932 resultados para culturally relevant services
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Thesis (Ph.D.)--University of Washington, 2016-08
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Religious authority figures often use religious texts as the primary basis for censuring homosexuality. In recent years, however, non-heterosexual Christians and Muslims have begun to contest the discursively produced boundary of sexual morality.Drawing upon two research projects on non-heterosexual Christians and Muslims, this article explores the three approaches embedded in this strategy.While acknowledging that homosexuality is indeed portrayed negatively in some parts of religious texts, the participants critique traditional hermeneutics by highlighting its inaccuracy and socio-cultural specificity, and arguing for a contextualized and culturally relevant interpretation. They also critique the credibility of institutional interpretive authority by highlighting its inadequacy and ideology, and relocating authentic interpretive authority to personal experience. Finally, they recast religious texts to construct resources for their spiritual nourishment.This strategy generally reflects the contemporary western religious landscape that prioritizes the authority of the self over that of religious institution.
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African American women account for a disproportionate burden of cervical cancer incidence and mortality rate when compared to non-Hispanic White women. Cervical cancer is one of the most preventable types of cancer, and women can be screened for it with a routine Pap test. Given that religion occupies an essential place in African American lives, framing health messages with important spiritual themes and delivering them through a popular communication delivery channel may allow for a more culturally-relevant and accessible technology-based approach to promoting cervical cancer educational content to African American women. Using community-engaged research as a framework, the purpose of this multiple methods study was to develop, pilot test, and evaluate the feasibility, acceptability, and initial efficacy of a spiritually-based SMS text messaging intervention to increase cervical cancer awareness and Pap test screening intention among African American women. The study recruited church-attending African American women ages 21-65 and was conducted in three phases. Phases 1 and 2 consisted of a series of focus group discussions (n=15), cognitive response interviews (n=8), and initial usability testing that were conducted to inform the intervention development and modifications. Phase 3 utilized a non-experimental one-group pretest-posttest design to pilot test the 16-day text messaging intervention (n=52). Of the individuals enrolled, forty-six completed the posttest (retention rate=88%). Findings provided evidence for the early feasibility, high acceptability, and some initial efficacy of the CervixCheck intervention. There were significant pre-post increases observed for knowledge about cervical cancer and the Pap test (p = .001) and subjective norms (p = .006). Additionally, results post-intervention revealed that 83% of participants reported being either “satisfied” or “very satisfied” with the program and 85% found the text messages either “useful” or “very useful”. 85% of the participants also indicated that they would “likely” or “very likely” share the information they learned from the intervention with the women around them, with 39% indicating that they had already shared some of the information they received with others they knew. A spiritually-based SMS text messaging intervention could be a culturally appropriate and cost-effective method of promoting cervical cancer early detection information to African American women.
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This presentation discusses the limited research of urban rehabilitation service evaluations and assesses the progress of Goori House Rehabilitation Service, identifying issues preventing a sustainable organisational future.
Identifying relevant information for emergency services from twitter in response to natural disaster
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This project proposes a framework that identifies high‐value disaster-based information from social media to facilitate key decision-making processes during natural disasters. At present it is very difficult to differentiate between information that has a high degree of disaster relevance and information that has a low degree of disaster relevance. By digitally harvesting and categorising social media conversation streams automatically, this framework identifies highly disaster-relevant information that can be used by emergency services for intelligence gathering and decision-making.
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Objective To evaluate health practitioners’ confidence and knowledge of alcohol screening, brief intervention and referral after training in a culturally adapted intervention on alcohol misuse and well-being issues for trauma patients. Design Mixed methods, involving semi-structured interviews at baseline and a post-workshop questionnaire. Setting: Targeted acute care within a remote area major tertiary referral hospital. Participants Ten key informants and 69 questionnaire respondents from relevant community services and hospital-based health care professionals. Intervention Screening and brief intervention training workshops and resources for 59 hospital staff. Main outcome measures Self-reported staff knowledge of alcohol screening, brief intervention and referral, and satisfaction with workshop content and format. Results After training, 44% of participants reported being motivated to implement alcohol screening and intervention. Satisfaction with training was high, and most participants reported that their knowledge of screening and brief intervention was improved. Conclusion Targeted educational interventions can improve the knowledge and confidence of inpatient staff who manage patients at high risk of alcohol use disorder. Further research is needed to determine the duration of the effect and influence on practice behaviour. Ongoing integrated training, linked with systemic support and established quality improvement processes, is required to facilitate sustained change and widespread dissemination.
