Process Model Of Change Research Articles

Implementation of clinical practice changes in the PICU: a qualitative study using and refining the iPARIHS framework

BackgroundLike in many settings, implementation of evidence-based practices often fall short in pediatric intensive care units (PICU). Very few prior studies have applied implementation science frameworks to understand how best to improve practices in this unique environment. We used the relatively new integrated Promoting Action on Research Implementation in Health Services (iPARIHS) framework to assess practice improvement in the PICU and to explore the utility of the framework itself for that purpose.MethodsWe used the iPARIHS framework to guide development of a semi-structured interview tool to examine barriers, facilitators, and the process of change in the PICU. A framework approach to qualitative analysis, developed around iPARIHS constructs and subconstructs, helped identify patterns and themes in provider interviews. We assessed the utility of iPARIHS to inform PICU practice change.ResultsFifty multi-professional providers working in 8 U.S. PICUs completed interviews. iPARIHS constructs shaped the development of a process model for change that consisted of phases that include planning, a decision to adopt change, implementation and facilitation, and sustainability; the PICU environment shaped each phase. Large, complex multi-professional teams, and high-stakes work at near-capacity impaired receptivity to change. While the unit leaders made decisions to pursue change, providers’ willingness to accept change was based on the evidence for the change, and provider’s experiences, beliefs, and capacity to integrate change into a demanding workflow. Limited analytic structures and resources frustrated attempts to monitor changes’ impacts. Variable provider engagement, time allocated to work on changes, and limited collaboration impacted facilitation. iPARIHS constructs were useful in exploring implementation; however, we identified inter-relation of subconstructs, unique concepts not captured by the framework, and a need for subconstructs to further describe facilitation.ConclusionsThe PICU environment significantly shaped the implementation. The described process model for implementation may be useful to guide efforts to integrate changes and select implementation strategies. iPARIHS was adequate to identify barriers and facilitators of change; however, further elaboration of subconstructs for facilitation would be helpful to operationalize the framework.Trial registrationNot applicable, as no health care intervention was performed.

The change management process in the contemporary environment

The success of change management is vital to every organisation as it ensures changes are implemented smoothly and have the planned impact. The literature review raises different questions regards to the change management process as only a few of articles copes with it profoundly. The fact is that organisations have been experiencing tremendous pressure for strategic change in last decade and even more intense in the last year. The central aim of this article is to provide a critical review of the main theories to change management with the focus on the change process. The article also provides fresh empirical data on change management process from top management point of view. The article concludes with constructing a change process model and recommendations for managing change in the contemporary fast-changing environment.

Behavior change

Despite rapid growth in the empirical research on behavior change, modern science has yet to produce a coherent set of recommendations for individuals and organizations eager to align everyday actions with enduringly valued goals. We propose the process model of behavior change as a parsimonious framework for organizing strategies according to where they have their primary impact in the generation of behavioral impulses. To begin, individuals exist in objective situations, only certain features of which attract attention, which in turn lead to subjective appraisals, then finally give rise to response tendencies. Unhealthy habits develop when conflicting impulses are consistently resolved in favor of momentary temptations instead of valued goals. To change behavior for the better, we can strategically modify objective situations, where we pay attention, how we construct appraisals, and how we enact responses. Crucially, behavior change strategies can be initiated either by the individual (i.e., self-control) or by others (e.g., a benevolent employer).

Leader’s Individualized Reframing for Strategic Change Towards Sustainable Business Model

Framing has been widely seen as a communication, negotiation and decision-making tool for leaders and managers. However, it has not been well established as a leadership tool for institutionalizing corporate sustainability. There is a plethora of research related to the need for adopting corporate sustainability by organizations but much more needs to be known about the ‘how’ part of it. Using an inductive approach, we studied how Interface Inc., the largest carpet tiles manufacturer in the world, was transformed to one of the most sustainable corporations in the world. Our qualitative study discovered that the founder-CEO, Ray Anderson, effectively used individualized reframing based on the role expectations of his firm’s stakeholders in order to overcome resistance and change towards an emphasis on sustainability across the value chain. We also offer useful practical insights for practitioners on the process model of change that was adopted by the CEO in institutionalizing sustainability across Interface Inc.

