General Positive Attitude Research Articles

DOES CAREGIVING HASTEN AGING? EXPLORING THE LINK BETWEEN TRIPLE-DUTY CAREGIVERS’ TRANSITIONS AND SUBJECTIVE AGE

Abstract Perceptions of aging serve as crucial indicators for evaluating positive aging. This study examines the relationship between various caregiving transition types and subjective aging over time. Utilizing data from the 2018 and 2020 waves of the China Longitudinal Aging Study, we examine six transition types, incorporating both intra- and extra-familial caregiving behaviors, by constructing three subjective aging change patterns: “Consistent over time”, “Accelerated growth”, and “Relative decline”. The findings reveal that sustained caregiving is associated with a relative decline in subjective age, with a more pronounced effect observed in the reduction of ongoing extramural caregiving. Caregiver role transitions, such as exiting caregiving and transitioning between intra- and extra-familial caregiving, lead to an accelerated increase in subjective age, while entering caregiving aligns subjective age with the passage of time. In the context of caregiving role transitions, a positive self-perception of aging enhances the subjective age of female caregivers, whereas a positive general aging attitude reduces the subjective age of male caregivers. The study underscores the significance of caregiving experiences as crucial predictive factors for subjective aging. Establishing comprehensive family support policies throughout the caregiving lifecycle, promoting voluntary caregiving participation, can contribute to enhancing adaptive aging

Attitudes of Engineering Students towards English Courses at Jadara University in Jordan

English is a crucial language for students to communicate effectively in various aspects of their lives, including study, work, and social interactions. In developing countries, English serves as a second language to overcome language barriers and facilitate international communication. Engineering students need to develop verbal and written communication skills for their profession. English's global spread is influenced by historical, social, cultural, and economic factors. It is now the primary international language. English plays a significant role in the development of communication technological advances, and engineering students have increased exposure to technological English. However, current college methodologies do not adequately address students' communicative needs during their English degree in Jordan.Objective: This study explored the attitudes of engineering students at Jadara University in Jordan towards English courses.Methods: A survey was conducted to gather quantitative data, and statistical analysis, both descriptive and inferential, was employed to interpret the findings.Results: The results revealed a general positive attitude towards the importance of English proficiency, although various factors such as course content, teaching methods, and perceived relevance to the engineering field influenced student perceptions.Conclusions: Recommendations for curriculum improvement and teaching strategies are provided based on the study's findings.

A cross-specialization study of pre-service teachers’ perception of STEM education

ABSTRACT This article investigates STEM education perceptions among pre-service teachers from various specialties at a pedagogical university in Ukraine, highlighting its role in addressing socio-economic and environmental challenges of the country. The study aims to understand how pre-service teachers from various specialties view the integration of STEM into their professional activity. Key findings indicate that while there is a general positive attitude towards STEM education, significant variations exist across different specialties. Pre-service teachers of the ‘Science’ and ‘Early Childhood and Primary Education’ categories demonstrate higher engagement with STEM-oriented tasks compared to those in the ‘Arts and Humanities’ and ‘Social Sciences’ categories. The research reveals a gap in pre-service teachers’ understanding of STEM's interdisciplinary nature, often associating it primarily with technological innovations. The study identifies several barriers to the effective implementation of STEM education, including limited resources, insufficient knowledge of teachers, and a lack of appropriate teaching materials. To address these challenges, the article suggests enhancing STEM courses, providing professional development for teachers, and fostering collaboration with industry. Overall, the research underscores the importance of aligning STEM education with the needs and perceptions of pre-service teachers, emphasising its role in developing critical skills for future educators and contributing to Ukraine's recovery.

COVID-19 Pandemic: Perception and Psychological Impact of COVID-19 Among Medical Students 2021- 2022, Sudan

