Background: This research was designed to understand factors influencing Motor Vehicle Crashes (MVCs) on or near the Hualapai Tribe’s reservation in northwestern Arizona. The goal is to enable the Tribe to develop and implement a locally relevant MVC intervention program. The specific aims were to: i) compile and analyze 2010-2016 MVC data from Hualapai and federal sources to assess distributions of frequency, rates, high risk-locales, causes, days, times, age and sex of the drivers, in addition to assessing related conditions; ii) document local perceptions of environmental, social, and behavioral barriers to safe driving practices, and knowledge of MVC risk factors and existing tribal laws; and iii) provide evidence-based recommendations using the results from quantitative and qualitative data analyses. Approach/Methods: The research process applied a Community-Based Participatory Research approach and mixed methods using: a) secondary data analyses of records from six tribal programs and Indian Health Service (IHS), and b) qualitative analyses of data from two focus groups and field documents. Sensitivity analyses were conducted of IHS and Tribal Driving Under the Influence (DUI) data, using the 2010 U.S. Census as the denominator after adjusting for an undercount of up to 25%. Descriptive statistics, Fisher’s Exact Test, and linear and logistic regressions were used to examine significance. MVCs per 10 miles per year were estimated for State Route 66 and Diamond Bar Road/Grand Canyon West on or near the reservation due to higher numbers of crashes. Statistical process control charts, especially g-charts monitoring time between events, were plotted to examine the stability in the number of MVCs over time for each road. NVivo11Pro© was used to code and analyze the focus group data, guided by both inductive and deductive theories. Results: Driver’s seatbelt use in the Hualapai community increased from 2010 to 2012 (p < .0005), and reported DUIs decreased from 2010 to 2016 (p = .027). Similarly, car/booster seat use improved from 2014 to 2015 (p < .0005). Two hundred and fifty (N = 250) MVC-related injuries were registered at IHS facilities for Hualapai community members between 2006 and 2015. The highest rate, 22.4%, was observed in 15- to 24-year-olds, followed by 21.6% in 55- to 64-year-olds. For several combinations of numerators and denominators, sensitivity analysis of the IHS data shows a clear disparity between the Tribe’s MVC rate compared to the 2008 U.S. rate of 771.4 nonfatal injuries per 100,000 persons and the national goal for Healthy People 2020 (694.3 nonfatal injuries/100,000 persons). The major themes emerged from qualitative analyses of the focus groups were: i) unsafe traffic infrastructures, ii) DUI, iii) repeated DUI offenders driving on the reservation, and iv) a perception of lenient tribal traffic laws and enforcement on the reservation. Using study results, five Public Service Announcements were co-developed to inspire community-members to continue the trends noted from 2010-2016 and be aware of continued risks. Conclusions: MVCs are a multidimensional issue needing communitywide awareness of the range of risk factors. An intervention that addresses human and structural risks requires an alliance of tribal programs and external partners (e.g., IHS, university, federal, and state). Recommendations: Local recommendations include providing school- and institution-based education about alcohol/alcoholism and DUI consequences, and ongoing culturally and locally relevant communitywide education through the local newsletter and radio station.

Introduction - Health and social care sector activities in the United Kingdom have a considerable carbon footprint which impacts on the natural environment. Waste management is one area of focus for the reduction of this environmental impact. Previous research has studied the quantities and compositions of healthcare waste highlighting the potential for recycling. Limited research to date has investigated both health and social care waste management in a holistic study incorporating the behaviour, composition and systems. The current study aimed to investigate waste management behaviour, systems and compositions at four health and social care sites in the South West of England, then derive a framework of health and social care waste management behaviour incorporating points of intervention for the improvement of waste management practices. Methods - A mixed methods multi-strategy concurrent triangulation design was used to investigate the waste management at four health and social care sites in the South West of England. This consisted of a management interview sub-study investigating waste management policy, guidance and training. An observational sub-study was used to investigate health and social care employee waste management behaviour. An audit of the clinical and domestic waste streams provided an overview of the waste composition at each site. Finally a self-report questionnaire sub-study of decision making was conducted to investigate the conscious and habitual aspects of waste management decision making. The findings from these four sub-studies were then synthesised through a data triangulation process. Findings - The domestic waste bins were most commonly used to dispose of waste during the observational sub-study. The waste audit sub-study found the domestic waste stream contained the largest percentage of potentially recyclable waste. The observational sub-study also uncovered twenty unique primary themes influencing the employee waste management behaviour. These themes included aspects internal to the health and social employee such as confusion, and external themes such as equipment. The management interviews highlighted a lack of waste management training and a reliance on the local site waste management policies to guide and monitor employee waste management behaviour. Discussion - The health and social care waste management behaviour improvement framework (HWMBIF) is presented. The HWMBIF is a novel framework, derived from the triangulated data of the current study, for understanding and improving waste management behaviour at the participating sites. Several interventions based in the HWMBIF and on the study findings are presented. Future research will focus on testing and refining the HWMBIF, the suggested interventions and developing further interventions.

