Investigating smart city adoption from the citizen's insights: empirical evidence from the Jordan context

This study aims to investigate the factors that perceive citizens' intention to adopt smart city technologies in the Arab world. A self-administered questionnaire that included 312 end users as citizens in Amman, Jordan's capital city, was used in this study. This study uses advanced statistical techniques to test an expanded technology acceptance model (TAM) that incorporates the determinants of perceived usefulness, perceived ease of use, security and privacy, ICT infrastructure and inadequate Internet connectivity, social influence, and demographic profiles. Based on the results, perceived ease of use and ICT infrastructure and Internet connectivity showed positive association with the intention of citizens to adopt smart city services in Jordan. By recognizing the factors that predict citizens' adoption of smart city services, this study presents some theoretical implications and practical consequences related to smart city service adoption.

Parenting stress and children's trauma symptoms over the course of TF-CBT: Examining differences between relative and foster/adoptive caregivers

BACKGROUND

Through Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), the gold standard in children's trauma treatment, caregivers participate in sessions parallel to the child. However, much of the research examining the impact of this caregiver involvement has focused on biological or relative caregivers, despite the high prevalence of trauma and trauma symptoms among youth in foster care and high rates of parenting stress among foster/adoptive caregivers.

OBJECTIVE

The current study examined differences among relative and foster/adoptive caregivers' levels of parenting stress throughout the course of TF-CBT and how these differences were associated with child trauma symptoms throughout treatment.

PARTICIPANTS AND SETTING

Participants were 130 caregiver-child dyads (84 = foster/adoptive; 46 = biological/relative) who completed TF-CBT in either an academic-based clinic or an associated mental health agency. Providing clinicians were trained in TF-CBT, participated in case consultation, and received ongoing clinical supervision.

METHODS

Children and caregivers completed baseline measures prior to beginning treatment and termination measures at the completion of treatment.

RESULTS

Prior to treatment, foster/adoptive caregivers reported greater dysfunction in their parent-child interactions and relative caregivers reported greater personal stress. These differences were not seen at treatment termination, and significant reductions in child trauma symptoms and caregiver parenting stress were evidenced from pre to post treatment. Significant covariation between child trauma symptoms and relative caregiver parenting stress at termination was also found.

CONCLUSIONS

There were different profiles of parenting stress for relative versus foster/adoptive caregivers, but treatment completion attenuated group differences in parenting stress over the course of treatment.

The influence of strong and weak ties in physician peer networks on new drug adoption

Physicians interact and exchange information through various social networks. Understanding peer effects through different networks can help accelerate new medical technology and innovative treatment adoption. In this research, we measure the influence of strong-tie and weak-tie connections on new drug adoption and study the overlap between advice-discussion and patient-sharing network. We construct two physician networks with strong and weak ties from peer nomination surveys and commercial medical claims data. We design a dynamic system to define peer adoption status and build patient-level hierarchical logistic models to measure the peer influence on new product adoption for treating new-to-therapy patients. Our results show that A strong-tie early adoption peer has six times more influence on new drug adoption than a weak-tie peer. Weak tie peers collectively exert as much or higher influence than strong-tie peers because of the larger network size. In the case of inaccessibility to strong-tie data, researchers can still reliably use the influence of the weak tie data only even though they will lose the effect of the omitted strong ties.

Varietal turn-over and their effect on yield and food security - Evidence from 20 years of household surveys in Kenya

Agricultural technology is key to food security in SSA, but new maize varieties are not able to replace the old, trusted ones. This study uses data from four representative household surveys conducted in Kenya over 21 years, to show that younger maize varieties have a clear, although limited, effect on yield (4 kg/ha/year controlling for fertilizer) and food security. Unfortunately, this is not sufficient to entice farmers to adopt them, and adoption rates have barely increased despite the market liberalization that brought many private seed companies and their varieties in the market, as the parastatal Kenya Seed Company continues to dominate the market. As a result, in combination with low fertilizer use, yields have stagnated for the last three decennia.

