Investigating the Association Between Computer-Mediated Communication (CMC) and the Health of Canadian Young People: A Mixed Methods Study

Canadian young people are increasingly more connected through technological devices. This computer-mediated communication (CMC) can result in heightened connection and social support but can also lead to inadequate personal and physical connections. As technology evolves, its influence on health and well-being is important to investigate, especially among youth. This study aims to investigate the potential influences of computer-mediated communication (CMC) on the health of Canadian youth, using both quantitative and qualitative research approaches. This mixed-methods study utilized data from the 2013-2014 Health Behaviour in School-aged Children survey for Canada (n=30,117) and focus group data involving Ontario youth (7 groups involving 40 youth). In the quantitative component, a random-effects multilevel Poisson regression was employed to identify the effects of CMC on loneliness, stratified to explore interaction with family communication quality. A qualitative, inductive content analysis was applied to the focus group transcripts using a grounded theory inspired methodology. Through open line-by-line coding followed by axial coding, main categories and themes were identified. The quality of family communication modified the association between CMC use and loneliness. Among youth experiencing the highest quartile of family communication, daily use of verbal and social media CMC was significantly associated with reports of loneliness. The qualitative analysis revealed two overarching concepts that: (1) the health impacts of CMC are multidimensional and (2) there exists a duality of both positive and negative influences of CMC on health. Four themes were identified within this framework: (1) physical activity, (2) mental and emotional disturbance, (3) mindfulness, and (4) relationships. Overall, there is a high proportion of loneliness among Canadian youth, but this is not uniform for all. The associations between CMC and health are influenced by external and contextual factors, including family communication quality. Further, the technologically rich world in which young people live has a diverse impact on their health. For youth, their relationships with others and the context of CMC use shape overall influences on their health.

WHEN INTERACTING ONLINE LEADS TO TAKING ACTION OFFLINE: EXAMINING THE EFFECTS OF ONLINE PERSUASION ON IS USERS’ PRO-ENVIRONMENTAL BEHAVIOURS

With the increasing attention towards the role of information systems (IS) as a vehicle to address environmental issues, IS researchers and practitioners have strived to leverage advanced Green IS innovations to persuade people to engage in environmentally responsible practices and support pro-environmental initiatives. Yet, existing research reveals that the persuasion effects of Green IS designs remain equivocal. In particular, many design characteristics advocated in Green IS research can produce bi-directional changes in IS users’ attitudes and behaviours. To address this issue, this thesis drew upon the circumplex model of social values (S.H. Schwartz, 1992) to explain when and how online persuasion designs come to affect people’s judgements on resource conservation and environmental protection. Three sets of working propositions and specific hypotheses were developed. Specifically, this research suggests that the use of an IS application can elicit different value primes and draw IS users’ attentions to different motivational functions of engaging in suggested behavioural changes. It is expected that matching online persuasion appeals with IS users’ personal value priorities can increase users’ acceptance of online behavioural suggestions. Second, it is hypothesized that the persuasion effect tends to be weakened, as the system users become aware of the valuematching design in a given IS application. Third, it is proposed that different value primes presented in an IS application can result in different unintended effects on IS users’ global pro-environmental attitudes and motivations. The hypotheses were tested in the two pilot studies and two full-scale online experiments. The study findings generally support the main predictions of the hypotheses. On the one hand, this thesis providesiii empirical evidence that IS design for online persuasion can be instrumental in influencing IS users’ judgements on a range of resource conservation practices. On the other hand, this work explains why the effectiveness of IS-enabled online persuasion attempts needs to be measured not only in terms of the intended changes in a target behavioural domain but also in terms of unintended changes in people’s general environmental orientations. Findings in this research may bring a different perspective on understanding and assessing the influence of Green IS applications on IS users’ judgements and behaviou

UPTAKE OF THE PERIODIC HEALTH EXAM AMONG ADULTS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES FROM 2003 TO 2015

Background: Over the past decade, annual heath exams have been de-emphasized for the general population but emphasized for adults with intellectual and developmental disabilities (IDD). The purpose of this project was to determine if there has been an increase in the uptake of the health exam among adults with IDD in Ontario, to what extent, and the effect on the quality of preventive care provided. Methods: Using administrative health data, the proportion of adults (18-64 years old) with IDD who received a health exam (long appointment, general assessment, and “true” health exam), a high value on the primary care quality composite score (PCQS), and a health exam or high PCQS each year was compared to the proportion in a propensity score matched sample of the general population. Negative binomial and segmented negative binomial regression controlling for age and sex were used to determine the relative risk of having a health exam/high PCQS/health exam or PCQS over time. Results: Pre joinpoint, the long appointment and general assessment health exam definitions saw a decrease and the “true” health exam saw an increase in the likelihood of adults having a health exam. Post joinpoint, all health exam definitions saw a decrease in the likelihood of adults having a health exam. Pre joinpoint, all PCQS measures (high PCQS, long appointment or high PCQS, “true” health exam or high PCQS) saw an increase in the likelihood for adults to achieve a high PCQS or high PCQS/have a health exam. Post joinpoint, all PCQS measures saw a decrease in the likelihood for adults to achieve a high PCQS or high PCQS/have a health exam. Achieving a high PCQS was strongly associated with having a health exam regardless of health exam definition or IDD status. Conclusions: Despite the publication of guidelines, only a small proportion of adults with IDD are receiving health exams. This indicates that the publication of guidelines alone was not sufficient to change practice. More targeted measures, such as the implementation of an IDD-specific health exam fee code, should be considered to increase the uptake of the health exam among adults with IDD.

A Poetics of Annotation: Alexander Pope's Footnotes

Studies of Alexander Pope's poetry tend to examine only the footnotes to his Dunciads, if they examine his footnotes at all. This dissertation will address this deficit in our understanding of Pope's poetics through an examination of Pope's use of footnotes in support of his verse throughout his career. With Gerard Genette's taxonomy of footnotes as variously paratext and text and Hugh Kenner's idea of the technological space of the printed page as frameworks within which Pope's footnotes operate, this dissertation will show that – over the course of his career – Pope developed a poetics of annotation that deployed footnotes rhetorically as appeals to ethos and pathos that both built up Pope's own authorial ethos for his audience in the literary market place of early eighteenth-century London and for posterity and used that authorial ethos in support of his literary and political friends.