Organizational Change Leadership Research: New Findings and Future Directions

The scholarship of both organizational change and leadership is extensive. However, there have been few attempts to systematically integrate these fields of research in terms of theory or empirical examination. As a result, our understanding of the role and impact of leadership on organizational change outcomes is incomplete. This symposium is designed to generate a dialogue about what constitutes effective change leadership. It is comprised of four papers (two empirical and two theoretical), which explore factors that influence the effectiveness of change leadership in terms of strategic choices, behaviors, and the demands and resources related to the change leader role. Authors of the two most comprehensive reviews of change leadership scholarship – Jeffrey Ford and Shaul Oreg – will introduce and conclude the symposium. In introductory comments, Dr. Ford will comment on the state of change leadership research to date and remaining questions. Shaul Oreg will offer discussant comments that integrate the insights from the papers and propose directions for further research. A Process Model of Organizational Change and Leadership Presenter: Myeong-gu Seo; U. of Maryland Leaders’ Choice of Change Processes: The Option of Dynamic Application to Improve Change Outcomes Presenter: Bradley J. Hastings; UNSW Sydney Presenter: Gavin M. Schwarz; UNSW Sydney The Motivation of Leader Change Messages: An Examination of Regulatory Fit & Follower Responses Presenter: Jill Waymire Paine; IE Business School Presenter: Myeong-gu Seo; U. of Maryland Presenter: Sirkwoo Jin; Merrimack College The Demands and Resources Underlying Change Leader Effectiveness Presenter: Art Uprety; IE Business School, IE U. Presenter: Jill Waymire Paine; IE Business School

Digital communication channels in Industry 4.0 implementation

Industry 4.0 describes a phenomenon which augments business models and also communication channels in commercial enterprises. This paper analyses scientific publications related to the business model changes driven by Industry 4.0, and also digital internal communication channels used to reduce risks in the process. The paper is based upon a systematic review of scientific publications and evaluation by experts. The research revealed a gap between internal communication through digital channels and the change process in Industry 4.0-driven business models. Each channel has its mission and contributes to reducing risk during the change process. Since there is no universal digital channel for internal communication, different digital communication channels are efficient at different stages of change. The paper makes recommendations for enterprises, related to the effectiveness of digital communication channels during the business model transformation. It further contributes to existing knowledge by expanding the change process model and aligning the change process with features of digital communication channels. The research focused on the manufacturing sector, exploring digital communication channels used to reduce risk during the change process, which is a limitation of this study, along with assumption of a basic level of digital competences in the enterprise.

Testing a self-determination theory-based process model of physical activity behavior change in rheumatoid arthritis: results of a randomized controlled trial.

Physical inactivity is prevalent in rheumatoid arthritis (RA) patients, increasing the risk of poor physical health and compromised well-being. Interventions are therefore required to support physical activity (PA) behavior change in this population. This study examined whether a self-determination theory (SDT) based exercise intervention for people with RA, increased autonomous motivation for PA and in turn, moderate-to-vigorous PA (MVPA) and subjective vitality RA patients (n = 115) were randomized to a 3-month SDT-based psychological intervention + RA-tailored exercise program (experimental group, n = 59) or a RA-tailored exercise program only (control group, n = 56). During the program, the SDT-based intervention group received one-on-one consultations with a PA advisor trained in delivering strategies to promote autonomous motivation for PA. Well-established questionnaires assessed autonomous and controlled motivation for PA, MVPA (min/week), and subjective vitality at baseline (T1) and 3 months (T2). Path analysis examined the hypothesized theoretical process model. The model demonstrated an excellent fit to the data (n = 70, χ2 (26) = 28.69, p = .33, comparative fit index = 0.99, root square mean error of approximation = 0.04). The intervention corresponded to higher autonomous motivation and lower controlled motivation for PA at T2, after controlling for T1 autonomous and controlled motivation. In turn, changes in autonomous motivation from T1 to T2 significantly positively predicted changes in MVPA and subjective vitality. Results suggest an SDT based psychological intervention comprising autonomy-supportive strategies for PA predicted greater reported autonomous reasons for PA in RA patients participating in a tailored 3-month exercise program. Increased autonomous motivation linked to increased engagement in MVPA and feelings of vitality in these patients.

From Mother’s Ruin to Ginaissance: Emergence, settlement and resettlement of the gin category

This article provides a historically grounded explanation of category emergence and change by using the gin category as an example. Formerly a standardized spirit produced by a narrow group of large England-based producers, gin has become a premium craft spirit made by thousands of big and small producers in every corner of the world – a categorical shift that commentators have dubbed the ‘ginaissance’. We approach product categories as socially constructed entities and make informed use of history to explain the successive categorical dynamics. Strategic action field theory is applied to explain how internal and external category actors interact to create and change product meanings and affect categorical configurations. Our results show how the intricate, complex and historically embedded processes that the product category underwent first triggered stigmatization and then put conditions in place that led to concentration and made the current ginaissance possible. Findings drawn from this study of gin contribute to research on product categories by revealing some peculiar dynamics of concentration and partitioning, status recategorization and categorical stigma, which are summarized in an empirically grounded process model of category emergence and change.

