Browsing by Subject "Global health"
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Item Changes in health resulting from the "Internship Process" in a cohort of professional psychology doctoral student applicants(2017-06-02) Manning, John Merrill; Henderson, Craig E.Graduate students enrolled in clinical, counseling, and school psychology doctoral programs are required to complete a one-year internship prior to graduating and earning their degree. Recently, an imbalance has grown between the number of internship positions and the number of applicants, with more applicants than available internship positions. This creates a period of intense stress and demand on prospective interns as they apply for, interview for, and receive word of pairing results to internship sites. This stress may negatively impact interns’ health and wellness over the application/interview period. To date, this remains an area that has not previously been studied. The current study utilizes a hierarchical, latent variable model of global health, with a global health factor comprised of five first-order factors: Physical health, mental health, spiritual health, social health, and stress (IS-Wel model; Hattie, Myers, & Sweeney, 2004). Using a time-interrupted series design, participants wore a physical activity monitor, completed semi-weekly surveys, and logged food intake via an online application across three phases lasting three, four, and three weeks, respectively. Using partial least squares structural equation modeling (PLS-SEM), the model was analyzed for fit and predictive validity. Subsequently, means structures were assessed for significant changes across phases, as well as accounting for the influence of resilience as a covariate, within SPSS using a MANCOVA analysis. Paired-sample t-tests were further used to analyze specific areas and direction of change. Results indicated non-significant changes in health across phases, as well as a non-significant interaction between resilience and health by phase. These results indicate that prospective interns are able to effectively cope with the multiple stressors unique to this period of training.Item Machina ex deos. Successes and challenges of implementing mobile computing technologies for development. The experience of nine Indian village health projects using a project-issued mobile application(2016-05) Schwartz, Ariel, Ph. D.; Weaver, Catherine, 1971-; Densmore, Melissa; Heinrich, Carolyn; Lentz, Erin; Ward, PeterAs mobile computing technologies become increasingly functional and affordable, global donor and local development organizations find ways to justify and fund their use in grassroots development work. This dissertation asks two questions: (1) In resource-constrained social sector settings, what project features govern and structure use of work-issued mobile devices? And: (2) How do decision-makers adjust to maximize the benefit of newly-introduced devices while minimizing new burdens to the project and project staff? More simply, what variables under social sector projects’ control might promote successful use of information and communication technologies in development (ICTD) projects? This research represents systematic, qualitative comparison of nine extended deployments of a popular mobile health application, CommCare. Each studied project deployed devices loaded with CommCare to health workers in India as a supportive job aid and/or a data collection tool to help monitor beneficiary populations’ health status and frontline workers’ work. This dissertation examines the conditions under which these health workers were able and willing to use CommCare devices in their jobs, and whether and how they deviated from the use of those devices prescribed by their supervisors. Primary data for this study come from 62 in-depth, semi-structured interviews, extensive review of project documents, and personal observations from field study in India over six months in 2013. Employing a sociotechnical lens and a principal agent model, my data support expectations that use of CommCare devices would help align community health workers’ behavior with their supervisors’ organization and mission-related priorities. Use of the devices improved health workers’ professional competence and improved communications, data quality, and data access. These improvements facilitated project supervisors’ monitoring of health workers and beneficiaries, and funders’ monitoring of projects. Contradicting expectations, use of CommCare devices also weakened organizational oversight and control through new data challenges and increased health worker autonomy in their personal and professional lives. These dual benefits and challenges ultimately served the overall projects’ missions.Item Wheelchair use in less resourced settings: a study on research quality, wheeled mobility in rural areas, and the user experience in the Lao People's Democratic Republic.(2015-08) Stanfill, Christopher John; Jensen, Jody L.; Cance, Jessica D.; Kohl III, Harold W.; Maslowsky, Julie; Lindsley, Robert B.The World Health Organization estimates that nearly twice as many people in the developing world are in need of wheelchairs compared to other mobility aids (e.g., prosthetics). Wheelchairs currently being manufactured in less resourced areas are rarely designed to withstand rural conditions with poor infrastructure, which leads to increased rates of product failure and/or abandonment. Global recognition of the need for more durable and efficient wheelchairs created a movement in evaluating how patients in these settings interact with various designs. This growing body of literature focuses primarily on the impact of wheelchair models in terms of performance and perception. Performance measures are often defined by physiological and biomechanical testing, while user perception outcomes are generated through feedback assessments, surveys, and interviews. Although the results from this literature suggests a preference toward tested wheelchairs compared to locally manufactured counterparts, it is necessary to expand on methodologies that can uncover further detail on product effectiveness. For example, wheeled mobility is a new effectiveness measure that has yet to be applied in less resourced settings. Additionally, it is important to continue implementing mixed methods study designs as these approaches yield the most comprehensive information about the relationship between performance and perception. In this series of studies, I expand upon the existing literature on wheelchair use in the developing world utilizing the mixed method approach and our purpose is threefold. The first study is an objective evaluation of previous work in the field that summarizes the brief history of this research and reveals the quality level of each respective piece of literature. In the second study, wheeled mobility is used to test the effect of different wheelchair designs that each feature different propulsion systems. Finally, the third study is an investigation of perceived quality of life among wheelchair users in rural areas of the Lao PDR with the use of semi-structured interviews. The combination of outcomes from these studies highlight the importance of mixed methods approaches when evaluating patients’ interactions with wheelchairs and assistive technologies as a whole. This research also serves as a reminder of the complexities associated with working in less resourced settings, but provides a framework of strategies that can guide improvements in global wheelchair service delivery.