Multilevel Study Research Articles

Interhemispheric reactivity of the subthalamic nucleus sustains progressive dopamine neuron loss in asymmetrical parkinsonism

Parkinson's disease (PD) is characterized by the progressive and asymmetrical degeneration of the nigrostriatal dopamine neurons and the unilateral presentation of the motor symptoms at onset, contralateral to the most impaired hemisphere. We previously developed a rat PD model that mimics these typical features, based on unilateral injection of a substrate inhibitor of excitatory amino acid transporters, L-trans-pyrrolidine-2,4-dicarboxylate (PDC), in the substantia nigra (SN). Here, we used this progressive model in a multilevel study (behavioral testing, in vivo 1H-magnetic resonance spectroscopy, slice electrophysiology, immunocytochemistry and in situ hybridization) to characterize the functional changes occurring in the cortico-basal ganglia-cortical network in an evolving asymmetrical neurodegeneration context and their possible contribution to the cell death progression. We focused on the corticostriatal input and the subthalamic nucleus (STN), two glutamate components with major implications in PD pathophysiology. In the striatum, glutamate and glutamine levels increased from presymptomatic stages in the PDC-injected hemisphere only, which also showed enhanced glutamatergic transmission and loss of plasticity at corticostriatal synapses assessed at symptomatic stage. Surprisingly, the contralateral STN showed earlier and stronger reactivity than the ipsilateral side (increased intraneuronal cytochrome oxidase subunit I mRNA levels; enhanced glutamate and glutamine concentrations). Moreover, its lesion at early presymptomatic stage halted the ongoing neurodegeneration in the PDC-injected SN and prevented the expression of motor asymmetry. These findings reveal the existence of endogenous interhemispheric processes linking the primary injured SN and the contralateral STN that could sustain progressive dopamine neuron loss, opening new perspectives for disease-modifying treatment of PD.

Family and school factors related to internalizing and externalizing problems in adolescence

ABSTRACT Family and school factors are among the most important determinants of internalizing and externalizing problem behavior in adolescents. The aim of this study is to explore how certain family and school factors explain internalizing and externalizing problems after one year. In addition to individual-level variables, school level variables are taken into account. This multilevel study was conducted among 507 adolescents (mean age 13.44; 52.3% girls) who reported their internalizing problems (anxiety, depressive symptoms), externalizing problems (aggressive and norm-breaking behavior), parental knowledge of their whereabouts, parental rule setting, school connectedness and teacher support. At the school level, the aggregated scores for school connectedness and teacher support were calculated. The results show that the differences between schools explained 13.4% of the variance in externalizing problem behavior although it did not account for internalizing behavior. Parental knowledge and school connectedness were significant predictors of both internalizing and externalizing problems. At the school level, aggregated teacher support predicted fewer externalizing problems. While some of the results are partially in line with previous findings, others were found to be contradictory. The implications for practice are provided.

The buffering role of collective mindfulness in customer incivility and service sabotage: a multilevel study of Indian banks

PurposeThis study explores the moderated mediation effect, wherein collective mindfulness attenuates the hypothesised relationship between customer incivility, service sabotage and psychological well-being and is supported by the conservation of resources (COR) theory.Design/methodology/approachMultiwave and multisource data were collected from 315 frontline employees (FLEs) working in 32 Indian bank branches. Using HLM 7.00, the authors tested a multilevel model in which branch-level collective mindfulness moderated the association amongst individual-level customer incivility, psychological well-being and service sabotage.FindingsA higher level of collective mindfulness had a profound cross-level effect on the association between customer incivility and service sabotage through psychological well-being.Originality/valueDistinct from prior research that focussed on individuals' personal resources as a buffer against customer incivility, the authors' study identified branch-level collective mindfulness as a boundary condition that helps employees experiencing customer incivility decrease service sabotage. By uncovering a branch-level variable that reduces the negative impact of customer incivility on service sabotage, the authors' study offers valuable insights for banks to enhance customer service at their branches.

The Association of Teen Pregnancy and Violence: A Multilevel Study in Colombia.

