Community diagnosis: A working tool for developing culturally appropriate diarrhea intervention programs

Most studies related to diarrhea have been focused narrowly on the etiological and pathophysiological factors involved in inducing the disease. Such studies have often failed to consider other facets contributing to and possibly prolonging the problem, namely: socio-economic conditions, educational opportunities and attainments, cultural characteristics and beliefs, and the political administration and its commitment towards fulfilling its moral and ethical obligations in responding to and fostering human development.^ This study utilized the diagnostic approach of the PRECEDE model. The acronym stands for the predisposing reinforcing, and enabling constructs in educational diagnosis and evaluation. The constituents of this model were identified by utilizing participant observation field methods, traditionally applied by ethnographers to collect data describing the multiple facets of a culture, and linguistic anthropology used to capture and define characteristic semantics and viewpoints. The household study sample was randomly selected from a defined list of households known to have at least one child less than five years of age. An open-ended questionnaire format was used to interview the 115 mothers in the selected households sample.^ Kalama, the study community, is characteristically an agricultural village, situated in the Governorate of Kaliobia and located approximately 25 Km (about 15.5 miles) from the capital, Cairo, Egypt. The 1986 census indicates a population size of 13,328 people in 4,818 households. There were 65 deaths occurring among children less than five years in 1986. The causes of death were primarily related to diarrhea, followed by upper respiratory infections, congenital anomalies and birth injuries.^ This study outlines (a) practices related to the management of diarrhea, including the administration of foods and drinks during such episodes; (b) influences of governmental policies; and (c) recommended strategies for overcoming barriers and promoting effective diarrhea intervention programs. ^

A qualitative and quantitative assessment of cancer patients' perceptions of barriers to treatment

This study examined barriers that cancer patients experience in obtaining treatment. The principal aim of the study was to conduct a comprehensive quantitative and qualitative assessment of barriers to cancer treatment for Texas cancer patients. The three specific aims of the study were to: (1) conduct a review and critique of published and unpublished research on barriers to cancer treatment; (2) conduct focus groups for the qualitative assessment of cancer patients' perceived barriers to cancer treatment; and (3) survey a representative sample of cancer patients regarding perceived barriers to treatment. The study was guided by the Aday and Andersen access framework of predisposing, enabling, and need determinants of care-seeking.^ To address the first specific aim, a total of 732 abstracts were examined, from which 154 articles were selected for review. Of these 154 articles, 57 that related directly to research on barriers to cancer treatment were chosen for subsequent analysis. Criteria were applied to each article to evaluate the strength of the study design, sampling and measurement procedures. The major barriers that were consistently documented to influence whether or not cancer patients sought or continued required treatment included problems with communication between the patient and provider, lack of information on side effects, the cost of treatment and associated difficulties in obtaining and maintaining insurance coverage, and the absence of formal and informal networks of social support. Access barriers were generally greater for older, minority women, and patients of lower socioeconomic status.^ To address the second specific aim, a total of eight focus groups (n = 44) were conducted across the State of Texas with cancer patients identified by the Texas Community Oncology Network, American Cancer Society, and community health centers. One important finding was that cost is the greatest hurdle that patients face. Another finding was that with the health care/insurance crisis, an increasing number of physicians are working with their patients to develop individually-tailored payment plans. For people in rural areas, travel to treatment sites is a major barrier due to the travel costs as well as work time forfeited by patients and their family members. A third major finding was the patients' family and church play important roles in providing social and emotional support for cancer patients.^ To address the third aim, a total of 910 cancer patients were surveyed during October and November, 1993. Approximately 65% of the cancer patients responded to the survey. The findings showed that the major barriers to treatment included costs of medications and diagnostic tests, transportation, lack of social support, problems understanding the written information regarding their disease as well as losing coverage or having higher premiums or copayments once they were diagnosed (particularly among blacks).^ Significant differences in reported barriers were found between racial groups. The minority respondents (i.e., blacks and Hispanics) tended to experience more barriers to treatment compared to the white respondents. More specifically, Hispanics were more likely to report transportation as a barrier to treatment than both white and blacks. Future research is needed to better understand the problems that minority cancer patients experience in receiving treatment. (Abstract shortened by UMI.) ^

The use of invasive myocardial revascularization procedures following myocardial infarction and the effectiveness of these procedures in the biethnic community of Nueces County, Texas, 1988--1991

