中国人留学生の親密圏を構成する「家族」と「友人」とのネットワークは、以前と比べてその構造が大きく変化していった。中国人留学生の親密圏の中心は、「生活圏中心」から「自文化圏中心」に変容してきた。一方、中国人留学生の「微信」に対する利用習慣は彼らの親密圏を中国人ネットワークに偏らせることにつながっている。中国における共同体としての家族が、「自文化中心」の親密圏をさらに強化している。しかし「日本人友人との連絡の頻度」が高いほど、「日本人とのコミュニケーションに対する満足感」が高いことも分かった。「自文化圏中心」の親密圏が中国人留学生の異文化適応にネガティブな影響を与えるといえる。 / The network of family and friends that make up the intimate sphere of Chinese international students has changed significantly compared to before. The center of the intimate sphere of Chinese international students has changed from "centered on the living area" to "centered on the self-cultural area." On the other hand, the usage habits of Chinese students for "Wechat" have led to their intimacy being biased toward the Chinese network. The family as a community in China strengthens the "self-cultural center" intimacy. However, it was also found that the higher the "frequency of contact with Japanese friends", the higher the "satisfaction with communication with Japanese people". It can be said that the intimate sphere of "self-cultural center" has a negative impact on the cross-cultural adaptation of Chinese international students. / 博士(社会学) / Doctor of Philosophy in Sociology / 同志社大学 / Doshisha University

The study identifies the challenges in the implementation of Inclusive Education in the Umgungundlovu District of Education and establishes the possible solutions. The basis for this investigation is the Education White Paper 6, Special Needs Education: Building an Inclusive Education and Training System (Department of Education, 2001). The study was conducted in the Umgungundlovu District of Education in the area of Pietermaritzburg. A qualitative research method was used. Data collection strategies that were used are structured interviews, observation and a questionnaire. The study reveals the following challenges that hamper theimplementation;Negative attitudes of some educators and parents towards inclusion, lack of Skills Development Programmes for educators, minimal involvement of parents as well as lack of infrastructural development. These challenges could be dealt with by appointing a Manager within the District to ensure that advocacy on Inclusive Education, training of educators and infrastructural improvement in all schools are done. / Educational Studies / M.Ed. (Inclusive Education)

The study identifies the challenges in the implementation of Inclusive Education in the Umgungundlovu District of Education and establishes the possible solutions. The basis for this investigation is the Education White Paper 6, Special Needs Education: Building an Inclusive Education and Training System (Department of Education, 2001). The study was conducted in the Umgungundlovu District of Education in the area of Pietermaritzburg. A qualitative research method was used. Data collection strategies that were used are structured interviews, observation and a questionnaire. The study reveals the following challenges that hamper theimplementation;Negative attitudes of some educators and parents towards inclusion, lack of Skills Development Programmes for educators, minimal involvement of parents as well as lack of infrastructural development. These challenges could be dealt with by appointing a Manager within the District to ensure that advocacy on Inclusive Education, training of educators and infrastructural improvement in all schools are done. / Educational Studies / M.Ed. (Inclusive Education)

[pt] Este estudo dá continuidade ao histórico de pesquisas do autor sobre o tema da maternidade, entendida enquanto um fenômeno humano relacional e situada enquanto etapa normal no ciclo de vida da mulher. O interesse atual repousa sobre a questão da gestação de alto-risco e as relações possíveis com a noção de rede de apoio social. A investigação tem como objetivoa apreciação da experiência do risco gravídico e as repercussões para a vivência da gestante no interior de um programa de pré-natal em uma unidade de saúde do Estado do Rio de Janeiro. Foram entrevistadas 12 mulheres, gestantes regularmente inscritas no programa de pré-natal, e seus relatos submetidos à análise de conteúdo. Foram aplicados dois instrumentos — Roteiro de Avaliação da Gestação (RAG) e a Ficha Biográfica (FB) —, com intuito de coletar informações sobre a composição e a função de redes sociais de apoio utilizadas pelas gestantes, identificar a concepção de risco gravídico adotada pelas mesmas e conhecer alguns dados pessoais e familiares. Os resultados apontam para uma relação entre a concepção de risco e a conscientização das gestantes acerca da necessidade de mudanças comportamentais para o enfrentamento da situação. A concepção de risco identificada pressupõe forte influência e controle do discurso biomédico hegemônico, contudo, a utilização do apoio oferecido por redes sociais parece relativizar este domínio e atuar como instrumento de promoção de saúde para as gestantes. De forma estrutural, figuras próximas e, preferencialmente, do sexo feminino, são mais consultadas e solicitadas para aquisição de suporte. A presença do companheiro é mais solicitada na qualidade de apoio instrumental e a mãe da gestante no que tange ao apoio afetivo. De forma paralela, utilizou-se o conceito de resiliência psicológica como aspecto relevante para a discussão na medida em que