Social and Behavioral Sciences Commons^™

Evaluating The Impact Of Integrated Care On Service Utilization In Serious Mental Illness, Heidi C. Waters

Walden Dissertations and Doctoral Studies

Serious mental illness (SMI) affects 5% of the United States population and is associated with increased morbidity and mortality. Use of high-cost healthcare services is common, including hospitalizations and emergency department (ED) visits. Integrating behavioral and physical healthcare may improve care for consumers with SMI, but prior research findings have been mixed. This quantitative retrospective cohort study addressed the impact of integrated care on physical health and ambulatory care sensitive (ACS) utilization via a program evaluation of an integrated health clinic (IHC) at a community mental health center (CMHC). The research questions assessed whether there was a predictive relationship between …

Predictors Of Obesity, Acculturation, And Perceived Stress In Meskhetian Turk (Ahiska) Immigrants In The United States, Zekeriya Temircan

Walden Dissertations and Doctoral Studies

Obesity is a risk factor for chronic diseases among the ethnic minorities for adult immigrants in the United States. There have been many research studies conducted to examine the relationship between the predictors and obesity in minority groups in the United States, that relationship was unknown in Meskhetian Turk (Ahiska) immigrant populations. Guided by social ecological model and acculturation theory, this study examined the predictors of obesity in the Meskhetian Turk (Ahiska) immigrant population in the western United States. Data were collected from 109 participants using CDC's Behavioral Risk Factor Surveillance System, Stephenson Multigroup Acculturation Scale, and Perceived Stress Scale. …

The Soldier 360°Orgram: Strengthening Combat-Exposed, Noncommisioned U.S. Army Officers' Interpersonal Sensitivity, Anne Harper

Walden Dissertations and Doctoral Studies

Interpersonal sensitivity is a foundational component of interpersonal relationships. It encompasses an individual's self-concept and self-identity, which are formed as the individual develops. An individual's self-concept develops from the norms and mores of his or her society. Soldiers in the U.S. Army have been trained to form a repurposed self to engage in combat and work in combat-focused jobs. The consequence of this training in many cases has been diminished interpersonal sensitivity that has been detrimental to their interpersonal relationships. The Soldier 360° course is a comprehensive treatment program that takes a holistic approach to providing soldiers with self-empowering tools …

Barriers Cardiac Nurses Face In Addressing Psychosocial Issues Of Heart Failure Patients, Debra Kay Disbrow

Walden Dissertations and Doctoral Studies

Heart failure is a chronic disease and a common cause of hospitalizations and readmissions within 30-days of discharge. To decrease the cost of care for patients with heart failure, the Centers for Medicare and Medicaid Services initiated the Readmissions Reduction Program that reduces payment to hospitals with preventable readmissions. Among the causes for readmissions of patients with heart failure are concurrent behavioral health issues that can lead to decreased medication compliance and increased risk for disease progression. The prevalence of comorbid depression is as high as 77% among patients with heart failure and may be an important factor in readmissions. …

Promoting Policy Advocacy In Nursing Via Education, Carolyn Sue Jurns

Walden Dissertations and Doctoral Studies

Nurses have a professional, ethical, and social responsibility to advocate for optimal healthcare and an optimal professional environment. However, nurses often default on that responsibility. Leadership at a national nursing organization's state affiliate (SNO) perceived a need to optimize its members' policy advocacy. To meet that need, the Policy Advocacy Toolkit for Nurses (PATN) was developed for this doctoral project. The evidence-based PATN relied on established theories and frameworks, notably Knowles' adult education theory and Kingdon's multiple streams approach; research specific to this project; evidence from other researchers, healthcare organizations, and government websites; and input from a statistician, nursing education …

The Adequacy And Perceived Impact Of Nigeria's Health Policy, Kennedy Magoma Ongwae

Walden Dissertations and Doctoral Studies

From 2004 to 2015, the health sector in Nigeria was substantially underfunded despite the existence of a federal health policy committing 15% of the national budget to health care financing. The purpose of this narrative and phenomenological study was to explore the nature and significance of economic claims made in this policy. The central research question examined the extent to which these economic claims were perceived to be realistic, attainable, and successful in meeting their intended policy objectives and impact. The study's conceptual framework combined Kingdon's ambiguity and multiple streams theory, Roe's narrative policy analysis, and Skocpol's policy feedback theory. …