Colombia has a high teen pregnancy (TP) rate. In 2018, one in five pregnancies was from teen mothers between 10 and 19 years of age. While TP rates are declining globally, Colombia's TP rate decline has been particularly low, despite sexual education and contraception campaigns. Other factors must be studied to prevent TP. Colombia has a long history of violence. We aim to assess whether there is a relationship between TP and exposure to violence in Colombia. Data from the Colombian Demographic and Health Survey 2015 and the Colombian National Department of Statistics were analyzed for association between TP and sexual violence, physical violence, physical punishment as a child, and community violence. Univariate, bivariate, multivariate, and multilevel binary logistic regression models were calculated using SPSS v.25 and HLM v.7. Fifteen percent of teens were pregnant. Emotional violence was reported by 47%, sexual harassment by 27%, physical violence by 17%, physical punishment as a child by 7%, and unwanted sex by 2%. Unwanted sex (odds ratio [OR]: 3.18, 95% confidence interval [95% CI]: 1.96-5.16), sexual harassment (OR: 2.43, 95% CI: 1.89-3.14), and physical punishment (OR: 20.30, 95% CI: 7.96-22.81) were associated with adolescent pregnancy. In unadjusted models, emotional violence was associated (OR: 1.22, 95% CI 1.06-1.40) and community violence showed a tendency (OR: 1.24, 95% CI: 0.99-1.55). Physical violence was not associated. Violence exposure and particularly physical punishment, unwanted sex and sexual harassment were associated with TP incidence and should be considered risk factors for TP.

Team climate and job satisfaction in a mobile emergency service: a multilevel study

Objetivo: examinar a relação entre clima em equipe e satisfação no trabalho de profissionais atuantes em atendimento pré-hospitalar móvel. Método: estudo quantitativo, correlacional, realizado em um serviço de atendimento pré-hospitalar móvel da Região Metropolitana de São Paulo. Participaram 95 profissionais, alocados em 40 equipes, os quais responderam a três questionários: dados sociodemográficos/laborais, Escalas de Clima na Equipe e de Satisfação no Trabalho S20/23. Para a análise, foram usados a estatística descritiva e os modelos lineares multiníveis, incluindo efeitos de moderação. Empregou-se o método Backward para averiguar a ordem de significância. Resultados: nos modelos, foram significantes as relações entre satisfação com relações hierárquicas e fator “apoio para novas ideias” moderado ao gênero homem e “orientação para as tarefas” às mulheres. Para satisfação com ambiente físico, foram significantes “jornada de trabalho” e “participação na equipe” e, para satisfação intrínseca, permaneceram significantes o regime, a jornada e os fatores “objetivos da equipe”, “participação na equipe” e “apoio para ideias novas”, e efeito de moderação entre tempo de atuação, “participação na equipe” e “apoio para ideias novas”. Conclusão: clima em equipe é influenciado pela satisfação no trabalho de modo heterogêneo e o efeito moderador dessa relação associa-se ao gênero e ao tempo de atuação no serviço.

Team climate and job satisfaction in a mobile emergency service: a multilevel study.

to investigate the relationship between team climate and job satisfaction among professionals working in mobile pre-hospital care. this is a quantitative, correlational study carried out in a mobile pre-hospital care service in the São Paulo Metropolitan Region. The participants were 95 professionals, allocated to 40 teams, who answered three questionnaires: sociodemographic/labor data, Team Climate Scale and S20/23 Job Satisfaction Scale. Descriptive statistics and multilevel linear models were used for the analysis, including moderation effects. The Backward method was used to ascertain the order of significance. in the models, the relationships between satisfaction with hierarchical relationships and the factor "support for new ideas" moderated for men and "task orientation" for women were significant. For satisfaction with the physical environment, "working hours" and "participation in the team" were significant and, for intrinsic satisfaction, the regime, working hours and the factors "team objectives", "participation in the team" and "support for new ideas" remained significant, as did the moderation effect between length of service, "participation in the team" and "support for new ideas". team climate is influenced by job satisfaction in a heterogeneous way and the moderating effect of this relationship is associated with gender and length of service. (1) There was a positive perception of the team climate and job satisfaction. (2)The team climate influenced job satisfaction in a heterogeneous way. (3) The moderating effect of this relationship was associated with gender and working hours. (4) The working regime and working hours directly affected intrinsic satisfaction.

