abstract: A core reform area of President Obama’s Race to the Top (RTT) framework, the Statewide Longitudinal Data Systems (SLDS) program, offered funding to states for the development of their own data systems. As a result, Arizona received funding to build a longitudinal student data system. However the targeted audience—teachers—needed training to move from a state of ‘data rich but information poor’ to one of developing actionable knowledge. In this mixed methods action research study, six teachers from three schools participated in job-embedded data-informed decision making (DIDM) and root cause analysis (RCA) professional development to improve their abilities to employ DIDM and RCA strategies to determine root causes for student achievement gaps. This study was based on the theories of situated learning, specifically the concept of communities of practice (CoP), change theory, and the Concerns-Based Adoption Model (CBAM). Because teachers comprise most of the workforce in a district, it is important to encourage them to shift from working in isolation to effectively implement and sustain changes in practice. To address this concern, an online wiki provided an avenue for participants to interact, reflect, and share experiences across schools as they engaged in the application of new learning. The results from this ten-week study indicated an increase in participant readiness levels to: (a) use and manage data sources, (b) apply strategies, and (c) collaborate with others to solve problems of practice. Results also showed that participants engaged in collaborative conversation using the online wiki when they wanted to share concerns or gain further information to make decisions. The online collaboration results indicated higher levels of online discussion occurred when participants were attempting to solve a problem of practice during the learning process. Overall, participants (a) used collaborative strategies to seek, create, and/or utilize multiple sources of data, not just student learning data, (b) worked through implementation challenges when making changes in practice, and (c) sought further types of data collection to inform their decisions about root causes. Implications from this study warrant further investigation into the use of an online CoP as an avenue for increasing teacher collaboration across schools. / Dissertation/Thesis / Doctoral Dissertation Leadership and Innovation 2016

abstract: Data and the use of data to make educational decisions have attained new-found prominence in K-12 education following the inception of high-stakes testing and subsequent linking of teacher evaluations and teacher-performance pay to students' outcomes on standardized assessments. Although the research literature suggested students' academic performance benefits were derived from employing data-informed decision making (DIDM), many educators have not felt efficacious about implementing and using DIDM practices. Additionally, the literature suggested a five-factor model of teachers' efficacy and anxiety with respect to using DIDM practices: (a) identification of relevant information, (b) interpretation of relevant information, (c) application of interpretations of data to their classroom practices, (d) requisite technological skills, and (e) comfort with data and statistics. This action research study was designed to augment a program of support focused on DIDM, which was being offered at a K-8 charter school in Arizona. It sought to better understand the relation between participation in professional development (PD) modules and teachers' self-efficacy for using DIDM practices. It provided an online PD component, in which 19 kindergarten through 8th-grade teachers worked through three self-guided online learning modules, focused sequentially on (a) identification of relevant student data, (b) interpretation of relevant student data, and (c) application of interpretations of data to classroom practices. Each module concluded with an in-person reflection session, in which teachers shared artifacts they developed based on the modules, discussed challenges, shared solutions, and considered applications to their classrooms. Results of quantitative data from pre- and post-intervention assessments, suggested the intervention positively influenced participants' self-efficacy for (a) identifying and (b) interpreting relevant student data. Qualitative results from eight semi-structured interviews conducted at the conclusion of the intervention indicated that teachers, regardless of previous experience using data, viewed DIDM favorably and were more able to find and draw conclusions from their data than they were prior to the intervention. The quantitative and qualitative data exhibited complementarity pointing to the same conclusions. The discussion focused on explaining how the intervention influenced participants' self-efficacy for using DIDM practices, anxiety around using DIDM practices, and use of DIDM practices. / Dissertation/Thesis / Doctoral Dissertation Leadership and Innovation 2017

