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Walden Dissertations and Doctoral Studies

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Articles 1561 - 1590 of 4997

Full-Text Articles in Social and Behavioral Sciences

Social Exclusion And Community Severance In Impoverished Neighborhoods, Melissa Kerry Stickel Jan 2021

Social Exclusion And Community Severance In Impoverished Neighborhoods, Melissa Kerry Stickel

Walden Dissertations and Doctoral Studies

Transportation infrastructure, such as highways and interstates, creates a barrier that can physically limit access to those living in adjacent neighborhoods, a phenomenon known as community severance. In addition to creating a physical disconnect, these infrastructures can leave residents feeling socially isolated and excluded from the rest of the community. This qualitative single-case study focused on social exclusion and community severance and problems arising from the U.S. transportation network, addressing the development of the interstate system and its possible impacts on communities. The exclusionary effects of transportation-related severance were well supported in the literature. However, most of research had been …

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Counselor Education And Supervision Students’ Stage Of Program And Intimate Relationship Investment, Rachel Dell Jan 2021

Counselor Education And Supervision Students’ Stage Of Program And Intimate Relationship Investment, Rachel Dell

Walden Dissertations and Doctoral Studies

The doctoral counselor education and supervision (CES) program has three stages (entry, integration, or candidacy), each involving specific challenges resulting in varying time requirements, workloads, and stress levels. Personal struggles may have consequences that influence the completion of students’ doctoral program and the outcomes of students’ research. Interdependence theory is the theoretical framework for this study. The purpose of this quantitative study was to determine CES doctoral students’ intimate romantic relationship investment as measured by the Investment Model Scale (IMS) and to investigate the relationship between CES doctoral students’ stage in the program and students’ intimate romantic relationship investment. The …

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Former Youth Care Workers' Experiences In Residential Treatment, Sonja Yvette Johnson Jan 2021

Former Youth Care Workers' Experiences In Residential Treatment, Sonja Yvette Johnson

Walden Dissertations and Doctoral Studies

AbstractAs juvenile crime increases across the United States, so do the costs to support incarceration programs. Youth care workers play a pivotal role in supporting the rehabilitation of youth. The effectiveness of a youth residential program is critical for the long-term employment of a youth care worker. The purpose of this qualitative transcendental phenomenological study was to obtain the lived experiences of young and departed youth care workers in residential settings about leaving employment. Pragmatism was the ontology that helped to guide this study with the aim of understanding how individuals’ reality was shaped by relational dynamics that contributed to …

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Cell Phone Use And Adolescent Weight Problems, Florence Kenkor Njang Jan 2021

Cell Phone Use And Adolescent Weight Problems, Florence Kenkor Njang

Walden Dissertations and Doctoral Studies

AbstractOverweightinadolescenceincreasestheriskofobesityandmanyadversehealthoutcomeslaterinlife.The purpose of this quantitative cross-sectionalstudy was to investigatetheassociationbetweencell phoneuseandweightstatusinadolescents,ages14 17yearsold,livingintheUnitedStates.Thesocio-ecologicalmodel(SEM)wasusedtoexplainthelinkbetweencellphoneuseandoverweightamongadolescents.Threeresearchquestionswere used to explore(a)therelationshipbetweencellphoneuseandadolescentweightstatusaftercontrollingforage,gender,andrace;(b)the effectofcellphoneuseonoverweightandnormalweightstatusesamongadolescentsaged 14 17yearsaftercontrollingforage,gender,andphysicalactivity;and(c)themodifyingeffectofraceontherelationshipbetweencellphoneuseandadolescentoverweightaftercontrollingforageandgender.Secondary data from the2017YouthRiskBehavioralSurveillanceSystemwere analyzed usingbinarylogisticregressiontoanswer theresearchquestions.Highcellphoneusesignificantlyandpositivelypredictedoverweightinadolescentsaftercontrollingforage,gender,andrace(p<0.001).Afteraccountingforage,gender,andphysicalactivity,highcellphoneusewasasignificantpredictorofoverweight(p<0.001).Similarly,racehadasignificantmodifyingeffectonthepositiveassociationbetweenhighcelluseandoverweightamongadolescents(p<0.001).Thekeypositivesocialchange implication of this studyis the potentialtointegratehealthycellphoneusewithexistingobesitypublichealthinterventionsthatcanreduceoverweightandpositivelyimpactindividuals,families,andcommunities.

