Public Policy Faculty Publications

Predicting Methamphetamine and Other Drug Offending: Evidence From a Rural County Drug Court.

Jospeter M. Mbuba et al. — Thu, 28 Jun 2012 14:49:54 PDT

International Exchange as a Transformative Learning Experience: A Case Study

Sheena Choi et al. — Thu, 31 May 2012 12:40:21 PDT

This study examines the role of international exchange programs on the transformative learning of English-speaking students. A student exchange program at a South Korean university is used for this case study. It explores how learning experiences are translated by participants onto their perceptions about the host country. An analysis of a pre- and post-survey suggests that transformative learning of the students is reflected in two overarching themes: 1) intercultural understanding and 2) global perspectives. Through their participation in the program, students developed a deeper understanding of their own and the host country's cultures and an enhanced appreciation for broadening their global perspectives. This study concludes that international exchange programs have a fundamental importance in educating students to become global citizens and leaders.

Evolution of an Innovation: Variations in Medicaid Managed Care Program Extensiveness

Ae-Sook Kim et al. — Thu, 31 May 2012 12:40:14 PDT

This paper utilizes a theoretical framework of policy innovation, diffusion, and reinvention to investigate the evolving nature of Medicaid managed care programs over time. By estimating two separate models, one for Primary Care Case Management (PCCM) and a second for risk-based program enrollment, this study seeks to disentangle two different paths of learning, internal and external, investigate the potential effects of vertical diffusion of policy, and examine the impact of internal state characteristics on the extent of Medicaid managed care. With respect to diffusion and learning, the data reveal that earlier adopters implement more extensive programs. The data fail to reveal much internal learning, although there is evidence of some. External impacts are clear: managed care enrollments in neighboring states and changes in the federal waiver process affect states’ decisions. Other policy choices are important; states with more generous Medicaid eligibility rules implement more extensive managed care programs. Complementing other studies of Medicaid, we find that politics and economics make a difference for the extent of managed care programs; unlike other Medicaid studies, we find no effect of race and ethnicity.

Lethal Rejection: Recounting Offenders’ Experience in Prison and Societal Reaction Post Release

Jospeter Mbuba — Mon, 14 May 2012 08:43:47 PDT

The significance of successful completion of a prison term and the eventual release from prison is that it marks not only the end of incarceration, but also the beginning of a second cycle of societal retribution, which inevitably comes, regardless of whether the former offender is reformed or not. The extent of retribution in the second cycle depends upon the offense type and is more pronounced if the offense was a felony, and particularly so if it was sexually-motivated. This study draws from intensive ethnographic interviews with former prison inmates with the aim of estimating the effect of incarceration on their lives while in prison and after release. The study reveals manifest and latent effects of incarceration and finds that further retribution continues upon release when society takes over with vindictiveness that follows the former offenders almost forever. The main policy implications of long-term imprisonment are made, and areas of further research suggested.

Federalism, Education, and Citizenship in an Era of Democratic Deliberation

Brian L. Fife — Tue, 08 May 2012 05:58:03 PDT

Why Don’t We Know More About Best Practices in Physician Investigations?

Stephen J. Ziegler Ph.D., J.D. — Wed, 02 May 2012 06:24:10 PDT

Improving Patient Satisfaction in Hospital Care Settings

Koichiro Otani et al. — Wed, 02 May 2012 06:24:09 PDT

Health-care managers have to address many aspects of the organization, and patient satisfaction is clearly one of the critical aspects for managers. To respond to the need of health-care managers, there have been many patient satisfaction studies. However, these studies focus on which attributes (factors such as nursing care and physician care) are more influential; they do not provide specific aspects for each attribute. In order to develop an effective intervention programme to improve patient satisfaction, more specific research outcomes are needed. This study utilized data collected between January 2007 and June 2008 from 32 hospitals representing a large, national private not-for-profit hospital system. The patient satisfaction survey included the Consumer Assessment of Healthcare Providers and Systems, Hospital version questionnaire items, and these are 31,471 cases. Two-stage multiple linear egression analyses were conducted with control variables (age, gender, perceived health, education and race). It was found that patients’ highest priority is to be treated with courtesy and respect by nurses and physicians. An effective intervention programme to improve patient satisfaction would include a training programme, where care providers understand that patients want them to show courtesy and respect. Then, well-trained and empathetic nurses and staff members can comfort patients, and consequently improve patient satisfaction.

