Background: Much research consistently shows that there are disparities in healthcare delivery. Healthcare disparities affect individuals across a broad range of demographics such as gender, race or ethnicity, and it is also related to socioeconomic factors such as income levels, access to health benefits and insurance, and health literacy. Recent immigrants to Canada encounter a different and unfamiliar healthcare system. This situation presents challenges to the practice of health care delivery. Therefore, it is crucial that innovative strategies be identified to reduce disparities in health care to promote the overall quality of care and public health services. Purpose: The purpose of this dissertation research was two-fold: (1) to examine cultural competence strategies, if any, that are used by healthcare organizations to improve interaction and communication between healthcare providers and their immigrant patients with the purpose to reduce healthcare disparities; and specifically, (2) to explore the use of Information and Communications Technologies (ICTs) to improve communication between healthcare providers and immigrant patients with the objective of reducing healthcare disparities. Methods: This dissertation research employed a mixed methods approach for data collection and analysis. The research was carried out in three phases. In the first phase, a series of focus group discussions with a sample of recent immigrants was conducted. In the second phase, an online survey was conducted to gain insights from healthcare providers regarding the role of ICTs in improving communication with immigrant patients to help reduce healthcare disparities. In the third phase, healthcare providers who participated in the survey were invited to participate in face-to-face, in-depth semi-structured interviews to further reflect on and extend the survey responses. Campinha-Bacote's Cultural Competence Model and Unified Theory of Acceptance and Use of Technology were employed for this dissertation research as its theoretical framework. Results: The findings indicated that the absence of effective communication as well as cultural and language barriers were major issues related to communication between healthcare providers and immigrant patients. The findings also indicated that immigrant patients might need to improve their digital and health literacy skills in order to improve their communication with their healthcare providers. Further, the findings indicated that it was important for healthcare providers to have access to more demographic data on immigrant patients because such data will allow healthcare providers to be better informed on how to most effectively tailor their healthcare services to this population group. Conclusion: Findings obtained from this dissertation research shed light on cross cultural communication issues related to working with immigrant patients that may lead to disparities in health care. Healthcare organizations may use these findings to better inform their decision making with regard to effective patient-provider communication. Finally, the findings bear important implications for the line of research that examines patient-provider communication from immigrant patients' perspectives. They can inform the design of cultural competence strategies for healthcare organizations.

Research indicates that positive attitudes toward information and communication technology, coupled with a high perceived level of self-efficacy, greatly assist teachers as they strive to integrate technology into their curricula. Therefore, the purpose of the study was to investigate the attitudes and perceived levels of self-efficacy as they pertain to information and communication technology (ICT) of career and technical educators at high schools in Mississippi in an effort to better understand one part of the fabric that makes up the educational mosaic in Mississippi. Participants for this study included career and technical educators teaching in one of three disciplines: 1) Agriculture, 2) Allied Health, or 3) Business and Technology. The instrument used for this study was the Information and Communication Technology Attitude and Self-Efficacy Survey (ICTASES). The researcher collected information pertaining to the educators’ attitudes and self-efficacy toward formation and communication technology, as well as participant demographics. The results of the study indicated that the attitudes of Mississippi career and technical educators toward ICT were positive, while their perceived levels self-efficacy toward ICT was high. The educators in each of the three disciplines demonstrated positive attitudes and high perceived levels of self-efficacy toward ICT despite significant differences between the disciplines. Business and Technology educators demonstrated attitudes and perceived levels of self-efficacy toward ICT that were significantly more positive, and higher, respectively, than those educators teaching Agriculture or Allied Health. Additionally, the study found that that the more advanced a degree the educator held, the greater the likelihood that he/she exhibited a more positive attitude and a greater level of perceived self-efficacy toward ICT. Those educators possessing a bachelor or master’s degree possessed attitudes and perceived levels of self-efficacy toward ICT that were significantly more than those educators possessing an associate’s degree. Finally, the attitudes of the educators toward ICT were found to be positively correlated with the educators’ perceived self-efficacy toward ICT. This result indicates that as the level of self-efficacy of the career and technical educators increases so does the likelihood that the positivity of their attitude will increase.

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京都大学 / 新制・課程博士 / 博士(経済学) / 甲第23669号 / 経博第652号 / 新制||経||300(附属図書館) / 京都大学大学院経済学研究科経済学専攻 / (主査)教授 山田 憲, 教授 西山 慶彦, 准教授 高野 久紀 / 学位規則第4条第1項該当 / Doctor of Economics / Kyoto University / DGAM

It is not unexpected that the field of information and communication has come under critique for falling short on delivering on their promises surrounding equality. It is an unfortunate irony that the people working closest as messengers between organizations and the public do not represent the society to which they communicate, especially so in a Swedish context. Partly inspired by the WFA report and other troubling findings around discrimination, the purpose of this study is to explore through quantitativ research how people with minority racial, ethnic, gender, cultural or religious backgrounds working within fields related to information and communication face workplace inequality within a Swedish context. A mixed methods approach was employed to analyze the open-ended answers, including qualitative content analysis. When asking whether the respondents had experienced discrimination or inappropriate treatment in their work during their information and communication career in Sweden, 66 percent of the respondents answered yes. The respondents who had endured discrimination or inappropriate treatment had mostly endured it because of ethnic origin or nationality, gender, age. From an intersectional lens the study illustrates the double threat of gender and racial discrimination in information and communications which women face, where it is demonstrated that their work is assessed differently than coworkers, face subjection to stereotyping and pigeonholing, are deprived of formal and informal networking opportunities, face barriers to their progression and have to regularly deal with microaggressions.

