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Extension for Community Healthcare Outcomes (Project ECHO) is a telementoring program for health professionals that uses adult learning techniques and interactive video technology to connect distal community providers with specialist and multidisciplinary teams in real-time collaborative sessions. We examine the adoption, implementation, and sustainability of ECHO programs at four academic medical centers through case studies based on structured interviews. The study and its analysis are informed by the Diffusion of Innovation theory and the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. We found that early adopters became aware of ECHO by chance and were persuaded through observations to adopt ECHO. Finding a home for ECHO was an important initial adoption decision. Five context factors influence the implementation of ECHO: Funding, networks, staffing processes, leadership, and individual characteristics of staff. Sustainability requires ongoing funding, which itself may rely on evidence of outcomes. Findings from this study can inform the implementation of Project ECHO at other academic medical centers and extend to decisions to adopt, implement, and sustain similar telementoring programs designed to close the research-practice care gap between communities and academic medical centers.

This study focuses on an under-investigated link between work–life interrelationships and health: how low-wage work impacts employees' health by influencing their management of health-related concerns. Using structuration theory, interviews with 21 low-wage service work (LWSS) women workers were analyzed to identify structures and interactional dynamics in their reported interactions with their supervisors about health-related matters that intersected with work. Three 'corporate privilege' structures or 'recipes for action' emerged, along with three 'life friendly' structures. The structures intersected in three dynamics of supervisor–worker interactions: (a) collaborative reproduction of 'corporate privilege' structures, (b) collaborative resistance to 'corporate privilege,' and (c) contested reproduction and resistance. In some situations, supervisors and workers alike reproduced corporate privilege structures. In other circumstances, supervisors and workers resisted corporate privilege structures, and in still others supervisors and workers contested structures differently, pointing to potential opportunities for more systematic disruption through organizational interventions. [ABSTRACT FROM AUTHOR]

Explores, using the framework of Negotiated Order Theory, critical interactions between faculty and students when students are experiencing difficulties in managing school and family/work responsibilities. Demonstrates that childcare concerns most often trigger students to initiate negotiations with faculty members. Discusses limitations and directions for future research. (SG)

The participation of fathers in parenting and care has become a topical issue in public discourse in Japan. The phenomenon is often epitomized in the popular neologism ikumen , defining fathers actively involved in childcare (ikuji) as "cool" men. On the basis of an extended ethnography, the article focuses on a group of men who reject the ostensibly carefree ikumen image and who explicitly and "proactively" (shutaiteki) define themselves as "househusbands." The article explores the interactive and creative process through which this marginal group of men "crafts" their new identities as self-reliant, responsible caretakers of children and the home. I suggest that these men affirm their potentially new masculine identity through relating to—and differentiating themselves from—three symbolic others: the ikumen, the trendy and cool but not really committed new father; the sarariiman , the epitome of Japanese hegemonic masculinity; and the dedicated housewife (sengyō shufu), the symbol of Japanese femininity. Adopting a perspective that does not hesitate to look at the potential of change in gender relations, the article poses crucial questions about the potential househusbands have to undo conventional understandings of masculinity and fathering—and, through this, "undo gender." [ABSTRACT FROM AUTHOR]

Social science research investigating the challenges of managing work and family has been extensive over the past 30 years. Recently, scholars have examined work and family issues from a number [...]

Between the years 1993 and 2000, the W. K. Kellogg Foundation sponsored the Comprehensive Community Health Models (CCHMs) Initiative in three Michigan counties. CCHMs was comprised of three closely related community initiatives carried out in the midst of a failed national health care reform effort and the continued penetration of managed care arrangements into many health care systems. This experimental initiative set out to test the hypothesis that traditional healthcare system animosities and exclusionary practices could be overcome by stakeholder participation in an ongoing, structured, collaborative dialogue about improving access to health services. In the process of collecting data through surveys, interviews, content analysis, and observation, we were struck by the occurrence of several overarching tensions that we perceive to exist in our data. The present article elucidates five such tensions and suggests how third parties such as communication researchers, evaluators, and practitioners can facilitate community health improvement initiatives and better their own data interpretation by acknowledging and understanding these tensions. KEY WORDS: Collaboration, community, health, tensions.

