Social and Behavioral Sciences Commons^™

Adults’ Lived Experiences With Placement In Child Protective Services During Adolescence, Michaela First Haynes

Walden Dissertations and Doctoral Studies

Perceptions of safety and emotional support during involvement with child protective services (CPS) during adolescence may play a significant role in shaping attachment experiences and relationships in adulthood. Although researchers have examined the effects of child maltreatment and foster care involvement, limited research has explored how adolescents perceive emotional support and safety during CPS involvement and how those experiences influence attachment in adulthood. The purpose of this qualitative study was to explore the lived experiences of adults who experienced CPS involvement during adolescence and to understand how perceptions of safety and emotional support are reflected in their adult attachment relationships. …

Exploring The Experiences Of Nigerian Army Personnel With Toxic Leadership, Shamsideen Toyin Shafaru

Walden Dissertations and Doctoral Studies

Toxic leadership has been shown to be present in Nigeria, promoting negative consequences for organizations and adverse effects on employee performance. However, how toxic leadership behaviors impact Nigerian Army operations and the performance of personnel have not been studied. Exploring toxic leadership in the Nigerian Army is important because the way in which leaders exercise influence determines the effects it has on followers. The purpose of this general qualitative study was to examine the lived experiences of Nigerian Army personnel who had worked as subordinates of individuals who exhibited toxic leadership traits and its impact on their performance. The theoretical …

Staff Education To Improve Clinical Staff Knowledge, Confidence, And Use Of The Patient Health Questionnaire-9 (Phq-9) In Outpatient Depression Screening, Madjou Stella Ngantche

Walden Dissertations and Doctoral Studies

Depression is one of the most common mental health conditions encountered in outpatient practice, yet inconsistent use of standardized screening tools contributes to missed opportunities for early identification and intervention. In outpatient settings, nurses and other clinical staff are often responsible for administering depression screenings; however, many lack formal education on the standardized use of the Patient Health Questionnaire-9 (PHQ-9). To address this practice gap, this Doctor of Nursing Practice (DNP) staff education project was implemented in an outpatient setting to determine whether staff education on the use of the PHQ-9 would improve staff knowledge, confidence, and intent to use …

Impact Of Emerging Technologies On Leadership Identity Of Behavioral Health Leaders, Jenah Habermehl

Walden Dissertations and Doctoral Studies

Emerging technologies are reshaping behavioral health leadership by changing documentation, communication, ethical responsibilities, and role expectations. Qualitative case study research methodology was used in this study. The problem addressed in this case study was the limited understanding of how emerging technologies influence the leadership identity and professional values of behavioral health leaders. The Baldrige Performance Excellence Framework guided this study of behavioral health leaders at a privately operated behavioral health organization in the South Atlantic region of the United States. Data were collected by conducting semistructured interviews with four behavioral health leaders at the organization and gathering internal archival and …

Economic Development Corporations In Small Communities, Mary L. Bullock

Certified Public Manager® Applied Research

This study evaluates the effectiveness of Type A and Type B Economic Development Corporations (EDCs) in supporting economic growth in small Texas communities. Using key indicators such as population trends, employment, infrastructure, housing, and legal frameworks, this paper compares how each EDC structure addresses these issues. While both Type A and Type B Economic Development Corporations contribute to economic growth, Type B EDCs are generally more effective in small Texas communities due to their broad ability to fund housing projects, create critical infrastructure, and shape quality-of-life community development projects that have a more immediate and measurable impact on unemployment, population …

Artificial Intelligence And Law Enforcement: Transforming Current And Future Policing Operations, Decision-Making, And Public Trust, Chad Taylor

Certified Public Manager® Applied Research

Artificial intelligence is having a major impact on our society. Many of our industries are attempting to grasp the benefits of this technology, and law enforcement is no different. Investigative, efficiency and administrative tools are all utilizing artificial intelligence to some degree. However, new tools bring new concern from communities. This article will investigate how artificial intelligence is being integrated into current and future law enforcement operations and decision-making. It will also investigate how AI affects public trust and what the profession needs to do to build community confidence. Regardless, artificial intelligence is a technology that is here and will …

