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<p>Electronic Health Record Systems (EHRs) are an important tool for today’s physicians. EHRs (commonly called EMRs in Canada) are used to store, retrieve and leverage patient information to achieve better clinical outcomes for patients. EHRs can also contribute to public policy by helping policy makers track population health data. There are barriers as well as drivers to successful implementation of EHRs. Also, with the introduction of EHRs and their accumulation of patient data physicians face challenges for better extraction and use of data as well as overall management of information within the clinic.</p> <p>This thesis performs a literature review and presents evidence on the barriers and drivers that exist in the area of EHR (Electronic Health Records) implementation in the US. The thesis also includes a survey that tracks responses of primary care physicians in the US. The responses were analyzed to determine key factors impacting EHR implementation and information management. The key factors included workflow, optimization of information technology (IT) resources that include software, hardware assets and trained personnel, and plan for extraction of data. Our research found, among other things, the need to raise awareness among physicians about optimizing clinical workflow, management of information in the EHRs, the need for additional training on the EHRs and, in case of non-urban physicians, the need for improved levels of IT and Internet expertise in the clinic.</p> / Master of Science (MSc)

Background: Lifestyle-related chronic disease is the leading cause of mortality and morbidity in the United States, accounting for more than 63% of deaths. Minority communities experience a disproportionate burden of adverse health outcomes related to these diseases. Collaborative partnerships with faith-based organizations (FBO) present a unique platform to effectively implement lifestyle-related health programs, especially in minority communities. Studies have consistently recognized a growing need to improve FBO capacity and readiness to design, deliver, and sustain programs more effectively. Methods: This research includes three phases: 1) preliminary research to gain the perspective of FBO, community, health and research partners actively involved in development and implementation of a collaborative lifestyle-related faith-based health program and to further explore capacity and readiness factors; 2) formative research to develop, pilot, revise, and improve content, format, measures, and implementation of a mixed methods questionnaire, Capacity and Readiness Church Health Assessment (CRCHA), that will further identify and assess FBO organizational capacity and readiness to implement lifestyle-related health and wellness programs; and 3) culminating research to pilot the CRCHA with descriptive and statistical analysis of associations between church characteristics and health programming. Results: Phase 1: Eighteen of 31 capacity and readiness factors were collectively rated as extremely important to participant roles and partnership experience. Qualitative analysis further contextualizes these factors. Phase 2: The CRCHA comprises four major sections with thirteen subsections to gather information about factors, characteristics, and attributes deemed relevant to FBO organizational capacity and readiness. Phase 3: Churches of varying size and capacity successfully completed the CRCHA. Data indicate potential utility for individual churches for self-assessment and capacity and readiness building and for researchers to identify church characteristics most strongly associated with effective health programming. Implications: Exploration of capacity and readiness within a larger and more diverse group of FBO will help to further identify capacity and readiness factors to facilitate active FBO participation in the development and implementation of effective lifestyle-related health and wellness programs. Thus, FBO would be better positioned to actively lead and/or partner in faith-based health programs that address their community's most pressing health issues. / Ph. D.

