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Title: "THE IMPACT OF POLICY ON STUDENT SUCCESS IN SECONDARY ONLINE EDUCATION: A CASE STUDY OF FLORIDA VIRTUAL SCHOOL".
Creator: McPherson, Rhonda, Wan, Thomas, University of Central Florida
Abstract / Description: Florida Virtual School (FLVS) was established in 1997 as an online education alternative for the residents of Florida. The purpose of this study was to identify policy changes at the organizational, state, and federal levels that had the propensity to impact student success (as measured by student's final letter grade) at FLVS. In addition, this study identified which type of institutional isomporphic policy (coercive, mimetic, or normative) best classified major policy changes in the...
Show moreFlorida Virtual School (FLVS) was established in 1997 as an online education alternative for the residents of Florida. The purpose of this study was to identify policy changes at the organizational, state, and federal levels that had the propensity to impact student success (as measured by student's final letter grade) at FLVS. In addition, this study identified which type of institutional isomporphic policy (coercive, mimetic, or normative) best classified major policy changes in the organization from 1997-2007. The use of institutional theory as the guiding framework for this study proved to be beneficial and enabled the researcher to conclude which types of policy are the most effective in increasing student success in the secondary online education environment. This study utilized ANOVA and regression analysis to detect whether or not changes in policy at the organizational and federal level have a statistically significant impact on student success in the secondary online education environment. This study reveals that student success at FLVS is consistently decreasing and that the change is statistically significant. Regression analysis found that the policy changes at FLVS in this study explain some of the variance detected in the change in the mean, or GPA, of the school. This study found that both coercive and mimetic policies have a statistically significant impact on student success in the secondary online education environment as identified in the isomorphic mechanisms outlined in institutional theory. This study is important to the field of literature regarding secondary online education in that it opens the discussion regarding types of policy and the potential impact that policy changes have on student success in the secondary online education environment. In addition, this study serves as a framework upon which future studies can be conducted and are recommended in this study.
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Date Issued: 2008
Identifier: CFE0002423, ucf:47741
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0002423

Title: A Root Cause Analysis of the Barriers to Transparency among Physicians: A Systemic Perspective.
Creator: Perez, Bianca, Liberman, Aaron, Oetjen, Dawn, Wan, Thomas, Abel, Eileen, University of Central Florida
Abstract / Description: Transparency in healthcare relates to formally reporting medical errors and disclosing bad outcomes to patients and families. Unfortunately, most physicians are not in the habit of communicating transparently, as many studies have shown the existence of a large medical error information gap. Research also shows that creating a culture of transparency would mutually support patient safety and risk management goals by concomitantly reducing medical errors and alleviating the malpractice crisis....
Show moreTransparency in healthcare relates to formally reporting medical errors and disclosing bad outcomes to patients and families. Unfortunately, most physicians are not in the habit of communicating transparently, as many studies have shown the existence of a large medical error information gap. Research also shows that creating a culture of transparency would mutually support patient safety and risk management goals by concomitantly reducing medical errors and alleviating the malpractice crisis. Three predictor variables are used to represent the various dimensions of the context just described. Perfectionism represents the intrapersonal domain, socio-organizational climate represents the interpersonal and institutional domains, and medico-legal environment represents the societal domain. Chin and Benne's normative re-educative strategy provides theoretical support for the notion that successful organizational change hinges upon addressing the structural and cultural barriers displayed by individuals and groups.The Physician Transparency Questionnaire was completed by 270 physicians who were drawn from a multi-site healthcare organization in Central Florida. Structural equation modeling was used to determine whether perfectionism, socio-organizational climate, and medico-legal environment significantly predict two transparency outcomes, namely, error reporting transparency and provider-patient transparency. Perfectionism and socio-organizational climate were found to be statistically significant predictors. Collectively, these variables accounted for nearly half of the variance in each transparency outcome. Within socio-organizational climate, policies had the greatest influence on transparency, followed by immunity and professional norms. Multiple group analysis showed that the covariance model developed in this study generalizes across gender, medical specialty, and occupation. In addition, group means comparisons tests revealed a number of interesting trends in error reporting and disclosure practices that provide insights about the behavioral and cognitive psychology behind transparent communication: 1) Physicians are more inclined to engage in provider-patient transparency compared to error reporting transparency, 2) physicians are more inclined to report serious errors compared to less serious errors, and 3) physicians are more inclined to express sympathy for bad outcomes than they are to apologize for a preventable error or be honest about the details surrounding bad outcomes. These results suggest that change efforts would need to be directed at medical education curricula and health provider organizations to ensure that current and future generations of physicians replace the pursuit for perfectionism with the pursuit for excellence. Also, a number of institutional changes are recommended, such as clearly communicating transparency policies and guidelines, promoting professional norms that encourage learning from mistakes rather than an aversion to error, and reassuring physicians that reporting and disclosure activities will not compromise their reputation. From the perspective of patient safety advocates and risk managers, the results are heartening because they emphasize a key principle in quality improvement - i.e., small changes can yield big results. From an ethical standpoint, this research suggests that healthcare organizations can inhibit (or facilitate) the emergence of professional virtues. Thus, although organizations cannot make a physician become virtuous, it is within their power to create conditions that encourage the physician to practice certain virtues. With respect to leadership styles, this research finds that bottom-up, grassroots change efforts can elicit professional virtues, and that culture change in healthcare lies beyond the scope of the medico-legal system.
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Date Issued: 2011
Identifier: CFE0004153, ucf:49083
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0004153