The Human Side Of Leadership: How Personality Assessments Build Self-Aware, Accountable, And Emotionally Intelligent Public Sector Leaders, Hillary Faulkner

Certified Public Manager® Applied Research

Public sector organizations face a persistent set of leadership challenges, including miscommunication, inconsistent accountability, and reactive decision-making, that are rarely resolved through technical training alone. This study examines how the intentional use of personality assessments can improve self-awareness, emotional intelligence, accountability, and communication among public sector leaders, and how those improvements contribute to more effective and cohesive leadership teams. Using a qualitative case study design, this research draws on Organization Analysis and Design (OAD) personality assessment data and in-depth interviews with two supervisors at a municipal government organization in Henderson, Texas, who participated in a structured six-month personality-based leadership development …

How Can Electronic Timekeeping Systems Provide Cost And Time Savings Compared To Manual Time Entry And Paper-Based Timesheets?, Jill Childs

Certified Public Manager® Applied Research

Paper-based timekeeping methods have historically been the default way for both municipalities and businesses to document hours worked by employees. However, due to analog timekeeping’s lack of verification methods, human error and intentional dishonesty combine to make this method unreliable. These discrepancies are also costly, as human resources staff must be compensated for the time it takes to verify entries and correct mistakes, and if unchecked, the falsified time can potentially result in thousands of dollars of unearned wages lost. This article details various methods and motivations for falsification and argues for the implementation of electronic timekeeping systems, such as …

Succession, Sustainability, And Service: Workforce And Leadership Challenges In Rural Municipal Governments, Dewayne Armstrong

Certified Public Manager® Applied Research

Rural municipal governments across Texas and the United States face a convergence of workforce and leadership challenges that threaten long-term service delivery and organizational sustainability. An aging public-sector workforce, persistent recruitment and retention constraints, and fragile leadership continuity interact in ways that uniquely affect small and rural communities. Public works departments, which play a vital role in infrastructure maintenance and regulatory compliance, are particularly vulnerable as experienced employees approach retirement without adequate succession pipelines or mechanisms for institutional knowledge transfer. At the same time, small-town governments face ongoing difficulty attracting and retaining qualified personnel due to constrained fiscal capacity, geographic …

Probation Officers’ Experiences Supervising Domestic And Intimate Partner Violent Probationers, Megan Davis

Walden Dissertations and Doctoral Studies

This study includes insights regarding potential supervision challenges that are faced by probation officers overseeing domestic and intimate partner violence (IPV) probationers, emphasizing the importance of effective management to enhance offender accountability and victim safety. The relationship dynamic between probation officers and domestic and IPV probationers influences recidivism rates, highlighting the importance of effective and empathetic supervision. The purpose of this study was to identify gaps in training, supervision strategies, and resources, with a focus on integrating attachment-based practices to improve outcomes. Guided by the attachment theory, the research included key questions about supervision effectiveness and relational dynamics. Employing a …

Lived Experience Of Secondary School Teachers During The Covid-19 Pandemic, Diane R. Lovett

Walden Dissertations and Doctoral Studies

The study emphasizes the need for a deeper understanding of secondary school teachers' experiences during the COVID-19 pandemic, particularly focusing on their challenges during the transition back to in-person instruction after teaching online. The purpose of this phenomenological study explored the experiences of U.S. secondary teachers during the onset of COVID-19, the shift to virtual teaching, and the return to in-person instruction. The study was grounded in Bandura’s (1986) social cognitive theory, specifically the concept of observational learning and self-efficacy, to understand how teachers learned from peer successes and challenges during the transition to virtual learning and when returning to …

The Relative Strength Of Justice-Related Satisfaction, Posttraumatic Maladaptive Beliefs, And Self-Compassion In Predicting Perceived Control Over Stressful Events, Katherine Mooney

