View All Items

Title: EFFECTS OF HEALTH INFORMATION TECHNOLOGY ADOPTION ON QUALITY OF CARE AND PATIENT SAFETY IN US ACUTE CARE HOSPITALS.
Creator: Seblega, Binyam, Zhang, Ning, University of Central Florida
Abstract / Description: The adoption of healthcare information technology (HIT) has been advocated by various groups as critical in addressing the growing crisis in the healthcare industry. Despite the plethora of evidence on the benefits of HIT, however, the healthcare industry lags behind many other economic sectors in the adoption of information technology. A significant number of healthcare providers still keep patient information on paper. With the recent trends of reimbursement reduction and rapid...
Show moreThe adoption of healthcare information technology (HIT) has been advocated by various groups as critical in addressing the growing crisis in the healthcare industry. Despite the plethora of evidence on the benefits of HIT, however, the healthcare industry lags behind many other economic sectors in the adoption of information technology. A significant number of healthcare providers still keep patient information on paper. With the recent trends of reimbursement reduction and rapid technological advances, therefore, it would be critical to understand differences in structural characteristics and healthcare performance between providers that do and that do not adopt HIT. This is accomplished in this research, first by identifying organizational and contextual factors associated with the adoption of HIT in US acute care hospitals and second by examining the relationships between the adoption of HIT and two important healthcare outcomes: patient safety and quality of care. After conducting literature a review, the structure-process-outcome model and diffusion of innovations theory were used to develop a conceptual framework. Hypotheses were developed and variables were selected based on the conceptual framework. Publicly available secondary data were obtained from the American Hospital Association (AHA), the Health Information and Management Systems Society (HIMSS), and the Healthcare Cost and Utilization Project (HCUP) databases. The information technologies were grouped into three clusters: clinical, administrative, and strategic decision making ITs. After the data from the three sources were cleaned and merged, regression models were built to identify organizational and contextual factors that affect HIT adoption and to determine the effects of HIT adoption on patient safety and quality of care. Most prior studies on HIT were restricted in scope as they primarily focused on a limited number of technologies, single healthcare outcomes, individual healthcare institutions, limited geographic locations, and/or small market segments. This limits the generalizability of the findings and makes it difficult to draw definitive conclusions. The new contribution of the present study lies in the fact that it uses nationally representative latest available data and it incorporates a large number of technologies and two risk adjusted healthcare outcomes. Large size and urban location were found to be the most influential hospital characteristics that positively affect information technology adoption. However, the adoption of HIT was not found to significantly affect hospitalsÃ‚Â' performance in terms of patient safety and quality of care measures. Perhaps a remarkable finding of this study is the better quality of care performance of hospitals in the Midwest, South, and West compared to hospitals in the Northeast despite the fact that the latter reported higher HIT adoption rates. In terms of theoretical implications, this study confirms that organizational and contextual factors (structure) affect adoption of information technology (process) which in turn affects healthcare outcomes (outcome), though not consistently, validating Avedis DonabedianÃ‚Â's structure-process-outcome model. In addition, diffusion of innovations theory links factors associated with resource abundance, access to information, and prestige with adoption of information technology. The present findings also confirm that hospitals with these attributes adopted more technologies. The methodological implication of this study is that the lack of a single common variable and uniformity of data among the data sources imply the need for standardization in data collection and preparation. In terms of policy implication, the findings in this study indicate that a significant number of hospitals are still reluctant to use clinical HIT. Thus, even though the passage of the American Recovery and Reinvestment Act (ARRA) of 2009 was a good stimulus, a more aggressive policy intervention from the government is warranted in order to direct the healthcare industry towards a better adoption of clinical HIT.
Show less
Date Issued: 2010
Identifier: CFE0003327, ucf:48445
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0003327

Title: Factors Influencing the Variability in Social Capital.
Creator: Downing, James, Wan, Thomas, Kapucu, Naim, Zhang, Ning, Ford, Robert, University of Central Florida
Abstract / Description: This research provides insights into three aspects of social capital: the factors that influence its variability; its two-dimensional nature; and the relationship between social capital and membership in a YMCA. These insights have implications for social capital theory, for public policy, for organizational management and for individual well-being. Most social capital research treats the construct as a causal variable and analyzes the implications of different levels of social capital for...
Show moreThis research provides insights into three aspects of social capital: the factors that influence its variability; its two-dimensional nature; and the relationship between social capital and membership in a YMCA. These insights have implications for social capital theory, for public policy, for organizational management and for individual well-being. Most social capital research treats the construct as a causal variable and analyzes the implications of different levels of social capital for certain aspects of individual and community well-being. This treatment implies that levels of social capital vary. Little research has been done to analyze the factors that cause social capital variability and therefore the understanding of social capital variability lacks insight. Before social capital variability can be explored, an intermediate issue must be addressed. Social capital is usually conceived of as a single-dimension construct. In fact social capital has two dimensions: the attitudes of social capital and the behaviors of social capital. Unidimensionality is sufficient when social capital is used exogenously but it is insufficiently nuanced when used for the purpose of recommending policies to increase it. This research analyzes the two-dimensional nature of social capital. Finally, a number of social capital behaviors have been studied but membership in the YMCA is not one of them. This research examines the relationship, ceteris paribus, between membership in the Central Florida YMCA and individual social capital.A survey questionnaire was mailed to 10,000 YMCA members in Central Florida and 21,000 residents who were demographically similar. There were 1,881 completed responses. The results were analyzed using structural equation modeling and were guided by social capital theory and the theory of reasoned action.ivThe results of the study indicate that the two most influential factors of social capital variability are personal educational attainment and the average educational attainment of the community. The study also confirms that social capital is a two-dimensional construct and the two dimensions are iterative. The study results also revealed that members of the Central Florida YMCA had higher levels of social capital ceteris paribus.This study is significant in four areas: social capital theory, public policy, management of social capital-generating organizations and for individuals. At the theoretical level, insight has been gained into both the causes of social capital variability and the two-dimensional nature of social capital. Regarding public policy, this research provides clear evidence that education provides a greater role in building a community than simply creating human capital; it also creates social capital. Both educational institutions and those organizations that create social capital should be supported. Furthermore, social capital promulgation through public policy should target both dimensions of social capital to be most effective. For managers of social capital-generating organizations social capital can be used as a metric for measuring organizational effectiveness and community impact. For individuals, there is now an evidence-based approach for developing a life plan for creating personal social capital. This research is unique because it simultaneously brings insights into four distinct spheres of social capital.
Show less
Date Issued: 2011
Identifier: CFE0004103, ucf:49085
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0004103

