Use of structural equation modeling to examine the association between breast cancer risk perception and repeat screening mammography among United States women

Breast cancer is the second leading cause of cancer death in United States women, estimated to be diagnosed in 1 out of 8 women in their lifetime. Screening mammography detects breast cancer in its pre-clinical stages when treatment strategies have the greatest chance of success, and is currently the only population-wide prevention method proven to reduce the morbidity and mortality associated with breast cancer. Research has shown that the majority of women are not screened annually, with estimates ranging front 6% - 30% of eligible women receiving all available annual mammograms over a 5-year or greater time frame. Health behavior theorists believe that perception of risk/susceptibility to a disease influences preventive health behavior, in this case, screening mammography The purpose of this dissertation is to examine the association between breast cancer risk perception and repeat screening mammography using a structural equation modeling (SEM) framework. A series of SEM multivariate regressions were conducted using self-reported, nationally representative data from the 2005 National Health Interview Survey. Interaction contrasts were tested to measure the potential moderating effects of variables which have been shown to be predictive of mammography use (physician recommendation, economic barriers, structural barriers, race/ethnicity) on the association between breast cancer risk perception and repeat mammography, while controlling for the covariates of age, income, region, nativity, and educational level. Of the variables tested for moderation, results of the SEM analyses identify physician recommendation as the only moderator of the relationship between risk perception and repeat mammography, thus the potentially most effective point of intervention to increase mammography screening, and decrease the morbidity and mortality associated with breast cancer. These findings expand the role of the physician from recommendation to one of attenuating the effect of risk perception and increasing repeat screening. The long range application of the research is the use of the SEM methodology to identify specific points of intervention most likely to increase preventive behavior in population-wide research, allowing for the most effective use of intervention funds.^

Multilevel structural equation models for longitudinal data where predictors are measured more frequently than outcomes : an application to the effects of stress on the cognitive function of nurses

Funded by Chief Scientist Office, Scotland. Grant Number: CZH/4/394 Economic and Social Research Council grant as part of the National Centre for Research Methods. Grant Number: RES-576-25-0032

An explanatory model of underwater adaptation

The underwater environment is an extreme environment that requires a process of human adaptation with specific psychophysiological demands to ensure survival and productive activity. From the standpoint of existing models of intelligence, personality and performance, in this explanatory study we have analyzed the contribution of individual differences in explaining the adaptation of military personnel in a stressful environment. Structural equation analysis was employed to verify a model representing the direct effects of psychological variables on individual adaptation to an adverse environment, and we have been able to confirm, during basic military diving courses, the structural relationships among these variables and their ability to predict a third of the variance of a criterion that has been studied very little to date. In this way, we have confirmed in a sample of professionals (N = 575) the direct relationship of emotional adjustment, conscientiousness and general mental ability with underwater adaptation, as well as the inverse relationship of emotional reactivity. These constructs are the psychological basis for working under water, contributing to an improved adaptation to this environment and promoting risk prevention and safety in diving activities.

Knowledge about dietary fibres (KADF): development and validation of an evaluation instrument through structural equation modelling (SEM)

Objectives: Because there is scientific evidence that an appropriate intake of dietary fibre should be part of a healthy diet, given its importance in promoting health, the present study aimed to develop and validate an instrument to evaluate the knowledge of the general population about dietary fibres. Study design: The present study was a cross sectional study. Methods: The methodological study of psychometric validation was conducted with 6010 participants, residing in ten countries from 3 continents. The instrument is a questionnaire of self-response, aimed at collecting information on knowledge about food fibres. For exploratory factor analysis (EFA) was chosen the analysis of the main components using varimax orthogonal rotation and eigenvalues greater than 1. In confirmatory factor analysis by structural equation modelling (SEM) was considered the covariance matrix and adopted the Maximum Likelihood Estimation algorithm for parameter estimation. Results: Exploratory factor analysis retained two factors. The first was called Dietary Fibre and Promotion of Health (DFPH) and included 7 questions that explained 33.94 % of total variance ( = 0.852). The second was named Sources of Dietary Fibre (SDF) and included 4 questions that explained 22.46% of total variance ( = 0.786). The model was tested by SEM giving a final solution with four questions in each factor. This model showed a very good fit in practically all the indexes considered, except for the ratio 2/df. The values of average variance extracted (0.458 and 0.483) demonstrate the existence of convergent validity; the results also prove the existence of discriminant validity of the factors (r2 = 0.028) and finally good internal consistency was confirmed by the values of composite reliability (0.854 and 0.787). Conclusions: This study allowed validating the KADF scale, increasing the degree of confidence in the information obtained through this instrument in this and in future studies.