Team climate and job satisfaction in a mobile emergency service: a multilevel study

Objetivo: examinar la relación entre el clima en equipo y la satisfacción laboral de los profesionales que trabajan en servicios de atención prehospitalaria móvil. Método: estudio cuantitativo y correlacional realizado en un servicio de atención prehospitalaria móvil en la Región Metropolitana de São Paulo. Participaron 95 profesionales, distribuidos en 40 equipos, que respondieron a tres cuestionarios: datos sociodemográficos/laborales, Escalas de Clima en Equipo y de Satisfacción Laboral S20/23. Para el análisis, se utilizaron estadísticas descriptivas y modelos lineales multiniveles, incluyendo efectos de moderación. Se empleó el método Backward para determinar el orden de significancia. Resultados: en los modelos, fueron significativas las relaciones entre la satisfacción con las relaciones jerárquicas y el factor “apoyo para nuevas ideas” moderado por el género masculino y “orientación hacia las tareas” en mujeres. Para la satisfacción con el ambiente físico, fueron significativos “jornada laboral” y “participación en el equipo”, y para la satisfacción intrínseca, se mantuvieron significativos el régimen, la jornada y los factores “objetivos del equipo”, “participación en el equipo” y “apoyo para ideas nuevas”, y el efecto de moderación entre el tiempo de actuación, “participación en el equipo” y “apoyo para ideas nuevas”. Conclusión: el clima en equipo es influenciado por la satisfacción laboral de manera heterogénea y el efecto moderador de esta relación se asocia con el género y el tiempo de actuación en el servicio.

Longitudinal effects of basic psychological need support on the development of intrinsic motivation and perceived competence in physical education. A multilevel study.

Grounded in self-determination theory, this article deals with a multidimensional measurement of the support of the basic psychological needs and the individual and combined effects on the development of intrinsic motivation and perceived competence in physical education. In addition to the supportive teacher behaviors of autonomy support, competence support and relatedness support, peer relatedness support is examined as an additional factor. A total of 1,047 students from 72 classes from various German-speaking Swiss cantons took part in the study. The hypothesized four factorial structure was analyzed using multilevel confirmatory factor analyses. Longitudinal measurement invariance testing of intrinsic motivation and perceived competence indicates scalar measurement invariance. Multilevel regression analyses were specified to analysis the longitudinal effects on the development of intrinsic motivation and perceived competence, whereby both the effects of the individual factors as well as the adjusted effects under the inclusion of all predictors were examined. Results of multilevel confirmatory factor analysis indicate that the hypothesized four-factor model (e.g., CFI = 0.97; TLI = 0.96; RMSEA = 0.04; SRMR between = 0.11) is to be favored over alternative models at both levels. Regarding the prediction of the development of intrinsic motivation and perceived competence our study underlines the predictive value of basic psychological need support. The models that examine the effects of the individual predictors indicate that the effects are largely consistent with expectations at both the class and individual level. At class level, however, autonomy support appears to be no significant predictor for the development of intrinsic motivation (p < 0.10), but for perceived competence (p < 0.05). Peer relatedness support is a significant predictor for both outcome variables at both levels of analysis. Regarding the simultaneous integration of all predictors, only the effects of peer relatedness support remain significant for both outcome variables. The empirical support of the multidimensionality of the instrument is particularly interesting in the context of the common conceptualization of a unidimensional measurement of autonomy support or a composite factor of psychological need support, whereby only few studies have adequately tested the factorial validity. Although significant effects of supportive teacher behaviors can be demonstrated in the multilevel regression analyses, it is also indicated that the different dimensions lack of incremental predictive validity. Particularly noteworthy is the rarely investigated role of peer relatedness support, which has been shown to be a meaningful predictor, even when supportive teacher behaviors are taken into account.

Spatial variation and determinants of traditional birth attendants utilization among women of reproductive age in Ethiopia: Spatial and multilevel analysis study.

Traditional birth attendant utilization has become a common malpractice and a leading cause of maternal morbidity and mortality in the developing world, such as Ethiopia. Therefore, this study was aimed at determining the geospatial variation and determinant factors of traditional birth attendant utilization among mothers of reproductive age in Ethiopia. The data were taken from the 2019 Ethiopian Demographic and Health Survey. Arc GIS, Excel, and STATA-14 software were used for the data analysis. The adjusted odds ratio with a 95% confidence interval was used to declare significant determinants of traditional birth attendance among mothers of reproductive age in Ethiopia. Among 5,753 mothers of reproductive age, 34.59% of them utilized traditional birth attendants in Ethiopia during the 2019 Ethiopian Demographic and Health Survey. There was a geospatial variation of traditional birth attendants among mothers of reproductive age in Ethiopia; the Global Moran's index value was 0.39 with a p-value <0.001. The significant factors associated with traditional birth attendant utilization were the age of mothers; higher odds were observed among older mothers aged 35-49 years (AOR = 1.31; 95% CI (1.04-1.63)); educational level of mothers (AOR = 3.04; 95% CI (2.13-4.33)); higher odds were observed in uneducated mothers, wealth index (AOR = 2.76; 95% CI (1.83-4.19)); higher odds were observed among the poorer and poorest households, place of residence (AOR = 5.69; 95% CI (3.35-9.67)); and the regions; the highest odds were observed in Somali (AOR = 12.1; 95% CI (4.99-25.68)) and Afar (AOR = 7.13; 95% CI (2.37-21.38)). The utilization of traditional birth attendants among reproductive-age mothers became a major public health concern, and the distribution showed geo-spatial variations among the regions of the country. We recommend taking appropriate measures to alleviate the current problem by improving access to maternal healthcare services.

