace S. Brown, Chudney Williams, Ryan E. Stephens, Jacqueline Sharp, Bobby Bellflower, Martinus T. Zeeman
Medicated-Assisted Treatment And 12-Step Programs: Evaluating The Referral Process, Candace S. Brown, Chudney Williams, Ryan E. Stephens, Jacqueline Sharp, Bobby Bellflower, Martinus T. Zeeman
Doctor of Nursing Practice Projects
Purpose/Background Overdose deaths in the U.S. from opioids have dramatically increased since the COVID-19 pandemic. Although medicated-assisted treatment (MAT) programs are widely available for sufferers of opiate addiction, many drop out of treatment prematurely. Twelve-step programs are considered a valuable part of treatment, but few studies have examined the effect of combining these approaches. We aimed to compare abstinence rates among patients receiving MAT who were referred to 12-step programs to those only receiving MAT.
Methods In this prospective study, a cohort of participants from a MAT clinic agreeing to attend a 12-step program was compared to 15 controls selected …
Benzodiazepine Reduction Program In A Psychiatric Mental Health Setting, Tracy Pacini
Benzodiazepine Reduction Program In A Psychiatric Mental Health Setting, Tracy Pacini
Dissertations
Benzodiazepine Reduction Program in a Psychiatric Mental Health Setting
The purpose of this pilot project was to reduce side effects and adverse effects of long-term benzodiazepines (BZDs) use in a non-profit community health center. This was a quality improvement project. The evidence-based practice (EBP) framework identified for the project was from the Institute for Healthcare Improvement (IHI) Plan-Do-Study-Act (PDSA) framework to decrease BZD use in a non-profit community health center. This model is focused on four stages: 1) gathering a proactive healthcare team to examine and identify solutions to reduce BZD usage, 2) testing the pilot program that the team …
Adverse Childhood Experiences And Urinary Incontinence In Elementary School Aged Children, Amanda Jill Travis Msn, Fnp-C, Margaret C. Harvey Phd, Aprn, Acnp-Bc, Chfn, Michelle Rickard Dnp, Apnp-C
Adverse Childhood Experiences And Urinary Incontinence In Elementary School Aged Children, Amanda Jill Travis Msn, Fnp-C, Margaret C. Harvey Phd, Aprn, Acnp-Bc, Chfn, Michelle Rickard Dnp, Apnp-C
Doctor of Nursing Practice Projects
Purpose/Background: Adverse Childhood Experiences (ACEs) have an impact on health throughout the lifespan (Filletti et al., 1999; Hughes et al., 2017). These experiences range from physical and mental abuse, substance abuse in the home, parental separation or loss, financial instability, acute illness or injury, witnessing violence in the home or community, and incarceration of family members (Hughes et al., 2017). Understanding and screening for ACEs in children with urinary incontinence can help practitioners identify psychological stress as a potentially modifiable risk factor.
Methods: A 5-month chart review was performed identifying English speaking patients ages 6-11 years presenting to the outpatient …
Shu Altop News Issue #4, Fall, Dr. Susan L. Davis, Rn & Richard J. Henley College Of Nursing
Shu Altop News Issue #4, Fall, Dr. Susan L. Davis, Rn & Richard J. Henley College Of Nursing
News, Magazines and Reports
Updates from the Davis & Henley College of Nursing Sacred Heart University Alternatives to Opioids for Pain Grant.
Alternatives to Opioids for Pain (ALTOP) is a HRSA funded project to help combat the opioid epidemic in Connecticut.
In this issue: • New Roles in Our Team • ANEW HRSA 2021-2022 Awardees • Southwest Community Health Center Chiropractic Care Services • Student Quality Improvement Project • Sacred Heart University Alumni Working at New Solutions Pain Management Clinic.
