A Systematic Review of Internet-Based Worksite Wellness Approaches for Cardiovascular Disease Risk Management: Outcomes, Challenges & Opportunities

Context The internet is gaining popularity as a means of delivering employee-based cardiovascular (CV) wellness interventions though little is known about the cardiovascular health outcomes of these programs. In this review, we examined the effectiveness of internet-based employee cardiovascular wellness and prevention programs. Evidence Acquisition We conducted a systematic review by searching PubMed, Web of Science and Cochrane library for all published studies on internet-based programs aimed at improving CV health among employees up to November 2012. We grouped the outcomes according to the American Heart Association (AHA) indicators of cardiovascular wellbeing – weight, BP, lipids, smoking, physical activity, diet, and blood glucose. Evidence Synthesis A total of 18 randomized trials and 11 follow-up studies met our inclusion/exclusion criteria. Follow-up duration ranged from 6 – 24 months. There were significant differences in intervention types and number of components in each intervention. Modest improvements were observed in more than half of the studies with weight related outcomes while no improvement was seen in virtually all the studies with physical activity outcome. In general, internet-based programs were more successful if the interventions also included some physical contact and environmental modification, and if they were targeted at specific disease entities such as hypertension. Only a few of the studies were conducted in persons at-risk for CVD, none in blue-collar workers or low-income earners. Conclusion Internet based programs hold promise for improving the cardiovascular wellness among employees however much work is required to fully understand its utility and long term impact especially in special/at-risk populations.

A realtime Internet-based quality control application for hurricane surface wind observations

This thesis chronicles the design and implementation of a Internet/Intranet and database based application for the quality control of hurricane surface wind observations. A quality control session consists of selecting desired observation types to be viewed and determining a storm track based time window for viewing the data. All observations of the selected types are then plotted in a storm relative view for the chosen time window and geography is positioned for the storm-center time about which an objective analysis can be performed. Users then make decisions about data validity through visual nearest-neighbor comparison and inspection. The project employed an Object Oriented iterative development method from beginning to end and its implementation primarily features the Java programming language. ^

“Who’s that Faggot at the Board?”: A School-based Intervention with a Gay Student

This article describes a successful intervention conducted in a public high school in Miami, Florida, to address an incident of harassment based on a student’s sexual orientation. The implications for educators and other school personnel to intervene in such instances are considered.

The effects of participation in an Internet -based project on the development of global knowledge, global mindedness, and global pedagogy among preservice social studies teachers

In order to prepare younger generations to live in a world characterized by interconnectedness, developing global and international perspectives for future teachers has been recommended by the National Council for the Social Studies and the National Council for the Accreditation of Teacher Education. The purpose of this study was to investigate the effects that participation in the International Communication and Negotiation Simulation (ICONS), an Internet-based communication project has on preservice social studies teachers' global knowledge, global mindedness, and global teaching strategies. ^ The study was conducted at a public university in South Florida. A combination of quantitative and qualitative approaches was employed. Two groups of preservice social studies teachers were chosen as participants: a control group composed of 14 preservice teachers who enrolled in a global education class in the summer semester of 1998 and an experimental group that included nine preservice teachers who took the same class in the fall semester of 1998. The summer class was conducted in a traditional format, which included lectures, classroom discussions, and student presentations. The fall class incorporated a five-week Internet-based communication project. The Global Mindedness Scale (Hett, 1993) and an adapted Test of Global Knowledge (ETS, 1981) were administered upon the completion of the class. ^ Contrasting case studies were utilized to investigate the impact of participation in the ICONS on the development of preservice teachers' global pedagogy. Four preservice teachers, two selected from each group were observed and interviewed to explore how they were infusing global perspectives into social studies curriculum and instruction during a 10-week student teaching internship in the spring semester of 1999. ^ This study had three major findings. First, preservice social studies teachers from the experimental group on average scored significantly higher than those from the control group on the global knowledge test. Second, no significant difference was found between the two groups in their mean scores on the Global Mindedness Scale. Third, all four selected preservice social studies teachers were infusing global perspectives into United States and world history curriculum and instruction during their student teaching internship. Using multiple resources was the common pedagogy. The two who participated in the ICONS were more aware of using the communication feature of the Internet and the web sites that reflect more international perspectives to facilitate teaching about the world. ^ Recommendations were made for further research and for preservice studies teacher education program development. ^

