Societal Level Research Articles

Aboriginal young people's experiences of type 2 diabetes diagnosis, management and support: A qualitative study in the Kimberley region of Western Australia.

In Australia, Aboriginal and Torres Strait Islander young people in remote settings are most-affected by young onset type 2 diabetes (T2D). It is necessary to understand young people's experiences, including factors impacting on self-management, to improve models of care. A phenomenological methodology underpinned this qualitative study in Western Australia's Kimberley region. Two Aboriginal Community Controlled Health Services supported recruitment of seven Aboriginal young people aged 12-24 with T2D, who participated in interviews. A carer and health professional of one young person in each site were also interviewed and relevant medical record data reviewed to assist with triangulation of data. De-identified transcripts were inductively coded and a coding structure developed with oversight by a Kimberley Aboriginal researcher. Young people reported varied experiences and emotions relating to a T2D diagnosis. Most recounted this was upsetting and some reported current negative impact on emotional wellbeing. Challenges with understanding and managing diabetes were highlighted, particularly regarding healthy eating, physical activity and medication. Family are a prominent source of self-management support, with the intergenerational impact of diabetes being evident for each participant. Positive relationships with health professionals, entailing continuity of care, were valued. There are significant emotional and medical challenges for young people with T2D and their families. Recommendations from this work will contribute to the development of local resources and initiatives to improve diabetes-related support. SO WHAT?: Alongside broader efforts to support good health at the societal level, enhanced health education and family-oriented support structures including Aboriginal clinical staff for young people with T2D are needed.

Perspectives of Female Physicians Who Lead in the Public Health Sector in India – A Qualitative Study

abstract Introduction: This qualitative, research studies female physicians in leadership roles to identify reasons for their underrepresentation. Materials and Methods: Fourteen female physicians in leadership positions in India’s federal and state ministries of health were purposively sampled and interviewed online. Results: Female physician face cultural, organisational and structural barriers. Familial expectations and imbibed, internalised responsibility to prioritise family hold them back. The rigid bureaucracy makes their workplaces non-inclusive. Microaggressions and implicit gender bias abound. A formalised training system and a performance-based reward system are absent. The enabling factors are family support, incidental learning, being emotionally intelligent and passion for their work. Conclusions: Action at the societal, medical education and public health system structural level can motivate female physicians to assume for leadership positions.

How Social Influence Affects Reporting: Toward an Integration of Crime Reporting, Whistleblowing, and Denunciation

Reporting—often by ordinary individuals—is the most common means by which authorities become aware of crimes, misconduct, and other types of deviant behavior. In this article, I integrate research across a variety of disciplines and domains to review the role of social influence in the decision to report. Such influences operate at the individual, group, and societal levels to shape reporting behavior, as potential reporters respond to both direct and indirect pressures, along with considering the anticipated reactions of others were a report to be made. Together, these influences can either suppress or promote reporting, which shapes who is identified, investigated, and ultimately punished for deviant behavior within organizations, communities, and states.

Educational performance pressure and mental ill-being: the case of Danish primary and lower secondary schools, 1975–2024

ABSTRACT Mental ill-being among children and adolescents have increased in many high-income countries. The causes for this development are still unclear, but due to the scale of the problem, broader societal changes are likely to contribute. One of the societal level hypotheses – the “educational stressors hypotheses” – suggests that the transformation in many high-income countries from industrial to knowledge economies makes a well-educated workforce increasingly important. Hence, performance monitoring and performance pressure increase. This article investigates 50 years of educational reforms to analyse whether they introduce increased structural performance pressure. Document analysis of policy documents in Danish primary and lower secondary education constitute the empirical data material. As a least likely case it contributes with knowledge about the extent of formalised performance pressure in education. During the investigated period two shifts emerge. The first introduces tests and examinations as technologies that produce external knowledge about the pupils’ performance. Hence, the performance of each pupil becomes highly visible and comparable in an external panopticon-like gaze. The second shift introduces mandatory self-evaluation and career-planning. It adds a mirror like self-gaze where the pupils are to see and monitor their own performance in accordance with their future wishes. The current performance measures in Danish education are in line with many high-income countries, adding to the hegemony of structural performance pressure in education and qualitatively substantiating the educational stressors hypothesis.

