Le handicap est multifactoriel. Toutes ses composantes sont potentiellement sources d’obstacles et de désavantages. L’originalité de cette thèse est de tenir compte de la complexité de définition du handicap dans l’analyse du recours aux soins de santé primaires. L’objectif ultime des soins de santé primaires est une meilleure santé pour tous, passant par la réduction des exclusions et des inégalités sociales d’accès au système santé. Nous appréhendons le handicap de différentes manières jusqu’à intégrer les trois dimensions d’« une situation de handicap » (dimension fonctionnelle, dimension environnementale, et participation sociale) dans un même modèle explicatif. D’abord, nous analysons la dimension fonctionnelle en considérant les personnes handicapées comme physiquement limitées. Puis, nous investiguons la dimension environnementale par une étude chez les adultes vivant en institution. Enfin, nous adoptons une vision globale du handicap en intégrant simultanément toutes les dimensions par la mesure de capabilités latentes. Le modèle estimé s’approche d’une comparabilité inter-individus révélant, toutes choses égales par ailleurs, les niveaux sur lesquels agir pour pallier les inégalités. Les analyses suggèrent qu’un environnement favorable, sociétal et/ou socioéconomique, pourrait compenser les effets négatifs des limitations et des restrictions cognitives et physiques. Nous concluons sur plusieurs voies possibles afin d’améliorer le recours aux soins primaires : agir sur la dimension environnementale et sur la participation sociale. / Disability is multifactorial. All its components are potential sources of barriers and disadvantages. The originality of this thesis is to take into account the complexity of disability definition to analyze the use of primary health care. The ultimate goal of primary health care is better health for all, reducing exclusion and social inequalities in access to the health care system. We approach disability in different ways, ending with a model that includes the three dimensions of a “disability situation” (functional dimension, environmental dimension and social participation). First we analyze the functional dimension considering people with disabilities as physically limited. Then, we investigate the environmental dimension through analysis among adults living in institutions. Finally, we adopt a global vision of disability that integrates all the dimensions simultaneously through the measures of latent capabilities. The estimated model approximates a fundamental inter-individual comparability and reveals all things being equal, the levels on which to act to overcome inequalities. The analyses suggest that favorable environment, societal and/or socioeconomic could offset the negative impact of the limitations and cognitive and physical restrictions. We conclude on several possible waysto improve the use of primary care: acting on the environmental dimension and acting on social participation.

<div> <div> <div> <p>This dissertation is a three study format. In this dissertation, I used an explanatory sequential mixed method design. Study 1 develops a measurement scale to capture first-generation college students’ agency using the constructs of intentionality, forethought, self-reactiveness, and self-reflectiveness. Study 2 used structural equation modeling to establish a relationship between personal agency, disciplinary role identities, and students’ desire to enact engineering agency. Study 3 was a narrative analysis of how Kitatoi, a Latina, first-generation college student, authored her identity as an engineer. Data for study 1 and 2 came from a survey administered in the Fall of 2017 of 3,711 first-year engineering students across 32 ABET universities. </p> </div> </div> </div>

