421 research outputs found

    Demographic and indication-specific characteristics have limited association with social network engagement: evidence from 24,954 members of four health care support groups

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    Background: Digital health social networks (DHSNs) are widespread, and the consensus is that they contribute to wellness by offering social support and knowledge sharing. The success of a DHSN is based on the number of participants and their consistent creation of externalities through the generation of new content. To promote network growth, it would be helpful to identify characteristics of superusers or actors who create value by generating positive network externalities. Objective: The aim of the study was to investigate the feasibility of developing predictive models that identify potential superusers in real time. This study examined associations between posting behavior, 4 demographic variables, and 20 indication-specific variables. Methods: Data were extracted from the custom structured query language (SQL) databases of 4 digital health behavior change interventions with DHSNs. Of these, 2 were designed to assist in the treatment of addictions (problem drinking and smoking cessation), and 2 for mental health (depressive disorder, panic disorder). To analyze posting behavior, 10 models were developed, and negative binomial regressions were conducted to examine associations between number of posts, and demographic and indication-specific variables. Results: The DHSNs varied in number of days active (3658-5210), number of registrants (5049-52,396), number of actors (1085-8452), and number of posts (16,231-521,997). In the sample, all 10 models had low R2 values (.013-.086) with limited statistically significant demographic and indication-specific variables. Conclusions: Very few variables were associated with social network engagement. Although some variables were statistically significant, they did not appear to be practically significant. Based on the large number of study participants, variation in DHSN theme, and extensive time-period, we did not find strong evidence that demographic characteristics or indication severity sufficiently explain the variability in number of posts per actor. Researchers should investigate alternative models that identify superusers or other individuals who create social network externalities

    Sociomateriality Implications of Software As a Service Adoption on IT-workers’ Roles and Changes in Organizational Routines of IT Systems Support

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    This paper aims to deepen our understanding on how sociomateriality practices influence IT workers’ roles and skill set requirements and changes to the organizational routines of IT systems support, when an organization migrates an on-premise IT system to a software as a service (SaaS) model. This conceptual paper is part of an ongoing study investigating organizations that migrated on-premise IT email systems to SaaS business models, such as Google Apps for Education (GAE) and Microsoft Office 365 systems, in New Zealand tertiary institutions. We present initial findings from interpretive case studies. The findings are, firstly, technological artifacts are entangled in sociomaterial practices, which change the way humans respond to the performative aspects of the organizational routines. Human and material agencies are interwoven in ways that reinforce or change existing routines. Secondly, materiality, virtual realm and spirit of the technology provide elementary levels at which human and material agencies entangle. Lastly, the elementary levels at which human and material entangle depends on the capabilities or skills set of an individual

    Punk is just a state of mind: Exploring what punk means to older punk women

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    What does punk mean to older punk women? And how are such understandings interwoven with experiences of ageing and gender? The complexity in defining punk has been noted and it has been suggested that this complexity in part results from punk’s dislike of being labelled/categorised. Drawing upon interviews with 22 self-identifying older punk women, this article considers how they conceived punk as ‘a state of mind’, exploring the four shared punk values seen to comprise this: DIY, subversion, political consciousness and community. An unpacking of these values in terms of what they might ‘look like’ and how they are put into action by the women highlights the considerable roles ageing and gender play

    Hiding Relations

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    The present vogue of ‘managing for development results’ is an expression of a historically dominant mode of thought in international aid – ‘substantialism’ – which sees the world primarily in terms of ‘entities’ such as ‘poverty’, ‘basic needs’, ‘rights’, ‘women’, or ‘results’. Another important mode of thought, ‘relationalism’ – in association more generally with ideas of process and complexity – appears to be absent in the thinking of aid institutions. Drawing on my own experiences of working with the UK Department for International Development (DFID), I illustrate how despite formally subscribing to the institution’s substantialist view of the world, some staff are ‘closet relationists’, behaving according to one mode of thought while officially framing their action in terms of the other, more orthodox mode. In so doing, they may be unwittingly keeping international aid sufficiently viable - by the apparent proof of the efficacy of results-based management - to enable the institution as a whole to maintain its substantialist imaginary

    Schools, teachers, and curriculum change: A balancing act?