Title: A study of EEG signature associated with Emotional and stress responses due to cyberbullying.
Creator: Alhujailli, Ashraf, Karwowski, Waldemar, Reinerman, Lauren, Hancock, Peter, Wan, Thomas, University of Central Florida
Abstract / Description: The human brain processes vital information regarding human feelings. Prior research has focused on the problems of underage bullying, workplace bullying, burnout, mobbing and, most recently, cyberbullying. Scholars have traditionally examined the adverse outcomes of cyberbullying using subjective measures of stress and emotion for decades. However, very few studies examined cyberbullying using objective measures like EEG. The main goal of this study was to explore the relationship between...
Show moreThe human brain processes vital information regarding human feelings. Prior research has focused on the problems of underage bullying, workplace bullying, burnout, mobbing and, most recently, cyberbullying. Scholars have traditionally examined the adverse outcomes of cyberbullying using subjective measures of stress and emotion for decades. However, very few studies examined cyberbullying using objective measures like EEG. The main goal of this study was to explore the relationship between the brain's EEG, expressed by the power spectral density, and emotions and stress due to two types of cyberbullying, specifically: 1) social exclusion, and 2) verbal harassment. This research also examined how cyberbullying factors of social interaction and publicity affect the emotional and stress responses. EEG data were collected from twenty-nine undergraduate students, aged 18-22, using 10/5 EEG system with 64 channels. Each cyberbullying experimental condition was treated as an independent study. The first study investigated the effects of social exclusion on EEG activity and the related emotional and stress factors while playing a virtual ball-tossing game known as cyberball. EEG results showed significant differences in alpha and beta power in the right posterior brain regions due to social exclusion. There were also significant differences in beta and gamma power in the left anterior brain regions due to social exclusion. The results suggest that EEG activity in the left anterior brain region may be important to identify social exclusion. The second study utilized a hypothetical scenario presented as impolite or complimentary online comments. EEG results showed marginally significant differences in gamma power at right- and left- anterior and midline brain regions due to verbal harassment. The results suggest that changes in gamma power at anterior brain regions might play an essential role in the processing of verbal harassment information. Self-reported measures confirmed that verbal harassment was more distressing than social exclusion.
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Date Issued: 2018
Identifier: CFE0006968, ucf:51628
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0006968

Title: A Study of Perceptions on Incident Response Exercises, Information Sharing, Situational Awareness, and Incident Response Planning in Power Grid Utilities.
Creator: Garmon, Joseph, Karwowski, Waldemar, Hancock, Peter, Elshennawy, Ahmad, Wan, Thomas, University of Central Florida
Abstract / Description: The power grid is facing increasing risks from a cybersecurity attack. Attacks that shut off electricity in Ukraine have already occurred, and successful compromises of the power grid that did not shut off electricity to customers have been privately disclosed in North America. The objective of this study is to identify how perceptions of various factors emphasized in the electric sector affect incident response planning. Methods used include a survey of 229 power grid personnel and the use...
Show moreThe power grid is facing increasing risks from a cybersecurity attack. Attacks that shut off electricity in Ukraine have already occurred, and successful compromises of the power grid that did not shut off electricity to customers have been privately disclosed in North America. The objective of this study is to identify how perceptions of various factors emphasized in the electric sector affect incident response planning. Methods used include a survey of 229 power grid personnel and the use of partial least squares structural equation modeling to identify causal relationships. This study reveals the relationships between perceptions by personnel responsible for cybersecurity, regarding incident response exercises, information sharing, and situational awareness, and incident response planning. The results confirm that the efforts by the industry on these topics have advanced planning for a potential attack.
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Date Issued: 2019
Identifier: CFE0007805, ucf:52349
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0007805

Title: An Ecological Analysis of Social and Economic Influences on Black and White Infant Mortality Risk In Orange County, FL.
Creator: Lopez-Littleton, Vanessa, Liberman, Aaron, Wan, Thomas, Wright, James, Lieberman, Leslie, University of Central Florida
Abstract / Description: Black health disparities are a salient public health issue with blacks in every socioeconomic level at a greater health disadvantage than their white counterparts. In particular, disparity in infant mortality rates between blacks and whites have widened in recent decades to differentials never before experienced in the United States. Social ecologists investigating the myriad of individual and environmental risk factors have failed to fully account for the persistent differential. This study...
Show moreBlack health disparities are a salient public health issue with blacks in every socioeconomic level at a greater health disadvantage than their white counterparts. In particular, disparity in infant mortality rates between blacks and whites have widened in recent decades to differentials never before experienced in the United States. Social ecologists investigating the myriad of individual and environmental risk factors have failed to fully account for the persistent differential. This study examines the relationships between individual and environmental influences on the health risk experienced by blacks, whites, as well as the differential between the two populations. This multi-level analysis was conducted using five-year aggregate data centering on the 2000 decennial census (1998 - 2002) as the most recent census data available. During the study period, the 193 census tracts in Orange County, Florida, experienced 504 infant deaths which included 242 black and 241 white infant deaths. Using the infant mortality target rate developed for Healthy People 2000 as the (")normal(") infant mortality rate, risk was calculated as the percentage of deviation from the (")normal("). A rate was also calculated to demonstrate the difference between black and white percent deviations from the (")normal("). Structural equation modeling was used to examine the relationship between socioeconomic influences (Socioeconomic Disadvantage), social risk factors (Social Disorganization), and behavioral risk factors (Poor Behavioral Choices) using a latent variable approach based on a conceptual model which integrated the social determinants of health framework and conflict theory. In this study, an inverse association was found between socioeconomic disadvantage and infant mortality risk for black infants. This finding is contradictory to the expected finding and may have been due to multicollinearity or the operationalization of the endogenous study variable for black infant mortality risk. Thus, this study highlights the complexity of unraveling the interrelationship between social and economic risk factors. The results of this study demonstrate the importance of the latent variable approach in public health research as well as the need to broaden the approach to selecting indicators. This study concludes with specific policy recommendations aimed at improving the health outcomes of vulnerable populations using the social determinants of health framework.
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Date Issued: 2011
Identifier: CFE0004129, ucf:49109
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0004129