How Can I Become More Secure?: A Grounded Theory of Earning Secure Attachment.

The purpose of this study was to develop a grounded theory of earning secure attachment. This study included 15 women and 5 men who met the criteria of having a self-reported history of attachment insecurity and demonstrated evidence of earned security. The grand tour research question, How do adults with a history of insecure attachment earn security?, was explored using constructivist grounded theory and semi-structured interviews emphasizing processes of positive attachment change. The results describe a process model of change hinging on three interrelated categories: meta-conditions of positive attachment change, making intrapsychic changes, and making interpersonal changes. Clinical implications include the importance of clients committing to the process, clients working with a clinician trained in trauma-focused therapy, and clinicians being surrogate attachment figures for clients.

Implementation of Social Innovations in Subsistence Marketplaces: A Facilitated Institutional Change Process Model

Implementation of social innovations in subsistence marketplaces often fails as a result of not bringing about institutional change. In this article, we study the process through which social enterprises facilitate local communities in effecting the process of institutional change as they introduce social innovations. Analyzing rich ethnographic data from 19 social enterprises, we develop the process of “facilitated institutional work” for implementing social innovation. We present a process model for implementing social innovation with four distinct stages involving social enterprises—(1) legitimating themselves within local communities, (2) disrupting aspects of the local institutional environment, (3) helping re‐envision institutional norms or practices, and (4) resourcing the institutional change process. The four stages relate to important concerns that local communities have in working with social enterprises implementing social innovations. These community‐level concerns revolve around the following questions: (1) Why should we allow an external social enterprise to be involved in our affairs? (2) Why do we need to change? (3) What should we change and what should we sustain? and (4) What role should we play in implementing change (such as in mobilizing resources)? This article demonstrates that bringing about institutional change is often necessary for implementing social innovations in subsistence marketplaces. The findings depict a participatory approach in which social enterprises work with local communities to bring about the institutional conditions necessary for implementing social innovation.

Explore the needs of the elderly with social awareness

ABSTRACTWith the growing trend in population aging, declining birthrates, and changing patterns in living arrangements, aging in place has become a primary choice for elderly people after retirement (Hooyman & Kiyak, 2010). Home care service has become a key aspect of successful aging so that recent studies started to examine how to serve the dailyneeds for the elderly by adopting new home care services, in particular technology-enabled services for better living. This study applied Maslow’s theory to conduct an in-depth assessment on elders need and examine the factors that influence their satisfaction.Based on the concept of the social change process model (Glofia 1983), the “social awareness” on seeking external (societal) help to solve the problem was proposed and tested on its moderating effects in satisfying elder’s needs. The results from the empirical testing reveal that that elderly people rely on assistance from others and home-care service providers mediating the service to satisfaction when they are in less favorable health and economic conditions.

Constructions of Nonagency in the Clients\u2019 Initial Problem Formulations at the Outset of Psychotherapy

This multiple case study investigated how clients construct nonagentic positions when formulating their problems in the beginning of their first psychotherapy session. The initial problem formulations of nine clients entering psychotherapy were analyzed with a detailed model drawing on discursive methodology, the 10 Discursive Tools model (10DT). We found ten problem formulation categories, each one distinguished by the tool from the 10DT model primarily used to construct nonagency. All clients gave several problem formulations from different categories and constructed nonagentic positions with a variety of discursive tools. When the resulting problem formulation categories were read in comparison with the descriptions of the client’s stance at the outset of psychotherapy as presented in two change process models, the Assimilation of Problematic Experiences Sequence and the Innovative Moments Coding System, some similarities were found. However, the 10DT model brought out much variation in the client’s nonagentic positioning in the formulations, forming a contrast with the more simplified presentations of the client’s initial nonagency given in the change process models. Therapists should pay close attention to how clients express their sense of lost agency at the outset of psychotherapy and how this positions both the client and the therapist as future collaborators in psychotherapy.