<div>Technology is rapidly transforming both vehicles and transportation systems. The nature of this transformation will depend on how fast the technology resulting from three related revolutions, those in automated, electric, and shared vehicles, will diffuse. At the same time, the ‘sharing’ economy is growing and affecting mobility in urban areas that includes additional travel alternatives, such as car-sharing services, ride-hailing services, bike-sharing services, and other micro-transit services. It is evident that to prepare for these large-scale operations involving autonomous vehicles (AVs), researchers and transportation professionals need the useful insights on people’s attitudes toward and on acceptance of AVs that can be gained through behavioral experiments. In addition to this, it is also important to understand how the deployment of AVs will impact vehicle ownership and mode choice decisions.</div><div><br></div><div>The goal of this dissertation is to assess the public acceptance of AVs and shared autonomous vehicles (SAVs) via a behavioral experiment (stated preference survey) and offer insights on the potential implications of AVs and SAVs on mode choices. The following four overarching research objectives were formulated: (a) identifying the factors influencing the behavioral intention to ride in AVs; (b) identifying the characteristics of the AV market segments; (c) evaluating the attributes impacting personal vehicle ownership decisions (i.e., decisions to postpone the purchase of a non-AV due to the emergence of AVs); and (d) assessing the factors affecting mode choice decisions after the emergence of autonomous ride-sharing services operated through AVs, and evaluating the corresponding value of travel time savings. The results of each part of the research framework are integrated in the last chapter of the dissertation in order to provide the final conclusions and recommendations of the study.</div><div><br></div><div>To achieve these research objectives, a survey of the general population was distributed online in a major urban area with an advanced multimodal transportation system and captive users of ride-sharing users (Chicago, Illinois) and in an urban area with a more automobile-oriented culture (Indianapolis, Indiana). The survey sample included 400 responses of adults, representative of age and gender on each area. </div><div><br></div><div>One of the contributions of this dissertation is a theoretical model to assess the behavioral intention to ride in AVs that includes components of the theory of Planned Behavior, the theory of Diffusion of Innovation and additional factors derived from the literature while evaluating possible interrelationships between these components. A more holistic approach along these lines can help explain whether the emerging AV technology can diffuse by identifying the factors and key determinants that influence the behavioral intention to ride in AVs. The market segmentation analysis can further provide knowledge of the socio-demographic characteristics of potential AV users and an accurate classification of these groups of potential users in terms of their willingness to ride in AVs. The findings can provide insights into perceptions of and attitudes toward AVs that can help transportation and urban planners, as well as original equipment manufacturers, to prepare for the deployment of AVs by designing marketing strategies to improve people’s perceptions of AVs and increase market penetration.</div><div><br></div><div>Moreover, this dissertation provides a well-documented and easy-to-use framework that can support both planning and policy decisions in urban areas in an era of emergent automated transportation technologies. In urban areas with advanced multimodal transportation networks, the framework can be applied to identify the impact attributes affecting shared mobility in urban settings. In urban areas with a more car-oriented culture, the framework can be applied to explore the potential impacts of the emergence of AVs on personal vehicle ownership patterns. Finally, the survey that was designed to fulfill the goal of this dissertation can be replicated and distributed in metropolitan areas outside the US with more advanced multimodal transportation systems or areas within the US with traditionally higher rates of affinity to innovativeness and areas where AVs have been pilot-tested in real-world road conditions.</div><div><br></div>

Orientador: Enzo Barberio Mariano / Resumo: A justiça climática tem como foco analisar em termos éticos e morais as ações climáticas adotadas pelas nações do mundo e agora, passa a contemplar mais um conceito: a justiça social baseada na teoria das capacidades. Assim, o objetivo desta pesquisa é compreender e quantificar a dupla relação entre desenvolvimento humano e práticas de adaptação e mitigação às mudanças do clima, visando a construção de um índice mundial de justiça climática. Para isso, foram utilizadas as técnicas Modelagem de Equações Estruturais (SEM) e Análise Envoltória de Dados (DEA) a fim de verificar a dupla relação entre desenvolvimento humano e ações climáticas, possibilitando a construção do índice de justiça climática. A partir dos resultados da pesquisa é possível destacar: a) validação de modelo teórico para mensuração de justiça climática composto por 5 constructos de desenvolvimento humano e 2 constructos de mudanças climáticas; b) elaboração de rankings com 198 países que medem a conversão de desenvolvimento humano e ações climáticas nos sentidos direto e inverso; c) evidências iniciais mostram que aumentos graduais de desenvolvimento humano podem contribuir para avanços de justiça climática em sociedades de baixo carbono, d) diferenças entre as médias de desempenho entre regiões geográficas do planeta podem oferecer novas perspectivas para negociações sobre mudança do clima. / Abstract: Climate justice focuses on analyzing in ethical and moral terms the climate actions adopted by the nations of the world and now, it starts to contemplate yet another concept: social justice based on the capabilities approach. Thus, the objective of this research is to understand and quantify the double relationship between human development and adaptation and mitigation practices to climate change, aiming at the construction of a global index of climate justice. For this, the Structural Equation Modeling (SEM) and Data Envelopment Analysis (DEA) techniques were used to verify the double relationship between human development and climate actions, enabling the construction of the climate justice index. From the results of the research, it is possible to highlight: a) validation of a theoretical model for measuring climate justice composed of 5 human development constructs and 2 climate change constructs; b) elaboration of rankings with 198 countries that measure the conversion of human development and climate actions in the direct and reverse directions; c) initial evidence shows that gradual increases in human development can contribute to advances in climate justice in low-carbon societies; d) differences in performance averages across geographic regions of the planet can offer new perspectives for climate change negotiations. / Doutor