Bakgrund: Fler kvinnor efterfrågar planerad hemförlossning. Sverige saknar en verksamhet för detta inom den offentliga hälso- och sjukvården. Tidigare forskning indikerar att det kan vara lika säkert att föda hemma som på sjukhus vid normal graviditet och förväntad normal förlossning. Kvinnors förlossningsterritorium främjas av hemlik miljö och stödjer den fysiologiska processen. Europadomstolen stadgar att valet av födelseplats är en grundläggande mänsklig rättighet. Syfte: Att beskriva barnmorskors inställning till planerad hemförlossning. Metod: Elva kvalitativa intervjuer med induktiv innehållsanalys.  Resultat: Barnmorskorna framhöll flera förutsättningar för att planerade hemförlossningar skulle anses säkra, dels att kvinnorna fattade ett informerat val, dels att de var omföderskor med tidigare normal förlossning. Barnmorskorna ansåg att sjukhusmiljön kunde anpassas och efterlikna hemmiljön för att främja trygghet. Barnmorskorna ansåg att bistå kvinnor i hemmet var ansvarsbetungande men kunde överväga detta om planerade hemförlossningar integrerades i offentlig hälso- och sjukvård. Slutsats: Barnmorskornas inställning till planerad hemförlossning var mångbottnad och tudelad. De värnade om kvinnans rätt till val av födelseplats, samtidigt som de uttryckte oro och såg risker i samband med planerade hemförlossningar, på grund av bristande medicinska och kollegiala resurser jämfört med sjukhus. Denna delade syn speglar balansen mellan att stödja kvinnors valfrihet och samtidigt säkerställa en säker förlossning. / Background: An increasing number of women desire the option of a planned home birth. As of today, Sweden lacks guidelines and infrastructure to support this. Previous research indicates that birthing at home may be equally safe compared to hospital birth in cases of normal pregnancy and expected normal births. The statutes of the European Court of Human Rights affirm that the choice of birthplace is a fundamental human right. Aim: To describe midwives’ attitudes toward planned home birth. Method: A qualitative interview study using an inductive approach with eleven midwives' interviewed. Results: The midwives emphasized several prerequisites for planned home births to be considered safe, including women making informed decisions and being multiparous with a history of previous normal deliveries. They believed that hospital environments could be adjusted to promote security and emulate home settings. While the midwives considered assisting women at home to be demanding, they were open to reconsidering this if planned home births were integrated into public healthcare. Conclusion: The midwives’ attitude towards planned home births was multifaceted and conflicted. They advocated for women’s autonomy and choice of birthplace, while simultaneously expressing concerns and seeing risks associated with planned home births due to inadequate resources and security compared to hospitals. This split perspective reflects the balance between supporting women’s autonomy while ensuring a safe delivery.

Objective: To understand the use of evidence-informed decision-making within an interorganizational network, and identify the facilitators and barriers to achieving network goals. Design: Case study. Setting: Rural health district in Nova Scotia, Canada (2006 to 2011). Participants: Members from 4 organizations representing community and hospital groups participating in a regional Baby Friendly Initiative network. Methods: A descriptive mixed methods study using focus group and questionnaire methodology. Data were analyzed using framework analysis and social network analysis (SNA). Results: The SNA results highlighted the role that relationships have on the sharing of knowledge among network members. The findings highlight the need for leadership at multiple levels (community, network members, primary organizations, and the provincial government). A lack of resources to achieve the network’s goals was a key barrier. Conclusions: The role of multi-level leadership is important for future network development and community consideration. The case study methodology facilitated momentum towards the network’s goals.

Objective: To understand the use of evidence-informed decision-making within an interorganizational network, and identify the facilitators and barriers to achieving network goals. Design: Case study. Setting: Rural health district in Nova Scotia, Canada (2006 to 2011). Participants: Members from 4 organizations representing community and hospital groups participating in a regional Baby Friendly Initiative network. Methods: A descriptive mixed methods study using focus group and questionnaire methodology. Data were analyzed using framework analysis and social network analysis (SNA). Results: The SNA results highlighted the role that relationships have on the sharing of knowledge among network members. The findings highlight the need for leadership at multiple levels (community, network members, primary organizations, and the provincial government). A lack of resources to achieve the network’s goals was a key barrier. Conclusions: The role of multi-level leadership is important for future network development and community consideration. The case study methodology facilitated momentum towards the network’s goals.