Energy consumption analysis of automatic tool change processes

The automatic tool change system was used frequently in numerical control machining processes. Preliminary studies indicate that the power demand of an automatic tool change system is an important part of auxiliary units power demand for numerical control machining processes. Research to date on energy consumption modeling largely focuses on cutting processes while the power demand of automatic tool change processes is treated as a given constant. However, energy consumption modeling of automatic tool change processes is a method that has been overlooked in previous investigations. In fact, the tool change power demand and time vary depending on the turret motor rotation angle for changing tools. Thus, this study aims at solving the above problem by analyzing the power demands of different tool stations for changing tools. The energy consumption modeling method of an umbrella tool changer system was proposed to address the limitations of existing models and validated on a vertical milling machine. In this study, one tool change cycle was divided into five different power demand stages. This is different from the common method where the power demand of one tool change cycle is fixed. The milling case was investigated, and experimental results showed that the proposed modeling method can provide a reliable energy consumption prediction for tool change processes with high accuracy, which can assist manufacturers to develop potential energy saving strategies.

Dynamic Modeling and Control of High-Speed Automated Vehicles for Lane Change Maneuver

Lane change maneuver of high-speed automated vehicles is complicated, since it involves highly nonlinear vehicle dynamics, which is critical for the driving safety and handling stability. Addressing this challenge, we present the dynamic modeling and control of high-speed automated vehicles for lane change maneuver. A nonlinear single-track vehicle dynamics model and a multisegment lane change process model are employed. Variable time steps are utilized for the vehicle model discretization to ensure a long enough prediction horizon, while maintaining model fidelity and computational feasibility. Accordingly, the control of lane change maneuver is addressed in two successive stages. First, by considering the lane change maneuver as primarily a longitudinal control problem, velocity profiles are determined to ensure the longitudinal safety of this maneuver. Then, the associated lateral control is generated with a model-predictive controller, taking the handling stability envelope, coupled tire forces, and environmental constraints into account. Simulations demonstrate the real-time ability and stable-handling capability of the proposed approach.

A dynamic perspective on how public actors shape transnational private regulatory regimes

This paper addresses recent calls to research interactions concerning private and public forms of governance in the transnational sphere. To date, the involvement of government has either not been considered, been promoted as a solution to the regulation proliferation problem or been conceptualized in the singular – one government interacting with numerous non-state actors. We extend these perspectives by studying the dynamics of a transnational regulatory field involving numerous government and intergovernmental actors. By means of 34 interviews and 474 archival sources covering a twenty-five year period, we examine public involvement in the development and evolution of private regulatory coalitions addressing sweatshop issues in global supply chains. Our findings disaggregate “government” from a temporal perspective, revealing the organizational and political dynamics that underpin transnational private regulation. We propose a process model of field-level change that takes into account the involvement of public actors over time, and draws attention to the inherent tensions between social policy (labor issues) and trade policy (harmonization of PRIs). These findings also contribute to practice and policy. We discuss the circumstances when the involvement of multiple governments lead to problematic and counterproductive outcomes at the field level and undermines the reasons for government creation of multi-stakeholder roundtables.

Numerical investigation of cavitation vortex dynamics in unsteady cavitating flow with shock wave propagation

The objective of this paper is to study the cavitation vortex dynamics in compressible turbulent cavitating flow, around a NACA66 hydrofoil. The simulations are conducted based on the open source software OpenFOAM, solving the compressible governing equations together with the Tait state equation for water and ideal gas state equation for vapor. The Saito cavitation model is used to model the cavitation phase change process and SAS SST turbulence model is adopted to account for the turbulence effects. The numerical results showed a good agreement with the experiments. The cavity evolution presents quasi-periodic behaviors, and the alternative re-entrant flow movement and shock wave dynamics play an important role in cavitation vortex dynamics. Strong coherent relationship between cavitation behaviors and vortex dynamics is illustrated. Based on the budget analysis of vorticity transport equation, it shows that during the attached cavity growth, the re-entrant flow development and the cloud cavity being shed stages, the baroclinic torque term dominates the vorticity transport process. During the shock wave propagation stage, the vortex dilatation term dominates in the attached cavity sheet region. Besides, the baroclinic torque term has strong influence on vorticity transport characteristics.

A meta-analysis of motivational interviewing process: Technical, relational, and conditional process models of change.

