Community engagement in health assessment enables researchers to better understand and prioritize community needs. The value of community engagement is increasingly documented; however, few studies engage youth. Research and assessments are often done for youth, but not with youth. Youth bring a unique contextual lens to community issues; without engagement, the likelihood that resultant efforts would be accepted by or appropriate for youth decreases. This dissertation explores opportunities and methodological approaches for, and contributions and feasibility of engaging youth in non-profit hospital community health needs assessments (CHNAs) mandated through the Affordable Care Act. This study has three specific aims, utilizing multiple methodological approaches: • Aim 1: Assess the current level of youth engagement, and prevalence of youth-focused priority areas in Massachusetts CHNAs. CHNAs were reviewed and analyzed using the Community Health Improvement Data Sharing System’s community engagement template. • Aim 2: Compare assessment results of focus groups and participatory photo mapping (PPM) in documenting youth observations of Boston community conditions. Three focus groups and PPM processes engaged 46 high-school age youth. Data were qualitatively compared, with attention to youth-identified community assets, concerns, and recommendations. • Aim 3: Compare youth results with existing CHNAs and identify potential contributions of youth engagement. Using the social determinants of health framework, youth recommendations were compared to Boston hospital community health improvement (CHI) publications to observe the convergence and divergence of priorities. While all MA hospitals minimally complied with required CHNA community engagement criteria, there was no standard practice or approach. 20% of CHNAs engaged youth, primarily through focus groups; yet, 80% of CHNAs that identified priorities included youth-focused priorities. Youth-driven results focused upon social determinants of health factors; furthermore, PPM results provided more detailed and granular CHI recommendations. Youth-identified CHI recommendations complemented those identified by hospitals, indicating that youth engagement can potentially strengthen CHI priorities and identify salient strategies for addressing youth health, specifically. Findings can be extrapolated to the many institutions conducting assessments, including health departments and Community Action Agencies. Findings will be disseminated through a series of practice briefs that make recommendations to hospitals, assessment practitioners, and youth organizations to consider for future efforts.

Studies have indicated that the prevalence of mental health disorders among refugees has increased. The social capital and socioeconomic status of the host country are believed to influence the development and maintenance of mental health. This study aims to generate knowledge about the factors that affect adult refugees’ mental illness in Sweden and inquires as to the activities in the labor market for preventing mental illness among adult refugees in Sweden. This study was conducted using a scoping review method. The author analyzed 14 articles, and the results revealed that refugees are more prone to experiencing mental health problems, such as depression and anxiety, than native-born Swedes. This study revealed that the social capital and socioeconomic status of the host country may influence the development and maintenance of adult refugees’ mental health.

Intense global competition and rapid technological advances have seen innovation become central towards enabling firms to adapt and rejuvenate themselves. While firms become increasingly focused on innovation, the challenge of managing innovation and developing innovation capabilities still remains. The purpose of this thesis is to analyse and evaluate the innovation capabilities of Ericsson’s Shared Services Organization (SSO). To do so, the existing literature and theories are synthesized and a multi-dimensional framework is utilized to conceptualize the determinants of organizational innovation capabilities. This framework is applied to analyse and evaluate the innovation capabilities of Ericsson’s SSO. Empirical data are collected through interviews in conjunction with qualitative content analysis of internal documents and participation in several meetings and discussions.Overall, the analysis of the case study revealed some common areas related to innovation capabilities, such as strategy intent for innovation, employees’ engagement with innovation initiatives, structured approach for innovation and management support. The conclusions and implications suggested reflect on the ways in which the case study could create a functional innovation program for fostering innovation in the organization and reaching its performance goals by exploiting untapped resources for innovation.

