Search Results (38)

Indonesia’s commitment to digital transformation is exemplified by the Gerakan 100 Smart City program, aiming to enhance public sector performance through technology integration. This study examines how information technology capability and 21st century digital skills influence public sector performance, mediated by managerial digital readiness and moderated by digital leadership. Grounded in Dynamic Capability Theory and Upper Echelon Theory, data from 1380 civil servants were analyzed using PLS-SEM via SmartPLS 4.1.0.9. Results show that both IT capability and digital skills significantly improve managerial digital readiness, which in turn positively impacts public sector performance. Managerial readiness mediates the effect of both predictors on performance, while digital leadership strengthens these relationships. Theoretically, this study frames managerial digital readiness as a dynamic capability shaped by leadership cognition. Practically, it highlights the importance of aligning infrastructure, skills, and leadership development to advance digital governance. Future research should consider longitudinal, multilevel, and qualitative designs to deepen insights. Full article

Background/objectives: Racial and ethnic minority patients are underrepresented in cancer clinical trials (CCTs) and multilevel strategies are required to increase participation. This study describes barriers and facilitators to minority CCT participation alongside feedback on a multilevel intervention (MLI) designed to reduce participation barriers, as posited by the socioecological model (SEM). Methods: Interviews with Moffitt Cancer Center (MCC) physicians, community physicians, patients with cancer, community residents, and clinical research coordinators (CRCs) were conducted from June 2023–February 2024. Verbal responses were analyzed using thematic analysis and categorized into SEM levels. Mean helpfulness scores rating interventions (from 1 (not helpful) to 5 (very helpful)) were summarized. Results: Approximately 50 interviews were completed. Thematic findings confirmed CCT referral and enrollment barriers across all SEM levels. At the community level, MCC patients and community residents felt that community health educators can improve patient experiences and suggested they connect patients to social/financial resources, assist with patient registration, and provide CCT education. While physicians and CRCs reacted positively to all institutional-level tools, the highest scored tool simultaneously addressed CCT referral and enrollment at the institution (e.g., trial identification/referrals) and interpersonal level (communication platform for community and MCC physicians) (mean = 4.27). At the intrapersonal level, patients were enthusiastic about a digital CCT decision aid (mean = 4.53) and suggested its integration into MCC’s patient portal. Conclusions: Results underscore the value of conducting formative research to tailor interventions to target population needs. Our approach can be leveraged by future researchers seeking to evaluate MLIs addressing additional CCT challenges or broader health topics. Full article

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States (U.S.) and a major contributor to several cancers, including cervical, anal, penile, and oropharyngeal cancers. Although a safe and effective vaccine is available, HPV vaccination rates remain suboptimal, particularly among racial, ethnic, and immigrant minority groups. This study explored multiple factors, such as cultural, social, and structural influences, influencing HPV vaccine decision-making among Cape Verdean immigrant parents in the U.S., a population currently underrepresented in HPV research. Methods: Qualitative study using individual, in-depth interviews with Cape Verdean immigrant parents of children aged 11 to 17 years living in the U.S. Interviews were transcribed verbatim and analyzed thematically using the social ecological model (SEM) to identify barriers and facilitators at the intrapersonal, interpersonal, organizational, community, and policy levels. Results: Forty-five Cape Verdean parents (27 mothers, 18 fathers) participated. Fathers were significantly older than mothers (50.0 vs. 41.1 years, p = 0.05). Most were married or partnered (60%), had at least a high school education (84.4%), and reported annual household incomes of US$50,000 or more (66.7%), with no significant gender differences. Nearly all spoke Creole at home (95.6%). Fathers had lower acculturation than mothers (p = 0.05), reflecting less adaptation to U.S. norms and language use. Most parents had limited knowledge of HPV and the vaccine, with gendered beliefs and misconceptions about risk. Only seven mothers (25.9%) reported receiving a provider recommendation; all indicated that their children had initiated vaccination (1 dose or more). Mothers were the primary decision-makers, though joint decision-making was common. Trust in providers was high, but poor communication and the lack of culturally and linguistically appropriate materials limited informed decision-making. Stigma, misinformation, and cultural taboos restricted open dialogue. Trusted sources of information included schools, churches, and Cape Verdean organizations. While parents valued the U.S. healthcare system, they noted gaps in public health messaging and provider engagement. Conclusions: Findings revealed that HPV vaccine uptake and hesitancy among Cape Verdean immigrant parents in the U.S. were influenced by individual beliefs, family dynamics, healthcare provider interactions, cultural norms, and structural barriers. These findings highlight the need for multilevel strategies such as culturally tailored education, community engagement, and improved provider communication to support informed vaccination decisions in this population. Full article