Social Network And Health Seeking Behavior Of Men Of West African Descent, Opeyemi Odewale

Walden Dissertations and Doctoral Studies

Men are less likely than women to seek help from health services providers regarding the health issues they face. In the United States, of the various race/ethnicity populations, Black American men are least likely to seek health related help, which is reflected in the substantially higher mortality and morbidity rates in Black American men compared to other populations. Guided by the social epidemiological framework, this study examined the relationship between social network measure and health help-seeking behavior among foreign-born and U.S.-born Black American men of West African descent residing in the state of Rhode Island. A cross-sectional study design with …

A Case Study Exploration Of Teachers' Perspectives On Children's Mental Health Service Needs In Title I Elementary Schools, Natalie Denise Yates

Walden Dissertations and Doctoral Studies

Children go to school for approximately 32 hours each week of an academic year. Many children who are in need of mental health treatment do not get the services they need because of barriers such as lack of access and stigma. Teachers are one of the primary sources of referrals for children's mental health services, and they often make referrals based on their perceptions of their students' mental health needs. Although teachers are typically the primary source of referrals for mental health services, they usually do not have any specialized mental health training. The purpose of this study was to …

Researchers', Stakeholders', And Investors' Perceptions Of U.S. Stem Cell Research Policy, Dorothy King-Moore

Walden Dissertations and Doctoral Studies

Federal support and funding for human embryonic stem cell (hESC) research in the United States lags behind stem cell programs in many countries because of the divisive debate over hESC research and the continually evolving federal policies that have hindered research efforts. The purpose of this phenomenological study was to explore the perceptions of stem cell researchers, stakeholders, and investors in the United States about the effects of the current federal stem cell policy on stem cell research in the United States, the moral disagreement with stem cell research, and their recommendations to improve stem cell research policy in the …

A Comparison Of Neuropathic Pain In Hiv Disease And Diabetes Mellitus, Mary Catherine George

Walden Dissertations and Doctoral Studies

Neuropathy is a nerve disorder found in HIV disease and diabetes mellitus that indicates damage in the peripheral nervous system. Burning, tingling, stabbing, shooting, and painful sensations in the hands and feet are common symptoms of this chronic disorder, and no treatments are available that repair the nerves. The approved pain treatments are few and only available for the diabetic neuropathy population. A mixed-methods study of archival data was performed to compare patients with painful neuropathy (PN) associated with 2 diseases: HIV (HIV-PN) and diabetes mellitus (DPN). This study examined the similarities and differences of the pain narratives and common …

Effect Of Intimate Partner Violence On Children Of Puerto Rican Women, Maria Natal-Gopin

Walden Dissertations and Doctoral Studies

Intimate partner violence [IPV] is a preventable and costly societal issue that has reached epidemic proportions. Women are often the victims of IPV, and millions of children are exposed to it annually. The purpose of this study was to explore experiences of Puerto Rican mothers and their perceptions of how IPV exposure may have impacted their children using resilience theory. Data were collected via audiotaped individual interviews with 9 Puerto Rican mothers who endured an array of escalating IPV, often exacerbated by the perpetrators use of alcohol or drugs, and had IPV-exposed children aged 6 -11 years. Data analysis integrated …

Individual And Socioeconomic Factors Associated With Childhood Immunization Coverage In Nigeria, Obinna Ositadimma Oleribe

Walden Dissertations and Doctoral Studies

Immunization remains one of the most successful and cost-effective public health interventions worldwide. The purpose of this study was to examine the individual and socioeconomic factors that influence childhood immunization coverage in Nigeria. The health belief model and the social ecological model were used as the theoretical framework for the study, which examined the effects of individual, parental, and socioeconomic factors on complete immunization among Nigerian children. Univariate, bivariate, and multivariate tests were conducted within a secondary analysis of 2013 Nigerian National Demographic and Health Survey was done. Of 27,571 children aged 0 to 59 months, 22.1% had full vaccination …