This research aims to identify the determinants of the ex-ante risk premium required by Italian private equity funds (PEFs) when valuing privately-held target companies. In theory, perceived risk is a key driver of expected returns and anticipated value, but: ¿Although PE (private equity) has experienced rapid growth, the risk and return profile of this asset class is not well understood.¿ (Jegadeesh et al., 2009). Some papers have attempted to assess the ex post returns pioneered by Lerner & Gompers (1997). Yet such studies reveal both contradictory conclusions and hitherto inexplicable phenomena: what some authors call the ¿private equity premium puzzle¿ (Moskowitz & Jorgensen, 2000). Such contradictory conclusions include a wide spread of abnormal realized returns ranging from -6% (Phalippou & Gottschalg, 2009) to +32% (Cochrane, 2005). In this research, the perceived risk and expected return drivers refer not to the ex-post realized return that PEF investors actually achieve, but to the required return the PEF hopes to gain from the target investment. At this stage, two important indicators adopted in PEF parlance have to be differentiated: (i) the Expected IRR (E.IRR) and (ii) the Threshold IRR (T.IRR). The first is the IRR as an output of a business plan, and the second assesses the return expected by PEFs according to the risk perceived in the business plan. Put simply, these are respectively, the anticipated return and the (risk-adjusted) required return. The study of the T.IRR is one of the main contributions of this thesis since it has never been studied before by academia as an indicator of the ex-ante perceived risk of a PEF target company. This is partly due to two important reasons. First, most previous papers examine ex-post performance, and only a few (e.g. Manigart et al., 2002), try to assess return expectations and risk perceptions using an ex-ante perspective. Second, most of the prior studies are quantitative and try to measure statistical effects captured by the ex-post IRR. By studying 26 deals (in 13 Italian PEFs) in detail (qualitatively and quantitatively), this research project has been able to observe how PEFs assess risk and estimate the T.IRR. The research project reveals that PEFs apply neither rational-based models nor explicit formulae to assess risk exante. By observing a set of phenomena unique to the PEF sector (fees effect, investment speed effect, persistence effect, money-chasing deal phenomenon, illiquidity effect, etc) whose existence has been suggested by many recent papers, this thesis has been able to propose an adjusted version of the three-factor model of Fama and French (1993, 1995) to assess risk. The application of a quasi-rational-based asset pricing model to guide PEFs assessments is also an important contribution of this thesis. In fact, Franzoni, Nowak and Phalippou (2010), claim to be the first to calculate the PEFs¿ cost of capital by applying asset pricing models. However, their approaches are not only based on the observations of realized returns, but also consider only one additional factor to the standard Fama & French three-factor model (1993), the liquidity factor. In contrast, the results and the model proposed by this thesis are based on qualitative and quantitative ex-ante information and include not only the classical factors of that model, but also some other factors intended to explain some of the phenomena listed above which might also drive the risk premium in private equity funds. Based, therefore, on explaining the behavior of PEFs, the research develops a framework that can be applied by Italian PEFs and perhaps other PEFs in a more rational manner than their past behavior suggests.

<p>  </p> <p>Maternal and infant health continues to be a compelling and urgent topic in the United States with prenatal care at its forefront for prevention of adverse outcomes. This study explored differences in adverse infant birth outcomes (i.e., preterm birth, low birthweight, and NICU stays) and postpartum maternal wellbeing outcomes (i.e., social support, depression, and confidence) related to the sociodemographic and baseline factors of mothers and their prenatal care experiences. </p> <p>Data was analyzed from the publicly available <em>Listening to Mothers III </em>dataset. Comprised of 2400 online-survey participants who gave birth to singleton infants in U.S. hospitals between 2011 and 2012. Structural equation modeling was employed with FIML to account for missing data. The model examined mediators of prenatal care (i.e., responsive provider behavior, week of first visit, duration of visits, group prenatal care; GPC) between maternal predictors and outcomes.</p> <p>Of infants in the sample, 8% were born preterm, 8% were born low birthweight, and 18% were admitted into the NICU. Depression and smoking during pregnancy, as well as participating in GPC, resulted in 15%, 20% and 18% greater proportions of infant NICU stays, respectively. For postpartum maternal wellbeing, participating in GPC increased the proportion of maternal confidence by 18%. Mothers who received responsive provider behavior had higher rates of social support (<em>b </em>= 0.28, <em>p </em>< .001), reported less depression (<em>b </em>= -0.19, <em>p </em>< .001), and felt more confident (<em>b </em>= 0.07, <em>p </em>= .02). </p> <p>Findings from this study suggest that the most impactful actions for prenatal care providers to take would be to provide increased support to mothers who identify as needing treatment for depression or smoking during pregnancy to best improve infant health through fewer admissions into the NICU, and to continue to bolster the responsiveness in which providers interact with patients to improve overall postpartum maternal wellbeing. </p>

No description available.

The Community Nurse Networker (CNN) pilot project represents an innovative collaboration between primary care, public health and municipal stakeholders, including a local neighbourhood resident planning team in a priority neighbourhood in Hamilton, Ontario. This pilot linked primary care to ongoing community development work. The goal of the CNN pilot was to address issues beyond physical health, and to consider issues related to the social determinants of health, or where people, live, work, and play. This developmental evaluation study used a qualitative descriptive approach (Sandelowski, 2000, 2010). Multiple perspectives and sources were used to describe the implementation of the CNN pilot, the following were collected and analyzed: Interviews (N=5), a focus group (participants = 11), documents (N=90), and a survey (N=1). The implementation of the pilot was described by the following foci: (a) conceptualization of the CNN’s roles and activities, (b) perceived barriers and enablers in implementing the CNN pilot, (c) perceived impacts of the intervention, and (d) perceptions surrounding the value of a nurse in the CNN position. The CNN pilot is a unique intervention, demonstrating how primary care can be a leader within the community, engaging with health and social services organizations and hard to reach populations. The findings of this study supported the ongoing development of the CNN position. It provided an example of a nurse-led intervention, with an integrative approach to primary care, community development, social, and health services. This study illustrates the potential for strengthened partnerships between primary care and the community within priority neighbourhoods. / Thesis / Master of Science (MSc)