Title: AN EVALUATION OF THE EFFECTS OF A LEISURE EDUCATION CURRICULUM ON DELINQUENTS' MOTIVATION, KNOWLEDGE, AND BEHAVIOR CHANGES RELATED TO BOREDOM.
Creator: Finn, Jr., Paul, Wan, Thomas, University of Central Florida
Abstract / Description: Adolescents today have more unsupervised and unstructured free time than ever before. Poor decisions by youth during periods of free time may lead to substance abuse, teen pregnancy and juvenile delinquency. The highest frequency of juvenile crime, a major social problem, occurs during the 2-4 hours following the end of the school day. Research has demonstrated the benefits of engaging adolecents in prosocial leisure activity. However, no research has studied the issues of free time and...
Show moreAdolescents today have more unsupervised and unstructured free time than ever before. Poor decisions by youth during periods of free time may lead to substance abuse, teen pregnancy and juvenile delinquency. The highest frequency of juvenile crime, a major social problem, occurs during the 2-4 hours following the end of the school day. Research has demonstrated the benefits of engaging adolecents in prosocial leisure activity. However, no research has studied the issues of free time and leisure education with a delinquent population. This paper documents the impact of a leisure education curriculum on a population of delinquent youth in a randomized experiment. The delinquent youths who received the leisure education reported higher intrinsic motivation and better use of free time. The delinquent youths also reported improved decision making related to their involvement in healthy, prosocial free time activities. Finally, the improvement in the delinquent youths' motivation influenced a significant decrease in the delinquent youths' proneness to boredom during their free time.
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Date Issued: 2006
Identifier: CFE0001472, ucf:47104
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0001472

Title: AN EXAMINATION OF CENTRAL ASIAN GEOPOLITICS THROUGH THE EXPECTED UTILITY MODEL: THE NEW GREAT GAME.
Creator: Stutte, Corey, Wan, Thomas, University of Central Florida
Abstract / Description: The New Great Game is a geopolitical competition between regional stakeholders over energy resources in Central Asia. The author seeks to use the expected utility voting model based on Black's median voter theorem for forecasting the New Great Game in Central Asia. To judge the external validity of the voting model, the author uses data from the Correlates of War project data set, to formulate three distinct models based only on the numbers in 1992 and 1993. Capabilities and alliance data...
Show moreThe New Great Game is a geopolitical competition between regional stakeholders over energy resources in Central Asia. The author seeks to use the expected utility voting model based on Black's median voter theorem for forecasting the New Great Game in Central Asia. To judge the external validity of the voting model, the author uses data from the Correlates of War project data set, to formulate three distinct models based only on the numbers in 1992 and 1993. Capabilities and alliance data were used to develop balance of power positions and compare the outcome of 100 simulations to the actual outcome in 2000 based on Correlates of War project data. This allows us to judge whether the emergence of Russia's weak advantage as well as the continuation of the competition in the New Great Game as of 2000 could have been predicted based on what was known in 1992 and 1993. By using only one year's data to forecast the New Great Game, we are able to eliminate historical and researcher bias and judge the applicability of the model in global policy and strategic analysis.
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Date Issued: 2009
Identifier: CFE0002861, ucf:48088
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0002861

Title: Assessing the Impact of Economies of Scale and Uncontrollable Factors on the Performance of U.S. Cities.
Creator: Allaf, Mamoon, Martin, Lawrence, Wan, Thomas, Kapucu, Naim, Baker, Paul, University of Central Florida
Abstract / Description: Despite the increased interest among local governments in collecting data on performance measurement, empirical evidence is still limited regarding the extent to which these data are utilized to assess the impact on efficiency of economies of scale and uncontrollable factors. Data envelopment analysis (DEA) is a linear programming method designed to estimate the relative efficiency of decision-making units. In addition to assessing relative efficiency, DEA can estimate scale efficiency and...
Show moreDespite the increased interest among local governments in collecting data on performance measurement, empirical evidence is still limited regarding the extent to which these data are utilized to assess the impact on efficiency of economies of scale and uncontrollable factors. Data envelopment analysis (DEA) is a linear programming method designed to estimate the relative efficiency of decision-making units. In addition to assessing relative efficiency, DEA can estimate scale efficiency and incorporate the impact of uncontrollable factors. Using data from the International City/County Association (ICMA), this study utilized DEA to evaluate the impact of economies of scale and uncontrollable factors on the relative efficiency of municipal service delivery in the United States. The findings from this doctoral dissertation show that uncontrollable variables such as population density, unemployment, and household income suppress the relative efficiency of local governments. Moreover, the findings imply that the prevalence of economies of scale in city governments depends on the types of services these governments provide.
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Date Issued: 2012
Identifier: CFE0004201, ucf:49002
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0004201

