Falls and the Social Isolation of Older Adults in the National Health and Aging Trends Study

Thesis (Ph.D.)--University of Washington, 2016-08

Social Return on Investment: Valuing Health Outcomes or Promoting Economic Values?

Interventions and activities that influence health are often concerned with intangible outcomes that are difficult to value despite their potential significance. Social Return on Investment is an evaluation framework that explores all aspects of change and expresses these in comparable terms. It combines qualitative narratives and quantitative measurements with a financial approach to enable outcomes that can otherwise be overlooked or undervalued to be incorporated appropriately. This article presents Social Return on Investment as an effective tool for supporting the development of a holistic appreciation of how interventions impact on the health and well-being of individuals, communities and societies.

Effects of early childhood development interventions on parental behaviour: evidence from a home-visiting programme in Peru

Las visitas a domicilio tienen por objeto mejorar los resultados del niño, desplazando las habilidades de crianza de los cuidadores para que puedan ofrecer mejores oportunidades de estimulación a sus hijos. A pesar de este objetivo explícito, hay poca evidencia de países en desarrollo con respecto a los efectos del modelo de visitas a domicilio, en la provisión de la estimulación por los cuidadores. También hay una falta de pruebas de los programas de trabajo a gran escala y poca atención a los mecanismos mediante los cuales estas intervenciones afectan al comportamiento de los padres. Este análisis tiene por objeto contribuir a la literatura sobre las intervenciones de dos maneras. Primero, proporciona evidencia causal sobre los efectos de un programa de visitas a domicilio envergadura sobre el comportamiento del cuidador. En segundo lugar, se explora las restricciones que limitan este cambio de comportamiento y ofrece una forma de pensando en sus mecanismos que es consistente con la evidencia. Yo uso el aleatorio grupal diseño del componente de visitas al hogar del programa Cuna Más en Perú para recoger datos de 20 de control y de tratamiento de 20 distritos rurales sobre las prácticas de crianza y las creencias de los cuidadores en cuanto a la importancia de las interacciones entre padres e hijos para el desarrollo infantil.

A representação social do cuidado no programa saúde da família na cidade de Natal

RODRIGUES, M. P.; LIMA, K. C.; RONCALLI, A. G. A representação social do cuidado no programa saúde da família na cidade de Natal. Ciênc. Saúde Coletiva, v. 13, n. 1, p. 71-82. 2008. ISSN 1413-8123.

A representação social do cuidado no programa saúde da família na cidade de Natal

RODRIGUES, Maisa Paulino; LIMA, Kenio Costa de; RONCALLI, Angelo Giuseppe. A representaçao social do cuidado no programa saúde da familia na cidade de Natal. Ciência & Saúde Coletiva, v. 13, n. 1, p. 71-82, 2008.Disponivel em: . Acesso em: 04 out. 2010.

Social Cognition, Negative Symptoms and Psychosocial Functioning in Schizophrenia.

Although functional recovery could be advocated as an achievable treatment goal, many effective interventions for the treatment of psychotic symptoms, such as antipsychotic drugs, may not improve functioning. The last two decades of cognitive and clinical research on schizophrenia were a turning point for the firm acknowledgment of how relevant social cognitive deficits and negative symptoms could be in predicting psychosocial functioning. The relevance of social cognition dysfunction in schizophrenia patients’ daily living is now unabated. In fact, social cognition deficits could be the most significant predictor of functionality in patients with schizophrenia, non-redundantly with neurocognition. Emerging evidence suggests that negative symptoms appear to play an indirect role, mediating the relationship between neurocognition and social cognition with functional outcomes. Further explorations of this mediating role of negative symptoms have revealed that motivational deficits appear to be particularly important in explaining the relationship between both neurocognitive and social cognitive dysfunction and functional outcomes in schizophrenia. In this paper we will address the relative contribution of two key constructs—social cognitive deficits and negative symptoms, namely how intertwined they could be in daily life functioning of patients with schizophrenia.

Analyse descriptive de deux filiales de service social : Roberval et Dolbeau

Il s'agit de la présentation de la description de deux filiales de service social dont l'une héritait d'orientations traditionnelles et l'autre débutait selon l'esprit de la loi des Services de Santé et des Services Sociaux. Ce travail se situe au niveau d'une action précise dans le domaine du service social. La première partie sera consacrée à une critique sommaire des objectifs et du fonctionnement de l'agence de Service Social du Diocèse de Chicoutimi des années 1970-72. Je retiendrai trois principes, soit l'accessibilité des services, la participation de la population et la flexibilité des interventions qui nous guideront dans l'orientation d'une filiale à Dolbeau. La deuxième partie consistera en une description comparative des objectifs et du fonctionnement entre deux filiales, soit celle de Roberval, modèle de la filiale traditionnelle en évolution et la nouvelle filiale, celle de Dolbeau, ouverte au début de l'année 1972, et orientée selon l'esprit de la nouvelle loi des Services de Santé et des Services Sociaux. Cette étude comparative nous permettra d'élaborer des hypothèses d'évaluation d'objectifs, de personnel et de rendement pour les deux filiales concernées, et c'est ce qui complétera le présent travail dans la troisième partie. [...]