Title: Recidivism Measurement and Sanction Effectiveness in Youth Diversion Programs.
Creator: Maroney, Thomas, Wan, Thomas, Sanborn, Joseph, Wolf, Ross, Zhang, Ning, University of Central Florida
Abstract / Description: With the rapid growth of juvenile offender diversion programs, which use many non-traditional sanctions, the effectiveness of sanction combinations in juvenile diversion programs and in each individual program needs to be evaluated. Those making sanctioning decisions currently do so based on intuition rather than using an evidence- or theory-based approach. Considerable research has examined the relationship between offender risk factors and recidivism (who is more likely to reoffend?) and...
Show moreWith the rapid growth of juvenile offender diversion programs, which use many non-traditional sanctions, the effectiveness of sanction combinations in juvenile diversion programs and in each individual program needs to be evaluated. Those making sanctioning decisions currently do so based on intuition rather than using an evidence- or theory-based approach. Considerable research has examined the relationship between offender risk factors and recidivism (who is more likely to reoffend?) and between offender risk factors and sanctions (who is more likely to receive what sanctions?), but little is known about the relationship between sanctions and recidivism (which sanctions best reduce recidivism and for whom?). Furthermore, recidivism studies vary drastically in how they measure or quantify recidivism. This variability of approach makes comparing studies difficult and provides a less-than-complete picture of recidivism in general. The present study used data from one specific youth diversion program to test certain hypotheses of sanctioning by developing and testing a model for assigning sanction combinations to certain offenders on the basis of their individual characteristics. The study first developed measurement models for Offender Risk Propensity, Multiplicity of Sanctions, and Recidivism using structural equation modeling (SEM). Then predictive models were developed to test specific relationships. Understanding the effectiveness of certain sanction packages on certain offenders can form the basis for effective sanctioning in youth diversion programs. This study sought to answer three research questions: What is the best way to measure recidivism? Does completion of a restorative justice program reduce recidivism? Which sanctions, if any, reduce recidivism for specific offender types? To answer the first question: a multi-indicator latent construct of recidivism did a very good job of measuring variation in recidivism. Multiple indicators analyzed simultaneously produced a robust tool that can be used in other recidivism studies and help to reduce comparability issues between studies. The recidivism construct, when tested as a function of completion of the restorative justice program, was seen to produce a significant model having an overall good fit with the data. Thus to answer the second research question: offenders' completion status for the restorative justice program was shown to be a significant predictor of the latent construct of recidivism at the 0.05 level (two-tailed), with those who failed to complete (or chose not to participate) having higher recidivism than did those who completed the program. To answer the third research question: the assignment of specific sanctions (both those suggested by research and theory and those traditionally assigned by this and similar programs) on the entire data set (and on various subsets) of this study have no statistically significant impact on recidivism at the 0.05 level (two tailed).The findings suggest many policy implications. Consistency is all but nonexistent in recidivism measurements in the academic literature and in program review studies. A multi-indicator latent construct of recidivism, such as the one proposed and proven effective in this study, provides a more complete picture than simply conceptualizing recidivism by one dummy variable. This recidivism model can be used as the endogenous variable to evaluate programs and their practices and could reduce the problem of study comparability. This could lead to a better understanding of program characteristics and their impact on offender success. This study also found that completion of the Neighborhood Restorative Justice Program was a significant predictor of recidivism, yet none of the eleven most commonly assigned sanctions were seen to have a significant impact on recidivism for any subgroup. Proponents of restorative justice argue that it is the programs' characteristics and not their specific activities that make the programs successful. Reintegrative Shaming Theory and Labeling Theory support this claim and suggest the best approach to address youth criminal behavior is to admonish the act and not the actor, have the offender and community agree on a plan to make the community whole after that criminal act, and prevent repeated interaction with the formal criminal justice system which encourages the youth to see themself as a deviant and engage in further deviant behavior. These characteristics should be further examined and widely employed if confirmed.
Show less
Date Issued: 2012
Identifier: CFE0004406, ucf:49392
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0004406

Title: The Impact of Mobbing and Job-related Stress on Burnout and Health-related Quality of Life: The Case of Turkish Territorial State Representatives.
Creator: Yesilbas, Mehmet, Wan, Thomas, Dziegielewski, Sophia, Steen, Julie, Zhang, Ning, University of Central Florida
Abstract / Description: Job-related stress occurs as one of the most serious issues in modern era in developed nations. It has direct and negative effects on employees' productivity and it may have negative impacts on employees' health. One of the potential results of prolonged stressors at work place is burnout and this response may lead to physical, emotional, and psychological exhaustion that can occur at both individual and organizational levels. Burnout is a job related threat that provokes social stress and...
Show moreJob-related stress occurs as one of the most serious issues in modern era in developed nations. It has direct and negative effects on employees' productivity and it may have negative impacts on employees' health. One of the potential results of prolonged stressors at work place is burnout and this response may lead to physical, emotional, and psychological exhaustion that can occur at both individual and organizational levels. Burnout is a job related threat that provokes social stress and can directly affect an individual's health. Health-related quality of life (HRQoL) is commonly used to measure an individual's overall/global health and quality of life. Another serious issue, mobbing, usually leads to some individual and organizational complications. It affects the organizational commitment, motivation and efficiency of staff, job satisfaction of employee, and may lead to potential burnout of the employees. The primary objective of this study is to determine whether stress and mobbing are directly related to burnout; and, whether burnout leads to an adverse effect on the HRQoL of Turkish territorial state representatives (TSRs). This study examines four specific research questions: 1) Whether and to what extent do the levels of perceived job related stress and mobbing affect the level of perceived burnout syndrome of TSRs? 2) Whether and to what extent is the level of perceived burnout syndrome associated with HRQoL of TSRs? 3) To what extent does the level of perceived burnout mediate the effects of job-related stress on HRQoL of TSRs? 4) What are the mediating factors between job burnout and HRQoL? This study is expected to offer valuable and insightful information about the role of job burnout factors influencing the variability in TSRs' HRQoL.The study utilized two statistical analyses, which were descriptive analysis and Structural Equation Modelling (SEM) which allows for the assessment of the relationships specified in the hypotheses and the SEM was used to validate the theoretically driven model. The findings of the study supported the hypotheses of the study, which asserted that there were correlations between job-related stress and burnout, mobbing and burnout, and burnout and HRQoL. The CFA results established that job-related stress was positively and significantly associated with the burnout of TSRs, while perceived mobbing was positively and significantly related to the burnout of TSRs. Moreover, perceived HRQoL of TSRs was negatively associated with the burnout of TSRs. Further, the findings indicated that the relationship between job-related stress and burnout and the relationship between burnout and HRQoL of TSRs were statistically significant. Thus the variable had a positive effect on burnout and a negative effect on the HRQoL of TSRs. In summary, the findings of the study showed that results and propositions of the theoretical frameworks of the study and literature were consistent with one another.
Show less
Date Issued: 2015
Identifier: CFE0006236, ucf:51071
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0006236