Public discourse of late has drawn attention to increases in number of married women in the U.S. who serve as their families’ primary breadwinners. Contributing to these conversations, this study examines how breadwinning mothers (BWMs) reproduce, resist or challenge hegemonic gender relations through an analysis of different ways these women discursively position their identities and tasks as earners. Findings from a discourse analysis of interviews with 44 female breadwinners married to stay-at-home fathers are presented in relation to 5 aspects of conventional breadwinning that emerged across BWMs discourse: (a) breadwinning as career-primary, (b) breadwinning as obligation, (c) breadwinning suitability and personality, (d) breadwinning as relational power and (e) breadwinners as ideal workers. Practical applications of these findings are considered in relation to women’s work–life conflict, martial role negotiation, and workplace interactions and interventions. [ABSTRACT FROM PUBLISHER]

The article focuses on the significant aspects of reflexvity practices in qualitative research. The authors mention that qualitative interviewing and/or data analysis are influenced by a variety of different and interellated ways of practicing reflexvity. They talk about the impact of the researcher's identity as scholars and individuals on the conceptualization of research problems. They discuss the need for researchers to practice emotional form of reflexvity during interview interactions. They also explore the need to have a sense of historic reflexivity for qualitative reseachers.

This interpretive study investigates the experiences of couples in which mothers are the primary wage earners and fathers are main childcare providers. We take up social constructionist and feminist perspectives on 'doing' and 'undoing' gender as well as the co-construction of multiple masculinities and femininities in relation to work and family. Research on dual-earner couples' marital negotiations, 'opting' out of the workforce, and stay-at-home fathers inform our in-depth interview-based work. We present our findings in the form of five homemaking and moneymaking stances: (a) reversing, (b) conflicting, (c) collaborating, (d) improvising, and (e) sharing. These stances embody the couples' diverse orientations toward identity construction, role eligibility, and task responsibility. We discuss implications of this study along with research directions and limitations. [ABSTRACT FROM AUTHOR]

In this chapter, I review and critique social research which explores micro-practices of gender transgressions and macro-level transformations of occupational and household divisions of labor. Today, "crossing over," even blurring of hegemonic gendered occupational and relational boundaries occurs more frequently. Yet, it remains a problematic and complex social phenomenon even in the 21st century, particularly with respect to highly sex-typed forms of paid and unpaid work. This review of literatures examines occupational gender crossing and sex segregation studies as well as parallel research on gender violations and/or sex segregation in the division of household labor and marital breadwinning. Literature findings are organized around three discursive fields: sexuality, skill and competence, and inequality. Finally, a critique is offered of the centrality of micro-practices in reproducing sex-segregation, heteronormative and patriarchical bias embedded in these bodies of research as well as related lessons for social change. An intradisciplinary agenda is also discussed for scholarship with respect to work, family, and difference. [ABSTRACT FROM AUTHOR]

Women construct their identities amidst contradictory and competing societal expectations about career success and motherhood. Due to the enormous value society places on our organizational lives and to the contradictory rhetoric on women `s roles today, the ability of stay-at-home mothers to construct their identities is argued to be in crisis. The purpose of this feminist critical-interpretive study is to interrogate corporate discourse as a new linguistic frame for defining mothering identity. Through textual analysis of online support Web sites and self-help books or guidebooks, four subject positions of stay-at-home mothers as professionals, managers, productive citizens, and irreplaceable workers are articulated and problematized. Corporate mothering is then further deconstructed in relation to historical ideologies of mothering, contemporary organizational privilege, feminist and postfeminist debates on women's roles today, and raced and classed ideologies of mothering. Finally, implications for feminist praxis and organizational communication scholarship are addressed. [ABSTRACT FROM AUTHOR]

Dramatic demographic, technological, and social changes are reshaping how individuals experience family and work as we begin the 21st century. As the composition of the paid workforce continues to change, men and are rearranging what used to be a rigid distribution of wage, work, and family responsibilities in traditional families. Coupled with these changing demographics, technological innovations have changed the way work is accomplished. Computer technologies now enable new forms of virtual work, thus blurring the boundaries between workspaces and homespaces. Communication can serve as a catalyst for empowerment when workers take opportunities to act by asking for family leave, pressing for flexible work schedules, and questioning traditional stereotypes surrounding who performs wage work and family labor. Until recently, work and family received limited attention from communication researchers in relation to researchers situated in psychology, sociology, and organizational behavior.

The article discusses an educational activity which aims to develop an understanding of the complexities that are linked with communication and supervisor-subordinates relationship. According to the article, the procedure involves a role-play simulation which provides students an experience concerning the tensions present in the workplace and serves as a useful reference for them in talking about the dimensions of supervisor-subordinate communication. In addition, it provides several scenarios needed in the process as well as the steps to follow on how students will react to the circumstances being given.