Browsing by Author "Boucher, Nathan"

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    Carbon Price Pass-Through in the Chinese Emissions Trading Scheme: Lessons from Korea and the European Union
    (2021-12) Murphy, Julia
    On July 16, 2021, the Chinese Emissions Trading Scheme (ETS) opened trading. Covering more than 4 billion tons of carbon dioxide, the ETS accounts for 40% of China’s national carbon emissions and is the largest carbon market in the world by volume. However, as it stands, the cost of carbon is not being reflected in electricity prices for consumers due to government regulation of the Chinese power market. This study examines the relationship between the Chinese ETS design and power market design to make a recommendation to facilitate the pass-through of carbon costs to consumers. Specifically, the study confronts the feasibility of two potential reform pathways for price pass-through, (1) power market deregulation, and (2) evolution in design of the Chinese emissions trading scheme. Comparative case study analysis of price-signaling methods in the Republic of Korea and the European Union informs the ultimate recommendation. The findings indicate that Chinese ETS design should optimize long-term coordination and mutual efficiency between the Chinese ETS and power market by implementing the regulation of indirect emissions with an upstream coefficient in the short-term to respond to the long-term gradual deregulation of the Chinese power market.
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    Exploring the Sources and Experiences of Joy in Caregiving: Insights From Formal Caregivers in Long-Term Care
    (Journal of the American Medical Directors Association, 2024-12-30) Boucher, Nathan
    Objectives To explore and understand the sources and experiences of joy in caregiving among formal caregivers in Canadian long-term care (LTC). Design A qualitative study with interpretative descriptive design. Setting and Participants The participants consisted of 20 formal caregivers from a large public LTC home in British Columbia, Canada, focusing on those with at least 6 months of direct caregiving experience. Methods Convenience sampling was conducted to recruit participants. Data were collected through 3 focus groups, with discussions moderated by the primary investigator, and were audio recorded and transcribed. Reflexive thematic analysis was used to identify themes, combining inductive and deductive strategies. To enhance rigor and trustworthiness, the research team engaged in reflective practices, leveraging diverse expertise, and ensuring a rich description of the study context. The study received ethical approval, and participant confidentiality was maintained through pseudonyms. Results Three interconnected themes of joy in caregiving were identified: (1) Joy in caregiving is a relational and dynamic process that evolves over time and coexists with other emotions, such as sadness and grief. (2) Joy is driven by an attitude shaped by the environment, stemming from an internal attitude, and contributing to a deeper sense of fulfillment despite challenges. (3) Joy in caregiving builds personal team resilience that reduces burnout, fostering compassion and creating a supportive atmosphere through gratitude and shared experiences, benefiting caregivers and residents. Conclusions and Implications This study highlights the relational and evolving nature of joy in caregiving, the influence of internal attitudes and supportive environments, and the impact of joy on resilience and burnout. The findings contribute to characterizing how joy functions within caregiving contexts—specifically for LTC workers—and its broader implications for caregiver well-being and team dynamics.
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    Frontline Clinician Appraisement of Research Engagement: "I feel out of touch with research"
    (Journal of General Internal Medicine) Boucher, Nathan
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    Mandated caregiver training in the Veterans Health Administration: Caregiver inquiry informs national dissemination.
    (The Gerontologist, 2022-11) Sperber, Nina R; Boucher, Nathan; Hughes, Jaime M; Bruening, Rebecca; Zullig, Leah L; Decosimo, Kasey; Tucker, Matthew; Christensen, Leah A; Allen, Kelli D; Hastings, Susan N; Van Houtven, Courtney H

    Background and objectives

    A minority of family caregivers receive training, with implications for their own and their recipient's outcomes. Federal policy has supported implementation and expansion of caregiver training and support. The Department of Veterans Affairs (VA) has developed a national Caregiver Support Program and collaborated with VA health services researchers to explore caregivers' acceptance of an evidence-based training program in preparation for system-wide dissemination.

    Research design and methods

    This approach entailed a convergent mixed-methods design, which involved separate analyses of quantitative and qualitative data. Survey questions based on the Kirkpatrick model for training evaluation measured caregivers' reaction and learning and interview questions elicited caregivers' reports about the value of the program for them.

    Results

    Most caregivers reported satisfaction with the training when responding to survey questions, although qualitative interviews revealed caveats suggesting need to hone the best timing and specific group of caregivers for maximal benefit.

    Discussion and implications

    Our findings indicate that understanding program-user fit may be particularly critical when implementing training for caregivers as they come to the program at different points along their caregiving journey, needing differing types and intensities of support. While a general program may appeal to policymakers aiming to scale caregiver training within a large, heterogeneous system, there may be shortcomings in terms of end-user acceptance and subsequent downstream outcomes such as reach and ultimately program effectiveness. Good, iterative communication flow between program developers and policymakers facilitates this understanding and, in turn, decisions about scaling.
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    Reporting the Shots: Exploring Barriers and Facilitators in Pediatric Vaccine Reporting
    (2023-04-19) Israelsen-Hartley, Sara
    For 30 years, the Vaccines for Children (VFC) Program has ensured low-income children have access to vaccines, leading to millions of illnesses averted, hundreds of thousands of deaths avoided and billions of dollars in health savings. Yet policy, technology and personnel gaps allow many VFC vaccines to remain unreported to a jurisdiction’s immunization information system (IIS). This study identified potential barriers and facilitators to IIS reporting among VFC providers through in-depth, qualitative interviews with pediatric healthcare workers across four reporting-mandated, but historically under-reporting states: Colorado, Connecticut, Maryland, and Massachusetts. The study also highlighted COVID-19 influences on provider IIS reporting.
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    The Enabling Factors & Barriers to the Passage of the Immigrant Children’s Health Improvement Act: A Florida Case Study
    (2020-11) Bond, Sarah
    More than 50% of first-generation immigrant children do not have health insurance. Lack of insurance directly contributes to worsened access to health care and worsened health outcomes. The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) prevented legal permanent residents (LPRs) from accessing federal benefits until they had lived in the United States for at least five years. In 2009, PRWORA’s impact was lessened by the Legal Immigrant Children’s Health Improvement Act (ICHIA), part of the Children’s Health Insurance Program Reauthorization Act (CHIPRA), allowing states to eliminate the five-year wait period for LPR pregnant women and children to be eligible for Medicaid/CHIP. 35 states passed the ICHIA for LPR children and/or pregnant women, while 15 states maintain the wait period for all. Existing literature shows which states implemented the ICHIA but says little about why some states have passed it and others have not. This paper aims to fill that gap by using Florida as a case study, a state in which the ICHIA was proposed unsuccessfully for six years before being passed in 2016. Based on legislative proceedings and interviews with key informants, I identified three key barriers (fiscal impact to the state, the perceived value of self- sufficiency, and anti-immigrant sentiment), and three enabling factors to the ICHIA’s passage (strong Latino Republican caucus, a low fiscal impact, and a unified lobbying coalition). By understanding the enabling factors and barriers in Florida, other states may learn how they can overcome obstacles to expanding immigrants’ access to health insurance.