Leadership Practices That Improve The Workplace Safety Environment, Nathan Nomore Chikono

Walden Dissertations and Doctoral Studies

Inadequate leadership is the reason workplace accidents in the mining industry remain high, making the industry one of the most hazardous operational activities in the world. Unsafe leadership practices may result in death or injury to workers. A group of 30 mining company leaders from 3 gold mines in Zimbabwe revealed an exception to these hazardous practices, however, notable through their outstanding safety improvement records. To better understand what these practitioners were doing, this multicase study research design explored their strategies to improve the workplace safety environment in the mines. Data were collected using audio-recorded semistructured interviews and document analyses. …

Executive Director Experiences With Consumer Operated Service Provider Governing Board Members, Merideth Mccallick Erickson

Walden Dissertations and Doctoral Studies

Consumer Operated Service Providers (COSPs) are programs that are directed and administratively controlled by mental health consumers for their peers. As such, many mental health consumers have been placed in the position of serving on a COSP and often with unclear descriptions and no training. As a result, there is often a disconnect between the will of the board and the vision of the executive director, leading to tension and the possibility of failed mission. Using servant leadership as the guide, the goal of this case study was to explore the experiences of executive directors who operate Consumer Operated Service …

Predictors And Moderators Of Sexual Distress In Women With Persistent Genital Arousal Disorder, Lisa Squibb

Walden Dissertations and Doctoral Studies

Persistent Genital Arousal Disorder (PGAD) is a complex, poorly understood condition characterized by unremitting, unwanted, distressing genital arousal which occurs frequently and for extended periods of time, often in the absence of sexual stimuli. The pathophysiology is unknown. Researchers have hypothesized underlying disorders of neurological, vascular, pharmacological and psychological origins. Possible causalities have been suggested including anxiety disorder, SSRI use, and pudendal nerve neuropathies among others. Despite the uncertainty of etiology, other aspects of the disorder are clearer, including distress and poor quality of life for many. In this study, I used a biopsychosocial model to examine three potential psychological …

The Influence Of Cardiovascular Disease Risk Factors On Exercise Participation, Chadrick Cooper

Walden Dissertations and Doctoral Studies

The study's purpose was to analyze whether the control (sustained healthy level) of independent cardiovascular disease risk factors could be used to significantly predict aerobic exercise status. The health belief and ecological model helped describe health awareness, autonomy, and ecological influences that could also influence the control of each risk factor. Multiple logistic regression analysis of behaviors and demographics was utilized to assess relationships of met aerobic recommendations to hypertension, diabetes, obesity, tobacco/alcohol use, diet, physical activity limitations, mood, and socio-economic status. The study consisted of 340 African American participants (37% male 63% female), between the ages of 30-64 who, …

The Critical Role Of The Psychiatric Emergency Response Team In The Adoption Of A Violence Risk Assessment Tool., Angela Mackay

Walden Dissertations and Doctoral Studies

Workplace violence is a persistent problem in health care, and incidence rates have increased over the years. Traditional reporting systems, relying mostly on paper formats, are inadequate for developing effective predictive models for intervention and reducing acts of violence by patients to staff. The purpose of the development and deployment of the psychiatric emergency response team (PERT) was to provide effective intervention within the MIAHTAPS (Altered Mental status, Irritability, Agitation, History of Violence, Threatening, Attacking Objects, Pacing, and Staring) behavior prediction tool to reduce the severity and rates of violence in a hospital setting. Lewin's change theory was used to …

Influence Of Media Messages On Obesity And Health Perceptions Among African American Women, Carolyn Grant

Walden Dissertations and Doctoral Studies

African American women have the highest prevalence of overweight and obesity in the United States, thus increasing their risks for chronic diseases. Their understanding of their health status and response to it could be triggered by messages in the media, yet few researchers have examined this topic with African American women. The purpose of this phenomenological study was to explore how advertisement and editorial content in media contributed to perceptions African American women have about overweight and obesity. Following the theoretical foundation of the social cognitive theory, the research questions explored what messages study participants encountered and which messages prompted …