Kappa-opioid receptor antagonism in the nucleus accumbens shell distinguishes escalated alcohol consumption and negative affective-like behavior from physiological withdrawal in alcohol-dependence

Alcohol use disorder (AUD) is a chronic relapsing disease that is deleterious at individual, familial, and societal levels. Although AUD is one of the highest preventable causes of death in the USA, therapies for the treatment of AUD are not sufficient given the heterogeneity of the disorder and the limited number of approved medications. To provide better pharmacological strategies, it is important to understand the neurological underpinnings of AUD. Evidence implicates the endogenous dynorphin (DYN)/κ-opioid receptor (KOR) system recruitment in dysphoric and negative emotional states in AUD to promote maladaptive behavioral regulation. The nucleus accumbens shell (AcbSh), mediating motivational and emotional processes that is a component of the mesolimbic dopamine system and the extended amygdala, is an important site related to alcohol's reinforcing actions (both positive and negative) and neuroadaptations in the AcbSh DYN/KOR system have been documented to induce maladaptive symptoms in AUD. We have previously shown that in other nodes of the extended amygdala, site-specific KOR antagonism can distinguish different symptoms of alcohol dependence and withdrawal. In the current study, we examined the role of the KOR signaling in the AcbSh of male Wistar rats in operant alcohol self-administration, measures of negative affective-like behavior, and physiological symptoms during acute alcohol withdrawal in alcohol-dependence. To induce alcohol dependence, rats were exposed to chronic intermittent ethanol vapor for 14 h/day for three months, during which stable escalation of alcohol self-administration was achieved and pharmacological AcbSh KOR antagonism ensued. The results showed that AcbSh KOR antagonism significantly reduced escalated alcohol intake and negative affective-like states but did not alter somatic symptoms of withdrawal. Understanding the relative contribution of these different drivers is important to understand and inform therapeutic efficacy approaches in alcohol dependence and further emphasis the importance of the KOR/DYN system as a target for AUD therapeutics.

The Gendered Influence of Cross-Gender Friends on the Development of Adolescents’ Gender Role Attitudes

Gender role attitudes have important implications at the individual, family, and societal levels, underscoring the importance of understanding their development. Although parents predominate in the socialization of gender role attitudes in childhood, the influence of friends increases during adolescence. In particular, cross-gender friends can provide unique insights and perspectives on another gender group, making them likely to shape gender role attitudes. However, empirical explorations of the link between gender role attitudes and cross-gender friendships have been rare. Furthermore, the few studies conducted have yielded ambiguous results and have struggled to separate the influence of cross-gender friends from a selection of such friendships based on gender role attitudes. This study addresses these limitations by using longitudinal social network models to assess the co-evolution of friendship networks and gender role attitudes among 3,194 youth (Mage = 15.2, SD = 0.67, 51% female) in German schools. The findings reveal that, after accounting for selection processes, boys with cross-gender friends develop more egalitarian gender role attitudes, while girls’ attitudes are unaffected by cross-gender friendships. These findings suggest that promoting cross-gender friendships among adolescent boys holds the potential to foster egalitarian gender role attitudes.

Intersectionality in Marketing: A Paradigm for Understanding Understudied Consumers

Intersectionality remains largely underutilized within marketing. To address this gap, this article synthesizes literature to provide tools for incorporating intersectionality into marketing research, including a framework for an intersectional marketing paradigm, a research design roadmap, a research agenda, and key takeaways for stakeholders. The definition of intersectionality focuses on three main components: (1) awareness and acknowledgment of overlapping (rather than isolated) social categories (e.g., gender, race, and class), (2) understanding of how differences in lived experiences at these intersections influence the marketplace, and (3) recognition of how power shapes these lived experiences. This article's novel research design roadmap features concrete theoretical and methodological approaches for marketing researchers from various backgrounds to utilize intersectionality in solving marketing problems: conducting exploratory subsample analyses, developing intersectional theory and hypotheses, conducting inclusive literature reviews, collecting and reporting detailed demographics, sampling understudied populations, and carefully situating conclusions. The research agenda provides research questions for emerging topics at societal, organizational, and consumer levels. Engaging with intersectionality will help ensure that marketing remains socially relevant, develops diverse and inclusive theories, and more accurately reflects the lived experiences of understudied populations and communities.