Title: The Effect of the Great Recession on Local Goverment Policy in Florida.
Creator: Levey, Richard, Martin, Lawrence, Zhang, Ning, Lawther, Wendell, Hawkins, Christopher, University of Central Florida
Abstract / Description: The length and depth of the Great Recession of 2008 provides an opportunity to examine the policy behavior of local governments unlike any window since the 1930's post Depression era. Utilizing Peterson's (1981) City Limits typology as a framework for local government policy allows for an evaluation of whether or not the economic downturn caused local governments to change their relative expenditures between policy categories. The City Limits typology has been widely used in the literature to...
Show moreThe length and depth of the Great Recession of 2008 provides an opportunity to examine the policy behavior of local governments unlike any window since the 1930's post Depression era. Utilizing Peterson's (1981) City Limits typology as a framework for local government policy allows for an evaluation of whether or not the economic downturn caused local governments to change their relative expenditures between policy categories. The City Limits typology has been widely used in the literature to explain how expenditures define a local government's role in economic development. The typology has had limited use in a pre-post natural experimental research design to determine if a local government has 'shifted' policy priorities as measured by changes in expenditures among and between policy categories. This research design and the use Peterson's framework combine for a study that has not yet been conducted under similar conditions.Most of the existing literature, including the research from the 1980's, failed to account for inter-state differences that directly affect local government expenditures and policy. Concentrating solely on Florida local governments, this study eliminates the confounding nature of a national study and ensures that the unit of analysis is comparable for research purposes. The study utilizes actual expenditure data for all cities and counties in Florida from FY2006 through FY2011. The research tests for the relationships between changes in policy priorities from pre- to post-recession, and the type of government, form of government, and various socio-economic factors.The research contributes to a new body of knowledge that is just beginning to emerge in the literature about how local governments respond to periods of extreme fiscal stress. The findings suggest that cities and counties had an inverse response from pre- to post-recession with cities shifting toward developmental expenditures and counties prioritizing allocational spending. Differences were also found between forms of government. In addition, the density of population was found to contribute differently to shifts in expenditures for cities and counties. The study identifies emerging patterns that can help local governments understand past behavior and better anticipate future economic downturns.
Show less
Date Issued: 2015
Identifier: CFE0005971, ucf:50782
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0005971

Title: Jail Mental Health Innovations: Factors Influencing Mental Health Services Innovations for Jails.
Creator: Clayton, Orville, Wan, Thomas, Anderson, Kim, Winton, Mark, Zhang, Ning, University of Central Florida
Abstract / Description: ABSTRACTThe U.S. is recognized for uniquely high incarceration rates. Over recent decades, there has been a concurrent dramatic increase of jail detainees with mental disorders. Provision of adequate mental health services for jail inmates is constitutionally mandated, and has legal, ethical, quality of care, and fiscal implications for jails, families, communities, and detainees. Significant variation exists in the provision of mental health services across jails, and increased understanding...
Show moreABSTRACTThe U.S. is recognized for uniquely high incarceration rates. Over recent decades, there has been a concurrent dramatic increase of jail detainees with mental disorders. Provision of adequate mental health services for jail inmates is constitutionally mandated, and has legal, ethical, quality of care, and fiscal implications for jails, families, communities, and detainees. Significant variation exists in the provision of mental health services across jails, and increased understanding of the factors that influence the adoption of such services may help guide jails to implement beneficial services, and ensure that such services reflect, reflect quality standards. This study used a mixed methods strategy to examine the influence of theoretically determined variables on the adoption of jail mental health services, and the quality assessment of such services. Data was gathered by survey instrumentation, secondary data review, and in-depth interviews with jail leaders. The study found that isomorphism has a significant effect on the structural adequacy of jail mental health services, innovation characteristics have a negligible relationship to structural adequacy and process integrity, structural adequacy mediates the effects of isomorphism on process integrity, and jail size has a significant effect on structural adequacy. This study advances the knowledge base in its specification of the roles of internal, external, and demographic factors in the adoption of jail mental health services, and in the testing and application of Donabedian's healthcare model to assess the quality of such services.
Show less
Date Issued: 2017
Identifier: CFE0006866, ucf:51755
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0006866

