Motivating customers to develop and maintain a relationship with pharmacists: an application of a Stages of Change Model

A consistent branch of research in health communication has been focused on the study of the pharmacist - patient relationship. In past decades, the pharmacist and his role in the health care setting has shifted from a product oriented approach, where the primary focus was the production and compound of medicines, to a more patient oriented approach, with main focus becoming the understanding and caring for clients and the problems they bring to their health care providers. As a consequence, research in the health communication field, with a focus on community pharmacy settings needs to examine strategies to get the pharmacist closer to the clients, developing a long – term relationship, and adopting a more patient- oriented information approach to move closer to the needs of the client. The main purpose of my doctoral thesis is to examine the pharmacist - client relationship focusing in particular on the attempt to integrate the Stages of Change Model (Prochaska and DiClemente, 1983), with two models currently in use to describe relationship development in the pharmacy context, in order to identify strategies that can support the pharmacists in building a relationship of loyalty with their clients in the future. I hypothesized that targeting health information according to the level of the relationship clients are in could produce the necessary loyalty to commit to the pharmacist and to enhance the long run acceptance and effectiveness of the health message. In particular, the empirical section is devoted to understanding how to produce the necessary loyalty that can lead to better future response for the therapeutic and health needs of the client. The hypothesis was tested in the context of Tessin pharmacist – client relationship by means of a three phase study: an explorative study, a descriptive study, and finally an intervention study. Using the data collected in the descriptive study, two models of relationship development were tested: one static and one dynamic. The static model treats the perceived relational benefits, relationship selling behaviours, perceived expertise and stages of change constructs as antecedents of trust. The dynamic model adds the Stages of Change moderating effect on perceived benefits, perceived expertise, perceived relationship selling behaviours, as antecedents of trust. In the dynamic model, trust is directly influenced by the perceived expertise of the pharmacist, relationship selling behaviours, and perceived relational benefits. The Stages of Change Model moderated the relationship between perceived relational benefits and trust, and approached significance in moderating the relationship between perceived expertise and trust. The moderated relationship influences the way to structure an intervention to increase client intention to frequent the pharmacy in the future: in particular, it suggests tailoring the message depending on the stage of the relationship. The analysis of the data shows that targeting health messages according to the level of client relationship (developmental stage/maintenance stage) and building the messages focusing on the variables most influential to the particular relationship stage should bring to a more “loyal client” in the future. Furthermore, results in the intervention study show that for people in the developmental stage, a targeted message, that is a message focused on relational benefits, was more effective than either no message, or a stage mismatched message

NASA/DOD Aerospace Knowledge Diffusion Research Project. Paper 24: A general approach to measuring the value of aerospace information products and services

This paper discusses the various approaches to measuring the value of information, first defining the meanings of information, economics of information, and value. It concludes that no general model of measuring the value of information is possible and that the usual approaches, such as cost/benefit equations, have very limited applications. It also concludes that in specific contexts with given goals for newly developed products and services or newly acquired information there is a basis for its objective valuation. The axioms and inputs for such a model are described and directions for further verification and analysis are proposed

An Empirical Comparison of Three Psychometric Measures of Adolescent Substance Use

Adolescent substance use is common and often accompanied by many negative consequences. The psychometric assessment of substance use, however, is highly varied and may misrepresent actual substance use. Given the importance of understanding adolescent substance use, this study examined three competing measurement models of substance use and their differential predictability of academic achievement and internalizing and externalizing symptomatology. Participants were drawn from the public-use Add Health data set (N = 5,857). The three measurement models were determined from seven items that assessed the lifetime use of cigarettes, chewing tobacco, alcohol, marijuana, cocaine, inhalants, and other illicit drugs. The first measurement model (lifetime use) grouped participants as abstainers (never used a drug) and users (used at least one drug). The second measurement model (proportion) refined substance users by accounting for the proportion of the seven drugs they endorsed. The final measurement model further refined substance users by creating factor scores through confirmatory factor analysis that allow each item to be differentially weighted as a function of severity. Nine separate regression analyses were estimated in which age, race, gender, and substance use measurement model predicted either academic achievement or externalizing or internalizing symptomatology. These analyses indicated that all three substance use measures were significant predictors of each outcome measure, but the proportion and factor score models accounted for substantially more of the variance within each model. These results suggest the proportion or factor score models would be better predictors of substance use, although the choice of model should be based on relevant theory.Bachelor of Scienc

NASA/DOD Aerospace Knowledge Diffusion Research Project. Paper 48: Valuing information in an interactive environment

Consideration effort has been devoted over the past 30 years to developing methods and means of assessing the value of information. Two approaches - value in exchange and value in use - dominate; however, neither approach enjoys much practical application because validation schema for decision-making is missing. The approaches fail to measure objectively the real costs of acquiring information and the real benefits that information will yield. Moreover, these approaches collectively fail to provide economic justification to build and/or continue to support an information product or service. In addition, the impact of Cyberspace adds a new dimension to the problem. A new paradigm is required to make economic sense in this revolutionary information environment. In previous work, the authors explored the various approaches to measuring the value of information and concluded that, in large measure, these methods were unworkable concepts and constructs. Instead, they proposed several axioms for valuing information. Most particularly they concluded that the 'value of information cannot be measured in the absence of a specific task, objective, or goal.' This paper builds on those axioms and describes under which circumstances information can be measured in objective and actionable terms. This paper also proposes a methodology for undertaking such measures and validating the results

