As an effort to guide patients toward being more informed and more involved as healthcare decision makers in the clinical processes, health care organizations have adopted a new technology referred to as an integrative social media platform (ISMP). This ISMP combines features of mobile technology and those of social media technology, integrating healthcare systems in order to support a more patient-centered healthcare process. However, users, both physicians and patients, have showed varied usages of ISMP, as a results, have shown mixed results of ISMP. To provide a better understanding of the use of ISMP, especially the interaction between patients and physicians, I turned to the concept of affordances. Affordances describe the possibilities for goal-oriented actions that a technical object offers to a user. Using a mixed-method approach with real archival event log data, conversation texts, documents, interview, and focus-group data from a large hospital which had adopted an ISMP, I confirmed three types of affordance: perceived affordance, behavioral affordance, and interactive affordance. I identified two key affordances of ISMP that lead to patient-centered care, namely ubiquitous access and virtual healthcare consultation, which represent a behavioral affordance and an interactive affordance, respectively. I also explored how different types of affordances are actualized and how they interact with each other to contribute to patient-centered care.

Enactments consist of episodes of direct couple engagement being carefully monitored and coached by the therapist. Enactments have been identified and studied as a potential common factor in marriage and family therapy. Attachment security is considered to be a foundational marker of marital health. This study explored what role enactments play in promoting attachment-related outcomes in therapy. A qualitative group hermeneutic approach was used to analyze the interviews of twelve participants (six couples) who had participated in six experimental sessions: three sessions with a preponderance of therapist-centered process and three of enactment-based process. The results of this analysis provide a general profile of participants' experiences of these two approaches in therapy and contribute to an emerging framework to inform potential best practice of enactments for helping couples work towards more secure attachment. Major findings include the importance of therapeutic alliance and sequencing of interventions for promoting positive attachment-related outcomes.