Title: Assessment of Information Security Culture in Higher Education.
Creator: Glaspie, Henry, Karwowski, Waldemar, Wan, Thomas, Hancock, Peter, Caulkins, Bruce, University of Central Florida
Abstract / Description: Information security programs are instituted by organizations to provide guidance to their users who handle their data and systems. The main goal of these programs is to protect the organization's information assets through the creation and cultivation of a positive information security culture within the organization. As the collection and use of data expands in all economic sectors, the threat of data breach due to human error increases. Employee's behavior towards information security is...
Show moreInformation security programs are instituted by organizations to provide guidance to their users who handle their data and systems. The main goal of these programs is to protect the organization's information assets through the creation and cultivation of a positive information security culture within the organization. As the collection and use of data expands in all economic sectors, the threat of data breach due to human error increases. Employee's behavior towards information security is influenced by the organizations information security programs and the overall information security culture. This study examines the human factors of an information security program and their effect on the information security culture. These human factors consist of stringency of organizational policies, behavior deterrence, employee attitudes towards information security, training and awareness, and management support of the information security programs. A survey questionnaire was given to employees in the Florida College System to measure the human aspects of the information security programs. Confirmatory factor analysis (CFA) and Structural Equation Modeling (SEM) were used to investigate the relationships between the variables in the study using IBM(&)#174; SPSS(&)#174; Amos 24 software. The study results show that management support and behavior deterrence have a significant positive relationship with information security. Additionally, the results show no significant association between information security culture and organization policies, employee commitment and employee awareness. This suggests a need for further refinement of the model and the survey tool design to properly assess human factors of information security programs and their effects on the organizational security culture.
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Date Issued: 2018
Identifier: CFE0007184, ucf:52272
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0007184

Title: BENCHMARKING COMMUNITY HEALTH CENTERS' EFFICIENCY:MULTIVARIATE ANALYSIS.
Creator: Marathe, Shriram, Wan, Thomas, University of Central Florida
Abstract / Description: Community Health Centers (CHCs), designed to provide accessible and affordable health care services to low-income families, were first funded by the Federal Government as part of the War on Poverty in the mid-1960s. Improving healthcare organizational performance efficiency is paramount. It is an especially pressing need for CHCs' because they carry a disproportionate burden of caring for the uninsured within limited budgets. Prior studies suffer from conceptual and methodological...
Show moreCommunity Health Centers (CHCs), designed to provide accessible and affordable health care services to low-income families, were first funded by the Federal Government as part of the War on Poverty in the mid-1960s. Improving healthcare organizational performance efficiency is paramount. It is an especially pressing need for CHCs' because they carry a disproportionate burden of caring for the uninsured within limited budgets. Prior studies suffer from conceptual and methodological limitations. A longitudinal multivariate analysis of factors influencing the performance of CHCs is needed. The purpose of this study is to benchmark CHC performance in terms of technical and cost efficiency, and examine factors that affect its variation. A theoretically grounded non-experimental study design is used, with five waves of panel data from 493 CHCs for the years 2000 through 2004. This study found that data mining and predictor tree analysis of factors influencing the variation in CHCs' technical and cost efficiency yielded inconsistent results. A declining trend in technical efficiency scores over the five-year study period was observed. Based on growth curve modeling, the three factors that influenced technical efficiency at the initial period of the study are: the percentages of Medicare, Medicaid, and Hispanic population being served by the CHCs. The five factors that positively influenced the variation in cost efficiency at the initial period were: the initial score of technical efficiency, the percentage of Hispanic patient population, staffing mix (ratio of providers to total staff), pay mix (ratio of federal grant dollars to total revenue), and percentage of Medicare-eligible. The initial cost-efficiency score and the initial technical efficiency score are negatively associated with the growth trend of technical efficiency. The initial level of technical efficiency is not statistically significantly associated with the growth trend of cost efficiency. The two factors influencing the growth trend of cost efficiency are the growth trend of technical efficiency (with a positive influence) and the initial level of cost efficiency (with a negative influence). Analysis of the effects of contextual and organizational-structural variables on the technical efficiency and cost efficiency of community health centers found that the explanatory power of the predictors is much greater for cost efficiency than for technical efficiency. The study lends support to contingency theory and confirms the independent and additive influences of contextual and organizational predictors on efficiency. Irrespective of the efficiency measures, contextual factors have much more influence on CHCs' efficiency than design (organizational structural) factors do. The three study hypotheses supported by multivariate analysis are: technical efficiency is associated with contextual factors and organizational factors; cost efficiency is associated with contextual factors and organizational factors; and technical efficiency positively affects cost efficiency.
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Date Issued: 2006
Identifier: CFE0001408, ucf:47067
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0001408

Title: Cities of Service: A Grounded Theory Exploration of Volunteer Service.
Creator: Hill, Brandy, Martin, Lawrence, Bryer, Thomas, Kapucu, Naim, Wan, Thomas, University of Central Florida
Abstract / Description: This research explores how volunteer service can be both included and impactful in strategies to address local challenges. Prior research would suggest that volunteer service has largely been overlooked when it comes to governmental efforts to solve society's biggest problems, particularly at the local level. Ignoring the potential for volunteer service in problem-solving approaches may hinder the development of effective problem-solving strategies. This research describes the ways cities...
Show moreThis research explores how volunteer service can be both included and impactful in strategies to address local challenges. Prior research would suggest that volunteer service has largely been overlooked when it comes to governmental efforts to solve society's biggest problems, particularly at the local level. Ignoring the potential for volunteer service in problem-solving approaches may hinder the development of effective problem-solving strategies. This research describes the ways cities drive demand for volunteer service. In particular, volunteer service demand can be explained through certain motivational bases(-)economic, aspirational, and need-based(-)together with various feasibility considerations. A grounded theory model for volunteer service demand from the perspective of the city and a generalized logic model for service as a strategy to address local challenges are presented.
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Date Issued: 2013
Identifier: CFE0004690, ucf:49849
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0004690