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This dissertation investigated perspectives on cultural competence among African-American women patients, staff, and the administrator of a dental clinic serving people living with HIV/AIDS; and evaluated the role of the National Standards for Culturally and Linguistically Appropriate Services in Health Care (CLAS) in advancing the provision of culturally competent care in the clinic. ^ The study was qualitative with data collection via focus groups and individual interviews with a sample of African-American women patients, and individual interviews with a sample of staff and the clinic administrator. Transcripts were coded and themes identified using the software program ATLAS.ti. A cultural audit template was developed and applied to evaluate cultural competency. ^ Among attitudes and behaviors that contributed to the provision of culturally competent care at the clinic were respect and empathic communication. Formal cultural competency was not featured strongly in the methods by which the staff learned to work with diverse populations. Instead cultural competence among the staff was based on thoughtful hiring practices, natural aptitude and a climate that encouraged learning through informal sharing of experiences. The staff and administrator felt that an African-American dentist would be an asset in improving culturally competent care at the clinic. Previous research and national policy also promote the provider-patient racial/ethnic concordance to improve care. In this study, however, the patients were happy with the care provided regardless of the race/ethnicity of the staff, probably reflecting the well developed cultural competence skills of clinic staff overall. ^ The clinic administrator was unaware of the CLAS standards although the clinic was implicitly operated under their mandates. This occurred because the clinic is supported by federal funding and the CLAS standards were incorporated into the requirements. Incorporation into and monitoring of the CLAS standards in federally funded programs therefore appears to be an effective means for ensuring that they are implemented. ^ This study illustrates that cultural competence, though not universally understood, can be systematically investigated to identify what constitutes appropriate care and the factors that support or inhibit it. Among important elements of culturally competent care are respect and empathic communication. ^
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The investigator conducted an action-oriented investigation of pregnancy and birth among the women of Mesa los Hornos, an urban squatter slum in Mexico City. Three aims guided the project: (1) To obtain information for improving prenatal and maternity service utilization; (2) To examine the utility of rapid ethnographic and epidemiologic assessment methodologies; (3) To cultivate community involvement in health development.^ Viewing service utilization as a culturally-bound decision, the study included a qualitative phase to explore women's cognition of pregnancy and birth, their perceived needs during pregnancy, and their criteria of service acceptability. A probability-based community survey delineated parameters of service utilization and pregnancy health events, and probed reasons for decisions to use medical services, lay midwives, or other sources of prenatal and labor and delivery assistance. Qualitative survey of service providers at relevant clinics, hospitals, and practices contributed information on service availability and access, and on coordination among private, social security, and public assistance health service sectors. The ethnographic approach to exploring the rationale for use or non-use of services provided a necessary complement to conventional barrier-based assessment, to inform planning of culturally appropriate interventions.^ Information collection and interpretation was conducted under the aegis of an advisory committee of community residents and service agency representatives; the residents' committee formulated recommendations for action based on findings, and forwarded the mandate to governmental social and urban development offices. Recommendations were designed to inform and develop community participation in health care decision-making.^ Rapid research methods are powerful tools for achieving community-based empowerment toward investigation and resolution of local health problems. But while ethnography works well in synergy with quantitative assessment approaches to strengthen the validity and richness of short-term field work, the author strongly urges caution in application of Rapid Ethnographic Assessments. An ethnographic sensibility is essential to the research enterprise for the development of an active and cooperative community base, the design and use of quantitative instruments, the appropriate use of qualitative techniques, and the interpretation of culturally-oriented information. However, prescribed and standardized Rapid Ethnographic Assessment techniques are counter-productive if used as research short-cuts before locale- and subject-specific cultural understanding is achieved. ^
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Los mercados asociados a los servicios de voz móvil a móvil, brindados por operadoras del Sistema Móvil Avanzado en Latinoamérica, han estado sujetos a procesos regulatorios motivados por la dominancia en el mercado de un operador, buscando obtener óptimas condiciones de competencia. Específicamente en Ecuador, la Superintendencia de Telecomunicaciones (Organismo Técnico de Control de Telecomunicaciones) desarrolló un modelo para identificar acciones de regulación que puedan proporcionar al mercado efectos sostenibles de competencia en el largo plazo. Este artículo trata sobre la aplicación de la ingeniería de control para desarrollar un modelo integral del mercado, empleando redes neuronales para la predicción de trarifas de cada operador y un modelo de lógica difusa para predecir la demanda. Adicionalmente, se presenta un modelo de inferencia de lógica difusa para reproducir las estrategias de mercadeo de los operadores y la influencia sobre las tarifas. Dichos modelos permitirían la toma adecuada de decisiones y fueron validados con datos reales.
