The aim of the research is to identify core conditions that support increased delivery of sustainability in the built environment. The selected methodology is constructive research, which is distinguished by the dual focus on practical industry perspectives and theoretical knowledge. The first research question examines how Target Value Design (TVD), an integrated design management process, can elicit better delivery of sustainability values. This is developed through case study research of an exemplary design team and project. The findings identify a gap in the capability of the team to adopt a whole systems approach in order to make explicit the values of sustainable prosperity and develop a unified vision. This provides the basis for the second research question - how can design teams gain an understanding of the systemic nature of sustainability, and how can this understanding impact the design process? �The research proposes an intervention method that aligns learning models from the disciplines of experiential learning cycles, design thinking, behavior modeling, systems thinking and unified vision. This integrated approach leverages creative design activities to capture the learning potential for individual skills and team building. �While the research acknowledges the limitations from the testing of a single workshop experiment, post-workshop data suggests the intervention framework is sufficiently robust and versatile enough to adapt to individual workshop circumstances. �The key research outcome is the importance of the people in the process of collaborative design, in their ability to envision a future state of sustainable prosperity and articulate explicit actionable values. / Ph. D.

Pain is a growing national public health problem that contributes to spiraling health care costs and significant societal burden in the United States. It is the most common reason for seeking health care services, and is the leading cause of disability (CDC, 2008). Inadequately treated pain has profound social, psychological, economic, and physiological consequences for patients, their families, and society (American Pain Society, 2009).A community-based participatory research (CBPR) approach was used for this project to develop a knowledge base about issues associated with chronic pain and its treatment among Native American people in Winslow, AZ. Mixed methods (qualitative and quantitative) were used to gain insight into the local factors that contribute to the self-management and treatment of chronic pain.The results of a provider survey indicated that there are negative psychological traits toward patients with chronic pain such as authoritarianism, intolerance of ambiguity, reliance on technology, and locus of control which are factors that are known to negatively influence pain care (Weinstein et al, 2000). Lack of knowledge regarding pain and pain management along with perceptions and fears related to drug regulatory agencies were additional factors that were found, constituting additional barriers. Patient participants were generally dissatisfied with the pain care practices at Winslow Indian Health. Patient reported treatment goals that included relief of pain, improved quality of life, the ability to return to work, the ability to perform household chores, and the ability to participate in more physical leisure activities.This results of this practice inquiry indicate there is a disconnect between patient and provider views and expectations around pain treatment and the need for further studies to determine the best ways to address chronic pain at the local level. The development of a pain management program is recommended to address the unmet needs of patients with chronic pain. Education in pain management is recommended for healthcare providers, including information regarding the benefits of non-pharmacologic therapies for pain management. The practice inquiry also supports the need for new policies at the local, tribal, and national levels to address pain as a growing public health issue.