'Stand By Me' Designated Tobacco Areas On U.S. Military Installations, Robert Thomas Gobble

Walden Dissertations and Doctoral Studies

U.S. Air Force (USAF) active duty Airmenshowunusually high tobacco prevalence rates (TPR); i.e., smoke, smokeless, both(SSL-B), when compared to civilian publics in the United States. Tobacco control efforts have proven largely ineffective inlowering nicotine habits among Airmen, while outdoor designated tobacco areas (DTAs) sited near worksites and popular localeson USAF bases (USAFBs) likelyswayAirmen to continue riskynicotine habits. The aim of this inquiry was to assess whetherquantities of DTAs on USAFBs and U.S. airbases (USABs) with 4 mediator variables(quality of DTAs,sites of DTAs, execution of a tobacco cessation program, and types of tobacco cessation programs) wereassociated with TPR (SSL-B) among Airmen …

Effect Of Self-Determination, Motivation, And Dispositional Optimism With Physical Therapy In Geriatric Patients, Leslie Yaneth Urias-Bodnar

Walden Dissertations and Doctoral Studies

Older people are frequently faced with physical conditions that require treatment. A better understanding of the components of engagement relating to the outcomes of treatment was the focus of the study. The purpose of this quantitative study was to examine whether there was an association between the independent variables of optimism, pessimism, motivation, and self-determination and their impact on the dependent variable of achieving physical activity goals in 86 geriatric patients, ages 65 to 80 receiving physical therapy services. The theoretical framework of self-determination, motivation, optimism, and pessimism was assessed by using two self-report questionnaires, The Self-Determination Scale and The …

Racial Ethnic Health Disparities: A Phenomenological Exploration Of African American Adults With Diabetes Complications., Florence A. Okombo

Walden Dissertations and Doctoral Studies

Racial/ethnic minority groups experience a higher mortality rate, a lower life expectancy, and worse mental health outcomes than non-Hispanic in the United States. There is a scarcity of qualitative studies on racial/ethnic health disparities. The purpose of this hermeneutic phenomenological study was to explore the personal experiences, attitudes, and perspectives of 6 African American adults with chronic health issues related to diabetes through a face-to-face interview. Social cognitive theory and health belief model guided the study. The participants were recruited through purposeful sampling. The data were coded using axial and thematic coding and subsequently analyzed through phenomenological interpretive inquiry. The …

Quality Improvement Initiative To Reduce Fall Risk In The Snf, Ramona C. Lancaster

Walden Dissertations and Doctoral Studies

Residents who fall in SNF either sustain significant decline to quality of life or die from their injuries. The average fall costs about $34,000 per incident. On average, 19.8% of residents fall at least once per month. The purpose of this project was to assess, identify, and advance nursing practice to decrease falls by evaluating current facility standard of practice, fall policy, procedures, and protocol. The objective was to create actions that would close the communication gap between clinicians and residents. This project encourages clinicians to intertwine resident feedback and strategies into the plan of care to help reduce fall …

Breast Cancer, Mana'olana/Hope, And The Experience Of Native Hawaiian Women, Karla Marie Calumet

Walden Dissertations and Doctoral Studies

Breast cancer is one of the leading causes of morbidity and mortality among women. A diagnosis of cancer is a stressful event that requires an individual to adapt to new stressors. The purpose of this qualitative study was to better understand the perceptions of mana'olana/hope and living with breast cancer among Native Hawaiian women. The conceptual framework of this phenomenological study was positive psychology. Data collection included in-depth interviews with 5 Native Hawaiian women who had been diagnosed with breast cancer. Data coding and analysis resulted in identification of 8 themes.