variáveis intrapsíquicas foram identificadas como mais intimamente relacionadas ao sucesso da experiência de gestação de risco rumo à saúde, como autonomia, sentimento de auto-eficácia e perseverança. Verificou-se uma forte crença no apoio informacional da equipe e em sua capacidade como agente de promoção de saúde, auxiliando a gestante em sua jornada cotidiana e agindo como fator de proteção diante do diagnóstico clínico de risco gravídico. A rede de apoio social, as variáveis relativas à resiliência psicológica e a equipe de saúde apresentam-se como agentes de promoção de saúde e atuam de forma a diminuir os fatores de risco associados ao diagnóstico clínico, ao participarem da criação de estratégias eficazes de enfrentamento da situação de adversidade. / [en] This study continues the author research on motherhood as a human relational phenomenon in a normal stage of a woman life cycle. The present interest concerns the problem of high risk pregnancy and the possible relations with the notion of social support network. The investigation focuses the experience of risky pregnancy and the consequences for the life of the pregnant woman in a pre-birth program of a health service of the state of Rio se Janeiro. 12 women regularly enrolled n the pre-birth program have been interviewed and all accounts have been fully analysed. Two instruments – pregnancy evaluation schedule and biographic card - have been used to collect the information concerning the organization and the work of the social support network used by the pregnant, identify the ideas of pregnancy risk and get some personal and family data. The results show a strong relation between the risk consciousness and the awareness concerning the necessary behaviour changes to face this situation. The idea of risk supposes a strong influence and control of the hegemonic biomedical speech but the use of the social support network seems to reduce this problem and acts as a health promotion instrument for the pregnant woman. Structurally, close friends, preferably women, are requested for help and support. The presence of the companion is rather requested for instrumental support while the mother of the pregnant woman gives emotional support. In the same way, it has been used the concept of psychological resilience as a relevant aspect for the discussion since intra-psychological variables have been identified as closely related to the success of the risky pregnancy experience for the good health as autonomy, feeling of self efficiency and perseverance. Despite the significant influence of the medical speech through the use of technical instruments by the pre-birth health service staff, it has been identified strong belief in the informational support of this staff and its capacity as an agent to promote health helping the pregnant woman daily and acting as a protection against the pregnancy risk. The social support network, the variables concerning psychological resilience and the health staff act as a health promotion agent and work to reduce the risk factors associated to clinic diagnosis when participating of the creation of creating good strategies to face the situation of adversity.

Bakgrund: Narkotikamissbruk har sedan 1960-talet ansetts vara ett allvarligt samhällsproblem som ökar risken för sjukdom och social utsatthet. Varje år dör omkring 900 personer i Sverige av läkemedels- och narkotikaförgiftningar. Personer som utvecklat ett narkotikamissbruk kan hamna i en ond spiral där de negativa konsekvenserna ökar och medför en risk att förlora allt så som jobb, hem och familj. Detta kan i sig öka de socioekonomiska skillnaderna i befolkningen. När en person bryter sitt missbruk sker en process som i denna studie förklarats utifrån modellen Stages of change. Syfte: Syftet med studien är att skildra betydelsefulla faktorer i förändringsprocessen för individer som tagit sig ur narkotikamissbruk. Metod: Studien var av kvalitativ karaktär och genomfördes med semistrukturerade intervjuer. I studien kombinerades induktiv och deduktiv ansats. Resultat: Resultatet visade att socialt stöd var en viktig faktor genom förändringsprocessen, framförallt under faserna action och maintenance. Olika strategier som att bryta gamla beteenden och mönster var betydande. Den egna viljan ansågs vara essentiell för att inleda och genomföra en förändring. Genom behandling fick informanterna verktyg att hantera sin vardag. De jobbade hårt med sig själva genom de olika förändringsfaserna i Stages of change för att uppnå ett vidmakthållande och minimera risken för återfall. Konklusion: Studiens resultat visar att när en person är i behov av hjälp, och uttrycker detta, då behöver familj och samhälle erbjuda stöd. För de individer som inte har det sociala nätverket bakom sig, där synliggörs ett större behov av att samhällsinsatser måste finnas tillgängliga för att bidra till jämlik hälsa. / Background: Since the 1960s, drug abuse has been considered a serious societal issue that increases the risk of illness and social exclusion. In Sweden approximately 900 people die from drug intoxication annually. People who develop a drug addiction can end up in a negative spiral with consequences such as loss of work, home and family. Consequences that can increase the socio-economic differences within