An investigation of the effects of a school-based intervention on feelings of personal expressiveness in multi-problem adolescent youth

This study was conducted to determine the effects of the Changing Lives Program intervention on troubled adolescents' feelings of personal expressiveness, believed to be one domain of positive identity development. Forty-three intervention and twenty nonintervention comparison control participants were given a battery of pre-, post-, and follow-up assessments including the Personally Expressive Questionnaire (Waterman, 1995), which was used to derive participants' feelings of personal expressiveness scores. Using Repeated Measures Analysis of Multivariate Analysis (RMANOVA), a significant four-way interaction of Time X Condition X Gender X Ethnicity was found relative to the Control, Roy's Ɵ = .166, F(2,47) = 3.899, p < .027 indicating that intervention participants' feelings of personal expressiveness did increase significantly relative to the control group. Furthermore, the results suggest differential outcomes based on ethnicity, suggesting the need for future study with respect to specificity of effects and mechanisms of identity formation in differing ethnic subgroups.

A realtime internet based quality control application for hurricane surface wind observations

This thesis chronicles the design and implementation of a Intemet/Intranet and database based application for the quality control of hurricane surface wind observations. A quality control session consists of selecting desired observation types to be viewed and determining a storm track based time window for viewing the data. All observations of the selected types are then plotted in a storm relative view for the chosen time window and geography is positioned for the storm-center time about which an objective analysis can be performed. Users then make decisions about data validity through visual nearestneighbor comparison and inspection. The project employed an Object Oriented iterative development method from beginning to end and its implementation primarily features the Java programming language.

A computer based approach to improve the dietary and physical activity patterns of a diverse group of adolescents

Diet and physical activity patterns have been implicated as major factors in the increasing prevalence of childhood and adolescent obesity. It is estimated that between 16 and 33 percent of children and adolescents in the United States are overweight (CDC, 2000). Moreover, the CDC estimates that less than 50% of adolescents are physically active on a regular basis (CDC, 2003). Interventions must be focused to modify these behaviors. Facilitating the understanding of proper nutrition and need for physical activity among adolescents is the first step in preventing overweight and obesity and delaying the development of chronic diseases later in life (Dwyer, 2000). The purpose of this study was to compare the outcomes of students receiving one of two forms of education (both emphasizing diet and physical activity), to determine whether a computer based intervention (CBI) program using an interactive, animated CD-ROM would elicit a greater behavior change in comparison to a traditional didactic intervention (TDI) program. A convenience sample of 254 high school students aged 14-19 participated in the 6-month program. A pre-test post-test design was used, with follow-up measures taken at three months post-intervention. ^ No change was noted in total fat, saturated fat, fruit/vegetables, or fiber intake for any of the groups. There was also no change in perceived self-efficacy or perceived social support. Results did, however, indicate an increase in nutrition knowledge for both intervention groups (p<0.001). In addition, the CBI group demonstrated more positive and sustained behavior changes throughout the course of the study. These changes included a decrease in BMI (ppre/post<0.001, ppost/follow-up<0.001), number of meals skipped (ppre/post<0.001), and soda consumption (ppre/post=0.003, ppost/follow-up=0.03) and an increase in nutrition knowledge (ppre/post<0.001, ppre/follow-up <0.001), physical activity (ppre/post<0.05, p pre/follow-up<0.01), frequency of label reading (ppre/follow-up <0.0l) and in dairy consumption (ppre/post=0.03). The TDI group did show positive gains in some areas post intervention, however a return to baseline behavior was shown at follow-up. Findings of this study suggest that compared to traditional didactic teaching, computer-based nutrition and health education has greater potential to elicit change in knowledge and behavior as well as promote maintenance of the behavior change over time. ^

