Thesis (Ph. D.)--University of Washington, 2000. / Vita. Includes bibliographical references (leaves 135-142).

Thesis (Ph. D.)--Rand Graduate School, 2002. / Title from web page (viewed Aug. 27, 2003). Includes bibliographical references.

Although day laborers are highly visible, as they seek employment, in public street corners or storefronts, their life struggles, including their mental health and social service needs, remain largely unknown to local officials or service providers. This is one of the first studies to directly examine the risk and protective factors impacting Latino Day Laborers’ (LDLs) well-being and substance use and abuse. The study utilized a mixed methods (qualitative and quantitative) design. Specifically, this study used risk and protective variables identified by LDLs in the initial qualitative phase of the study to quantitatively examine the impact on these factors on LDLs’ well-being and substance use and abuse. Based on a sample of 147 LDLs, the quantitative results indicate that risk factors for well-being include psychological distress, social isolation, and older age; while factors protective of well-being include higher levels of religiosity and sending remittances to family members. In addition, psychological distress was found to be a risk factor for substance abuse. A member checking focus group was conducted to contextualize and validate the quantitative findings with the lived experiences of LDLs. Implications for practice and policy are discussed. / text

published_or_final_version / Public Administration / Master / Master of Public Administration

published_or_final_version / Public Administration / Master / Master of Public Administration

published_or_final_version / Public Administration / Master / Master of Public Administration

published_or_final_version / Public Administration / Master / Master of Public Administration

published_or_final_version / abstract / History / Master / Master of Philosophy

In order for computerised information systems (CIS) to be utilised to their full potential they must first be successfully implemented. The acquisition and implementation process continues to be an area which is reported by the media to present problems for both public and private sector organisations (Keen, 1994; Collins, 1996). The process was originally considered to be a technical process only, but more recently there has been acknowledgement that there are human implications. The process of acquisition and implementation of CIS in the NHS has, therefore, been studied in order to identify the barriers which might be present. The research commenced by conducting a comprehensive literature search which showed some of the barriers found by previous researchers. A number of theories were examined which it was thought would be helpful in approaching the subject. A change model was then identified (MIT9Os, Scott Morton, 1991) which was used to structure the study and as an aid to analysis. The model would be examined for its utility as a change model in the NHS setting. The research used both quantitative and qualitative methods of data collection. A macro view of the process was initially sought because this approach is seldom taken (Kwon & Zmud, 1987). The major part of the research consisted of 4 case studies and 2 survey questionnaires. One survey questionnaire was sent to IT/IS directors and managers about the process. It was sent to eight NHS Regions (359 questionnaires) and a response rate of 51.5% was attained. An additional questionnaire was sent out to human resource directors in the NHS. This was sent to 400 directors and the response rate was 48%. The study identified a number of barriers to implementation in different elements of the organisation, one of the most important barriers being related to politics/power. It was found that the reasons for acquiring new systems are not always articulated, and if these are not in the interests of powerful stakeholder groups, then implementation may be more difficult. Labour process theory was helpful in examining this aspect (Dent, 1996). Results show that existing models are inappropriate for the majority of CIS implementations. The MIT9Os Model (Scott Morton, 1991) was adapted, adding the element of politics/power, together with money and time as major constraining factors. The element of strategy was given a more prominent position, to indicate a pivotal role and it is argued that the model should not be an equilibrium model because of the constant change necessaiy in the modern business environment. The previous model was expanded to show some of the important issues and questions which need to be addressed by those approaching implementation. However, the research showed that the complexity of the process precluded any simple prescriptive answers to implementation problems being given. Models are little used by practitioners, but if they are used they need to carry a warning note that they are only an aid to preliminary thought, and much other background reading and analysis of the particular situation needs to accompany them.

This study examines the importance of age, education, and the health system reforms in the mid 1990's on the utilization of five health services: specialists' visits, family doctor visits, non-physician health professional visits, hospital use, and home care services. The analysis focuses on the Canadians 45 and over, and uses data from the National Population Health Survey. / Results. Age per se has only a minor effect on utilization; the relative high utilization rates observed among the aged relate to the use of services by people with chronic conditions, whose prevalence is higher among the aged. Education has little impact on use of services among the aged. The reforms had only significant effect for four services. They increased utilization of non-medical health professional consults, and increased probability of consulting a specialist. They reduced length of stay, and decreased the number of visits made to family doctors.