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New mobile digital communication technologies present opportunities for advertisers to capitalize on the evolving relationships of consumers with their mobile devices and their desire to access enhanced information services while mobile (m-services). Consumers already use mobile devices (cell phones, personal mobile digital assistants) for traditional phone calls and message handling (e.g., Kalakota and Robinson, 2002; Sullivan Mort and Drennan, 2002). The combination of rapidly developing mobile digital technology and high uptake rates of mobile devices presents enormous potential for delivery of m-services through these devices (Bitner, Brown, and Meuter, 2000). M-services encompass a wide variety of types including the ability to trade stock, to book theater and movie tickets while accessing seating plans online, to send and receive text and pictures, and receive personalized direct advertising such as alerts for shopping bargains. Marketing communications, and specifically advertising, may be delivered as an m-service and termed m-services advertising, forming part of the broader category of m-services. However, advertising research has not yet addressed the area of m-services and needs to do so to be able to take advantage of the advanced interactivity (Yadav and Varadarajan, 2005) of mobile communication devices. Such advertising research is likely to help develop open attitudes and responses to new business models as has been advocated for other new technology such as advanced television (Tauder, 2005). In this article, we model the factors influencing the use of m-services, in the context of consumers' existing relationships with mobile devices. First, we address the value propositions underpinning consumer involvement with mobile devices. Next, we canvass the types of involvement relevant to this consumption domain and argue that involvement, together with personal attributes innovativeness and self-efficacy, will influence use of m-services. Finally, implications for advertising delivered as an m-service are discussed, the potential for m-services advertising as part of m-commerce are canvassed, and directions for future research identified.
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Web 1.0 referred to the early, read-only internet; Web 2.0 refers to the ‘read-write web’ in which users actively contribute to as well as consume online content; Web 3.0 is now being used to refer to the convergence of mobile and Web 2.0 technologies and applications. One of the most important developments in mobile 3.0 is geography: with many mobile phones now equipped with GPS, mobiles promise to “bring the internet down to earth” through geographically-aware, or locative media. The internet was earlier heralded as “the death of geography” with predictions that with anyone able to access information from anywhere, geography would no longer matter. But mobiles are disproving this. GPS allows the location of the user to be pinpointed, and the mobile internet allows the user to access locally-relevant information, or to upload content which is geotagged to the specific location. It also allows locally-specific content to be sent to the user when the user enters a specific space. Location-based services are one of the fastest-growing segments of the mobile internet market: the 2008 AIMIA report indicates that user access of local maps increased by 347% over the previous 12 months, and restaurant guides/reviews increased by 174%. The central tenet of cultural geography is that places are culturally-constructed, comprised of the physical space itself, culturally-inflected perceptions of that space, and people’s experiences of the space (LeFebvre 1991). This paper takes a cultural geographical approach to locative media, anatomising the various spaces which have emerged through locative media, or “the geoweb” (Lake 2004). The geoweb is such a new concept that to date, critical discourse has treated it as a somewhat homogenous spatial formation. In order to counter this, and in order to demonstrate the dynamic complexity of the emerging spaces of the geoweb, the paper provides a topography of different types of locative media space: including the personal/aesthetic in which individual users geotag specific physical sites with their own content and meanings; the commercial, like the billboards which speak to individuals as they pass in Minority Report; and the social, in which one’s location is defined by the proximity of friends rather than by geography.
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Background: Relatively little research attention has been given to the development of standardised and psychometrically sound scales for measuring influences relevant to the utilisation of health services. This study aims to describe the development, validation and internal reliability of some existing and new scales to measure factors that are likely to influence utilisation of preventive care services provided by general practitioners in Australia.----- Methods: Relevant domains of influence were first identified from a literature review and formative research. Items were then generated by using and adapting previously developed scales and published findings from these. The new items and scales were pre-tested and qualitative feedback was obtained from a convenience sample of citizens from the community and a panel of experts. Principal Components Analyses (PCA) and internal reliability testing (Cronbach's alpha) were then conducted for all of the newly adapted or developed scales utilising data collected from a self-administered mailed survey sent to a randomly selected population-based sample of 381 individuals (response rate 65.6 per cent).----- Results: The PCA identified five scales with acceptable levels of internal consistency were: (1) social support (ten items), alpha 0.86; (2) perceived interpersonal care (five items), alpha 0.87, (3) concerns about availability of health care and accessibility to health care (eight items), alpha 0.80, (4) value of good health (five items), alpha 0.79, and (5) attitudes towards health care (three items), alpha 0.75.----- Conclusion The five scales are suitable for further development and more widespread use in research aimed at understanding the determinants of preventive health services utilisation among adults in the general population.