Is Internalised Homonegativity associated with HIV testing and HIV risk behaviours of men who have sex with men: a multilevel cross-sectional study of sub-Saharan African countries

ObjectivesThis study assessed the associations of Internalised Homonegativity (IH) with HIV testing and risk behaviours of adult men who have sex with men (MSM) in sub-Saharan Africa (SSA) and effect...

Inter-disciplinary and multi-level study of seismic liquefaction susceptibility in the coastal area of Casamicciola Terme (Ischia Island, Italy)

Inter-disciplinary and multi-level study of seismic liquefaction susceptibility in the coastal area of Casamicciola Terme (Ischia Island, Italy)

Examining subjective well-being during pregnancy and its association with pregnancy intendedness among women in Nigeria: A population-based cross-sectional multilevel study.

In this study, we examined the patterns of subjective well-being (SWB) measures among pregnant women and quantified the extent to which pregnancy intendedness is associated with low SWB measures during pregnancy. We analyzed data from the 2021 Nigeria Multiple Indicator Cluster Survey comprising 3,491 pregnant women. The associations between pregnancy intention and low SWB measures (unhappiness, low life satisfaction [LS] and diminished optimism) were determined by fitting series of multilevel logistic regression models with random intercepts. Among pregnant women in our sample 20%, 37.5% and 9.6%, reported being unhappy, experiencing low LS and having diminished optimism, respectively. However, we found no significant association between pregnancy intention and being unhappy (mistimed: adjusted odds ratio [aOR]=1.19, 95% CI=0.88-1.60; unwanted: aOR=1.16, 95% CI=0.71-1.91), experiencing low LS (mistimed: aOR=1.07, 95% CI=0.83-1.37; unwanted: aOR=1.06, 95% CI=0.69-1.65) and having diminished optimism (mistimed: aOR=1.22, 95% CI=0.82-1.82; unwanted: aOR=1.07, 95% CI=0.56-2.04). Findings from the study suggest that pregnant women in Nigeria who reported having either a mistimed or unwanted pregnancy were just as likely to report being unhappy, experience low LS and have diminished optimism as women whose pregnancy was intended.

How physical exercise with others and prioritizing positivity contribute to (work) wellbeing: a cross-sectional and diary multilevel study.

This work is a dual study employing a cross-sectional approach and a diary method to investigate how physical exercise can become a habit. Guided by the Upward Spiral Theory of Lifestyle Change, we examined the role of prioritizing positivity and engaging in physical exercise with others as advantageous resources and their impact on the relational loop of physical exercise behavior, emotions, and engagement. The first study involved a sample of 553 participants, and the second study included 146 participants, all of whom were employed and regularly engaged in physical exercise. We utilized structural equation modeling and multilevel analysis for the respective studies. The results of the first study indicate that individuals exercise more when they experience higher levels of engagement and positive emotions, particularly when exercising with others and prioritizing positivity. The findings of the second study reveal that prioritizing positivity acts as a precursor to positive emotions during physical exercise, which in turn reinforces the relational loop between emotions and exercise behavior. Both studies conclude that individuals who prioritize positivity experience better psychological wellbeing and higher engagement in physical exercise.

Феминистское инсталляционное искусств в современном Китае

Feminist installation art in contemporary China is one of the most dynamic and controversial trends in Chinese contemporary art. It reflects the complex processes of social, political and cultural transformation that have been taking place in China in recent decades. Feminist installations express critical attitudes towards traditional gender roles, national identity, environmental issues and globalization. However, feminist installation art in contemporary China has not received sufficient scholarly coverage and analysis in domestic and foreign literature. Existing studies are often limited to describing individual works or female artists without considering the historical, cultural, and social contexts in which this trend is formed and developed. In addition, many feminist installations have a complex semiotic structure that requires a deep and multidimensional interpretive approach. The expected outcome of the article is a comprehensive and multilevel study of feminist installation art in contemporary China, which will allow for a better understanding and appreciation of its significance.