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Leadership Influence On Dispatcher Access Of Trauma Recovery Resources, Ariel R. Place Jan 2021

Leadership Influence On Dispatcher Access Of Trauma Recovery Resources, Ariel R. Place

Walden Dissertations and Doctoral Studies

Emergency dispatchers experience duty-related trauma exposure that can lead to reduced work engagement, compromised employee health, and increased organizational costs. Leadership is crucial in providing guidance and support to first responders following traumatic events. This study’s purpose was to understand how one public service organization’s (PSO) leaders influence emergency dispatchers’ access to trauma-recovery resources. The Baldrige Excellence Framework provided the framework for this qualitative case study. Semi-structured interviews with the public service organization partner site (PSOPS) leaders were conducted and archival data and documents were reviewed and analyzed to gain a clearer picture of PSOPS leaders’ personal perspectives of and …

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The Lived Experience Of La Raza’S Membership In Lowrider Car Clubs: A Phenomenological Study, Elizabeth Ramos Jan 2021

The Lived Experience Of La Raza’S Membership In Lowrider Car Clubs: A Phenomenological Study, Elizabeth Ramos

Walden Dissertations and Doctoral Studies

Lowriding is a cultural practice that has become a way of life among some Raza or individuals of Mexican descent. However, the literature lacks an understanding of these individuals and what has influenced their participation in car clubs. The purpose of this phenomenological study is to explore the lived experience of Raza, who are members of lowrider car clubs. The theoretical frameworks were Erikson’s identity development theory, social identity theory, and Hofstede’s cultural dimensions theory. These guided this qualitative study to answer the following research questions: How Raza described their lived experience as members of a lowrider car club and …

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Mental Health Disparities In Social Work Practice Of Minority Youth Offenders, Beverly Ann Rivera Jan 2021

Mental Health Disparities In Social Work Practice Of Minority Youth Offenders, Beverly Ann Rivera

Walden Dissertations and Doctoral Studies

AbstractA large number of minority youths placed in the juvenile justice system across the United States have mental health disorders. Most of these youths do not receive mental health services or support within the system, which increases risk factors such as undiagnosed and untreated mental illness and adverse outcomes such as recidivism. This action research sought to uncover whether mental health disparities in social work practice in the juvenile justice system were due to race and ethnicity and asked social workers to recommend strategies to improve mental health availability, access, and provision. Participants in the study were social workers who …

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Parental Stress And Coping In U.S. And Caribbean Immigrant Parents Of Adolescents, Simone A. Wright Jan 2021

Parental Stress And Coping In U.S. And Caribbean Immigrant Parents Of Adolescents, Simone A. Wright

Walden Dissertations and Doctoral Studies

The immigrant population in the U.S. is growing, and the way immigrants cope with the stress of parenting may differ from parents in their host country. There is a gap in the literature regarding knowledge about how Caribbean parents cope with parenting stress compared to U.S. parents. The purpose of this quasi-experimental quantitative study was to predict coping strategies used by Caribbean immigrant and U.S.-born parents of adolescents living in the U.S based on country of origin using transactional stress and coping theory as frameworks. Thirty-seven U.S.-born and 37 Caribbean-born caregivers living in the U.S. were recruited from social media …

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The Impact Of Far-Right Groups On The Lives Of Latinas/Os In Gwinnett County Georgia, Collins Uhuangho Jan 2021

The Impact Of Far-Right Groups On The Lives Of Latinas/Os In Gwinnett County Georgia, Collins Uhuangho

Walden Dissertations and Doctoral Studies

AbstractThe research problem that this study sought to address was the effects of far-right groups on the lives of Latinas/os. The research problem is important as far-right groups can spread racism- and violence-related propaganda and assault, insult, and racially discriminate against minorities and immigrants, which likely negatively impacts the lives of the victimized individuals. The purpose of the study was to explore how the Latina/o population living in the County are impacted by far-right groups in Gwinnett County, Georgia. The main research question was: To what extent are Latinas/os living in Gwinnett County, Georgia, affected by the presence of racism- …

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Parent Practices In Homeschooling Children With Autism Spectrum Disorder Who Demonstrate Problem Behaviors, Cymantha Jewel Channey-White Jan 2021