the population. When a person decides to end their addiction a process of change takes place, in this study explained using the Stage of change model. Purpose: The purpose of the study is to describe significant factors during the process of change within individuals who have recovered from drug abuse. Method: The study design was qualitative and was conducted using a semi-structured interview guide. The study combined inductive and deductive analysis. Results: The results indicated that social support was an important factor throughout the process of change, especially during the phases action and maintenance. Various strategies such as breaking old habits and patterns were also significant. Self-determination was considered essential to initiate and implement change. During treatment, the informants were given coping strategies to handle their everyday lives. They worked hard with themselves throughout the various stages in Stages of change to achieve sustainability and minimize the risk of relapse. Conclusion: The study's result implies that when a person is in need of help, and expresses this, family and community need to offer support. Individuals who do not have the social network requires more interventions from the community to enable a healthy life.

Contexte : Au Québec, la très grande majorité des personnes âgées vivent dans un logement conventionnel. Pour celles qui sont en plus grande perte d’autonomie et qui ont besoin d’un environnement adapté à leurs besoins, soit environ 12 % de la population âgée de 65 ans ou plus en 2006, les options sont relativement limitées. Au 1er rang, on retrouve les résidences privées, pour ceux et celles qui en ont les moyens. Pour les autres, il y a les centres de soins de longue durée publics ou privés. Viennent ensuite les organismes sans but lucratif qui opèrent des projets résidentiels pour aînés, les communautés religieuses qui accueillent des personnes âgées dans leurs résidences, les ressources intermédiaires, les ressources de type familial, les habitations à loyer modique pour personnes âgées et les coopératives d’habitation. Les ressources alternatives du type projets novateurs arrivent en dernière position, ce qui explique que l’on en sait encore très peu sur la transition vers ce type d’hébergement. Problème et objet de recherche : La transition vers un milieu de vie substitut est un processus qui peut être potentiellement stressant dans la vie d’une personne âgée. Son réseau de soutien peut être appelé à jouer un rôle important pour l’aider à vivre cette transition avec plus de facilité. Si la littérature sur le soutien social est abondante, elle est plus limitée en ce qui concerne la relation entre le soutien social et la transition en milieu d’hébergement. La plupart des travaux recensés étudient les conséquences de l’hébergement durant les mois qui suivent le relogement. Quelques études analysent le processus décisionnel mais rares sont celles qui s’intéressent à toutes les étapes du processus qui précèdent le relogement. La plupart des recherches analysent surtout le point de vue des aidants et parfois celui des professionnels. Celui des personnes âgées est moins connu. But et objectifs : Le but de cette étude consiste à mieux comprendre comment opèrent les différentes formes de soutien social auprès des personnes âgées durant les diverses étapes du processus de transition en milieu d’hébergement. Plus précisément, elle vise à mieux comprendre comment ces personnes perçoivent les différents types de soutien apporté par leur réseau de soutien durant la transition, la signification que prend pour elles l’aide reçue, les besoins auxquels répond le soutien reçu et pourquoi elles apprécient ou non le soutien reçu. Cadre conceptuel : Cette recherche de type exploratoire et rétrospective se situe dans une approche des parcours de vie. La transition en milieu d’hébergement est étudiée comme un processus faisant partie de la trajectoire résidentielle de la personne. On privilégie une approche interactionnelle et constructiviste du soutien social qui accorde une attention plus grande aux interprétations subjectives des personnes faisant partie des réseaux de soutien. Méthodologie : On a interviewé huit (8) résidents (6 femmes et 2 hommes) de 64 ans ou plus, vivant dans un milieu d’hébergement alternatif de type projet novateur : les Habitations St-Christophe, une ressource alternative située dans la ville de Laval au Québec. Les perceptions des sujets du soutien social reçu durant la transition sont analysées à l’aide de la théorisation ancrée, la plus appropriée pour comprendre de l’intérieur le point de vue des participants. Résultats : L’analyse des perceptions des résidents interviewés du processus qui les a conduits aux Habitations St-Christophe a permis de mieux comprendre l’influence de leurs trajectoires résidentielles, les transitions ayant mené à leur hébergement, leurs perceptions du processus décisionnel et du rôle joué par des tiers dans les décisions prises, ainsi que les motifs de ces décisions, de même que le rôle joué par le soutien social durant la transition. Trois modèles de réseaux ont été identifiés, en tenant compte de la fréquence des contacts, de l’intensité des liens et de la disponibilité du soutien. Les formes les plus importantes de