Inpatients’ Willingness to Recommend: A Multi-level Analysis

Dean Klinkenberg et al. — Thu, 19 Apr 2012 07:47:40 PDT

Background: Satisfaction with health care is one of the most widely assessed measures of hospital care quality, yet studies that account for clustering effects are uncommon. We constructed a multilevel model to identify predictors of willingness to recommend while controlling for clustering effects due to hospital and care unit. We also examined differences in predictors by care unit. Purpose:The aim of this study was to identify factors that both influence patient perceptions of care and are potentially modifiable by the hospital delivering care. Methodology: Our sample includes Hospital Consumer Assessment of Healthcare Providers and Systems survey data collected between July 1, 2007, and June 30, 2008, for 131 hospitals and 33,445 patients. The primary outcome was willingness to recommend the hospital to family and friends. Variables were collected at three levels: patient (Hospital Consumer Assessment of Healthcare Providers and Systems survey item responses and demographics), care unit, and hospital. Data were analyzed using multilevel modeling. We also ran a series of two-level models to explore differences in predictors by care type. Findings: The strongest predictors of willingness to recommend, controlling for clustering effects, were items that generally reflected interpersonal aspects of care such as nursing and physician behaviors. In the two-level models, predictors of willingness to recommend overlapped across care units, but important differences were noted.

Felons and Gun Control

Rachel L. Rayburn et al. — Wed, 18 Apr 2012 06:36:13 PDT

Death, Drugs, and Disaster: Mortality Among New Orleans’ Homeless

Rachel L. Rayburn et al. — Wed, 18 Apr 2012 06:36:11 PDT

Social Media and Web 2.0 for Rethinking E-government Maturity Models

B. Joon Kim et al. — Fri, 09 Mar 2012 12:09:02 PST

In this chapter, the authors argue that social media and Web 2.0 technologies have the potential to enhance government responsiveness, representation, citizen participation, and overall satisfaction with the public policy-making process. To do that, this chapter suggests the dialectical approach of a new E-government maturity model through both New Public Service and Social Construction of Public Administration views. Then, they provide guidance to practitioners who are responsible for developing social media and Web 2.0 strategies for public service organizations. Finally, to provide guidelines for public administrators, this chapter argues that the “public sphere” should be redefined by citizen’s online social networking activities with public administrators and capacity building activities among practitioners in public service agencies through their use of social media and Web 2.0 tools.

Civic Engagement and Internet Use in Local Governance: Hierarchical Linear Models for Understanding the Role of Local Community Groups

B. Joon Kim et al. — Fri, 09 Mar 2012 12:08:58 PST

Civically and politically interested individuals often use the Internet to facilitate and augment their civic and political participation. At the local level, such people also use the Internet to communicate and share information with fellow members of the local community groups to which they belong. In doing so, local groups help to create awareness and draw citizens into public deliberation about local issues and concerns, not only offline (a role they have played for many years) but also online. This research examines the interplay of individual level and local group-level factors through an analysis of household survey data from the town of Blacksburg, Virginia, and surrounding areas in 2005 and 2006. It seeks to reconcile different levels of analysis—individual and group levels—relating to the use and impact of the Internet on civic engagement. This study identifies the distinctive influences at both the individual level and the community group level by applying a multilevel statistical model (specifically, the hierarchical linear model). First, at the individual level of analysis, this study found that internal and external political efficacy and community collective efficacy were significant individual-level factors explaining the Internet use for civic and political purposes. Second, at the group level of analysis, community group Internet use—which includes listservs, discussion forums, and blogs, among other emerging Internet technologies—and group political discussion were revealed as key influences on citizens’ perspectives on the helpfulness of the Internet for civic and political purposes. Finally, in multilevel analysis, when taking individual-level variables into account, the group-level variables (group Internet use and group political discussion and interests) are positively associated with the views of the helpfulness of the Internet in connecting with others in the community and becoming more involved in local issues.

Social Media, Social Design and Social Construction: Dialectic Approach for the Use of Social Media in the Public Sector

B. Joon Kim et al. — Thu, 05 Jan 2012 07:43:03 PST

In this article, the authors argue the need for a “dialectic approach” to bring positive salience in current social media activities that focus on public participation at the community level and emphasize the needs of reflective public administrators and their praxis in terms of the ideas of dialectic, social construction and social design. The authors make a case for revamping our understanding of civic engagement through the use of social media in order to overcome one-sided epistemologies, such as functionalist or interpretive epistemologies, and to find a constructive way of recognizing the dialectical possibility and the complex influence of social media in public administration. The article concludes that the “public sphere” seems to be redefined at each turn by both citizens’ and administrators’ social network activities via both online and offline communication channels. New social media technologies complement the face-to-face encounters by helping community members participate in meaningful ways through activities ranging from understanding issues better, defining courses of action, and devising mechanisms to work towards solving concrete problems.