Agroecology-specific varietal matching to achieve self-sufficiency in wheat production in Ethiopia

Agroecology-specific variety selection helps to account site and plot level biophysical conditions, farmers' wisdom and local environmental aspects, which in turn enhances crop productivity. This study demonstrated the importance of an agroecology-specific improved wheat variety in achieving national wheat self-sufficiency. The study involved randomly selected 235 farming households in Central Highlands of Ethiopia who grew four improved varieties (Hidase, Danda'a, Kakaba, Kubsa) along with local cultivars. Descriptive, trend, inequality and regression analyses were used to analyze the data and a scenario analysis was employed to forecast the nation's wheat self-sufficiency. The results showed that nearly 72% of farmers adopted either of the improved wheat varieties, and the majority of households (34.04%) adopted Hidase variety. The adoption of agroecology-specific improved wheat variety (Hidase) enabled farmers to obtain an average yield of 4.29 t/ha and this yield surpassed Danda'a, Kakaba, Kubsa and the local cultivar with a yield advantage of 19.4%, 130.6%, 138.3%, and 167.5%, respectively. It also excelled the national wheat yield (2.77 t/ha) by 54.4%. Because of increased productivity, the marketed portion from Hidase variety approached to 57.9%, and this is significant and by far large as compared to the national marketed average of 21.9%. Yield inequality among adopters also narrowed as compared to the local variety growers. Thus, agroecology-specific improved variety is a worthy strategy to consider to address productivity, marketed volume and yield inequality concerns concomitantly. If Ethiopia promotes agroecology-specific improved wheat varietal recommendation, the country could produce a maximum of 8.13 million tons per year and a minimum of 7.05 million tons of wheat, with an average scenario of 7.47 million tons, which in all cases are above the annual consumption demand of the country (6.4 million tons in 2018/19), and thus enabling the country to be self-sufficient in wheat production.

What Factors Explain Low Adoption of Digital Technologies for Health Financing in an Insurance Setting? Novel Evidence From a Quantitative Panel Study on IMIS in Tanzania

BACKGROUND

Digital information management systems for health financing are implemented on the assumption thatdigitalization, among other things, enables strategic purchasing. However, little is known about the extent to which thesesystems are adopted as planned to achieve desired results. This study assesses the levels of, and the factors associated withthe adoption of the Insurance Management Information System (IMIS) by healthcare providers in Tanzania.

METHODS

Combining multiple data sources, we estimated IMIS adoption levels for 365 first-line health facilities in2017 by comparing IMIS claim data (verified claims) with the number of expected claims. We defined adoption as abinary outcome capturing underreporting (verified

RESULTS

We found a median (interquartile range [IQR]) difference of 77.8% (32.7-100) between expected and verifiedclaims, showing a consistent pattern of underreporting across districts, regions, and months. Levels of underreportingvaried across regions (ANOVA: F=7.24, P<.001) and districts (ANOVA: F=4.65, P<.001). Logistic regression resultsshowed that higher service volume, share of people insured, and greater distance to district headquarter were associatedwith a higher probability of underreporting.

CONCLUSION

Our study shows that the adoption of IMIS in Tanzania may be sub-optimal and far from policy-makers'expectations, limiting its capacity to provide the necessary information to enhance strategic purchasing in the healthsector. Countries and agencies adopting digital interventions such as openIMIS to foster health financing reform areadvised to closely track their implementation efforts to make sure the data they rely on is accurate. Further, our studysuggests organizational and infrastructural barriers beyond the software itself hamper effective adoption.

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Key Words

• Adoption
• Digital Health Intervention
• Health Financing
• Health Insurance
• Strategic Purchasing
• Tanzania

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MESH Headings

• Humans
• Tanzania
• Healthcare Financing
• Digital Technology
• Insurance, Health
• Universal Health Insurance

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Health Care and Adoption Service Experiences of People Who Placed Children for Adoption During Adolescence: A Qualitative Study

STUDY OBJECTIVE

To understand the perspectives of people who placed children for adoption during adolescence DESIGN: We conducted qualitative interviews with adults who placed children for adoption during adolescence. We recruited participants through social media and two adoption-related organizations. We audio-recorded and transcribed interviews. Using thematic analysis, 2 investigators coded the transcripts and identified themes.