High levels of poverty and unemployment, and low levels of health insurance coverage may pose barriers to obtaining cardiac care by Mexican Americans. We undertook this study to investigate differences in the use of invasive myocardial revascularization procedures received within the 4-month period following hospitalization for a myocardial infarction (MI) between Mexican Americans and non-Hispanic whites in the Corpus Christi Heart Project (CCHP). The CCHP is a population-based surveillance program for hospitalized MI, percutaneous transluminal coronary angioplasty (PTCA), and aortocoronary bypass surgery (ACBS). Medical record data were available for 1706 patients identified over a three-year period. Mexican Americans had significantly lower rates of receiving a PTCA following MI than non-Hispanic Whites (RR: 0.56, 95% CI: 0.44-0.70). No meaningful ethnic difference was seen in the rates of ACBS use. History of PTCA use appeared to interact with ethnicity. Among patients without a history of PTCA use, Mexican Americans were less likely to receive a PTCA than non-Hispanic whites (RR: 0.59; 95% CI: 0.46-0.76). Among patients with a history of PTCA use, however, Mexican Americans were more likely to receive a PTCA than non-Hispanic whites (RR: 1.47; 95% CI: 0.75-2.87).^ Differences in the effectiveness of a first-time PTCA and first-time ACBS between Mexican Americans and non-Hispanic whites in the CCHP were also investigated. Mexican Americans were more likely to receive a 2nd PTCA (RR: 1.56, 95% CI: 1.11-2.17) and suffer a subsequent MI (RR: 1.42, 95% CI: 1.03-1.96) following a first-time PTCA than non-Hispanic whites. No meaningful ethnic differences were found in the rates of death and rates of ACBS following a first-time PTCA. Also, no significant ethnic differences were found in the rates of any of the events following a first-time ACBS. After adjusting for potential demographic, socioeconomic, clinical and angiographic confounders using Cox regression analysis, Mexican Americans were still more likely to receive a 2nd PTCA (HR: 1.38; 95% CI: 0.99-1.93) following a first-time PTCA than non-Hispanic whites. A significant difference in the rates of a subsequent MI following a first-time PTCA persisted (HR: 1.39, 95% CI: 1.01-1.93). (Abstract shortened by UMI.) ^

THE DEVELOPMENT OF COMMUNITY COMPETENCE THROUGH A NEIGHBORHOOD ORGANIZATION (LOS ANGELES, MEXICAN-AMERICAN)

This investigation focused on how people cope with the demands of their environment in a competent manner. It sought to assess the effects of learning competent coping behaviors on self-reported well-being. The study chose a community-evolved, organized effort on the part of a group of neighborhoods to build competence in the Mexican-American community of East Los Angeles. This network was a citizen-action organization called the United Neighborhoods Organization. UNO was selected because it concentrated on developing community leaders by using spiritual beliefs and family values as shared community resources. Neighborhood leaders were encouraged to engage in risk-taking and confrontation maneuvers. They were also taught problem-solving skills and provided with social support.^ A survey instrument was developed to assess sociodemographic characteristics, acculturation history and status, willingness to engage in risk-taking and confrontation and self-perceived general well-being. The study relied on eight months of daily participant-observation of the organization, the East Los Angeles environment and the interaction between the two. At the end of the observation period, a sample of 150 UNO participants were given the survey questionnaire as was a matched group of 150 non-UNO participants who were ELA residents.^ The study sample was mostly women, in their middle age years who had lived in the area from 5 to more than 30 years. Significantly more single persons were found in the UNO group. The sample was almost equally divided into English and Spanish speaking respondents. Acculturatively almost all the sample fell in the Very Mexican and Mostly Mexican types. The survey found a trend of association between participating in UNO and reporting feeling well. A statistically significant association was found among UNO participants between taking risks and reporting feeling well, regardless of a tendency for all the sample to minimize risk. A trend was seen for married UNO participants to report feeling well. Slightly more UNO participants were willing to engage in confrontation and a substantial proportion of the participants who were confronters reported feeling well in comparison to their counterparts. Ethnic pride was positively associated with participation in UNO and showed a trend in the expected direction with reported self-perceived well-being. ^

Using intervention mapping to develop a community garden program at the women's home

This culminating experience was a practice based intervention conducted by an organization, utilizing an intervention mapping approach for the program planning. It took place summer 2010 through spring 2011 and included incorporating a community garden into the Gusto wellness program at The Women's Home. This organization offers long-term residential care, and therapeutic services. Literature relating to community gardens and nutrition behavior change was reviewed. Short-term objectives included: 1) Conducting a needs assessment using focus groups, 2) Designing gardening program components based on intervention mapping guidelines, 3) Constructing a garden bed at Midtown Community Garden for use of The Women's Home, 4) Planning and implementing gardening education, and 5) Assessing feasibility of the garden program. The target population included 24 residents living at the residential dormitory of The Women's Home at the time of this project. The major variables are intervention mapping constructs including: 1) Needs assessment, 2) Preparing matrices of change objectives, 3) Selecting theory-informed intervention methods and practical strategies, 4) Producing program components and materials, 5) Planning program adoption, implementation, and sustainability, and 6) Planning for evaluation. The specific focus was lack of access to fresh fruits and vegetables (FV) for this population. Focus group responses revealed interest in community garden participation. Matrices of change were developed for lack of FV access based on performance objectives for behavioral and environmental factors and related determinants and theory. Methods and strategies were developed to implement a community garden and encourage participation. Program components included initiating a garden club, networking activities, creating gardening curriculum, and participating at Midtown Community Garden. Adoption and implementation performance objectives were outlined, and many were carried out. Evaluation questions were designed and outcomes of the garden project were discussed. ^ Outcomes of the project included exposure of garden topics and activities for The Women's Home residents, focus group responses revealing an interest in gardening among this population, gardening program components designed based on intervention mapping steps, and a constructed garden bed that was used for planting vegetables and flowers through fall 2010. Limited resources and budget along with a lack of a residential coordinator at The Women's Home were the main limiting factors for this project. Future garden projects can be developed using the intervention mapping process.^