Inhibitory Control (IC), a vital facet of childhood development, involves the ability to suppress a dominant response, as well as the ability to suppress irrelevant thoughts and behaviors. This ability emerges during the first year of life and develops rapidly during the preschool years. A variety of tasks have been developed to measure IC in this age group and, recently, research has demonstrated important differences in task performance according to various distinctions among these tasks. One under-researched distinction is that of whether an IC task requires the child to give a verbal or a motoric response. Therefore, the purpose of this study was to examine, in 4-year-old children, the differences and similarities among IC tasks requiring either a verbal or a motoric response. Differences were explored with respect to the contributions to verbal and motoric IC performance of language, intelligence, temperament, and frontal encephalography, as well as with respect to social and school readiness outcomes. IC was best described by a two-component model, distinguishing verbal and motoric IC. Both baseline and task electrophysiology contributed to task performance in the verbal Yes-No task as well as the motoric IC composite. Language and intelligence, too, were associated with both verbal and motoric IC, although nonverbal intelligence was less strongly correlated with verbal IC than it was with motoric IC. All laboratory measures of IC related to parent report of children’s IC as well as to other parent-reported temperament scales and factors. Children’s verbal and motoric IC were associated, too, with children’s social development, surprisingly showing the most consistent associations with social inhibition. Asocial behavior positively correlated more strongly with motoric IC than with verbal IC. Children’s laboratory IC positively correlated with their school readiness, even when controlling for their intelligence although children’s emergent literacy more positively related to their motoric, rather than verbal, IC. An interaction of intelligence and IC contributed to social variables, but not to school readiness. This research supports the important distinction between verbal and motoric IC, and demonstrates the utility of including an array of measures of both in early childhood research. / Ph. D.

Although many children enter kindergarten having some form of preschool experience, the quality of these experiences differs greatly among the programs that are available to families. This variability can create school readiness gaps, especially for children from disadvantaged backgrounds (Isaacs, 2012). Children not being ready for school has come to the attention of stakeholders around the country and in the Commonwealth of Virginia. According to a state-wide study, approximately 30% of the students entering Virginia's schools either were not ready academically and/or behaviorally (Joint Legislative Audit and Review Commission [JLARC], 2017). Fortunately, the Virginia Preschool Initiative (VPI) program was created to give students with the greatest risk of school failure an opportunity to overcome potential learning obstacles. The general purpose of this study was to examine the efficacy of a state-funded prekindergarten program in a rural school division in Central Virginia. Specifically, this study examined academic and behavioral data for four cohorts of kindergarten students to determine if students who participated in the VPI program performed better on school readiness measures compared to their peers without any preschool or prekindergarten experience. Two-tailed t-tests were used to determine if any significant differences existed on measures of literacy, mathematics, self-regulation, and social skills between students who attended a state-funded prekindergarten program to their peers without any prekindergarten or preschool experience. / Doctor of Education / Children not being ready for school has come to the attention of stakeholders around the country and in the Commonwealth of Virginia. According to a state-wide study, approximately 30% of the students entering Virginia's schools either were not ready academically and/or behaviorally (Joint Legislative Audit and Review Commission [JLARC], 2017). Fortunately, the Virginia Preschool Initiative (VPI) program was created to give the students with the greatest risk of school failure an opportunity to overcome potential learning obstacles. The general purpose of this study was to examine the efficacy of a state-funded prekindergarten program in a rural school division in Central Virginia. Specifically, this study examined academic and behavioral data for four cohorts of kindergarten students to determine if students who participated in the VPI program performed better on school readiness measures compared to their peers without any preschool or prekindergarten experience.

This study will attempt to determine an adequate program of readiness for Texas History.

The purpose of this study is to make an investigation of the reading readiness program of the elementary schools in Collin County, Texas, to determine whether the program is planned in accord with modern theories of education, or administered in the traditional manner of considering the subject.

Internships provide a platform for students to apply theoretical knowledge in a practical setting and to gain hands-on experience (Simons et al., 2012). Moreover, internships can help students build networks and connections within their chosen industry, which can later prove valuable in their career development. This qualitative exploratory study investigated students' perceptions of their hospitality and tourism internships on how they perceive their career pathways after completing an internship in a four-year degree program. For this study, a group of Junior and Senior hospitality and tourism university students from a major university were interviewed. The researcher utilized a phenomenological approach to analyze the data to best understand their lived experiences and perceptions. This was further contextualized under the theoretical framework of Transformational Leadership Theory (Northouse, 2019) to help elucidate the students' perceptions of their internships on their career pathways. From this analysis process, four themes emerged from their perceptions: 1) Servant Leadership, 2) mission and vison alignment, 3) mentors, and 4) connection of learning. This study addressed the gap in the current literature of transformational leadership and college students' perceptions of their career pathways after completing an internship by understanding how the 4i's of idealized influence and charisma, inspirational motivation, intellectual stimulation, and individualized consideration are positively or negatively perceived. A key finding of the study was that students' perceptions of their career pathways were positive in both transformational and transactional internships, and only differed in the 4i's constructs. However, students who completed a transformational internship could see themselves as leaders within the organization and could see a pathway for career advancement increasing retention within the organization.