<i>Introduction</i>: COVID-19 is highly infectious disease with air-borne based transmissibility, quick spread causes global pandemic. Impacted in medical education specially, medical student is more susceptible to infection due to their position as students and in training, their understanding of illness is essential for both their safety and reassuring information in their families and communities. <i>Objectives</i>: This study aimed to assess COVID-19 related perception and practice among medical students at Alzaiem Alazhari University, and their psychological response during outbreak. Methods: Descriptive cross-sectional study was done among 277 participants of medical students at Alzaiem Alazhari University in Khartoum, Sudan, using electronic structural questionnaire by google form. <i>Results</i>: 153 of participants are female (55.2%). 50.2% ageing 19-21years. 22.7% think older adults not vaccinated are the most susceptible to get infected. 71.8% of participants think it is a serious and life threatening. 33.9% of participants get their information from social media, 20.9% from medical journals. Majority of participant (66.1%) think it is a disease should follow the news of. 41.2% take the vaccine. 28.9% get infected, (18.8%) of them undergo home quarantine, (20.6%) take vitamin C, (13.7%) take Paracetamol. 40.4% of participants have a family member infected. Majority of participants show good practice and health precaution to avoid infection. 26.4% of participants afraid of getting sick. 4.7% of participants have previous psychological disorders not related to COVID-19. 26.4% have psychological symptoms during pandemic. 25.6% of them increase their previous existing symptoms severity. <i>Conclusion and recommendations</i>: Study revealed that most of participants (44%) show moderate level of knowledge, and (50%) of them have moderate level of attitude and practice. Regarding the correlation between the level of knowledge with attitude and practice as general good knowledge and positive attitude among medical students were translated into good practice. Also, study show a disturbed psychological response was experienced by medical students.

Towards Healthy and Sustainable Human Settlement: Understanding How Local Communities Perceive and Engage with Spa Tourism Development Initiatives in Rural Areas

This study investigated the intersection of healthy and sustainable human settlement, and land use for spa tourism in rural areas. Recognizing the crucial role of youth in shaping the future of tourism, this research aimed to provide an insight into the young local rural community representatives’ perception of sustainable spa tourism development and to identify whether these attitudes are shaped by their socio-demographic characteristics. The applied methodology was the Sustainable Tourism Attitude Scale (SUS-TAS). A total of 254 respondents took part in this research. Using SPSS 30.0.0, the gathered data were subjected to additional analyses based on factor analysis, descriptive statistics, and the general linear model. The results showed a general positive attitude of local community members towards the further development of spa tourism in their communities. The especially important factors were the following: long-term planning of development, environmental protection, negative attitudes towards spa tourism development, economic benefits, as well as community participation. By providing an empirical analysis based on the use of robust tools for measuring youth attitudes, this research offers valuable insights for policymakers, planners, and community leaders into how they can design and implement tourism strategies that align with sustainability principles while fostering local economic development and environmental stewardship. The ultimate goal is to contribute to the broader discussion on developing healthy, sustainable human settlements that balance economic benefits with ecological and social well-being. Synergy/harmony between communities and their natural surroundings is essential for the social, economic, and environmental sustainability of rural human settlements. Mineral springs and spas facilitate sensory experiences for individuals (both tourists and residents) through the utilization of natural resources and the environment.

Nutrition Knowledge, Attitude, and Practice of Students in the Faculty of Environmental Sciences, VNU University of Science

Healthy nutrition plays a crucial role in improving health and preventing disease within communities. This study aims to evaluate the current state of nutrition knowledge, attitudes, and practices, as well as the factors influencing nutritional choices among students in the Faculty of Environmental Sciences. A questionnaire survey method was used for data collection. The research findings indicate that 80% of students possess good general knowledge about nutrition, with female students representing 85,2% and male students 73,2%. Regarding attitudes, 74,7% of students display a positive general attitude toward nutrition. Students majoring in Food Science and Technology exhibit a higher rate of positive attitudes (87,0%) compared to those in Environmental Engineering Technology (73,7%) and Environmental Sciences (86,4%). Furthermore, 74,7 % of students demonstrate good general practices in nutrition. Notably, students living with their families tend to have worse nutritional practices than those residing in boarding houses or dormitories. The study also reveals that students with good nutritional knowledge and positive attitudes are more likely to have better nutritional practices. Factors influencing students' nutritional choices, in descending order of importance, include: i) Hygiene and safety; ii) Nutritional and health benefits; iii) Costs and prices; iv) Environmental protection; v) Personal interests and habits; and vi) Convenience.

