abstract: A post occupancy evaluation (POE) was conducted at the Ngeruka Health Center (NHC) in the Bugesera District of Rwanda. The POE was limited to the education spaces within the health center, its participants, and staff. A POE is a combination of methods both quantitative and qualitative to determine user satisfaction and whether the design intent of the built environment was met. In rural Rwanda where healthcare facilities are scarce and people become seriously ill from preventable diseases, help is needed. The smallest injuries become life threatening. Healthcare facilities and providers must develop approaches that stop these minor illnesses and diseases from costing further problems. The healthcare facility is a healing environment. Healing environments nurture health and provide a sense of safety and security. The Ngeruka facility has incorporated education spaces within their facility to teach the community ways to prevent minor health problems from becoming major ones. The research that was conducted at this healthcare facility sought to answer the main questions: Does the built environment of the NHC contribute to healing by engaging education program attendees to learn about preventing illness and disease and other health promotion strategies? In addition, can you measure healing effects of the built environment? The research took measurements of the built environment and combined them with user satisfaction questionnaires. Site observations and a participant engagement questionnaire were used to determine the amount of engagement the participants put forth into the education programs within the designated design space. Measuring engagement is a tool schools use to find out if their facilities are producing their intended results. This same thought process was incorporated into this research. The participants did prove to be engaged, but it is not definitive that the built environment was responsible. It was a combination of many factors. / Dissertation/Thesis / Masters Thesis Design 2015

The Rehabilitation Act of 1973, as amended, calls for participants to become “active and full partners in the vocational rehabilitation process.” Although it is probable that the participant’s active engagement is a major factor in a successful vocational rehabilitation outcome, little is known about the actual meaning of engagement in the vocational rehabilitation process. This construct is often entangled with other concepts such as motivation and readiness. A clear operational definition of engagement in the vocational rehabilitation process would allow professionals to better support participants in their role. The purpose of this research was to (a) operationally define the construct of participant engagement in the vocational rehabilitation process, and (b) develop and validate an instrument to measure engagement based on this definition. After creating measurement items to reflect three proposed subdimensions of engagement (Attendance, Expected Contribution, and Homework), the items were evaluated for content validity and clarity by an expert panel and then piloted with a small group of vocational rehabilitation counselors. The refined items were then administered to a sample of public vocational rehabilitation counselors through an online survey platform. The data from the usable responses (n = 88) were summarized and then tested for an optimal factor solution using exploratory factor analysis. Next, a confirmatory factor analysis was used to confirm the adequacy of the measurement model. Finally, structural equation modeling analyses were used to identify a structural model that explained the relationships among the subdimensions and overall engagement. The results of the analyses suggest that engagement is a multidimensional construct consisting of three factors: (a) Attendance; (b) Expected Contribution; and (c) Homework. The Expected Contribution factor acts as the strongest predictor of overall engagement and also mediates the effects of Attendance and Homework on engagement. Implications of the study are provided, focusing on the need to teach participants their expected role as full partners in vocational rehabilitation. Counselors should be encouraged to facilitate high levels of engagement through competent counseling skills and appropriate counseling approaches. Finally, limitations of the research are addressed and suggestions for future research are provided.

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