Factors influencing participation in individuals with disability: A secondary data analysis

Individuals with disabilities face numerous barriers to participation due to biological and physical characteristics of the disability as well as social and environmental factors. Participation can be impacted on all levels from societal, to activities of daily living, exercise, education, and interpersonal relationships. This study evaluated the impact of pain, mood, depression, quality of life and fatigue on participation for individuals with mobility impairments. This cross sectional study derives from self-report data collected from a wheelchair using sample. Bivariate correlational and multivariate analysis were employed to examine the relationship between pain, quality of life, positive and negative mood, fatigue, and depression with participation while controlling for relevant socio-demographic variables (sex, age, time with disability, race, and education). Results from the 122 respondents with mobility impairments demonstrated that after controlling for socio-demographic characteristics in the full model, 20% of the variance in participation scores were accounted for by pain, quality of life, positive and negative mood, and depression. Notably, quality of life emerged as being the single variable that was significantly related to participation in the full model. Contrary to other studies, pain did not appear to significantly impact participation outcomes for wheelchair users in this sample. Participation is an emerging area of interest among rehabilitation and disability researchers, and results of this study provide compelling evidence that several psychosocial factors are related to participation. This area of inquiry warrants further study, as many of the psychosocial variables identified in this study (mood, depression, quality of life) may be amenable to intervention, which may also positively influence participation.^

Interpretation services for immigrants in federally qualified health centers: Barriers, best practices, and suggestions for the future

This paper examines the provision of interpretation services to immigrants with limited English proficiency in Federally Qualified Health Centers, through examination of barriers and best practices. The United States is a nation of immigrants; currently, more than 38 million, or 12.5 percent of the total population, is foreign-born. A substantial portion of this population does not have health insurance or speak English fluently: barriers that reduce the likelihood that they will access traditional health care organizations. This service void is filled by FQHCs, which are non-profit, community-directed providers that remove common barriers to care by serving communities who otherwise confront financial, geographic, language, and cultural barriers. By examining the importance and the implementation of medical interpretation services in FQHCs, suggestions for the future are presented.^

Let their voices be heard: Understanding the barriers to seeking early prenatal care for low-income non-Hispanic Black women

Background: Receipt of early prenatal care, care during the first three months of pregnancy, is the standard in the United States. Sixty percent of non-Hispanic Black women who had a live birth in the Sunnyside community of Houston did not obtain early prenatal care in 2009. ^ This study's aims were to: 1) Describe the barriers to obtaining early prenatal care in non-Hispanic Black women who live in the Sunnyside community of Houston; and, 2) Describe the actions that could encourage non-Hispanic Black women who live in the Sunnyside Community to obtain early prenatal care. The goal was to provide information to organizations that promote early prenatal care use in non-Hispanic Black women in Harris County that may aid in developing interventions. ^ Methods: The Participatory Learning for Action rapid assessment qualitative method was used in a group setting to answer the research questions on behalf of women in the community. Women who participated in the group sessions also participated in an in-depth interview. Key informants who work in the community with pregnant women, or promote the use of prenatal care services, were also interviewed. An inductive analysis of the data was conducted to identify common themes that address the study's aims. ^ Results: Aim 1: Group participants identified fear of the reaction from family and/or the baby's daddy and shame, not having insurance or money, and lack of knowledge of the pregnancy and resources as the top three barriers to early prenatal care for women in the community. Aim 2: Group participants stated that to help women to overcome these barriers, communication, awareness and support; help, resources and services; and information and early education are needed. Participant in-depth interviewees echoed the themes of fear of the reaction from family and/or the baby's daddy and not knowing of the pregnancy. Key informants mentioned these themes as well, though not at the same priority level. Participants and key informants also mentioned similar themes for helping women to overcome barriers to early prenatal care. ^ Conclusion: A comprehensive approach is needed to improve early prenatal care use in the Sunnyside community. Education efforts must include all members of the community, young and old, to promote support for pregnant women. Community members must be a part of the process for developing education campaigns. Engaging the community builds a relationship with organizations that serve the community, which may promote use of the organizations' services, and build trust with the community. All efforts must be ongoing so that women and men of all ages in the community understand the importance of prenatal care and support women obtaining care early in the pregnancy.^