This study investigates the mechanisms through which employees’ green behavioural intention (GBI) translates into employee in-role green behaviour (EGB-IR) in the hospitality sector. Drawing on the Theory of Planned Behaviour (TPB) and the Value-Belief Norm (VBN) theory, we propose an extended model that incorporates four contextual mediators —customers’ environmental attitudes (CEAs), coworkers’ green work climate (CGWC), supervisors’ commitment to the environment (SCE), and environmental organisational policy (EOP)—to explain how the relationship between intentions and behaviours is mediated by these social and organisational factors. Data were collected through a self-administered survey of 497 employees from hotels located in the Canary Islands, a recognised coastal tourism destination facing relevant environmental challenges. The proposed relationships were tested using Partial Least Squares Structural Equation Modelling (PLS-SEM). Results confirm that GBI significantly predicts in-role green behaviour (EGB-IR), and all four contextual factors partially mediate this relationship. Among them, EOP and CGWC emerged as the most influential mediators. These findings underscore the importance of aligning individual motivation with supportive workplace environments to foster consistent sustainable practices in hospitality organisations. This research contributes to the growing literature on green behaviours in hospitality by empirically validating a multilevel TPB-VBN-theory-based framework and highlighting key points for hotel managers aiming to strengthen their environmental commitment through employee engagement. Full article

With the advancement of the global Sustainable Development Goals (SDGs), residents’ green perception has become a key factor in driving green behavior and the implementation of environmental policies. However, due to differences in socio-economic environments, policy enforcement, and resource accessibility between urban and rural areas, residents’ levels of green perception exhibit significant regional disparities. Based on the Social Ecological Model, this study constructs an analytical framework encompassing the individual, social relationships, community, policy, and organizational levels to systematically explore the multi-level factors influencing urban and rural residents’ green perception. This study collects data through questionnaire surveys and employs Structural Equation Modeling (SEM) to validate the relationships between variables at different levels. The findings indicate that residents’ green perception is influenced by multiple interacting factors, among which environmental knowledge and attitudes at the individual level, family support and social networks at the social relationship level, as well as community atmosphere and policy advocacy play particularly significant roles in enhancing green perception. Furthermore, there are distinct differences in the mechanisms of green perception formation between urban and rural residents; urban residents rely more on government policies and green infrastructure, whereas rural residents’ green perception is primarily influenced by community atmosphere and direct environmental experiences. This study deepens the understanding of urban–rural differences in green perception and their driving factors, providing region-specific policy recommendations to promote widespread green behavior, advance ecological civilization construction in both urban and rural areas, and facilitate the achievement of sustainable development goals. Full article

Background/Objectives: The transition to university life brings significant social, psychological, and environmental changes, making it a critical period for establishing long-term dietary habits. However, many Mexican university students fail to meet national dietary guidelines, increasing their risk of non-communicable diseases. This study examines the determinants of healthy eating among university students in Oaxaca using a holistic, multi-level approach grounded in the Social Ecological Model (SEM) and Social Cognitive Theory (SCT). Methods: A mixed-methods approach was employed, integrating ethnography with a validated self-report questionnaire completed by 411 students at the Universidad Autónoma Benito Juárez de Oaxaca (UABJO). The ethnographic data included observations, field notes, photographs, informal conversations, and 13 semi-structured interviews. Data triangulation provided a comprehensive understanding of dietary behaviors by capturing both self-reported patterns and real-world eating practices and the food environment, as captured through ethnographic methods. The analysis included descriptive statistics, normality tests, and parametric tests to assess significant differences. Results: The findings revealed a decline in diet quality, characterized by low fruit and vegetable intake, high snack consumption, and irregular meal patterns, particularly among students living independently. Key barriers included academic stress, time constraints, low cooking self-efficacy, limited nutritional knowledge, peer pressure, and negative social norms, which contributed to reliance on convenient, processed foods. The lack of healthy food options on campus and the high perceived cost of nutritious food further led students to prioritize cheap, calorie-dense foods over healthier choices. Conversely, enablers included structured university schedules; peer support; hands-on culinary interventions; and improved access to affordable, healthy food. Conclusions: Addressing these barriers requires multi-level interventions that enhance nutrition literacy, cooking self-efficacy, and peer-led strategies while improving the campus food environment. Future research should explore SCT-based initiatives leveraging social networks and culinary education to foster sustainable dietary behavior change in university settings and assess how these findings can be applied in other socioeconomic and cultural contexts. Full article