Towards a culturally appropriate mental health system: Sudanese-Australians' experiences with trauma
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Australia is fortunate to welcome approximately 13,000 humanitarian entrants per year, most of whom have experienced protracted violence, hardship and life in refugee camps. The majority of humanitarian migrants were raised in cultural contexts very different to that of Australia, contributing to the increasing diversity of this region. With this diversity comes a responsibility to ensure every Australian receives culturally appropriate mental healthcare. Those who are forced into migration have experienced trauma and the stress of acculturation often compounds this trauma. This study investigated the experience of trauma from the perspectives of Sudanese-Australians. Grounded theory methodology was employed to extract themes from interviews with 15 Sudanese-Australians aged between 19 and 49 years. Results demonstrated four overarching themes: support, religion, strength and new possibilities. The data within these themes are compared and contrasted with previous literature that has examined notions of trauma, distress and growth in western populations. Conclusions drawn from these results highlight the need to build inclusive practices that support diversity into existing trauma services in Australia.
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There is a growing body of literature within social and cultural geography that explores notions of place, space, culture, race and identity. When health services in rural communities are explored using these notions, it can lead to multiple ways of understanding the cultural meanings inscribed within health services and how they can be embedded with an array of politics. For example, health services can often reflect the symbolic place that each individual holds within that rural community. Through the use of a rural health service case study, this paper will demonstrate how the physical sites and appearances of health services can act as social texts that convey messages of belonging and welcome, or exclusion and domination. They can also produce and reproduce power and control relations. In this way, they can influence the ways that Aboriginal people engage in health service environments – either as places where Aboriginal people feel welcome, comfortable, secure and culturally safe and happy to use the health service, or as places where they utilise the service provided with a great deal of effort, angst and energy. It is important to understand how these complex notions play out in rural communities if the health and wellbeing of Aboriginal people is going to be addressed.
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The travel and hospitality industry is one which relies especially crucially on word of mouth, both at the level of overall destinations (Australia, Queensland, Brisbane) and at the level of travellers’ individual choices of hotels, restaurants, sights during their trips. The provision of such word-of-mouth information has been revolutionised over the past decade by the rise of community-based Websites which allow their users to share information about their past and future trips and advise one another on what to do or what to avoid during their travels. Indeed, the impact of such user-generated reviews, ratings, and recommendations sites has been such that established commercial travel advisory publishers such as Lonely Planet have experienced a pronounced downturn in sales ¬– unless they have managed to develop their own ways of incorporating user feedback and contributions into their publications. This report examines the overall significance of ratings and recommendation sites to the travel industry, and explores the community, structural, and business models of a selection of relevant ratings and recommendations sites. We identify a range of approaches which are appropriate to the respective target markets and business aims of these organisations, and conclude that there remain significant opportunities for further operators especially if they aim to cater for communities which are not yet appropriately served by specific existing sites. Additionally, we also point to the increasing importance of connecting stand-alone ratings and recommendations sites with general social media spaces like Facebook, Twitter, and LinkedIn, and of providing mobile interfaces which enable users to provide updates and ratings directly from the locations they happen to be visiting. In this report, we profile the following sites: * TripAdvisor, the international market leader for travel ratings and recommendations sites, with a membership of some 11 million users; * IgoUgo, the other leading site in this field, which aims to distinguish itself from the market leader by emphasising the quality of its content; * Zagat, a long-established publisher of restaurant guides which has translated its crowdsourcing model from the offline to the online world; * Lonely Planet’s Thorn Tree site, which attempts to respond to the rise of these travel communities by similarly harnessing user-generated content; * Stayz, which attempts to enhance its accommodation search and booking services by incorporating ratings and reviews functionality; and * BigVillage, an Australian-based site attempting to cater for a particularly discerning niche of travellers; * Dopplr, which connects travel and social networking in a bid to pursue the lucrative market of frequent and business travellers; * Foursquare, which builds on its mobile application to generate a steady stream of ‘check-ins’ and recommendations for hospitality and other services around the world; * Suite 101, which uses a revenue-sharing model to encourage freelance writers to contribute travel writing (amongst other genres of writing); * Yelp, the global leader in general user-generated product review and recommendation services. In combination, these profiles provide an overview of current developments in the travel ratings and recommendations space (and beyond), and offer an outlook for further possibilities. While no doubt affected by the global financial downturn and the reduction in travel that it has caused, travel ratings and recommendations remain important – perhaps even more so if a reduction in disposable income has resulted in consumers becoming more critical and discerning. The aggregated word of mouth from many tens of thousands of travellers which these sites provide certainly has a substantial influence on their users. Using these sites to research travel options has now become an activity which has spread well beyond the digirati. The same is true also for many other consumer industries, especially where there is a significant variety of different products available – and so, this report may also be read as a case study whose findings are able to be translated, mutatis mutandis, to purchasing decisions from household goods through consumer electronics to automobiles.