Title: Tobacco Prevention and Cessation Policies and Youth Tobacco Use in Florida Public Schools.
Creator: Terry, Amanda, Zhang, Ning, Martin, Lawrence, Gammonley, Denise, Delnevo, Cristine, University of Central Florida
Abstract / Description: Tobacco use is the leading cause of preventable disease and premature death in the United States. In 2014, an estimated 16.8% of adults were current cigarette smokers, and 9.2% of high school students smoked cigarettes. Nearly 90% of smokers developed their habit as teenagers, and students' tobacco use in high school influences their behaviors later in adulthood. Smoking behaviors appear to be inseparable from the social environment, physical environment, small social groups, and cognitive...
Show moreTobacco use is the leading cause of preventable disease and premature death in the United States. In 2014, an estimated 16.8% of adults were current cigarette smokers, and 9.2% of high school students smoked cigarettes. Nearly 90% of smokers developed their habit as teenagers, and students' tobacco use in high school influences their behaviors later in adulthood. Smoking behaviors appear to be inseparable from the social environment, physical environment, small social groups, and cognitive and affective processes. Preventive strategies, such as advertising bans, clean indoor air laws, education programs, increased taxes, labeling limitations, mass-media campaigns, and youth access regulations, have been commonly used to prevent and reduce youth tobacco use nationwide. In Florida, local public school districts were authorized to develop new tobacco-free school policies through an amendment to the Florida Clean Indoor Air Act in June 2011. The purpose of this study was to determine the impact of the recently implemented smoking cessation policies, as well as individual-level factors and interpersonal-level factors, on youth tobacco use in Florida public schools. This study employed a pooled cross-sectional design with data for high school students from the Florida Youth Tobacco Survey (FYTS) in 2010 (n=37,797) and 2014 (n=32,930). It was guided by a theoretical framework based on the reasoned action approach and the social ecological model. Hierarchical logistic regression was used to analyze the data. The four models were binary logistic regression for cigarette use, multinomial logistic regression for cigarette use, binary logistic regression for cigar use, and multinomial logistic regression for cigar use. The results of this study support the importance of the individual-level constructs of background factors, behavioral beliefs, and control beliefs, the interpersonal-level construct of normative beliefs, and the policy-level construct of actual behavioral control when applied to youth tobacco use. These findings led to a better understanding of which policies, environments, and cognitions contribute to preventing and reducing teenage tobacco use, which is imperative in controlling the risks related to smoking and improving youth health. Now that the individual-level factors, interpersonal-level factors, and policy-level factors that contribute to youth tobacco use were recognized, preventative and therapeutic programs and interventions can be suggested and improved. This study provided evidence-based knowledge for improving public policies and interventional strategies towards smoking prevention and cessation for youth.
Show less
Date Issued: 2016
Identifier: CFE0006188, ucf:51128
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0006188

Title: Influence of Personal and State Level Variables on Perception of State Emergency Management Network Resilience In 47 States.
Creator: Jennison, Victoria, Wan, Thomas, Zhang, Ning, Ramirez, Bernardo, Kapucu, Naim, University of Central Florida
Abstract / Description: Emergency management coordination in the United States has fallen victim to over a century of strategies to organize, reorganize, consolidate, or decentralize disaster preparedness, planning and response. Regardless of the agency in charge at the federal level, individual citizens have been responsible for their own well-being immediately after any disaster or emergency event for more than 100 years because it takes time to mobilize and deliver aid. The system most often charged with managing...
Show moreEmergency management coordination in the United States has fallen victim to over a century of strategies to organize, reorganize, consolidate, or decentralize disaster preparedness, planning and response. Regardless of the agency in charge at the federal level, individual citizens have been responsible for their own well-being immediately after any disaster or emergency event for more than 100 years because it takes time to mobilize and deliver aid. The system most often charged with managing that mobilization during an emergency event that exceeds the response capacity of local public safety agencies is the state emergency management network. Many entities in a state emergency management network have different responsibilities during disaster states vs. non-disaster states. Regardless of their role and function, entities need to be able to exchange resources and information with each other, often under time, economic, or other constraints during disasters. This resource exchange generates trust, an essential element of a resilient network. Resilient networks suffer fewer negative impacts from disaster related loss and are more likely to retain collective capacity to respond and help communities recover.The purpose of this study is to explore the ability of individual and state level attributes to explain variability in perception of network resilience. One-hundred fifty one state emergency management agency employees were surveyed regarding their perception of 5 constructs of network resilience (rapidity, redundancy, relationships, resourcefulness, and robustness) and individual level attributes. State level indicators from FEMA, NEMA, American Human Development Index, and Social Vulnerability Index were also analyzed. Overall, it was found that the individual attribute of perception of network integrity had the most influence on perception of network resilience, followed by perception of community resilience and state level attributes including disaster experience, state well-being, and number of full time state emergency management agency employees. These findings can improve network resilience by informing state emergency management network development activity. Networks that increase member opportunities to develop relationships of resource and information exchange will increase their resilience. That increased network resilience impacts community resilience because, as Winston Churchill's wise words during World War II reconstruction advise, (")We shape our communities and then they shape us(").?
Show less
Date Issued: 2015
Identifier: CFE0005812, ucf:50040
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0005812

Title: The Relationship of State Political Instability and Economic Failure to Predatory Organized Crime in Multiple Nations: A Global Comparative Anaylsis.
Creator: Ruth, Terrance, Wan, Thomas, Zhang, Ning, Winton, Mark, Matusitz, Jonathan, University of Central Florida
Abstract / Description: ABSTRACTThis dissertation examines the relationship of political instability and economic failure to predatory organized crime in multiple nations. This is an important issue since each year the increase in predatory crime networks contributes to international economic failure, security risks, and the spread of organized crime. In an effort to understand the relationship between state failure and economic failure on the one hand, and organized crime on the other, this study will seek to...
Show moreABSTRACTThis dissertation examines the relationship of political instability and economic failure to predatory organized crime in multiple nations. This is an important issue since each year the increase in predatory crime networks contributes to international economic failure, security risks, and the spread of organized crime. In an effort to understand the relationship between state failure and economic failure on the one hand, and organized crime on the other, this study will seek to address three goals. First, the study tests the degree to which variables that imply economic failure and state failure correlate with predatory organized crime. Second, the study determines the extent of the relationship between the social and economic indicators and predatory organized crime in multiple nations. Third, the study examines the future implications of predatory organized crime predictor variables in the context of national strategies to eradicate or reduce organized crime.This study investigates the relationship in failed states between predatory crime groups and various economic and state stability indicators. In particular, this study examines the impact of seven predictor variables on the variation in Predatory Organized Crime in 122 countries. The findings suggest that the state failure hypothesis correctly articulates the failure of the state to offer key social goods such as security, stability, and justice, thereby producing an environment where crime groups assume state responsibilities. The findings also support the economic failure hypothesis that poor economic outcomes such as high unemployment, low SES, and a dependency on an underground economy encourage the development of criminal groups.The ultimate goal of this study is to assist policy makers, policy analysts, scholars, and officials at donor agencies and international financial institutions in establishing effective tools for identifying and removing predatory organized crime units. Analytical results provide general support to all hypotheses. Moreover, policy implications for predatory organized crime control in developing countries are discussed. The author's objective is to increase understanding of this issue and show the need for further research.
Show less
Date Issued: 2013
Identifier: CFE0005546, ucf:50296
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0005546