Design and implementation of a web based shop floor control system to maintain schedule feasibility in a dynamic job shop environment

The effective control of production activities in dynamic job shop with predetermined resource allocation for all the jobs entering the system is a unique manufacturing environment, which exists in the manufacturing industry. In this thesis a framework for an Internet based real time shop floor control system for such a dynamic job shop environment is introduced. The system aims to maintain the schedule feasibility of all the jobs entering the manufacturing system under any circumstance. The system is capable of deciding how often the manufacturing activities should be monitored to check for control decisions that need to be taken on the shop floor. The system will provide the decision maker real time notification to enable him to generate feasible alternate solutions in case a disturbance occurs on the shop floor. The control system is also capable of providing the customer with real time access to the status of the jobs on the shop floor. The communication between the controller, the user and the customer is through web based user friendly GUI. The proposed control system architecture and the interface for the communication system have been designed, developed and implemented.

A systems approach to describing the process of individual adoption of IT innovations

Research on the adoption of innovations by individuals has been criticized for focusing on various factors that lead to the adoption or rejection of an innovation while ignoring important aspects of the dynamic process that takes place. Theoretical process-based models hypothesize that individuals go through consecutive stages of information gathering and decision making but do not clearly explain the mechanisms that cause an individual to leave one stage and enter the next one. Research on the dynamics of the adoption process have lacked a structurally formal and quantitative description of the process. ^ This dissertation addresses the adoption process of technological innovations from a Systems Theory perspective and assumes that individuals roam through different, not necessarily consecutive, states, determined by the levels of quantifiable state variables. It is proposed that different levels of these state variables determine the state in which potential adopters are. Various events that alter the levels of these variables can cause individuals to migrate into different states. ^ It was believed that Systems Theory could provide the required infrastructure to model the innovation adoption process, particularly applied to information technologies, in a formal, structured fashion. This dissertation assumed that an individual progressing through an adoption process could be considered a system, where the occurrence of different events affect the system's overall behavior and ultimately the adoption outcome. The research effort aimed at identifying the various states of such system and the significant events that could lead the system from one state to another. By mapping these attributes onto an “innovation adoption state space” the adoption process could be fully modeled and used to assess the status, history, and possible outcomes of a specific adoption process. ^ A group of Executive MBA students were observed as they adopted Internet-based technological innovations. The data collected were used to identify clusters in the values of the state variables and consequently define significant system states. Additionally, events were identified across the student sample that systematically moved the system from one state to another. The compilation of identified states and change-related events enabled the definition of an innovation adoption state-space model. ^

Employee engagement: An examination of antecedent and outcome variables

This nonexperimental, correlational study (N = 283) examined the relation among job fit, affective commitment, psychological climate, discretionary effort, intention to turnover, and employee engagement. An internet-based self-report survey battery of six scales were administered to a heterogeneous sampling of organizations from the fields of service, technology, healthcare, retail, banking, nonprofit, and hospitality. Hypotheses were tested through correlational and hierarchical regression analytic procedures. Job fit, affective commitment, and psychological climate were all significantly related to employee engagement and employee engagement was significantly related to both discretionary effort and intention to turnover. For the discretionary effort model, the hierarchical regression analysis results suggested that the employees who reported experiencing a positive psychological climate were more likely to report higher levels of discretionary effort. As for the intention to turnover model, the hierarchical regression analysis results indicated that affective commitment and employee engagement predicted lower levels of an employee’s intention to turnover. The regression beta weights ranged from to .43 to .78, supporting the theoretical, empirical, and practical relevance of understanding the impact of employee engagement on organizational outcomes. Implications for HRD theory, research, and practice are highlighted as possible strategic leverage points for creating conditions that facilitate the development of employee engagement as a means for improving organizational performance.