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    Educational change is a fact of life for teachers across the world, as schools are subjected to constant and ubiquitous pressures to innovate. And, yet, many school practices remain remarkably persistent in the face of such innovation. This paradox of innovation without change is perplexing for policymakers and practitioners alike. This paper investigates the gap between policy and practice, between innovation and the changes in social practices that occur in response to such innovation. It draws upon empirical data from two case studies in Scotland — schools responding to new curriculum policy—exploring contrasting approaches to the management of innovation. One is a laissez faire approach, and the other a more directive managerial strategy. Through an analytical separation of culture, structure, and agency, derived from the social theory of Margaret Archer, the paper sheds light on the social processes that accompanied innovation in these two settings demonstrating how teacher culture and differing management styles impact upon externally initiated policy

    Credibility in Policy Expertise: The Function of Boundaries Between Research and Policy

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    As science becomes an increasingly crucial resource for addressing complex challenges in society, extensive demands are placed upon the researchers who produce it. Creating valuable expert knowledge that intervenes in policy or practice requires knowledge brokers to facilitate interactions at the boundary between research and policy. Yet, existing research lacks a compelling account of the ways in which brokerage is performed to gain credibility. Drawing on mixed-method analysis of twelve policy research settings, I outline a novel set of strategies for attaining symbolic power, whereby policy experts position themselves and others via conceptual distances drawn between the ‘world of ideas’ and the ‘world of policy and practice’. Disciplinary distance works to situate research as either disciplinary or undisciplinary, epistemic distance creates a boundary between complex specialist research and direct digestible outputs, temporal distance represents the separation of slow rigorous research and agile responsive analysis, and economic distance situates research as either pure and intrinsic or marketable and fundable. I develop a theoretical account that unpacks the boundaries between research communities and shows how these boundaries permit policy research actors to achieve various strategic aims.ESRC Future Research Leaders ES/N016319/1 Commonwealth Scholarship Commissio

    Understanding uptake of continuous quality improvement in Indigenous primary health care: lessons from a multi-site case study of the Audit and Best Practice for Chronic Disease project

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    <p>Abstract</p> <p>Background</p> <p>Experimentation with continuous quality improvement (CQI) processes is well underway in Indigenous Australian primary health care. To date, little research into how health organizations take up, support, and embed these complex innovations is available on which services can draw to inform implementation. In this paper, we examine the practices and processes in the policy and organisational contexts, and aim to explore the ways in which they interact to support and/or hinder services' participation in a large scale Indigenous primary health care CQI program.</p> <p>Methods</p> <p>We took a theory-driven approach, drawing on literature on the theory and effectiveness of CQI systems and the Greenhalgh diffusion of innovation framework. Data included routinely collected regional and service profile data; uptake of tools and progress through the first CQI cycle, and data collected quarterly from hub coordinators on their perceptions of barriers and enablers. A total of 48 interviews were also conducted with key people involved in the development, dissemination, and implementation of the Audit and Best Practice for Chronic Disease (ABCD) project. We compiled the various data, conducted thematic analyses, and developed an in-depth narrative account of the processes of uptake and diffusion into services.</p> <p>Results</p> <p>Uptake of CQI was a complex and messy process that happened in fits and starts, was often characterised by conflicts and tensions, and was iterative, reactive, and transformational. Despite initial enthusiasm, the mixed successes during the first cycle were associated with the interaction of features of the environment, the service, the quality improvement process, and the stakeholders, which operated to produce a set of circumstances that either inhibited or enabled the process of change. Organisations had different levels of capacity to mobilize resources that could shift the balance toward supporting implementation. Different forms of leadership and organisational linkages were critical to success. The Greenhalgh framework provided a useful starting point for investigation, but we believe it is more a descriptive than explanatory model. As such, it has limitations in the extent to which it could assist us in understanding the interactions of the practices and processes that we observed at different levels of the system.</p> <p>Summary</p> <p>Taking up CQI involved engaging multiple stakeholders in new relationships that could support services to construct shared meaning and purpose, operationalise key concepts and tools, and develop and embed new practices into services systems and routines. Promoting quality improvement requires a system approach and organization-wide commitment. At the organization level, a formal high-level mandate, leadership at all levels, and resources to support implementation are needed. At the broader system level, governance arrangements that can fulfil a number of policy objectives related to articulating the linkages between CQI and other aspects of the regulatory, financing, and performance frameworks within the health system would help define a role and vision for quality improvement.</p

    Machina ex Deus? From Distributed to Orchestrated Agency

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    In this chapter, the author draws on a historical case study of the Australian wine industry to explore variations in collective agency. The inductively derived process model illustrates the emergence of a new profession of scientific win- emaking, which unfolds in three phases. Each phase is characterized by a dis- tinct form of agency: distributed agency during the earliest phase, coordinated agency during later phases, and orchestrated agency during consolidation. In addition to exploring the temporal shifts in agency, the study includes a detailed analysis of the early stages of distributed agency, examining how col- lective agency is achieved in the absence of shared intentions
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