The Effect Of Postpartum Depression Screening Education For Postpartum Nurses, Shecarra S. Cook
The Effect Of Postpartum Depression Screening Education For Postpartum Nurses, Shecarra S. Cook
Electronic Theses and Dissertations
Depression affects about 13% of pregnant women and about 10% of women after childbirth. Some cases are so severe, the mother may even commit suicide. If left untreated, postpartum depression (PPD) affects both the mother’s and the infant’s health as well as their quality of life. The gap in clinical practice is that currently, patients only complete a postpartum depression screening tool during their 6-week follow-up appointment with their OB/GYN, leaving a gap in PPD detection and care during the immediate postpartum period. Postpartum nurses are not usually given specialized training in postpartum depression. The purpose of this study was …
Mindfulness-Based Cognitive Therapy Staff Training Program To Tackle Postpartum Depression, Helen Xumin Chen
Mindfulness-Based Cognitive Therapy Staff Training Program To Tackle Postpartum Depression, Helen Xumin Chen
Doctor of Nursing Practice (DNP) Projects
Abstract
Background: Women in the process of childbirth go through significant physical and psychological changes. The internal changes along with other external factors can be overwhelming. There is a high rate of new mothers suffering from postpartum depression (PPD) as a result. Problem: High prevalence of PPD is a public health crisis. The condition has a negative impact on the mother-baby unit and the wellbeing of the whole family. Aside from the implications on the health of new mothers and babies, PPD is also costly to the economy. Methods: Mindfulness-Based Cognitive Therapy (MBCT) is a common and effective intervention for …
Evaluation Of Depression, Anxiety And Stress In Graduate Nursing Students, Rachel Dunston
Evaluation Of Depression, Anxiety And Stress In Graduate Nursing Students, Rachel Dunston
Dissertations
Mental health issues are growing in the United States. Postgraduate school is widely known to increase the level of psychological difficulties (Dyrbye et al., 2006) experienced by students. There is a need to address mental health care in graduate nursing students. This project was a descriptive observational comparison pre-post-intervention design used to see if online modes of delivery would aid in decreasing mental health issues for nursing graduate students. Participants were provided with access to three podcasts and encouraged to use the Sanvello mobile application provided to all students at this university. The first podcast focused on using the Sanvello …
Impact Of Social Isolation In Hiv-Positive Individuals During A Pandemic, Corina Jane Bakoylis
Impact Of Social Isolation In Hiv-Positive Individuals During A Pandemic, Corina Jane Bakoylis
Dissertations
Problem: The global pandemic of COVID-19 caused concern for immunocompromised individuals. The purpose of this quality improvement initiative was to assess the impact of social isolation on feelings of loneliness, depression, and social isolation experiences in HIV-positive individuals residing in a long-term care facility.
Methods: A mixed-method convergent design with a purposeful sample of HIV-positive adult residents residing in a long-term care facility was utilized. An evaluation of loneliness using the University of California Los Angeles (UCLA) Loneliness Scale (Version 3) and depression using the Patient Health Questionnaire-8 (PHQ-8) were completed. Personal experiences were also assessed with five predetermined open-ended …
Intimate Partner Violence Education For High School Students, Morgan Foster
Intimate Partner Violence Education For High School Students, Morgan Foster
Dissertations
Problem Adolescents are at risk for experiencing intimate partner violence (IPV). As early as seventh grade, over half of adolescents have reported being in a romantic relationship. Adolescent screening for and education of IPV is minimal, and only the Healthy Relationships Quiz developed by the U.S. Department of Health and Human Services [HHS] screens young adolescents across all aspects of IPV, including psychological and sexual violence. The purpose of this project was to develop an IPV education plan for high school students in a health course.
Methods An educational lesson plan for IPV was created for high school teachers.
Results …
Shu Altop News Issue #3, Summer, Dr. Susan L. Davis, Rn & Richard J. Henley College Of Nursing
Shu Altop News Issue #3, Summer, Dr. Susan L. Davis, Rn & Richard J. Henley College Of Nursing
News, Magazines and Reports
Updates from the Davis & Henley College of Nursing Sacred Heart University Alternatives to Opioids for Pain Grant.
