Multilevel Conceptual Framework Research Articles

Intersectional employee voice inequalities and culture care theory: the case of migrant palliative care nurses inSaudi Arabia.

This narrative literature review examines intersectional employee voice inequalities in a non-Western, high power distance context to develop a multilevel conceptual framework. The authors use Leininger's (1997, 2002) culture care model to explore multilevel influences on intersectional voice inequalities. The article applies insights from a review of 31 studies to the specific challenges of migrant palliative care (PC) nurses in Saudi Arabia. The themes identified in the review indicate how better transcultural communications might mitigate voice inequalities that influence migrant employee wellbeing and intentions to quit which result from cultural incongruities. The impact of national culture differences and intersectional inequalities on employee voice has largely been ignored in academic research. This paper offers unique insights drawing on culture care theory into intersectional voice challenges from a non-Western perspective in the underresearched setting of Saudi Arabia which is mid-way through a national transformation program. It starkly contrasts policy ambitions for advancing healthcare with discriminatory practices based on conservative attitudes which stifle migrant worker voices.

The digitalization of family life: A multilevel conceptual framework

AbstractThe internet and digital technologies have penetrated all domains of people's lives, and family life is no exception. Despite being a characterizing feature of contemporary family change, the digitalization of family life has yet to be systematically theorized. Against this backdrop, this article develops a multilevel conceptual framework for understanding the digitalization of family life and illustrates the framework by synthesizing state‐of‐the‐art research from multiple disciplines across global contexts. At a micro level, as individuals “do” family online, digitalization influences diverse aspects of family practices, including family formation, functioning, and contact. How individuals “do” family online is not free‐floating but embedded in macro‐level economic, sociocultural, and political systems underpinning processes of digitalization. Bridging the micro–macro divide, family‐focused online communities serve as a pivotal intermediary at the meso level, where people display family life to, and exchange family‐related support with, mostly nonfamily members. Meso‐level online communities are key sites for forming and diffusing collective identities and shared family norms. Bringing together the three levels, the framework also considers cross‐level interrelations to develop a holistic digital ecology of family life. The article concludes by discussing the contributions of the framework to understanding family change and advancing family scholarship in the digital age.

Abstract A130: Stakeholder perspectives of the multi-level barriers to treatment among rural endometrial cancer patients: A qualitative study

Abstract Purpose. Rural individuals with endometrial cancer (EC) have an 8-17% higher mortality risk than their urban counterparts. EC patients have distinct needs, such as requiring treatment to be directed by gynecologic oncologists who are often located in urban areas or at academic medical centers. Our objective was to identify barriers to treatment of rural EC patients. Methods. We conducted semi-structured interviews with 25 providers (e.g. gynecologic oncologists, nurses, pharmacists), and healthcare administrators who provided services to EC patients. Participants represented three large and geographically-diverse, integrated healthcare systems located across North Carolina. A semi-structured interview guide was developed to examine the treatment process and then probe on multi-level barriers to treatment. Initial codes were derived from an adapted multi-level conceptual framework of rural cancer control. We used template analysis to analyze transcribed interviews. Results. The majority of interview participants were gynecologic oncologists (n=7) and nurses (n=7). Participants highlighted barriers at multiple levels, including the patient-, provider/clinic-, and community-levels. At the patient-level, common barriers included patients’ anxiety and fears about undergoing treatment as well as patients’ low medical literacy. Patients without a support network or caregiver often encountered logistical problems when it came to traveling and planning their treatment; in some cases, interviewees said patients would have to hire someone to take them to their treatment appointments. At the provider/clinic-levels, interviewees reported that providers were not always made aware of supportive resources, such as gas cards, that were available to patients; this was particularly a problem since, to access these resources, patients often had to be referred by a provider. At the same time, however, providers who were aware of these supportive resources said that only a limited amount was available and insufficient in meeting patients’ needs. Finally, at the community-level, treatment services for patients with gynecologic malignancies were often only available at large urban or academic medical centers; consequently, EC patients frequently faced geographic barriers and had to travel long distances for treatment. This travel burden for treatment created financial hardship for patients, due to the increased temporary housing and travel costs. Furthermore, even if there were oncology-related providers within a patient’s community, most did not have appropriate experience or feel comfortable in treating patients with EC. Among the few community-based oncology-related providers that would treat EC patients, interviewees expressed concerns about the quality of care received by these patients as they could not oversee or direct the patient’s treatment plan. Conclusions. To achieve equitable outcomes among EC patients, those living in rural areas may require more intensive outreach, support, and resources that can effectively target multi-level barriers. Citation Format: Lisa P. Spees, Blen M. Biru, Wendy R. Brewster, Jennifer Leeman, Brianna Taffe, Stephanie B. Wheeler. Stakeholder perspectives of the multi-level barriers to treatment among rural endometrial cancer patients: A qualitative study [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A130.