Cheers to local! Exploring consumer ethnocentrism in the context of regional wines

PurposeExtending the Attitudes-Behavior-Context (ABC) theoretical framework by incorporating consumer expertise as an antecedent, the study investigates the intricate relationship between consumer attitudes toward locally produced goods (wine) and purchasing behavior, examined within the context of consumer ethnocentrism.Design/methodology/approachThe study employed an online survey of Texas wine consumers (N = 895). To investigate consumer attitudes towards local wine, the data were first subjected to descriptive analyses, namely means comparison and chi-square tests. Subsequently, path analysis was employed to explore the hypothesized relationships within the proposed model.FindingsWhile consumers with higher wine knowledge are less likely to choose local wines for various consumption occasions, consumers who are highly involved with wine tend to exhibit more favorable perceptions. Taste emerged as the strongest driver of purchase intent. Consumer ethnocentrism plays a critical role, boosting purchase intent for those with positive general attitudes and considering local wines for various occasions. However, this effect disappears when perceptions of the taste of regional wines are unfavorable, highlighting once again the critical role of taste in purchase decisions, even for ethnocentric consumers.Originality/valueThis study expands the ABC framework by incorporating consumer expertise with a product as a new antecedent, thereby broadening its applicability to consumer behavior research within an ethnocentric context.

Students’ GAI Acceptance: Role of Demographics, Creative Mindsets, Anxiety, Attitudes

ABSTRACT This study examined the impact of university students’ demographic characteristics, creative mind-sets, AI anxiety and attitudes on their acceptance of Generative Artificial Intelligence (GAI) technologies. The participants of this study consisted of 183 university students, 77 (42%) females and 106 (58%) males. According to the results of Hierarchical Multiple Linear Regression Analyses, all models examined significantly predicted the acceptance of GAI. The results showed that acceptance toward GAI technologies was significantly predicted by a fixed creative mind-set (β = 0.111, p = .032), growth creative mind-set (β = 0.413, p = .000), and positive general attitude toward AI (β = 0.456, p = .000). A positive attitude toward AI and a growth creative mind-set played an important role in GAI acceptance. In line with the information obtained from this study, ways to utilize the transformative power of GAI to foster innovation and creativity were discussed, and valuable insights were revealed.

Exploring the usability of simulated patient methodology in dental clinics in Western Australia:A pilot survey.

This study aimed to explore the dental staff knowledge of simulated patient methodology and support for its use to investigate dental staffs' triaging ability. Staff at dental practices in Western Australia were invited to participate in a cross-sectional online questionnaire, consisting of demographic questions, questions on triaging, and knowledge of simulated patient methodology. Descriptive and parametric tests were undertaken for quantitative data; qualitative responses were thematically analyzed. Of the 100 participants, most were female (71%), aged 25-39 years (57%), dentists (46%), and worked in private practices (60%). While 82% of participants triaged dental appointment enquiries, only 26% had heard of simulated patient studies. The majority (66%) of participants spent 1-5 min when triaging appointments and less than half (29%) asked about medical history, aggravating or alleviating factors. Although there was a general positive attitude towarduse of simulated patient methodology to investigate practice, some concerns were identified. The findings of our exploratory study suggests that there may be a potential for utilizing simulated patient studies to improve the care of patients by dental receptionists in general dental practices.

Exploring pet rat care: A comprehensive survey of husbandry, health, behavior, and the associations between caretaker attitudes, attachment, and husbandry practices

Pet rats are still understudied in terms of animal welfare and human-animal interaction research. An extensive online survey targeting German-speaking rat caretakers was conducted (n = 978). One of the study's goals was to investigate husbandry practices, health indicators, rat behaviors that suggest either good or compromised welfare, as well as elements of the human-animal relationship, including interactions between humans and animals, caretaker attitudes, and attachment. The second aim was to explore the associations between caretaker attitudes and attachment, and caretaker behavior, encompassing routine health checks, interactions between humans and animals, as well as the activities and enrichment provided to rats. In some instances, welfare issues were identified: insufficient space (evident in 10.6% of rats), provision of unhealthy snacks (14.6%). The vast majority of rats enjoyed a variety of enrichment objects, e.g., huts/houses (98.4%), nesting material (92.7%), hammocks (91.7%), and tunnels/tubes (83.7%). The average amount of space and time provided for roaming in case of no permanent roaming possibility (13.9 m2 and 2.5 h per day) was positive in terms of welfare. About 79.0% of rats did not suffer from a disease diagnosed by a veterinarian. Repetitive behaviors, which may represent stereotypies, were uncommon (plucking out own fur and cage bar chewing occurred “never” in 99.1% and 81.5%). Indicators of good welfare (e.g., self-grooming, rearing, eye-boggling) were observed several times/day in 89.6%, 46.7%, and 11.6% respectively. Caretakers who formed strong bonds with their rats tended to express positive general attitudes (such as finding rats ‘‘lovable’’ and ‘‘fun’’), while showing little agreement with statements reflecting negative attitudes (like considering rats ‘‘dirty’’). About 84.4% reported stroking their rat, 94.9% reported talking to it, and 70.9% mentioned hand-feeding their rat several times per day. Caretaker attitudes and attachment and human-animal interactions and caretaker behaviors correlated weakly but consistently (P < 0.01): respondents who felt more comfortable during positive interactions, stroked, hand-fed their rats, offered rat-friendly enrichment and performed health checks more often. In contrast, higher agreement to rats being ‘‘dirty’’ related to less frequent health checks and less frequent positive human-animal interactions. The identified relationships between caretaker attitudes and behaviors can help design interventions to promote caretaker behavior that is beneficial for rat welfare.

