The full text will be available at the end of the embargo: 15th Dec 2026

Mutah University in Jordan / The full text will be available at the end of the emabargo: 17th June 2024

Yes / Background: Electronic personal health records (ePHRs) are secure Web-based tools that enable individuals to access, manage, and share their medical records. England recently introduced a nationwide ePHR called Patient Online. As with ePHRs in other countries, adoption rates of Patient Online remain low. Understanding factors affecting patients’ ePHR use is important to increase adoption rates and improve the implementation success of ePHRs. Objective: This study aimed to examine factors associated with patients’ use of ePHRs in England. Methods: The unified theory of acceptance and use of technology was adapted to the use of ePHRs. To empirically examine the adapted model, a cross-sectional survey of a convenience sample was carried out in 4 general practices in West Yorkshire, England. Factors associated with the use of ePHRs were explored using structural equation modeling. Results: Of 800 eligible patients invited to take part in the survey, 624 (78.0%) returned a valid questionnaire. Behavioral intention (BI) was significantly influenced by performance expectancy (PE; beta=.57, P<.001), effort expectancy (EE; beta=.16, P<.001), and perceived privacy and security (PPS; beta=.24, P<.001). The path from social influence to BI was not significant (beta=.03, P=.18). Facilitating conditions (FC) and BI significantly influenced use behavior (UB; beta=.25, P<.001 and beta=.53, P<.001, respectively). PE significantly mediated the effect of EE and PPS on BI (beta=.19, P<.001 and beta=.28, P=.001, respectively). Age significantly moderated 3 paths: PE→BI, EE→BI, and FC→UB. Sex significantly moderated only the relationship between PE and BI. A total of 2 paths were significantly moderated by education and internet access: EE→BI and FC→UB. Income moderated the relationship between FC and UB. The adapted model accounted for 51% of the variance in PE, 76% of the variance in BI, and 48% of the variance in UB. Conclusions: This study identified the main factors that affect patients’ use of ePHRs in England, which should be taken into account for the successful implementation of these systems. For example, developers of ePHRs should involve patients in the process of designing the system to consider functions and features that fit patients’ preferences and skills to ensure systems are useful and easy to use. The proposed model accounted for 48% of the variance in UB, indicating the existence of other, as yet unidentified, factors that influence the adoption of ePHRs. Future studies should confirm the effect of the factors included in this model and identify additional factors.

Police officers provide emergency services to the public, while being simultaneously exposed to various organisational and social stressors over which they have little or no control. The outcome of this may be that highly committed and loyal police officers become psychologically and physically burned-out. Adversely, others may accept the same conditions and situations as a challenge and live an energetic and proactive life while experiencing a positive affective state (vigour) toward their duties. Officers who are burned-out may fail to meet their goal to protect the public, but eventually may suffer. The general objective of this study was to investigate vigour and burnout as obliquely related outcomes of the stress and coping process in terms of its dynamic relationship with challenges or threats, and the mediating role of personal factors, social resources and coping resources in the police context. The research is a qualitative explication of theoretical concepts and constructs, followed by a quantitative empirical survey design. The survey led to a Structural Equation Model (SEM) fit between empirical data and the Moos (1994) hypothesised stress and coping model. Seven measuring instruments were used to collect data. Job demands, work overload and uncertainty were identified as causes of work stress originating within the work situation. Respondents indicated that family members play a role in social support, although it decreases when stress increases. The SEM procedure revealed that social support and personality has a limited and direct effect on well-being when experiencing a positive affective state (vigour), with coping strategies deleted from the experimental model. Adversely, stress has a direct effect on well-being (and eventually burnout) with no moderating effects by the hypothesised variables. The study proposes a new Police Vigour and Burnout Model (PVBM) as an alignment to the Moos (1994) model. It is recommended that vigour and burnout, as outcomes of the stress and coping process, be included in future studies as obliquely related variables in other spheres of society. An additional proposal is that stress inducing features within the police organisation should be scrutinized and critically addressed to prevent negative psychological affects. / Industrial Psychology / D.Litt. et Phil. (Industrial and Organisational Psyschology)

