An Integrated Social and Behavioral System Approach to Evaluation of Healthcare Information Technology for Polychronic Conditions

Healthcare delivery systems are evolving with the advances in health information technology (HIT) development and its applications to coordinated or guided care for polychronic conditions. The design features of artificial intelligence in healthcare reflect the public interest in optimizing care coordination and communication between providers and patients. This article offers a practical evaluation and assessment of the relevance of theoretical frameworks and appropriate methodologies to formalize a multi-criteria optimization of a logic model applicable for achieving the system’s efficiency and effectiveness. In specifying theoretical constructs and evaluation methods for HIT evaluation, a three-fold purpose is to show the relevance of personal and behavioral determinants of HIT use, articulate the need for developing a transdisciplinary framework, and formulate appropriate multilevel modeling and causal analysis of the determinants of HIT use and its impacts on chronic care.

Attachment, dependency, and attachment-related behaviors in foster children: A closer look at the nature of the foster child–caregiver relationship

There is evidence that within the first year in the foster home, children are capable of forming secure attachment comparable to normative samples. However, less is known about the nature of these newly formed relationships and it has been claimed that they may serve different developmental functions as those to primary caregivers formed in the first year of life. The current study aimed to address this void by applying a behavioral system approach. The sample consisted of 46 children (aged 3–6), 16 of which were currently placed in foster care. Attachment security and dependency were assessed during a home visit using the Attachment Q-Sort. Furthermore, activation of several attachment-related behavioral systems was assessed during a stranger approach in a standardized laboratory setting. Compared to the control group, foster children showed equal levels of attachment security but highly increased dependency scores. Also, during the stranger approach, they showed increased attachment behaviors toward their foster mothers and, at the same time, increased looking behavior toward the stranger. The study points out the relevance of taking into account various attachment-related constructs when investigating formations to new attachment figures in out of home care. It further claims that increased dependency and proximity-seeking scores in foster children are characteristic of the newly formed relationship and a possible indicator of foster children’s adaption. Moreover, this behavior may even be highly beneficial to foster children’s socio-emotional development as it possibly serves important developmental functions.