A multilevel conceptual framework on green practices: Transforming policies into actionable leadership and employee behavior.

As organizations have recognized their cause/solution relationship with the environment, increasing attention is being given to the role of employees make in achieving green organizational objectives. Even though, business sustainability initiatives are often led by leaders; employee green behavior (EGB) plays a vital role in success of such initiatives. The current paper focuses on relatively less researched topic of EGB. It uses a narrative review approach to develop a multi-level conceptual framework that draws upon the connectivity of leadership influence at firm and team levels, and how this influences individual level EGB. The paper offers a holistic approach to influencing effective green strategies in organizational contexts. By doing so, it contributes to the larger debate on different dimensions, mechanisms, and levels of environmentally responsible behavior in organizational settings and opens up new avenues for multi-level and cross-layer empirical research.

Drivers and success factors of digital entrepreneurship: A systematic literature review and future research agenda

ABSTRACT Digital entrepreneurship is playing an increasingly prominent role for economic growth and development. However, the most effective methods of facilitating it remain unclear, as scholars continue to debate the factors that contribute to its success. We therefore conducted a comprehensive systematic literature review by searching the Web of Science and Scopus databases for empirical studies examining the drivers of successful digital entrepreneurship. By this first review paper on this topic, we were able to identify a total of 45 different drivers, encompassing subjective and objective factors at the individual, organizational, and regional/national levels. While certain drivers were specific to the digital context, such as smart-city initiatives, many aligned with those identified in broader research on entrepreneurial success, such as the educational attainment of founders. To enhance our understanding and facilitate action in promoting digital entrepreneurship, we propose a multi-level conceptual framework that places greater emphasis on specific digital-related drivers.

A framework for linking hemispheric, full annual cycle prioritizations to local conservation actions for migratory birds

AbstractThe conservation of migratory birds poses a fundamental challenge, their conservation requires coordinated action across the hemisphere, but those actions must be designed and implemented locally. To address this challenge, we describe a multilevel framework for linking broad‐scale, full annual cycle prioritizations to local conservation actions for migratory birds. We developed hemisphere‐scale spatial prioritizations for the full annual cycle of migratory birds that breed in six different ecosystems in North America. The full annual cycle prioritizations provide a hemispheric context within which regional priorities can be identified. Finer resolution, regional prioritizations can then inform local conservation actions more effectively. We describe the importance of local conservation practitioner contributions at each level of the process and provide two examples of regional spatial prioritizations that were developed to guide local action. The first example focused on coastal North and South Carolina, USA, and used information on marsh birds, shorebirds, ecological integrity, and co‐benefits for people to identify Cape Romain, South Carolina as a high‐priority site for conservation action. The second example in Colombia used information on migrant and resident birds to identify the Cauca Valley as a high‐priority site. The multilevel conceptual framework we describe is one pathway for identifying sites for implementation of local conservation actions that are guided by conservation priorities for migratory birds across their full annual cycle.

From Evidence-Based Corona Medicine to Organismic Systems Corona Medicine

The Covid-19 pandemic has challenged both medicine and governments as they have strived to confront the pandemic and its consequences. One major challenge is that evidence-based medicine has struggled to provide timely and necessary evidence to guide medical practice and public policy formulation. We propose an extension of evidence-based corona medicine to an organismic systems corona medicine as a multilevel conceptual framework to develop a robust concept-oriented medical system. The proposed organismic systems corona medicine could help to prevent or mitigate future pandemics by transitioning to a bifocal medicine that extends an empirical evidence-based medicine to a theory-oriented organismic systems medicine.