Walden Dissertations and Doctoral Studies

Coercive control and domestic violence perpetrated by men against women are global social problems sustained by patriarchal norms that normalize gender-based violence. These norms often contribute to victims' maladaptive self-beliefs, leading women to believe they provoked the abuse. When survivors seek legal protection, they may experience revictimization through legal processes that minimize their claims and enable perpetrators to continue exerting power and control through the justice system. As a result, dissatisfaction with the legal system may reinforce self-blame, while low self-compassion may further undermine women's perceived control over stressful events in both the short and long term. While previous research …

Hubungan Paparan Informasi Anemia Dan Tablet Tambah Darah (Ttd) Melalui Media Digital Dengan Kebiasaan Konsumsi Makanan Ibu Hamil Berdasarkan Food Frequency Questionnaire (Ffq), Muthiah Salsabilah, Bernadette Oktavia Jelita, Thariq Zafar Surapati, Alya Khairunnissa, Primasti Nuryandari Putri, Ratu Ayu Dewi Sartika

Perilaku dan Promosi Kesehatan : Indonesian Journal of Health Promotion and Behavior

Background: Proper nutrition is important for the mother and baby. The media is an important source of information for every pregnant woman, but the information might be inaccurate.

Aim: This study aims to examine the association between exposure to digital media information on anemia and iron-folic acid (IFA) supplementation and the food consumption habits of pregnant women as measured by the Food Frequency Questionnaire (FFQ) at Puskesmas Kecamatan Beji, Depok City in 2024.

Method: This study utilized a cross-sectional design involving secondary data analysis of the 2024 antenatal care (ANC) survey conducted at Beji Primary Health Center, Depok City. Purposive …

Medical Tourism Patient Guidance: A Content Analysis Of Risk Reduction Guidelines Available To Global Health Seekers., Alicia Mason, Angela Ashmore

Faculty Submissions

This study examines medical tourism (MT) patient guidance messages intended to reduce procedural risks—those directly related to biomedical treatments—and process risks, which involve logistical, administrative, and interpersonal challenges of seeking healthcare abroad. The analysis focuses on print and digital publications authored by individuals independent of the MT industry, including policy researchers, travel health experts, lifestyle reporters, and consumer-focused medical travel writers. Using a two-phase digital and database search strategy, 27 publications from 2009 to 2024 were identified and analyzed using exploratory content analysis methods. Findings reveal important differences in the scope and depth of guidance aimed at reducing risks for …

Relationship Of Covid-19-Related Racial Discrimination And Oppressed Identities On Chinese American Mental Health, Allison A. Fong

Doctoral Dissertations

Although anti-Asian hate has been present throughout history, the country witnessed an uptick in race-based violence and discrimination against Asian Americans during the COVID-19 pandemic. Utilizing the framework of intersectionality, this quantitative cross-sectional study aimed to capture the additive impact of various forms of oppression, including COVID-19-related racial discrimination, on levels of depression, anxiety, and life satisfaction in Chinese American college students (n = 35) in the Greater San Francisco Bay Area. Within this relationship, bicultural identity integration was also explored as a possible moderator. Although regression analysis did not show significant relationships between COVID-19-related racial discrimination and intersectional discrimination …

Creating Sustainable School And Home Gardens: Creating An Outreach Booth, Aurora Hughes Villa, Tyelar Haines, Rita Hagevik, Kathy Cabe Trundle, Michelle Parslow

All Current Publications

An outreach booth is a physical presentation that allows your audience to learn more about a subject and how they can participate. It provides information on a topic (e.g., an environmental issue or a community project) through direct interaction with experts in the field. Through this approach, people become engaged, and discussions emerge that foster a sense of community around the topic. Interested in creating one for yourself? Follow the steps outlined in this fact sheet.