Title: Organizational Complexity, Emergency Management Plan Adequacy, and Nursing Home Resiliency: A Contingency Perspective.
Creator: Boyce, Cherie, Wan, Thomas, Zhang, Ning, Oetjen, Reid, Rivera, Fernando, Kapucu, Naim, University of Central Florida
Abstract / Description: Some social and organizational behavior scientists measure resiliency through anecdotal qualitative research, i.e. personality analyses and stories of life experience. Empirical evidence remains limited for identifying measurable indicators of resiliency. Therefore, a testable contingency model was needed to clarify resiliency factors pertinent to organizational performance. Two essential resiliency factors were: 1) a written plan and 2) affiliation with a disaster network.This contingency...
Show moreSome social and organizational behavior scientists measure resiliency through anecdotal qualitative research, i.e. personality analyses and stories of life experience. Empirical evidence remains limited for identifying measurable indicators of resiliency. Therefore, a testable contingency model was needed to clarify resiliency factors pertinent to organizational performance. Two essential resiliency factors were: 1) a written plan and 2) affiliation with a disaster network.This contingency study demonstrated a quantifiable, correlational effect between organizational complexity, disaster plan adequacy and organizational resiliency. The unit of analysis, the skilled nursing facility proved vulnerable, therefore justifying the need for a written emergency management plan and affiliation with a disaster network. The main purpose of this research was to verify the significance of emergency management plans within a contingency framework of complexity theory, resource dependency, systems theory, and network theory. Distinct sample moments quantified causal relationships between organizational complexity (A), plan adequacy (B) and resiliency (C). Primary and secondary research data were collected from within the context of public health and emergency management sectors within the State of Florida.
Show less
Date Issued: 2015
Identifier: CFE0005929, ucf:50842
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0005929

Title: Academic Performance among Homeless Students: Exploring Relationships of Socio-Economic and Demographic Variables.
Creator: Moore, Miriam, Bryer, Thomas, Zhang, Ning, Steen, Julie, Bai, Haiyan, University of Central Florida
Abstract / Description: This study examines homeless student academic performance, types of temporary housing used among the homeless, degree of stability or instability for families with school-aged children, child needs for academic success, the importance of parental involvement in a child's academic growth, and other known factors in relations to child student academic performance, with a focus on grade level and racial differences. A multiple linear regression model is used to test the hypotheses while...
Show moreThis study examines homeless student academic performance, types of temporary housing used among the homeless, degree of stability or instability for families with school-aged children, child needs for academic success, the importance of parental involvement in a child's academic growth, and other known factors in relations to child student academic performance, with a focus on grade level and racial differences. A multiple linear regression model is used to test the hypotheses while controlling confounding variables. Statistically significant relationships are reported between race and academic performance, and grade level and academic performance. Practical and policy implications are discussed, as well as limitations of the study and need for future research.
Show less
Date Issued: 2015
Identifier: CFE0005848, ucf:50910
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0005848

Title: The influence of perceived organizational support, perceived coworker support (&) debriefing on work-related compassion satisfaction, burnout, and secondary traumatic stress in Florida public safety personnel.
Creator: Miller, Anastasia, Unruh, Lynn, Zhang, Ning, Wharton, Tracy, Liu, Albert Xinliang, University of Central Florida
Abstract / Description: The purpose of this study was to examine the relationships between perceived organizational support, perceived coworker support, and debriefing on the one hand, and compassion satisfaction, burnout, and secondary traumatic stress on the other hand in Florida law enforcement, fire, emergency medical services, and dispatch public safety workers. In order to explore the relationships between these constructs, the research questions examined the relationships of the work environment of Florida...
Show moreThe purpose of this study was to examine the relationships between perceived organizational support, perceived coworker support, and debriefing on the one hand, and compassion satisfaction, burnout, and secondary traumatic stress on the other hand in Florida law enforcement, fire, emergency medical services, and dispatch public safety workers. In order to explore the relationships between these constructs, the research questions examined the relationships of the work environment of Florida public safety by administering surveys gauging perceived organizational support, perceived coworker support, psychological resilience, and debriefing activities that the personnel participate in. The Professional Quality of Life: Compassion Satisfaction and Compassion Fatigue Version 5 was also sent out to establish the self-reported levels of compassion satisfaction, burnout, and secondary traumatic stress. The study found that there were differences in the levels of compassion satisfaction, burnout, and secondary traumatic stress between the public safety fields. It also found that there was a positive relationship between the presence of perceived organizational support, perceived coworker support, psychological resilience, and debriefing activities on at least one of the constructs of compassion satisfaction, burnout, or secondary traumatic stress within the different public safety fields. This study furthers the literature by being the first study to compare the four different public safety fields in the state of Florida and with regards to those constructs.
Show less
Date Issued: 2016
Identifier: CFE0006357, ucf:51533
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0006357