Corporate Social Responsibility of Financial Cooperatives: A Multi-Level Analysis

Cooperatives, which have a dual mission that includes both business and social goals, are of particular interest for the study of corporate social responsibility (CSR). The aim of this study was to examine how cooperative directors influence the CSR strategies of their organization. We used a multi-level conceptual framework, consisting of micro, meso, and macro levels, to analyze qualitative data (20 interviews, observation of two board meetings and analysis of over 25 public documents) collected through a case study design that focused on the directors of three financial cooperatives operating under a large group of Canadian financial service cooperatives. Our study contributes first by building on prior studies that link CSR goals to the cooperatives’ dual mission and commitment to improving their community. We enrich prior findings by showing how directors play a crucial role in the enactment of the social dimension of CSR, but that conversely, cooperatives are vehicles for directors who want to contribute to the improvement of their community, thus creating a virtuous circle. Secondly, comparing bureaus operating in urban and rural areas allows us to show how the specificities of the community in which a cooperative evolves influence the approach of the directors towards the environmental dimension of CSR.

Employee well-being and innovativeness: A multi-level conceptual framework based on citation network analysis and data mining techniques.

This study proposes a multilevel conceptual framework for a deeper understanding of the relationship between employee well-being and innovativeness. We overview 49 years of well-being research [1972-2021] and 54 years of research on innovativeness [1967-2021] to uncover 24 dominant themes in well-being and ten primary topics in innovativeness research. Citation network analysis and text semantic similarity were used to develop a conceptual framework featuring 21 components and three levels: individual, organizational, and market. These components consist of constructs, domains, and factors that can influence or be influenced by employee well-being and innovativeness either directly or indirectly. This is the first study to use citation network analysis and data mining techniques to investigate the relationship between employee well-being and innovativeness. This novel framework can aid organizations in identifying more holistic and efficient strategies for fostering innovativeness and enhancing the well-being of their workforce. It can also assist in developing new theories and serve as a roadmap for future research. We discuss the research limitations and theoretical and practical implications and propose three research themes that future studies may address.

Modifiable Barriers and Facilitators for Breast Cancer Care: A Thematic Analysis of Patient and Provider Perspectives

IntroductionWe sought to examine patient and provider perspectives regarding modifiable contributors to breast cancer treatment and to assess perceptual alignment between these two groups. MaterialsParticipants were women≥18 y with stage 0-IV breast cancer who received all oncologic care in a single health system and physicians and advanced practice providers who provided medical, radiation, or surgical oncology care for breast cancer. All completed ∼45-min semistructured interviews that were recorded and transcribed verbatim. A 5-stage approach to thematic analysis was conducted, with emergent themes and exemplar quotes placed into clinical, psychological, social/logistical, financial, and lifestyle categories using a multilevel conceptual framework. ResultsEighteen patients (9 Black, 9 White, and median age 60 y) and 10 providers (6 physicians and 4 advanced practice providers) were interviewed from May to November 2018. Both patients and providers perceived suboptimal communication, parking and transportation, and competing family-caregiving responsibilities as modifiable barriers to care. Treatment costs were cited by patients as barriers that were inadequately addressed even with referrals to financial counselors, but providers did not raise the issue of cost unless prompted by patients and did not feel prepared to discuss the topic when it arose. Providers cited obesity as a barrier to treatment, a view not shared by patients. ConclusionsSeveral modifiable factors were recognized by both patients and providers as either promoting or detracting from treatment receipt, but there was also significant incongruence and asymmetry. Alignment of provider and patient perceptions regarding contributors to guideline-concordant care receipt could mitigate disparities in breast cancer treatment and outcomes.

Engagement marketing for social good: Application to the All of Us Research Program.

Engagement marketing, when applied to increasing the social good, involves making a deliberate effort to engage communities with an organization's brand that might not have otherwise happened organically. Organizations that typically focus on increasing the social good include non-profits, community organizations, public health departments, and federal, state, and local agencies. Engagement marketing builds relationships, gives a voice to, and fosters collaboration with community members to transform their insights into impactful experiences that motivate and empower them to act to increase the social good. These actions may include making an informed decision, changing a health or prosocial behavior, or joining an effort that promotes or increases social good. In this paper, we translate the commercial engagement marketing approach, typically used, and studied widely to increase profits, to one that uses engagement marketing to increase prosocial outcomes. We propose a new definition of engagement marketing applied to the social good, a multi-level conceptual framework that integrates individual, social, community and macro-level processes and outcomes, and illustrates an example applying this translated model to co-create digital engagement experiences using a human centered design approach for the All of Us Research Program. This model can also guide research and practice related to DNA-based population screening.

