Indiana University-Purdue University Indianapolis (IUPUI) / The purpose of this study was to examine the relationships among motives for health-related YouTube use, cognitive involvement with health information on YouTube, post-exposure online activity, and sense of empowerment regarding health and health care. As a result of the analysis of data from 263 participants, social utility, convenient information-seeking, habit-passing time, and exciting entertainment motives were identified as four motives for health-related YouTube use. Social utility and convenient information-seeking motives were positively related to cognitive involvement and cognitive involvement was positively related to perceived control. Social utility motive was negatively related to perceived competence, whereas convenient information-seeking motive was positively related to perceived competence. Habit-passing time motive was negatively related to goal internalization, whereas convenient information-seeking and exciting entertainment motives were positively related to goal internalization. The findings from this study imply that YouTube could be a useful health communication media for health professionals and organizations to use for empowering users in coping with health-related concerns.

M. Tech. (Public Relations Management, Faculty of Human Sciences), Vaal University of Technology / Health communication has become an integral component of quality health care. However, it is not just the process of giving information, but rather an active process that facilitates the use of information to improve decision-making and change behaviour that lead to positive health outcomes. Therefore, effective communication should be encouraged by means of two-way interaction between the health practitioners and the patients. The purpose of this research study was to determine the effectiveness of health communication in the Vaal region, using Levai Mbatha clinic as a case study. The study used the mixed method design consisting of both qualitative and quantitative methods. Quantitative research design was done through the distribution of questionnaires to parents in order to ascertain how child immunisation issues are communicated to them. Simple random sampling approach was used to gather the data, and the sample size for this design was 100 parents. For the qualitative approach, semi-structured interviews was used to determine the effectiveness of health communication information as disseminated by health practitioners to parents. Purposive sampling approach was used to select six (6) health practitioners. From the descriptive results (quantitative) it was evident that there is ineffective health communication at Levai Mbatha clinic. Parents are not aware of other illnesses related to child immunisation, and they feel that it would be better if the content of communication mediums were to be written in their mother tongue. It is therefore evident that, due to lack of understanding of the content, parents cannot participate in the discussions related to child immunisation this hinders effective communication. The interviews (quantitative) revealed that health practitioners felt that much needs to be done when it comes to the dissemination of child immunisation information. They indicate that there is not enough health communication material at their disposal to distribute to parents. Furthermore, there seem to be a challenge in language when they have to communicate with parents. Consequently, the efforts to effectively communicate child immunisation to parents effectively becomes insignificant.

Recent developments in implantable medical devices (IMDs) have created a need for communication systems integrated directly into the implant with feedback data for various sensing systems. The need for modern communication techniques, power delivery systems, and usable interfaces for smart implants present an interesting challenge for engineers trying to provide doctors and medical professionals with the best resources available for medical research. This dissertation will cover the design of an integrated CMOS transceiver and near-field inductive link used for an IMD and the accompanying CMOS front end for the application space of neural recording in the brain of lab mice. The design process of the CMOS IC, along with thinning techniques, the nearfield inductive link, and the design of an external reading system will be discussed in detail. The various wireless power and data telemetry techniques applicable for IMDs and their strengths and weaknesses will also be described. Software techniques and implementation for real-time analysis of a high data rate communication system from the designed IMD will be covered. Finally, transceiver verification will be given for both power and data telemetry under various scenarios, with front end verification performed via controlled lab bench experiments using input sinusoidal wave forms.

The utility of narrative as a persuasive mechanism has been increasingly investigated in recent years especially within the context of health behaviors. Although many studies have noted the effectiveness of narrative-based persuasive appeals, conceptual inconsistencies have made it difficult to determine what specific aspects of narrative messages lead to the most effective persuasive outcomes. In the present study, 145 female college students were randomly assigned to read one of four narrative health messages about a female freshman college students experiences with the human papillomavirus (HPV). Two elements of the narrative message structure were manipulated: the message frame (gain framed vs. loss framed), and the grammatical person of the text (first-person vs. third-person).The messages were presented via the medium of an online blog. After reading a narrative participants responded to a brief questionnaire designed to measure perceptions of threat regarding HPV contraction, perceptions of efficacy regarding HPV prevention, and intentions to get the Gardasil vaccine. Participants exposed to loss framed messages reported higher levels of perceived threat (susceptibility and severity) than participants exposed to gain framed messages although participants in the gain framed message conditions reported higher levels of perceived self-efficacy. Significant correlations were also found between levels of reported character identification and the two threat variables. No effects were found for grammatical person.

