Background: Wilderness therapy is one type of residential treatment that has been shown to successfully engage adolescents in mental health and substance use treatment. A growing body of wilderness therapy outcomes research supports this and wilderness therapy is being increasingly recognized as a legitimate intervention for adolescents experiencing challenges with mental health and substance use. Some evidence suggests that not all elements of wilderness therapy necessarily work the same for all clients. The question of client fit in wilderness therapy, or what works for whom, is one that has yet to receive much empirical attention in the literature. Purpose: The purpose of this study is to examine how participation in one Canadian wilderness therapy program effects two outcome variables, trait emotional intelligence and readiness to change, and how client fit moderates these relationship. Specifically, this research examines: (1) changes in clients’ trait emotional intelligence from pre- to post-wilderness therapy, (2) changes in clients’ readiness to change from pre- to post-wilderness therapy, and (3) if these changes differ by pre-treatment client-level variables – sex, age, funding, digital interference in everyday life, or substance abuse severity. Methodology: Research was conducted with 48 participants ranging in age from 14 to 20 years. A longitudinal case study design was employed. Data were gathered by program staff using standardized data collection tools, modified versions of standardized tools, and administrative forms. Findings/Conclusions: Findings indicate that participation in this Canadian wilderness therapy program leads to statistically significant increases in readiness to change but not trait emotional intelligence. On average, participants who experienced interference in their everyday life due to video games or online activity before wilderness therapy had larger trait emotional intelligence change scores, while participants who experienced interference in their everyday life due to a virtual relationship had larger changes in readiness to change. None of the client-level pre-treatment variables included in this study significantly predicted increases in readiness to change following wilderness therapy. / Graduate / 2021-12-08

The prevalence of childhood obesity is increasing at an alarming rate and is implicated in the onset of serious and life threatening health problems of both a physical and psychological nature. The current research comprised of three main components. Firstly, the reliability of a readiness to change questionnaire was examined, which had been completed by parents of obese children enrolled in the Bodywise childhood obesity programme. Secondly, an analysis of outcome data from 36 families who completed the above programme was also undertaken in order to determine if the data identified their stage of change, as defined by the questionnaire Thirdly, four semi-structured interviews were conducted with families involved with the Bodywise programme. These parents provided information related to their experiences of lifestyle change, including what initiated change, what assisted change, and what barriers to change they had encountered. Findings revealed that in accordance with the transtheoretical model the readiness to change questionnaire was a reasonably reliable instrument for indentifying parents' readiness to change their child's eating patterns and physical activity levels. Analysis of the outcome data from the 36 families revealed individuals in the action stage of change for both eating and physical activity made more rapid change at the outset of the programme than individuals in earlier stages of change. In addition, information derived from the interviews with families identified several promoters and barriers to change, many of which were similar across families. Until now no studies have examined the application of the transtheoretical model to an intervention for childhood obesity. Previous research has shown support for the model's use with other health problems. Overall this study lends support for the utility of the transtheoretical model in childhood obesity intervention.

The primary aim of this study was to enhance understanding of readiness to change excessive alcohol use in young adults, ages 18-29 in order optimize clinical care for military personnel. Secondary data analysis was conducted using Structural Equation Modeling (SEM) with a proxy sample of community health center beneficiaries obtained from the 2009 Insight Project Research Group’s study on Screening Brief Intervention and Referral to Treatment (SBIRT) in the Harris County Hospital District (HCHD). Based on research-supported predictors of readiness to change alcohol use a multivariate model of pathways to readiness to change was created which incorporated psychological (i.e., emotional distress), behavioral (i.e., drinking severity, consequences severity), and maturation (i.e., age, marital status) factors, as well as demographic characteristics (i.e, race/ethnicity, gender). Multiple fit indices were used to assess the model fit with the data, while multiple group analysis was used to test for invariance between pathways to readiness to change for the young (18-29) and middle adult (30-60) groups. The study sample was ethnically diverse and consisted of 1,256 young adults and 4,623 middle adults. The proposed model showed a good fit with the InSight data set. Results demonstrated a strong path connecting emotional distress to both drinking severity and consequences severity, and then from consequence severity to readiness to change. Together, this path lends support to the concept that young adults are using alcohol to modulate their emotions and further, consequences may play an important role in readiness to chance excessive drinking. Variance detected in the multi-group analysis between young and middle adults also provided support for theory claiming differentiation of these groups, particularly as it relates to excessive drinking and readiness to change. Implications for future research and practice include the importance of replicating this and future studies with military samples. These findings lend support to the role of emotional distress and the coping theory paradigm in treating young adults. The military may be best served by continuing to support resources which promote healthy stress tolerance while simultaneously fostering proactive screening procedures and evidence-based care. Further, these findings also suggest that pathways to readiness to change may vary between young and middle adults, particularly as they relate to alcohol related consequences. Future research should focus on the role of consequences and the influence they may have in promoting readiness to change for each age group within the clinical setting. / text