This dissertation examines the effectiveness and political support surrounding third-party interventions in civil wars, which have increased in frequency, type, and number of actors since the collapse of Cold War bipolarity. The existing literature has mainly examined the individual effects of third-party strategies, though the growing presence of concurrently occurring types of third-party interventions necessitates exploration of their interactive effects. Thus, this thesis seeks to understand different actions from multiple actors dependently rather than independently. Understanding the effectiveness of these strategies is only one step towards realizing whether third-party interventions are desirable. The motivation and the will of the actors responsible for the policy execution are crucial in realizing the full picture. The ubiquitous problem arising from the third-party interventions requires a multipronged methodological approach. This thesis, therefore, combines both observational and experimental data to explore this issue. While the primary results show that peacekeeping and mediation are the most effective and supported strategies of engagement, both effectiveness and support appear to be highly context-dependent. Further, this thesis surveys American public and political elites to delve into the determinants of support for third-party interventions. It nds that both the public and the political elite are sensitive to civilian casualties, yet in the face of a political rivalry these humanitarian concerns dissipate. Additionally, political elites are interested in ending hostilities only as long as their national security interests are at stake. By filling a gap in the literature, generating original data, and utilizing novel methodological approach, these results have underlined the need for improvement of policy decisions in the area of international confict management and, at the same time, build upon the new direction of research in the eld of confict dynamics.

This systematic review examined literature spanning the last 10 years from Canada, the U.K., the U.S.A., Australia, and New Zealand. Findings highlight the significant gap in comparative literature examining (structural) racism as a determinant of South Asian healthcare access, utilization, and outcomes, and identifies areas of future research to address South Asian health equity concerns. / Background: Race, or specifically racism, has been well-established as a critical determinant of health, though current healthcare practices and policies in Western countries do not adequately address these issues. South Asians are the largest minority group in Canada, and they face disproportionate rates of chronic illnesses, mental health conditions, and barriers to care globally. However, their experiences in healthcare settings and the impact of race and racism on their health equity remain unexplored. This systematic review examined whether race affects healthcare access, utilization, and outcomes of South Asians compared to White-majority populations in Western countries. Methods: Embase, PsycInfo, Ageline, and CINAHL, were searched following PRISMA guidelines, as well as Google Scholar. Articles from 2013-2022 were included if they discussed racism, discrimination, or disparities/inequalities in South Asian physical and mental health, healthcare access, and utilization, outcomes compared to White populations in Canada, the U.K., the U.S.A., Australia, and New Zealand. The Mixed Methods Appraisal Tool (MMAT) was used to assess methodological quality. Data was synthesized narratively. Results: The review included 89 studies from Canada (n=19), the U.K. (n=51), the U.S.A. (n=17), and Australia (n=2), with most studies (n=76) utilizing cross-sectional or cohort designs and examining physical health outcomes (n=50). Study samples predominantly included Indians, Pakistanis, and Bangladeshis over other subgroups. Notably, there was no overall increase in comparative studies over the last decade; however, the U.K. observed an 85% increase compared to an 82% and 64% decrease in Canada and the U.S.A., respectively. The review also identified limited research on experiences within healthcare settings and mental health outcomes, sexual/reproductive health, and all health outcomes for children/youth. Few studies directly discussed the impacts of structural or organizational racism or discrimination on outcomes, though some commented on individual racism as well. Instead, studies relied on the social determinants of health as proxies for structural racism, such as education and income. Conclusion: This review highlights the significant lack of comparative research on the impact of structural, organizational, and individual racism on the healthcare access, utilization, and outcomes of South Asians compared to White-majority populations in Western countries. The review emphasizes the need for more primary, comparative research that quantifies and contextualizes South Asian experiences in obtaining healthcare services. Future research must employ rigorous and representative sampling methods, diverse study designs, and quantitative and qualitative measures that capture implicit, covert, and overt racism in healthcare among South Asians. Additionally, studies should measure factors such as religion, housing, language, and racialized institutional policies, in addition to the typically examined social determinants of health. Finally, this review highlights the need to collect and report disaggregated race and ethnicity health data with input from community leaders, and stratify these data by South Asian subgroups to avoid homogenization of distinct cultures and differential experiences in healthcare systems. Overall, acknowledging racism in healthcare and institutional policies is essential to effectively dismantle these issues and ensure health equity for South Asians. / Thesis / Master of Public Health (MPH)

No description available.