Background/Objectives: Childhood eating behaviors result from a complex interplay of familial, social, and environmental factors, influenced by socioeconomic and cultural contexts. These behaviors impact dietary habits, nutritional status, and long-term health. Using the Social Ecological Model (SEM), this narrative review synthesizes evidence on key determinants of childhood eating behaviors and proposes a framework for multi-level interventions. Methods: A structured literature search was conducted across PubMed, PsycINFO, and CINAHL, focusing on studies published between January 2014 and September 2024. Keywords related to childhood eating behaviors, familial determinants, and social influences were used to identify relevant studies. Inclusion criteria centered on empirical research examining how social and familial factors impact childhood eating behaviors within the SEM framework. Results: The review highlights critical determinants, including parental feeding practices, home food environments, peer influences, screen time, school meal programs, and socioeconomic disparities. These factors interact across multiple levels, emphasizing the importance of holistic interventions that target both individual behaviors and broader systemic influences. Conclusions: Addressing childhood eating behaviors requires a multi-level approach that integrates caregiver education, peer-led interventions, improved food environments, and supportive policies. Healthcare providers and policymakers play a crucial role in implementing strategies that foster healthier dietary behaviors and mitigate childhood obesity risks. Full article

Recognizing the factors that influence business formation in developing contexts is critical for promoting economic growth. This study examines the drivers of entrepreneurship among university alumni in Ecuador, addressing gaps in the literature regarding the roles of individual, organizational, and institutional factors in business creation. Drawing on established theories such as the Theory of Planned Behavior and Resource-Based Theory, a multilevel causal model was developed and tested using Partial Least Squares Structural Equation Modeling (PLS-SEM). Data were collected from 550 alumni through a structured questionnaire, complemented by semi-structured interviews. The model integrates micro-level (entrepreneurial attitudes and funding experience), meso-level (entrepreneurial knowledge acquired from working experience), and macro-level determinants (opportunity cost). Results indicate that while individual traits play a role, organizational knowledge and institutional context have more pronounced impacts on entrepreneurial actions. In particular, opportunity costs have a negative impact on the business formation process, reflecting the challenges of entrepreneurship in unfavorable environments. The findings highlight the importance of fostering entrepreneurial ecosystems within universities, emphasizing education and support mechanisms tailored to overcoming institutional barriers. This study contributes to the understanding of entrepreneurship in Latin America, offering insights for policymakers and academic institutions aiming to enhance entrepreneurial activity and economic development. Full article

Background/Objectives: Sexual and gender minority (SGM) adults are at an increased risk for suicide and suicidal ideation compared with cisgender/heterosexual adults. Due to the complexity of suicidal ideation, individual, social, and systemic factors must be considered. The purpose of this study was to identify determinants of suicidal ideation among SGM adults using constructs from the Social–Ecological Model (SEM). Methods: This was a cross-sectional study of data collected from 1034 SGM adults between 27 January and 7 February 2022, and variables reflected the four constructs of the SEM, including individual, family, community, and societal levels. Hierarchical multiple linear regression was used to enter the variables in blocks. Results: The final model explained 55% of the variance in suicidal ideation, and determinants of suicidal ideation were identified at all four levels. At the individual level, factors were depression (p < 0.001, β = 0.231), anxiety (p < 0.001, β = 0.279), vigilance distress (p = 0.036, β = 0.157), not being out/open (p = 0.046, β = 1.136), having some college education (p = 0.002, β = −1.875), and personal strength (p = 0.012, β = −0.131). Family of origin discrimination distress was significant at the family level (p = 0.016, β = 0.174). Social resources (p < 0.001, β = −0.113), victimization distress (p < 0.001, β = 0.795), and harassment/discrimination distress (p = 0.035, β = 0.179) were significant at the community level. At the social level, SGM protective state law score (p = 0.43, β = −0.35) and having a proposed or enacted transgender sports ban (p = 0.027, β = 1.480) were significant. Conclusions: Understanding the factors across the various levels of the SEM that influence suicidal ideation allows for the development of multi-level, social-ecological suicide prevention programs. Such programs can address the unique needs of SGM individuals and help mitigate suicidal ideation. Full article

