Multidimensional Leadership Strategies to Reduce African American Health disparities: A Grounded Theory Study

Multidimensional Leadership Strategies to Reduce African American Health disparities: A Grounded Theory Study

Author: 
Myrna L. Jenkins
Program of study: 
D.M.
Abstract: 
The purpose of the qualitative grounded research study was to explore the potentialities of deploying multidimensional leadership strategies to reduce African American health disparities. Research encompassed a qualitative examination of the intricacies of the African American healthcare system within Washington, DC. The study included 11 African American healthcare recipients and 12 healthcare providers to acquire data and an understanding concerning health disparities, quality of care, healthcare access, leadership, healthcare reform, availability of services, and change processes. Research methods included: (a) qualitative written surveys, (b) semi-structured interviews, (c) pilot studies, and (d) a five-step grounded theory research approach. Subsequent findings from the surveys, interviews, pilot studies, and the qualitative grounded theory processes were incorporated within the study. The research findings revealed eight, significant, emerging themes derived from the healthcare providers, and the African American participants. The study indicated the need to advance social services within the community, increase patient education, improve healthcare access, advance universal health care, improve healthcare leadership, recruit healthcare providers, and elevate cultural competence. Results further indicated the subsequent need for more African Americans as healthcare providers within the historic black university (HBU) Family Medical Residency program. The generation of a grand theory from the multiple experiences of the healthcare providers and participants were based on the premise of the multidimensional physician-leader as a change agent. Multidimensional changes are accomplished by the physician-leader through the implementation of a multidimensional healthcare model, transformational processes, leadership strategies, technological advances, and quality management to diminish health disparities.
Dedication: 
The dissertation is dedicated to God in the Highest and to my Lord and Savior Jesus Christ for encouraging me to break through tribulations and embark on this doctoral journey. God’s consummate love, support, caring, and steadfast commitment helped me to achieve this momentous endeavor. I thank God and Jesus Christ, for being my intercessor, advocate, protector, provider, and friend, who helped me to relieve the heartache and pain by giving me solace to endure many midnights and many tears. I have learned many life lessons, which has made me stronger and wiser for having taken the doctoral journey. There were many mountains, adversities, sleepless nights, and revisions to overcome. Prayer, supplication, the support of angels of mercy, humanitarians, advocates, family, and devoted friends, and the championing spirits of the saints empowered me from the front lines and behind the scenes, which has made the dissertation possible. The doctoral pursuit has been a journey of truth and resolve. The experience has humbled me to become a consummate professional, a scholar, an awe-inspiring practitioner, and an exemplary quality leader. Faith in God, determination, and commitment to goals has given me the wherewithal to complete the refining process afforded through University of Phoenix’s quality facilitators and instructors. The facilitators’ valued insight and instruction brought to fruition the Chinese proverb, “If you are planning for a year, sow rice; if you are planning for a decade, plant trees; if you are planning for a lifetime, educate people” (Think Exist, 2012, p. 1).
Acknowledgements: 
“Strength and honor are her clothing: and she shall rejoice in time to come, she openeth her mouth with wisdom; and in her tongue is the law of kindness” (Proverbs 31:25-26). A meaningful and reflective doctoral journey is worth the expenditure of time, energy, and effort. The doctoral journey is best traveled with the support of family members, diligent humanitarians, caring advocates, compassionate proponents, and caring angels who have one’s best interest in mind. Special love goes to my children, Toiya, Antonio Christopher, and Troy for demonstrating patience and love while their mother pursued the dream of a lifetime in obtaining a doctoral degree. A path has been traveled, a course charted, and a foundation of wisdom laid as a legacy for them to follow. Total praise goes to my mother, father, sister, and a host of aunts, uncles, cousins, nieces, and nephews for many hours of prayers of support. My heart goes out to all the strong, bold, and positive women in the world who dared to dream, who overcame mountains of adversities, pursued aspirations, and are still forging destinies of a lifetime. Special thanks are conferred to the many wondrous people who spoke life, health, encouragement, and strength into my life. Acknowledgement, honor, and respect bestowed to my dissertation chair, Dr. Randall Medeiros, for being gallant in understanding many of my hardships, trials, and difficulties in completing the dissertation process. Everyone who was near and dear to me, truth be told, discounted my efforts. They believed I would never achieve my goals or amount to anything with the exception of my dissertation chair, committee members, spiritual leaders, humanitarians, advocates, luminaries, shining stellar team members, and angels of mercy. I know a God, who is capable and able to provide for all my needs. Honor and glory is given to my Heavenly Father and to Dr. Medeiros, who has been a consummate force in my life, encouraging me to hold fast to my dreams. Respect and acknowledgement are conferred additionally to my committee members, Dr. Macharia Waruingi and Dr. Marsha Heck. Appreciation is given to Dr. Waruingi as an astute healthcare scholar and Dr. Heck, who recently joined the committee team as a valued and compassionate member. My wholehearted thanks go to my committee members, who offered me their significant wisdom, vision, perseverance, and knowledge in honing the proposal and dissertation. Supplementary recognition is given to Dr. Paul M. Connolly of Performance Programs for the use of three qualitative questions from the Survey of Leadership in Health Services™ (LHS). Complementary recognition is given additionally to Dr. Christine Crofton of the Agency for Healthcare Research and Quality for the use of the CAHPS® Health Plan, Clinician & Group Surveys. Special gratitude goes to a Washington, DC residential faith-based community health center and nonprofit health organization. Esteemed thankfulness goes specifically to Executive Director David Treadwell, Pastor James Lewis, Reverend David Howard, Social Work Director Shirley Johnson, and Administrative Assistants Robert Taylor and Ryan Simpson. They opened their hearts in assisting me regarding the doctoral forms and in recruiting research participants for interview sessions. Distinctive appreciation goes to the historically black university’s (HBU) College of Medicine’s Dr. Pam Carter-Nolan, DC PrimCare Director, and to Finie Hunter-Richardson, MPH, as the Practice-Based Research Network (PBRN) coordinator. They were extremely instrumental and in charge of the Department of Community and Family Medicine, Community Engagement and Research, Georgetown Howard Universities Center for Clinical and Translational Science. Their cooperation, collaboration, and assistance were greatly appreciated in the dissemination of the written qualitative survey to the HBU’s medical faculty and medical residents in the data collection. My sincere appreciation goes to HBU’s medical faculty and medical school residents for their cooperation in assisting me by volunteering their time in taking the written surveys. In the course of this doctoral journey, there came a significant point at the crossroads of my life when I had to realized who mattered, who never did, who will not matter anymore, and who always will. Therefore, I do not worry about people from my past; there is a distinct reason that they did not make it to my future. I truly believe in my heart of hearts that life is eternal, but love is immortal. Sustained faith in God delivered me from the naysayers and detractors as proof that all things are possible with God. The doctoral journey and the dissertation process were arduous accomplishments, but like any impassioned endeavor, it has made me stronger, wiser, and bolder. Supreme thanks are bestowed to Bishop T.D. Jakes and the exceptional congregational team who have inspired me to succeed despite tremendous odds, circumstances, many trials, and barriers to pursue purposive and positive goals in life, family, and love. I have planted seeds of love, compassion, truth, hope, and faithfulness to blossom as fruit in the fulfillment of this dream. Many have written their own stories and destinies. The accomplishment of the dissertation is a testament that God can truly use any woman, even me, for His glory.