Qualidade de vida e suporte social em doentes com esquizofrenia

A Esquizofrenia é considerada pela OMS como uma das dez doenças mais incapacitantes. Sendo uma perturbação complexa e de caráter crónico, gera prejuízos significativos na qualidade de vida dos pacientes. O interesse por este tema surge aquando da desinstitucionalização dos doentes psiquiátricos, contudo os avanços no tratamento desta patologia nem sempre vêm acompanhados de melhora na qualidade de vida, fator este que levou a ter também em consideração, aspetos psicossociais. Assim, pretende-se com este estudo contribuir para a compreensão do nível de satisfação com o suporte social e qualidade de vida destes doentes, comparando-os com indivíduos sem psicopatologia. A amostra é composta por 202 participantes, os quais se dividem em dois grupos, indivíduos com esquizofrenia, que frequentam hospitais na zona norte, centro e sul do país (n=101) e indivíduos sem psicopatologia (n=101), com idades compreendidas entre os 20 e os 75 anos. Os participantes responderam a um protocolo de investigação composto por quatro instrumentos: um questionário sociodemográfico; o WHOQOL-Bref, que avalia a qualidade de vida; a escala de satisfação com o suporte social; e a escala de afeto positivo e negativo. Os resultados principais evidenciam a pouca literatura existente, mostrando que existem diferenças significativas no que refere à qualidade de vida e satisfação com o suporte social entre os indivíduos com esquizofrenia e indivíduos sem patologia psiquiátrica, sendo que os valores mais baixos destas variáveis se concentram nos indivíduos com esquizofrenia. Para estes doentes, verificou-se que a qualidade de vida está positivamente correlacionada com o suporte social e com o afeto positivo, estando também correlacionada negativamente com o afeto negativo. Contudo, não se verificaram correlações da qualidade de vida com a escolaridade, o número de internamentos e o tempo de doença. A satisfação com o suporte social e o afeto positivo e negativo revelaram-se preditores de qualidade de vida nos indivíduos com esquizofrenia. No sentido de promover a melhoria da qualidade de vida destes doentes deverão ser tidas em consideração em vários contextos, intervenções psicossociais.

Ledroit Park, A Portrait In Black And White: A Study Of Historic Districts, Social Change, And The Process Of Neighborhood Placemaking

This research examines the process of placemaking in LeDroit Park, a residential Washington, DC, neighborhood with a historic district at its core. Unpacking the entwined physical and social evolution of the small community within the context of the Nation’s Capital, this analysis provides insight into the role of urban design and development as well as historic designation on shaping collective identity. Initially planned and designed in 1873 as a gated suburb just beyond the formal L’Enfant-designed city boundary, LeDroit Park was intended as a retreat for middle and upper-class European Americans from the growing density and social diversity of the city. With a mixture of large romantic revival mansions and smaller frame cottages set on grassy plots evocative of an idealized rural village, the physical design was intentionally inwardly-focused. This feeling of refuge was underscored with a physical fence that surrounded the development, intended to prevent African Americans from nearby Howard University and the surrounding neighborhood, from using the community’s private streets to access the City of Washington. Within two decades of its founding, LeDroit Park was incorporated into the District of Columbia, the surrounding fence was demolished, and the neighborhood was racially integrated. Due to increasingly stringent segregation laws and customs in the city, this period of integration lasted less than twenty years, and LeDroit Park developed into an elite African American enclave, using the urban design as a bulwark against the indignities of a segregated city. Throughout the 20th century housing infill and construction increased density, yet the neighborhood never lost the feeling of security derived from the neighborhood plan. Highlighting the architecture and street design, neighbors successfully received historic district designation in 1974 in order to halt campus expansion. After a stalemate that lasted two decades, the neighborhood began another period of transformation, both racial and socio-economic, catalyzed by a multi-pronged investment program led by Howard University. Through interviews with long-term and new community members, this investigation asserts that the 140-year development history, including recent physical interventions, is integral to placemaking, shaping the material character as well as the social identity of residents.