soutien reçu ont été identifiées à partir des perceptions des sujets de l’aide émotionnelle, instrumentale et cognitive fournie pendant la transition et de leur appréciation du soutien reçu. L’analyse a permis d’identifier deux modèles de transition (transition réfléchie, préparée et anticipée versus transition précipitée) et deux modèles de soutien (soutien valorisé versus soutien peu valorisé). Conclusions : Outre les éléments de convergence et les points de divergence observés entre nos résultats et la littérature, un certain nombre d’enseignements ont été retenus au niveau de l’intervention. Ceux-ci concernent les conditions gagnantes à mettre en place par les gestionnaires des services publics, certains principes à respecter dans les interventions, les mesures à prendre pour améliorer les interventions des professionnels et les interventions à mettre en place à l’intention des personnes âgées et de leurs proches aidants. / Context : In Quebec, a vast majority of senior citizens live within the community. For the elderly who has greater difficulty or who needs to be in an environment adapted to their specific needs are about 12% of the population aged 65 years and over in 2006, the options are relatively limited. Firstly, we have private seniors homes, for those who can afford it. Next, we have non-profit organizations that provides housing projects for the elderly; religious communities who welcomes senior citizens in their homes; board and care homes; foster and care homes; low-income public housing for the elderly and cooperative housing. Then, lastly we have the innovative projects of alternative model housing, which explains that very little is known on the transition towards this type of habitation. Subject : The transition towards supportive housing is a process that can be potentially stressful for senior citizens. Their support network may be called upon to play an important role to help make the transition easier for the individuals involved. If the literature on the social network is abundant, it is even more limited when it comes to the relationship between the social support and the transition to supportive housing. Most censuses done, studies the effects after relocation. Some studies analyse the decision making process but it is rare that they are interested in every step of the relocation process. The majority of researchers analyses the perception of caregivers, and sometimes those of professionals. That of the elderly less is known. Goals & Objectives : The goal of this study helps to better understand how the various forms of social support operates close to the elderly during the different stages of the transition process in supportive housing. More precisely, it helps to understand how these people perceive the different types of support received from their networks during the transition, the meaning of help received, the support responds to the needs and why they appreciate or not the support received. Conceptual Framework : This exploratory and retrospective study has a life course approach. The transition to supportive housing is studied as being part of the residential trajectory process of the person. We prefer an interactive and constructive approach to the social support, which accords more attention to the subjective interpretations of the people who are part of the social networks. Methodology : We interviewed eight residents (6 females and 2 males) aged from 64 years or more living in an innovative project of alternative model of housing : Les Habitations St-Christophe, an alternative resource located in the city of Laval, in the province of Quebec, Canada. The subject perceptions of the social support received during the transition were analysed with the grounded theory, the most appropriate strategy for better understanding of residents’ perceptions. Results : The analysis of the residents’ perceptions of the housing process at the Habitations St-Christophe gives a better understanding of the influence on their residential trajectories, housing transition, their perceptions of the decision making process, role played by others relatives in this process, as well as motivations, also the role played by the social support group during this transition. Three network models were identified, taking into account the frequency of the contacts, intensity of the links, and the support available. The most important forms of support received were identified from the subjects’ perceptions of emotional, instrumental, and cognitive help or assistance received during the transition, and their satisfaction level of the assistance given by their relatives. The analysis revealed two transition models (anticipated, considered and prepared transition versus precipitated transition) and also two support models (valued support versus not valued support). Conclusions : In addition to the convergence elements and different points observed among our results and the literature, a number of practice lessons for the intervention were found. These include certain conditions to be put in place by managers in the public services, some principles to respect when intervening by the professionals, measures to take to improve the operations, and the interventions to take for seniors citizens and the caregivers.