published_or_final_version / Community Medicine / Doctoral / Doctor of Philosophy

This study examined the effects of entrepreneurship level and legal regulatory environment on environmental scanning in one component of the health services industry, private practice physical therapy. Two aspects of scanning served as dependent variables: (1) extent to which firms scrutinized six environmental sectors (competitor, customer, technological, regulatory, economic, social-political) and (2) frequency of information source use (human vs. written). Availability of information was a covariate for frequency of source use. Three levels of entrepreneurship were determined by scores on the Covin and Slevin (1986) entrepreneurship scale. Firms were placed in one of three legal regulatory categories according to the state in which the firm delivered services. A structured questionnaire was sent to 450 randomly selected members of the American Physical Therapy Association's Private Practice Section. Respondents were major decision makers, e.g., owners, chief executive officers. The sample was stratified according to three types of regulatory environment. A response rate of 75% was achieved (n = 318) with equal representation from each stratum. All questionnaire subscales exhibited high internal reliability and validity. The study used a 3x3 factorial design to analyze the data. Two multivariate analyses were conducted, one for each dependent variable set. Results indicated that "high" entrepreneurial level firms scanned the technological, competitor and customer environmental sectors to a significantly greater degree than "middle" or "low" level groups, regardless of type of legal regulatory environment. Also, "high" level firms were found to use human sources to a significantly greater degree than did lower level groups. Empirical evidence supporting Miles and Snow's (1978) proposition that "high" level entrepreneurial firms (prospectors) monitor a wider range of environmental conditions when compared to "low" level (defender) firms was presented. The results also confirmed that market and technological environments were scanned most often. Finally, the results added to the construct validity of the Covin and Slevin entrepreneurship scale and provided evidence of its generalizability to small businesses.

Thesis (Ph.D.)--University of the Witwatersrand, Faculty of Commerce, Law and Management, School of Economic & Business Sciences, November 2016 / Community Health Workers or “CHWs” are often the only link to healthcare for millions of people in the developing world. They are the first point of contact with the formal care system, and represent the most immediate and cost effective way to save lives and improve healthcare outcomes in low-resource contexts. Mobile-health or ‘mHealth’ technologies may have potential to support CHWs at the point-of-care and enhance their performance. Yet, there is a gap in substantive empirical evidence on whether the use of mHealth tools enhances CHW performance, and how their use contributes to enhanced healthcare service delivery, especially in low-resource communities. This is a problem because a lack of such evidence would pose an obstacle to the effective large-scale implementation of mHealth-enabled CHW projects in low-resource settings. This thesis was motivated to address this problem in the Kenyan community health worker context. First, it compared the performance of CHWs using mHealth tools to those using traditional paper-based systems. Second, it developed and tested a replicable Technology-to-Performance Chain (TPC) model linking a set of CHW task and mHealth tool characteristics, to use and user performance outcomes, through four perspectives of Task-Technology Fit (TTF), namely Matching, Moderation, Mediation, and Covariation. A quasi-experimental post-test only research design was adopted to compare performance of CHWs using an mHealth tool to those using traditional paper-based systems. A primary structured questionnaire survey instrument was used to collect data from CHWs operating in the counties of Siaya, Nandi, and Kilifi, who were using an mHealth tool to perform their tasks (n = 257), and from CHWs operating in the counties of Nairobi and Nakuru using traditional paper-based systems to perform their tasks (n = 353). Results showed that CHWs using mHealth tools outperform their counterparts using paper-based systems, as they were observed to spend much less time completing their monitoring, prevention, and referral reports weekly, and report higher percentages of both timeous and complete monthly cases. In addition, mHealth tool users were found to have more positive perceptions of the effects of the technology on their performance, compared to those using traditional paper-based systems. An explanatory, predictive, research design was adopted to empirically assess the effects of a ‘fit’ between the CHW task and mHealth technology (TTF) on use of the mHealth technology and on CHW user performance. TTF was tested from the Matching, Moderation, Mediation, and Covariation ‘fit’ perspectives using the cross-sectional survey data collected from the mHealth tool users (n = 257). Results revealed that there are various unique ways in which a ‘fit’ between the task and technology can have significant impacts on use and user performance. Specifically, results showed that the paired-match of time criticality task and technology characteristics impacts use, while that of time criticality and information dependency task and technology characteristics impacts user performance. Results also showed that the cross-product interaction of mobility task and interdependence technology characteristics impacts use, and that of mobility task and interdependence and information dependency technology characteristics, impacts user performance. Similarly, the cross-product interaction of information dependency task and time criticality technology characteristics impacts user performance. Moreover, results showed that a perceived ‘fit’ between CHW task and mHealth technology characteristics partially and fully mediates the effects of user needs and tool functions on use and user performance, whereas ‘fit’ as an observed pattern of holistic configuration among these task and technology characteristics impacts use and user performance. It was also found that the perfect ‘fit’ between CHW task and mHealth tool technology characteristics leads to the highest levels of use and user performance, while a misfit leads to a decline in use and user performance. Notably, an over-fit of mHealth technology support to the CHW task leads to declining use levels, while an under-fit leads to diminishing user performance. Of the four ‘fit’ perspectives tested, the matching and cross-product interaction of task and technology characteristics offer the most dynamic insights into use and user performance impacts, whereas user-perception and holistic configuration, were also shown to be significant, thus further reinforcing these effects. Tests of a full TPC model revealed that greater mHealth tool use had a positive effect on the effectiveness, efficiency, and quality of CHW performance in the delivery of patient care. Moreover, it was found that ‘facilitating conditions’ and ‘affect toward use’ had positive effects on mHealth tool use. Furthermore, a perceptual TTF was found to have positive effects on mHealth tool use and CHW performance. Of note, this perceived TTF construct was found to be simultaneously a stronger predictor of mHealth tool use than ‘facilitating conditions’ and ‘affect toward use’, and a stronger predictor of CHW performance than mHealth tool use. Consequently, TTF was confirmed as the central construct of the TPC. The findings constitute significant empirical insights into the use of mHealth tools amongst CHWs in low resource settings and the extent to which mHealth contributes to the enhancement of their overall performance in the capture, storage, transmission, and retrieval, of health data as part of their typical workflows. This study has provided much needed evidence of the importance of a ‘fit’ between CHW task and mHealth technology characteristics for enabling mHealth impacts on CHW performance. The study also shows how these inter-linkages could improve the use of mHealth tools and the performance of CHWs in their delivery of healthcare services in low-resource settings, within the Kenyan context. Findings can inform the design of mHealth tools to render more adequate support functions for the most critical CHW user task needs in a developing world context. This study has contributed to the empowerment of CHWs at the point-of-care using mHealth technology-enabled service delivery in low-resource settings, and contributes to the proper and successful ‘scaling-up’ of implemented mHealth projects in the developing world. / MT 2018