Alternatives to Opioids for Pain (ALTOP) is a HRSA funded project to help combat the opioid epidemic in Connecticut.
Balancing Provider Stress And Resilience In The Time Of Covid, Zachary Love
Balancing Provider Stress And Resilience In The Time Of Covid, Zachary Love
Doctor of Nursing Practice Final Manuscripts
Purpose: The purpose of this evidence-based practice project is to improve secondary traumatic stress (STS), compassion satisfaction, and burnout amongst providers—physicians, residents, and nurse practitioners—within the acute psychiatry units of the La Jolla Veterans Health Administration (VHA) through a one-time educational training session.
Background: Mental health providers at the VHA acute psychiatry units experience one of the highest risks for the development of STS, CF, and burnout amongst all professions due to a number of individual and institutional factors. STS is characterized by secondhand traumatization with symptoms similar to that of Post-Traumatic Stress Disorder—difficulty sleeping, mood changes, upsetting images appearing …
Neonatal Abstinence Syndrome Nonpharmacological Intervention Education For Healthcare Professionals Caring For Newborns, Darby Harvey
Neonatal Abstinence Syndrome Nonpharmacological Intervention Education For Healthcare Professionals Caring For Newborns, Darby Harvey
Doctor of Nursing Practice Scholarly Project
Neonatal abstinence syndrome has increased significantly in the United States over the past few decades due to the increase of maternal substance abuse. The overall goal of caring for these infants is effective management of the withdrawal symptoms, including both pharmacological and nonpharmacological interventions. However, nonpharmacological interventions have been shown to improve infant outcomes and reduce length of hospitalization. This project sought to increase healthcare professionals’ knowledge and confidence regarding neonatal abstinence syndrome and the utilization of nonpharmacological interventions when caring for infants diagnosed with neonatal abstinence syndrome through the provision of an educational presentation. This study utilized a one-group …
The Effects Of Virtual Reality Therapy On Acrophobia: A Literature Review, Emma Zobal
The Effects Of Virtual Reality Therapy On Acrophobia: A Literature Review, Emma Zobal
The Eleanor Mann School of Nursing Undergraduate Honors Theses
This paper examines the effects of virtual reality therapy on acrophobia. Virtual reality therapy is a valuable tool that can be utilized to expose individuals to their phobias in a controlled, virtual setting with the use of technology. Acrophobia is described as an extreme fear of heights and can interfere with the daily lives of individuals. In this review, four studies were examined that focused on the use of virtual reality therapy in individuals with acrophobia. The overall findings indicated that virtual reality therapy was effective in reducing symptoms of acrophobia. Furthermore, this literature review examines the benefits and successful …
Treatment Access For Dual Diagnosis Substance Use And Mental Health Disorders, Pedro Banuelos
Treatment Access For Dual Diagnosis Substance Use And Mental Health Disorders, Pedro Banuelos
Electronic Theses, Projects, and Dissertations
In 2018, of 1.3 million Latinx adults in the United States facing concurrent issues with substance use disorders (SUD) and mental health disorders (MHD) 93% remained untreated for either diagnosis. This is concerning since Substance Abuse and Mental Health Services Administration (SAMHSA) data reveals that this population is at greater risk for suicidal thoughts, plans, and attempts. They also face structural barriers such as employment, housing, legal involvement, and insurability that further impede access to treatment.