Title: Constructing and Validating an Integrative Economic Model of Health Care Systems and Health Care Markets: A Comparative Analysis of OECD Countries.
Creator: Helligso, Jesse, Wan, Thomas, Liu, Albert Xinliang, King, Christian, Hamann, Kerstin, University of Central Florida
Abstract / Description: This dissertation argues that there are three basic types of health care systems used in industrial nations: free market (private insurance and provision), universal (public insurance and private provision), and socialized (public insurance and provision). It examines the role of market forces (supply and demand) within the health care systems and their effects on health outcomes by constructing an integrative model of health care markets and policies that is lacking within the scientific and...
Show moreThis dissertation argues that there are three basic types of health care systems used in industrial nations: free market (private insurance and provision), universal (public insurance and private provision), and socialized (public insurance and provision). It examines the role of market forces (supply and demand) within the health care systems and their effects on health outcomes by constructing an integrative model of health care markets and policies that is lacking within the scientific and academic literature. The results show that, free market systems have decreased access to care, good quality of care, and are economically inefficient resulting in 2.7 years of life expectancy lost and wasted expenditures (expenditures that do not increase life expectancy) of $3474 per capita ($1.12 trillion per year in the U.S.). Socialized systems are the most economically efficient systems but have decreased access to care compared to universal systems, increased access to care compared to free market systems and have the lowest quality of care of all three systems resulting in 3 months of life expectancy lost per capita and a saving of $335 per capita. Universal systems perform better than either of the other 2 systems based on quality and access to care. The models show that health insurance is a Giffen Good; a good that defies the law of demand. This study is the first fully demonstrated case of a Giffen good. This investigation shows how the theoretically informed integrative model behaves as predicted and influences health outcomes contingent upon the system type. To test and substantiate this integrative model, regression analysis, Time-Series-Cross-Section analysis, and structural equation modeling were performed using longitudinal data provided and standardized by the Organization for Economic Cooperation and Development (OECD). The results demonstrate that universal health care systems are superior to the other two systems.
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Date Issued: 2018
Identifier: CFE0007335, ucf:52114
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0007335

Title: Cross-Sector And Inter-Organizational Collaborative Capacity In Community Disaster Resilience And Sustainability: Evidence From Central Florida Counties.
Creator: Demiroz, Fatih, Kapucu, Naim, Hawkins, Christopher, Knox, Claire, Wan, Thomas, Rivera, Fernando, University of Central Florida
Abstract / Description: This study examines the relationships between interorganizational network development and sustainability, organizational capacity for emergency management, technology utilization, and community disaster resiliency. It is proposed that cross sector and interorganizational collaboration (i.e., network development and sustainability), information communication technology (ICT) utilization, and organizational capacity have a positive impact on disaster resiliency. Disaster resiliency is measured...
Show moreThis study examines the relationships between interorganizational network development and sustainability, organizational capacity for emergency management, technology utilization, and community disaster resiliency. It is proposed that cross sector and interorganizational collaboration (i.e., network development and sustainability), information communication technology (ICT) utilization, and organizational capacity have a positive impact on disaster resiliency. Disaster resiliency is measured with a three dimensional metric which includes effectiveness of disaster response, effectiveness of disaster recovery, and adaptive capacities.A questionnaire was sent to organizations that are part of the emergency management system in 11 counties in Central Florida. These organizations were identified by each county's comprehensive emergency management plans. County emergency managers served as the liaison people to reach organizations. They distributed the questionnaire and sent reminders to participants. The study aimed to reach an entire population of 855 emergency management affiliated organizations. The survey had a 25.28% response rate. Structural equation modeling was used to determine the impact of interorganizational network development, interorganizational network sustainability, information communication technology utilization, and organizational capacity on community disaster resiliency. The results of the study show that one third of the total variation in disaster resiliency was explained with the exogenous variables in the structural equation model (R2=.31). There was no statistically significant relationship between network development and disaster resiliency. Also, a correlation was hypothesized between organizational capacity and ICT utilization, according to the study findings no correlation was found between these two variables. Network development, organizational capacity, and ICT utilization were found to be positively associated with disaster resiliency. Among all the variables, organizational capacity had the highest impact on disaster resiliency (?=.36). ICT utilization and network development had almost equal regression weights (?=.25, ?=.26 respectively). A correlation was also found between network development and ICT utilization with ?=.23.The results suggest that organizations that are part of emergency management systems in Central Florida counties could enhance disaster resiliency of their communities by focusing on interorganizational and cross-sector network development, information communication technology utilization, and organizational capacity. Managerial craft has a critical role in developing relationship as most of the interorganizational ties are established with informal connections and mutual trust. Building relationship, installing technological systems, and carrying out joint trainings often exceeds financial capacities of organizations. Enabling more funding for these initiatives is another key point to which policy makers may pay attention.
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Date Issued: 2012
Identifier: CFE0004505, ucf:49286
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0004505

Title: Determinants of hospital efficiency and patient safety in the United States.
Creator: Shettian, Kruparaj, Wan, Thomas, Noblin, Alice, Gurupur, Varadraj, Cobb, Enesha, Anderson, Kim, University of Central Florida
Abstract / Description: Hospitals engage in undertakings on a continual basis to enhance IT capabilities, diffusion of innovations, hospital-physician integration, and standardization to improve their performance. This empirical study explored the interdependence of three macro-level structural factors and their independent impact on the hospital performance measures efficiency and patient safety, with standardization as an important mediator. The researcher conducted a cross-sectional analysis of multiple data sets...
Show moreHospitals engage in undertakings on a continual basis to enhance IT capabilities, diffusion of innovations, hospital-physician integration, and standardization to improve their performance. This empirical study explored the interdependence of three macro-level structural factors and their independent impact on the hospital performance measures efficiency and patient safety, with standardization as an important mediator. The researcher conducted a cross-sectional analysis of multiple data sets from public user files on the acute care hospital industry. The theoretical underpinnings of the study included the structure-process-outcome theory and institutional isomorphism theory. The statistical analysis comprised confirmatory factor analysis (CFA) and covariance structural equation modeling (SEM). The study comprised data for 2,352 acute care hospitals in the United States, which represented more than half of the hospital population. As expected by the hypotheses, the study demonstrated that IT capability, hospital-physician integration, and innovativeness directly affect the variability in standardization, but they did not directly influence the variation in hospital efficiency and patient safety. This revealed that hospitals should focus on standardization because it is the mediating process between structural variables and performance variables. The results indicated a strong negative influence of standardization on hospital efficiency and a weak positive influence on patient safety. The study confirmed the triadic model that (")structure(") influences the process, which in turn influences organizational outcomes. As standardization through coercive, mimetic, and normative pressure mechanisms becomes more common through system integration and increased collaborative governance, more research on how the implementation of standards may perpetuate isomorphism or uniformity is imperative. The researcher recommends future studies to employ a longitudinal study design to explore the determinants of a variety of performance and outcome indicators, such as patient satisfaction, timeliness of care, the effectiveness of care, and equity/financial performance in addition to patient safety and hospital efficiency.
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Date Issued: 2017
Identifier: CFE0006794, ucf:51810
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0006794