Screenomics : a new approach for observing and studying individuals' digital lives

This study describes when and how adolescents engage with their fast-moving and dynamic digital environment as they go about their daily lives. We illustrate a new approach—screenomics—for capturing, visualizing, and analyzing screenomes, the record of individuals’ day-to-day digital experiences. Sample includes over 500,000 smartphone screenshots provided by four Latino/Hispanic youth, age 14 to 15 years, from low-income, racial/ethnic minority neighborhoods. Screenomes collected from smartphones for 1 to 3 months, as sequences of smartphone screenshots obtained every 5 seconds that the device is activated, are analyzed using computational machinery for processing images and text, machine learning algorithms, human labeling, and qualitative inquiry. Adolescents’ digital lives differ substantially across persons, days, hours, and minutes. Screenomes highlight the extent of switching among multiple applications, and how each adolescent is exposed to different content at different times for different durations—with apps, food-related content, and sentiment as illustrative examples. We propose that the screenome provides the fine granularity of data needed to study individuals’ digital lives, for testing existing theories about media use, and for generation of new theory about the interplay between digital media and development

Types of interventions targeting dietary, physical activity and weight-related outcomes among university students : a systematic review of systematic reviews

Belogianni, Katerina - ORCID 0000-0002-3634-7861 https://orcid.org/0000-0002-3634-7861Item previously deposited in Kingston University repository on 17 April 2019 at: http://eprints.kingston.ac.uk/id/eprint/43127Item not available in this repository.A plethora of studies aiming to improve dietary, physical activity (PA), and weight-related (WR) outcomes among university students have been implemented and summarized in a series of systematic reviews, with unclear conclusions regarding their effectiveness. This overview aims to identify systematic reviews and meta-analyses of studies aiming to improve health outcomes in university students, to assess their methodological quality, to identify the different types of interventions used and outcomes assessed, and to estimate their overall effect. Four electronic databases were searched until 19 March, 2018 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The identified reviews were described and their methodological quality was rated. The studies of reviews were investigated to identify the different types of interventions used and outcomes assessed. Effectiveness was assessed by measuring the overall number of improved outcomes out of the total number of outcomes reported. As a result, 8 reviews were identified targeting food sales (n = 2), dietary (n = 3), PA (n = 1), WR (n = 1), or all outcomes (n = 1). The methodological quality of the reviews was moderate (n = 5) to low (n = 3). In all, the reviews included 122 studies, of which 36 used an environmental, 51 a face-to-face, 30 an e-intervention, and 5 a combined approach. Environmental interventions improved a moderate number of food sales (32 of 61) and dietary intake (22 of 47) outcomes. Face-to-face interventions improved a high number of dietary cognitive outcomes (15 of 18), a moderate number of dietary intake (28 of 65) and WR (11 of 18) outcomes, and a low number of PA behavioral (22 of 69) and cognitive (2 of 14) outcomes. E-interventions improved a high number of dietary cognitive variables (11 of 16) but had a low effect (≤33%) on the other types of outcomes. In conclusion, face-to-face and e-interventions improved cognitive variables toward diet or PA but were less effective in changing actual behaviors. Environmental interventions favorably changed food sales. Face-to-face and e-interventions moderately affected WR outcomes. Future research should focus on long-term studies.http://dx.doi.org/10.1093/advances/nmz027inpressinpres

O Efeito da Sinalização de Qualidade no Contexto de Serviços

Signaling theory states that signals are firms’ actions that communicate information about the quality of a product. The main purpose of this research is to investigate the effect of signal quality in a service context, through the investigation of the signaling effects of price and responsiveness in a service context. Perceived behavior control, regarded as an individual's perception of the ability to perform a behavior, was proposed as a moderator between signaling variables and perceived quality. Two experimental studies with factorial and inter-subject designs were conducted in order to test the hypotheses formulated from the literature review. Results from both experiments show that signaling quality through price and responsiveness can affect perceived quality. The second experiment supports the hypothesis of perceived behavior control moderation between price as a signaling variable and perceived quality, but not between responsiveness and perceived quality. These results and their implications are discussed in the final section of the paper

Translating shared decision-making into health care clinical practices: Proof of concepts

Background: There is considerable interest today in shared decision-making (SDM), defined as a decision-making process jointly shared by patients and their health care provider. However, the data show that SDM has not been broadly adopted yet. Consequently, the main goal of this proposal is to bring together the resources and the expertise needed to develop an interdisciplinary and international research team on the implementation of SDM in clinical practice using a theory-based dyadic perspective. Methods: Participants include researchers from Canada, US, UK, and Netherlands, representing medicine, nursing, psychology, community health and epidemiology. In order to develop a collaborative research network that takes advantage of the expertise of the team members, the following research activities are planned: 1) establish networking and on-going communication through internet-based forum, conference calls, and a bi-weekly e-bulletin; 2) hold a two-day workshop with two key experts (one in theoretical underpinnings of behavioral change, and a second in dyadic data analysis), and invite all investigators to present their views on the challenges related to the implementation of SDM in clinical practices; 3) conduct a secondary analyses of existing dyadic datasets to ensure that discussion among team members is grounded in empirical data; 4) build capacity with involvement of graduate students in the workshop and online forum; and 5) elaborate a position paper and an international multi-site study protocol. Discussion: This study protocol aims to inform researchers, educators, and clinicians interested in improving their understanding of effective strategies to implement shared decision-making in clinical practice using a theory-based dyadic perspective