This study’s purpose was to examine barriers to accessing treatment for Latinx populations confronting co-occurring SUDs and MHDs. This study used a qualitative design …
Effectiveness Of Ehr-Depression Screening Among Adult Diabetics In An Urban Primary Care Clinic, Filipina C. Schnabel Md, Mph, Msn, Fnp-Bc, Danielle Aldridge Msn, Fnp-C, Laura Reed Dnp, Fnp-Bc
Effectiveness Of Ehr-Depression Screening Among Adult Diabetics In An Urban Primary Care Clinic, Filipina C. Schnabel Md, Mph, Msn, Fnp-Bc, Danielle Aldridge Msn, Fnp-C, Laura Reed Dnp, Fnp-Bc
Doctor of Nursing Practice Projects
Background Diabetes mellitus (DM) and depression are important comorbid conditions that can lead to more serious health outcomes. The American Diabetes Association (ADA) supports routine screening for depression as part of standard diabetes management. The PHQ2 and PHQ9 questionnaires are good diagnostic screening tools used for major depressive disorders in Type 2 diabetes mellitus (DM2). This quality improvement study aims to compare the rate of depression screening, treatment, and referral to behavioral health in adult patients with DM2 pre and post-integration of depression screening tools into the electronic health record (EHR).
Methods We conducted a retrospective chart review on patients …
A Descriptive Study Of Health-Related Risks And Outcome Differences By Loneliness Status In A Sample Of Older Veterans, Rachael Beard
A Descriptive Study Of Health-Related Risks And Outcome Differences By Loneliness Status In A Sample Of Older Veterans, Rachael Beard
Dissertations
There is a need to understand the influences and outcomes related to loneliness in veterans living with complex illness. Patients require self-care to manage complications and exacerbations associated with complex illness. Deficits in self-care result in negative health outcomes and drive resource utilization upward. The identification of potential factors related to self-care is important. Loneliness may be one factor that influences patients’ ability and desire to care for themselves. Descriptive correlational design was used to evaluate loneliness both as a predictor and outcome in veterans admitted to the hospital for three complex respiratory illnesses (heart failure, chronic obstructive pulmonary disease, …
Efficacy Of Integrating Cbt For Mental Health Care Into Substance Abuse Treatment In Patients With Comorbid Disorders Of Substance Abuse And Mental Illness, Laura U. Madu, Jacqueline Sharp, Bobby Bellflower
Efficacy Of Integrating Cbt For Mental Health Care Into Substance Abuse Treatment In Patients With Comorbid Disorders Of Substance Abuse And Mental Illness, Laura U. Madu, Jacqueline Sharp, Bobby Bellflower
Doctor of Nursing Practice Projects
Abstract: Multiple studies have found that psychiatric disorders, like mood disorders and substance use disorders, are highly comorbid among adults with either disorder. Integrated treatment refers to the treatment of two or more conditions and the use of multiple therapies such as the combination of psychotherapy and pharmacotherapy. Integrated therapy for comorbidity per numerous studies has consistently been superior to the treatment of individual disorders separately. The purpose of this QI project was to identify the effectiveness of Cognitive Behavioral Therapy (CBT) instead of current treatment as usual for treating Substance Use Disorder (SUD) or mental health diagnosis independently. It …
Reducing Patient Risk For Suicidal Behaviors With A Safety Bundle Of Best Practices With Non-Psychiatric Patients, Olayemi Akindele
Reducing Patient Risk For Suicidal Behaviors With A Safety Bundle Of Best Practices With Non-Psychiatric Patients, Olayemi Akindele
Student Scholarly Projects
Practice Problem: Suicide is a public health condition that affects people globally. The increased suicidal behaviors of patients in a medical-surgical unit demanded an effective screening protocol to identify high-risk patients.
PICOT: In patients 18 years and older on a medical-surgical unit, does the implementation of the Columbia Suicide Severity Rating Scale (C-SSRS) tool and application of a Safety Bundle of Best Practices (SBBP) increase early identification of suicide risk with decreased patient self-harm behaviors, compared to the current standard practice of no assessment tool or safety bundle of best practices within 12 weeks?