Ching Ho-hong Boby. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (leaves 63-78). / Abstracts in English and Chinese. / List of Tables --- p.vii / Chapter Chapter 1: --- Introduction --- p.1 / General Oral Health Status in Hong Kong --- p.2 / """How"" is the Message Constructed： Gain versus Loss Frames" --- p.3 / """Who"" are the Recipients： Individual Differences in Self-Construal" --- p.4 / What Accounts for the Message-Self Compatibility Effects： The Mediating Factors --- p.6 / Stage One： Cognitive Integration of the Message Contents --- p.6 / Stage Two: Acceptance of the Messages --- p.8 / Stage Three： Perceptions of Health Behavior --- p.9 / An Addition to the Three-Stage Model: The Role of Anticipated Feelings --- p.11 / Overview of the Present Study --- p.12 / Chapter Chapter 2: --- Method --- p.15 / Participants --- p.15 / Oral Health Message --- p.15 / Independent Measures --- p.16 / Self-Construal --- p.16 / Principle Dependent Measures --- p.17 / Recognition Memory --- p.17 / Subjective Evaluations of the Messages --- p.17 / Self-Efficacy to Perform Oral Health Behavior --- p.18 / Outcome Expectancy of Performing Oral Health Behavior --- p.19 / Anticipated Feelings to Perform Oral Health Behavior --- p.20 / Intentions to Perform Oral Health Behavior --- p.21 / Behavioral Measures --- p.22 / Potential Covariates Measures --- p.22 / Personality --- p.22 / Need for Cognition --- p.23 / Dispositional Optimism --- p.24 / Oral Health Locus of Control --- p.25 / Dental History --- p.26 / Cognitive Ability --- p.26 / Mood --- p.26 / Perceived Threat of Developing Oral Diseases --- p.27 / Perceived Normative Pressure of Performing Oral Health Behavior --- p.28 / Fear and Worry Toward Developing Oral Diseases --- p.28 / Other Potential Covari ates --- p.29 / Procedure --- p.29 / Chapter Chapter 3: --- Results --- p.31 / Manipulation Checks --- p.31 / Different Operationalizations of Gain- and Loss-Framed Messages --- p.31 / Principle Analyses： General --- p.33 / Moderation of the Framing Effects by Self-Construal on Behavioral Intentions --- p.34 / Moderation of the Framing Effects by Self-Construal on Subjective Evaluations --- p.37 / The Mediating Effect of Personal Outcome Expectancy on Behavioral Intentions --- p.39 / The Mediating Effect of Social Outcome Expectancy on Behavioral Intentions --- p.42 / The Mediating Effect of Anticipated Feelings on Behavioral Intentions --- p.44 / Chapter Chapter 4: --- General Discussion --- p.46 / How to Frame the Message: Tailoring Messages to Match Self-construal --- p.47 / Identifying the Mediating Factors of Compatibility Effects Between Message and Self-Construal --- p.49 / The Importance of Anticipated Feelings --- p.55 / The Intention - Behavior Relationships --- p.56 / Improvements and Further Studies --- p.59 / Concluding Remarks --- p.61 / References --- p.63 / Appendix A --- p.79