Antecedents of travellers' electronic word-of-mouth communication

Electronic word-of-mouth (eWOM) is recognised as a means of interpersonal communication and a powerful marketing tool. However, previous studies have focussed on related motivations, and limited attention has been given to understanding the antecedents of eWOM communication behaviour in the travel industry. This study proposes a full and partial mediation model, which brings together for the first time three key antecedents: adoption of electronic communication technology, consumer dis/satisfaction with travel consumption experience, and subjective norm. The model aims to understand the impact of these antecedents on travellers' attitude towards eWOM communication and intention to use eWOM communication media. The data were collected from international travellers (n = 524), and structural equation modelling is used to test the conceptual framework. The findings of the study suggest that overall attitude towards eWOM communication partially mediates the impact of the traveller's adoption of electronic communication technology and subjective norm, and fully mediates the impact of consumer dis/satisfaction with travel consumption experience on travellers' intention to use eWOM communication media.

Symbolic consumption of tourism destination brands

Electronic word-of-mouth (eWOM) is recognised as a means of interpersonal communication and a powerful marketing tool. However, previous studies have focussed on related motivations, and limited attention has been given to understanding the antecedents of eWOM communication behaviour in the travel industry. This study proposes a full and partial mediation model, which brings together for the first time three key antecedents: adoption of electronic communication technology, consumer dis/satisfaction with travel consumption experience, and subjective norm. The model aims to understand the impact of these antecedents on travellers' attitude towards eWOM communication and intention to use eWOM communication media. The data were collected from international travellers (n = 524), and structural equation modelling is used to test the conceptual framework. The findings of the study suggest that overall attitude towards eWOM communication partially mediates the impact of the traveller's adoption of electronic communication technology and subjective norm, and fully mediates the impact of consumer dis/satisfaction with travel consumption experience on travellers' intention to use eWOM communication media.

Knowledge management capabilities and organizational performance: an investigation into the effects of knowledge infrastructure and processes on organizational performance

Knowledge is one of the most important assets for surviving in the modern business environment. The effective management of that asset mandates continuous adaptation by organizations, and requires employees to strive to improve the company's work processes. Organizations attempt to coordinate their unique knowledge with traditional means as well as in new and distinct ways, and to transform them into innovative resources better than those of their competitors. As a result, how to manage the knowledge asset has become a critical issue for modern organizations, and knowledge management is considered the most feasible solution. Knowledge management is a multidimensional process that identifies, acquires, develops, distributes, utilizes, and stores knowledge. However, many related studies focus only on fragmented or limited knowledge-management perspectives. In order to make knowledge management more effective, it is important to identify the qualitative and quantitative issues that are the foundation of the challenge of effective knowledge management in organizations. The main purpose of this study was to integrate the fragmented knowledge management perspectives into the holistic framework, which includes knowledge infrastructure capability (technology, structure, and culture) and knowledge process capability (acquisition, conversion, application, and protection), based on Gold's (2001) study. Additionally, because the effect of incentives ̶̶ which is widely acknowledged as a prime motivator in facilitating the knowledge management process ̶̶ was missing in the original framework, this study included the importance of incentives in the knowledge management framework. This study also identified the relationship of organizational performance from the standpoint of the Balanced Scorecard, which includes the customer-related, internal business process, learning & growth, and perceptual financial aspects of organizational performance in the Korean business context. Moreover, this study identified the relationship with the objective financial performance by calculating the Tobin's q ratio. Lastly, this study compared the group differences between larger and smaller organizations, and manufacturing and nonmanufacturing firms in the study of knowledge management. Since this study was conducted in Korea, the original instrument was translated into Korean through the back translation technique. A confirmatory factor analysis (CFA) was used to examine the validity and reliability of the instrument. To identify the relationship between knowledge management capabilities and organizational performance, structural equation modeling (SEM) and multiple regression analysis were conducted. A Student's t test was conducted to examine the mean differences. The results of this study indicated that there is a positive relationship between effective knowledge management and organizational performance. However, no empirical evidence was found to suggest that knowledge management capabilities are linked to the objective financial performance, which remains a topic for future review. Additionally, findings showed that knowledge management is affected by organization's size, but not by type of organization. The results of this study are valuable in establishing a valid and reliable survey instrument, as well as in providing strong evidence that knowledge management capabilities are essential to improving organizational performance currently and making important recommendations for future research.