The wave of knowledge loss that organisations are facing on account of layoffs, retirements, staff turnover and mergers gave rise to this research. The main research aim was to identify the organisational and behavioural factors that could enhance or impede tacit knowledge retention. A multidisciplinary approach focusing on knowledge management, organisational behaviour and organisational development was followed. The nature of knowledge in organisations was explored by following a contextualised theorybuilding process, focusing on epistemology, and the appearance and application of knowledge. Knowledge in the context of this research is the knowledge and experience that reside in the minds of people. It is not easily documented, and is referred to as tacit knowing. A theoretical model was developed that revealed the factors that could influence tacit knowledge retention. The model focused on human input factors taking into account knowledge loss risks, strategic risks and behavioural threats that could cause knowledge loss.The main purpose of the empirical research was to operationalise the theoretically derived knowledge retention constructs, determine statistically the enhancing and impeding factors that influence knowledge retention and develop a structural equation model to verify the theoretical model. A quantitative empirical research paradigm using the survey method was followed. A questionnaire was compiled, and a survey conducted in the water supply industry. The principal component factor analysis postulated nine factors. A composite factor, knowledge retention, as the dependent variable was compiled. The questionnaire was found to be reliable, with a Cronbach alpha coefficient of .975. A structural equation model development strategy produced a new best-fitting knowledge retention model based on the new constructs postulated in the factor analysis. The model indicated that there is a direct causal relationship between strategy implementation and knowledge retention and between knowledge behaviours and knowledge retention. The regression analysis showed that most of the intercorrelations are significant, thus confirming the theory. The research contributed towards a comprehensive understanding of the factors that influence tacit knowledge retention. The questionnaire and the new knowledge retention model could assist organisations in determining the extent to which knowledge is retained and where to focus in developing and implementing a knowledge retention strategy. The study encourages practitioners to take cognisance of the fact that organisations are different and that the enhacing and impeding factors of knowledge retention are to be considered. / Information Science / D. Litt. et Phil. (Information Science)

Among the many promises of the revolution in the information and communication technologies (ICT), particularly the Internet, continues to be its potential to significantly transform governments around the world. This transformation is referred to as e-government or web-based government, often used interchangeably in most of the IS literature. Despite these however, the level of adoption and use of such innovation is still low and does not meet expectations in developing countries in general and Jordan in particular. Yet, existing research on the adoption and implementation of e-government in developing countries is still lacking explanatory power for the following reasons: 1) focusing either on the supply-side, or on the demand-side separately to study the adoption and implementation of e-government, and therefore there is no enough research on the integration between them as a single phenomenon, and 2) focusing on the results of previous research, and therefore not to develop theories fit the new context to be investigated to understand the relationship between the IT implementation and social structures in the same context. This research aims to fill these gaps through the use of a holistic approach to enable in-depth understanding and gain valuable insights on the adoption and implementation of e-government from multiple perspectives, and in the real context of a developing country, namely Jordan. This would reduce the gap between government strategies and policies related to implementation of e-government services and applications on the one hand, and perceptions of citizens on the other hand, allowing a better understanding of the needs of citizens and the priorities that must be taken into account by governments in order to ensure the success of such projects on a large scale. Through two phases, this research proposes and empirically tests an integrated model of the determinants of adoption and implementation of e-government services and applications in Jordan. The first phase employs a grounded theory methodology for the development of the research model, as well as the survey instruments necessary to test the model. The second phase employs a survey questionnaire to test the research model using multivariate and SEM with the results demonstrating support for the proposed model. The empirical results indicate that perceived ease of use, perceived usefulness, and the security of e-government systems are no longer among the main determinants that affect the decision to adopt and implement e-government services and applications in this particular context. This confirms that the prevailing models and theories on the adoption of IT do not apply equally to the context of developing countries such as Jordan, and thus do not explain and predict behaviour toward the adoption and implementation of e-government services and applications in the same context. There is a direct and positive relationship between citizen involvement in the change process towards e-government and the decision to adopt and implement e-government services and applications. There is also a strong positive relationship between the decision to adopt and implement e-government services and applications and the decision to use such services and applications within the same context. Unexpectedly, the prevailing sociocultural determinants indicate a direct and positive relationship with the decision to adopt and implement e-government services and applications in the same context. Also, the results indicate direct and negative relationships between citizen trust and website design issues with the decision to adopt and implement e-government services and applications. Finally, the research concludes by highlighting the theoretical and practical implications, limitations and future directions.