Service robots and innovation: An ecosystem approach

AbstractThe proliferation of service robots has stimulated innovation across industries. These autonomous, physically embodied, and adaptable robots engage in diverse interactions, from patient care to goods delivery and hospitality services. However, the deployment of increasingly capable service robots demands not only designing user–robot interactions, but also holistic innovation management that transcends organizational boundaries and involves various societal stakeholders. Our research draws on the emerging Public Value Theory to examine the types of service robots and the innovation ecosystems that harness the expertise of public and private stakeholders and produce Public Value. Based on literature and an illustrative case study, we conceptualize service robots along characteristics such as autonomy, aesthetics, assistive roles, and user interfaces, and introduce Service Robot‐based Innovation as the ecosystem‐enabled development and employment of such robots. The service robot's autonomy and ecosystem integration are key dimensions determining innovation management practices and Public Value creation. The illustrative case, centered on long‐term care, dissects the integration of service robots across the micro (user), meso (organizational), and macro (societal) levels of the ecosystem. An ecosystem‐as‐structure approach identifies the roles and activities of stakeholders aligning around a shared value proposition of Public Value. A research agenda presents future opportunities within and across various ecosystem levels to advance scholarly understanding of Service Robot‐based Innovation.

Structural Racism Conceptualization and Operationalization for Research for the U.S. HIV Epidemic: Findings from a Scoping Review and Implications for Advancing Research for Structural Interventions.

In the U.S., inequities by race/ethnicity in health outcomes, such as in the HIV epidemic, are long standing but have come to the forefront during the COVID-19 pandemic. There is growing recognition of the role of structural racism in racialized health inequities, yet the conceptualization and operationalization of structural racism in HIV research lags. We conducted a scoping review of existing published literature, between 1999-April 2024, conceptualizing and measuring structural racism's impact among people living with or at risk for HIV in the U.S. Our initial search yielded 236 unique articles, which after title and abstract screening yielded ten articles meeting full text review criteria. We then extracted key parameters, such as conceptualization, method of measurement of structural racism, study aims, design, and findings. Three of the articles were qualitative studies that conceptualized structural racism using (1) the social network model, (2) individual and structural intersectionality and (3) critical race theory. Operationalization of structural racism within the seven quantitative studies fell into three categories: (1) structural level, (2) a scale of experiences of racism, including structural racism, and (3) using explanatory demographic factors as downstream measures of the effects of structural racism. The variance in the conceptualization and operationalization of structural racism highlights the different interpretations of structural racism in its applications to the field of HIV research. Given the vast racial/ethnic inequities in HIV, we propose three overarching suggestions for next steps in improving the conduct of research on structural racism in HIV: (1) we must prioritize measuring racism past the individual and interpersonal levels to consider systemic factors at a societal level that manifest as structural racism to improve HIV outcomes in the U.S., (2) consider intergenerational effects of structural racism through the use of longitudinal data, and (3) broaden the agenda of structural racism to incorporate other systems of oppression. Additionally, broadening the scope of funding and inclusion of more researchers and individuals with lived experiences to support structural racism research to drive the scientific agenda and design of structural-level interventions will not only bolster achieving the U.S. Ending the HIV Epidemic goals but will do so by addressing inequities.

Perspectives of pregnant women on broadening the scope of noninvasive prenatal testing from screening for foetal aneuploidies to prediction of adverse pregnancy outcomes: Aqualitative study.

To explore the perspectives of pregnant women on broadening the scope of noninvasive prenatal testing (NIPT) from screening for foetal aneuploidies to prediction of adverse pregnancy outcomes. Four online focus groups (n=23 participants) and 14 individual semi-structured interviews were conducted. Participants included pregnant women with and without a history of adverse pregnancy outcomes. Both women at low and high risk of adverse pregnancy outcomes had a positive attitude towards using NIPT to predict adverse pregnancy outcomes. Perceived benefits included the possibility to potentially improve maternal and foetal outcomes by taking risk-reducing measures and/or intensified monitoring during pregnancy and the ability to mentally prepare for the potential adverse outcome. Perceived concerns included anxiety and stress caused by a high-risk test result, a false sense of control over pregnancy, and potential false reassurance. Additionally, women reasoned that broadening the scope of NIPT could increase the complexity of prenatal screening and raised concerns on the combined screening aims in one test (prediction of adverse pregnancy outcomes to improve foetal and maternal health vs. screening for foetal aneuploidies to increase reproductive autonomy). On a societal level, considerations on the risk of medicalising pregnancy and overall pressure to opt for NIPT were mentioned. In general, pregnant women have a positive attitude towards broadening the scope of NIPT to the prediction of pregnancy outcomes, although some concerns are acknowledged.