The link between HR practices, psychological contract fulfillment, and organizational performance:the case of the Greek services sector

The purpose of this study is to investigate the impact of human resource (HR) practices on organizational performance through the mediating role of psychological contract (expressed by the influence of employer on employee promises fulfillment through employee attitudes). The study is based on a national sample of 78 organizations from the public and private services sector in Greece, including education, health, and banking, and on data obtained from 348 employees. The statistical method employed is structural equation modeling, via LISREL and bootstrapping estimation. The findings of the study suggest that employee incentives, performance appraisal, and employee promotion are three major HR practices that must be extensively employed. Furthermore, the study suggests that the organization must primarily keep its promises about a pleasant and safe working environment, respectful treatment, and feedback for performance, in order for employees to largely keep their own promises about showing loyalty to the organization, maintaining high levels of attendance, and upholding company reputation. Additionally, the study argues that the employee attitudes of motivation, satisfaction, and commitment constitute the nested epicenter mediating construct in both the HR practices–performance and employer–employee promise fulfillment relationships, resulting in superior organizational performance. © 2012 Wiley Periodicals, Inc.

Firm's network capability and innovation performance: evidences from China hi-tech industry

ABSTRACT : A firm's competitive advantage can arise from internal resources as well as from an interfirm network. -This dissertation investigates the competitive advantage of a firm involved in an innovation network by integrating strategic management theory and social network theory. It develops theory and provides empirical evidence that illustrates how a networked firm enables the network value and appropriates this value in an optimal way according to its strategic purpose. The four inter-related essays in this dissertation provide a framework that sheds light on the extraction of value from an innovation network by managing and designing the network in a proactive manner. The first essay reviews research in social network theory and knowledge transfer management, and identifies the crucial factors of innovation network configuration for a firm's learning performance or innovation output. The findings suggest that network structure, network relationship, and network position all impact on a firm's performance. Although the previous literature indicates that there are disagreements about the impact of dense or spare structure, as well as strong or weak ties, case evidence from Chinese software companies reveals that dense and strong connections with partners are positively associated with firms' performance. The second essay is a theoretical essay that illustrates the limitations of social network theory for explaining the source of network value and offers a new theoretical model that applies resource-based view to network environments. It suggests that network configurations, such as network structure, network relationship and network position, can be considered important network resources. In addition, this essay introduces the concept of network capability, and suggests that four types of network capabilities play an important role in unlocking the potential value of network resources and determining the distribution of network rents between partners. This essay also highlights the contingent effects of network capability on a firm's innovation output, and explains how the different impacts of network capability depend on a firm's strategic choices. This new theoretical model has been pre-tested with a case study of China software industry, which enhances the internal validity of this theory. The third essay addresses the questions of what impact network capability has on firm innovation performance and what are the antecedent factors of network capability. This essay employs a structural equation modelling methodology that uses a sample of 211 Chinese Hi-tech firms. It develops a measurement of network capability and reveals that networked firms deal with cooperation between, and coordination with partners on different levels according to their levels of network capability. The empirical results also suggests that IT maturity, the openness of culture, management system involved, and experience with network activities are antecedents of network capabilities. Furthermore, the two-group analysis of the role of international partner(s) shows that when there is a culture and norm gap between foreign partners, a firm must mobilize more resources and effort to improve its performance with respect to its innovation network. The fourth essay addresses the way in which network capabilities influence firm innovation performance. By using hierarchical multiple regression with data from Chinese Hi-tech firms, the findings suggest that there is a significant partial mediating effect of knowledge transfer on the relationships between network capabilities and innovation performance. The findings also reveal that the impacts of network capabilities divert with the environment and strategic decision the firm has made: exploration or exploitation. Network constructing capability provides a greater positive impact on and yields more contributions to innovation performance than does network operating capability in an exploration network. Network operating capability is more important than network constructing capability for innovative firms in an exploitation network. Therefore, these findings highlight that the firm can shape the innovation network proactively for better benefits, but when it does so, it should adjust its focus and change its efforts in accordance with its innovation purposes or strategic orientation.