How economic development affects healthcare access for people with disabilities: A multilevel study in China

Meeting the healthcare needs of people with disabilities is an important challenge in achieving the central promise of “leave no one behind” during the Sustainable Development Goals era. In this study, we describe the accessibility of healthcare for people living with disabilities, as well as the potential influences of individuals’ socioeconomic status and regional economic development. Our data covered 324 prefectural cities in China in 2019 and captured the access to healthcare services for people with disabilities. First, we used linear probability regression models to investigate the association between individual socioeconomic status, including residence, poverty status, education, and healthcare access. Second, we conducted an ecological analysis to test the association between prefectural economic indicators, including GDP (gross domestic product) per capita, urbanization ratio, average years of education, Engel’s coefficient, and the overall prevalence of access to healthcare for people with disabilities within prefectures. Third, we used multilevel regression models to explore the association between the individual’s socioeconomic status, prefectural economic indicators, and access to healthcare at the individual level for people with disabilities. The results showed, first, that higher individual socioeconomic status (urban residence or higher educational level) was associated with better access to healthcare for people with disabilities. Second, regional economic indicators were positively associated with access to healthcare at the aggregate and individual levels. This study suggests that local governments, particularly in low- and middle-income countries, should promote economic development and conduct poverty alleviation policies to improve healthcare access for disadvantaged groups.

Integrated Agent-Based Simulation and Game Theory Decision Support Framework for Cash Flow and Payment Management in Construction Projects

Effective cash flow management has become crucial for projects and stakeholders given the wide payment-related problems and financial risks encountered in the construction industry worldwide. Previous studies mostly addressed cash flow and payments from the perspective of a specific stakeholder, resulting in an imbalanced cash flow management culture that is further intensified by the power asymmetry of the top-down payment decision-making process. This research proposes an adaptive decision support framework for evaluating and negotiating payment options in construction projects while incorporating the individual and collective financial roles of stakeholders. The framework is comprised of three modules for data acquisition, payment simulation, analysis, and negotiation, as well as decision support. It integrates agent-based simulation, data envelopment analysis, and game theory for a multi-level study of project performance while capturing the driving forces of stakeholders in payment negotiations. A case study project is used to demonstrate the framework implementation under varying payment conditions and interest rates. The results provide quantitative profiles of stakeholders to identify incurred charges, balanced payment conditions, and suitable compensation. Finally, the framework can be utilized by stakeholders and jurisdictions to move towards enhanced contractual arrangements that alleviate economic and financial risks with the informed collaboration of its entities.

Southern Ethiopian skilled birth attendant variations and maternal mortality: A multilevel study of a population-based cross-sectional household survey.

Studies examining skilled birth attendants (SBA) use and its correlation with maternal mortality at lower administrative levels are scarce. This study assessed the coverage and variations of SBA, the physical accessibility of health facilities for SBA, and the association of SBA with maternal mortality. A cross-sectional study using a population-based household survey was conducted in six Sidama National Regional State, southern Ethiopia districts, from July 2019 to May 2020. Women who had given birth in the past two years before the study were included. Stata 15 and ArcGIS 10.4.1 were used for data analysis. A multilevel logistic regression analysis was conducted to assess the effect of the sampling units and identify factors independently associated with SBA. The association between SBA and maternal mortality was examined using maternal mortality household survey data. A total of 3191 women who had given birth in the past two years and resided in 8880 households sampled for the associated maternal mortality household survey were interviewed. The coverage of SBA was 46.7%, with high variations in the districts. Thirty percent of SBA use was accounted for by the differences among the districts. One-third of the women travel more than two hours on foot to access the nearest hospital. Districts with low coverage of SBA and located far away from the regional referral centre had high maternal mortality. Education of the mother, occupation of the husband, pregnancy-related complications, use of antenatal care, parity, and distance to the nearest hospital and health centre were associated with the use of SBA. The coverage of SBA in the Sidama Region was low, with high variations in the districts. Low SBA use was associated with high maternal mortality. Due attention should be given to districts with low coverage of SBA and those located far away from the referral centre. Access to hospitals has to improve. All women should be encouraged to get antenatal care services.

The individual- and community-level women's empowerment and utilization of maternity care services in Afghanistan: a multilevel cross-validation study.