The Consequences Of Using Human Behavior To Train Ai, Lauren Treiman

McKelvey School of Engineering Graduate Student Theses & Dissertations

Artificial intelligence (AI) is now an integral part of everyday decision making. These systems not only help us make choices but also learn from our behavior. Therefore, it is important to understand how our interactions with AI influence these systems. Current approaches often assume that the behavior used to train AI accurately reflects how people would naturally behave. However, people are often informed that their choices will be used for AI training, and as a result, may change how they would normally act. In this dissertation, we combine psychological and computer science perspectives to investigate the consequences of this awareness. …

``But What About Me?'': A Structural Redesign For Cascading Trust Into An Integrated Culture Of Care, Hazelin Hei Laam Ngan

Patient Experience Journal

In healthcare, patient experience (PX) and employee experience (EX) are often managed as separate priorities despite their interdependence. This article presents a case study from NYC Health + Hospitals/Community Care, a 250-person safety-net division providing home-based services across New York City. In response to frontline staff repeatedly asking, ``But what about me?'' when offered PX best practice suggestions, the organization integrated patient experience, staff engagement, and wellness into a unified Care Experience portfolio led by the Chief Experience Officer. From this structural redesign emerged a practical framework for trust-building organized around three pillars: Purpose, Presence, and Partnership. Purpose aligns staff …

Building A Culture Of Trust: Engaging Teams With Targeted Tactics For Meaningful Improvement In Patient Experience, Anna Buckner, Kimberly Lewis

Patient Experience Journal

Rising financial pressures and the need to revitalize culture prompted a renewed emphasis on patient experience at Billings Clinic. This case study describes the impact of redefining patient experience as a measure of trust and a set of care processes. It presents an alternative to the more traditional view of patient experience as an outcome metric based on meeting patient expectations. Billings Clinic chose the patient survey question likelihood of recommending as an organizational goal or key performance indicator (KPI). Under the direction of executive leadership, the patient experience team developed a new strategic framework aimed at driving improvement for …

Plan Of Day | Plan Of Stay: How Inter-Disciplinary Communication Improved Patient Experience And Hospital Throughput, Theresa Jean Dionne, Felicia Hurst, Danna Qunibi, Lauren Lazar, Sydney Mccurdy, Ashlyn Coenraad, Brittney Ward, Whitney Black, Ashley Nelson, Judd Salem, Luisa Restrepo

Patient Experience Journal

Background: Effective communication among healthcare team members is critical for delivering high-quality, patient- and family-centered care while optimizing hospital operations. This case study examines the implementation of a structured ``Plan of Day | Plan of Stay'' model, leveraging bedside whiteboards to enhance inter-disciplinary communication in a pediatric hospital setting. By providing a clear, visual summary of daily care plans, care team members, and discharge goals, whiteboards foster transparency, empower patients and families, and facilitate coordinated clinical decision-making. Purpose: This quality improvement initiative evaluated the implementation of a standardized Plan of Day | Plan of Stay communication model on a pediatric …

Patient Psychological Safety: A Qualitative Study Of Patient Experiences, Derick R. Simmons, Cheryl Rathert, Ryan Valayil, Maria Joseph, Ibraheem Jawadi

Patient Experience Journal

There is growing interest in understanding patients' experiences with psychological safety during healthcare encounters. Recent studies reveal that patients describe needing patient psychological safety (PPS) to form connections with their care providers, which are associated with better health outcomes. Therefore, it is critical to examine indicators of PPS. Using a phenomenological interpretive approach, this study utilized a patient narrative survey methodology to qualitatively explore how and why patients experience a lack of PPS during their healthcare encounters. We surveyed patients from across the U.S. and analyzed responses among a sub-sample of respondents to an open-ended question whose responses indicated they …

Patient-Centred Care: An Integrated Bibliometric And Structural Equation Modelling Approach, Japheth Nuhu Ahmed

