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Designing for Practice Development in a Social Learning System: Communicating Norms and Vicarious Experience

Author: Claire Loe, BA, MPH (2015)

Primary Advisor: Amy Franklin, PhD

Committee Members: Jiajie Zhang, PhD; Trevor Cohen, MBChB, MD, PhD; María E. Fernández, PhD, MA

PhD thesis, The University of Texas School of Health Information Sciences at Houston.


Over the past quarter century, the United States has experienced an increase in demand for health services. Expanded use of community health workers (CHWs) has been identified as a strategic response for more effective distribution of healthcare resources by alleviating pressures on clinical personnel and infusing prevention education into the community-to-clinical care continuum. Expansion of the CHW workforce poses many challenges. For CHWs to effectively reduce costs and pressures on the healthcare system, ‘expansion’ implies not only increasing their numbers, but also assuring a workforce that has the capacity to perform in diverse settings. I propose a theoretical framework for practice development in a healthcare workforce and use the framework as a guide to test whether system design can motivate specific types of communications in an online social learning system. The results have important implications for 1) system design for development of a diverse healthcare workforce like CHWs, 2) designing for specific types of learning communications, and 3) the theoretical support for practice development. We successfully designed a social learning system to motivate what we believe to be norm affirming and self-efficacy developing communications. Further studies will determine whether this supports practice in healthcare as proposed by the theoretical framework.