This study aimed to explore the relationship between women's empowerment and utilization of maternity care for married Afghan women aged 15-49 y in Afghanistan, assessing the convergence validity of the Survey-based Women's Empowerment Index in Afghanistan (SWEI-A). The study used data from the 2015 Afghanistan Demographic Health Survey to examine the association of different domains of women's empowerment with the utilization of maternity care using multilevel Poisson regression at both individual and community levels. The utilization of maternity services was considerably higher among women with high scores compared with those with low scores in almost all domains of the SWEI-A, except for property owning, in which women with high scores appeared to have lower rates of utilization of such services compared with those with low scores. At the community level, those communities with high participation of women in the labor force were less likely to have adequate antenatal care (ANC), institutional delivery and postnatal care (PNC). Individual-level literacy was associated with higher utilization of ANC, institutional delivery and PNC, contrary to community-level literacy. Except for property owning, the high score in almost all other domains was associated with higher utilization of maternity care, which indicates an acceptable level of convergence validity for the developed index (i.e. the SWEI-A) in measuring women's empowerment among married Afghan women aged 15-49 y.

The Guidelines of the Defensibility of the Republic of Armenia in the Context of Global Turbulence / Ориентиры обороноспособности республики армения в контексте глобальной турбулентности

Contemporary security challenges facing countries in the Middle East and Eastern Europe have led many experts to think about reviving the traditional security paradigm. In these conditions, a re-evaluation of Armenia's security guidelines involves a multi-level study of the relationship between individuals, public institutions and the state. Moreover, existing challenges have created the need for a “predatory defense strategy,” which must be considered in the context of integrating the functions of the army-education system-church.

Unlocking the potential: the impact of digital leadership on firms' performance through digital transformation

PurposeThis study aims to investigate the impact of digital leadership (capabilities, experience, predictability and vision) and green organizational culture on firms' digital transformation and financial performance. Additionally, the research aims to evaluate the mediating role of digital transformation in the relationship between digital leadership and firms' financial performance.Design/methodology/approachA purposive sampling technique was employed to identify and select individuals with relevant expertise and experiences in the field of digital transformation. A total of 164 responses were collected, and the questionnaire was designed based on a five-point Likert-type scale. The data were analyzed using SmartPLS 4 (Statistical Software for Structural Equation Modeling).FindingsThe findings indicate that digital leadership capabilities, experience, predictability and vision do not directly impact firms' performance. However, there is an indirect influence on firms' performance through digital transformation. While both digital transformation and green organizational culture (GOC) positively influence firms' financial performance, GOC, leader predictability and leader vision positively influence digital transformation. The results confirm that digital transformation mediates the relationship between capabilities, experience, predictability and vision and firms' financial performance.Research limitations/implicationsThe study highlights that strategic capabilities can enhance value-added processes during digital transformation, contributing to sustainability in the digital era. Overall, this research significantly advances both theoretical understanding and practical applications in the context of digital leadership and its impact on firms. Limited digital transformation stages among Malaysian firms impact the research, with some entities cautious about data disclosure and having limited cooperation with researchers. Gathering data from diverse sources would have strengthened the findings and methodological rigor of this multilevel study. Despite these limitations, the research offers fresh insights into the role of GOC, different facets of digital leadership and their influence on digital transformation and financial performance. This enhances existing knowledge and challenges assumptions of the transformational leadership theory (TLT) framework.Practical implicationsThe study opens the door to further research into distinct leadership components and their effects in a similar context. By highlighting the positive influence of capabilities, experience, predictability and vision on digital transformation, it expands the theoretical and empirical scope in the realm of digital leadership. These findings encourage critical examination, refinement and evolution of TLT, providing insights for leaders and managers as they navigate digitalization, financial performance and digital leadership within organizations. In an era of digital transformation, leaders play a central role in building a psychologically safe environment and nurturing digitally skilled teams capable of managing technological changes. Leaders should possess the digital capabilities, experience, vision and predictability necessary to drive digital transformation, mitigate potential threats and adapt to the dynamic digital landscape.Social implicationsThese findings support government initiatives to accelerate digitalization and Industry 4.0 implementation. Collaboration between the government and private organizations is essential to create policies and practices that facilitate broad participation in digital transformation programs. Policymakers must adopt a proactive approach to address issues related to Internet accessibility, trade barriers, financing access and resource reallocation. These policies aim to ensure a high-quality and affordable digital infrastructure, cultivate trust in digital technologies and equip organizational leaders with the necessary digital skills.Originality/valueThis research provides valuable insights for practitioners to enhance firms' digital transformation. As a practical contribution, this study’s findings can inform how firms can better manage their key digital leadership resources and GOC to foster digital transformation and improve their financial performance.