Tamara Dimitrijevska-Markoski – Public Administration Track
Dissertation Chair: Naim Kapucu
Dissertation Title: Use of Performance Information by Local Government Administrators: Evidence from Florida
This dissertation examines the factors that facilitate and hinder the use of performance information by public administrators in local governments in Florida. Acknowledging the incompleteness of many theoretical and conceptual models in previous performance management studies and the absence of theory on the use of performance information; this study utilizes a grounded theory approach to develop and test a model analyzing the use of performance information. The research focuses on cities and counties, members of the Florida Benchmarking Consortium (FBC), and surveys public administrators whose tasks are related with the collection and/or reporting of performance information. The study examines three research questions: First, to what extent and in what capacity do local government administrators use performance information? Second, what are the predictors of the use of performance information among local government administrators? Finally, to what extent does the design adequacy of a performance measurement system (PMS), institutionalization of performance measurement (IPM), organizational support (OS), individual factors (IF) and external influences (EI) impact the use of performance information among local government administrators?
Waleed M. Kattan – Health Services Mgmt. & Research Track
Dissertation Chair: Thomas Wan
Dissertation Title: Factors Influencing Hypoglycemia Care Utilizations and Outcomes Among Adult Diabetic Patients Admitted to Hospitals: A Predictive Model
Diabetes is the most prevalent chronic disease in the Central Florida and one of the common unpleasant consequences among people with diabetes is hypoglycemia (HG), where the level of blood glucose falls below the optimum level. HG is the second most common complication among diabetic patients in Central Florida. Episodes of HG vary in their severity, many require medical assistance, and are usually associated with higher utilizations of healthcare resources. Additionally, patients who experience HG frequently have poor outcomes such as higher rates for morbidities and mortality.
Although plenty of studies have been conducted to explore the risk factors associated with HG, most of these studies failed to establish a theoretical foundation and integrate a comprehensive list of personal risk factors. Therefore, this study aimed to employ Andersen’s health behavior model of health care utilization as a framework to examine the problems of HG. This holistic approach facilitates enumerating predictors and examining differential risks of the predisposing, enabling, and need-for-care factors influencing HG and their effects on utilization and outcomes.
Brandon Presley – Criminal Justice Track
Dissertation Chair: Kenneth Adams
Dissertation Title: Probation Officer Productivity: Using the Effort-Reward Imbalance Model
The purpose of this study was to determine the extent to which workplace efforts and rewards are associated with probation officer, stress health and productivity. This project used the effort-reward imbalance model on a subgroup of criminal justice; probation officers. The probation officers were asked to complete questionnaires regarding their perceptions of health, perceived reward, perceived effort, perceptions of overcommitment, and perceived productivity. Afterward, the responses were collected and analyses were conducted using correlation and multiple regression to determine the extent to which perceptions of effort, reward, and overcommitment effect probation officer productivity and health. The results suggest that perceptions of reward have a limited effect of perceived productivity. Furthermore, study found a significant relationship between higher levels of stress and perceptions of overcommitment. The study also found a significant relationship between perceptions of overcommitment and perceptions of reduced health. Finally, the study suggests that the interaction of effort-reward imbalance and overcommitment are correlated with perceptions of health decline. The results of the study demonstrate the perception among probation officers of being overworked and undercompensated. The results also support the need for improvements in organizational practice, so that efficiency and effectiveness can be maximized among probation officers.
Wanzhu Shi – Public Administration Track
Dissertation Chair: Tom Bryer
Dissertation Title: Social Media Stakeholders’ Relationship in Nonprofit Organizations
Social media tools have penetrated into nonprofit management field prevalently. The philanthropy industry hopes that social media tools could bring them the new opportunities to engage with their stakeholders. However, the studies of using social media strategically in nonprofit field are still at the infant stage. Many nonprofit practitioners are confused and questioning the effectiveness of adopting social media for civic engagement. Learning how to adopt it advantageously and helping nonprofit organizations to have more opportunities is critical.
This study uses a mix of methodology to examine whether social media tools could help nonprofit organizations to gain a stronger relationship with their stakeholders. The study is guided by social capital and social exchange theory to develop the theoretical framework. Data is collected directly from 200 art/culture/humanities nonprofit organizations’ social media platforms. The study conducted both regression analysis and content analysis to investigate the effective strategy could attract the online stakeholders and promote their engagement.
Madhu Shettian – Health Services Management and Research Track
Dissertation Chair: Dr. Thomas Wan
Dissertation Title: Determinants of Hospital Efficiency and Patient Safety in the United States
Hospitals engage in undertakings on a continual basis to enhance IT capabilities, diffusion of innovations, hospital-physician integration, and standardization to improve their performance. This empirical study explored the interdependence of three macro-level structural factors and their independent impact on the hospital performance measures efficiency and patient safety, with standardization as an important mediator. The researcher conducted a cross-sectional analysis of multiple data sets from public user files on the acute care hospital industry. The theoretical underpinnings of the study included the structure-process-outcome theory and institutional isomorphism theory. The statistical analysis comprised confirmatory factor analysis (CFA) and covariance structural equation modeling (SEM). The study comprised data for 2,352 acute care hospitals in the United States, which represented more than half of the hospital population. As expected by the hypotheses, the study demonstrated that IT capability, hospital-physician integration, and innovativeness directly affect the variability in standardization, but they did not directly influence the variation in hospital efficiency and patient safety. This revealed that hospitals should focus on standardization because it is the mediating process between structural variables and performance variables. The results indicated a strong negative influence of standardization on hospital efficiency and a weak positive influence on patient safety. The study confirmed the triadic model that “structure” influences process, which in turn influences organizational outcomes. As standardization through coercive, memetic, and normative pressure mechanisms becomes more common through system integration and increased collaborative governance, more research on how implementation of standards may perpetuate isomorphism or uniformity is imperative. The researcher recommends future studies to employ a longitudinal study design to explore the determinants of a variety of performance and outcome indicators, such as patient satisfaction, timeliness of care, effectiveness of care, and equity/financial performance in addition to patient safety and hospital efficiency.
Tina Yeung – Health Services Management & Research Track
Dissertation Chair: Thomas Wan
Dissertation Title: Local Health Department Adoption of Health Information Technology and Its Impact on Population Health
Since the enactment of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, our healthcare system has invested billions in building a health information technology (HIT) infrastructure that is secure, capable of the electronic transfer of data and allows for real-time access of patient medical data, among others. This empirical study explored the driving forces (coercive, mimetic, and normative) in the adoption of HIT (i.e. EHRs and HIEs) by local health departments (LHDs) and how it has impacted the population health of counties in the US. The researcher conducted a cross-sectional, quantitative study using secondary data sources from the 2008 and 2013 National Profile of Local Health Departments’ dataset (Profile Study), and the 2016 County Health Rankings dataset. The study included data on 505 local health departments and 433 counties’ population health data. Institutional theory guided this research and multiple statistical methods including generalized estimating equations, logistic regression, and multiple linear regression, was utilized to analyze health IT adoption by LHDs and its impact on county-level health outcomes.
Results showed that normative forces, as measured by the employment of IS specialists was most impactful in the adoption of both EHRs and HIEs. Mimetic forces, as measured by the completion of a CHA was statistically significant in predicting the adoption of EHRs but not HIEs, and coercive forces as measured by the implementation of the HITECH Act was not found to be statistically significant in the adoption of either EHRs or HIEs. Finally, EHR adoption was found to be statistically significant at improving population health at the county level.