In 2014, breast cancer was the second leading cause of death among Canadian women, with women over age 50 years making up 82% of the identified cases. To address this issue, the Ontario Breast Screening Program developed a media campaign that promoted the benefits of mammogram screening, but not the associated risks (i.e., false-positive, false-negative, radiation exposure, and overdiagnosis). This study was designed to determine whether there was a statistically significant relationship between knowledge of overdiagnosis and participation in mammogram screening. This cross-sectional, correlational study used schema theory supported by the effective health communication model. Forty-one women were invited to listen to a brief presentation on the benefits and risks of screening mammograms and then completed a modified Champion Health Belief Model Scale survey. Two sample t tests and logistic regression analyses of the survey scores showed that the data did not support any correlations with education and screening, but did indicate a correlation between overdiagnosis and participation. The less a participant felt that overdiagnosis was a negative consequence, the more likely they were to participate in breast screening. Survey participants also stated that promotions of mammograms should present balanced information about the benefits and risks of screening. The positive social change and policy implications of this study include providing women aged 50-69 years more information on overdiagnosis in mammograms so they are more informed participants in the decision-making process, and educating Ontario government policymakers with information about the barriers that women aged 50-69 years face in getting balanced information on mammography programs.

Transparens är avgörande för att förbättra hållbarheten förmikrotransaktioner i spel, eftersom det gör det möjligt för spelarna att fattainformerade beslut. Men det är viktigt att ha en balans eftersom för myckettransparens kan ha negativa ekonomiska konsekvenser för företagen, då detkan avskräcka köp. Syftet med studien är att skapa förståelse kring hurtransparens kan användas som ett verktyg för att spelutvecklare ska kunnadesigna hållbara mikrotransaktioner. I studien genomfördes intervjuer medåtta spelare och fyra spelutvecklare. Dessutom användes en probe för attfördjupa den empiriska insamlingen av upplevelser kring transparens. Istudien definieras även hållbart spelande, genom att fokusera på att designamikrotransaktioner utefter ett hållbart spelande kan datorspelsindustrin bidratill en ökning av den sociala och ekonomiska hållbarheten. Fem temanidentifierades genom en tematisk analys där transparens kan stödjainformerade beslut: valuta, värde, varningar, kommunikation och tillit.Studiens resultat kan användas av spelutvecklare och andra aktörer inomdatorspelsindustrin för att främja informerade beslut med en mer transparentoch hållbar spelkultur. / Transparency is crucial to improving the sustainability of microtransactionsin gaming, as it enables players to make informed decisions. However, it isimportant to strike a balance because excessive transparency can havenegative economic consequences for companies, as it may discouragepurchases. The purpose of the study is to generate an understanding of howtransparency can be used as a tool for game developers to design sustainablemicrotransactions. The study involved interviews with eight players andfour game developers. Additionally, a probe was used to further enhance theempirical collection of experiences related to transparency. The study alsodefines sustainable gaming, as designing microtransactions based onsustainable gaming can contribute to increased social and economicsustainability within the gaming industry. Five themes were identifiedthrough a thematic analysis where transparency can support informeddecision-making: currency, value, warnings, communication, and trust. Thefindings of this study can be utilized by game developers and otherstakeholders in the gaming industry to promote informed decision-makingand foster a more transparent and sustainable gaming culture.