Evidence: Ten studies served as evidence …
Depression Symptoms And Covid-19, Kaylee Armendariz
Depression Symptoms And Covid-19, Kaylee Armendariz
The Eleanor Mann School of Nursing DNP Capstone Projects
The COVID-19 pandemic presents new challenges in behavioral healthcare. Americans may face anxiety surrounding the virus, economic strain, isolation, and grief, putting them at increased risk for depression symptoms. This Doctor of Nursing Practice (DNP) quality improvement project aimed to increase depression screening rates and utilized data from a Federally Qualified Health Center (FQHC) to identify population groups at higher risk for depression symptoms during the COVID-19 pandemic. Using the Patient Health Questionnaire (PHQ) depression screening tool, a statistical analysis determined if being tested for COVID-19 or testing positive for COVID-19 had an impact on depression symptoms. Additionally, this project …
The Effect Of Covid-19 On The Mental Health Of College Athletes, Molly Mcardle
The Effect Of Covid-19 On The Mental Health Of College Athletes, Molly Mcardle
Senior Theses
This research aimed to explore how the mental status of student athletes at the University of South Carolina has been affected by the unprecedented COVID-19 pandemic. A total of 61 student athletes between the ages of 17 and 24 participated in the study and completed a series of questions including the Depression-Anxiety-Stress Scale 21 (DASS-21) and the Group Environment Questionnaire (GEQ). Independent samples t-tests and descriptive analyses were used for comparisons between gender and age. The results showed that female athletes reported statistically significantly higher levels of anxiety and stress than male athletes (p = 0.049 and p = …
The Effects Of Administrative Support On Registered Nurse Well-Being During The Covid-19 Pandemic, Cassandra Fox
The Effects Of Administrative Support On Registered Nurse Well-Being During The Covid-19 Pandemic, Cassandra Fox
The Eleanor Mann School of Nursing DNP Capstone Projects
Attention to the well-being of nurses is necessary to ensure the healthcare system can operate effectively, particularly during the COVID-19 pandemic. The workplace environment and support from nursing leadership strongly contribute to nurses’ well-being. Currently, there is little evidence on the effect nursing leadership has on nurses’ well-being during the COVID-19 pandemic. This DNP clinical inquiry project sought to learn more about the effects of caring leadership behaviors on nurses’ well-being during the COVID-19 pandemic. A survey composed of questions from previously validated and reliable surveys used in the field of nursing was used to collect data. Neuman’s systems theory …
Addressing Psychosocial Outcomes Of Social Isolation In Older Adults, Megan Friesen, Madeline M. Christensen
Addressing Psychosocial Outcomes Of Social Isolation In Older Adults, Megan Friesen, Madeline M. Christensen
Nursing DNP Projects
Purpose and Rationale
The aim of the evidence-based practice (EBP) project is to improve psychological outcomes for socially isolated older adults enrolled in a Homebound Program (HP) through the implementation of an EBP intervention. Social isolation has a multitude of negative consequences, including impacting the psychological health (e.g. depression, loneliness, anxiety) of the older adult population.
Synthesis of Evidence
Meta-analyses, systematic reviews, and randomized controlled trials addressing the clinical problem of social isolation were identified. Through critical appraisal of the evidence, physical activity, psychotherapy, and socialization interventions have shown to decrease depression and loneliness in older adults. There were mixed …
Improving Psychological Trauma Awareness For Culturally Responsive Care: A Dnp Project, Jose M. Cruz
Improving Psychological Trauma Awareness For Culturally Responsive Care: A Dnp Project, Jose M. Cruz
Doctor of Nursing Practice Projects
Racism and racial discrimination occur in a variety of forms (Kendi, 2017). Both can contribute to poor mental health outcomes in the United States (Alvarez, Liang, & Neville, 2016; Comas-Diaz, Hall, & Neville, 2019; Levy, 2019; Malott & Schaefle, 2015; Williams, Lawrence, Davis, & Vu, 2019). These social conditions have been identified as chronic stressors that can illicit trauma symptoms, result in post-traumatic stress disorder (PTSD), and contribute to increased suicidality (French et al., 2020). Providers should understand the ramifications of the psychological trauma that can occur and endeavor to deliver evidence-based solutions. This doctoral project was designed to develop, …