Dynamic Capabilities and Firm Performance

Firms operating in a changing environment have a need for structures and practices that provide flexibility and enable rapid response to changes. Given the challenges they face in attempts to keep up with market needs, they have to continuously improve their processes and products, and develop new products to match market requirements. Success in changing markets depends on the firm's ability to convert knowledge into innovations, and consequently their internal structures and capabilities have an important role in innovation activities. According 10 the dynamic capability view of the firm, firms thus need dynamic capabilities in (he form ofassets, processes and structures that enable strategic flexibility and support entrepreneurial opportunity sensing and exploitation. Dynamic capabilities are also needed in conditions of rapid change in the operating environment, and in activities such as new product development and expansion to new markets. Despite the growing interest in these issues and the theoretical developments in the field of strategy research, there are still only very few empirical studies, and large-scale empirical studies in particular, that provide evidence that firms'dynamic capabilities are reflected in performance differences. This thesis represents an attempt to advance the research by providing empirical evidence of thelinkages between the firm's dynamic capabilities and performance in intenationalization and innovation activities. The aim is thus to increase knowledge and enhance understanding of the organizational factors that explain interfirm performance differences. The study is in two parts. The first part is the introduction and the second part comprises five research publications covering the theoretical foundations of the dynamic capability view and subsequent empirical analyses. Quantitative research methodology is used throughout. The thesis contributes to the literature in several ways. While a lot of prior research on dynamic capabilities is conceptual in nature, or conducted through case studies, this thesis introduces empirical measures for assessing the different aspects, and uses large-scale sampling to investigate the relationships between them and performance indicators. The dynamic capability view is further developed by integrating theoretical frameworks and research traditions from several disciplines. The results of the study provide support for the basic tenets of the dynamic capability view. The empirical findings demonstrate that the firm's ability to renew its knowledge base and other intangible assets, its proactive, entrepreneurial behavior, and the structures and practices that support operational flexibility arepositively related to performance indicators.

Supply management capabilities, routine bundles and their impact on firm performance

Despite the generally positive contribution of supply management capabilities to firm performance their respective routines require more depth of assessment. Using the resource-based view we examine four routines bundles comprising ostensive and performative aspects of supply management capability – supply management integration, coordinated sourcing, collaboration management and performance assessment. Using structural equation modelling we measure supply management capability empirically as a second-order latent variable and estimate its effect on a series of financial and operational performance measures. The routines-based approach allows us to demonstrate a different, more fine-grained approach for assessing consistent bundles of homogeneous patterns of activity across firms. The results suggest supply management capability is formed of internally consistent routine bundles, which are significantly related to financial performance, mediated by operational performance. Our results confirm an indirect effect of firm performance for ‘core’ routines forming the architecture of a supply management capability. Supply management capability primarily improves the operational performance of the business, which is subsequently translated into improved financial performance. The study is significant for practice as it offers a different view about the face-valid rationale of supply management directly influencing firm financial performance. We confound this assumption, prompting caution when placing too much importance on directly assessing supply management capability using financial performance of the business.