In the present meta-analysis, we test the technical and relational hypotheses of Motivational Interviewing (MI) efficacy. We also propose an a priori conditional process model where heterogeneity of technical path effect sizes should be explained by interpersonal/relational (i.e., empathy, MI Spirit) and intrapersonal (i.e., client treatment seeking status) moderators. A systematic review identified k = 58 reports, describing 36 primary studies and 40 effect sizes (N = 3,025 participants). Statistical methods calculated the inverse variance-weighted pooled correlation coefficient for the therapist to client and the client to outcome paths across multiple target behaviors (i.e., alcohol use, other drug use, other behavior change). Therapist MI-consistent skills were correlated with more client change talk (r = .55, p < .001) as well as more sustain talk (r = .40, p < .001). MI-inconsistent skills were correlated with more sustain talk (r = .16, p < .001), but not change talk. When these indicators were combined into proportions, as recommended in the Motivational Interviewing Skill Code, the overall technical hypothesis was supported. Specifically, proportion MI consistency was related to higher proportion change talk (r = .11, p = .004) and higher proportion change talk was related to reductions in risk behavior at follow up (r = -.16, p < .001). When tested as two independent effects, client change talk was not significant, but sustain talk was positively associated with worse outcome (r = .19, p < .001). Finally, the relational hypothesis was not supported, but heterogeneity in technical hypothesis path effect sizes was partially explained by inter- and intrapersonal moderators. This meta-analysis provides additional support for the technical hypothesis of MI efficacy; future research on the relational hypothesis should occur in the field rather than in the context of clinical trials. (PsycINFO Database Record

Motivational Interviewing and Medication Review in Coronary Heart Disease (MIMeRiC): Intervention Development and Protocol for the Process Evaluation.

BackgroundTrials of complex interventions are often criticized for being difficult to interpret because the effects of apparently similar interventions vary across studies dependent on context, targeted groups, and the delivery of the intervention. The Motivational Interviewing and Medication Review in Coronary heart disease (MIMeRiC) trial is a randomized controlled trial (RCT) of an intervention aimed at improving pharmacological secondary prevention. Guidelines for the development and evaluation of complex interventions have recently highlighted the need for better reporting of the development of interventions, including descriptions of how the intervention is assumed to work, how this theory informed the process evaluation, and how the process evaluation relates to the outcome evaluation.ObjectiveThis paper aims to describe how the intervention was designed and developed. The aim of the process evaluation is to better understand how and why the intervention in the MIMeRiC trial was effective or not effective.MethodsThe research questions for evaluating the process are based on the conceptual model of change processes assumed in the intervention and will be analyzed by qualitative and quantitative methods. Quantitative data are used to evaluate the medication review in terms of drug-related problems, to describe how patients’ beliefs about medicines are affected by the intervention, and to evaluate the quality of motivational interviewing. Qualitative data will be used to analyze whether patients experienced the intervention as intended, how cardiologists experienced the collaboration and intervention, and how the intervention affected patients’ overall experience of care after coronary heart disease.ResultsThe development and piloting of the intervention are described in relation to the theoretical framework. Data for the process evaluation will be collected until March 2018. Some process evaluation questions will be analyzed before, and others will be analyzed after the outcomes of the MIMeRiC RCT are known.ConclusionsThis paper describes the framework for the design of the intervention tested in the MIMeRiC trial, development of the intervention from the pilot stage to the complete trial intervention, and the framework and methods for the process evaluation. Providing the protocol of the process evaluation allows prespecification of the processes that will be evaluated, because we hypothesize that they will determine the outcomes of the MIMeRiC trial. This protocol also constitutes a contribution to the new field of process evaluations as made explicit in health services research and clinical trials of complex interventions.

How innovators reframe resources in the strategy‐making process to gain innovation adoption

Research Summary: This multicompany qualitative field study combines strategy process and strategy‐as‐practice perspectives to show how innovators successfully gain adoption for their autonomous innovations by reframing the meaning and potential of the associated internal resources to create fit with their organization's strategy. Mapping the five steps involved in the resource reframing process onto the different parts of the Bower‐Burgelman process model of strategic change shows that innovators can shape the strategic context for their autonomous innovations before external market validation is available. These findings confirm the unique potential and importance of different forms of discourse in shaping the strategic innovation process.Managerial Summary: How do innovators from lower levels of an organization gain approval for their innovations especially when their ideas do not readily fit their organization's strategy? To explore this question, we conducted 138 interviews with innovators and their decision makers in 14 firms based in Silicon Valley. We find that successful innovators shape a story supporting their innovation by rethinking their firm's current and potential resources. They then use this story to convince decision makers that their innovation creates unique competitive advantage. Contrary to conventional wisdom, decision makers approved such innovations even without external validation, solely based on the innovators' success in depicting their reorganization of the firm's resources.

Supplemental Material for A Meta-Analysis of Motivational Interviewing Process: Technical, Relational, and Conditional Process Models of Change

Supplemental Material for A Meta-Analysis of Motivational Interviewing Process: Technical, Relational, and Conditional Process Models of Change