Title: Variations in Health Services Utilization by Patients with Prostate Cancer.
Creator: McKee, Roberta, Wan, Thomas, Martin, Lawrence, Zhang, Ning, Sivo, Stephen, University of Central Florida
Abstract / Description: Among men living in the United States, prostate cancer is the second leading cause of cancer death, and, excluding skin cancers, it is the cancer diagnosed most frequently. While incidence and mortality rates have been declining, the American Cancer Society estimated that there were 220,800 men diagnosed with prostate cancer and more than 27,500 prostate cancer deaths in 2015. Various patient-level and community-level factors have been shown to influence the differential patterns of diagnosis...
Show moreAmong men living in the United States, prostate cancer is the second leading cause of cancer death, and, excluding skin cancers, it is the cancer diagnosed most frequently. While incidence and mortality rates have been declining, the American Cancer Society estimated that there were 220,800 men diagnosed with prostate cancer and more than 27,500 prostate cancer deaths in 2015. Various patient-level and community-level factors have been shown to influence the differential patterns of diagnosis, care, and outcomes for men with prostate cancer. Detailed information regarding the utilization of health services by prostate cancer patients, particularly those with higher propensity for health services use, could be used to inform efforts intended to improve the coordination and delivery of care to work towards the elimination of disparities. The purpose of the study is to facilitate a better understanding of the determinants of health services utilization by older males with prostate cancer in the United States by examining the relative influence and interaction effects of factors characterizing individual patients and their county of residence. Andersen's behavioral model of health services utilization is used as a framework to guide this study. A cross-sectional design is used to analyze administrative claims data from the 2008 Medicare Provider Analysis Review (MEDPAR) file (n=5,754). County-level data from Area Health Resources File (ARHF) are merged to include the community and contextual characteristics. American Hospital Association (AHA) annual survey data are also used to examine the importance of hospital attributes in a subset analysis (n=555). A two-stage approach is used for analyzing the data. First, several social and demographic variables are included in automatic interaction detector (AID) analysis to identify relatively homogenous subgroups of patients with similar service utilization patterns for emergency room visits and hospital length of stay. Second, regression analysis is performed in the full dataset including all patients, and in each subgroup to determine the amount of variance explained by predictor variables categorized as predisposing, enabling, and need-for-care factors. Hierarchical logistic regression is performed to analyze the variability in emergency room use, and hierarchical multiple regression is performed to analyze the variability in hospital length of stay. The results show that the need-for-care factors are dominant predictors of service use. However, the relative importance of the predictor variables varies by subgroups of prostate cancer patients identified in the initial AID analysis. The findings lend some support of the use of an integrated approach to examine the personal and social determinants of health services utilization by prostate cancer patients enrolled in the U.S. Medicare program. The theoretical framework and analytic approach employed in this study make it possible to obtain an in-depth understanding of the influential factors associated with emergency room use and length of stay for all-cause hospitalizations, which can be used to inform future research and efforts aimed at developing targeted interventions to improve the coordinated care and to reduce health disparities among Medicare beneficiaries with prostate cancer.
Show less
Date Issued: 2016
Identifier: CFE0006352, ucf:51523
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0006352

Title: Determinants of Health-related Quality of Life of Patients with End-stage Renal Disease.
Creator: Varghese, Shabu, Dziegielewski, Sophia, Burg, Mary Ann, Zhang, Ning, Jacinto, George, University of Central Florida
Abstract / Description: End-stage Renal Disease (ESRD) or Chronic Kidney Disease (CKD) constitutes a serious public health problem in the United States. According to the United States Renal Data System (USRDS), in 2013, Medicare spending alone accounts for $30.9 billion for the treatment-related expenses for ESRD. The purpose of this study was to examine the causal relationship of two important determinants, perceived social support and treatment adherence with health-related quality of life (HRQOL) of ESRD patients...
Show moreEnd-stage Renal Disease (ESRD) or Chronic Kidney Disease (CKD) constitutes a serious public health problem in the United States. According to the United States Renal Data System (USRDS), in 2013, Medicare spending alone accounts for $30.9 billion for the treatment-related expenses for ESRD. The purpose of this study was to examine the causal relationship of two important determinants, perceived social support and treatment adherence with health-related quality of life (HRQOL) of ESRD patients. Using the health belief model and Bandura's self-efficacy theory, the study explained the theoretical underpinnings of the causal relationships of the patient's perspectives of perceived social support and treatment adherence in predicting the HRQOL of ESRD patients. The study utilized a non-experimental research design and the statistical tool Structural Equation Modeling (SEM), in evaluating the causal relationships between the variables. With a convenience sample size of 413 ESRD patients from the Central West region of Florida, the findings of the study validated a statistically significant relationship between perceived social support and HRQOL as well as between perceived social support and treatment adherence in ESRD patients. However, the study didn't find any significant relationships between treatment adherence and HRQOL. The results of the study enhanced the body of knowledge relating to HRQOL of ESRD patients, provided foundation for interventions and policy formation in improving the HRQOL of patients with ESRD.
Show less
Date Issued: 2016
Identifier: CFE0006512, ucf:51366
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0006512

Title: Emergency Room Utilization Disparities among Older Adults Treated by Rural Health Clinics.
Creator: Bagwell, Matt, Wan, Thomas, Zhang, Ning, Ortiz, Judith, Hofler, Richard, Bushy, Angeline, University of Central Florida
Abstract / Description: Examining the persistence of disparities over time is an important obligation in terms of rectifying, maintaining, and improving community health and social well-being for all. This study analyzed the individual factors of (a) race/ ethnicity and (b) dual eligibility, as a proxy measure of socioeconomic status, as well as the environmental factor of (c) place of residence, and the organizational factor of (d) Rural Health Clinic (RHC) type on emergency room (ER) utilization of older adult...
Show moreExamining the persistence of disparities over time is an important obligation in terms of rectifying, maintaining, and improving community health and social well-being for all. This study analyzed the individual factors of (a) race/ ethnicity and (b) dual eligibility, as a proxy measure of socioeconomic status, as well as the environmental factor of (c) place of residence, and the organizational factor of (d) Rural Health Clinic (RHC) type on emergency room (ER) utilization of older adult Medicare patients treated by RHCs within the Department of Health and Human Services' (DHHS) Region 4. A prospective, multi-level, longitudinal design was employed to analyze potential health disparities or gaps that may exist among RHC Medicare beneficiary patients (+65) using longitudinal, mixed multilevel modeling in SPSS. The years of investigation were 2010 through 2012. R4 has continually lagged behind other Regions in the Nation in having higher Health Disparities and ER Utilization rates related to Race, Poverty, and Rural Isolation. A key question is: Do these disparities persist? This study's findings support that dual eligible RHC patients utilized ER services at higher rates than non-dual eligible, Medicare only RHC patients at: 77%, 80%, and 66%, in 2010, 2011, and 2012, respectively; and above the White reference group, Black RHC Medicare patients utilized ER services at higher rates of: 18%, 20%, and 34%, in 2010, 2011, and 2012, respectively. These findings support that dual Medicare and Medicaid eligibility, as a proxy measure of socioeconomic status, and race continue to influence higher rates of ER utilization in Region 4. In terms of health and utilization disparities, strikingly and persistently, as recent as 2012, Black, dual eligible RHC Medicare beneficiary patients age 65 and over are twice as likely to utilize ER services for health care than their more advantaged counterparts. Health care leaders and policymakers are seeking evidence-based performance measures as tools for detecting gaps in health care and using those subsequent findings as leverage to implement policy change for the purpose of increasing health care delivery performance system-wide while lowering health disparities across various patient populations. Toward that goal, communicating and disseminating the findings of this study contributes to the body of knowledge and enables policy leaders to better make decisions based on empirical evidence in order to strengthen the health care delivery system for older adults in diverse rural contexts. From a health and public affairs policy perspective, crafting in tandem targeted, top-down, population health and bottom-up, community interventions to curb poor health outcomes and high health care utilization would be in the public interest at-large within this region of the Southeastern United States.
Show less
Date Issued: 2016
Identifier: CFE0006259, ucf:51051
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0006259