ENGINEERING DIGITAL SHARING PLATFORM TO CREATE SOCIAL CONTAGION: EVIDENCE FROM LARGE SCALE RANDOMIZED FIELD EXPERIMENTS

Peer-to-peer information sharing has fundamentally changed customer decision-making process. Recent developments in information technologies have enabled digital sharing platforms to influence various granular aspects of the information sharing process. Despite the growing importance of digital information sharing, little research has examined the optimal design choices for a platform seeking to maximize returns from information sharing. My dissertation seeks to fill this gap. Specifically, I study novel interventions that can be implemented by the platform at different stages of the information sharing. In collaboration with a leading for-profit platform and a non-profit platform, I conduct three large-scale field experiments to causally identify the impact of these interventions on customers’ sharing behaviors as well as the sharing outcomes. The first essay examines whether and how a firm can enhance social contagion by simply varying the message shared by customers with their friends. Using a large randomized field experiment, I find that i) adding only information about the sender’s purchase status increases the likelihood of recipients’ purchase; ii) adding only information about referral reward increases recipients’ follow-up referrals; and iii) adding information about both the sender’s purchase as well as the referral rewards increases neither the likelihood of purchase nor follow-up referrals. I then discuss the underlying mechanisms. The second essay studies whether and how a firm can design unconditional incentive to engage customers who already reveal willingness to share. I conduct a field experiment to examine the impact of incentive design on sender’s purchase as well as further referral behavior. I find evidence that incentive structure has a significant, but interestingly opposing, impact on both outcomes. The results also provide insights about senders’ motives in sharing. The third essay examines whether and how a non-profit platform can use mobile messaging to leverage recipients’ social ties to encourage blood donation. I design a large field experiment to causally identify the impact of different types of information and incentives on donor’s self-donation and group donation behavior. My results show that non-profits can stimulate group effect and increase blood donation, but only with group reward. Such group reward works by motivating a different donor population. In summary, the findings from the three studies will offer valuable insights for platforms and social enterprises on how to engineer digital platforms to create social contagion. The rich data from randomized experiments and complementary sources (archive and survey) also allows me to test the underlying mechanism at work. In this way, my dissertation provides both managerial implication and theoretical contribution to the phenomenon of peer-to-peer information sharing.

Processus d’adaptation des personnes vivant avec la schizophrénie et ayant un soutien social limité

Résumé : La schizophrénie est un trouble mental grave qui affecte toutes les facettes de la vie de la personne. En outre, le manque de soutien social est un problème important qui contribue à l’aggravation de la maladie, notamment en influençant négativement la capacité d’adaptation. Chez les personnes atteintes de schizophrénie, la capacité à utiliser des stratégies d’adaptation adéquates et efficaces est essentielle afin d’améliorer la santé, le bien-être et la prévention des rechutes. Cette recherche utilise la conception de l’adaptation de Roy (2009). De nombreuses études confirment la présence de difficultés d’adaptation chez ces personnes. De plus, le processus d’adaptation lui-même reste mal connu. La question de recherche était : Quel est le processus d’adaptation des personnes vivant avec la schizophrénie lorsque leur soutien social est limité ? Cette question sous-tendait deux objectifs : 1) décrire le processus d’adaptation des personnes atteintes de schizophrénie dans un contexte de soutien social limité et 2) contribuer au développement du modèle de Roy dans le contexte des troubles mentaux graves. Le devis de recherche était la théorisation ancrée constructiviste, auprès de 30 personnes vivant avec la schizophrénie. Les données étaient composées d’entrevues et de résultats de trois questionnaires qui ont contribué à décrire de façon plus détaillée le profil des participants. Les résultats sont une modélisation du processus d’adaptation nommée « les filtres dans le processus d’adaptation des personnes vivant avec la schizophrénie ». Cette modélisation met en lumière le fait que le potentiel d’adaptation des personnes vivant avec la schizophrénie est affecté à la fois par des éléments de l’environnement social et des éléments inhérents à la maladie elle-même. Ces éléments altèrent la possibilité et la capacité à utiliser des stratégies d’adaptation adéquates et efficaces. Ces résultats de recherche pourraient permettre d’améliorer l’évaluation des personnes atteintes de schizophrénie et de diminuer les « inconnues » dans l’effet des interventions, tout comme de favoriser les actions visant à lutter contre les conditions sociales qui nuisent à l’adaptation.