Contexte : Au Québec, la très grande majorité des personnes âgées vivent dans un logement conventionnel. Pour celles qui sont en plus grande perte d’autonomie et qui ont besoin d’un environnement adapté à leurs besoins, soit environ 12 % de la population âgée de 65 ans ou plus en 2006, les options sont relativement limitées. Au 1er rang, on retrouve les résidences privées, pour ceux et celles qui en ont les moyens. Pour les autres, il y a les centres de soins de longue durée publics ou privés. Viennent ensuite les organismes sans but lucratif qui opèrent des projets résidentiels pour aînés, les communautés religieuses qui accueillent des personnes âgées dans leurs résidences, les ressources intermédiaires, les ressources de type familial, les habitations à loyer modique pour personnes âgées et les coopératives d’habitation. Les ressources alternatives du type projets novateurs arrivent en dernière position, ce qui explique que l’on en sait encore très peu sur la transition vers ce type d’hébergement. Problème et objet de recherche : La transition vers un milieu de vie substitut est un processus qui peut être potentiellement stressant dans la vie d’une personne âgée. Son réseau de soutien peut être appelé à jouer un rôle important pour l’aider à vivre cette transition avec plus de facilité. Si la littérature sur le soutien social est abondante, elle est plus limitée en ce qui concerne la relation entre le soutien social et la transition en milieu d’hébergement. La plupart des travaux recensés étudient les conséquences de l’hébergement durant les mois qui suivent le relogement. Quelques études analysent le processus décisionnel mais rares sont celles qui s’intéressent à toutes les étapes du processus qui précèdent le relogement. La plupart des recherches analysent surtout le point de vue des aidants et parfois celui des professionnels. Celui des personnes âgées est moins connu. But et objectifs : Le but de cette étude consiste à mieux comprendre comment opèrent les différentes formes de soutien social auprès des personnes âgées durant les diverses étapes du processus de transition en milieu d’hébergement. Plus précisément, elle vise à mieux comprendre comment ces personnes perçoivent les différents types de soutien apporté par leur réseau de soutien durant la transition, la signification que prend pour elles l’aide reçue, les besoins auxquels répond le soutien reçu et pourquoi elles apprécient ou non le soutien reçu. Cadre conceptuel : Cette recherche de type exploratoire et rétrospective se situe dans une approche des parcours de vie. La transition en milieu d’hébergement est étudiée comme un processus faisant partie de la trajectoire résidentielle de la personne. On privilégie une approche interactionnelle et constructiviste du soutien social qui accorde une attention plus grande aux interprétations subjectives des personnes faisant partie des réseaux de soutien. Méthodologie : On a interviewé huit (8) résidents (6 femmes et 2 hommes) de 64 ans ou plus, vivant dans un milieu d’hébergement alternatif de type projet novateur : les Habitations St-Christophe, une ressource alternative située dans la ville de Laval au Québec. Les perceptions des sujets du soutien social reçu durant la transition sont analysées à l’aide de la théorisation ancrée, la plus appropriée pour comprendre de l’intérieur le point de vue des participants. Résultats : L’analyse des perceptions des résidents interviewés du processus qui les a conduits aux Habitations St-Christophe a permis de mieux comprendre l’influence de leurs trajectoires résidentielles, les transitions ayant mené à leur hébergement, leurs perceptions du processus décisionnel et du rôle joué par des tiers dans les décisions prises, ainsi que les motifs de ces décisions, de même que le rôle joué par le soutien social durant la transition. Trois modèles de réseaux ont été identifiés, en tenant compte de la fréquence des contacts, de l’intensité des liens et de la disponibilité du soutien. Les formes les plus importantes de soutien reçu ont été identifiées à partir des perceptions des sujets de l’aide émotionnelle, instrumentale et cognitive fournie pendant la transition et de leur appréciation du soutien reçu. L’analyse a permis d’identifier deux modèles de transition (transition réfléchie, préparée et anticipée versus transition précipitée) et deux modèles de soutien (soutien valorisé versus soutien peu valorisé). Conclusions : Outre les éléments de convergence et les points de divergence observés entre nos résultats et la littérature, un certain nombre d’enseignements ont été retenus au niveau de l’intervention. Ceux-ci concernent les conditions gagnantes à mettre en place par les gestionnaires des services publics, certains principes à respecter dans les interventions, les mesures à prendre pour améliorer les interventions des professionnels et les interventions à mettre en place à l’intention des personnes âgées et de leurs proches aidants. / Context : In Quebec, a vast majority of senior citizens live within the community. For the elderly who has greater difficulty or who needs to be in an environment adapted to their specific needs are about 12% of the population aged 65 years and over in 2006, the options are relatively limited. Firstly, we have private seniors homes, for those who can afford it. Next, we have non-profit organizations that provides housing projects for the elderly; religious communities who welcomes senior citizens in their homes; board and care homes; foster and care homes; low-income public housing for the elderly and cooperative housing. Then, lastly we have the innovative projects of alternative model housing, which explains that very little is known