With educational effectiveness studies, school-level aggregates of students' characteristics (e.g. achievement) are often used to assess the impact of school composition on students' outcomes – school compositional effects. Empirical findings on the magnitude and direction of school compositional effects have not been consistent. Relevant methodological studies raise the issue of under-specification at level 1 in compositional models - evident when the student-level indicator on which the aggregation is based is mis-measured. This phenomenon has been shown to bias compositional effect estimates, leading to misleading effects of the aggregated variables – phantom compositional effects. My thesis, consisted of three separate studies, presents an advanced methodological framework that can be used to investigate the effect of school composition net of measurement error bias. In Study 1, I quantify the impact of failing to account for measurement error on school compositional effects as used in value added models of educational effectiveness to explain relative school effects. Building on previous studies, multilevel structural equation models are incorporated to control for measurement error and/or sampling error. Study 1a, a large sample of English primary students in years one and four (9,059 students from 593 schools) reveals a small, significant and negative compositional effect on students' subsequent mathematics achievement that becomes more negative after controlling for measurement error. Study 1b, a large study of Cyprus primary students in year four (1694 students in 59 schools) shows a small, positive but statistically significant effect that becomes non-significant after controlling for measurement error. Further analyses with the English data (Study 2), demonstrates a negative compositional effect of school average mathematics achievement on subsequent mathematics self-concept – a Big Fish Little Pond Effect (BFLPE). Adjustments for measurement and sampling error result in more negative BFLPEs. The originality of Study 2 lies in verifying BFLPEs for students as young as five to eight/nine years old. Bridging the findings related to students' mathematics self-concept (Study 2) and the findings on students’ mathematics achievements (Study 1a), I demonstrate that the prevalence of BFLPEs with the English data partly explains the negative compositional effect of school average mathematics achievement on students' subsequent mathematics achievement. Lastly, in Study 3 I consider an alternative approach to school accountability to conventional value added models, namely the Regression Discontinuity approach. Specifically, I use the English TIMSS 1995 primary (years four and five) and secondary (years eight and nine) data to investigate the effect of one extra year of schooling on students' mathematics achievement and the variability across schools in their absolute effects. The extent to which school composition, as given by school average achievement, correlates with schools' added-year effects is addressed. Importantly the robustness of the RD estimates to measurement error bias is demonstrated. My findings have important methodological, substantive and theoretical implications for on-going debates on the school compositional effects on students' outcomes, because nearly all previous research has been based on traditional approaches to multilevel models, which are positively biased due to the failure to control for measurement error.

The research was aimed at addressing the challenge of evaluating a large scale change intervention in a large organisation and in a complex environment. Finding robust, meaningful yet realistic methodologies from among the array of possible approaches, methods and techniques has proved problematic, for both organisational practitioners and academics alike. The research explored this issue of choice from the perspective of ¿fit for purpose¿ and suggests a multi-faceted approach, using a range of evaluation methods and techniques, which were applied to an ongoing example at the BBC. It was also planned to use structural equation modelling (SEM) techniques to examine the relationships between variables critical to the study. The approach described represents a ¿pilot¿ evaluation exercise, which drew on data collected from early cohorts going through the BBC Leadership Programme, a key element of the ¿Making it Happen¿ change strategy initiated by the then Director General, Mr. Greg Dyke. As a second level of research, an evaluation of the primary evaluation itself, i.e. of the BBC Leadership Programme, was also undertaken to assess the effectiveness of the primary evaluation strategy and its implementation. Three hypotheses were examined in terms of programme impact: It was proposed that participation in the programme would bring about collective improvements in individual leadership behaviour (Ho1), leading to improved departmental performance across the business (Ho2), in turn, resulting in improved organisational performance (Ho3). Due to limitations in the application of the methodology it was not possible to use SEM analyses on the data collected. Alternative analyses failed to demonstrate conclusive support for all three hypotheses and, while other factors besides programme attendance appear to influence leadership performance the afore-mentioned limitations restrict the ability to draw firm conclusions. Following evaluation of the primary evaluation it was evident that, as a pilot exercise, important outcomes from the programme evaluation give rise to ¿lessons learned¿ and changes are suggested for any future evaluation exercise of this kind.

The research was aimed at addressing the challenge of evaluating a large scale change intervention in a large organisation and in a complex environment. Finding robust, meaningful yet realistic methodologies from among the array of possible approaches, methods and techniques has proved problematic, for both organisational practitioners and academics alike. The research explored this issue of choice from the perspective of 'fit for purpose' and suggests a multi-faceted approach, using a range of evaluation methods and techniques, which were applied to an ongoing example at the BBC. It was also planned to use structural equation modelling (SEM) techniques to examine the relationships between variables critical to the study. The approach described represents a 'pilot' evaluation exercise, which drew on data collected from early cohorts going through the BBC Leadership Programme, a key element of the 'Making it Happen' change strategy initiated by the then Director General, Mr. Greg Dyke. As a second level of research, an evaluation of the primary evaluation itself, i.e. of the BBC Leadership Programme, was also undertaken to assess the effectiveness of the primary evaluation strategy and its implementation. Three hypotheses were examined in terms of programme impact: It was proposed that participation in the programme would bring about collective improvements in individual leadership behaviour (Ho1), leading to improved departmental performance across the business (Ho2), in turn, resulting in improved organisational performance (Ho3). Due to limitations in the application of the methodology it was not possible to use SEM analyses on the data collected. Alternative analyses failed to demonstrate conclusive support for all three hypotheses and, while other factors besides programme attendance appear to influence leadership performance the afore-mentioned limitations restrict the ability to draw firm conclusions. Following evaluation of the primary evaluation it was evident that, as a pilot exercise, important outcomes from the programme evaluation give rise to 'lessons learned' and changes are suggested for any future evaluation exercise of this kind.

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