Title: Family Dependency Drug Courts: An Empirical Test of Therapeutic Jurisprudence.
Creator: Lindsey-Mowery, Elizabeth, Reynolds, Kenneth, Surette, Raymond, Eastep, Mary, Winton, Mark, Zhang, Ning, University of Central Florida
Abstract / Description: The rise in cases of child abuse and neglect over the past two decades has overwhelmed the nation's dependency court and child welfare agencies. While multiple factors are associated with child abuse and neglect, it is indisputable that substance abuse plays a significant role. The families that come into the dependency system with substance abuse issues are substantially more difficult and challenging to serve. Consequently, the families experience low levels of reunification and high levels...
Show moreThe rise in cases of child abuse and neglect over the past two decades has overwhelmed the nation's dependency court and child welfare agencies. While multiple factors are associated with child abuse and neglect, it is indisputable that substance abuse plays a significant role. The families that come into the dependency system with substance abuse issues are substantially more difficult and challenging to serve. Consequently, the families experience low levels of reunification and high levels of child welfare recidivism. In response to the increase in dependency cases involving substance abuse and the inability of the traditional dependency courts (TDC) to handle these cases, Family Dependency Drug Courts (FDDC) were created.The study utilized Therapeutic Jurisprudence Theory to examine differences in child welfare outcomes between substance abusing individuals served in a traditional dependency court system versus the therapeutic jurisprudence driven Family Dependency Drug Court system. Logistic regression, ANOVA and Chi-square were performed on a non-random sample derived from court systems in two Central Florida counties to examine two child welfare outcomes, specifically reunification rates and child welfare recidivism.The findings indicate that substance using participants in the FDDC have much higher rates of reunification than comparable substance using participants processed through the traditional dependency court. Also, of the individuals who attended FDDC, those who graduated were reunified at a significantly higher rate than those that didn't graduate. In regards to child welfare recidivism within a one year time period, there was not a statistically significant difference when comparing the FDDC participants and the TDC participants. When comparing the FDDC participants who completed the program versus those that failed to complete the program, while the child welfare recidivism rates were not significantly different, there is some evidence that the participants that completed the FDDC program experience less child welfare recidivism than those that don't have the full experience of therapeutic jurisprudence. This research lends some support for both the FDDC program and the explanatory power of Therapeutic Jurisprudence Theory. Theoretical and policy implications, as well as further research, are proposed and discussed.
Show less
Date Issued: 2013
Identifier: CFE0005027, ucf:49983
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0005027

Title: Home Care Quality Effects of Remote Monitoring.
Creator: Williams, Cynthia, Wan, Thomas, Oetjen, Dawn, Burg, Mary Ann, Zhang, Ning, University of Central Florida
Abstract / Description: Despite concerted efforts to decrease costs and increase public health, the embattled U.S. health care system continues to struggle to alleviate these widespread issues. Because the problem of hospital utilizations among patients with heart failure is posited to increase as the population ages, innovative methodologies need to be explored to mitigate adverse events. Remote monitoring harnesses the strength of advanced information and communication technology to affect positive changes in...
Show moreDespite concerted efforts to decrease costs and increase public health, the embattled U.S. health care system continues to struggle to alleviate these widespread issues. Because the problem of hospital utilizations among patients with heart failure is posited to increase as the population ages, innovative methodologies need to be explored to mitigate adverse events. Remote monitoring harnesses the strength of advanced information and communication technology to affect positive changes in health care quality and cost. By reaching across geographical boundaries, remote monitoring may support increased access to less costly services and improve the quality of home health care.The purpose of the study was to examine the home care quality effects of remote monitoring technology in patients with heart failure and to provide an economic justification for its adoption and diffusion. It compared remote monitoring as a potential intervention strategy to a standard no-intervention group (without remote monitoring). Specifically, it analyzed remote monitoring as a viable strategy to decrease hospital readmissions and emergency department visits. It also compared the cost of remote monitoring against the current standard-of-care. The theoretical framework of Donabedian's Quality Model was used in the evaluation of remote monitoring. A retrospective posttest only, case control study design was used to test the degree which remote monitoring was effective in promoting health care quality (hospital readmissions and decreased emergency department visits). Retrospective chart reviews were performed using electronic medical records (EMR). Analysis of Variance, Path Analysis, Automatic Interaction Detector Analysis (Dtreg), and Cost Outcomes Ratio were used to test the hypotheses and validate the proposed theoretical model.No significant difference was noted in remote monitoring and usual care groups. Results suggested that remote monitoring does not statistically lead to a decrease in heart failure-related hospital readmissions and all-cause emergency department visits. Results of the cost ratio analysis suggested that there was no statistically significant difference in the net income between usual care and remote monitoring; however, data suggest that there were significant increases in cost and intensity of nursing utilization for the remote monitoring intervention. The Automatic Interaction Detector Analysis showed that the unfavorable results in hospital readmissions were due to a decrease in collaborative care and patient education prior to the recommendation for hospitalization. The role of nursing care, whether in hospital or community-based care, in heart failure management is critical to quality outcomes. As the field continues to consider the use of technology in health care, decision makers should think through the process of patient care such that preventable hospital readmissions are decreased and patients received quality care.
Show less
Date Issued: 2014
Identifier: CFE0005442, ucf:50383
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0005442

