Explaining system-level change in welfare governance: the role of policy indeterminacy and concatenations of social mechanisms

2020 ◽  
pp. 1-15
Author(s):  
Edoardo Ongaro ◽  
Francesco Longo
Keyword(s):  
Chronic Disease ◽  
Chronic Disease Management ◽  
Policy Design ◽  
Major Change ◽  
System Level ◽  
Change Processes ◽  
Social Mechanisms ◽  
Public Governance ◽  
Level Change

Abstract This paper argues that a certain level of indeterminacy in policy design may be a factor facilitating rather than hindering system-level change in welfare governance arrangements, provided it is combined with the triggering of specific concatenations of social mechanisms shaping the dynamics of the change process. The argument is illustrated by an analysis of a case of systemic change in chronic disease management occurred in the Italian region of Lombardy over 2016–2017, when a radically novel governance of chronic disease for the 10 million population was put in place (a health care system that was later tested to its limits by the COVID-19 pandemic outburst which reached dramatic intensity in this region). This represented a major change in a key area of social and health policy. We claim that such change processes may be studied by means of the conceptual tools of social mechanisms. The analysis of social mechanisms represents a lively research agenda for explaining change in public governance and public policy.

scholarly journals Influence Mechanism of The Affordances of Chronic Disease Management Apps on Continuance Intention: Mediating Role of Health Empowerment (Preprint)

2020 ◽  
Author(s):  
Yongmei Liu ◽  
Peiyang Lin ◽  
Fei Jiang
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Chronic Disease Management ◽  
Equation Modeling ◽  
Significant Positive Effect ◽  
Continuance Intention ◽  
Positive Effects ◽  
Health Empowerment ◽  
Positive Effect

BACKGROUND Mobile health apps are becoming increasingly popular, and they provide opportunities for effective health management. The existing chronic disease management (CDM) apps cannot meet users’ practical and urgent needs, and user adhesion is poor. Few, however, have investigated the factors that influence the continuance intention (CI) of CDM app users. OBJECTIVE Starting from the affordances of CDM apps, this study aimed to analyze how such apps can influence CI through the role of health empowerment (HE). METHODS Adopting a stimulus-organism-response framework, an antecedent model was established for CI from the perspective of perceived affordances, uses and gratifications theory, and HE. Perceived affordances were used as the “stimulus,” users’ gratifications and HE were used as the “organism,” and CI was used as the “response.” Data were collected online through a well-known questionnaire survey platform in China. 323 valid questionnaires were obtained. The theoretical model was tested using structural equation modeling. RESULTS Perceived connection affordances (PCA) were found to have significant positive effects on social interactivity gratification (SIG) (t=6.201, P<.001) and informativeness gratification (IG) (t=5.068, P<.001). Perceived utilitarian affordances (PUA) had significant positive effects on IG (t=7.029, P<.001), technology gratification (TG) (t=8.404, P<.001), and functions gratification (FG) (t=9.812, P<.001). Perceived hedonic affordances (PHA) had significant positive effects on FG (t=5.305, P<.001) and enjoyment gratification (EG) (t=13.768, P<.001). Five gratifications (t=2.767, P<.01; t=4.632, P<.001; t=7.608, P<.001; t=2.496, P<.05; t=5.088, P<.001) had significant positive effect on HE. SIG, IG, and FG had significant positive effects on CI. TG and EG had no significant effect on CI. HE had a significant positive effect on CI. HE and gratifications play mediating roles in the influence of affordances on CI. CONCLUSIONS HE and gratifications of users' needs are effective ways to promote CI. The gratifications of users' needs can realize HE and then inspire CI. Affordances are key antecedents that affects gratifications of users' needs, HE and CI.

Optimizing Self-Management of Diabetes and the Role of the Physiotherapist on an Interdisciplinary Chronic Disease Management Team

2018 ◽  
Vol 42 (5) ◽  
pp. S29
Author(s):  
Bonnie Doyle ◽  
Tara Jones ◽  
Laura Burchell ◽  
Jennifer Moore ◽  
Cindy Keith ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Chronic Disease Management ◽  
Management Team ◽  
Self Management

scholarly journals Social Support: a Key Variable for Health Promotion and Chronic Disease Management in Hispanic Patients with Rheumatic Diseases

2014 ◽  
Vol 7 ◽  
pp. CMAMD.S13849 ◽  
Author(s):  
Alyssa T. Brooks ◽  
Regina E. Andrade ◽  
Kimberly R. Middleton ◽  
Gwenyth R. Wallen
Keyword(s):  
Social Support ◽  
Health Promotion ◽  
Chronic Disease ◽  
Disease Management ◽  
Rheumatic Diseases ◽  
Chronic Disease Management ◽  
Family Members ◽  
Psychosocial Burden ◽  
Cross Sectional

Chronic diseases, including rheumatic diseases, can cause immense physical and psychosocial burden for patients. Many Hispanics suffering with arthritis face activity limitations. Social support, or the functional content of relationships, may be important to consider when examining treatment and outcomes for Hispanic individuals. Participants were recruited from an urban community health center (CHC) as part of a larger health behavior study. A cross-sectional, descriptive, mixed methods analysis was conducted to explore the role of social support in the sample. Only Hispanic/Latino patients (n = 46) were included in this analysis. Interviews were conducted in both English and Spanish. The majority of the sample (87%) perceived some presence of social support in their lives. The two most commonly cited types of social support were emotional and instrumental. The two most common sources of social support were family members other than spouses (52.2%) and spouses (32.6%). Body mass index (BMI) was significantly correlated with the number of perceived sources of support. The presence or absence and the role of social support in supporting optimal health outcomes should be considered for Hispanics with chronic rheumatic diseases. Involving family members and spouses in the plan of care for this population could facilitate health promotion and chronic disease management.

Transforming The Role Of Medical Assistants In Chronic Disease Management

2010 ◽  
Vol 29 (5) ◽  
pp. 963-965 ◽  
Author(s):  
Karen Nelson ◽  
Maria Pitaro ◽  
Andrew Tzellas ◽  
Audrey Lum
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Chronic Disease Management ◽  
Medical Assistants
Sign in / Sign up

Export Citation Format

Share Document