Title: DETERMINANTS OF PRODUCTIVITY IN HOSPITAL-BASED RURAL HEALTH CLINICS: A GROWTH CURVE MODELING APPROACH.
Creator: Agiro, Abiy, Wan, Thomas, University of Central Florida
Abstract / Description: The Patient Protection and Affordable Care Act of 2010 expanded rural Medicaid and Medicare coverage. However, different vehicles of delivering care (e.g., hospitals, health clinics, etc.) have differing organizational capacity that may or may not enable them to overcome the challenges of expanded provision. Consequently, this research employed structural contingency and organizational performance models to investigate the impact of organizational factors on productivity growth, while...
Show moreThe Patient Protection and Affordable Care Act of 2010 expanded rural Medicaid and Medicare coverage. However, different vehicles of delivering care (e.g., hospitals, health clinics, etc.) have differing organizational capacity that may or may not enable them to overcome the challenges of expanded provision. Consequently, this research employed structural contingency and organizational performance models to investigate the impact of organizational factors on productivity growth, while recognizing that contextual factors also affect the delivery of care. Latent growth curve modeling was used to study a national panel of 708 U.S. hospital-based Rural Health Clinics for the years 2005 to 2008. Productivity was measured through dynamic slacks-based data envelopment analyses. Unconditional and conditional linear growth curve models were fitted to data. Findings revealed that 1) hospital-based clinics with higher baseline levels of productivity in 2005 had a slower rate of growth in productivity for the years 2006 to 2008, 2) hospital-based clinics with physicians had significantly higher productivity, 3) hospital-based clinics in urban focused areas had significantly higher productivity, 4) newer hospital-based clinics had significantly higher productivity, and 5) prospective payment system was negatively related to the rate of change in productivity growth. Organizational and contextual factors included in this study significantly explained initial differences in productivity but were unable to explain productivity growth.Future research could improve the study by 1) including additional explanatory variables, such as the use of technology and disease management programs, 2) adjusting productivity measures by case mix measures, and 3) conducting truncated panel data regression with Monte Carlo simulation.
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Date Issued: 2011
Identifier: CFE0003912, ucf:48753
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0003912

Title: DETERMINANTS OF TURKISH POILICE OFFIERS' PERCEPTION OF INTEGRITY: IMPACT OF ORGANIZATIONAL CULTURE.
Creator: Kucukuysal, Bahadir, Wan, Thomas, University of Central Florida
Abstract / Description: The purpose of this research was to examine the influence of police organizational culture on officers' perception of integrity in the Turkish National Police (TNP). Adopting an organizational rather than an individualistic perspective, this study focused on police organizational culture to investigate the causes of integrity problems in the TNP. While focusing on police organizational culture, this study also aimed to determine to what extent officers' perceptions of integrity are...
Show moreThe purpose of this research was to examine the influence of police organizational culture on officers' perception of integrity in the Turkish National Police (TNP). Adopting an organizational rather than an individualistic perspective, this study focused on police organizational culture to investigate the causes of integrity problems in the TNP. While focusing on police organizational culture, this study also aimed to determine to what extent officers' perceptions of integrity are influenced by personal and occupational attributes such as age, gender, rank, income, educational level, years of employment, and assignment type. The research was conducted in Turkey's two largest cities, Istanbul and Ankara, as well as the largest city of southeastern Turkey, Diyarbakir. Three hundred officers, consisting of 200 regular police officers and 100 ranked officers, were selected from each city, making a sample size of 900 in total. With a total of 507 respondents, after eliminating cases with missing values, the study achieved a 57% response rate. Structural equation modeling was used to test the hypothesized relationships, since it is the most appropriate statistical method for testing hypotheses based on relations among latent and observed variables. This method enabled the researcher to measure the perception of police integrity and the perception of police organizational culture with their multiple indicators, providing rigorous measurements for both constructs. The results of the statistical analysis supported the research hypothesis. The findings showed that officers' perception of police organizational culture negatively influenced their perception of integrity. It was also found that officers' age and educational level also had a statistically significant influence on their perception of integrity.
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Date Issued: 2008
Identifier: CFE0002242, ucf:47898
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0002242