Essays on the Effects of Social Insurance for Disability

This dissertation examines how social insurance, family support and work capacity enhance individuals' economic well-being following significant health and income shocks. I first examine the extent to which the liquidity-enhancing effects of Worker's Compensation (WC) benefits outweigh the moral hazard costs. Analyzing administrative data from Oregon, I estimate a hazard model exploiting variation in the timing and size of a retroactive lump-sum WC payment to decompose the elasticity of claim duration with respect to benefits into the elasticity with respect to an increase in cash on hand, and a decrease in the opportunity cost of missing work. I find that the liquidity effect accounts for 60 to 65 percent of the increase in claim duration among lower-wage workers, but less than half of the increase for higher earners. Using the framework from Chetty (2008), I conclude that the insurance value of WC exceeds the distortionary cost, and increasing the benefit level could increase social welfare. Next, I investigate how government-provided disability insurance (DI) interacts with private transfers to disabled individuals from their grown children. Using the Health and Retirement Study, I estimate a fixed effects, difference in differences regression to compare transfers between DI recipients and two control groups: rejected applicants and a reweighted sample of disabled non-applicants. I find that DI reduces the probability of receiving a transfer by no more than 3 percentage points, or 10 percent. Additional analysis reveals that DI could increase the probability of receiving a transfer in cases where children had limited prior information about the disability, suggesting that DI could send a welfare-improving information signal. Finally, Zachary Morris and I examine how a functional assessment could complement medical evaluations in determining eligibility for disability benefits and in targeting return to work interventions. We analyze claimants' self-reported functional capacity in a survey of current DI beneficiaries to estimate the share of disability claimants able to do work-related activity. We estimate that 13 percent of current DI beneficiaries are capable of work-related activity. Furthermore, other characteristics of these higher-functioning beneficiaries are positively correlated with employment, making them an appropriate target for return to work interventions.

Being more certain about random assignment in social policy evaluations

Social experiments have been widely utilised in evaluations of social programmes in the US to identify ‘what works’, whilst in the UK their use is more controversial. This paper explores the paradigmatic, technical and practical issues evaluators confront in using randomised experiments to evaluate social policies. Possible remedies to some of these problems are outlined. It is argued that although no evaluation methodology is problem-free, policy makers and researchers should be more confident about the merits of using random assignment, provided it is used in conjunction with other methodologies more suited to understanding why and how interventions work.

Responsabilidade social: visões e perspectivas de empresários do segmento industrial do Rio Grande do Norte

The theme Corporate Social Responsibility is relatively recent both in the academic field and in the business practice. Because of the lack of socialization of experiences and precision of concepts, there are gaps regarding the understanding of the subject and, also, how to conduct operations. This study just seeks to investigate such matter, focusing applications of social responsibility in business. It takes, as empirical field, winners of the PSQT - SESI Prize of Quality at Work in Rio Grande do Norte (2002-2007) in order to systematize the various approaches on the issue, aiming to reveal subjective visions and perspectives of the theme. It is characterized as a qualitative study, carried out by structured interview. The universe was composed by 15 companies. It was used analysis of content categorical as an axis for the interpretation of the information. Three approaches guided the analysis: Business Ethics, (normative); Business & Society (contractual); Social Issues Management (strategic). The findings are related in three ways: 1) reasons for the CSR practice; 2) the results obtained; 3) the means of CSR. It was found that the award participation occurs, mostly, linked to SESI invitations, so, as an articulated movement of industrial corporations in Brazil it occurs, also, because of the organizational commitment with the society and the possibility of internal and social growths and because of the importance attributed to the report as an instrument of consultancy. There are no indicators to check impacts of organizational interventions, in spite of the existence of planning for the actions. Social responsibility appears as a tool to reinforce the organizational image and to increase satisfaction of the employees. There is a tendency of large and medium firms to a contractual commitment while the small and the micros firms are on strategic or normative level. The analysis of the perspectives of social responsibility future revealed trends towards for strategic approach

Soziale Ungleichheiten beim Übergang von der Grundschule in die Sekundarstufe I. Theorie, Forschungsstand, Interventions- und Fördermöglichkeiten

Auf der Basis eines theoretischen Modells zum Übergangsprozess, in dem primäre und sekundäre Herkunftseffekte nach Boudon unterschieden werden, fasst der vorliegende Beitrag den empirischen Kenntnisstand zum Einfluss der familiären Herkunft auf den Übergang von der Grundschule in die Sekundarstufe I zusammen. Dabei wird neben den primären Effekten zwischen verschiedenen Arten von sekundären Herkunftseffekten unterschieden: sekundäre Effekte der Leistungsbeurteilung, der Schullaufbahnempfehlung und des Übergangsverhaltens. Die Befunde sprechen für die Existenz primärer und sekundärer Herkunftseffekte im deutschen Schulsystem: Kinder aus sozial schwachen Familien haben schlechtere Schulleistungen, erhalten jedoch selbst bei gleichen Testleistungen noch schlechtere Beurteilungen durch die Lehrkräfte (Noten und Schullaufbahnempfehlungen) und gehen bei gleichen Testleistungen und Schulnoten und gleicher Empfehlung häufiger auf niedrigere Schulformen über. Weiterhin werden Ergebnisse aus Studien zur Quantifizierung und Neutralisation von primären und sekundären Herkunftseffekten vorgestellt und diskutiert sowie mögliche Interventions- und Fördermöglichkeiten zur Verringerung der Herkunftseffekte beim Übergang aufgezeigt.