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Conceptualizing Productive Engagement in a System Dynamics Framework.

ABSTRACT: Gerontologists have argued that the growing human capital of the aging population can be better marshaled as a resource for families, communities, and society at large. Additionally, this active, purposeful engagement can produce positive outcomes for older adults themselves. In this manuscript, we propose that existing conceptual frameworks articulating antecedents and outcomes of productive engagement, including working, volunteering, and caregiving can be improved using a system dynamics (SD) approach. Through a series of five unstructured group model-building sessions, experts from gerontology and systems science developed a qualitative SD model of the productive engagement of older adults. The model illustrates the reciprocal and dynamic nature of the stocks of human capital of older adults, social capital of older adults, and family resources; the engagement of older adults in productive activities; and the social and organizational variables that affect the flow and depletion of these stocks. Given this is the first attempt to develop a SD model for productive engagement in later life, the model is preliminary and heuristic. However, it offers a new approach to advancing theory and research on productive engagement in later life. Further, it can guide the development of mathematical models to estimate the effects of changes in any part of this system.

SUBMITTER: Morrow-Howell N

PROVIDER: S-EPMC6177040 | biostudies-literature | 2017 Mar

REPOSITORIES: biostudies-literature

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Conceptualizing Productive Engagement in a System Dynamics Framework.

Morrow-Howell Nancy N Halvorsen Cal J CJ Hovmand Peter P Lee Carmen C Ballard Ellis E

Innovation in aging 20170301 1

Gerontologists have argued that the growing human capital of the aging population can be better marshaled as a resource for families, communities, and society at large. Additionally, this active, purposeful engagement can produce positive outcomes for older adults themselves. In this manuscript, we propose that existing conceptual frameworks articulating antecedents and outcomes of productive engagement, including working, volunteering, and caregiving can be improved using a system dynamics (SD) ...[more]

PMID: 30480112

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Project description:BackgroundPatient engagement is a priority for health care quality improvement and health system design, but many organizations struggle to engage patients meaningfully. We describe patient engagement activities and success factors that influence organizational decision-making in Ontario's patient medical homes.MethodsFrom March to May 2018, we conducted an online survey focused on practice-level patient engagement that targeted primary care organization leaders at all Ontario family health teams, community health centres, nurse practitioner-led clinics and Aboriginal Health Access Centres. We asked questions from the Measuring Organizational Readiness for Engagement (MORE) and Public and Patient Engagement Evaluation Tool (PPEET) questionnaires. We used factor and mediation analysis to identify organizational conditions and activities that are associated with the outcomes of patient engagement, affecting board decisions, program-level decisions and the formation of collaborative partnerships.ResultsWe achieved a 53% response rate (n = 149/283); after removing missing data, our final sample size was 141 respondents. Most respondents perceived that their organization's patient engagement activities and resources were insufficient. Processes that had a direct effect on outcomes (β = 0.7, p < 0.0001) included planning, training and supporting employees; identifying, recruiting and supporting relevant patients; and using leaders. Structures - including an organizational mission and vision for patient engagement, and policies, procedures, job positions, training programs and organizational culture that reflect that mission - indirectly affected outcomes, mediated by the aforementioned processes (β = 0.7, p < 0.0001).InterpretationBased on the perceptions of primary care leaders, organizational structures and processes are related to successful patient engagement. Organizations that seek to improve patient engagement should assess their commitment and follow-through with associated resources and activities.

Project description:An adequate understanding of the acculturation processes affecting immigrants and their descendants involves ascertaining the dynamic interplay between the way these individuals manage their multiple (and sometimes conflictual) cultural value systems and identifications and possible changes in their social networks. To fill this gap, the present research examines how key acculturation variables (e.g., strength of ethnic/host cultural identifications, bicultural identity integration or BII) relate to the composition and structure of bicultural individuals' personal social networks. In Study 1, we relied on a generationally and culturally diverse community sample of 123 Latinos residing in the US. Participants nominated eight individuals (i.e., alters) from their habitual social networks and across two relational domains: friendships and colleagues. Results indicated that the interconnection of same ethnicity alters across different relationship domains is linked to cultural identifications, while the amount of coethnic and host individuals in the network is not. In particular, higher interconnection between Latino friends and colleagues was linked to lower levels of U.S.Conversely, the interconnection of non-Latino friends and colleagues was associated with lower levels of Latino identification. This pattern of results suggests that the relational context for each type of cultural identification works in a subtractive and inverse manner. Further, time spent in the US was linked to both Latino and U.S. cultural identifications, but this relationship was moderated by the level of BII. Specifically, the association between time in the US and strength of both cultural identities was stronger for individuals reporting low levels of BII. Taking the findings from Study 1 as departure point, Study 2 used an agent-based model data simulation approach to explore the dynamic ways in which the content and the structure of an immigrant's social network might matter over time in predicting three possible identity patterns: coexisting cultural identifications, conflicting cultural identifications, and a mixture of the two. These simulations allowed us to detect network constellations, which lead to identification or disidentification with both cultures. We showed that distinct patterns of social relations do not lead to identity outcomes in a deterministic fashion, but that often many different outcomes are probable.

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Conceptualizing Productive Engagement in a System Dynamics Framework.

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Conceptualizing Productive Engagement in a System Dynamics Framework.

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