Cancer screening behaviors among Asian Americans in Houston, Texas

Background: Cancer is the second-leading cause of death in the United States, and Asian Americans/Pacific Islanders are the only racial/ethnic group for which cancer is the leading cause of death. Regular cancer screenings help to identify precancerous lesions and cancer at an earlier stage, when the cancer is more treatable. Ethnic disparities in participation in cancer screenings are also striking, and evidence indicates that Asian Americans may have lower rates of cancer screening participation than other racial/ethnic groups. The Health of Houston Survey 2010 (HHS 2010) is an address-based survey, administered via telephone, website, and mail, of over 5,000 respondents in Houston and Harris County that provides recent data on the health status and needs of the Houston community. HHS 2010 researchers oversampled for Asians and Vietnamese Americans in order to obtain a sample size large enough to obtain statistical power. This dataset provides a unique opportunity to examine the cancer screening behaviors and predictors of Vietnamese and Chinese Americans living in Houston, Texas.^ Methods: This study was a secondary data analysis of HHS 2010 data. The data were analyzed to compare the breast, cervical, and colorectal cancer screening compliance rates of Vietnamese and Chinese Americans with other racial/ethnic groups in Houston, Texas. Key predictors of participation and barriers to cancer screening were identified.^ Results: The results of this study indicate that in Houston, Vietnamese Americans and Asian Americans as a whole have strikingly lower rates of participation in cancer screenings compared to other ethnic groups. Chinese Americans had the highest rate of noncompliance for mammography of all ethnic groups; Asian Americans and Vietnamese Americans also had high rates of noncompliance. Similarly, Vietnamese and Asian Americans had high rates of noncompliance with colorectal cancer screening recommendations. Importantly, Vietnamese, Chinese, and Asian Americans had by far the worst pap test participation, with noncompliance rates more than double that of all other racial/ethnic groups. In general, the findings indicated several key predictors in cancer screening behaviors, including English language proficiency, years lived in the United States, health insurance, college education, and income; however, the significance and patterns of these variables varied by ethnic group as well as cancer site.^ Conclusions: This secondary analysis highlights the disparities in cancer screening participation among Vietnamese, Chinese, and Asian Americans in Houston, Texas and indicate the need to identify Asian Americans as a high-risk group in need of health promotion attention. Barriers to screening and educational needs appear to be specific to each target ethnic group. Thus, health educators and health professionals in Houston must focus on the specific educational needs of the key ethnic groups that make up the Houston population. Further, more ethnic-specific research is needed to examine the health behaviors and needs of Houston's Asian American subgroups.^

Key Factors to Successful Community Development: The Korean Experience

The Saemaul Undong of the Republic of Korea has been world-widely recognized as a successful model of rural community development. The Saemaul Undong was a pure Korean way of community development program which was initiated by the political will of the top national leadership in order to escape from poverty. There are several key factors to the success of the Saemaul Undong. First, the national government's guidance and support for the movement played a very important role in the whole period of the movement. Second, there was a wide range of people's participation in the implementation process. Third, the Saemaul Undong could make a big success by nurturing community leadership which was selected by rural residents themselves. Finally, as a movement for the spiritual reform, the Saemaul Undong imbued the people with the spirits of diligence, the self-reliance, and cooperation.

Recent trends in Asian integration and Japanese participation

In East Asia, de facto integration is taking place because Free Trade Agreements (FTAs) and Economic Partnership Agreements (EPAs) are flourishing in the region. ASEAN aims to form an ASEAN Economic Community (AEC) by 2015 with the completion of the ASEAN Free Trade Area (AFTA). Surrounding countries have been competing with each other to forge FTAs or EPAs with ASEAN, including China, Japan, Korea, Australia and New Zealand, and India. As a result, ASEAN has become a trading hub in East Asia. Bilateral FTAs/EPAs are also partly in place among 16 countries (ASEAN + 6). These economic ties in trade, services and investment are accelerating this region’s development as the world’s largest production base and biggest consumption market, helping to turn around the global recession in the aftermath of the so-called Lehman Shock. However, some problems also need to be pointed out in the East Asian integration such as the spaghetti bowl effect, severe competition, labor issues, environmental destruction and power struggles.

Yangtze River Delta's system integration: institutional barriers and countermeasures

This paper addresses the issue of institutional barriers to the Yangtze River Delta integration and the resulting slow development. It analyzes the problems including the coordination of local interests and regional interests, market segmentation during the regional integration, competition for the local government‘s investment on the public goods, labor movement within the delta. The paper argues that to reduce the negative impacts of these barriers and to promote the further integration of the Yangtze Delta region, the central government should strengthen the coordination between local governments, regulate their disorderly competition and reform the official evaluation system.