Antecedents and Boundary Conditions of Employees’ Uncertainty Regulation Processes

While the management literature stresses the necessity for firms to take risks and face uncertainty to sustain and improve their performance, considerably less is known about how firms and their employees effectively regulate such uncertain task environments and what kind of work behaviors this entails. Therefore, this study aims to advance knowledge on opportunities in the concept of uncertainty regulation by disentangling the mechanism that shapes the uncertainty perception and appraisal of individuals in the workplace and subsequent behavioral outcomes e.g., adaptive or proactive responses in the light of uncertain events. To achieve this, we conduct a systematic literature review to develop an integrated multilevel conceptual framework spanning the drivers, mechanisms, and consequences of employees’ uncertainty perception and appraisal. We specifically focus on the interactions of individual personality traits, the organizational environment, and the external task-environment. The derived multi-theoretical framework provides specific suggestions for future research on how employees regulate uncertainty in the face of firm-internal changes.

Home-Based Care for Children with Serious Illness: Ecological Framework and Research Implications.

Care for U.S. children living with serious illness and their families at home is a complex and patchwork system. Improving home-based care for children and families requires a comprehensive, multilevel approach that accounts for and examines relationships across home environments, communities, and social contexts in which children and families live and receive care. We propose a multilevel conceptual framework, guided by Bronfenbrenner’s ecological model, that conceptualizes the complex system of home-based care into five levels. Levels 1 and 2 contain patient and family characteristics. Level 3 contains factors that influence family health, well-being, and experience with care in the home. Level 4 includes the community, including community groups, schools, and providers. Level 5 includes the broader regional system of care that impacts the care of children and families across communities. Finally, care coordination and care disparities transcend levels, impacting care at each level. A multilevel ecological framework of home-based care for children with serious illness and families can be used in future multilevel research to describe and test hypotheses about aspects of this system of care, as well as to inform interventions across levels to improve patient and family outcomes.

A house divided: A multilevel bibliometric review of the job search literature 1973–2020

A growing body of research across multiple disciplines has aimed to better understand the phenomenon of job search. However, little empirical research has examined the combined content and structure of the job search literature to accumulate programmatic knowledge. Unfortunately, this has resulted in redundancies and isolated advances that harm our ability to make concrete practical recommendations to aid policy makers, organizations, and broader society. Using bibliometric analysis of 3,197 articles on job search, the present article identifies and describes 10 distinct communities of thought and assesses patterns of integration between these communities. Assessment of community relationships confirms disciplinary divides, but reveals insights into patterns of thought within disciplines, and structural and conceptual relationships between them. Based on these findings, we offer a multilevel conceptual framework to organize the job search literature and suggest possible ways to improve its integration to build a more programmatic understanding of the job search phenomenon.

A framework for addressing health inequities in sexual and gender diverse populations by nurses

There is a need to increase health equity in sexual and gender diverse (SGD) populations, a medically underserved group with widening health disparities. To better understand and address SGD health disparities, we have developed a multi-level conceptual framework for nurse scientists that incorporates the concepts of stigma, intersectionality, identify affirmation, and life course trajectory. Social determinants of health formed the background of our conceptual framework. Using this framework, we proposed recommendations to promote SGD health equity through nursing research, health care practice, health care education, and public health care policy. These recommendations align with the National Institute of Nursing Research's goals of dismantling structures that perpetuate racism and impede health inequity and the need to implement interventions that address social determinants of health. As a result, nurse scientists are poised to influence health care policy by translating effective interventions to reduce health disparities for the SGD population into practice.

Gesture, Music and Computer: The Centro di Sonologia Computazionale at Padova University, a 50-Year History.