Explaining Variations in Medicaid Managed Care Program Coverage

Ae-Sook Kim et al. — Tue, 16 Aug 2011 08:32:16 PDT

This paper explores variations in the coverage of medical services and groups of beneficiaries of the Medicaid managed care programs in the American states. Program variations – the comprehensiveness of coverage – are investigated in relation to states’ internal and external characteristics utilizing Zero Inflated Negative Binomial Regression Model (ZINBRM). To measure the comprehensiveness, we construct a composite score of program coverage for 70 first adopted managed care programs separately for the Primary Care Case Management (PCCM) and risk-based programs. The results of the analyses demonstrate that the political dynamics behind the two programs differ. Both approaches are affected in a similar manner by unified Democratic Party control, physicians per population, and generosity. Years since program adoption, the comprehensiveness of neighboring state programs, urban population, and the federal matching rate affect PCCM programs while having no effect on risk-based programs. On the other hand, management capacity affects the comprehensiveness of risk-based programs negatively while having no effect on PCCM programs.

Effects of U.S. States’ Social Welfare Systems on Population Health

Ae-Sook Kim et al. — Tue, 16 Aug 2011 08:32:13 PDT

Social scientists have studied the welfare state extensively. Many studies seek to understand the determinants of the welfare state; however, a few have explored the social consequences of social welfare systems, especially on health outcomes of the population. Even though cross-national comparative studies support the thesis that the welfare state regime type, which represents different levels of commitment on social welfare, is closely linked to population health, there is little research to support this argument at a sub-national level. To fill the gap, this study explores the effects of the U.S. states' social welfare systems on health using age-adjusted mortality rates as a proxy for population health. By operationalizing social welfare systems as three dimensions—public expenditures, tax structures, and welfare program rules—we find that more generous education spending, progressive tax systems, and more lenient welfare program rules help to improve population health. The model corrects for first-order serial correlation using Prais-Winsten regression methods and is estimated with state and year-fixed effects.

Attitude Towards the Police: The Significance of Race and Other Factors Among College Students

Jospeter M. Mbuba — Wed, 03 Aug 2011 08:42:13 PDT

Various factors have been identified by previous studies as predictive of citizens’ attitudes toward the police, but there has not been as much effort to establish whether higher educational attainment has any effect on the gap between the various population groups that typically differ in their perception of the police. This study tests for the effect of race and other factors on the attitude of college students toward the police. Students in a mid-sized 4-year public university were presented with an instrument of 14 statements and asked to indicate the extent to which they agreed or disagreed with each of them on a 5-point Likert scale. A comparison of the mean responses was made and independent t-tests were established by race, gender, prior police encounter, and academic major. The attitudinal differences were most significant by race followed by gender, whereas the differences by prior police encounter and academic major failed to rise to statistical significance. The implications are discussed.

Approaches to Crime Control and Order Maintenance in Transitional Societies: The role of Village Headmen, Chiefs, Sub-Chiefs & Administration Police in Rural Kenya

Jospeter M. Mbuba et al. — Wed, 03 Aug 2011 08:42:12 PDT

The need to illuminate and contextualize approaches to crime control and order maintenance in transitional societies has become increasingly necessary, thanks to the pervasiveness of social disorder and the elusive nature of crime in general. This study focuses on the functions of the Provincial Administration and the Administration Police in Kenya in order to reveal the little known but overarching powers of Chiefs and Sub-Chiefs as the official agents of crime control and order maintenance in the rural parts of the country. The study, which is a culmination of an in-depth review of Kenya’s legal framework and other germane literature, uses the country to cast a thoughtful appraisal of the African experience and, as a result, to provide a strong and reliable data point that could be used in cross-cultural and comparative crime control studies.

Cell Phone Use with Social Ties during Crises: The Case of the Virginia Tech Tragedy

Andrea Kavanaugh et al. — Wed, 03 Aug 2011 08:42:10 PDT

Many Proposed technological solutions to emergency response during disasters involve the use of cellular telephone technology. However, cell phone networks quickly become saturated during and/or immediately after a disaster and remain saturated for critical periods. This study investigated cell phone use by Virginia Tech students, faculty and staff during the shootings on April 16, 2007 to identify patterns of communication with social networks tie. An online survey was administered to a random sample pool to capture communications behavior with social tie during the day of these tragic events. The results show that cell phones were the most heavily used communication technology by a majority of respondents (both voice and text messaging). While text messaging makes more efficient use of bandwidth than voice, most communication on 4/16 was with parents, since the majority of the sample is students, who are less likely to use text messaging. These findings should help in understanding how cell phone technologies may be utilized or modified for emergency situations in similar communities.

Local Groups Online: Political Learning and Participation

Andrea Kavanaugh et al. — Wed, 03 Aug 2011 08:42:08 PDT

Examining the Link between Physical Pain and Requests for Hastened Death: Different Results of Different Values/

Stephen J. Ziegler — Wed, 03 Aug 2011 08:42:06 PDT