SETTING

Telephone interviews PARTICIPANTS: Adults ages 18-35 years old who placed children for adoption before they were 20 years old INTERVENTIONS: Semi-structured telephone interviews MAIN OUTCOME MEASURES: Qualitative data RESULTS: We conducted interviews with 18 individuals (median age of 32 years; range 21-35 years). The median age at pregnancy was 18 years (range 13-19 years). Seventeen participants identified as female and one as nonbinary. Themes included the following: (1) Negative experiences with counseling included limited empowerment to make choices about pregnancy or adoption options; (2) negative experiences with counseling included limited information about practical or financial support for pregnant adolescents; (3) negative experiences with the health care system included insensitivity or lack of awareness of the adoption plan at delivery; (4) positive experiences with counseling included comprehensive unbiased options counseling and adoption counseling emphasizing birth parent choice in openness and family placement; (5) positive experiences included longitudinal emotional support during pregnancy, particularly in ways that normalized adoption placement; and (6) participants desired therapy and/or psychological support following adoption placement.

CONCLUSIONS

Individuals who chose adoption after adolescent pregnancy described positive and negative encounters with health care and adoption professionals that could serve as targets to improve the overall care experience for this population.

Evaluating adoption of climate smart agricultural practices among farmers in the Fujian Province, China

This study examined the adaptation level of climate-smart agricultural (CSA) practices among the farmers and the factors influencing the adoption of CSA practices in the Fujian Province, China. In this study, questionnaire survey data was analyzed, and 600 respondents were randomly selected as sample through randomly sampling technique. Descriptive statistics, adoption level index (ALI), and binary logit model were used for data analyses. These results indicated a moderate adoption level of CSA practices in the Fujian Province. Use of improved varieties, conservation tillage, fallow cropping, new technology, and intercropping were prevalent CSA practices among the farmers in the study area. In addition, farmers were not very interested in using herbicides on their farmlands, and only 20% of the respondents used herbicides in the Fujian Province. Except for Nindge village in the Fujian Province, all other studied villages have adapted to using organic fertilizer (around 50% of total respondents). However, more than 60% of respondents have claimed they still use chemical weed/insect/disease control in their farmlands. Age and working experience of farmers were the most influencing factors affecting the increase in the adoption of CSA practices among the farmers, and to the results of the binary logit model, education was not significant. Landholding, loan access, and access to agricultural extensions and organizations considerably impacted the adoption level of CSA practices among the farmers in the Fujian Province. Finally, this study will be helpful to decision-makers to make appropriate decisions to minimize the impact of climate change on agriculture and improve the standard of human life and food security.

Implementation and scaling-up of an effective mHealth intervention to increase adherence to triage of HPV-positive women (ATICA study): perceptions of health decision-makers and health-care providers

BACKGROUND

The ATICA study was a Hybrid I type randomized effectiveness-implementation trial that demonstrated effectiveness of a multicomponent mHealth intervention (Up to four SMS messages sent to HPV-positive women, and one SMS message to CHWs to prompt a visit of women with no triage Pap 60 days after a positive-test), to increase adherence to triage of HPV positive women (ATICA Study). We report data on perceptions of health decision-makers and health-care providers regarding the intervention implementation and scaling-up.

METHODS

A qualitative study was carried out based on individual, semi-structured interviews with health decision-makers (n = 10) and health-care providers (n = 10). The themes explored were selected and analyzed using domains and constructs of the Consolidated Framework for Implementation Research (CFIR) and the maintenance dimension of the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework.

RESULTS

Both health-care providers and decision-makers had a positive assessment of the intervention through most included constructs: knowledge of the intervention, intervention source, design quality, adaptability, compatibility, access to knowledge and information, relative advantage, women's needs, and relative priority. However, some potential barriers were also identified including: complexity, leadership engagement, external policies, economic cost, women needs and maintenance. Stakeholders conditioned the strategy's sustainability to the political commitment of national and provincial health authorities to prioritize cervical cancer prevention, and to the establishment of the ATICA strategy as a programmatic line of work by health authorities. They also highlighted the need to ensure, above all, that there was staff to take Pap tests and carry out the HPV-lab work, and to guarantee a constant provision of HPV-tests.