The main objective of this thesis is to verify the relationship of the contextually specific motivation in sport to a global self-esteem and possible mediation effects of the physical self-perceptions in this relationship. To achieve this objective six individual studies were conducted. First, we focused on the translation of diagnostic instruments: the Sport Motivation Scale (SMS; Pelletier et al., 1995) and the Social Physique Anxiety Scale (SPAS; Hart, Leary, Rejeski, 1989) into the Czech language. Next, the validity and reliability of the scores obtained by Czech versions of the instruments were examined. Based on the results of the structural equation modeling and using a known-difference evidence validity approach we concluded that both translated instruments may be useful as a valid and reliable diagnostic tools for measuring different kinds of motivation in sport (SMS) and negative physical self-perception (social physical anxiety - SPAS). Using structural equation modeling, we also concluded that different types of motivation in sport (which vary in degree of relative autonomy of the subject) affect specific self-esteem associated with the body, as well as the evaluation of one's self at the global level. Relationship of the sport motivation and the global self-esteem was largely mediated...

Under the George W. Bush U.S. presidential administration, the federal government pushed for greater accountability among institutions of higher education for educational outcomes. Graduation rate is a key performance indicator of institutional accountability. Previous researchers of student attrition focused primarily on the effects of student level factors on student persistence/withdrawal behavior. Recently, researchers put more focus on the effects of institutional characteristics on graduation rates, but most of these studies were exploratory and based on multiple regression models. No institutional model has existed to synthesize their results within a theoretical framework. Such an institutional model is needed to explain the process of student persistence at the institutional level. The purpose of this study was to develop a model of institutional performance in graduation rate for four-year, public and private not-for-profit, Title IV institutions in the United States. This study validated the institutional model based on the IPEDS dataset using the structural equation modeling (SEM) technique. Further group comparison analyses are conducted by fitting the same SEM model to several subgroup datasets based on grouping variables such as control, geographical region and state. Benchmarking analyses were conducted to demonstrate how administrators and policy-makers can use the institutional model to compare the performance of an institution with its peers and what policy changes can they pursue to improve graduation rates.

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<p>Socioeconomic inequality unduly impacts the pathways of socioeconomically disadvantaged students (SDS) in engineering. Past and present scholarship suggests that inequitable access to physical and interpersonal resources inhibits K-16+ students' ability to engage in Science, Technology, Engineering, and Mathematics (STEM) meaningfully. This lack of access negatively impacts SDS' pursuit of, and success in, engineering. Thus far, quantitative studies seeking to understand SDS' trajectories to and through engineering have used income as a proxy for socioeconomic disadvantage. However, such measures are not theoretically positioned to accurately depict or account for the complex sociological processes that lead to, or result from, socioeconomic inequality. Furthermore, such measures do not account for parallel inequalities such as racism, sexism, and classism that exist, influence, and are influenced by it. Therefore, the purpose of this work was to 1) develop a more sociologically accurate measure of socioeconomic inequality, 2) to use that measure to identify the impacts of such inequality on SDS' pathways to and through engineering, and finally, 3) to explore the narrative experiences of SDS when accounting for a more accurate depiction. Using a Critical Realist Feminist approach to structural equation modeling, restricted data from the National Center for Education Statistics’ Educational Longitudinal Study of 2002 (ELS:2002) as well as other supplemental data were used to construct and test a more complex and representative measure of socioeconomic disadvantage, the Model of Socioeconomic Inequality (Study 1). Study 2 used this model to examine how aspects predicting important engineering student outcomes. Neighborhood location and conditions, level of Parent Educational Involvement, and availability of Household Educational Resources negatively impact SDS' opportunities to engage and succeed in engineering and college more broadly. Furthermore, the model suggested that such interactions are uniquely mediated by the intersectional inequalities experienced by SDS and their families. Finally, a rich narrative of one student, Samantha, is included to better understand the lived experiences of SDS amongst their pathways to and through engineering. Samantha was a Queer Asian American female SDS graduating from Computer Science Engineering who has low scores on Parent Educational Involvement and Household Educational Resources. Samantha's narrative shows the important role that the factors identified in the Model of Socioeconomic Inequality had in her experiences. Specifically, Samantha had little access to Parent Educational Involvement and Household Educational Resources from her parents. Rather, these forms of support came from what she referred to as her ``chosen family,'' a group of professors, co-workers, friends, and others who viewed and supported her identity authentically and provided her physical resources when she needed them. Access to this group and the resources they provided supported Samantha's belonging and her ability to succeed in engineering. However, Samantha's narrative also uncovered findings not included in the Model of Socioeconomic Inequality. Specifically, Samantha's narrative suggested she had experienced significant, long-term traumas that were both related and unrelated to her socioeconomic experiences. These traumas negatively impacted Samantha's feelings of belonging and caused her to question her place in engineering, but they were partially mitigated by the support of her chosen family. This three-study dissertation challenges current engineering education thinking regarding the knowledge and study of socioeconomics, trauma, and Intersectionality more broadly. It also challenges engineering education researchers and practitioners to question the current methods of how they support SDS in a multitude of spaces.</p>