The leading role of personality in concerns about autonomous vehicles.

Development of autonomous vehicles (AVs) is growing in a rapid rate, however, the most dominant barriers in their adoption seem to be rather psychological than technical. The present online survey study aimed to investigate which demographical and personality dimensions predict attitudes towards AVs on a Hungarian sample (N = 328). Data was collected by convenience and snowball sampling. Three-level hierarchical regression models were applied: in the first level, demographical variables, then general personality traits and third, attitude-like personality factors were entered. We demonstrated that the predictive effect of age, gender and education disappeared when personality dimensions were included into the models. Importantly, more positive general attitudes towards technology and higher optimism regarding innovations predicted eagerness to adopt AVs. On the other hand, individuals with more negative attitudes and higher dependence on technology as well as those with lower level of Sensory Sensation Seeking and higher level of Conscientiousness were more concerned about AVs. Our results suggest that AV acceptance cannot be regarded as a one-dimensional construct and that certain personality traits might be stronger predictors of AV acceptance than demographical factors.

Development and testing of immersive virtual reality environment for safe unmanned aerial vehicle usage in construction scenarios

Robotics and autonomous systems are increasingly being used on construction sites to complete tasks and complement human effort. One such autonomous system is unmanned aerial vehicles (UAV), although their wrong use could be potentially hazardous to humans and the environment. Given its relative novelty in construction, there remains a dearth of knowledge about safety risks associated with their use as well as knowledge on skills and protocols for their safe operation. With construction being one of the most dangerous and accident-prone sectors, there is even more impetus to develop UAV safety competence. In this study, we explore the application of immersive virtual reality (VR) use for purposes of safety training pertaining to the use of UAVs in construction scenarios. Whereas, previous studies, focussed on effectiveness of VR as a tool for training individuals on UAV operations and safety risks in general, this study evaluates its effectiveness across distinctive themes of safety in order to compare its effectiveness in different domains of UAV safety. The study adopts design science for development of bespoke UAV safety training tool in VR using Building Information Modelling (BIM) and game engine-driven virtual prototyping. The immersive training tool was then applied in an experiment of participants (n = 100) with (n = 50) constituting a control group using more traditional training methods and a series of pre/post-test assessments. The findings confirmed the relative superiority of VR training over traditional methods, improving performance and retention by up to 22 % on average. The immersive VR was found to be most effective on participants retention of knowledge in general flight preparation, air traffic documentation, visibility management and warning signals. Further usability tests were performed on all participants (n = 100) revealing general presence and positive attitudes towards VR based UAV safety training when compared to traditional training. From a practice perspective this research proofs the effectiveness of a VR approach as more cost effective and safe approach to UAV training for both academia and practice with added advantage of being more realistic simulation of the UAV risk scenarios.