Policy processes and collective action in water reforms: the cases of Nicaragua and Suriname

Las reformas de agua en países en desarrollo suelen llevarse a cabo junto con cambios institucionales más profundos o, incluso, acompañadas de cambios constitucionales o de régimen político. Por lo tanto, los marcos institucionales adaptados a países gobernados sujetos al estado de derecho pueden no ser apropiados para contextos gobernados fundamentalmente, al menos en sus inicios, por instituciones informales o poco maduras. Esta tesis toma las reformas de agua como punto de partida y pretende contribuir a la literatura mediante una serie de análisis empíricos tanto del ámbito general como del plano individual o sujeto personal de la política del agua. En el ámbito general, el foco se pone en los factores que explican el fallo de la acción colectiva en dos contextos diferentes: 1) en la implementación de la nueva Ley de Aguas de Nicaragua y 2) en el mantenimiento y revitalización de las instituciones de riego en Surinam. En el plano del individuo, la investigación se centra en las decisiones de los usuarios de los recursos y analiza el papel crítico de las variables sociales para la gestión de los recursos comunes. Para ello, el método de investigación utilizado es mixto, combinando el análisis de entrevistas, encuestas y experimentos. En el ámbito general, los resultados muestran que las principales barreras para la implementación de la nueva Ley de Aguas de Nicaragua podrían tener su reflejo en el lenguaje de la Ley y, por tanto, en la forma en la que se definen y configuran las instituciones incluidas en dicha Ley. Así, la investigación demuestra que la implementación de políticas no puede ser estudiada o entendida sin tener en cuenta tanto el diseño de la propia política como el marco socio-ecológico en el que se enmarca. El contexto específico de Nicaragua remarca la importancia de considerar tanto las instituciones formales como informales en los procesos de transición política. A pesar de que las reformas de agua requieren plazos largos para su implementación, el hecho de que exista una diferencia entre las reglas tal cual se definen formalmente y las reglas que operan en la realidad merece una mayor consideración en el diseño de políticas basadas fundamentalmente en instituciones formales. En el ámbito de la conducta individual, el análisis de la acción colectiva ofrece una serie de observaciones empíricas interesantes. En el caso de Nicaragua, los resultados indican que la intensidad de las relaciones sociales, el tipo de agentes dispuestos a proporcionar apoyo social y el nivel de confianza en la comunidad son factores que explican de manera significativa la participación en la comunidad. Sin embargo, el hecho de que la gestión colectiva de riego se produzca, en la mayoría de casos, en torno a lazos familiares sugiere que las variables de capital social críticas se definen en gran medida en la esfera familiar, siendo difícil que se extiendan fuera de estos nexos. El análisis experimental de los resultados de un juego de uso de recurso común y contribución al bien público muestra que las preferencias pro-sociales de los individuos y la heterogeneidad del grupo en términos de composición por sexo son factores que explican significativamente los resultados y las decisiones de apropiación a lo largo del juego. En términos del diseño de las políticas, es fundamental tener en cuenta las dinámicas de participación y uso de los recursos comunes de manera que los niveles de cooperación puedan mantenerse en el largo plazo, lo cual, como se observa en el caso de Surinam, no es siempre posible. Finalmente, el caso de Surinam es un ejemplo ilustrativo de los procesos de acción colectiva en economías en transición. El análisis del fallo de la acción colectiva en Surinam muestra que los procesos políticos vinculados al período colonial y de independencia explican en gran medida la falta de claridad en las reglas operacionales y colectivas que gobiernan la gestión de los sistemas de riego y drenaje. Los resultados empíricos sugieren que a pesar de que la acción colectiva para la provisión de los servicios de riego y drenaje estaba bien establecida bajo el régimen colonial, la auto-organización no prosperó en un contexto dependiente del apoyo externo y regido fundamentalmente por reglas diseñadas al nivel competencial del gobierno central. El sistema socio-ecológico que se desarrolló durante la transición post-colonial favoreció, así, la emergencia de comportamientos oportunistas, y posteriormente la inoperancia de los Water Boards (WBs) creados en la época colonial. En este sentido, cualquier intento por