The Digital Economy: Opportunities and Difficulties Isamic Economy's Future

The advent of technical innovation and economic digitalization via social media platforms and shopping applications has an impact on community social and economic activity. The manual, traditional economic system has been replaced by a modern one. A basic definition of a digital economy is any economic output that uses multifunctional internet-based technologies applied in a variety of digital business models for products or services. The expansion of the Islamic economy's involvement in e-commerce must be promoted in order to support the rise of financing via the digital economy and the empowerment that comes with it. One approach that can be used to create halal product innovations that are popular on the digital economy platform is principle-based regulation. With this technology, one would anticipate that. The results of this study demonstrate that initiatives to support innovation, entrepreneurship, and economic expansion may present a chance to increase access, particularly to Islamic economic inclusion. The digital economy is also anticipated to serve as a platform for the exchange of knowledge about how to better public services, finance, or social services, as well as new technologies that could offer all societal levels first-rate, quick, and reasonably priced Islamic economic services while also enhancing the effectiveness and efficiency of economic activity.

Experiences of Midwestern obstetric clinicians during the Coronavirus disease 2019 pandemic

BackgroundThe Coronavirus disease 2019 (COVID-19) pandemic led to healthcare system changes aimed at minimizing disease transmission that impacted experiences with obstetric healthcare. ObjectiveTo explore experiences of clinicians providing obstetric care during the COVID-19 pandemic. Study DesignQualitative, in-depth, semi-structured interviews were conducted with five nurse practitioners and 16 obstetrical physicians providing a mix of outpatient and inpatient obstetric care during the COVID-19 pandemic in a mid-sized, Midwestern city in the United States. Interviews elucidated challenges and facilitators of obstetric care provision and vaccination of pregnant patients against COVID-19 during the pandemic. Transcripts were coded inductively then deductively using the Health Equity Implementation Framework (HEIF), which integrates a disparities framework and implementation framework to highlight multilevel factors that influence obstetric care. Thematic analysis was conducted, and thematic saturation was reached. ResultsWe interviewed 21 clinicians. Clinicians recounted personal challenges such as social isolation and burnout that could be countered by social support. Challenges within the clinical encounter included implementation of infection mitigation efforts, vaccine counseling, and limitations of telehealth. However, when successfully implemented, telehealth facilitated care and circumvented barriers. Clinicians cited challenges at the healthcare system level such as rapidly evolving knowledge and recommendations, restrictive visitor policies, personnel shortage, and inadequate institutional resources to support pandemic-related stressors. However, interdisciplinary care and guidelines available for clinicians facilitated care. Clinicians reported that challenges at the societal level included financial strain, lack of childcare, medical mistrust, politicization of medicine, misinformation, and racism. Societal-level facilitators included insurance access, community outreach, positive policy changes, and fostering trust in medicine. ConclusionThe pandemic produced unique stressors and exacerbated existing challenges for clinicians providing obstetric care. Applying the HEIF to the findings emphasizes the influence of societal factors on all other levels. Identified facilitators can inform interventions to address stressors in obstetric care that have resulted from the changed sociopolitical landscape of the pandemic.

Lifelong learning and the transformation of higher education

Societal development in the 21st century has had an impact on competencies needed in working life. Such development includes a continuous professional development, and a lifelong learning process where higher education institutions are an essential partner. Contemporary lifelong learning has multiple purposes such as increased employability, organisational development, global competition, and also hopefully involves the aspect of personal development. This paper aims at reporting preliminary results focused on lifelong learning and the current transformation of higher education, posing the following research question: How can a preliminary framework for lifelong learning based on networked learning experts' perceptions of the transformation of higher education be designed? Eight experts from six different global regions, known for their research and publication records in higher education, lifelong and work-integrated learning, were invited to participate in this study, which involved multiple data collection methods. Data analysis involved staged thematic analysis with multiple coders and inter-rater verification and negotiation. The preliminary findings note the current state of the analysis based on the perceptions expressed by these experts in interviews. These findings consist of the following elements: Lifelong learning, Pedagogy, and Technology. These elements are each represented by a circle that intersects with the transformation of higher education and are seen to be surrounded and impacted by three different levels: the individual, organizational and societal levels. These levels interplay with the elements of Lifelong learning, Pedagogy, and Technology as driving forces in the transformation of higher education. How these driving forces will continue to have an impact on higher education, and how higher education steps up to take on these challenges warrant further research.