Lors de l’exploration d’espace de conception, les données résultantes de la simulation d’un grand nombre d’alternatives de conception peuvent conduire à la surcharge d’information quand il s’agit de choisir une bonne solution de conception. Cette exploration d’espace de conception s’apparente à une méthode d’optimisation en conception multicritère mais en mode manuel pour lequel des outils appropriés à la visualisation de données multidimensionnelle sont employés. Pour le concepteur, un processus en trois phases – découverte, optimisation, sélection – est suivi selon un paradigme dit de Design by Shopping. Le fait de « parcourir » l’espace de conception permet de gagner en intuition sur les sous-espaces de solutions faisables et infaisables et sur les solutions offrant de bons compromis. Le concepteur apprend au cours de ces manipulations graphiques de données. La sélection d’une solution optimale se fait donc sur la base d’une décision dite informée. L’objectif de cette recherche est la performance des représentations graphiques pour l’exploration d’espace de conception, pour les trois phases du processus en Design by Shopping. Pour cela, cinq représentations graphiques, identifiées comme potentiellement performantes, sont testées à travers deux expérimentations. Dans la première, trente participants ont testé trois graphiques, pour la phase de sélection dans une situation multi-attribut, à travers trois scénarios de conception où une voiture doit être choisie parmi quarante selon des préférences énoncées. Pour cela, un indice de qualité est proposé pour calculer la qualité de la solution du concepteur pour un des trois scénarios définis, la solution optimale selon cet indice étant comparée à celles obtenues après manipulation des graphiques. Dans la deuxième expérimentation, quarante-deux concepteurs novices ont résolu deux problèmes de conception à l’aide de trois graphiques. Dans ce cas, la performance des graphiques est testée pour la prise de décision informée et pour les trois phases du processus dans une situation multi-objectif. Les résultats révèlent qu’un graphique est adapté à chacune des trois phases du Design by Shopping :: le graphique Scatter Plot Matrix pour la phase de découverte et pour la prise de décision informée, le graphique Simple Scatter pour la phase d’optimisation et le graphique Parallel Coordinate Plot pour la phase de sélection aussi bien dans une situation multi-attribut que multi-objectif. / In Design space exploration, the resulting data, from simulation of large amount of new design alternatives, can lead to information overload when one good design solution must be chosen. The design space exploration relates to a multi-criteria optimization method in design but in manual mode, for which appropriate tools to support multi-dimensional data visualization are employed. For the designer, a three-phase process - discovery, optimization, selection - is followed according to a paradigm called Design by Shopping. Exploring the design space helps to gain insight into both feasible and infeasible solutions subspaces, and into solutions presenting good trade-offs. Designers learn during these graphical data manipulations and the selection of an optimal solution is based on a so-called informed decision. The objective of this research is the performance of graphs for design space exploration according to the three phases of the Design by Shopping process. In consequence, five graphs, identified as potentially efficient, are tested through two experiments. In the first, thirty participants tested three graphs, in three design scenarios where one car must be chosen out of a total of forty, for the selection phase in a multi-attribute situation where preferences are enounced. A response quality index is proposed to compute the choice quality for each of the three given scenarios, the optimal solutions being compared to the ones resulting from the graphical manipulations. In the second experiment, forty-two novice designers solved two design problems with three graphs. In this case, the performance of graphs is tested for informed decision-making and for the three phases of the process in a multi-objective situation. The results reveal three efficient graphs for the design space exploration: the Scatter Plot Matrix for the discovery phase and for informed decision-making, the Simple Scatter Plot for the optimization phase and the Parallel Coordinate Plot for the selection phase in a multi-attribute as well as multi-objective situation.