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Extant information systems literature has viewed systems acceptance and adoption from a technocentric viewpoint that emphasizes post-implementation intentions and attitudes - mainly usefulness and ease of use. Further, the effects of organizational hierarchy and work-environment factors have not been adequately factored largely because the single level user-level perspective has dominated. This dissertation addresses this gap by incorporating work environment factors while focusing on users’ preliminary, pre-implementation attitudes, perceptions, and intentions. It thus employs a multilevel perspective that allows for deeper insights into the interplay between workgroup- and individual-level phenomena. The objectives herein are, first, to illuminate change readiness as a plausible lens through which system acceptance and adoption can be viewed. Although change readiness is predominantly studied in organizational behavior, it has not yet been applied in information systems research. Consequently, it presents a promising approach to explore users’ responses to new systems. Secondly, this dissertation aims to empirically explore the multilevel nature of the change readiness constructs as envisaged in the framework of the antecedents and outcomes of change readiness. The research model is adapted from the multilevel framework of the antecedents and outcomes of change readiness as propounded by Rafferty et al. (2013). Appropriate hypotheses are developed and a survey instrument established to test those hypotheses. To ensure validity, preliminary investigations are conducted after an expert panel review. Subsequently, data was collected and analyzed to assess the extent to which the proposed model and hypotheses are empirically supported. Results and findings from this dissertation have theoretical and practical implications. Extant literature notes the dearth of research that theorizes outcomes of change readiness in the organizational behavior domain. This dissertation theorizes intention to adopt as an outcome of change readiness. Practice benefits from the context-based empirical results which (1) examine whether change readiness has any significant impact on system adoption and (2) the effect of workgroup change readiness on individual’s intention to adopt the system.

This purpose of the study was twofold: to create and assess factors affecting organizational preparation for change and to assist the USF College of Medicine's administrators in developing and implementing an initiative in order to comply with regulations of the accreditation board. Randomly selected program directors participated in three training modules between September and November 2002. The training was targeted toward the development and implementation of learning objectives for medical residents. A panel evaluated the learning objectives developed by both trained and control directors to see whether the training resulted in the development of superior objectives. Additionally, program directors, residents and faculty were surveyed to determine if there was any impact of changes in learning objectives. More specifically, the three groups were surveyed before and after the development of the learning objectives on perceptions of organizational readiness to change and satisfaction with the current resident evaluation system. Respondents included 20 program directors, 56 residents in training and approximately 52 faculty members in the various programs at the USF medical school. Three sets of analyses were conducted. The first of the analyses concerned the immediate outcome of the training. This analysis was based on an expert panel's judgments of the quality of learning objectives generated by the program directors. The second and third analyses concerned more distal outcomes of the training, and focused on (a) perceptions of organization readiness to change and attitudes about resident evaluation, and (b) perceptions of whether any change actually occurred. For both readiness to change and perceptions of resident evaluation, the design was a 2X2X2X3 mixed ANOVA design. A single factor (trials, pre and post intervention) was within participants. The two main factors of interest for the study were between participants; the first between factor was the training program (experimental vs. control group); the second between factor was time pressure (facing more time pressure vs. facing less). The last independent variable, position, was included in the analyses to reduce error from the individual's position with the organization (i.e., program director, faculty, resident). The dependent variables included attitudes concerning resident evaluation procedures and organization readiness for change. For the third analysis, perceptions of whether any changes actually occurred served as the dependent variable. Because such perceptions could only be taken meaningfully at posttest, the design was a 2X2 between participants analysis in which the independent variables were training (trained vs. control) and time pressure (more vs. less). Results indicated that there was no difference in the quality of learning objectives between trained and control groups and no difference in the changes that were reported by residents, faculty and program directors. The training intervention did not have the intended effect as attitudes toward resident evaluations and perceptions of readiness to change did not improve as a function of the treatment. Time pressure did have an effect on perceptions of readiness to change but in the opposite direction from what was hypothesized; programs under less pressure had more positive perceptions of readiness to change. There was a change from time 1 to time 2 based on position; residents perceptions of readiness to change improved over the course of the study while faculty perceptions became more negative and program directors remained the same.