This dissertation presents novel tools to help instructors measure students linking of content knowledge and the actions students perform for studying in the context of post-secondary General Chemistry. The first tool described in this work is Creative Exercises (CEs), an open-ended assessment that has the potential to promote students making connections across the content covered in General Chemistry. Students are given a simple prompt that describes a chemistry situation, and asked to write as many statements as they can that are correct, distinct and relevant to the prompt and the course content. The written responses to CEs from both in-class exams and homework assignments are examined for evidence of linking chemistry concepts. The findings indicate that students are able to use a wide range of topics to answer CEs based on the prompts. Also, from student responses to CEs, students’ misunderstandings of chemistry models are uncovered. To determine the prevalence of links and facilitate implementation in large classes, the second tool termed Measure of Linked Concepts (MLCs) is developed and implemented in General Chemistry. MLCs provide similar prompts as CEs and also a series of statements developed from prior student responses to CEs. Students are asked to evaluate the legitimacy of these statements. Students’ performance on MLCs is examined and the results show that the majority of students show proficiency in prior knowledge. However, a sizeable proportion of students can’t recognize the situation where a chemistry model is misused. Student responses to the above two assessments (CEs and MLCs) provide evidence for linking chemistry concepts of students in General Chemistry, both correctly and incorrectly. They also serve as tools for showing the relevance of prior topics and subsequent topics throughout the course and communicating with students for learning chemistry as a theme instead of separated facts. Finally, text message inquires are used to explore student study habits in General Chemistry. Study habits are defined as the frequency and type of actions taken toward studying outside the classroom in this work. The evidence for the feasibility of using text message inquiries as a data collection tool and the validity of the collected data is presented. Students in General Chemistry are characterized as three clusters based on their study habits. The cluster of students who reported studying in addition to the required course material outperform the other two clusters of students, who knowingly do not study and who reported studying only required course materials. By tracking study habits of a common group of students, we observe the signs of adapting. In addition, study habits of students at-risk of failing the course based on incoming SAT scores are explored in this work. The results indicate both frequency and quality play a role in students’ academic performance, and quality may be more important than frequency. These results provide a path for at-risk students to improve success rates in General Chemistry.

Burundi’s high maternal and child mortality is caused in part by the high fertility rate, prompted by low rate of contraceptive use. Available sources report a contraceptive use of 18% among married women, but this excludes unmarried sexually active women. This study employed mixed methods to understand rates of contraceptive use in rural Burundi. We first assessed availability and uptake of contraceptives in 39 health clinics in the rural districts of Rumonge and Bururi. We selected sites with different utilization rates and conducted individual interviews and focus group discussions. 56 individuals participated including women, men, facility managers and community leaders. Uptake of family planning averaged 2.96%. Greater uptake was positively associated with the number of health professionals engaged and trained in family planning service provision as well as the number of different types of contraceptives available. Uptake was inversely associated with duration of stockouts and number of contraceptives stocked out. Qualitative data pointed to scarce resources, sociocultural factors, fear of disclosure and side effects, partner’s disapproval, and lack of information on modern contraceptives as explanations of low uptake. Interventions would need to take into account one or more of these factors in order to improve uptake of family planning