CONCLUSION

Health decision-makers and health-care providers had a positive perception regarding implementation of the multicomponent mHealth intervention designed to increase adherence to triage among women with HPV self-collected tests. This increases the potential for a successful scaling-up of the intervention, with great implications not only for Argentina but also for middle and low-income countries considering using mHealth interventions to enhance the cervical screening/follow-up/treatment process.

Profiles of Adoptee Adjustment in Young Adulthood

The developmental stage of young adulthood, the period from one's late twenties through thirties, has grown in attention and research focus among general populations. However, little is known about the adjustment of adopted individuals during this phase. The present study sought to expand our understanding of the various patterns of adoptee adjustment in young adulthood. Latent profile analysis was used to identify profiles across eight domains of functioning spanning physical and mental health to relationships, achievement, and engagement. Three profiles were identified, demonstrating varying levels of adult functioning. Adoption related and non-adoption related variables were explored using a series of multinomial logistic regressions to determine which factors differentiated between profiles. It appears that, although some adoption related variables remain significant in young adulthood, non-adoption related variables are more strongly linked to adoptee adjustment at this developmental stage. Implications and future directions for clinical care and research are discussed.

Factors associated with the adoption of evidence-based innovations by substance use disorder treatment organizations: A study of HIV testing

INTRODUCTION

Though prior research shows that a range of important regulatory, market, community, and organizational factors influence the adoption of evidence-based practices (EBPs) among health care organizations, we have little understanding of how these factors relate to each other. To address this gap, we test a conceptual model that emphasizes indirect, mediated effects among key factors related to HIV testing in substance use disorder treatment organizations (SUTs), a critical EBP during the US opioid epidemic.

METHODS

We draw on nationally representative data from the 2014 (n = 697) and 2017 (n = 657) National Drug Abuse Treatment System Survey (NDATSS) to measure the adoption of HIV testing among the nation's SUTs and their key organizational characteristics; we also draw on data from the US Census Bureau; Centers for Disease Control; and legislative sources to measure regulatory and community environments. We estimate cross-sectional and longitudinal structural equation models (SEM) to test the proposed model.

RESULTS

Our longitudinal model of the adoption of HIV testing by SUTs in the United States identifies a pathway by which community and market characteristics (rurality and the number of other SUTs in the area) are related to key sociotechnical characteristics of these organizations (alignment of clients, staff, and harm-reduction culture) that, in turn, are related to the adoption of this EBP.

CONCLUSIONS

Results also show the importance of developing conceptual models that include indirect effects to account for organizational adoption of EBPs.

Facial emotion recognition in adopted children

Children adopted from public care are more likely to experience emotional and behavioural problems. We investigated two aspects of emotion recognition that may be associated with these outcomes, including discrimination accuracy of emotions and response bias, in a mixed-method, multi-informant study of 4-to-8-year old children adopted from local authority care in the UK (N = 42). We compared adopted children's emotion recognition performance to that of a comparison group of children living with their birth families, who were matched by age, sex, and teacher-rated total difficulties on the Strengths and Difficulties Questionnaire (SDQ, N = 42). We also examined relationships between adopted children's emotion recognition skills and their pre-adoptive histories of early adversity (indexed by cumulative adverse childhood experiences), their parent- and teacher-rated emotional and behavioural problems, and their parents' coded warmth during a Five Minute Speech Sample. Adopted children showed significantly worse facial emotion discrimination accuracy of sad and angry faces than non-adopted children. Adopted children's discrimination accuracy of scared and neutral faces was negatively associated with parent-reported behavioural problems, and discrimination accuracy of angry and scared faces was associated with parent- and teacher-reported emotional problems. Contrary to expectations, children who experienced more recorded pre-adoptive early adversity were more accurate in identifying negative emotions. Warm adoptive parenting was associated with fewer behavioural problems, and a lower tendency for children to incorrectly identify faces as angry. Study limitations and implications for intervention strategies to support adopted children's emotion recognition and psychological adjustment are discussed.