Growing research where economies grow: essays on strategy and international expansion of companies from emerging countries

In recent years, emerging countries have assumed an increasingly prominent position in the world economy, as growth has picked up in these countries and slowed in developed economies. Two related phenomena, among others, can be associated with this growth: emerging countries were less affected by the 2008-2009 global economic recession; and they increased their participation in foreign direct investment, both inflows and outflows. This doctoral dissertation contributes to research on firms from emerging countries through four independent papers. The first group of two papers examines firm strategy in recessionary moments and uses Brazil, one of the largest emerging countries, as setting for the investigation. Data were collected through a survey on Brazilian firms referring to the 2008-2009 global recession, and 17 hypotheses were tested using structural equation modeling based on partial least squares. Paper 1 offered an integrative model linking RBV to literatures on entrepreneurship, improvisation, and flexibility to indicate the characteristics and capabilities that allow a firm to have superior performance in recessions. We found that firms that pre-recession have a propensity to recognize opportunities and improvisation capabilities for fast and creative actions have superior performance in recessions. We also found that entrepreneurial orientation and flexibility have indirect effects. Paper 2 built on business cycle literature to study which strategies - pro-cyclical or counter-cyclical – enable superior performance in recessions. We found that while most firms pro-cyclically reduce costs and investments during recessions, a counter-cyclical strategy of investing in opportunities created by changes in the environment enables superior performance. Most successful are firms with a propensity to recognize opportunities, entrepreneurial orientation to invest, and flexibility to efficiently implement these investments. The second group of two papers investigated international expansion of multinational enterprises, particularly the use of distance for their location decisions. Paper 3 proposed a conceptual framework to examine circumstances under which distance is less important for international location decisions, taking the new perspective of economic institutional distance as theoretical foundation. The framework indicated that the general preference for low-distance countries is lower: (1) when the company is state owned, rather than private owned; (2) when its internationalization motives are asset, resource, or efficiency seeking, as opposed to market seeking; and (3) when internationalization occurred after globalization and the advent of new technologies. Paper 4 compared five concurrent perspectives of distance and indicated their suitability to the study of various issues based on industry, ownership, and type, motive, and timing of internationalization. The paper also proposed that distance represents the disadvantages of host countries for international location decisions; as such, it should be used in conjunction with factors that represent host country attractiveness, or advantages as international locations. In conjunction, papers 3 and 4 provided additional, alternative explanations for the mixed empirical results of current research on distance. Moreover, the studies shed light into the discussion of differences between multinational enterprises from emerging countries versus those from advanced countries.

Spontaneity and international marketing performance

Purpose: The purpose of this paper is to ascertain how today’s international marketers can perform better on the global scene by harnessing spontaneity. Design/methodology/approach: The authors draw on contingency theory to develop a model of the spontaneity – international marketing performance relationship, and identify three potential moderators, namely, strategic planning, centralization, and market dynamism. The authors test the model via structural equation modeling with survey data from 197 UK exporters. Findings: The results indicate that spontaneity is beneficial to exporters in terms of enhancing profit performance. In addition, greater centralization and strategic planning strengthen the positive effects of spontaneity. However, market dynamism mitigates the positive effect of spontaneity on export performance (when customer needs are volatile, spontaneous decisions do not function as well in terms of ensuring success). Practical implications: Learning to be spontaneous when making export decisions appears to result in favorable outcomes for the export function. To harness spontaneity, export managers should look to develop company heuristics (increase centralization and strategic planning). Finally, if operating in dynamic export market environments, the role of spontaneity is weaker, so more conventional decision-making approaches should be adopted. Originality/value: The international marketing environment typically requires decisions to be flexible and fast. In this context, spontaneity could enable accelerated and responsive decision-making, allowing international marketers to realize superior performance. Yet, there is a lack of research on decision-making spontaneity and its potential for international marketing performance enhancement.

The reasonant influence of supply chain management practices on organizational performance

A single supply chain management (SCM) practice will have a certain impact on organizational performance(OP). However, since it is placed in a system that many other practices are conducted simultaneously, the practice itself will interact with other ones and have a greater impact on OP. This mechanism is named the "resonant" influence. The technique of Structural equation modelling (SEM) was used to test the above mechanism with data collected from Vietnamese garment enterprises. The tcst results showed that the model without mutual interaction among SCM practices could explain 42.8%, 26.3% and 34% variance of operational performance, customer satisfaction and financial performance. While the one containing this interaction is capable to explain 69.5%, 33.1% and 57.3%, respectively.