Background: Pregnancy is a significant period of time for individual women. Promoting optimal health behaviors and supporting individuals during critical periods of health (such as pregnancy) is an important aspect of public health research and practice. One way of supporting individuals in promoting positive health behaviors and outcomes is by increasing their health literacy. The ability to find appropriate health information is the first step in the health literacy process. This process of finding information in health contexts is called Health Information Seeking Behavior (HISB). Whereas, HISB has been extensively studied in chronic health contexts, little research has been conducted regarding maternity-related information seeking in women. Purpose: The purpose of this study is to explore the pregnancy-related health information seeking behavior (HISB) of women while they were pregnant. This objective will be achieved through the following specific aims: (1) To describe topics sought, and (2) describe the sources of information used by women during pregnancy. Methods: To achieve these aims, a multi-phase, descriptive, mixed methods, cross-sectional research design will be utilized. Phase I consisted of an online survey disseminated to collect HISB data on first-time mothers (N = 168) who delivered a child within the prior 12 months. Phase II consisted of in-depth individual interviews (n=26) with a sub-set of participants who completed the online survey assessment to check the consistency of the survey findings and further explore constructs related to HISB. Findings: Using primary data collection, pregnant women seek information on numerous pregnancy and childbirth topics (average 18.7 topics). Of information they sought, women ranked the three most important topics to them. If looking at topics deemed ‘most important’ irrespective of rank positioning, the most frequently cited topics were ‘How My Baby Grew While I was Pregnant’, ‘Complications during Pregnancy’, and ‘What NOT to Eat during Pregnancy.’ If we look at only those topics ranked as being first ‘most important’, ‘What NOT to Eat during Pregnancy’ is replaced by ‘Natural Birth’. Findings from the qualitative phase of the study indicated that topics were salient for a number of reasons, including curiosity about pregnancy as a new experience, wishing to avoid poor health outcomes, and wanting to achieve maternity-related goals. Quantitative results indicated that women used multiple sources of information during pregnancy to meet their information needs (average 9.9 sources). Of information sources they used, women ranked the three used ‘most often’. If looking at sources used ‘most often’ irrespective of rank positioning, the most frequently used information sources were ‘My Doctor(s) that Took Care of Me while Pregnant,’ ‘Pregnancy and Childbirth Books,’ and ‘Pregnancy and Childbirth Mobile Applications.’ If we look only at those information sources ranked as used ‘most often’, ‘Pregnancy and Childbirth Books’ are no longer used as often, and ‘Midwive(s) Who Took Care of Me while Pregnant’ becomes important. Qualitative interviews indicate that women use information sources for a variety of reasons including ease of access, access to the lived experiences of other pregnant women, reliance on professional expertise, and anticipatory guidance. Conclusion: This study found that pregnant women look for many different pregnancy and childbirth-related topics, using multiple sources of information to do so. There were multiple motivations driving information needs and use of information sources. Further, beliefs about the value of information sources were different given the motivation behind using them. Understanding pregnant women’s HISB may allow us to understand which translational practices better address individual information needs in ways that they are more likely to use. Further, if the motivation behind why women seek out information is understood and why they use certain information topics, better targeted and tailored health literate educational materials for pregnant and postpartum women may be created. Exploring health information seeking behavior of pregnant women is the first step in understanding and affecting health literacy in this priority population.

Sustainability concerns have become prevalent in environmental, societal, and economic systems. To address education towards sustainability the need for explicit instruction in sustainable systems is apparent; however, it is underrepresented in American schools. Despite the emergence of sustainability topics in the literature, few have addressed teacher dispositions about providing this needed instruction and none have reported quantitative measures with acceptable estimates of reliability and validity.Dispositions are defined as the tendency to act in a particular manner that aligns with an individual’s belief which can develop and change over time, and are influenced by the experiences and circumstances faced by the individual. To provide the necessary instruction not only are instructors responsible for the curricular content and pedagogical content, but most importantly, they must possess positive dispositions towards providing this instruction. The purpose of this study was to construct and determine estimates of the validity and reliability of the Dispositions Toward Teaching Sustainable Systems Instrument. Using a sequential mixed methods design and Luyt’s Framework for instrument development the researcher, using qualitative methods such as interviews, identified themes that were supportive of the theoretical construct. The four themes that emerged were: administrative support, outdoor resources, collaboration, and professional development, all receiving above 80% interrater agreement (n=3 judges). The quantitative aspect identified the key indicators (items) and their estimates of reliability and validity, and their goodness of fit to the four theoretical constructs. Content validity estimates of the items generated from the interviews were explored using expert judges (n=2) in the area of sustainability education, also achieving above 80% agreement. Participants enrolled in three succeeding semesters of the Teaching Elementary Science Methods course (n=233) were then used to further estimate the reliability (α >.08), construct validity (normed chi-Square = 2.04; GFI=.86 RMSEA =.076; NFI=.96 CFI =.98 PGFI=.634 binomial index of model fit ppR=.271 R2=.073 (4,227)=4.5 pp

The ubiquity of Web 2.0 technologies has led to a seismic shift in the way educational services are delivered. It comes as no surprise then that e-tutoring—otherwise known as electronic or online tutoring—is quickly supplanting face-to-face tuition for reasons of both cost and convenience. While e-tutoring is an effective form of academic support for many students, its efficacy remains tenuous for those confronted with a digital divide that figures predominantly around geographic barriers, socio-economic status, and educational levels. Premised on diffusion research, this master's dissertation explores the implementation of an e-tutoring service known as Homework Help that has effected relatively low adoption rates. It uses a concurrent mixed-methods approach—including surveys, interviews, and focus groups—to examine the factors that have led to this low adoption rate. The results are presented via two journal articles situated within a larger meta-talk: The first article contrasts the adoption patterns apparent between rural and urban students, while the second article looks at the utility of diffusion research in examining educational technologies, as it explores the use of e-tutoring for applied stream students. The findings of this study suggest that rural and urban, as well as applied and academic student subgroups, differ in terms of their perception and adoption of e-tutoring. Implications for educational policy, especially in regards to rural education, are discussed.