Changes of Interprofessional Education in Athletic Training: A 5-Year Follow-up Study

Interprofessional Education (IPE) prepares students in the healthcare field for collaborative practices. Faculty perceptions of IPE have been investigated among several health professions. We assess athletic training (AT) faculty perceptions of the importance of the four IPE competencies, their attitudes towards IPE, their attitudes and beliefs about IPE in the academic settings, their perceived barriers, and opportunities towards implementing IPE in AT curricula; and how these have changed. This study utilized a cross-sectional online survey administered anonymously in 2017 and 2022. The study population was faculty from accredited AT education programs in the USA identified through the National Athletic Trainers&amp;rsquo; Association (NATA). We find that in the last five years, faculty perception of IPE has shifted to a more positive attitude toward understanding and implementing IPE in AT programs. However, data showed no significant differences between the initial and follow-up studies. Values and ethics and teams and teamwork were the two competencies ranked the highest in both studies. Younger respondents ranked communication higher than older respondents. Barriers to IPE implementation included lack of resources, allocated funding, and institutional support. The creation of an IPE program coordinator was one of the opportunities highlighted. Faculty of AT programs are aware of the importance of IPE and demonstrated a general positive attitude toward implementing IPE in their AT curricula. However, several barriers have been identified, including a perceived negative attitudes toward AT from other health professions.

Menstrual Products: Attitudes About Taxation and Safety.

Background: This study explored factors associated with the differences between women and men in attitudes, norms, and the support of taxation of menstrual products (MPs) and menstrual-adjacent products. It also investigated the use of these products in women. Methods: Young adults from 18 to 30 years of age were recruited via social media, listserve emails, and flyers placed throughout a university campus. Following cognitive interviewing, a survey investigated attitudes, beliefs, and behaviors associated with MPs. Results: Individuals self-identified as men or women. Women (n = 154) had more positive general attitudes, less positive safety attitudes, and less support for taxation of MPs than men (n = 43). Regression analyses indicated that factors, such as race, age, attitudes, norms, and taxation, were associated with product use. Conclusions: Attitudes about safety and taxation differ for men and women. Tax policies and attitude-shifting interventions need to be tailored to their audience, and our study can inform that effort.

‘Situational barriers are keeping me from participating’, but are they situational? Examining low-educated adults’ psychosocial views on adult learning

Despite the attention devoted to situational and institutional barriers in studying participation in adult education, psychosocial barriers are often overlooked in research. However, low-educated, and non-participating adults are more likely to experience them. In this study, we examine low-educated, both participating and non-participating, adults’ psychosocial views on learning. We interviewed 15 adults by using vignettes to elicit discussion on a delicate and difficult to interview theme and carried out a qualitative content analysis. Our findings demonstrate that adults point to situational barriers for not participating and, contrary to what we anticipated, have positive general attitudes towards learning. However, there are several prerequisites to having this attitude. For instance, learning has to be useful, a learning trigger is needed, spare hours should not be devoted, and there should be no exams or tests. As a result, our research demonstrates the complex nature of perceived ‘situational’ barriers, which frequently pertain to psychosocial stances.

Stigmatization of patients with mental disorders: a comparative study of nurses in forensic psychiatry and inpatient settings.

Forensic psychiatric patients require specialized care due to the unique challenges in forensic settings. Negative attitudes and beliefs towards mentally disordered offenders can lead to discrimination against patients and are related to worse outcomes. Forensic psychiatric nurses play a crucial role in the treatment of these patients. This study aimed to investigate the perceptions, attitudes, and beliefs of forensic psychiatric nurses and general medicine nurses towards psychiatric patients and to compare them between nurse groups. The study was conducted with 46 nurses working in the High-Security Forensic Psychiatry Clinic (Mean age: 35.46, SD= 7.16) and 58 nurses working in other inpatient settings (Mean age:36.28, SD=8.78) aged between 18-65 between December 2020 and April 2021 in Turkey. Nurses in the forensic psychiatry clinic were required to have at least 6 months of experience in the clinic. Forensic psychiatric nurses exhibited more positive attitudes towards patients (p<.0001), showing lower tendency to be socially distant (p=.009), higher trust (p<.0001), higher willingness to treat (p<.0001), lower tendency to perceive patients as threatening (p=.004), and more general positive attitudes. Significant relationships were found between some of the stigma-related scales we used and certain factors. For forensic nurses, being male (p=0.043) and single (p=,025), working long hours (p=.047), and having fewer children (p=.005) were related to more negative perceptions about delinquents. Insufficient knowledge about forensic psychiatry was linked to negative beliefs about mental disorders (p=0.017) and specifically the curability of mental disorders (p=0.008). Having more siblings was related to higher embarrassment about mental disorders (p=.043). For general nurses, having first-degree relatives who receive psychiatric treatment was related to perceiving patients as threatening (p=.021)) and negative perceptions about delinquents (p=.007). Being older was related to more positive beliefs about mental patients' dangerousness (p=.026). Having more siblings was associated with higher trust toward patients (p=0.002). These findings emphasize the importance of addressing stigmatization among healthcare professionals, particularly forensic psychiatry nurses and general nurses. Providing comprehensive training about mental disorders and forensic psychiatry and promoting empathy and understanding can enhance the quality of care for patients with mental illnesses and contribute to better mental health outcomes for society.