Usage of a workplace health promotion app: an evaluation of app usage data and medical check-up results

Smartphone applications (apps) have been used and evaluated in the context of workplace health promotion (WHP) programs. However, there is a lack of studies analyzing actual app usage data and measuring changes in medical markers to evaluate the effectiveness of WHP apps in terms of health improvements in practice. In this study, we evaluated data from 555 employees of an IT company who participated in a WHP program over the course of one year. Participants of the program received a medical check-up as well as a health app to understand their medical results and receive advice for a healthier lifestyle. In addition, 99 of these employees underwent a follow-up medical check-up. It was found that the smartphone app for healthy lifestyle promotion in combination with onsite medical check-ups was effective in improving various health indicators, for example, BMI, body fat, blood pressure and triglycerides. The study further identified influence factors for sustained app usage, and analyzed different usage behaviors among gender and age groups.

"Adoption is just not for me": How abortion patients in Michigan and New Mexico factor adoption into their pregnancy outcome decisions

Objectives

In public discourses in the United States, adoption is often suggested as a less objectionable, equal substitute for abortion, despite this pregnancy outcome occurring much less frequently than the outcomes of abortion and parenting. This qualitative study explores whether and how abortion patients weighed adoption as part of their pregnancy decisions and, for those who did, identifies factors that contributed to their ultimate decision against adoption.

Study design

We interviewed 29 abortion patients from 6 facilities in Michigan and New Mexico in 2015. We conducted a thematic analysis using both deductive and inductive approaches to describe participants' perspectives, preferences, and experiences regarding the consideration of adoption for their pregnancy.

Results

Participants' reasons why adoption was not an appropriate option for their pregnancy were grounded in their ideas of the roles and responsibilities of parenting and fell into three themes. First, participants described continuing the pregnancy and giving birth as inseparable from the decision to parent. Second, choosing adoption would represent an irresponsible abnegation of parental duty. Third, adoption could put their child's safety and well-being at risk.

Conclusions

Adoption was not an equally acceptable substitute for abortion among abortion patients. For them, adoption was a decision that represented taking on, and then abdicating, the role of parent. This made adoption a particularly unsuitable choice for their pregnancy.

Implications

Rhetoric suggesting that adoption is an equal alternative to abortion does not reflect the experiences, preferences, or values of how abortion patients assess what options are appropriate for their pregnancy.

Country- and app-level factors affecting the adoption and evaluation of COVID-19 mobile apps

BACKGROUND

Countries across the globe have released many COVID-19 mobile apps. However, there is a lack of systematic empirical investigation into the factors affecting the adoption and evaluation of COVID-related apps. This study explores what factors at the country level and the app levels would influence the adoption and evaluation of COVID-19 apps.

METHODS

We collected data on 267 COVID-19 apps in App Store and Google Play. The number of installs, ratings, reviews and rating scores were used as indicators of adoption and evaluation. Country-level predictors include the number of infected cases and the political system (i.e., democratic vs. non-democratic). App-level predictors include developer (i.e., government vs. non-government) and functions. Four app functions were coded for analysis: providing health information, contact tracing, home monitoring, and consultation. Negative binomial regression and OLS (Ordinary Least Square) regression were used to analyze the data.

RESULTS

Our analyses show that apps developed by countries with more infected cases (B = 0.079, CI (Confidence Interval) = 0.000, 0.158; P = .049) and by non-governmental institutions (B=-0.369, CI=-0.653, -0.083; P = .01) received more positive rating scores. Apps with home monitoring function received lower rating scores (B=-0.550, CI=-0.971, -0.129; P = .01). Regarding adoption, apps developed by governments were more likely to be installed (IRR (Incident Rate Ratio) = 8.156, CI = 3.389, 19.626; P < .001), to be rated (IRR = 26.036, CI = 7.331, 92.468; P < .001), and to receive user comments (IRR = 12.080, CI = 3.954, 37.568; p < .001). Apps with functions of contact tracing or consultation were more likely to be installed (IRR = 4.533, CI = 2.072, 9.918; p < .001; IRR = 4.885, CI = 1.970, 12.111; p < .001), to be rated (IRR = 11.634, CI = 3.486, 38.827; p < .001; IRR = 17.194, CI = 5.309, 55.680; p < .001), and to receive user comments (IRR = 5.688, CI = 2.052, 5.770; p < .001; IRR = 16.718, CI = 5.363, 52.113; p < .001). Apps with home monitoring functions were less likely to be rated (IRR = 0.206, CI = 0.047, 0.896; P = .04) but more likely to receive user comments (IRR = 3.874, CI = 1.044, 14.349; P = .04). Further analysis shows that apps developed in democratic countries (OR (Odd Ratio) = 3.650, CI = 1.238, 10.758; P = .02) or by governments (OR = 7.987, CI = 4.106, 15.534, P < .001) were more likely to include the function of contact tracing.