This study examines the messages and accuracy of the messages sent to students from the Arizona Instrument to Measure Standards (AIMS) math test regarding academic preparedness for postsecondary education. Previous studies investigating messages sent to students, derived from information such as educational standards, grades, course taking policies, test material, and college admissions requirements, focused on content alignment of secondary and postsecondary content standards. However, a dearth of research exists on messages from high school performance, as measured by exit exams and college performance measured by grades, major selection, or graduation. This study addresses the need to understand and interpret messages students receive based on academic performance. Specifically, this study aims to answer three questions. First, what is the relationship between AIMS math scores and college math performance defined by the University of Arizona math requirement and college graduation? Second, to what degree do AIMS math scores predict college math performance? Third, what is the average AIMS math score and performance level for students who choose certain majors? To answer the research questions posed in this study, various statistical analyses were employed. To answer the first question, a one-way ANOVA and logistic regression analyses were used. A linear regression analysis served to analyze the second and third questions. Results indicate that the messages sent to students regarding college readiness are, in fact, well aligned and clear and consistent. Also, there is evidence that the messages vary by gender and ethnicity.

The work described herein is situated in a larger study investigating regional food systems as a method for improving food access for vulnerable communities. This research is part of the United States Department of Agriculture's Agriculture and Food Research Initiative project titled Enhancing Food Security in the Northeast for Underserved Populations (EFSNE). This work is ongoing and currently in year five of five. One of the primary objectives in year five is to facilitate the development of Learning Communities in each of the eight communities participating in the study. To do so, the research team planned to develop tools and strategies for facilitation. The team identified a need to match strategies to the specific situation of each community. Thus, a tool was identified that might be useful in assessing the needs and readiness of the communities with respect to their access to healthy food sources. This research simultaneously evaluated the usefulness of the tool while assessing community readiness in six of the eight project communities. The tool used in this study, was a community level behavioral change model, the Community Readiness Model (CRM). The model was originally developed by the Tri-Ethnic Center in Colorado. We followed the CRM protocol for identifying participants. Twenty-four individuals from six locations involved in the EFSNE study participated in the interview process. The interviews were conducted using the semi-structured interview guide provided in the CRM protocol. We amended the guide by tailoring questions to address food access and ensuring questions were asked at the five levels of influence found in the Socio-Ecological Model. The final guide contained 40 questions; 18 were required by the protocol to score each community. Interviews were conducted by telephone by one researcher, transcribed, and then scored by two researchers according to the CRM protocol. The mean overall readiness score for the six communities assessed was 4.9 (SD 1.0). This score is firmly rooted in the pre-planning stage of readiness. Scores ranged from 3.7 to 6.2 on the 9-point scale. The CRM scoring protocol coupled with the overall readiness scores indicated that the three urban communities scored higher (mean 5.7, SD 0.6) than the three rural communities (mean 4.1, SD 0.7). While we found a utility to having scores on a continuum to quickly assess the communities of study, we found the qualitative data obtained from the interview process imperative to understanding the scores and the communities. We concluded that with a few amendments, the Community Readiness Model is a useful methodology to understand food access at the community level. Revealing the stages of readiness for food access change in the study communities contributed to our understanding of what types of programs exist for food access, what the communities' attitudes and feelings are around food access and guided strategy development for moving readiness for change forward. This lens also revealed that there is a need for education on existing and development of new food access policies. Furthermore, this work contributes to the practice of assessing community food security while simultaneously contributing to the development of parameters for community food security theory in food systems scholarship.