revitalizar los WBs y fomentar el desarrollo de la auto-organización de los usuarios necesitará abordar los problemas relacionados con los patrones demográficos, incluyendo la distribución de la tierra, el diseño de instituciones y la falta de confianza en el gobierno, además de las inversiones típicas en infraestructura y sistemas de información hidrológicos. El liderazgo del gobierno, aportando empuje de arriba-abajo, es, además, otro elemento imprescindible en Surinam. ABSTRACT Water reforms in developing countries take place along deeper institutional and even constitutional. Therefore, institutional frameworks that might result in positive outcomes in countries governed by the rule of law might not fit in contexts governed mainly by informal or immature institutions. This thesis takes water reforms as the starting point and aims to contribute to the literature by presenting several conceptual and empirical analyses at both general and individual levels. At the general national level, the focus is on the factors explaining failure of collective action in two different settings: 1) in the implementation of the new Nicaraguan Water Law and 2) in sustaining and revitalizing irrigation institutions in Suriname. At the individual level, the research focuses on the actions of resource users and analyzes the critical role of social variables for common pool resources management. For this purpose, the research presented in this thesis makes use of a mixed-method approach, combining interviews, surveys and experimental methods. Overall, the results show that major barriers for the implementation of the new Nicaraguan Water Law have its reflection on the language of the Law and, therefore, on the way institutions are defined and configured. In this sense, our study shows that implementation cannot fruitfully be studied and understood without taking into account both the policy design and the social-ecological context in which it is framed. The specific setting of Nicaragua highlights the relevance of considering both formal and informal institutions when promoting policy transitions. Despite the unquestionable fact that water reforms implementation needs long periods of time, there is still a gap between the rules on paper and the rules on the ground that deserves further attention when proposing policy changes on the basis of formal institutions. At the level of the individual agent, the analysis of collective action provides a number of interesting empirical insights. In the case of Nicaragua, I found that the intensity of social networks, the type of agents willing to provide social support and the level of trust in the community are all significant factors in explaining collective action at community level. However, the fact that most collective irrigation relies on family ties suggests that critical social capital variables might be defined within the family sphere and making it difficult to go beyond it. Experimental research combining a common pool resource and a public good game in Nicaragua shows that individuals’ pro-social traits and group heterogeneity in terms of sex composition are significant variables in explaining efficiency outcomes and effort decisions along the game. Thus, with regard to policy design, it is fundamental to consider carefully the dynamics of agents' participation and use of common pool resources, for sustaining cooperation in the long term, which, as seen in the case and Surinam, is not always possible. The case of Suriname provides a rich setting for the analysis of collective action in transition economies. The analysis of decay of collective irrigation in Suriname shows that the lack of clear operational and collective choice rules appear to be rooted in deeper political processes that date back to the colonial period. The empirical findings suggest that despite collective action for the provision of irrigation and drainage services was well established during the colonial period, self-organization did not flourish in a context governed by colonial state-crafted rules and mostly dependent on external support. The social-ecological system developed during the post-colonial transition process favored the emergence of opportunistic behavior. In this respect, any attempt to revitalize WBs and support self-organization will need to tackle the problems derived from demographic patterns, including land allocation, institutions design and government distrust, in addition to the typical investments in both physical infrastructure and hydrological information systems. The leadership role of the government, acting as a top-down trigger, is another essential element in Suriname.