With the advent of digital technologies, the computer has become a generalized tool for music production. Music can be seen as a creative form of human–human communication via a computer, and therefore, research on human–computer and computer–human interfaces is very important. This paper, for the Sensors Special Issue on 800 Years of Research at Padova University, presents a review of the research in the field of music technologies at Padova University by the Centro di Sonologia Computazionale (CSC), focusing on scientific, technological and musical aspects of interaction between musician and computer and between computer and audience. We discuss input devices for detecting information from gestures or audio signals and rendering systems for audience and user engagement. Moreover, we discuss a multilevel conceptual framework, which allows multimodal expressive content processing and coordination, which is important in art and music. Several paradigmatic musical works that stated new lines of both musical and scientific research are then presented in detail. The preservation of this heritage presents problems very different from those posed by traditional artworks. CSC is actively engaged in proposing new paradigms for the preservation of digital art.

Circular economy adoption by SMEs in emerging markets: Towards a multilevel conceptual framework

Adding to the growing literature on circular economy (CE) and employing the theoretical lens of change management, this research explores SMEs’ challenges in the emerging markets context of India for adopting CE practices. We use a multi-case qualitative design, interviewing senior leaders and owners of Indian SMEs, CE intermediaries and two large firms on the nature and extent of critical barriers and enablers of CE adoption. Including CE market intermediaries, sustainability and CE managers of large organizations, who are required to educate and incentivize CE adoption of their SME value chain members, we analyze the barriers and opportunities from both sides of the coin. We develop a multilevel theoretical framework grounded in CE and change management literature, which presents the nature and extent of CE activities, barriers and contextual enablers of SMEs’ adoption of CE in emerging markets. Implications for policy, theory and practice are also discussed.

The lockdown, mobility, and spatial health disparities in COVID-19 pandemic: A case study of New York City

The world has adopted unprecedented lockdown as the key method to mitigate COVID-19; yet its effect on pandemic outcomes and health disparities remains largely unknown. Adopting a multilevel conceptual framework, this research investigates how city-level lockdown policy and public transit system shape mobility and thus intra-city health disparities, using New York City as a case study. With a spatial method and multiple sources of data, this research demonstrates the uneven impact of the lockdown policy and public transit system in shaping local pandemic outcomes. Census tracts with people spending more time at home have lower infection and death rates, while those with a higher density of transit stations have higher infection and death rates. Residential profile matters and census tracts with a higher concentration of disadvantaged population, such as Blacks, Hispanics, poor and elderly people, and people with no health insurance, have higher infection and death rates. Spatial analyses identify clusters where the lockdown policy was not effective and census tracts that share similar pandemic characteristics. Through the lens of mobility, this research advances knowledge of health disparities by focusing on institutional causes for health disparities and the role of the government through intervention policy and public transit system.

An integrated sustainable lean approach for the SMEs in India: A multi-level conceptual frame work

Sustainability has become the prime focus in most of the manufacturing industries in and around the world due to high competitive demand, recent alleviation of change in global climate and government policies. Lean Manufacturing (LM), on the other hand have been globally accepted and it is now the heart of production in the industrial sectors. Researches depict that the lean philosophy in most of the SMEs are not properly carried out in a progressive and continuous manner and are getting declined in course of time. Also the limited number of researches done in the triple bottom line (TBL) of sustainability adds to the de-escalation of lean philosophy in the industries. In short, lean is not getting sustained. In order to make a sustainable lean system, a multi-level model, which identifies the enablers and inhibitors of sustainability, has been developed. The details of which is included in this paper. 39 enablers and 27 inhibitors have been identified from different literatures and expert interactions. Incorporating the enablers and inhibitors in the sustainability pillars (Environment, Economic & Social), and lean ideologies, multi-level sustainable- lean (Sus-Lean) enabler model and inhibitor model has been carved out in this paper. This will give an insight on how to make a sustainable lean approach in the SMEs of India. Also, the future research orientations in this regard are proposed based on the models.

Investigating School Leaders’, Teachers’ and Education Officials’ Perceptions of the Effectiveness of an Educational Leadership Program in Bahrain: a Multilevel Conceptual Framework Approach

Investigating School Leaders’, Teachers’ and Education Officials’ Perceptions of the Effectiveness of an Educational Leadership Program in Bahrain: a Multilevel Conceptual Framework Approach