on the transition towards this type of habitation. Subject : The transition towards supportive housing is a process that can be potentially stressful for senior citizens. Their support network may be called upon to play an important role to help make the transition easier for the individuals involved. If the literature on the social network is abundant, it is even more limited when it comes to the relationship between the social support and the transition to supportive housing. Most censuses done, studies the effects after relocation. Some studies analyse the decision making process but it is rare that they are interested in every step of the relocation process. The majority of researchers analyses the perception of caregivers, and sometimes those of professionals. That of the elderly less is known. Goals & Objectives : The goal of this study helps to better understand how the various forms of social support operates close to the elderly during the different stages of the transition process in supportive housing. More precisely, it helps to understand how these people perceive the different types of support received from their networks during the transition, the meaning of help received, the support responds to the needs and why they appreciate or not the support received. Conceptual Framework : This exploratory and retrospective study has a life course approach. The transition to supportive housing is studied as being part of the residential trajectory process of the person. We prefer an interactive and constructive approach to the social support, which accords more attention to the subjective interpretations of the people who are part of the social networks. Methodology : We interviewed eight residents (6 females and 2 males) aged from 64 years or more living in an innovative project of alternative model of housing : Les Habitations St-Christophe, an alternative resource located in the city of Laval, in the province of Quebec, Canada. The subject perceptions of the social support received during the transition were analysed with the grounded theory, the most appropriate strategy for better understanding of residents’ perceptions. Results : The analysis of the residents’ perceptions of the housing process at the Habitations St-Christophe gives a better understanding of the influence on their residential trajectories, housing transition, their perceptions of the decision making process, role played by others relatives in this process, as well as motivations, also the role played by the social support group during this transition. Three network models were identified, taking into account the frequency of the contacts, intensity of the links, and the support available. The most important forms of support received were identified from the subjects’ perceptions of emotional, instrumental, and cognitive help or assistance received during the transition, and their satisfaction level of the assistance given by their relatives. The analysis revealed two transition models (anticipated, considered and prepared transition versus precipitated transition) and also two support models (valued support versus not valued support). Conclusions : In addition to the convergence elements and different points observed among our results and the literature, a number of practice lessons for the intervention were found. These include certain conditions to be put in place by managers in the public services, some principles to respect when intervening by the professionals, measures to take to improve the operations, and the interventions to take for seniors citizens and the caregivers.

Indiana University-Purdue University Indianapolis (IUPUI) / A study design has been developed that employs a dual modeling approach to identify factors associated with facility-level cancer screening improvement and how this is mediated by the use of clinical decision support. This dual modeling approach combines principles of (1) Health Informatics, (2) Cancer Prevention and Control, (3) Health Services Research, and (4) Organizational Change/Theory. The study design builds upon the constructs of a conceptual framework developed by Jane Zapka, namely, (1) organizational and/or practice settings, (2) provider characteristics, and (3) patient population characteristics. These constructs have been operationalized as measures in a 2005 HRSA/NCI Health Disparities Cancer Collaborative inventory of 44 community health centers. The first, statistical models will use: sequential, multivariable regression models to test for the organizational determinants that may account for the presence and intensity-of-use of clinical decision support (CDS) and information systems (IS) within community health centers for use in colorectal, breast, and cervical cancer screening. A subsequent test will assess the impact of CDS/IS on provider reported cancer screening improvement rates. The second, computational models will use a multi-agent model of network evolution called CONSTRUCT® to identify the agents, tasks, knowledge, groups, and beliefs associated with cancer screening practices and CDS/IS use to inform both CDS/IS implementation and cancer screening intervention strategies. This virtual experiment will facilitate hypothesis-generation through computer simulation exercises. The outcome of this research will be to identify barriers and facilitators to improving community health center facility-level cancer screening performance using CDS/IS as an agent of change. Stakeholders for this work include both national and local community health center IT leadership, as well as clinical managers deploying IT strategies to improve cancer screening among vulnerable patient populations.