A personal health record (PHR) allows a patient to exert control over his/her healthcare by enhancing communication with healthcare providers. According to research, patients find value in having access to information contained in their medical records. Often a glossary is required to aid in interpreting the information and understanding the content. However, giving patients the ability to speak with providers about their medical conditions empowers them to participate as informed healthcare consumers. The majority of patients (75%) at Medical Specialists expressed their intention to adopt the PHR if it is made available to them. Although the perceived usefulness of a PHR was a significant determining factor, comfort level with technology, health literacy, and socioeconomic status were indirectly related to intention to adopt as well. Perceived health status was not found to be a significant factor in this population for determining intention to adopt a PHR. The majority of patients in each category of gender, age, marital status, and race/ethnicity (except American Indian/Alaska Native) expressed interest in adopting a PHR, with most categories being above 70%. Findings indicate a broad acceptance of this new technology by the patients of Medical Specialists. Improvement of adoption and use rates may depend on availability of office staff for hands-on training as well as assistance with interpretation of medical information. Hopefully, over time technology barriers will disappear, and usefulness of the information will promote increased demand.

This study examines the relationships between interorganizational network development and sustainability, organizational capacity for emergency management, technology utilization, and community disaster resiliency. It is proposed that cross sector and interorganizational collaboration (i.e., network development and sustainability), information communication technology (ICT) utilization, and organizational capacity have a positive impact on disaster resiliency. Disaster resiliency is measured with a three dimensional metric which includes effectiveness of disaster response, effectiveness of disaster recovery, and adaptive capacities. A questionnaire was sent to organizations that are part of the emergency management system in 11 counties in Central Florida. These organizations were identified by each county's comprehensive emergency management plans. County emergency managers served as the liaison people to reach organizations. They distributed the questionnaire and sent reminders to participants. The study aimed to reach an entire population of 855 emergency management affiliated organizations. The survey had a 25.28% response rate. Structural equation modeling was used to determine the impact of interorganizational network development, interorganizational network sustainability, information communication technology utilization, and organizational capacity on community disaster resiliency. The results of the study show that one third of the total variation in disaster resiliency was explained with the exogenous variables in the structural equation model (R2=.31). There was no statistically significant relationship between network development and disaster resiliency. Also, a correlation was hypothesized between organizational capacity and ICT utilization, according to the study findings no correlation was found between these two variables. Network development, organizational capacity, and ICT utilization were found to be positively associated with disaster resiliency. Among all the variables, organizational capacity had the highest impact on disaster resiliency (β=.36). ICT utilization and network development had almost equal regression weights (β=.25, β=.26 respectively). A correlation was also found between network development and ICT utilization with β=.23. The results suggest that organizations that are part of emergency management systems in Central Florida counties could enhance disaster resiliency of their communities by focusing on interorganizational and cross-sector network development, information communication technology utilization, and organizational capacity. Managerial craft has a critical role in developing relationship as most of the interorganizational ties are established with informal connections and mutual trust. Building relationship, installing technological systems, and carrying out joint trainings often exceeds financial capacities of organizations. Enabling more funding for these initiatives is another key point to which policy makers may pay attention.