The purpose of this study was to gain a better understanding of the effect that attribution style and presenting symptoms has on the self-reported readiness to change of female survivors of childhood sexual abuse. The aim was to demonstrate that the stages of change are a useful concept in understanding how to approach treatment with female child sexual abuse survivors seeking psychotherapy. One factor that influences the effectiveness of psychotherapy is a client's degree of motivation. The concept of "stage of change" has been used as a measure of client motivation. Stage of change consists of four basic stages; precontemplative, contemplative, action, and maintenance. Prior research has demonstrated that assisting clients in transitioning from a lower to a higher stage of change early in psychotherapy can improve outcomes. Assigning clients a "readiness to change" score is a simple method of categorizing their stage of change. There are many variables that could impact a client's readiness to change. The two selected for this study were attributional style and presenting symptoms. The statistical analysis consisted of using correlation to determine the strength of the relationship between readiness to change, overall attribution styles, and presenting symptoms. Multiple regression was used to see how much of the variance in readiness to change could be accounted for by different levels of attributions or symptomatology. No correlation was found between readiness to change and the other variables, although internal attribution style, external attribution style, and symptomatology were all correlated with each other. Likewise, the different levels of attribution and symptomatology did not account for a significant amount of variance in readiness to change. A secondary analysis into the relationship between total attributions endorsed and symptomatology provided evidence that individuals who make more attributions report significantly more presenting symptoms than individuals who make fewer attributions. The conclusions drawn from this study focus on the importance of utilizing client motivation in the initial sessions of therapy, and propose that focusing on reducing the number of attributions made could be more beneficial to clients than helping them move from one attribution style to another.

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Culture, resource, and regulatory concerns are elevating the importance of business expansion inthe contemporary world. Everyone, including service providers, must overcome the obstacles.Change readiness assists individuals and organizations in accepting and embracing obstacles. This study seeks to evaluate the different types of services offered to the elderly as well as the obstacles that arise when attempting to expand them, taking into account the diverse cultural backgrounds of the country's population, the dearth of available resources, and regulatory hurdles. In this research, a qualitative method was undertaken, followed by an exploratory analysis. This thesis investigates the service offerings and problems of eleven Bangladeshi service providers using primary data gathered from semi-structured interview. This also utilizes previous scholarly articles and published data from other academic sources.The study's findings highlight service provider challenges and offer a research paradigm for theservice business, notably elderly care. The results indicate that the majority of aged care services provided by different institutions are identical. Healthcare, along with other services like social and recreational programs, and educational and training courses, are all part of this category. Italso demonstrates that cultural, resource, and regulatory constraints are major roadblocks to this industry's development. Furthermore, research finding shows, currently providers are not ready tomeet the incremental demand and subsequent changes will take place in the near future.This thesis contributes to the literature on business development by examining organizational readiness to change (ORC) and the challenges faced by business. Despite focusing on a singlenation, this research provides a comprehensive evaluation of the importance of organizational change preparedness for service growth. This study suggested a conceptual model that relates institutional care obstacles from the provider's perspective.