CONCLUSION

This study systematically investigates factors affecting the adoption and evaluation of COVID-19 apps. Evidence shows that government-developed apps and the inclusion of contact tracing and consultation app functions strongly predict app adoption.

Psychological predictors of consumer-level virtual reality technology adoption and usage

In recent years, virtual reality (VR) technology has been mainstreamed for at-home use, with various consumer-oriented devices released by media firms such as Meta, Google, Samsung, and HTC. The present research investigates the role of psychological traits-including immersive tendencies, absorption, sensation seeking, need for cognition, neophobia, and belief in science-as well as trait levels of individual innovativeness, self-perception of social well-being, and owner demographics, in predicting VR adoption rates and sustained use over time. Separate analyses were conducted for different classes of VR device (fixed, mobile, and standalone devices). In general, psychological factors generally emerged as more determinative of adoption than did demographics. Users' immersive tendencies predicted earlier adoption of VR technology while absorption was associated with later adoption, with both predictive of higher overall initial usage of different types of devices. Additionally, perceiving oneself as socially successful was associated with higher initial VR usage, while a tendency to see one's emotions as influenced by in-person rather than online contacts was negatively associated with usage. Finally, belief in science predicted greater consistency in usage over time while higher levels of absorption were associated with unstable usage patterns. These findings expand upon the limited work previously investigating the role of individual differences in adoption of VR and mark the promise of psychometrics for understanding the diffusion and continued usage of consumer-facing VR devices.

Family, twin and adoption studies of severe mental disorders in sub-Saharan Africa: a scoping review

PURPOSE

The traditional genetic epidemiological studies are necessary to improve accurate risk communication to service users and their families. This scoping review aimed to describe the volume and scope of existing research evidence on family, twin and adoption studies of severe mental disorders (SMDs) in SSA. This is with a view to identifying gaps in the literature and the adequacy of data for a systematic review and meta-analysis.

METHODS

Literature search was done for all original peer-reviewed research articles on the topic in SSA using PubMed and MEDLINE. Publications included were peer-reviewed original articles, irrespective of their quality, carried out in the region from the 1970s till 9th March, 2022, which were available in English or translated to English. Case reports, abstracts, and studies among populations living outside the region were excluded.

RESULTS

A total of five studies that met the inclusion criteria across the 46 countries in the region were identified. Of the three thematic areas of focus, only family studies on SMDs had research work in SSA. These studies provided evidence of familial clustering of SMDs in SSA. There were no twin and adoption studies on SMDs in the region. However, the review noted the establishment of two twin registries in Guinea-Bissau and Nigeria. A huge gap exists in the area of twin and adoption studies on SMDs in SSA.

CONCLUSION

The volume of research evidence on traditional family genetic studies of SMDs is grossly inadequate to consider a systematic review in SSA. We have suggested studies to remedy the situation.

How a steeper organisational hierarchy prevents change-adoption and implementation of a sustainable employability intervention for employees in low-skilled jobs: a qualitative study

BACKGROUND

Adoption and implementation are prerequisites for the effectiveness of organisational interventions, but successful implementation is not self-evident. This article provides insights into the implementation of the organisational intervention 'Healthy Human Resources' (HHR). HHR is developed with Intervention Mapping and aims at improving sustainable employability (SE) of employees in low-skilled jobs.