The themes included: (a) mana'olana /hope is the essence …

Policing The Mentally Ill In Coronado, Ca, Jennifer Susan Ayres

Walden Dissertations and Doctoral Studies

The growing number of individuals suffering from mental illnesses and their inability to access intervention methods has adverse effects on the criminal justice system. These impairments increase the likelihood that police officers will have negative attitudes about persons with mental illnesses. This study sought to understand whether police officers' empathy, education, experience outside of work as well as on the job, and officers' training in the field of mental health all related to police officers' attitudes relating to persons with mental illness. The purpose of this study was to expand the body of knowledge and determine how factors such as …

Staffing Standards And Care Outcomes In For-Profit And Not-For-Profit Religious-Based Nursing Homes, Ara Omobola Omotowa

Walden Dissertations and Doctoral Studies

Vulnerable older adults residing in nursing homes continue to experience poor care outcomes due to nurse staffing levels that are below the levels required for maintaining their well-being. Studies have shown that patient care outcomes in nursing homes are related to nurse staffing standards/levels, which are affected by profit maximization on adherence to registered nurses and licensed nurse staffing standards. The purpose of this descriptive study was to determine if there was a relationship between adherence to staffing standards and care outcomes in for-profit (FP) and not-for-profit religious-based (NFPRB) nursing homes using the profit maximization theory. Research questions focused on …

Online Versus In-Person Therapy: Effect Of Client Demographics And Personality Characteristics, Joel Joseph Kofmehl

Walden Dissertations and Doctoral Studies

Traditionally, mental health professionals have provided psychotherapeutic services through face-to-face sessions. As the Internet has become an increasingly important part of individuals' personal and professional lives, psychologists and clients have used this medium to expand access to psychotherapy. The purpose of this quantitative correlational design was to investigate whether demographic variables and the personality traits of extroversion/introversion (E/I), as assessed by the Big Five Inventory, predicted clients' preferences for a specific method of administered psychotherapy. The theoretical framework for this study was social information processing through computer-mediated communication. An online survey site was used to assist in survey design and …

Facilitating Environmental Enrichment In Senior Care Activities With Professional Development, Celia Mary Ross

Walden Dissertations and Doctoral Studies

There is little known about the current state of professional development and continuing education practices for empowering activity professionals to better enhance environmental enrichment in long term care. The purpose of this qualitative study was to explore the activity professional's perceived role and best strategies for professional development to enrich the long-term care environment. The study used social cognitive theory as its theoretical framework to develop research questions focused on the views of activity professionals concerning professional development and continuing education to support care for long-term care residents. Using a narrative approach, 9 activity professionals were recruited through networking at …

Multifamily Subsidized Housing Seniors' Awareness Of Aging And Disability Resource Center Services, Katrina Polk

Walden Dissertations and Doctoral Studies

Over 75% of adults 60 years of age or older who live in Washington, D.C. are unaware of access to Aging and Disability Resource Centers' (ADRC) community-based services. Approximately 25% of these individuals are low-income and reside in multifamily subsidized housing. With a theoretical basis in Penchansky and Thomas' construct of access, this phenomenological study explored whether increased awareness of access to ADRC service delivery may potentially better meet the needs of this socioeconomically marginalized population. Data were collected through semi-structured interviews with 20 senior citizens in Washington, D.C. who received some programmatic assistance, such as housing or meal delivery, …

Using Music Intervention To Reduce Anxiety And Agitation For Dementia Residents In Long Term Setting, Sonia Brown

Walden Dissertations and Doctoral Studies

Abstract

Dementia is one of the degenerative conditions that present in old age with a decline in cognitive function resulting in changes in personality and the ability to carry out activities of daily living and social functions. Dementia is usually associated with behavioral disturbances that include anxiety and agitation that pose a challenge for family members or caregivers in an alternate home or care-related facility. The purpose of this project was to design and implement a quality improvement program to evaluate music therapy intervention for residents in a long-term care who have dementia. The aim was to evaluate if music …

Identifying Stressors Experienced By Single Fathers Who Are Parenting In New York City, Stacey Theresa Melhado

Walden Dissertations and Doctoral Studies

Fathers face difficulties when taking on the single parent role, including having to prove their ability to care for their children alone. Existing research does not address issues concerning single fathers and the stressors they experience in raising their children. This study addresses these issues and helps researchers understand single fathers by using a qualitative approach to understand their perception of parenting. Fourteen participants from New York City participated in semi-structured interviews to elicit information about this phenomenon. This study focused on experiences the men have while being a single parent, the impact of living in New York City on …