An investigation of the strategies used by organizations participating in the welfare-to-work network program and correlation of the strategies with the retention data to determine best practices for job retention among former welfare recipients

This ex post facto study (N = 209) examined the relationships between employer job strategies and job retention among organizations participating in Florida welfare-to-work network programs and associated the strategies with job retention data to determine best practices. ^ An internet-based self-report survey battery was administered to a heterogeneous sampling of organizations participating in the Florida welfare-to-work network program. Hypotheses were tested through correlational and hierarchical regression analytic procedures. The partial correlation results linked each of the job retention strategies to job retention. Wages, benefits, training and supervision, communication, job growth, work/life balance, fairness and respect were all significantly related to job retention. Hierarchical regression results indicated that the training and supervision variable was the best predictor of job retention in the regression equation. ^ The size of the organization was also a significant predictor of job retention. Large organizations reported higher job retention rates than small organizations. There was no statistical difference between the types of organizations (profit-making and non-profit) and job retention. The standardized betas ranged from to .26 to .41 in the regression equation. Twenty percent of the variance in job retention was explained by the combination of demographic and job retention strategy predictors, supporting the theoretical, empirical, and practical relevance of understanding the association between employer job strategies and job retention outcomes. Implications for adult education and human resource development theory, research, and practice are highlighted as possible strategic leverage points for creating conditions that facilitate the development of job strategies as a means for improving former welfare workers’ job retention.^

Adapting Mpowerment to a Rural Area

As HIV/AIDS continues to disproportionately impact men who have sex with men (MSM) (CDC, 2010a), effective and timely prevention strategies for this population must be developed. Specifically, evidence-based interventions that can be easily adapted and have proven effectiveness are needed. Hence, the purpose of the current study was to assess the impact of the Mpowerment Project (Hayes, Rebchook, & Kegeles, 2003), a community level HIV prevention program originally designed for young urban gay men, when adapted for rural gay men. The Mpowerment Project is recognized as evidence- based intervention by the CDC (CDC, 2009b). The current study is an extension of this research, assessing Mpowerment model fidelity and the behavioral and attitudinal changes that occurred among participants. Data were collected from participants in a rural area of southeast Idaho from 2002-2004. Data were collected prior to M-Group participation and at a three months follow-up. The 66 individuals completing the M-Group pre and posttest assessment also attended a minimum of three study events and a maximum of 226 events. Results revealed no significant changes in attitudinal variables and all but one behavioral variable among Rural Mpowerment (R-MP) participants. The one significant behavior change was an increase in reported safer sex discussion among friends, indicating a possible change in the social norm regarding safer sex. Results also indicate that program fidelity was maintained and the Mpowerment Project is adaptable to rural areas. However, there was no indication of attitudinal changes in participants of this study. There were no changes in behavioral variables aside from discussion about safer sex with friends increasing. The lack of evidence-based interventions for rural gay men highlights the need for further research on the community impact of the Mpowerment Project on rural participants.

Adapting Mpowerment to a rural area

As HIV/AIDS continues to disproportionately impact men who have sex with men (MSM) (CDC, 2010a), effective and timely prevention strategies for this population must be developed. Specifically, evidence-based interventions that can be easily adapted and have proven effectiveness are needed. Hence, the purpose of the current study was to assess the impact of the Mpowerment Project (Hayes, Rebchook, & Kegeles, 2003), a community level HIV prevention program originally designed for young urban gay men, when adapted for rural gay men. The Mpowerment Project is recognized as evidence- based intervention by the CDC (CDC, 2009b). The current study is an extension of this research, assessing Mpowerment model fidelity and the behavioral and attitudinal changes that occurred among participants. Data were collected from participants in a rural area of southeast Idaho from 2002-2004. Data were collected prior to M-Group participation and at a three months follow-up. The 66 individuals completing the M-Group pre and posttest assessment also attended a minimum of three study events and a maximum of 226 events. Results revealed no significant changes in attitudinal variables and all but one behavioral variable among Rural Mpowerment (R-MP) participants. The one significant behavior change was an increase in reported safer sex discussion among friends, indicating a possible change in the social norm regarding safer sex. Results also indicate that program fidelity was maintained and the Mpowerment Project is adaptable to rural areas. However, there was no indication of attitudinal changes in participants of this study. There were no changes in behavioral variables aside from discussion about safer sex with friends increasing. The lack of evidence-based interventions for rural gay men highlights the need for further research on the community impact of the Mpowerment Project on rural participants.