The two research questions presented in this study are: (1) What factors motivate cities to include volunteer service in strategies designed to address local challenges? and (2) How do cities describe the impact of initiatives that rely on volunteer service to address local challenges? This constructivist grounded theory study (Charmaz, 2006) uses the data coding technique proposed by Corbin and Strauss (2008). Themes in the data are uncovered through the coding process, which includes open coding, axial coding, and selective coding (Corbin & Strauss, 2008). The triangulated data for this study derives from two types of sources: extant texts and key informant interview transcripts from the 39 key informant interviews conducted for this study. The criterion-based purposive sample (Patton, 2002) for this study includes 39 cities belonging to the Cities of Service coalition as of June 2012 that participated in key informant interviews through elected or appointed officials. The Cities of Service coalition is made up of over 100 cities that have subscribed to a Declaration of Service resolving and committing to engage citizens in strategies to address local challenges (Cities of Service, 2010). The Cities of Service initiative specifically promotes the use of volunteer service in addressing local challenges. This study makes a theoretical contribution to the scholarship on volunteering by proposing a grounded theory model for volunteer service demand. The findings of this study suggest that the motivational bases for local governments to engage volunteers in iii strategies to address local challenges are economic motivation, aspirational motivation, and need-based motivation. Additionally, certain feasibility considerations bear on volunteer service demand by local governments. Those feasibility considerations relate to the liability climate, skilled volunteer supply, partnership opportunities, manageability, measurability of impact, and resources. Using data from city organizational charts and 2010 U.S. Census data, the researcher explored whether differences existed as to motivational bases for volunteer service demand relative to city size, mayoral political affiliation, and form of government. No statistically significant differences existed with respect to city size or mayoral political affiliation. The data for this study suggest that cities organized according to the council-manager form of government are less likely to report aspirational motivations for volunteer service demand than cities organized according to the strong mayor-council or weak mayor-council form of government (χ2 =14.36; df=2; p-value=0.007). Additionally, as to need-driven motivations, cities organized according to the council-manager form of government were less likely to be motivated to include volunteers in strategies to address local challenges based on citizen need than cities with the strong mayor-council or weak mayor-council forms of government (χ2 =6.59; df=2; p-value=0.036). According to the findings in this study relative to the second research question, cities assess the impact of service in a variety of ways. Specifically, cities report assessing the impact of volunteer service initiatives in three ways: (1) by creating metrics; (2) by measuring outcomes; and (3) by telling qualitative stories. Notably, two cities report that iv they applying a mix of methods to assessing the impact of volunteer service. The grounded theory model for volunteer service demand and the coded data presented in this study were used to create a generalized logic model for assessing the impact of volunteer service as a strategy to address pressing local issues. Additional findings were made on the data. In particular, a typology for citizen service for cities grounded in the data for this study is presented as an additional finding. The typology identifies four ways citizens serve cities through volunteerism: (1) by serving as ambassadors; (2) by giving money; (3) by supporting city function; and (4) by delivering services. Differences between cities with respect to citywide volunteer coordination based on city size, mayoral political affiliation, and form of government were also explored. A statistically significant difference was observed between small and large cities with respect to the existence of citywide volunteer coordination (χ2 =5.68; df=1; p value=0.007). No statistically significant relationships between mayoral political affiliation or form of government and citywide volunteer coordination were found in this study. Finally, nonthematic observations on the data are presented. These non-thematic observations are comprised of data that did not emerge as a core category of data with respect to the research questions. In sum, cities drive demand for volunteer service, and that demand can be explained through certain motivational bases—economic, aspirational, and need-based—together with various feasibility considerations. Citizens meet the demand for volunteer service in a variety of ways, as the typology offered in this study suggests. The impact of this service v demanded by cities and supplied by citizens can be assessed in a multitude of ways. This study shows that, while assessing the impact of volunteer service as a strategy to address local challenges may be inherently difficult, employing a logic model may be useful to effectively communicate the impact of volunteer service as a strategy to address local challenges.

The purpose of this study was to explore whether attributes of sex role identity and gender role stress differed between perpetrators of child sexual abuse (CSA) and perpetrators of intimate partner violence (IPV). The primary research question posed in the research sought to determine if participants’ attitudes on gender role stereotyping or gender role stress were significantly different between perpetrators of CSA and perpetrators of IPV. Participants in this study were a convenience sample of adult males with histories of CSA and IPV from two different outpatient counseling programs. Participants completed the Bem Sex Role Inventory-Short Form (BSRI-SF) and the Male Gender Role Stress (MGRS) scales to investigate whether the gender role attributes and gender role stress scores of the perpetrators of CSA and IPV were (a) similar or different from each other and (b) whether they fell outside the norms established by the two standardized instruments. This study utilized multiple regression and one sample t-tests to analyze the data. There was a statistically significant relationship between perpetrator type and the BSRI-SF and MGRS scores. Additionally, perpetrators of CSA and IPV had lower scores on the MGRS scale than those men in previous research. Additional research was suggested to further explore the relationship between gender role stereotypes and gender role stress on the perpetration of CSA.