Insights from the EQUALS4COVID19 study on migrant mental health in Portugal: a cross-sectional mixed-methods approach

BackgroundThe COVID-19 pandemic and related disruptive consequences in the economic, health, and educational sectors have impacted people’s lives, contributing to a context of increased economic and social vulnerability. The pandemic has revealed and accentuated social inequalities and discrimination based on racial or ethnic origin. This study aimed to contribute to the promotion of the mental health and well-being of migrant populations living in Portugal via the definition of an analytical framework and recommendations emerging from the EQUALS4COVID19 project.MethodsTo gather information on the impact of the COVID-19 pandemic and resilience determinants among immigrants, a mixed-methods approach was implemented in 2022, combining a cross-sectional survey targeting immigrant adults in Portugal, focus groups with immigrants, focus groups with healthcare professionals, and in-depth individual interviews with stakeholders involved in the implementation of measures related to mental health and well-being during the pandemic. The analysis followed an integrated framework; quantitative data informed the script of qualitative data collection methods, and qualitative analysis informed the reinterpretation of quantitative data.ResultsThe survey with 604 Brazilian and Cape Verdean immigrants revealed that gender (being a woman) was associated with both psychological distress and depression-related symptomatology and that the perception of discrimination was a major risk factor for psychological suffering, while perceived social support and individuals’ resilience characteristics were protective factors. Qualitative data provided deeper insights into these findings, revealing the ways mental health is affected by social structures, such as gender and ethnic hierarchies. Migrants tend to work in precarious jobs requiring physical presence, which, together with dense housing conditions, puts them at higher risk of infection. The deterioration of the economic conditions of the general population has also increased the perception of ethnic-racial discrimination, which was found to be related to the increase in insecurity and anxiety-related symptomatology among the migrant population. Newly arrived migrants, with reduced support networks, experienced a greater sense of insecurity as well as concern and anguish regarding relatives who live far away, in their home country. Migrant women reported greater family-related distress, including work-life balance problems.ConclusionsProposals to address mental health inequalities should be considered in the context of the necessary global changes both at the societal level and in the delivery of mental health services. Additionally, they should be considered with the active involvement of migrants, families, and communities in the design and delivery of mental health promotion and care processes.

Temporomandibular disorder pain is associated with increased sick leave and reduced health related quality of life.

Temporomandibular disorders (TMD) are the most common reason for chronic pain in the orofacial area and significantly impact the lives of those affected. The role of lifestyle factors in TMD, however, remains less explored. This cohort study aims to estimate TMD prevalence by addressing potential selection biases and to evaluate the association between TMD and lifestyle factors with a specific focus on sick leave and health related quality of life. By linking data on TMD in the general population in Västerbotten, northern Sweden (n = 180,000) to health survey data (n = 120,000), information on sociodemographic factors and quality of life was available for 52,961 individuals (50.6% women) with a mean age of 53 years. We applied inverse probability weighting to adjust for selection bias and Poisson regression to explore associations with TMD. TMD prevalence was 9.2% during the study period, being higher in women (12.9%) than men (5.4%). Weighting for varying visiting frequencies did not affect TMD prevalence (average difference 0.4% points). Individuals with TMD, especially women, reported more sick leave and use of pain medication, with a significant association between TMD and increased sick leave (prevalence ratio 1.89, 95% CI: 1.78-2.01) among both women and men. In addition, TMD was associated with a lower health related quality of life (p < 0.001). The association of TMD with sick leave highlights the condition's profound impact on the lives of affected individuals. These findings underscore the influence of TMD on work life and the burden of TMD on the societal level. The findings provide insight into how TMD affect individuals, by incorporating lifestyle factors, social determinants and the impact of sick leave at a population level. By incorporating these areas into the study of TMD, we can deepen our understanding of how TMD affects individuals' lives. This approach may also create opportunities to develop more comprehensive strategies to address TMD, focusing on broader implications beyond the clinical symptoms.