Introduction: Les incertitudes des pronostics cliniques et les dilemmes moraux associés aux technologies des tests prénataux affectent les expériences et les processus décisionnels des femmes et des couples. D’une part, la validité des normes relatives au ‘consentement autonome’ et au conseil ‘non directif’ est remise en question. D’autre part, les aides à la décision sont prônées pour rehausser la prise de décision éclairée. L’objectif de ce mémoire est de construire un modèle de l’expérience des femmes et des couples qui font face aux tests prénataux afin d’identifier les facteurs qui amélioreraient les expériences, la prise de décision et le rôle des aides à la décision et informeraient le modèle de soin. Méthodologie: La modélisation et l’analyse des expériences des femmes et des couples qui affrontent les tests prénataux reposent sur une méta-ethnographie des études qualitatives et sur une analyse narrative thématique des études quantitatives. La critique d’un outil (PT) en matière de tests prénataux est également effectuée en ayant recours aux critères de qualité de l’International Patient Decision Aid Standards (IPDAS). Résultats: Un cadre conceptuel décrivant les expériences vécues est construit et l’analyse thématique le complète en soulignant que la prise de décision n’est que rarement éclairée. Les normes d’une ‘décision autonome’ et d’un ‘conseil non directif’ sont problématiques pour les femmes. Les aides à la décision amélioraient les scores de connaissances, sans pour autant modifier la perception du risque, ni les niveaux d'anxiété. L’outil PT favorise une prise de décision basée sur les préférences, mais les critères IPDAS sont difficilement applicables et leur rôle dans une décision de qualité est incertain. Discussion et conclusion: Les résultats éclairent les facteurs macro, méso et micro pouvant améliorer les expériences vécues des femmes et des couples et affecter la prise de décision et l’utilisation des aides à la décision. Un changement de paradigme préconisant le concept d’autonomie relationnelle dans le modèle de soins est suggéré. Dans le contexte des avancées en matière de test prénataux, une réévaluation des normes de pratique et de modèles de soin est requise. Le rôle des aides à la décision devra être élucidé. / Introduction: The clinical prognostic uncertainties and moral dilemmas associated with technological advances of prenatal testing impact the experiences and decision-making of women and couples. While the validity of the norms of ‘autonomous consent’ and ‘non-directive’ counseling is being questioned, decision aids are promoted to enhance informed decision-making. The goals of this thesis are to develop a model of the experiences of women and couples in prenatal testing so as to identify factors that may improve experiences, decision-making, the role of decision aids and inform the care model. Methods: A model of the experiences of prenatal testing is developed through a meta-ethnography of qualitative studies and a narrative synthesis of the themes explored in quantitative studies. A prenatal testing (PT) decision tool is critically assessed using the International Patient Decision Aids Standards (IPDAS) quality criteria for decision aids. Results: A conceptual framework of the experiences of women and couples in prenatal diagnosis is constructed and complemented by a narrative thematic analysis showing that decision-making is rarely informed and that the norms of an ‘autonomous decision’ and a ‘non-directive’ counselling are problematic for women. Decision aids improve knowledge scores, but do no modify risk perception or anxiety levels. A PT tool increases preference based informed decision-making, but quality criteria are not always applicable and their role in quality decision-making is unclear. Discussion and conclusion: The results highlight macro, meso and micro-level factors that may improve the experiences of women and couples and inform decision-making processes as well as the use of decision aids. A paradigm shift towards the concept of relational autonomy in the prenatal diagnosis model of care is suggested. Advances in prenatal testing require a re-evaluation of the norms of practice and care model. The role of decision aids requires further elucidation.

In this study, the aim is to review principals' data-based decision-making process, which is based on analysing the discourses that are expressed in the documentation of their decision-making process. There are 84 decisions reviewed which come from 12 different principals in 13 different schools (pre-school class and year 1 - 9 compulsory school).  The theoretical startingpoint for the study is organisational theory and a model for Critical discourse analysis (CDA), which consists of three interrelated processes of analysis. Four different decision discourses are identified, efficiency discourse, knowledge discourse, documentation discourse and problem-based discourse. Previous research in the same field are confirmed. However, it contradicts with the idea that data-based decision-making process is following certain steps and fixed order in this kind of decision process in school. The conclusions are that despite guidelines and a strong focus on assessing results, the decision-making process seems to take other directions than planned in policies. Some parts in the process seems to be particularly complicated, and schools would gain from clarifying a designed data-based decision process. / I den här studien är syftet att granska rektorers välgrundade eller databaserade beslutsprocess, vilket sker genom att analysera de diskurser som kommer till uttryck i rektorers dokumentation om analys av resultat och planerade åtgärder. Utifrån en flerdimensionell analysmodell granskas 84 planerade åtgärder, från 12 olika rektorer i 13 olika grundskolor. Den teoretiska och metodologiska utgångspunkten finns i kritisk diskursanalys och organisationsteori. Resultatet stämmer till viss del överens med och bekräftar tidigare forskningsresultat inom samma område, men det motsäger att den välgrundade beslutsprocessen går till i bestämda steg och i en viss ordning. I studien identifieras fyra beslutsdiskurser: effektivitetsdiskurs, kunskapsdiskurs, dokumentationsdiskurs och problembaserad diskurs. Slutsatserna är, att trots riktlinjer och ett starkt fokus på att bedöma resultat verkar beslutsprocessen ta andra vägar än det som planeras i direktiv och policys. Vissa delar är särskilt komplicerade och av den anledningen kan alla organisationsnivåer vinna på att ge en mer tydlig form till processen för de databaserade besluten.