Title: EFFECTS OF HOSPITAL STRUCTURAL COMPLEXITY AND PROCESS ADEQUACY ON THE PREVALENCE OF SYSTEMIC ADVERSE EVENTS AND COMPLIANCE ISSUES: A BIOMEDICAL ENGINEERING TECHNICIAN PERSPECTIVE.
Creator: Fiedler, Beth, Wan, Thomas, University of Central Florida
Abstract / Description: Purpose: The purpose of this study is to understand the relationships among structural complexity, process adequacy, and level of quality in a hospital environment of care from the perspective of the biomedical engineering technician (BMET). The BMET health support occupation is under-represented in research. The BMET influences on patient outcomes were observed indirectly through the influence on nursing performance. The unit of analysis is biomedical engineering technician. The study...
Show morePurpose: The purpose of this study is to understand the relationships among structural complexity, process adequacy, and level of quality in a hospital environment of care from the perspective of the biomedical engineering technician (BMET). The BMET health support occupation is under-represented in research. The BMET influences on patient outcomes were observed indirectly through the influence on nursing performance. The unit of analysis is biomedical engineering technician. The study examined the predictors of adverse events in hospital care and suggested how to promote reduction in adverse events (hospital acquired infections) associated with medical equipment. Methods: Primary data were gathered by the Biomedical Engineering Interdepartmental Survey of BMETs' professional perception of organizational factors (Structural Complexity), process factors (Process Adequacy), Level of Quality and control variables that characterizes the study population. A total of 317 BMETs in 46 states and the District of Columbia completed the survey. The survey instrument was developed using Dillman's Tailored Design Methods and validated for reliability. A majority of respondents reported 5+ years of experience working at large, non-profit, Joint Commission accredited, urban facilities across 5 regions. The effect of structural complexity and process adequacy was analyzed by structural equation modeling (SEM) under the theoretical framework of Donabedian's Structure-Process-Outcome model. Findings: The SEM data analysis indicates strong, positive relationships between constructs as statistically significant (2-tailed) with normal distribution: 1) Structural Complexity and Process Adequacy at Beta =.889, t=7.248, p<0.001; 2) Process Adequacy and Level of Quality at Beta =.563, t=3.136, p=0.002; and 3) Structural Complexity and Level of Quality at Beta =.430, t=2.469, and p=0.014. Translation of these findings into equation form as follows: Level of Quality = .889 Structural Complexity + .563 Process Adequacy The study finds several determinants of quality derived from structural complexity including 1) uniform standards, 2) inter-professional training, and 3) coordination evidence. In addition, the intervening effect of process adequacy comprising regular meetings, equipment purchasing involvement, formal equipment training across departments, and formal department information on the level of quality is supported. Conclusion: Predictors identified from interdepartmental and inter-professional partnerships and associated processes suggest that integration of the biomedical engineering technician into the hospital delivery system can improve the quality of care. Administrators can manage and improve quality through employing simple, effective and efficient solutions such as 1) updating internal hospital policy to require regularly scheduled meetings between nursing and biomedical staff regarding equipment issues, 2) linking the BMET department goals to organization objectives, 3) interdepartmental reporting of hospital acquired infections, and 4) standardizing clinical engineering practices to facilitate increased internal and external hospital quality.
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Date Issued: 2011
Identifier: CFE0003980, ucf:48670
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0003980

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.
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Date Issued: 2016
Identifier: CFE0006259, ucf:51051
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0006259

Title: EVALUATION OF A QUALITY MANAGEMENT INITIATIVE AND HIV AMBULATORY SERVICES PERFORMANCE IN THAILAND.
Creator: Meemon, Natthani, Wan, Thomas, University of Central Florida
Abstract / Description: The accomplishment of pilot implementation of the HIVQUAL-T model, an innovative HIV care quality management tool, has led to an authoritative decision to scale up the use of the model nationwide in Thailand. However, the level of implementing this model varies across target hospitals. Some hospitals have fully adopted the model by conducting quality improvement (QI) activities following performance measurement (PM) results while others have partially adopted only PM or have not used this...
Show moreThe accomplishment of pilot implementation of the HIVQUAL-T model, an innovative HIV care quality management tool, has led to an authoritative decision to scale up the use of the model nationwide in Thailand. However, the level of implementing this model varies across target hospitals. Some hospitals have fully adopted the model by conducting quality improvement (QI) activities following performance measurement (PM) results while others have partially adopted only PM or have not used this model at all. The differential level of implementation could be a contributing factor accounting for discrepancies in the quality of care across different HIV ambulatory care facilities. A cross-sectional study was conducted by using two main datasets, including Thailand's national HIV care performance results and an online survey of all public hospitals nationwide. A total of 382 hospitals responded to the survey, accounting for a response rate of 50%. A confirmatory factor analysis (CFA) method was performed to examine the validity of latent constructs developed from the diffusion of innovation theory. Structural equation modeling (SEM) approach was employed to investigate the relationship between the determinants of organizational decision-making and their contribution to organizational outcomes, under the context-design-performance framework. Furthermore, using a panel model of hospitals that reported performance results across a 3-year period, the improvement in HIV ambulatory services performance among the adopters was examined. The results indicated that two innovation attributes -relative advantage and simplicity perceived by HIV care practitioners in hospitals- were found to be positively associated with the level of the HIVQUAL-T model implementation. Two structural characteristics -interconnectedness and organizational slack- appeared to be positively associated with the level of model implementation, while rate of adoption in the region also had significant positive contribution. Ultimately, the extensiveness of the HIVQUAL-T model implementation demonstrated a proportionate impact on the variation in hospitals' HIV ambulatory services performance. It was noted that the implementers considerably improved their performance within two years of implementing the model. The study findings imply that adoption is more likely when individual practitioners assess the innovation and find it to be easy to comprehend and operate and also worthwhile to implement. Furthermore, hospitals' decision making is likely influenced by their relations to external environment. The findings suggest more emphasis on individual and hospital-level capacity building for meaningful use of this quality management initiative, accompanied by an adjustment of performance measurement software with valid, reliable, and interpretable indicators.
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Date Issued: 2011
Identifier: CFE0003753, ucf:48785
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0003753