METHODS

Qualitative data on adoption and implementation were collected by interviews with three employees and seven middle managers in five Dutch organisations and by extensive notes of observations and conversations in a logbook. Data triangulation was applied and all data were transcribed and analysed thematically using the qualitative analysis guide of Leuven (QUAGOL).

RESULTS

All organisations adopted HHR, but three failed during the transition from adoption to implementation, and two implemented HHR only partially. The steepness of the organisational hierarchy emerged as an overarching barrier: steeper hierarchical organisations faced more difficulties with implementing HHR than flatter ones. This was reflected in middle managers' lack of decision-making authority and being overruled by senior management. Middle managers felt incapable of remedying the lack of employees' voice. Subsequently, 'us-versus-them' thinking patterns emerged. These power imbalances and 'us-versus-them' thinking reinforced each other, further strengthening the hierarchical steepness. Both processes could be the result of wider socio-political forces.

CONCLUSIONS

This study improved the understanding of the difficulties to adopt and implement such organisational intervention to contribute to the sustainable employability of employees in low-skilled jobs. Practical implications are given for future implementation of organisational interventions.

Factors influencing adoption of e-learning in healthcare: integration of UTAUT and TTF model

BACKGROUND

The importance of successful implementation of e-learning, especially since the emergence of the Covid-19 pandemic, has become increasingly apparent to universities. Thus, identifying the effective factors in adopting e-learning in the Covid-19 pandemic is crucial. This study was conducted to identify determining factors in adopting E-learning in healthcare.

METHOD

This was a descriptive-analytical study in which 143 faculty members from Iran were randomly selected. The faculty members' intentions, concerning the adoption of e-learning, were assessed by the conceptual path model of integration of unified theory of acceptance and use of technology (UTAUT) and The Task-Technology Fit (TTF).

RESULTS

The results showed that the combination of the two classical theories, UTAUT and TTF, was an appropriate model to explain faculty members' intention in adopting e-learning. Moreover, the findings showed that technology and task characteristics, task- technology fit, social influences, effort expectancy, performance expectancy and facilitating conditions had direct and significant effect on e-learning adoption.

CONCLUSION

By presenting a conceptual path model to elucidate users' behavior in adopting e-learning, this study investigated and identified the key determining factors in adopting e-learning. The findings of the present study can contribute to the design and implementation of e-learning by practitioners, policy makers, and curriculum designers.

Furthering climate-smart farming with the introduction of floating agriculture in Bangladeshi wetlands: Successes and limitations of an innovation transfer

Although floating farming, a climate-smart practice, is a response to climate change challenges facing agriculture in wetland areas, the adoption of floating agriculture in Bangladesh wetland areas (also known as Haor) is slow. The purpose of our study was to identify the factors that motivate and barriers that inhibit the adoption of floating agriculture in the Haor region in Bangladesh's Kishoreganj district. To achieve our purpose, we used Roger's five-stage innovation-decision theory. We collected data from a sample of 120 Haor rural farmers using a quantitative questionnaire answered via a personal interview. We used a binary logistic regression to identify the factors that predict farmers' motivational actions in adopting floating agriculture. In addition, we rank ordered the data to identify the obstacles that prohibit farmers from implementing floating agriculture. The results demonstrate that education, training related to floating agriculture, credit received, communication behavior, trialability and observability, and complexity in practicing floating agriculture motivate farmers to adopt floating agriculture. The results also show that climatic factors (e.g., high waves and excessive rainfall, aquatic plant scarcity) and non-climatic factors (e.g., inadequate demonstration plots, conflict, and political power abuse) inhibit adoption of floating agriculture. Our study provides suggestions for increasing farmers' adoption of floating agriculture in wetland areas.