Parent Practices In Homeschooling Children With Autism Spectrum Disorder Who Demonstrate Problem Behaviors, Cymantha Jewel Channey-White

Walden Dissertations and Doctoral Studies

AbstractThere is a gap in literature regarding parent practices in homeschooling children with autism spectrum disorder (ASD) who demonstrate problem behaviors during instructional sessions. Research literature showed that children with ASD demonstrate problem behaviors during instructional sessions in educational environments. The problem is a gap in the literature regarding how parents who homeschool their students with ASD address the same behaviors. The conceptual framework—social learning theory. The research questions were focused on parent practices of managing problem behavior during homeschool instructional sessions and the support they received. Qualitative research was used to explore the experiences of homeschool parent practices in …

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Correlation Between Therapeutic Outcomes And Acculturation For Hispanic Veterans With Posttraumatic Stress Disorder, Laura H. Hernandez Jan 2021

Correlation Between Therapeutic Outcomes And Acculturation For Hispanic Veterans With Posttraumatic Stress Disorder, Laura H. Hernandez

Walden Dissertations and Doctoral Studies

AbstractHispanic veterans returning from the wars in Iraq and Afghanistan have a higher prevalence of posttraumatic stress disorder (PTSD) than veterans of other ethnicities, and yet little research is devoted to examining this discrepancy. The purpose of this quantitative study, framed by Leininger’s cultural care theory, was to examine self-identified outcomes of three treatment modes and how they correlate with acculturation for Hispanic veterans diagnosed with PTSD at outpatient clinics and community outreach agencies. Independent variables were individual and group behavioral therapy, or a combination of both. Dependent variables of PTSD and well-being scores and level of acculturation were examined …

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Intersectionality And Community-Based Counseling: Experience Of African American Female Sexual Minority Youth, Lauren Smith Jan 2021

Intersectionality And Community-Based Counseling: Experience Of African American Female Sexual Minority Youth, Lauren Smith

Walden Dissertations and Doctoral Studies

The social problem examined in this qualitative analysis is the limited available knowledge on the experience of ethnic minorities who are also sexual minority youth. Sexual minority youth are at increased risk of experiencing mental health disparities compared to their heterosexual peers. Due to the increased risk for psychosocial stressors such as substance use, suicidal ideation, suicidal attempts, homelessness, and trauma, clinicians should be aware of the intersectionality of identifying as a sexual minority youth who is also an ethnic minority. The purpose of this qualitative study was to understand the experiences of African American sexual minority female youth ages …

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Social Support Experiences Of Stably Housed Emancipated Foster Youth, Camron L. Whitacre Jan 2021

Social Support Experiences Of Stably Housed Emancipated Foster Youth, Camron L. Whitacre

Walden Dissertations and Doctoral Studies

Youth emancipating from foster care are at increased risk of housing instability and homelessness and have reduced access to needed social supports to aid in the difficult transition to independent living. The purpose of this hermeneutic phenomenological study was to understand the lived formal social support experiences of stably housed emancipated foster youth. Purposive sampling techniques and inclusion criteria guided the recruitment of nine study participants from a state-administered postemancipation services program to take part in semistructured interviews. A conceptual framework, including social convoy and attachment theories, informed inquiry, and interpretation of findings. Participant lived experiences illuminated the importance of …

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Haitian Immigrant Parents’ Perceptions On Acculturation And High-Risk Behaviors Among Their Children, Weiselande Cesar Jan 2021

Haitian Immigrant Parents’ Perceptions On Acculturation And High-Risk Behaviors Among Their Children, Weiselande Cesar

Walden Dissertations and Doctoral Studies

Immigrant Haitian parents experience acculturative stress when adjusting to the norms and expectations of a new country. Acculturative stress may be exacerbated if their adolescent children display unfamiliar behaviors, which may result in a greater need for psychological assessments and education programs to mitigate the instances of family breakdown. Following Haiti’s 2010 earthquake, there has been an increase in high-risk behaviors among Haitian adolescents. To date, there is limited research on acculturative stress in immigrant Haitian parents and how this stress may relate to their actions and perceptions of high-risk behaviors in their adolescent children. In this case study date …

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Retired Military Officers’ Length Of Service And Loss Of Social Identity In Second Careers, Moriah Elizabeth Thomas Jan 2021

Retired Military Officers’ Length Of Service And Loss Of Social Identity In Second Careers, Moriah Elizabeth Thomas