In much the same way as the racial integration movement, advocates for students with disabilities (SWD) have cultivated an active and vocal lobby seeking to establish and then implement legal mandates to integrate classrooms in the hope that social acceptance would follow. Through federal mandates such as the Individuals with Disabilities Education Act (IDEA), conceptually initiated in 1975 and revised in 2004 as the Individuals with Disabilities Education Improvement Act (IDEIA) along with Section 504 of the Rehabilitation Act of 1973, these students have a voice to cry out for access to the experiences of work, conversation and play with their peers. This study explores the impact that classroom efforts to offer "inclusion" have on their nondisabled peers' intent to include their fellow SWD in their lives as students. Using survey research methods and guided by the Theory of Planned Behavior (Aizen, 1985), 593 responses were obtained from a convenience sample of 936 third, fourth and fifth grade students educated in 52 classrooms spread across 6 different schools in two counties (Seminole and Orange) in Central Florida. Survey results were also collected from the students' parents and their teachers and used to add a richer depth to the data analysis. The data was compiled and analyzed using mean comparison tests (T test and One & Two way ANOVA tests) and a multinomial logistic regression equation. SPSS 13.0 was used to compute the impact that independent variables (integration and interaction) had on the dependent variable (intent to include). The results suggest that the integration of SWD had a significant impact on nondisabled peers; yet efforts to promote peer interaction seemed to have a mixed result. Additionally, the students' gender (female), the students' prior exposure to SWD and a positive teacher attitude toward people with disabilities also had a significant impact on the response of students' intent to include SWD. The results of this analysis are presented along with a discussion of these findings in relation to public policy initiatives to promote the social inclusion of community members. Limitations and recommendations for future research are also indicated.

ABSTRACT A major change in longstanding police organizational behavior is increasingly evident in the recent emergence of computerized information-sharing networks in public safety. From both theoretical and empirical perspectives, a better understanding of the determinants that can explain and predict the rise and growth of this new and significant development in American policing is needed. A highly limited body of empirical studies has endeavored to validate effective predictors of adoption and utilization of electronic information-sharing networks by local law enforcement agencies. Utilizing an integrated theoretical framework largely built upon Rogers' diffusion of innovations theory, sixteen hypotheses were tested through logistic regression and multiple regression analyses of survey research data collected from local law enforcement executives in the three states of California, New York, and Georgia. Qualitative research organized and conducted through targeted telephone interviews with twenty law enforcement executives across the three study states and with responses to open ended questions within the study survey instrument aided in the examination of these hypotheses. 66.7% of the cases of agency adoption of information sharing were correctly classified by the predictors within the logistic regression model. Adoption was positively influenced by a chief executive who demonstrated strong leadership and possessed more extensive experience in law enforcement. Adoption was negatively affected by increasing the opportunity to experiment with this innovation and advancing age of the chief executive. Both quantitative and qualitative findings confirmed that law enforcement agencies that exhibited dedicated leadership are more likely to adopt information-sharing networks. 19.4-25.9% of the variation in the outcome variable of adoption was explained by the predictors within the logistic regression model. Utilization was negatively impacted by growing autonomy of police organizations within the network but benefited from innovation attributes such as the acquisition of an advantage in crime fighting capabilities and reduced complexity in employment of the information-sharing network. 9.1% of the variation in utilization of information-sharing networks could be explained by the predictor variables included within the multiple regression model. Qualitative research also cross-validated the positive effect of gaining an advantage over the criminal element as influential to utilization. A greater advantage in preventing and solving crimes, higher levels of inter-organizational trust between police agencies, and enthusiastic executive leadership were found by the qualitative inquiry to enhance both adoption and utilization. Knowing in advance which theoretically informed and empirically validated antecedents can facilitate or impede adoption and utilization of information integration networks could enable policymakers and law enforcement administrators to optimize strategies to attain successful outcomes.