Patient Experience Journal

This study investigates how communication and service quality in Patient Relationship Management impact patient satisfaction through trust. The literature in this field is predominantly in developed countries, whereas it is scarce in sub-Saharan Africa. Combining bibliometric analysis and structural equation modelling, the study highlights emerging research trends and provides empirical evidence to guide healthcare practitioners, policymakers, and researchers in improving patient care. To strengthen its theoretical foundation, the study integrates the Social Exchange Theory and Expectancy–Disconfirmation Theory to explain the model. The study retrieved quantitative data from the Scopus database for bibliometric analysis. A questionnaire was used to collect data …

From Anticipation To Relief: Anxiety Reduction And Patient Experience As Indicators Of Trust During Dental Extractions In Orthodontic Treatment, Kanza Tahir, Mubassar Fida, Rashna Hoshang Sukhia

Patient Experience Journal

Trust is central to healthcare encounters involving fear and uncertainty. This quasi-experimental study evaluated changes in anxiety before and after dental extractions performed during orthodontic treatment planning and examined whether patient experience factors were associated with post-extraction anxiety. Fifty patients aged 11–40 years undergoing fixed orthodontic treatment requiring extraction were recruited consecutively at a tertiary care hospital from October 2023 to June 2024. Anxiety was measured immediately before and after extraction using the Beck Anxiety Inventory. Post-procedure patient experience was assessed with a structured questionnaire addressing reassurance, communication, privacy, shared decision-making, perceived understanding, and overall experience. Paired t-tests and simple …

Self-Medication Experience And Healthcare Trust Among Youth: A Regionally Concentrated Digital Survey In Indonesia, Wahyudi Wahyudi, Azra Muzaiyana Nasution, Arini Dwi Rahmadani, Alysa Rahmadani Hasibuan

Patient Experience Journal

Self-medication has become a central experience for youth transitioning toward independent medical decision-making. In the digital era, young people must navigate a complex landscape of health information while seeking independent health solutions. This study investigates self-medication experiences and healthcare trust among youth, utilizing a regionally concentrated digital survey approach in Indonesia. Data were collected via a cross-sectional approach using digital platforms (Instagram, TikTok, and Twitter/X), facilitated by 76 trained enumerators. While respondents from all 38 provinces participated, the sample (N = 2,790) exhibits a major geographical concentration in the Sumatra region. The study employed a validated 16-item instrument to evaluate …

Trust Earned Through Relational Care: How Adverse Childhood Experiences Shape Patient Trust In Their Inpatient Physicians—A Convergent Mixed-Methods Study, Marlise Jeanne Pierre-Wright, Ibrahim Badreldin Mokhtar, Uma Thachapuzha, Yashoswini Chakraborty, Revika Singh, Rachel O'Conor, Jing Song, Julia Lee, Maria E. Theodorou, Christine Schaeffer, Kimberly Collins, Muriel Jean-Jacques

Patient Experience Journal

Background: Adverse childhood experiences (ACEs) are common, with approximately 60% of the population reporting at least one exposure. Despite well-established links between ACEs and adverse health outcomes, little is known about how ACE exposure shapes hospitalized patients' trust in inpatient physicians. Objective: To examine the association between ACEs and hospitalized patients' trust in inpatient physicians and to explore how trust is formed among patients with high ACE exposure. Methods: In this convergent mixed-methods study, 86 patients admitted to a general internal medicine teaching service at a large urban academic medical center were surveyed across six data-collection sessions (January–July 2024). Participants …

Navigating Uncertainty: Patient Experiences Of Birads 0 Mammogram Results, Petranea Smith, Jasmine Warren, Marina Demas, Roberta Goldman, Joanne E. Wilkinson

Patient Experience Journal

Objective: Describe experiences of patients receiving BIRADS 0 (inconclusive) mammogram results in electronic health portals. Methods: Recruited eighteen patients who had received BIRADS 0 results via the portal in the last 5 years.Semi-structured interviews yielded qualitative data, analyzed sequentially using the immersion crystallization method to identify content and then iterative coding both individually and in groups. A team of 4 researchers coded and analyzed the transcripts, using repeated meetings and a shared spreadsheet to organize codes and develop thematic elements via visual organization. Results: Themes included baseline comfort/trust with healthcare and how it interacted with anxiety about the uncertainty of …

