Walden University College of Health Sciences This is to certify that the doctoral dissertation by Samuel N. Jacobs-Abbey has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Christopher Miller, Committee Chairperson, Health Services Faculty Dr. Kimberly Dixon-Lawson, Committee Member, Health Services Faculty Dr. Frederick Schulze, University Reviewer, Health Services Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2020