Healthcare services for the aging population in the United States are a complex configuration of acute healthcare organizations, and post acute nursing facilities, home healthcare, and community based services. The system encompasses all services that imply the need for clinical, medical, or professional judgment (Baldrige National Quality Program, 2006). Most Americans believe the system exists to provide preventive services, management for chronic conditions, and health care services to meet the needs of the people (National Committee for Quality Assurance (NCQA), 2004). However, the healthcare delivery system is fragmented across a broad array of settings (Coleman, Smith, Frank, Min, Parry, & Kramer, 2004), plagued by gaps in quality of care, and does not provide optimal care to the majority of American citizens (NCQA, 2004). As a result, national efforts are focused on the identification of quality indicators, performance measures, and the driving need for consensus standards across a multiplicity of providers, payers, and stakeholders. The overarching focus of this effort is to bridge the gaps in health care quality, and reduce documented disparities for vulnerable populations (National Quality Forum (2004). Healthcare transitions occur as patients receive a broad range of services across a multiplicity of providers, payers, and settings. Aging patients > 65 are most vulnerable during these transitions. A poorly executed transition can result in complications for the patient, duplication of tests and services, discharge delays, increased lengths of stay, early readmissions to the acute care setting, frustration for families and care givers, and dissatisfaction with overall services. Management of care and accountability across settings is limited and patients are falling through the cracks in the foundation of the healthcare system (Covinsky, 2003). The intent of this research was to examine healthcare transitions for patients > 65 admitted to a large acute healthcare system, and to identify measurable quality indicators for an innovative delivery model designed to optimize early discharge from the hospital through rapid rehabilitation. This was a quasi-experimental, cross-sectional design measured at the patient level. The research included a total sample of 250 patients representing both the intervention and the control group. The intervention group consisted of 100 patients who were rapidly discharged to a transitional care facility in the community, and 150 patients randomly selected to a control group that did not transition to rapid rehabilitation. The groups were matched as closely as possible by age, gender, race, primary diagnoses, and the complexity of case. Inefficiency was measured by 3 indicators (1) length of stay, (2) total expenses before contractual allowances, and (3) discharge delays from the hospital. Ineffectiveness was measured by 3 indicators: (1) readmission within 30 days, (2) patient safety with falls serving as the proxy, and (3) overall patient satisfaction. Descriptive analysis was performed utilizing SPSS 15.0. Path analysis was method of choice for data analysis and AMOS 7.0 was utilized for the measurement model. Descriptive analysis found a broad range of diagnosis related groups across 183 women and 67 men with a mean age of 80 for both groups. Initial analysis found the intervention group had a mean length of stay of 9.17 days, and experienced 20 readmissions. The control group had a mean length of stay of 6.77 days, and 30 readmissions. The statistical analysis suggested length of stay and cost of healthcare services are statistically significant indicators at the 0.05 or lower level and that patient safety has the potential to be developed as an indicator for effective outcomes. The identification of quality indicators, measurement of efficiency and effectiveness, and establishing predictors for successful healthcare transitions is dependent on the quality and integrity of data abstracted from hospital information systems, accuracy of information in patient records, and the consensus of standards and definitions across a multiplicity of stakeholders. Further research and collaboration is necessary to ensure that patient transition to innovative care programs such as rapid rehabilitation is based on well-defined patient selection criteria. The intent of the methodologies and quality indicators explored in this research supports the increasing need to ensure that inferences and quality measurements drawn from healthcare information is based on valid, reliable, and well defined data sources (Pan, Fergusson, Schweitzer, & Hebert, 2005). This research suggests hospitals are making steady progress to overcome challenges to safe, quality health services as outlined by the Institute of Medicine (2001) for system redesign, but finds specific implications for hospital leadership. There is a need to thread evidence based practice initiatives into hospital and clinical structures to accommodate new delivery models, processes, and case management. Health services information needs to be housed in a central repository or data warehouse to increase transparency of reportable information across systems and to ensure that valid and reliable information is utilized to draw inferences about performance of hospital systems (Selden & Sowa, 2004) and that quality measurements are established to ensure a scientific foundation for the management of healthcare services (Wan, 2002).