Walden Dissertations and Doctoral Studies

Many past researchers have reported problematic issues and challenges with militarypersonnel transitioning to civilian life and to the civilian workplace. The purpose of this qualitative study was to explore the lived experiences of 20 retired military officers who had between 24 and 42 years of military service regarding how they may have experienced the losses of social identity and organizational socialization and how those losses may have impacted their second careers in civilian organizations. Data for this study were collected via semistructured interviews and the use of interview protocols. The conceptual framework consisted of a combination of social identity theory …

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Local Government Agencies Constraints With 5% Management Cost Allocation From Fema, Mike Lalbachan Jan 2021

Local Government Agencies Constraints With 5% Management Cost Allocation From Fema, Mike Lalbachan

Walden Dissertations and Doctoral Studies

Local government agencies have deviated from federal hazard mitigation contractual requirements despite been paid by the federal emergency management agency (FEMA) to accomplish these requirements. Noncompliance with meeting federal requirements can result in returning part or all the financial award to the federal government. The current literature does not address the causations of the deviations. The purpose of this case study research was to gain the perceptions from local government employees in the state of Florida that are managing the hurricane IRMA hazard mitigation grant program (HMGP) projects on the effectiveness of the 5% management costs allocation. The theoretical framework …

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The Relationship Between Cross-Cultural Psychological Capital And Organizational Commitment, Steven Andrew Snell Jan 2021

The Relationship Between Cross-Cultural Psychological Capital And Organizational Commitment, Steven Andrew Snell

Walden Dissertations and Doctoral Studies

For many organizations, the cultural demographics of the workforce reflect the growing diversity of the global workforce. Effective intercultural interactions require individuals to have several personal psychological resources, including cross-cultural psychological capital (PsyCap). Without such resources, employees may not have the ability to effectively work with individuals from other cultures, making working in these environments stressful. These stressful situations may negatively impact employee commitment levels, potentially increasing turnover rates. The purpose of this study was to explore the influence that employees’ cross-cultural PsyCap has on their organizational commitment (OC) as indicated by the three-component model of OC. To date, researchers …

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African American Blended Parent Strategies’ And The Influence On Children’S School Performance, Christine Li'chele' Moore Jan 2021

African American Blended Parent Strategies’ And The Influence On Children’S School Performance, Christine Li'chele' Moore

Walden Dissertations and Doctoral Studies

AbstractDue to increasing divorce rates, the number of Americans living in blended family households have increased over the decades. Studies have revealed that some school-aged children who experience family structural changes due to blending families may experience stress that negatively affects their school performance. The purpose of this study was to determine what strategies African American parents in blended family units used to lessen the impact of family structure change on their school-aged children’s school performance. Bowen’s family system’s theory was used to guide this research. A generic qualitative design was used to obtain data from eight participants residing in …

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Vicarious Traumatization And Vicarious Resilience In Mental Health Professionals: An Investigation Of Group Differences, Marie Demchak-Buotte Jan 2021

Vicarious Traumatization And Vicarious Resilience In Mental Health Professionals: An Investigation Of Group Differences, Marie Demchak-Buotte

Walden Dissertations and Doctoral Studies

AbstractThe purpose of this study was to investigate individual differences between mental health professionals with varied levels of clinical experience and their personal levels of vicarious trauma (VT) and vicarious resilience (VR) as measured by the Secondary Traumatic Stress Scale (STSS) and the Connor-Davidson Resilience Scale (CD-RISC), respectively. A sample of 161 mental health professionals in New York State completed the scales and separate one-way between-subjects ANOVA tests examined the relationship between variables. A test for the moderating effect of the percentage of trauma clients on the clinician’s caseloads was also conducted between experience level of the clinician and their …

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Strategies To Expand And Obtain Funding For Nonprofit Organizations, Topaz Lonia Walton-Good Jan 2021

Strategies To Expand And Obtain Funding For Nonprofit Organizations, Topaz Lonia Walton-Good

Walden Dissertations and Doctoral Studies

Expanding a nonprofit organization (NPO) can be beneficial to the community; however, such expansion comes with challenges, including finding ways to obtain additional funding and understanding which additional services to provide. A single-case study was conducted to explore the challenges facing a nonprofit behavioral health organization as it seeks to obtain funding to expand current services and identify new services for underserved communities. Data were collected through interviews with the behavioral health leader (BHL) and five staff members using the Baldrige excellence framework. Five themes emerged from the data analysis: access, programs, services, funding, workforce, and leadership. Although leadership was …

