Browsing by Subject "diffusion of innovation"

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    Mutually Reinforcing Relationships Between Bicycling and Infrastructure
    (2017-04) Schoner, Jessica
    Researchers have long sought evidence about whether dedicated bicycling infrastructure induces people to cycle, based on a supply-driven assumption that providing infrastructure causes the behavior change. However, supply inducing demand is only one of four theoretical relationships between bicycling and infrastructure. The aims of this research are twofold: 1. Develop a theoretical framework to identify and evaluate all of the possible relationships between bicycling and infrastructure and describe how these factors reinforce one another to shape diffusion of bicycling and infrastructure in cities; and 2. Develop and execute a research plan to empirically model selected hypotheses within the theoretical framework. The empirical portion of the dissertation tests the hypotheses that (1) bicycling infrastructure supply induces bicycling demand, and (2) bicycling demand induces additional demand. The research uses a series of cross-sectional tests at multiple points in time as well as lagged variable models to add a layer of temporal precedence to our otherwise cross-sectional understanding of associations between bicycling and infrastructure. The findings show persistent associations between infrastructure and bicycling over time, across geographies, and at both the individual and aggregate level. The association between bicycling and additional bicycling holds over time at the individual household level and for bike share membership. However, the tests failed to find evidence of bike share stations and activity affecting general population cycling rates. This dissertation provides a roadmap for future research into feedback loops between bicycling and infrastructure. It additionally provides practitioners with guidance on both the strengths and limitations of both infrastructure provision and socially-focused bicycling initiatives. Like most bicycling research, this dissertation is limited by the quality of data available for both bicycling behavior and infrastructure supply. Neither the data nor the tests performed are rigorous enough to infer causality; instead, the findings add strength and nuance to the existing body of literature.
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    “Until they know how much you care”: A qualitative analysis of an innovative practice in community pharmacy
    (University of Minnesota, College of Pharmacy, 2011) Melczak, Michael; Pringle, Janice
    Purpose: This qualitative study was concerned with investigating community pharmacists’ thoughts on the use of two brief scales to measure patient outcomes and therapeutic alliance in the context of their Medication Therapy Management (MTM) services. The scales were originally developed for use in behavioral healthcare, but were used in a novel (community pharmacy) setting as part of a previous parent study. We describe this practice (using these scales in a novel setting) as an innovative practice, report on the pharmacists’ experiences with the practice, and discuss relative advantages and disadvantages for integrating the use of the scales as part of routine practice. Methods: Six community pharmacy practitioners participated in a semi-structured interview pertaining to the use of the scales in their MTM services. Pharmacist interviews were transcribed, analyzed according to qualitative content analysis methodology, and presented in relation to the guiding interview questions. Results: Pharmacists had varying opinions on the use of the scales as part of their practice. Initial concerns included patient (mis)understanding about the purpose and proper completion of the scales, as well as apprehension about the use of the information. These concerns were largely resolved through education, repeated use, and routinization. Pharmacists, in general, saw a value to using these scales in clinical practice, for clinical and professional reasons, although there was variability on the degree to which pharmacists integrated the scales into practice after the study completion. Pharmacists had varied opinions as well as on the degree to which the use of the scales would impact medication adherence. Pharmacists were most surprised by how much participation in this study prompted them to reflect on their interactions with patients. Conclusions: Pharmacists, in general, were receptive to participating in the parent study and using two brief scales to measure patient outcomes and therapeutic alliance. Pharmacists had varying opinions on the degree to which the use of these scales could impact patient medication adherence, although they perceived other value and benefits secondary to the interactions. While most pharmacists did not maintain formal use of the scales after study end, they took away general principles of patient-centered care and individualized feedback.