Chronic exhaustion is a consequence of detrimental working conditions and demands, as well as inadequate coping techniques, potentially resulting in burnout. Previous research has studied occupational environment and individual factors as predictors of exhaustion. Although these differ between former East and West German states, the regional distinction regarding exhaustion has been neglected. To fill this gap, we used the Copenhagen Burnout Inventory in a representative German sample from 2014 to assess the burnout symptom exhaustion. Estimating ordinary least squares regressions, important burnout predictors were compared between the former East and West German states. Regional differences concerning occupational environments were related to the associations between individual factors, situational aspects of technostress and exhaustion. Associations between individual factors (e.g., female sex, lower working hours, age, partnership status, and household income) and exhaustion were stronger in East Germany, whereas technostress (strain of internet use, number of e-mails during leisure time, and social pressure to be constantly available) was more strongly associated with exhaustion in West Germany. Despite lower financial gratification and a higher social pressure to be constantly available in the East, West Germans were more afflicted by exhaustion. Individual factors and technostress should thus be considered when focusing on job-related mental health issues.

Politically interested individual citizens often use information and communication technology (ICT) to facilitate and augment their civic and political participation. At the local level, ICT plays an important role for communication and information sharing in order for local groups to create awareness and draw citizens into public deliberation about local issues and concerns. This research examines the interplay of individual and local group level factors in order to better understand the relationship between civic engagement and ICT, especially the internet, by using household survey data from the town of Blacksburg, Virginia and environs in 2005 and 2006. It seeks to reconcile those different levels of analysis relating to the use and impact of the internet on civic engagement in local governance. This study identifies the distinctive influences at both the individual citizen level and the group level by applying a multilevel statistical model (the Hierarchical Linear Model). First, this study found the effects of internal and external political efficacy and community collective efficacy as significant individual level influences on internet use for civic and political purposes. Second, group internet use—which includes new internet technologies—and group political discussion were revealed as key influences on citizens' perspectives on the helpfulness of the internet for civic and political purposes at the group level of analysis. Finally, in multilevel analysis, those recognized group level variables (group internet use and group political discussion and interests) led to positive agreement with the following statements: 1) the internet has helped me feel more connected with people like myself in the local area; 2) the internet has helped me feel more connected with a diversity of people in the local area; and 3) the internet has helped me become more involved in local issues that interest me when taking individual level variables into account. / Ph. D.

The present study explored the effects of the national and cultural contexts on students' mathematics achievement. The study also investigated the nature and magnitude of student-level (level 1), school-level (level 2), and country-level (level 3) factors that are associated with math achievement. The Program for International Student Assessment (PISA) 2018 datasets were used. The main predictors focusing on this study included university admission procedure and the country's culture of mindsets about intelligence at level 3, indicating extra-curricular activities at level 2, growth mindset, and resilience self-efficacy at level 1. Other than main predictors, various predictors including country's characteristics, school characteristics, school climate factors, students' demographic characteristics, and non-cognitive abilities were added in the analysis to examine the main predictors are statistically significant after controlling for other predictors. The findings of HLM analysis showed that mathematics achievement is associated with national and cultural contexts since the study found 31.30% of the total variation was accounted for level 3 in math achievement. Also, the significant findings of the study indicated that university admission procedure was significantly associated with country-mean math achievement while the country's culture of mindsets about intelligence was not at level 3. At level 2, providing extra-curricular activities in school was a significant predictor for math achievement. At level 1, a growth mindset and information and Communication Technology (ICT) usage were positively associated with math achievement. The other significant predictors for math achievement were found in the model. In addition, the study found that the compositional effect of ICT usage explained a significant amount of between schools and countries variance even after controlling for other predictors in the analysis. Moreover, the study found several counterintuitive association phenomena due to shift of meaning. These findings were explained in terms of practical and theoretical implications for policymakers, educators, and researchers to improve students' mathematics achievement. / Doctor of Philosophy / Policymakers and researchers have been concerned about the shortage of students pursuing STEM disciplines in the United States despite the increasing demand for STEM professionals. Since mathematical skills play an important role in a nation's economic development, improving mathematics performance is essential for developing professional STEM workers. Therefore, conducting a cross-national comparative study of mathematics achievement is needed to provide a useful empirical perspective and deeper understanding of mathematics performance. The present study examined the association of diverse predictors at the country-, school-, and student-level with math achievement using multilevel modeling which is also called hierarchical linear modeling (HLM). It was found that university admission procedure was significantly associated with country-mean math achievement at the country-level. Also, providing extra-curricular activities in school was a significant predictor for math achievement at the school-level and a growth mindset and information and Communication Technology (ICT) usage were positively associated with math achievement at the student-level. In addition, the study found the positive compositional effect of ICT usage at school- and country-level which indicates that developing the infrastructure of ICT in school and country should be needed to for high and sustainable students' math achievement. Moreover, the study found several counterintuitive association phenomena due to shift of meaning. These findings were explained in terms of practical and theoretical implications for policymakers, educators, and researchers to improve students' mathematics achievement.