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Exploring Postsurgical Decision Attitudes Among Young Women Electing Hysterectomy, Mary Esther Webb-Tafoya Jan 2021

Exploring Postsurgical Decision Attitudes Among Young Women Electing Hysterectomy, Mary Esther Webb-Tafoya

Walden Dissertations and Doctoral Studies

Over half a million women undergo a hysterectomy procedure for reproductive issues each year. For over a decade, researchers have explored the impact of a hysterectomy on women over age 35 with a diagnosis of malignancy. Much less is known on the impact of an elected hysterectomy over alternative treatments for younger women with benign reproductive issues. The purpose of this study was to understand women’s postsurgical attitude towards an elected hysterectomy. A qualitative phenomenological design was used with purposive sampling to interview 15 women between 18-40 years of age who had a hysterectomy for a benign reproductive issue using …

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Delinquent Behavior And Recidivism Among Juveniles In The Southeastern United States, Anthony Bernard Essix Jr. Jan 2021

Delinquent Behavior And Recidivism Among Juveniles In The Southeastern United States, Anthony Bernard Essix Jr.

Walden Dissertations and Doctoral Studies

In the United States, juvenile delinquent behavior has continued to rise despite attempts by the legal system and policymakers. Much of the research contributing to the understanding of juvenile delinquency and recidivism has been focused on risk factors believed to push an individual to show signs of delinquency. Limited research has been conducted to explain how policies affect juvenile behaviors. The current study examined risk factors that contribute to juvenile delinquency to determine if a factor may have been overlooked in prior juvenile studies. Based on anomie and strain theory, a qualitative method of general inquiry was used to gain …

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Working With Sexually Violent Persons: Grit, The Supervisory Working Alliance, And Burnout, Stalina Harris Jan 2021

Working With Sexually Violent Persons: Grit, The Supervisory Working Alliance, And Burnout, Stalina Harris

Walden Dissertations and Doctoral Studies

Clinicians who work with sexually violent persons (SVPs) are faced with various problems related to the nature of their job duties, job settings, and the specificity of the population they serve. Although researchers have investigated the phenomenon of burnout extensively over the last decade, research focusing on burnout among counselors who work with SVPs is insufficient. The purpose of this quantitative comparative survey study was to investigate differences in burnout among clinicians working with SVPs by examining their grit, the supervisory working alliance, and job settings. The Grit Short Scale (Grit-S), the Supervisory Working Alliance Inventory—Trainee version (SWAI-T), and the …

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Relationship Between Wellness, Resilience, And Vicarious Trauma Among Clinical Mental Health Counselors Serving Interpersonal Violence Survivors, Elizabeth O'Neill Hunter Jan 2021

Relationship Between Wellness, Resilience, And Vicarious Trauma Among Clinical Mental Health Counselors Serving Interpersonal Violence Survivors, Elizabeth O'Neill Hunter

Walden Dissertations and Doctoral Studies

Interpersonal violence (IPV) can result in the traumatization of primary survivors, as well as the mental health professionals who support them, which is referred to as vicarious trauma (VT). VT is an occupational hazard that if unaddressed can lead to significant personal and professional disruption. Clinical mental health counselors (CMHCs) who provide counseling services to IPV survivors are at increased risk of integrating the traumatic session content into their worldview. VT can lead to psychological distress including symptoms of post-traumatic stress disorder and can threaten the quality and ethical nature of the counseling relationship. The purpose of this quantitative survey …

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Perceptions Of Help-Seeking Experiences Among Female Veteran Survivors Of Military Sexual Assault, Hiza Jackson-Price Jan 2021

Perceptions Of Help-Seeking Experiences Among Female Veteran Survivors Of Military Sexual Assault, Hiza Jackson-Price

Walden Dissertations and Doctoral Studies

AbstractThe numerous obstacles that female military sexual assault (MSA) survivors face after discharge from military service are well documented in research. However, there is a need for qualitative studies regarding perceptions of female veterans’ help-seeking experiences in disclosing MSA to understand how to encourage them to seek help and provide it for them when they do seek help. Based on this scarcity of knowledge, this study aimed to provide a voice to this population as well as provide results that can be used to aid this population. A social constructionist perspective, which postulates that knowledge and experience are constructed by …