From Hospital To Home After Lower-Extremity Open Reduction And Internal Fixation: Patients' Experiences Of Pain Self-Management And Trust-Building Discharge And Follow-Up Support, Sahrudi Sahrudi, Achmad Fauzi Kamal, Masfuri Masfuri, Kasiyah Junus

Patient Experience Journal

After lower-extremity open reduction and internal fixation (ORIF), patients often return home while pain, wound care, mobility restrictions, medication routines, and follow-up needs are still evolving. During this transition, trust in discharge information may shape how patients interpret symptoms, use analgesics, mobilise, involve family members, and decide when to seek help. This qualitative descriptive study explored patients' experiences of pain self-management after lower-extremity ORIF in an Indonesian public hospital context, with attention to trust-building needs across discharge and early follow-up. Eighteen adults participated in individual face-to-face semi-structured interviews at an orthopaedic outpatient clinic. Interviews were audio-recorded, transcribed verbatim, and analysed …

Nurses' Perceptions Of Medical Services In Acute Care Hospitals In The Post-Covid-19 Era, Yoko Nakano, Tomoya Yokotani, Rika Nakajima, Hidemi Yoshii

Patient Experience Journal

Purpose: This study aimed to clarify nurses' perceptions of healthcare services in acute care hospitals. Methods: A cross-sectional, anonymous, web-based questionnaire was conducted using SurveyMonkey. Participants were selected using convenience sampling. The survey included questions about the participants' basic attributes and the 22-item M-SERVQUAL scale (a modified multiple-item scale for measuring consumer perceptions of medical service quality). Data analysis involved age-based comparisons using the Kruskal–Wallis test, followed by multiple comparisons using the Bonferroni method. The significance level was set at p < 0.01. Results: The survey was distributed to 1,542 participants, yielding 566 valid responses, with an effective response rate of 36.7%. …

Pathways To Patient-Provider Conflict In Nigeria: A Structural Equation Model Of Expectations, Communication, Trust, And Organizational Constraints, Akaninyene O. Unaam, Christie Divine Akwaowo, Edidiong A. Unaam

Patient Experience Journal

Objective: This study empirically investigated the drivers of patient-provider conflict and tested a conceptual model linking treatment expectations, communication, trust, and organizational constraints to conflict intensity in Nigerian tertiary care. Methods: A cross-sectional survey of 400 patients (response rate 82.3%) and 150 healthcare providers (response rate 71.2%) from three Nigerian tertiary hospitals was conducted using stratified random sampling. Validated, culturally adapted scales measured unrealistic treatment expectations, communication barriers, organizational constraints, trust, and conflict intensity. Data were analyzed using Structural Equation Modeling (SEM) with maximum likelihood estimation and bootstrapping for mediation testing. Multi-group confirmatory factor analysis established measurement invariance across samples. …

Centering Community Voices To Address Healthcare Inequities In Underserved Utah Populations, Karishma Shah, Jazmine Abril, May Shaaban, Silvia Soule, Sonia Sehgal, Rawad Farhat, Jeannette Villalta, Oreta Tupola, Valentine Mukundente, Cathy Wolfsfeld, Ivana Holiday, Walter Watchman, Carrie Olvera, Lauren Gleave, Kamaile Tripp, Alexander Sperber, Rita Osborn

Patient Experience Journal

Persistent disparities in health outcomes across the United States are often driven by systemic inequities and social determinants of health. In Utah, these inequities are particularly pronounced among racially, ethnically, and geographically underserved populations. Community healthcare workers (CHWs) who share lived experiences with these communities are uniquely positioned to bridge the gap between patients and a fragmented healthcare system. This study aimed to explore how underserved communities in Utah perceive and interact with the healthcare system, centering their lived experiences to inform more equitable care models. We conducted eight focus groups with 73 participants from six medically underserved communities: African …