(1) Background: The aim of this study was to understand the factors associated with vaccine hesitancy and refusal in Indonesia using the Social–Ecological Model (SEM). (2) Methods: Data on demographics, religiosity, family dynamics, and perceptions of public health efforts were collected through an online survey and compared to the rates of vaccine hesitancy and refusal. (3) Results: Income and sex were significantly associated with vaccine hesitancy. Based on a vaccine passport policy to enter public spaces, people who felt inhibited to enter public spaces or perceived privacy threats were twice as likely to exhibit vaccine hesitancy. Participants who believed that religious groups had a difficult time getting vaccinated were nearly twice as likely to exhibit vaccine hesitancy and three times more likely to exhibit vaccine refusal. However, participants who believed in a higher religious power were 58% less likely to exhibit vaccine hesitancy. Religious leaders significantly influenced participants to make the decision regarding vaccination. Individuals with vaccine refusal were more than twice as likely to share information with others without fact-checking. Notably, structural barriers such as distance and transportation were most strongly associated with vaccine hesitancy and refusal. (4) Conclusion: Cultural factors play a significant role in vaccine hesitancy and refusal. The SEM can be used to propose multi-level interventions with collaboration and communication among stakeholders to improve community health. Full article

The given research employs high-resolution air quality monitoring and contemporary statistical methods to address gaps in understanding the urban air pollution in Pavlodar, a city with a significant industrial presence and promising touristic potential. Using mobile air quality sensors for detailed spatial data collection, the research aims to quantify concentrations of particulate matter (PM_2.5, PM₁₀), carbon monoxide (CO), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), and ground-level ozone (O₃); assess their distribution; and identify key influencing factors. In this study, we employed Geographic Information Systems (GISs) for spatial analysis, integrating multi-level B-spline interpolation to model spatial variability. Correlation analysis and structural equation modeling were utilized to explore the relationships between variables, while regression analysis was conducted to quantify these relationships. These techniques were crucial for accurately mapping and interpreting spatial patterns and their underlying factors. The study identifies PM_2.5 and NO₂ as the primary contributors to air pollution in Pavlodar, with NO₂ exceeding the 24 h threshold in 87.38% of locations and PM_2.5 showing the highest individual air quality index (AQI) in 75.7% of cases. Correlation analysis reveals a positive association between PM_2.5 and AQI and a negative correlation between NO₂ and AQI, likely due to the dominant influence of PM_2.5 in AQI calculations. Structural equation modeling (SEM) further underscores PM_2.5 as the most significant impactor on AQI, while NO₂ shows no significant direct impact. Humidity is positively correlated with AQI, though this relationship is context-specific to seasonal patterns observed in May. The sectoral analysis of landscape indices reveals weak correlations between the green space ratio (GSR) and air quality, indicating that while vegetation reduces pollutants, its impact is minimal due to urban planting density. The road ratio (RR) lacks sufficient statistical evidence to draw conclusions about its effect on air quality, possibly due to the methodology used. Spatial variability in pollutant concentrations is evident, with increasing PM_2.5, PM₁₀, and AQI towards the east-northeast, likely influenced by industrial activities and prevailing wind patterns. In contrast, NO₂ pollution does not show a clear geographic pattern, indicating vehicular emissions as its primary source. Spatial interpolation highlights pollution hotspots near industrial zones, posing health risks to vulnerable populations. While the city’s overall AQI is considered “moderate”, the study highlights the necessity of implementing measures to improve air quality in Pavlodar. This will not only enhance the city’s attractiveness to tourists but also support its sustainable development as an industrial center. Full article