Exposure to drug trafficking and school truancy: Empirical evidence from Costa Rica

Exposure to crime and violence associated with drug trafficking has been shown to have negative consequences on students’ health, peer relationships, and educational outcomes. However, little attention has been devoted to analyzing the effects of exposure to drug trafficking on students’ truancy behavior, a critical outcome with a high cost at an individual and societal level. This study investigates the connection between exposure to drug trafficking (an increasingly common form of chronic crime and subsequent violence in Latin America) and school truancy in Costa Rica. To do so, we use a unique and comprehensive microdata set that merges detailed information on a specific measure of exposure to drug trafficking (cocaine seizures) and socioeconomic characteristics of Costa Rican districts with student and school data from the Programme for International Student Assessment (PISA). In total, we obtain a sample of 4,584 students in secondary education attending 195 schools in 147 districts. Using logistic regression, we find that students in districts with higher exposure to drug trafficking (measured by cocaine seizure rate) are more prone to school truancy. This finding suggests that strategies to tackle school truancy should consider a neighborhood context perspective.

Role of Social Media in COVID-19 Pandemic

Coronavirus disease 2019 (COVID-19) pandemic has produced a global health crisis that has had a deep impact on the way we perceive our world and everyday lives. Not only the spread rate of contagion and patterns of transmission endangered our sense of security, but the safety measures put in place to contain the spread of the virus also require social distancing by refraining from doing what is inherently human, which is to find comfort in the company of others. Within this context of physical threat, social and physical distancing, the role of the different mass media channels and social media in lives on individual, social and societal levels cannot be underestimated.

Early-life risk factors for depression among young adults in the United States general population: Attributable risks and gender differences

BackgroundThis study adopts individual and societal-level approaches to examine the contribution of childhood risk factors to major depressive episodes (MDE) in 2526 American young adults. MethodsNationally representative data from the 2017 U.S. Panel Study of Income Dynamics – Transition into Adulthood Supplement (PSID-TAS) were analyzed using multivariate methods to assess the impact of parental mental illness, childhood adversities, childhood mental disorders, and childhood physical conditions. Adjusted odds ratios and population attributable risk proportions (PARPs) are calculated to estimate the proportion of MDE cases related to risk factors. ResultsThe 12-month prevalence of positive screens for MDE was 25.4 %. Approximately 34 % of these were attributable to childhood mental disorders, 24 % to childhood physical conditions, 21 % to childhood adversities, and 16 % to parental mental illness. Childhood and parental depression were critical risk factors, both at the individual (odds ratio exceeding 2) and societal (PARP approximately 24 %) levels. Gender-specific risk factors were identified, with childhood physical abuse and childhood anxiety disorders constituting risk factors for females, and childhood externalizing disorders and childhood headaches as risk factors for males. Approximately 60 % of U.S. young adult MDE cases are attributable to risk factors before age 18. LimitationsPossible over reporting of MDE may have biased the associations between predictors and depression. ConclusionsExposure to depression at a young age—one's own or parental depression—is a robust risk factor for both genders. Policies and interventions focused at alleviating the societal burden of depression should value its generational transmission.

Application and performance evaluation of recycled building materials in civil engineering

The concept of renewable materials has received extensive advocacy and promotion in the ongoing development of the construction industry. Furthermore, emerging renewable building materials, such as bio-based composite materials, are continually evolving and gradually being incorporated into civil engineering applications. This paper focuses on the application and performance assessment of recycled building materials in civil engineering. As a crucial component of environmental protection and sustainable development, recycled building materials possess vast potential for application. In this article, the characteristics of common materials such as recycled concrete, recycled steel, and recycled glass are introduced, and their mechanical performance, durability, and other vital attributes are evaluated. Finally, the feasibility and challenges of recycled building materials are analyzed, along with discussions on sustainable development strategies and policy support. The comprehensive research results demonstrate the significant role of recycled building materials in promoting sustainable development in civil engineering, warranting increased support and promotion at the policy and societal levels.

Reflecting on the Impact of Hybrid Work on an Academic Library Using the Socio-Ecological Model

Covid-19 led to a dramatic change in the academic library work environment, with many workers shifting to a hybrid work schedule once they returned to in person work. The authors describe the impact of this schedule shift through the novel use of the socio-ecological model. The socio-ecological model looks at the impact of choices through varying circles or levels. The authors discuss the individual, interpersonal, community, and societal levels of impact that the switch to hybrid work had within their context and discuss their role as unit leaders and the decisions made to address these varying impacts.