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Sociodemographic And Psychosocial Factors And Wellbeing Among Adults 65 And Older In England, Dainelle Clark Jan 2021

Sociodemographic And Psychosocial Factors And Wellbeing Among Adults 65 And Older In England, Dainelle Clark

Walden Dissertations and Doctoral Studies

The increased number of older adults living longer parallels with the growth of public health concerns regarding the impact of sociodemographic and psychosocial factors (e.g., loneliness and social isolation) on older adults' wellbeing. The purpose of this quantitative study was to examine the association between loneliness, social isolation, the combined model of loneliness, and social isolation on wellbeing among older adults when accounting for age, gender, ethnicity, and social support. The socioecological model (SEM) was used to evaluate the multiple levels of environmental determinants for loneliness, social isolation, and wellbeing. The target population included older adults 65 years and older …

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Resilience As A Moderator Between Food And Housing Insecurity And Mental Distress, Denise Mchugh Loggie Jan 2021

Resilience As A Moderator Between Food And Housing Insecurity And Mental Distress, Denise Mchugh Loggie

Walden Dissertations and Doctoral Studies

The prevalence of food insecurity (FI) and housing insecurity (HI) in college students has increased over the last decade along with an associated increase in mental health problems. Studies show significant increases in many markers for mental distress in this population including a higher prevalence of mood disorders, non-lethal self-harm, and attempted and completed suicides, particularly over the last decade. Compounding these challenges is the low level of resilience found in college-age young adults, potentially limiting their ability to cope with and recover from the hardship of FI and HI. This quantitative study, guided by resilience theory and Maslow’s hierarchy …

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Medical Brain Drain And Its Effect On The Nigerian Healthcare Sector, Oluwakemi Osigbesan Jan 2021

Medical Brain Drain And Its Effect On The Nigerian Healthcare Sector, Oluwakemi Osigbesan

Walden Dissertations and Doctoral Studies

Nigeria suffers from a huge brain drain issue across different sectors, particularly in the healthcare sector. The WHO assessed that there is a current shortage of 2.8 million physicians in the world A heuristic phenomenological method was used in this study to explore the lived experiences of 12 Nigerian healthcare practitioners that migrated to the United States. The push-pull theory served as the theoretical framework that grounded this study. The central research questions for this study focused primarily on the reasons healthcare practitioners are leaving Nigeria and what the impact of those decisions have on the Nigerian healthcare sector. Qualitative …

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Nonprofit Employees’ Responsibility To Provide Ethical Solutions To Prevent Workplace Bullying, Tionette M. Burton Jan 2021

Nonprofit Employees’ Responsibility To Provide Ethical Solutions To Prevent Workplace Bullying, Tionette M. Burton

Walden Dissertations and Doctoral Studies

AbstractWorkplace bullying is not illegal in the United States and is not classified with other forms of harassment, making it hard for organizations to adopt appropriate prevention and solution methods. Human resource employees have been identified as key contributors in preventing workplace bullying in organizations by using ethics-based strategies. The purpose of this case study was to explore the perceptions of human resource employees or employees with human resource duties regarding their responsibility to use duty-based ethical approaches to prevent workplace bullying and the practicality of its implementation. Duty-based ethics formed the theoretical approach for this study. Duty-based ethics, founded …

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Counselor-In-Training Self-Efficacy When Working With Transgender And Gender Non-Conforming Clients, Thomas John Hegblom Jan 2021

Counselor-In-Training Self-Efficacy When Working With Transgender And Gender Non-Conforming Clients, Thomas John Hegblom

Walden Dissertations and Doctoral Studies

Researchers highlighted a significant void in existing literature surrounding the preparation of counselors working with the transgender and gender non-conforming (TGNC) population. The problem addressed is the limited understanding of self-efficacy counselors-in-training (CIT) possess while working with TGNC clients. The purpose of this quantitative study rooted in self-efficacy theory was to examine the relationship between three independent variables: (a) the cumulative time the participant spent as a CIT, (b) the amount of training the CIT received specific to transcompetent counseling practices, and (c) a CIT’s competency in delivering transcompetent counseling, and the dependent variable: a CIT’s self-efficacy in providing transcompetent …

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