Title: Examining multi-level and inter-organizational collaborative response to disasters: The case of Pakistan Floods in 2010.
Creator: Khosa, Sana, Kapucu, Naim, Wan, Thomas, Knox, Claire, Sadri, Houman, University of Central Florida
Abstract / Description: Catastrophic disasters are different than routine disasters and managing them requires the mobilization of inter-organizational, inter-governmental, cross-sectoral and international humanitarian support. The role of the international community through International Non-governmental Organizations (INGOs), and multi-lateral organizations such as the United Nations (UN) becomes imperative when the scale of the disaster is unprecedented and difficult for a country to manage on its own. The...
Show moreCatastrophic disasters are different than routine disasters and managing them requires the mobilization of inter-organizational, inter-governmental, cross-sectoral and international humanitarian support. The role of the international community through International Non-governmental Organizations (INGOs), and multi-lateral organizations such as the United Nations (UN) becomes imperative when the scale of the disaster is unprecedented and difficult for a country to manage on its own. The initial response and relief phase of managing disasters is one in which many agencies with different expertise, capacities, working mandates, resources, skills, working cultures and norms come together to coordinate and collaborate to provide timely response and relief services. Thus, the terrain of managing catastrophic disasters is complex and requires a deeper study to understand and delineate the factors shaping and facilitating collaborative response and relief efforts.This study examines the multi-level and multi-layered collaborative response networks present at the national-international level, provincial and district/local level of disaster response and interactions. In this research the nature and effectiveness of collaboration is being studied through a relevant case study of a catastrophic natural disaster, the 2010 Pakistan Floods. The phase of immediate response is explored primarily through Network Theory perspectives including supportive theoretical perspectives such as Social Capital, Resource Dependency, and Institutional Collective Action Theory perspectives that help to explain collaborative interactions in disaster response networks. This study explores and describes factors that influence (either facilitate or hinder) collaboration is disaster response networks.The key research questions for this study are: What factors facilitate and impede collaborative response to catastrophic disasters at the local, provincial, national and international levels? What are the differences and similarities in response systems at different levels? Additional questions address how leadership support (attributed to government and political leaders and organizations), institutional support (in the form of plans, international appeals of response, and development of relief funds to manage aid), network capacity of different organizations (programmatic and relational), nature of resource dependencies between responding agencies, and structural configurations of response systems impact the collaborative response in disasters.A case study method has been applied in this research. The 2010 Pakistan Floods response network/system is identified through content analysis of various newspapers, situation reports and after-action reports using the Social Network Analysis (SNA) method via UCINET Software 6.1. The actual response network is analyzed and compared with existing national disaster response plans to examine the effectiveness of collaborative response through centrality measures, clique analysis and visual display. This approach is supplemented with semi-structured interviews of key institutional representatives that responded to the 2010 Floods. These organizations and institutions were primarily identified through the networks formulated via SNA.Findings and results from the analysis reflect that the response networks at each level of analysis differ both in structural aspects and also in functional aspects. The nature of the international-national response system is focused on mobilizing donor support and receiving and managing aid, both in-kind and cash. Also a major role at the international and national level is to mobilize the UN cluster approach and focus on broader aims of response such as providing shelter and food to affected areas. Some of the factors identified as facilitating collaborative response were leadership of both national and international leaders, and availability of donor support and funds.At the provincial level of analysis, the Chief Minister of Punjab is playing a central and influential role and is partnering closely with the Armed Forces and local district administration. Interviews conducted of provincial level officials help to support the hypotheses concerning leadership support's influence on collaborative response and also the role of institutional support in the form of creation of plans, and policies that help to mobilize quick funds and resources for relief. At the local level of response, networks are highly influenced by local conditions and local capacities of the district administration. Thus, there are diverse factors impacting each level of collaborative disaster response. All in all, leadership support, institutional support and network structural aspects are important variables that impact the effectiveness of collaborative response.Today policy makers are trying to figure out ways to collaborate successfully across sector boundaries for better and effective service delivery, both in the mundane operational tasks and in uncertain and complex situations such as disasters and catastrophic events. Thus, this research helps in expanding the literature on collaborative public management, collaborative emergency management, and network management. Also the frequency of natural disasters throughout the world demonstrate the need to study and examine factors that contribute to or hinder the effectiveness of inter-organizational response in disasters
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Date Issued: 2013
Identifier: CFE0005361, ucf:50496
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0005361

structural equation modeling (5)	+ -
Structural Equation Modeling (3)	+ -
social capital (3)	+ -
Data Envelopment Analysis (DEA) (2)	+ -
Efficiency (2)	+ -

Performance Measurement (2)	+ -
Social Disorganization (2)	+ -
Structural Equation Model (2)	+ -
disaster resilience (2)	+ -
efficiency (2)	+ -
health disparities (2)	+ -
health insurance (2)	+ -
income (2)	+ -
institutional theory (2)	+ -
isomorphism (2)	+ -
patient safety (2)	+ -
social network (2)	+ -
Accountable Care Organizations (1)	+ -
Andersen’s health Behavior Model of health care utilization (1)	+ -
Balance of Power (1)	+ -
Caspian (1)	+ -
Central Asia (1)	+ -
Central Florida (1)	+ -
Clinical Engineering (1)	+ -
Collaborative Disaster Management (1)	+ -
Combat (1)	+ -
Complex Adaptive Systems (1)	+ -
Conflict Studies (1)	+ -
Coping (1)	+ -
Criminalization and mental illness (1)	+ -

University of Central Florida (56)	+ -
Zhang, Ning (11)	+ -
Kapucu, Naim (7)	+ -
Liu, Albert Xinliang (5)	+ -
Martin, Lawrence (4)	+ -

Anderson, Kim (3)	+ -
Dziegielewski, Sophia (3)	+ -
Fottler, Myron (3)	+ -
Hancock, Peter (3)	+ -
Karwowski, Waldemar (3)	+ -
Liberman, Aaron (3)	+ -
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