Covid-19 pandemic? Mental health implications among nurses and Proposed interventions.

With its abrupt and huge health and socio-economic consequences, the coronavirus disease (COVID-19) pandemic has led to a uniquely demanding, intensely stressful, and even traumatic period. Healthcare workers (HCW), especially nurses, were exposed to mental health challenges during those challenging times. Review the current literature on mental health problems among nurses caring for COVID-19 patients. This is a narrative review and critical evaluation of relevant publications. Nurses experienced higher levels of stress, burnout, anxiety, depression, frustration, stigma, and depersonalization compared to other HCW. Factors that increased this symptomatology included concerns about infection or infection of family members, inadequate staff protective equipment, extended working hours, insufficient information, a reduced sense of security, and post-traumatic stress disorder. The factors that improved the psychopathology included a general positive attitude, job satisfaction, adequate information and education, harmonious group relationships, post-traumatic development, emotional intelligence, psychological counseling, mindfulness-based stress reduction, stable leadership, guidance, and moral and practical administrative support. Recent studies clearly show that nurses, especially women, are the most vulnerable subgroup among HCW and are particularly prone to mental health impacts during the COVID-19 pandemic. The documented mental health vulnerability of frontline nursing staff during the COVID-19 pandemic requires preventive nursing management actions to increase resilience and to develop relevant defense mechanisms.

Cystic fibrosis carrier screening: a Health technology assessment.

This project of Health technology assessment was aimed at defining the impacts of offering a cystic fibrosis (CF) carrier screening to the general population, compared to the current situation, where the test is offered to individuals at high-risk to give birth to a child with CF. Results revealed: i) a lack of robust and updated data; ii) a return on investment up to six years from the screening's introduction, despite important economic and organizational efforts; iii) a general positive attitude of healthcare professionals, people with CF, families and general population; iv) possible issues related to the social impact.

Studying the effects of educational games on cultivating computational thinking skills to primary school students: a systematic literature review

This article presents a systematic literature review (SLR) on the effects of serious games, or more specifically educational games that aim to teach Computational Thinking (CT) skills to primary school students. Sixty one studies from various data sources were evaluated based on the CT skills and programming concepts addressed, the evaluation instruments used, the target audience, the learning outcomes and their results. The findings of the studies on the efficiency or impact of educational games on the acquisition of the proposed topics were positive, indicating that educational programming games can help primary school students develop CT skills or understand fundamental programming concepts. Additionally, the results suggest a general positive attitude towards the use of an educational game for learning purposes, while students perceive games as a great motivator for engaging in CT activities. Finally, the research discusses research gaps and shortages, as well as methodological limitations and recommendations for future work in the relevant domain.

Qualitative Interviews to Add Patient Perspectives in Colorectal Cancer Screening: Improvements in a Learning Health System.

Health systems are interested in increasing colorectal cancer (CRC) screening rates as CRC is a leading cause of preventable cancer death. Learning health systems are ones that use data to continually improve care. Data can and should include qualitative local perspectives to improve patient and provider education and care. This study sought to understand local perspectives on CRC screening to inform future strategies to increase screening rates across our integrated health system. Health insurance plan members who were eligible for CRC screening were invited to participate in semi-structured phone interviews. Qualitative content analysis was conducted using an inductive approach. Forty member interviews were completed and analyzed. Identified barriers included ambivalence about screening options (e.g., "If it had the same performance, I'd rather do home fecal sample test. But I'm just too skeptical [so I do the colonoscopy]."), negative prior CRC screening experiences, and competing priorities. Identified facilitators included a positive general attitude towards health (e.g., "I'm a rule follower. There are certain things I'll bend rules. But certain medical things, you just got to do."), social support, a perceived risk of developing CRC, and positive prior CRC screening experiences. Study findings were used by the health system leaders to inform the selection of CRC screening outreach and education strategies to be tested in a future simulation model. For example, the identified barrier related to ambivalence about screening options led to a proposed revision of outreach materials that describe screening types more clearly.