<p>  </p> <p>Transportation and health are undeniably related. Transportation and its relationship with health are widely recognized as facing unique challenges in different geographic settings. However, research to date has mainly focused on understanding this relationship in urban areas. Remarkably, the importance of promoting physical activity through active travel (i.e., walking, biking, transit) is understudied in places other than urban areas. Increasing awareness regarding the ability of one's surroundings to encourage or inhibit active travel is critical to preparing us for the transformation of transportation habits. This issue takes on added significance considering telecommuting and the advent of autonomous vehicles.</p> <p>The overall goal of this dissertation is to examine the complex relationship between transportation and transport-related health determinants in diverse geographical settings (i.e., urban core, suburban, large rural towns, and rural areas) from an active travel perspective. To that end, four interdependent studies were conducted to address the following research questions: (i) Do the relationships among built environment, access to infrastructure, and physical activity differ across diverse geographic settings? (ii) What is the relationship among car usage, self-perceived health, and physical activity in rural areas? (iii) Which are the most significant pathways in the association between transportation and health in rural areas? (iv) What are the potential public health implications of adopting Autonomous Vehicles (AVs) in urban areas?</p> <p>First, the differences between various geographic settings regarding the built environment, access to infrastructure, and physical activity levels were assessed using individual-level data in the contiguous U.S. This dissertation employed behavioral science techniques (Structural Equation Modeling – Multi-group Analysis) to estimate how statistical constructs varied across multiple geographic settings. This dissertation concluded that the possibility of being physically active through active transportation, facilitated by the built environment and access, does not decrease linearly with the level of rurality defined in this study. Isolated Rural areas’-built environments and access to infrastructure were usually negatively associated with physical activity levels. This conclusion called for a deep analysis of rural areas regarding their ability to promote active travel.</p> <p>This dissertation studied rural areas' physical activity and its connection with socioeconomic determinants, perceived health, and car usage. Given that this relationship is described as non-linear, using statistical techniques such as path analysis allowed quantifying the direct and indirect effects among variables. This study concluded that high car usage and poor self-perceived health are mediators of physical activity levels. Therefore, efforts from both the transportation and health domain need to promote active travel in rural areas.</p> <p>Informed by transportation and health literature review, a conceptual framework was created by considering socioeconomic, personal, and physical transport-related health determinants. Structural equation models helped elucidate the complex relationships among determinants. The model results confirmed significant pathways among the various transport-related health determinants; hence comprehensive solutions need to be contemplated in future interventions to promote active travel. Interventions such as town center revitalization, heavy transit investments, and better broadband access that facilitate technology-enabled mobility services could significantly impact health outcomes in rural areas. Completing this objective fulfilled a pronounced research gap that has only been addressed using qualitative research. </p> <p>Finally, this dissertation examines how access to technologies, such as AVs, could impact the urban settings’-built environment and its potential to promote or inhibit active travel. Two urban settings were used as a case study since urban areas might be the first to experience this technology's deployment. This dissertation used cluster analysis and ordered probit models to understand AV adopters' individual and location-based characteristics. Our results suggest that AV implementation based only on the propensity to adopt might have adverse health outcomes (i.e., obesity). This dissertation points out the need for place-based interventions to enhance active travel and decrease the "obesogenic" environment that could arise in the AV era. </p> <p>Overall, we conclude that transportation's impact on public health cannot be seen as a "one exposure- one outcome- one solution" approach, and all-inclusive planning is needed to generate changes and prepare for transportation innovations to come. This dissertation proposed the ABC PATH framework that offers guidance to improve the population's health from transport-related changes comprehensively. The results of this research can help different organizations, such as planning organizations and rural health associations, advance communities' health through transportation.</p>