Chapter 1 raises the research question guiding this study. Do relationships that board members of nonprofits have to officials in other agencies affect the likelihood of acquiring grants? The objective of this study was to examine the role that relationship ties played in the nonprofit sector’s ability to receive grants. Chapter 2 ties the research agenda to existing research. Nonprofit organizational and financial behavior was explained in terms of resource dependence. Since nonprofit organizations face uncertainty in resource allocation, the behavior of the organization and the board members change in reaction to uncertainty. The relationships that board members possess serve as social capital for the nonprofit through a series of formal and informal ties. Chapter 3 provides a theoretical framework for measuring relationship ties as well as other variables to funding. Ties that were measured included previous work experience in government agencies, nonprofit agencies, for-profit organizations, and universities. Relationships ties also included previous appointment to a nonprofit board and membership in professional associations. Additional variables such as financial and organizational measures were considered that had an effect on funding likelihood. Expected funding then became a function of all of these variables. This framework led to the hypothesis that nonprofits with a greater number of relationship ties, controlling for appropriate variables, will receive more funds from a government agency. Chapter 4 describes the methods used. The sample of organizations included 176 nonprofit community healthcare organizations over the span of five fiscal years. Board member names, financial and organizational data, and relationship ties were collected as they were expected to affect funding outcomes. Information on relationships was obtained from three sources: LinkedIn profiles, Who’s Who profiles, and agency websites. Financial and organizational variables were obtained from nonprofit organizations’ 990 tax forms. Chapter 5 details the analyses and the results from the collected data. Conducted analyses included a series of multiple regressions, a probit regression, and fixed-effects and between-effects panel data regression models. The findings partially supported the hypothesis. While there were some relationship ties that were correlated to anticipated funding, the effects were small across analyses. Financial and organizational variables overshadowed the effects of relationship ties. There was evidence of mediation in that a number of variables were significant only if board members were in an organization receiving funds prior to the examined time period. Ties to other nonprofits mattered only when an agency already had funding. Chapter 6 concludes with possible explanations, policy implications, and further directions.

This paper examines common and past applications of affirmative action, including arguments for and against the application; presents John Rawls’ theory of justice, and proposes a framework using Rawls’ theory for future applications of affirmative action. The proposal relieves heavily on the principle of fair equality of opportunity, both as an indicator for when using affirmative action is appropriate as well as a tool to help identify the people that affirmative action programs should target. Using this framework, the public education system is identified as a sector of society that fails to provide fair equality of opportunity for all citizens, and an example of how the Rawlsian conception of affirmative action should be used in practice to help address the inequalities and help restore equality of opportunity within the public education system is given. Objections to affirmative action, both in general and more specifically tailored to the model proposed in this paper, are raised and responded to. This paper comes to the conclusion that affirmative action programs, when targeted towards individuals who are denied fair equality of opportunity and have low rates of social mobility, will help create a more just society.

Cultural competence is critical to public service, yet it is often ignored and underutilized, especially in post-disaster response and recovery. The current literature on cultural competence and frameworks developed by the private sector do not fully consider the complexities of a post-disaster public service context. This project explores the importance of cultural competence in post-disaster response and recovery, identifies effective training methods and organizational policies which may present barriers to competence acquisition, and proposes a new theoretical framework by which to assess cultural competence in international response and recovery work. This study used focus groups with Haitian beneficiaries (n=7), in-depth interviews with response and recovery workers (n=50), close ended surveys with both groups (n=226), observation, and a review of secondary sources (e.g. job announcements, training manuals) to explore cultural competence from the perspectives of international response and recovery workers, their agencies, and Haitian beneficiaries after the January 2010 Haitian earthquake. The analysis revealed that although 88% of participating aid workers identified cultural competence (CC) as critical to program effectiveness, 42% had no training before or during deployment. An analysis of the job announcements revealed that only 37% of agencies required cultural competencies. While aid workers and beneficiaries identified experiential strategies (e.g. immersion, mentoring) as critical to cultural competence acquisition, organizational policies (e.g. curfews, restrictions on travel) were often found to be at odds with these methods and more than 1/3 of participating aid workers felt that these policies were a barrier to cultural competency. Findings from this study may help aid workers better understand the importance of cultural competence and how it can improve the effectiveness of aid programs, and provide ways in which aid agencies can enhance cultural competence acquisition by their employees.