The purpose of this research is to explore the context of youth recreational soccer, and to examine how coaches volunteering in this context learn to coach soccer. Framed within Jarvis’ (2006, 2007, 2008, 2009) theory of lifelong learning and employing a mixed-methods approach, this dissertation research had two distinct phases. Phase One involved the collection of data via an on-line survey from 433 recreational youth soccer coaches from Eastern Ontario. The survey served to collect demographic information, as well as general information about their team, their role as a recreational coach, and their approach to learning. The data analysis for the on-line surveys was comprised of an analysis of descriptive statistics. Phase Two involved semi-structured interviews. Recruited through their participation in Phase One, 30 coaches were purposefully targeted and interviewed based on their varied biographies, experiences, and social contexts. Additionally, seven soccer administrators were interviewed. Interview data was analyzed according to the principles of thematic analysis (Braun & Clark, 2006). Findings examine the biographies of youth recreational coaches, their coaching context, how recreational coaches learn to coach, issues of shared responsibilities related to learning, as well as practical implications. It is suggested that recreational coaches differ from one-another on many factors, and that the context of recreational youth soccer is similarly diverse and presents unique challenges to coaches. Recreational youth coaches learn to coach through a variety of sources; mostly through informal learning situations. Responsibilities surrounding coach development fall on the shoulders of individual coaches and clubs, as well as regional, provincial, and national associations; and suggestions for increased engagement in this regard are provided.

Over the past few decades, research into public perceptions of crime has largely focused on how mass media consumption shapes beliefs about crime. Substantially less research has been dedicated to exploring the potential influence of alternative sources of information, and even less attention has been devoted to exploring the spatiotemporal aspect of perceptions of crime. This thesis combined Geographic Information Systems (GIS) and structured interviews in order to explore the narratives about crime constructed by three sources: (1) the Ottawa Police Service, (2) the Ottawa Citizen newspaper, and (3) residents of Ottawa. Eight participants were taken on a walking tour interview, and their responses were compared to two maps depicting the geographies of crime presented by the Ottawa Police Service and the Ottawa Citizen. It was found that the places participants believed to be criminal ones were poorly maintained and dirty, were populated by large numbers of homeless individuals, had little to no commercial space, were geographically close to other areas of the city believed to be criminal spaces, and were poorly lit. The three construction of the spatial distribution of crime in Ottawa shared many common features (such as a focus on the Byward Market area as highly criminal) while remaining distinct in their presentation of certain types of spaces (such as the newspaper’s presentation of homeless shelters as highly criminal spaces). Ultimately, this thesis explores three distinct narratives about the geography of crime in Ottawa through the use of a unique mixed methods design that provides an alternative way of interpreting data most commonly analyzed through deductive or quantitative means.

Background: The current literature concerning self-harm and suicide has shown firstly that self-harm is a major public health problem, secondly that people who self-harm are at increased risk of suicide and thirdly, that women prisoners have a higher rate of self-harm than women in the general population and than male prisoners. Women prisoners are therefore particularly high risk of self-harm and suicide and yet to date, no specific intervention has been developed for this group. Aims: This study intends to build on an intervention found to be effective in the community and to describe a methodology of conducting a therapeutic intervention in a prison environment. Method: The research utilized both qualitative and quantitative methods conducted over four phases. In Phase 1, semi-structured interviews were completed with women prisoners who self-harm and with prison staff. Data was analysed thematically. In Phase 2, the results from the analysis were then used to inform the modification of a Psychodynamic Interpersonal skills Therapy (PIT) model originally used in the community. During the third phase of the study, prison staff were recruited and trained to deliver the therapy. Finally, the fourth phase consisted of a feasibility and acceptability study with 64 women prisoners who had recently self-harmed. Thirty-two were randomized to the treatment group which consisted of four sessions of individual PIT therapy and 32 to the control condition which consisted of four sessions with a member of staff not trained in the therapy. Rates of self-harm were measured pre- and post-treatment. Standardized measures for depression, suicide intention, hopelessness and interpersonal skills were also administered. These data were further supported by interviews conducted with participants who completed the intervention, therapists and therapy supervisors. The methods used in the study were constantly evaluated and amended when required to describe a methodology suitable for this environment. Results: There was evidence of a lack of understanding of self-harm by prison officers. The trial phase of the study did not show evidence of efficacy for the intervention. There was an overall reduction in rates of self-harm pre- and post- treatment across the sample. Comparison of scores on outcome measures, pre- and post-intervention, showed a reduction on all tests in both treatment groups but this was not significant. It was not feasible to deliver the therapy as originally envisaged and substantial changes to the methods were needed. The results showed that prison staff had the skill and capacity to deliver PIT therapy but that the prison was not able to support such a role. As a result external therapists had to be brought in to the study. Conclusions: It is acknowledged that the study was not feasible as originally designed, but due to the small sample size we cannot say it was not effective and therefore, not worthy of further study.