Análisis de los factores de influencia en la adopción de herramientas colaborativas basadas en software social. Aplicación a entornos empresariales

En las últimas dos décadas, se ha puesto de relieve la importancia de los procesos de adquisición y difusión del conocimiento dentro de las empresas, y por consiguiente el estudio de estos procesos y la implementación de tecnologías que los faciliten ha sido un tema que ha despertado un creciente interés en la comunidad científica. Con el fin de facilitar y optimizar la adquisición y la difusión del conocimiento, las organizaciones jerárquicas han evolucionado hacia una configuración más plana, con estructuras en red que resulten más ágiles, disminuyendo la dependencia de una autoridad centralizada, y constituyendo organizaciones orientadas a trabajar en equipo. Al mismo tiempo, se ha producido un rápido desarrollo de las herramientas de colaboración Web 2.0, tales como blogs y wikis. Estas herramientas de colaboración se caracterizan por una importante componente social, y pueden alcanzar todo su potencial cuando se despliegan en las estructuras organizacionales planas. La Web 2.0 aparece como un concepto enfrentado al conjunto de tecnologías que existían a finales de los 90s basadas en sitios web, y se basa en la participación de los propios usuarios. Empresas del Fortune 500 –HP, IBM, Xerox, Cisco– las adoptan de inmediato, aunque no hay unanimidad sobre su utilidad real ni sobre cómo medirla. Esto se debe en parte a que no se entienden bien los factores que llevan a los empleados a adoptarlas, lo que ha llevado a fracasos en la implantación debido a la existencia de algunas barreras. Dada esta situación, y ante las ventajas teóricas que tienen estas herramientas de colaboración Web 2.0 para las empresas, los directivos de éstas y la comunidad científica muestran un interés creciente en conocer la respuesta a la pregunta: ¿cuáles son los factores que contribuyen a que los empleados de las empresas adopten estas herramientas Web 2.0 para colaborar? La respuesta a esta pregunta es compleja ya que se trata de herramientas relativamente nuevas en el contexto empresarial mediante las cuales se puede llevar a cabo la gestión del conocimiento en lugar del manejo de la información. El planteamiento que se ha llevado a cabo en este trabajo para dar respuesta a esta pregunta es la aplicación de los modelos de adopción tecnológica, que se basan en las percepciones de los individuos sobre diferentes aspectos relacionados con el uso de la tecnología. Bajo este enfoque, este trabajo tiene como objetivo principal el estudio de los factores que influyen en la adopción de blogs y wikis en empresas, mediante un modelo predictivo, teórico y unificado, de adopción tecnológica, con un planteamiento holístico a partir de la literatura de los modelos de adopción tecnológica y de las particularidades que presentan las herramientas bajo estudio y en el contexto especifico. Este modelo teórico permitirá determinar aquellos factores que predicen la intención de uso de las herramientas y el uso real de las mismas. El trabajo de investigación científica se estructura en cinco partes: introducción al tema de investigación, desarrollo del marco teórico, diseño del trabajo de investigación, análisis empírico, y elaboración de conclusiones. Desde el punto de vista de la estructura de la memoria de la tesis, las cinco partes mencionadas se desarrollan de forma secuencial a lo largo de siete capítulos, correspondiendo la primera parte al capítulo 1, la segunda a los capítulos 2 y 3, la tercera parte a los capítulos 4 y 5, la cuarta parte al capítulo 6, y la quinta y última parte al capítulo 7. El contenido del capítulo 1 se centra en el planteamiento del problema de investigación así como en los objetivos, principal y secundarios, que se pretenden cumplir a lo largo del trabajo. Así mismo, se expondrá el concepto de colaboración y su encaje con las herramientas colaborativas Web 2.0 que se plantean en la investigación y una introducción a los modelos de adopción tecnológica. A continuación se expone la justificación de la investigación, los objetivos de la misma y el plan de trabajo para su elaboración. Una vez introducido el tema de investigación, en el capítulo 2 se lleva a cabo una revisión de la evolución de los principales modelos de adopción tecnológica existentes (IDT, TRA, SCT, TPB, DTPB, C-TAM-TPB, UTAUT, UTAUT2), dando cuenta de sus fundamentos y factores empleados. Sobre la base de los modelos de adopción tecnológica expuestos en el capítulo 2, en el capítulo 3 se estudian los factores que se han expuesto en el capítulo 2 pero adaptados al contexto de las herramientas colaborativas Web 2.0. Con el fin de facilitar la comprensión del modelo final, los factores se agrupan en cuatro tipos: tecnológicos, de control, socio-normativos y otros específicos de las herramientas colaborativas. En el capítulo 4 se lleva a cabo la relación de los factores que son más apropiados para estudiar la adopción de las herramientas colaborativas y se define un modelo que especifica las relaciones entre los diferentes factores. Estas relaciones finalmente se convertirán en hipótesis de trabajo, y que habrá que contrastar mediante el estudio empírico. A lo largo del capítulo 5 se especifican las características del trabajo empírico que se lleva a cabo para contrastar las hipótesis que se habían enunciado en el capítulo 4. La naturaleza de la investigación es de carácter social, de tipo exploratorio, y se basa en un estudio empírico cuantitativo cuyo análisis se llevará a cabo mediante técnicas de análisis multivariante. En este capítulo se describe la construcción de las escalas del instrumento de medida, la metodología de recogida de datos, y posteriormente se presenta un análisis detallado de la población muestral, así como la comprobación de la existencia o no del sesgo atribuible al método de medida, lo que se denomina sesgo de método común (en inglés, Common Method Bias). El contenido del capítulo 6 corresponde al análisis de resultados, aunque previamente se expone la técnica estadística empleada, PLS-SEM, como herramienta de análisis multivariante con capacidad de análisis predictivo, así como la metodología empleada para validar el modelo de medida y el modelo estructural, los requisitos que debe cumplir la muestra, y los umbrales de los parámetros considerados. En la segunda parte del capítulo 6 se lleva a cabo el análisis empírico de los datos correspondientes a las dos muestras, una para blogs y otra para wikis, con el fin de validar las hipótesis de investigación planteadas en el capítulo 4. Finalmente, en el capítulo 7 se revisa el grado de cumplimiento de los objetivos planteados en el capítulo 1 y se presentan las contribuciones teóricas, metodológicas y prácticas derivadas del trabajo realizado. A continuación se exponen las conclusiones generales y detalladas por cada grupo de factores, así como las recomendaciones prácticas que se pueden extraer para orientar la implantación de estas herramientas en situaciones reales. Como parte final del capítulo se incluyen las limitaciones del estudio y se sugiere una serie de posibles líneas de trabajo futuras de interés, junto con los resultados de investigación parciales que se han obtenido durante el tiempo que ha durado la investigación. ABSTRACT In the last two decades, the relevance of knowledge