Although many researchers have studied language attitudes in the last three decades, none of the studies have been conducted in the hospital setting, where there are more serious consequences for those working with patients being labeled linguistically "incompetent," as charges of incompetence in language are apt to lead to charges of incompetence in other areas of mastery as well (e.g., Ryan, 1983). This study examines the attitudes of a sample of nurses from three Portland-area hospitals towards nonnative English speaking physicians. The subjects, 156 medical-surgical nurses, listened to three anonymous audiotaped physicians who were from three different ethnic backgrounds: American, Japanese and Persian. The physicians were first all recorded reading a short patient history and giving a verbal order directed toward a nurse. This was the formal context. For the informal context, the physicians gave an impromptu response to a question regarding their future plans. The nurses rated each physician twice, once for each context, using the Speech Evaluation Instrument (SEI), a semantic differential scale using bipolar adjectives developed by Zahn and Hopper (1985). Results indicated that there was a significant positive relationship between a physician's pronunciation and a nurse's perceptions of his medical competency, as measured by the SEI, with the native English speaking physician receiving a higher rating than the two nonnative English speaking physicians. The native Japanese speaking physician, who had the strongest accent, received the lowest ratings on the SEI. There was also a significant positive relationship between the context the physician was speaking in and the ratings he received on the SEI, with the informal context receiving a higher rating for all three physicians than the formal context. If a physician's pronunciation or speech style causes nurses, not to mention patients, to evaluate him/her negatively, then one implication of this study is for the need for more pronunciation work and accent reduction exercises not only in the English as a second/foreign language classroom, but also as a continued offering for nonnative English speaking hospital personnel in teaching hospitals. Another implication relates to the need for better preparing nurses to work and communicate successfully with nonnative English speaking physicians, other hospital personnel, and patients by offering transcultural nursing classes in nursing school and making it a mandatory part of every nurse's education.

Thesis (Ph. D. (Translation Studies)) -- University of Limpopo, 2014 / The study focuses on communication during consultations between English-speaking foreign medical doctors, patients and nurses as interpreters in the Limpopo province. It aims to identify and describe the communication strategies, politeness strategies, influence of gender on the communication process as well as a review of the policy on language practice in the hospitals with a view to suggesting amendments. Through a field work carried out in 10 public health facilities in Limpopo province, the study adopts an eclectic research method of semi-structured interviews, audio recording, and observation in the collection of data. Thirty-five patients, thirteen nurses and nineteen medical doctors are involved in the study. All the interviews and audio recordings were transcribed and translated wherever needed. Collected data was analysed using the Statistical Package for Social Sciences (SPSS) and Nvivo softwares. Results showed that many foreign doctors were frustrated that they could not communicate directly with patients because they could not speak the indigenous language and the assumption that most patients could communicate in English often turned out to be erroneous. The hospitals are ill equipped to deal with the language problems. The linguistic barrier made it difficult to give equal medical care to all patients and doctors resorted to avoidance strategies in selecting patients. Five consultations types based on the turn-taking were identified. These are clarification, continuation, convergence, knowledge and avoidance strategies. The study also reveals that the doctors use more positive politeness strategies when communicating with the patients and nurses. Gender was found to influence the choice of communication strategies by the foreign doctors. The inadequacies of the National Department of Health Language Practice Policy are highlighted and suggestions are made towards its amendment. KEY CONCEPTS English-speaking foreign medical doctors, communication strategies, politeness strategies, gender, language policy, interpreters.