O'Hagan, Fergal

The present thesis entails a qualitative investigation of the unique notion to transition media change from the current paper-based system to the potential use of information technology innovation for communication between health care providers and employers during return to work. Stakeholder perspectives on relevant communication phenomena were gathered from workers, employers, and health care providers with experience in return to work. Methods for analysis involved critical realist grounded theory, as well as the use of a prototype innovation, named the Return to Work Expert App, as a platform for participant evaluation and discourse. The study's findings provided comprehensive and in-depth understanding of return to work communication, beyond its empirical regularities. The generative mechanisms of common communication problems that were discovered included situated reasoning, media as information ("the medium is the message"), epistemological disjuncture, egoism-altruism-collectivism quandary, and perspective taking. A novel theoretical framework based on ecological psychology was also advanced to offer a coherent and systematic understanding of the situated nature of health care providers' reasoning and information development. Media change via the Return to Work Expert App was argued to be limited in handling and resolving many of the communication problems that can occur. However, the app had perceptible value and benefits to prospective users that suggested a distinct advantage over current paper-based practices. Opportunities for further development and research exist to address relevant challenges, most notable of all being the need to address the app's burden of proof. For the interested reader, this thesis advances research and knowledge of provider-employer communication to a state that is truly fitting of the importance acknowledged of it in the field of return to work.

Author Keywords: critical realism, ecological psychology, media change, return to work, stakeholder communication, technological acceptance

Athletes' concussion risk is part of a complex system of personal and contextual factors. This study differentiated athletes based on attitudes and intentions towards protective behaviours. A cross-sectional survey design was used to sample varsity athletes. Three intention response subgroups (indifferent, reactive, and proactive) were identified. The indifferent group (28%) reported little-to-no intent to engage in risk reduction behaviours. These athletes reported lower belief in the efficacy of concussion management behaviours and greater risk acceptance attitudes. The proactive group (32%) reported intent to actively reduce personal concussion risk through engaging in behaviours such as confronting aggressive opponents about the risk they pose to others. The reactive group (40%) only reported intent to engage in concussion management behaviours. Indifferent athletes had the highest likelihood of concussion exposure followed by reactive athletes. The proactive athletes had the lowest likelihood. Concussion programs must address beliefs and intentions towards protective behaviours to improve effectiveness.

Author Keywords: Athlete, Attitudes, Concussion, Injury Prevention, Intentions, Risk