A meta-analysis of agricultural conservation intentions, behaviors, and practices: Insights from 35 years of quantitative literature in the United States

Conservation practices (CPs) are integral to maintaining the long-term viability of agro-ecological systems. Because farming systems and farmers' values and attitudes are heterogeneous, factors that consistently predict conservation behaviors remain elusive. Moreover, heterogeneity is present among studies regarding the type of CPs examined, and whether behavioral intentions or actual behaviors were measured. This study considers the characteristics of each CP, and whether a given study measured behavioral intention or actual behavior, to better understand farmers' adoption of CPs. We reviewed and analyzed 35 years (1982-2017) of quantitative conservation adoption literature in the United States. We categorized CPs based on their primary purpose, the type of benefit they provide, and whether they are operational or structural. We also examined the following five CPs: conservation tillage, buffers or borders, soil testing, grassed waterways, and cover crops. In our behavioral intention and actual behavior analysis, we found that attitudinal factors predicted both conservation intention and action (actual behavior), whereas current or previous use of practices only influenced actions, not stated conservation intentions. In our analysis focusing on CP characteristics, we found that having specific knowledge about and positive attitudes toward the CP, adoption of other CPs, seeking and using information, larger farm size, and vulnerable land predicted actual adoption across nearly all CP categorizations. Nuances emerge when comparing predictors of CPs that share a particular characteristic. For example, we found farm characteristics to be comparatively more important in predicting adoption of soil management CPs than nutrient and livestock management CPs, and farmers' stewardship identity to be more important for permanent practices than operational practices.

Understanding the process of meanings, materials, and competencies in adoption of mobile banking

COVID-19 has changed the way people live, bank, shop, and work by moving them toward digitalization. It has also driven the trend toward a cashless society, and this change has taken place in an increasingly uncertain and fearful environment. This study explores the social practice of mobile banking (MB) adoption during the global COVID-19 pandemic. Data were collected from banking customers and managers using online customer reviews, semi-structured interviews, and focus groups to develop an in-depth understanding of the subjective realities of their use of MB. This approach also ensured that social distancing practices were maintained during interviews conducted during the COVID-19 outbreak. Analysis of the data suggests that social media, social circles, family members, and teams of customer service agents play an important role in developing the social practice of MB. This study culminates in the presentation of the social practice of MB adoption (SPOTA) framework. This framework is based on extended social practice theory in the context of MB adoption. The study discusses the practical implications of the findings for systems developers. The many expectations of people with or without disabilities of MB are discussed and the findings could be used to improve the accessibility and habitual practice of MB adoption.

Advancing Pharmacological Treatments for Opioid Use Disorder (ADaPT-OUD): an Implementation Trial in Eight Veterans Health Administration Facilities

BACKGROUND

Identifying effective strategies to improve access to medication treatments for opioid use disorder (MOUD) is imperative. Within the Veterans Health Administration (VHA), provision of MOUD varies significantly, requiring development and testing of implementation strategies that target facilities with low provision of MOUD.

OBJECTIVE

Determine the effectiveness of external facilitation in increasing the provision of MOUD among VHA facilities with low baseline provision of MOUD compared to matched controls.

DESIGN

Pre-post, block randomized study designed to compare facility-level outcomes in a stratified sample of eligible facilities. Four blocks (two intervention facilities in each) were defined by median splits of both the ratio of patients with OUD receiving MOUD and number of patients with OUD not currently receiving MOUD (i.e., number of actionable patients). Intervention facilities participated in a 12-month implementation intervention.

PARTICIPANTS

VHA facilities in the lowest quartile of MOUD provision (35 facilities), eight of which were randomly assigned to participate in the intervention (two per block) with twenty-seven serving as matched controls by block.

INTERVENTION

External facilitation included assessment of local barriers/facilitators, formation of a local implementation team, a site visit for action planning and training/education, cross-facility quarterly calls, monthly coaching calls, and consultation.

MAIN MEASURES

Pre- to post-change in the facility-level ratio of patients with an OUD diagnosis receiving MOUD compared to control facilities.

KEY RESULTS

Intervention facilities significantly increased the ratio of patients with OUD receiving MOUD from an average of 18% at baseline to 30% 1 year later, with an absolute difference of 12% (95% confidence interval [CI]: 6.6%, 17.0%). The difference in differences between intervention and control facilities was 3.0% (95% CI: - 0.2%. 6.7%). The impact of the intervention varied by block, with smaller, less complex facilities more likely to outperform matched controls.

CONCLUSIONS

Intensive external facilitation improved the adoption of MOUD in most low-performing facilities and may enhance adoption beyond other interventions less tailored to individual facility contexts.