acquisition and dissemination processes has been highlighted and consequently, the study of these processes and the implementation of the technologies that make them possible has generated growing interest in the scientific community. In order to ease and optimize knowledge acquisition and dissemination, hierarchical organizations have evolved to a more horizontal configuration with more agile net structures, decreasing the dependence of a centralized authority, and building team-working oriented organizations. At the same time, Web 2.0 collaboration tools such as blogs and wikis have quickly developed. These collaboration tools are characterized by a strong social component and can reach their full potential when they are deployed in horizontal organization structures. Web 2.0, based on user participation, arises as a concept to challenge the existing technologies of the 90’s which were based on websites. Fortune 500 companies – HP, IBM, Xerox, Cisco- adopted the concept immediately even though there was no unanimity about its real usefulness or how it could be measured. This is partly due to the fact that the factors that make the drivers for employees to adopt these tools are not properly understood, consequently leading to implementation failure due to the existence of certain barriers. Given this situation, and faced with theoretical advantages that these Web 2.0 collaboration tools seem to have for companies, managers and the scientific community are showing an increasing interest in answering the following question: Which factors contribute to the decision of the employees of a company to adopt the Web 2.0 tools for collaborative purposes? The answer is complex since these tools are relatively new in business environments. These tools allow us to move from an information Management approach to Knowledge Management. In order to answer this question, the chosen approach involves the application of technology adoption models, all of them based on the individual’s perception of the different aspects related to technology usage. From this perspective, this thesis’ main objective is to study the factors influencing the adoption of blogs and wikis in a company. This is done by using a unified and theoretical predictive model of technological adoption with a holistic approach that is based on literature of technological adoption models and the particularities that these tools presented under study and in a specific context. This theoretical model will allow us to determine the factors that predict the intended use of these tools and their real usage. The scientific research is structured in five parts: Introduction to the research subject, development of the theoretical framework, research work design, empirical analysis and drawing the final conclusions. This thesis develops the five aforementioned parts sequentially thorough seven chapters; part one (chapter one), part two (chapters two and three), part three (chapters four and five), parte four (chapters six) and finally part five (chapter seven). The first chapter is focused on the research problem statement and the objectives of the thesis, intended to be reached during the project. Likewise, the concept of collaboration and its link with the Web 2.0 collaborative tools is discussed as well as an introduction to the technology adoption models. Finally we explain the planning to carry out the research and get the proposed results. After introducing the research topic, the second chapter carries out a review of the evolution of the main existing technology adoption models (IDT, TRA, SCT, TPB, DTPB, C-TAM-TPB, UTAUT, UTAUT2), highlighting its foundations and factors used. Based on technology adoption models set out in chapter 2, the third chapter deals with the factors which have been discussed previously in chapter 2, but adapted to the context of Web 2.0 collaborative tools under study, blogs and wikis. In order to better understand the final model, the factors are grouped into four types: technological factors, control factors, social-normative factors and other specific factors related to the collaborative tools. The first part of chapter 4 covers the analysis of the factors which are more relevant to study the adoption of collaborative tools, and the second part proceeds with the theoretical model which specifies the relationship between the different factors taken into consideration. These relationships will become specific hypotheses that will be tested by the empirical study. Throughout chapter 5 we cover the characteristics of the empirical study used to test the research hypotheses which were set out in chapter 4. The nature of research is social, exploratory, and it is based on a quantitative empirical study whose analysis is carried out using multivariate analysis techniques. The second part of this chapter includes the description of the scales of the measuring instrument; the methodology for data gathering, the detailed analysis of the sample, and finally the existence of bias attributable to the measurement method, the "Bias Common Method" is checked. The first part of chapter 6 corresponds to the analysis of results. The statistical technique employed (PLS-SEM) is previously explained as a tool of multivariate analysis, capable of carrying out predictive analysis, and as the appropriate methodology used to validate the model in a two-stages analysis, the measurement model and the structural model. Futhermore, it is necessary to check the requirements to be met by the sample and the thresholds of the parameters taken into account. In the second part of chapter 6 an empirical analysis of the data is performed for the two samples, one for blogs and the other for wikis, in order to validate the research hypothesis proposed in chapter 4. Finally, in chapter 7 the fulfillment level of the objectives raised in chapter 1 is reviewed and the theoretical, methodological and practical conclusions derived from the results of the study are presented. Next, we cover the general conclusions, detailing for each group of factors including practical recommendations that can be drawn to guide implementation of these tools in real situations in companies. As a final part of the chapter the limitations of the study are included and a number of potential future researches suggested, along with research partial results which have been obtained thorough the research.

Youth participation in development planning: case study of Sayausí (Rural Parish) Cuenca-Ecuador

Young people now represent the highest percentage of the world population. Soon, they will be seniors and they will take decisions for a more orderly and equitable world. For this reason, the participation of young people in development planning is very important and many countries are trying to promote it through various measures. This article analyzes the trajectory of youth participation in the Latin American region and specifically the profile of youth participation in Ecuador, country in which the Constitution recognizes the strategic role of youth in development. The case study of Sayausí rural parish in canton Cuenca is analyzed, through surveys, interviews and an Empowerment Evaluation workshop to young people and decentralized government. The results obtained allow to propose strategies to help improve the participation of youth in the community.