INTRODUCTION: Device discontinuance is a widespread problem with assistive technology (AT) and durable medical equipment (DME), affecting approximately one third of people with disabilities who successfully acquire equipment. Consumers’ dissatisfaction with service and device-related factors can directly lead to AT device non-use. Roger’s Diffusion of Innovation Theory provides a foundation for understanding how to address device discontinuance, potentially through follow-up services. OBJECTIVE: The aim of this doctoral capstone is to discuss the piloting and feasibility of using follow-up outcome measures in an outpatient occupational therapy rehabilitation setting in order to identify and address challenges with equipment discontinuance. METHODS: A sample of 69 clients receiving equipment recommendations from a specialty AT clinic were contacted. The COPM, ATUFS, and QUEST 2.0 were piloted to measure device use and satisfaction. The feasibility of using these measures within a follow-up protocol for this outpatient practice was then evaluated. RESULTS: A total of 63% of the sample (N=69) was successfully contacted. The site-specific protocol successfully determined whether these clients had acquired and used their devices, subsequently allowing AT practitioners to provide additional supports for clients who had experienced discontinuance or non-acquisition. CONCLUSION: Using standardized outcome measures to follow-up with clients in this setting was deemed not feasible secondary to time constraints and difficulty contacting clients. Recommendations for improving follow-up with and without use of standardized measures is discussed. Follow-up encouraged clients to schedule additional appointments, utilize recommended funding resources, or seek out referrals.

京都大学 / 新制・課程博士 / 博士(医学) / 甲第24188号 / 医博第4882号 / 新制||医||1060(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 古川 壽亮, 教授 中山 健夫, 教授 寺田 智祐 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Ride-hailing platforms (RHP) are sharing economy platforms that connect passengers who need to order a private ride or to share a vehicle with drivers who want to share a ride. However, after rapid growth, major RHPs (e.g., Uber, Lyft, and Didi) have begun to face severe driver shortages. Attracting and maintaining a large driver base is critical to the survival and success of any RHP no matter its size. While practitioners are urging to seek suggestions from academia to prevent driver loss, limited research attention has been paid to RHP drivers’ discontinuance. To fill this gap, this dissertation aims to explore factors that motivate drivers to discontinue using RHPs from the perspective of algorithm unfairness. The algorithm is the boss of ride-hailing drivers as they are matched, paid, and evaluated by various algorithms. While algorithms have the potential to make the ride-hailing process more efficient, they also yield socially biased outcomes which create inequalities and uncomfortable experiences for both drivers and riders which may further influence their decisions to use to not use RHPs. Following the logic, the research question of the current dissertation is “how does algorithm unfairness of RHPs affect drivers’ discontinuance?” Stressor-strain-outcome model and organizational justice theory are adapted to the ride-hailing context based on the contextualization approach to serve as theoretical frameworks of the current study. An online survey is conducted to empirically test drivers’ discontinuance of ride-hailing platforms. Research participants of the studies are recruited by employing the service provided by Prolific. co. Data analysis is conducted by employing the covariance-based structural equation modeling approach by following previously defined approaches. The results support most of the hypotheses. The study is expected to contribute to the current literature on information systems discontinuance, ride-hailing, IT stress, AI-empowered algorithm management, algorithm unfairness, dark side of AI, stressor-strain-outcome model, and organizational justice theory. My dissertation is also expected to offer rich insights into how to retain the user base effectively for practitioners in emerging sharing economy platforms. Moreover, the results of the current dissertation also offer rich implications on how to manage dispersed workforces using AI-empowered algorithms.

A death in research exacerbates the lack of knowledge and information in respect of the needs and life view of the aged. Two studies were conducted in this population group with specific reference to the 'once-off interview'. Information was gathered using interview schedules focusing on therapeutic skills of social workers working within the system which cares for the aged. Results of a pilot study and an expanded study were compared in order to establish the inter-relationship between the. needs of the elderly, their elemental experiences in line with Bloom's theory (1984), and the role of the social worker. Findings revealed that the majority of "discontinuances" after the first interview were because the needs of the elderly clients had in fact been met. The need for day care services, transport and the expansion of the 'home help' facility was highlighted to enable the elderly to retain their independence in the community / Social Science / M.A. (Social Science: Mental Health)

A death in research exacerbates the lack of knowledge and information in respect of the needs and life view of the aged. Two studies were conducted in this population group with specific reference to the 'once-off interview'. Information was gathered using interview schedules focusing on therapeutic skills of social workers working within the system which cares for the aged. Results of a pilot study and an expanded study were compared in order to establish the inter-relationship between the. needs of the elderly, their elemental experiences in line with Bloom's theory (1984), and the role of the social worker. Findings revealed that the majority of "discontinuances" after the first interview were because the needs of the elderly clients had in fact been met. The need for day care services, transport and the expansion of the 'home help' facility was highlighted to enable the elderly to retain their independence in the community / Social Science / M.A. (Social Science: Mental Health)

To end the use of a digital technology one must go througha process that research entitle information systems (IS)discontinuance. Prior research has developed phases andactivities that can be implemented in the IS discontinuanceprocess, but this knowledge is limited and has not beencompiled. This study purpose is therefore to create a modelof the IS discontinuance process and in it identify furtheractivities. To accomplish this, a real IS discontinuance hasbeen studied, who has had different circumstances andstakeholders than of previous studies. The discontinuanceprocess has occurred at a large organisation whomanufacture vehicles and the study has been conducted incollaboration with this organisation. The studied IS inquestion is an eLearning authoring tool. Information aboutthis discontinuance process has been collected throughsemi-structured personal interviews with five participantswho are employees at the organisation. The collected datahas been analysed and interpreted in comparison to atheoretical model of the IS discontinuance process, whichcontains phases and activities. The result of the analysis andinterpretation is an iterative model of the IS discontinuanceprocess with phases and activities, of which 34 are newfound activities. A big part of these activities can be relatedto the new circumstance and stakeholders within thestudied discontinuance process / Att sluta använda digitala teknologier sker genom en processsom forskningen benämner sominformationssystemsavveckling (IS-avveckling). Tidigareforskning har tagit fram faser och aktiviteter som kangenomföras i IS-avvecklingsprocessen, men denna kunskapär begränsad och har inte sammanställts. Denna studie syftarsåledes att skapa en modell av IS-avvecklingsprocessen och iden identifiera ytterligare aktiviteter. För att realisera dettahar en verklig IS-avvecklingsprocess studerats som haft ettannat förhållande och intressenter än i tidigare studier.Avvecklingen har skett hos en stor organisation somtillverkar fordon och studien har genomförts tillsammansmed dem. Avvecklingen harutförts på organisationens eLearning författarverktyg.Information om avvecklingen har samlats in genomsemistrukturerade personliga intervjuer med fem styckenrespondenter som är anställda hos organisationen. Deninsamlade datan har analyserats och tolkats i jämförelse meden framtagen teoretisk modell för IS-avvecklingsprocessensom innehåller faser och aktiviteter. Resultatet av analysenoch tolkningen blev en iterativ modellen för ISavvecklingsprocessen med faser och aktiviteter, varav 35stycken nya aktiviteter hittats. Stor del av dessa nyaaktiviteter kan kopplas till det nya förhållandet ochintressenterna i avvecklingen.