The influence of neurocognitive impairment, alcohol and other drug (AOD) use, and psychosocial factors on antiretroviral treatment adherence, service utilization and viral load among HIV-seropositive adults

Among people living with HIV (PLWH), adherence to antiretroviral therapy (ART) can be affected by problems of neurocognitive (NC) impairment, stress, alcohol and other drug (AOD) abuse, and other barriers. The aims of this research were to: (1) examine factors associated with NC impairment, (2) explore relationships between psychosocial variables with ART adherence and viral load (VL), and (3) evaluate the efficacy of an evidence-based intervention in improving ART adherence, increasing service utilization, and decreasing VL. The first study (n=370) was cross sectional and used structural equation modeling to test whether AOD use, years living with HIV, and time from HIV diagnosis to seeking care were associated with poorer NC functioning. The second study (n=246) used similar methods to test the hypothesis that stress, barriers to adherence, NC impairment, poor social support, and AOD use were related to lower VL mediated by ART adherence. The third study (n=243) evaluated an evidence-based, eight-session program to improve ART adherence, reduce VL, and increase service utilization in a randomized controlled trial. Study participants were PLWH living in South Florida, 18 to 60 years old, with a history of alcohol abuse enrolled from January 2009 through November 2012. Secondary analysis of available data showed: (1) scores on interference with executive functioning increased by 0.32 for each day of marijuana use and 1.18 for each year living with HIV, but no association was found between alcohol use and NC functioning; (2) each barrier to adherence was associated with a 10% decrease in adherence to ART and a 0.42 unit increase in VL (log10) and the relationship between barriers and VL was partially mediated by ART adherence; (3) participants in the evidence-based program were more likely than the comparison group to report an undetectable VL (OR=2.25, p<0.01) at 6 months, but not 3 months, post-intervention. Psychosocial factors affect VL, but ART adherence is essential in achieving an undetectable VL in PLWH.

The Influence of Neurocognitive Impairment, Alcohol and other Drug (AOD) Use, and Psychosocial Factors on Antiretroviral Treatment Adherence, Service Utilization and Viral Load Among HIV-Seropositive Adults

Among people living with HIV (PLWH), adherence to antiretroviral therapy (ART) can be affected by problems of neurocognitive (NC) impairment, stress, alcohol and other drug (AOD) abuse, and other barriers. The aims of this research were to: (1) examine factors associated with NC impairment, (2) explore relationships between psychosocial variables with ART adherence and viral load (VL), and (3) evaluate the efficacy of an evidence-based intervention in improving ART adherence, increasing service utilization, and decreasing VL. The first study (n=370) was cross sectional and used structural equation modeling to test whether AOD use, years living with HIV, and time from HIV diagnosis to seeking care were associated with poorer NC functioning. The second study (n=246) used similar methods to test the hypothesis that stress, barriers to adherence, NC impairment, poor social support, and AOD use were related to lower VL mediated by ART adherence. The third study (n=243) evaluated an evidence-based, eight-session program to improve ART adherence, reduce VL, and increase service utilization in a randomized controlled trial. Study participants were PLWH living in South Florida, 18 to 60 years old, with a history of alcohol abuse enrolled from January 2009 through November 2012. Secondary analysis of available data showed: (1) scores on interference with executive functioning increased by 0.32 for each day of marijuana use and 1.18 for each year living with HIV, but no association was found between alcohol use and NC functioning; (2) each barrier to adherence was associated with a 10% decrease in adherence to ART and a 0.42 unit increase in VL (log10) and the relationship between barriers and VL was partially mediated by ART adherence; (3) participants in the evidence-based program were more likely than the comparison group to report an undetectable VL (OR=2.25, p Psychosocial factors affect VL, but ART adherence is essential in achieving an undetectable VL in PLWH.