We propose and demonstrate a new two-stage maximum likelihood estimator for parameters of a social relations structural equation model (SR-SEM) using estimated summary statistics ($\widehat{\mathsf{\Sigma }}$) as data, as well as uncertainty about $\widehat{\mathsf{\Sigma }}$ to obtain robust inferential statistics. The SR-SEM is a generalization of a traditional SEM for round-robin data, which have a dyadic network structure (i.e., each group member responds to or interacts with each other member). Our two-stage estimator is developed using similar logic as previous two-stage estimators for SEM, developed for application to multilevel data and multiple imputations of missing data. We demonstrate out estimator on a publicly available data set from a 2018 publication about social mimicry. We employ Markov chain Monte Carlo estimation of $\widehat{\mathsf{\Sigma }}$ in Stage 1, implemented using the R package rstan. In Stage 2, the posterior mean estimates of $\widehat{\mathsf{\Sigma }}$ are used as input data to estimate SEM parameters with the R package lavaan. The posterior covariance matrix of estimated $\widehat{\mathsf{\Sigma }}$ is also calculated so that lavaan can use it to calculate robust standard errors and test statistics. Results are compared to full-information maximum likelihood (FIML) estimation of SR-SEM parameters using the R package srm. We discuss how differences between estimators highlight the need for future research to establish best practices under realistic conditions (e.g., how to specify empirical Bayes priors in Stage 1), as well as extensions that would make 2-stage estimation particularly advantageous over single-stage FIML. Full article

This paper addresses the role of multilevel microstructures on the fatigue crack propagation behavior and the tensile properties of lath martensite with different substructure sizes. Microstructure characterization of the alloy was carried out by transmission electron microscopy (TEM), scanning electron microscopy (SEM), electron back-scattering diffraction (EBSD), and optical microscopy (OM). Based on the classic Hall–Petch relationship, the results of tensile tests showed that martensitic block is the effective control unit of yield strength. Furthermore, the plasticity of lath martensite is not sensitive to grain size. The tensile deformation mechanisms were also discussed. Fatigue crack propagation tests revealed that the coarse grain has a higher crack propagation threshold and lower crack propagation rate than the fine grain in lath martensitic steel. The change in the plasticity zone ahead of the crack tip leads to the transitional behavior of the fatigue crack propagation rate. When plasticity zone sizes are equal to the block size, the fatigue crack propagation reverts to a stable propagation stage. Finally, an empirical model was established to predict the fatigue crack propagation rate of the stable propagation stage based on the tensile properties of the lath martensitic steel. Full article

Work plays a significant role in societies; however, currently, work is a particularly difficult area for those in the most vulnerable social categories who have been heavily affected by the COVID-19 pandemic. Because there is scarce research on labor integration of people affected by armed conflicts from work adjustment (WA) perspectives, we have developed research to understand the relationship between people and their work setting in an employment program inspired in supported employment models (SEMs). To achieve this, a nonexperimental mixed-methods research design with a convergent parallel approach and multilevel design was developed. The results show that the work-adjustment approach is a useful framework with which to understand the relationship between the work setting and individuals. The conclusions of the research are as follows: (1) people who have been involved in armed conflicts can develop attitudes and abilities to properly develop their work; (2) the configuration of a labor-inclusion model is related to the results in the medium and long term, both in the program itself and in its participants and society; (3) the SEMs contribute to the effective inclusion of people affected by armed conflicts, which have low skills, scarce social contacts, and low educational levels. Full article

In the present work, a hybrid hierarchical coating (HHC) system comprising a plasma electrolytic oxidation (PEO) coating and a homogeneously porous structured polycaprolactone (PCL) top-coat layer, loaded with ciprofloxacin (CIP), was developed on Mg3Zn0.4Ca alloy. According to the findings, the HHC system avoided burst release and ensured gradual drug elution (64% over 240 h). The multi-level protection of the magnesium alloy is achieved through sealing of the PEO coating pores by the polymer layer and the inhibiting effect of CIP (up to 74%). The corrosion inhibition effect of HHC and the eluted drug is associated with the formation of insoluble CIP-Me (Mg/Ca) chelates that repair the defects in the HHC and impede the access of corrosive species as corroborated by FTIR spectra, EIS and SEM images after 24 h of immersion. Therefore, CIP participates in an active protection mechanism by interacting with cations coming through the damaged coating. Full article