Title: The Effect of Health Education on Clinical and Self-Reported Outcomes of Diabetes in a Medical Practice.
Creator: Rav-Marathe, Karen, Wan, Thomas, Fottler, Myron, Matusitz, Jonathan, Zhang, Ning, March, Allan, University of Central Florida
Abstract / Description: A majority of diabetes self-management programs have been shown to improve knowledge, attitude, practice, and health care outcomes. However, in the literature the underlying causal mechanisms for the improvement attributable to health education have not been explored, especially, how diabetes educational intervention may affect diabetes care outcomes. The purpose of the present study was to identify the causal mechanisms responsible for improved knowledge, attitude, practice and outcomes, so...
Show moreA majority of diabetes self-management programs have been shown to improve knowledge, attitude, practice, and health care outcomes. However, in the literature the underlying causal mechanisms for the improvement attributable to health education have not been explored, especially, how diabetes educational intervention may affect diabetes care outcomes. The purpose of the present study was to identify the causal mechanisms responsible for improved knowledge, attitude, practice and outcomes, so that educational interventions can be tailored efficiently and effectively to patients who are most likely to benefit from self-care management. The study used the knowledge, attitude, practice and outcome (KAP-O) framework. The specific purpose of the study was to examine the causes of variation in the outcomes of glycated hemoglobin (A1C), low-density lipoprotein cholesterol (LDLC), functional capacity (FC), and poor perceived health (PPH).An experimental study with a randomized control trial design involving 141 participants was conducted. The experimental group (N = 87) and control group (N = 52) were comparable in terms of demographics and major diagnoses. The experimental group received diabetes education. The control and experimental groups received usual customary care. Knowledge, attitude, practice, functional capacity and poor perceived health were measured before and after intervention using reliable and valid instruments. The study used a tailored attitudinal instrument. Glycated hemoglobin (A1C) and low-density lipoprotein cholesterol (LDLC) were measured before and after intervention. Multiple analytic strategies were applied to examine the experimental data.The four outcome variables of (A1C), (LDLC), (FC), and (PPH) did not constitute one common factor measurement model for outcome evaluation. Results of the Independent sample t-test showed that health educational intervention directly improves knowledge about diabetes. The path analysis of panel regression showed that health educational intervention directly lowers glycated hemoglobin (A1C). The causal modeling of {(Exp_Status)-(K-T2)-(A-T2)-(P-T2)} model showed that health educational intervention also indirectly improves preventive practice via knowledge. The effect of attitude (A-T2) was greater than the effect of knowledge on preventive practice of self-care. The difference-in-differences analysis showed that difference in practice (DP) statistically significantly affects the difference in glycated hemoglobin (DA1C). The greater the preventive practice, the greater the lowering of glycated hemoglobin (A1C), indicating a better control of diabetes. The data from this experiment do not support a strong causal path of experimental effects on outcomes via knowledge, attitude, and practice of self-care.The study should be replicated using the KAP-O model in research based on multi-centers, multiple providers, and a diverse population of Type 2 diabetes patients. The study should assess outcomes more than four times over a period of one to two years to elicit the trajectory of change in outcome variables. Knowledge and attitude should be assessed at baseline and continuously improved for the duration of the study.?
Show less
Date Issued: 2014
Identifier: CFE0005541, ucf:50311
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0005541

burnout (2)	+ -
Constructivist Self-Development Theory (1)	+ -
Criminalization and mental illness (1)	+ -
Dependency Drug Court (1)	+ -
Donabedian Model (1)	+ -

Donabedian’s healthcare model (1)	+ -
EMS (1)	+ -
EMT (1)	+ -
Emergency Room Utilization (1)	+ -
Emergency medical services (1)	+ -
End-stage renal disease (ESRD) (1)	+ -
FCAT (1)	+ -
FLorida (1)	+ -
Failed States (1)	+ -
Family Dependency Drug Court (1)	+ -
Family Drug Court (1)	+ -
First responders (1)	+ -
Florida (1)	+ -
Globalization (1)	+ -
Great Recession (1)	+ -
HIT (1)	+ -
Health Disparities (1)	+ -
Heart Failure (1)	+ -
Homeless (1)	+ -
Identify causal mechanisms for improved knowledge (1)	+ -
Job-related stress (1)	+ -
Multilevel Modeling (1)	+ -
Older Adults (1)	+ -
Organized Crime (1)	+ -
Predatory Crime (1)	+ -

University of Central Florida (18)	+ -
Zhang, Ning (18)	+ -
Wan, Thomas (11)	+ -
Kapucu, Naim (3)	+ -
Martin, Lawrence (3)	+ -

Winton, Mark (3)	+ -
Burg, Mary Ann (2)	+ -
Dziegielewski, Sophia (2)	+ -
Matusitz, Jonathan (2)	+ -
Steen, Julie (2)	+ -
Anderson, Kim (1)	+ -
Bagwell, Matt (1)	+ -
Bai, Haiyan (1)	+ -
Boyce, Cherie (1)	+ -
Bryer, Thomas (1)	+ -
Bushy, Angeline (1)	+ -
Clayton, Orville (1)	+ -
Delnevo, Cristine (1)	+ -
Downing, James (1)	+ -
Eastep, Mary (1)	+ -
Ford, Robert (1)	+ -
Fottler, Myron (1)	+ -
Gammonley, Denise (1)	+ -
Hawkins, Christopher (1)	+ -
Hofler, Richard (1)	+ -
Jacinto, George (1)	+ -
Jennison, Victoria (1)	+ -
Lawther, Wendell (1)	+ -
Levey, Richard (1)	+ -
Lindsey-Mowery, Elizabeth (1)	+ -

Search In

Sort Results By:

Narrow results by:

Topical Subject

Collection

Type of Resource

Language

Creator

Format

Owner