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Current research about American Indians of all ages is in short supply, yet design and allocation of public services and resources are increasingly guided by ‘evidence’ provided by research. The health and wellness of this population is persistently poorer than that of other marginalized populations. American Indian tribes have been beset progressively since the earliest arrival of European settlers by both malevolent and well-intentioned assaults on their cultures and peoples. This long history of cultural and physical genocide continues into the present and undermines the effectiveness of Eurocentric processes for research that have been shaped by values and beliefs antithetical to those of most tribes (e.g. individualism, proprietary ownership, science as the way of knowing). Individual and collective historical trauma is present in all of the more than 500 federally recognized tribes in the United States of America, and a lack of trust further compromises the validity and positive impact of most research. This chapter describes the roots and foundations of flawed and successful research and identifies practical resources and approaches that are valid and beneficial for conducting research with indigenous people. The processes described in this chapter are grounded in the experiences of tribes in the United States of America; however, parallel experiences of indigenous populations that have a continuing legacy of trauma are found in many other countries (such as in Brazil and New Zealand) and the insights and approaches found in this chapter may be applicable to some degree.

Why is it that highly trained and seasoned executives fail? On the surface, this doesn’t make sense because they are very successful; yet research in the organization sciences provides no shortage of evidence to prove just that. From the classic Mann Gulch fire disaster of Weick’s famous collapse of sensemaking study, to studies of myopia of learning, escalation of commitment, threat-rigidity, dominant logic, the architecture of simplicity, the Icarus Paradox, to core competencies turning into core rigidities, and navigating new competitive markets using “old” cognitive maps, and many more such examples point to a ubiquitous phenomenon where highly trained and experienced professionals find themselves “stuck” in the heat of battle, unable to move and progress. On the one hand, for some, there is a desperate need for change, but are unable to do so, due to their trained incapacities. On the other hand, some simply cannot see the need for change, and continue with their “business as usual” mentality. For both, their visions of the world shrink, they have a tendency to cling onto their past habitual practices and oversimplify the complexity of the situation. In moments like these: DROP YOUR TOOLS and UNLEARN! This book chapter introduces a framework (grounded in clinical psychology) that has had consistent success in helping seasoned executives and key decision-makers open up the alternatives whenever they find themselves stuck with complexity.

Diffusion of innovations, defined as the adoption and implementation of new ideas, processes, products, or services in health care, is both particularly important and especially challenging. One known problem with adoption and implementation of new technologies is that, while organizations often make innovations immediately available, organizational actors are more wary about adopting new technologies because these may impact not only patients and practices but also reimbursement. As a result, innovations may remain underutilized, and organizations may miss opportunities to improve and advance. As innovation adoption is vital to achieving success and remaining competitive, it is important to measure and understand factors that impact innovation diffusion. Building on a survey of a national sample of 654 clinicians, our study measures the extent of diffusion of value-enhancing care delivery innovations (i.e., technologies that not only improve quality of care but has potential to reduce care cost by diminishing waste, Faems et al., 2010) for 13 clinical specialties and identifies healthcare-specific individual characteristics such as: professional purview, supervisory responsibility, financial incentive, and clinical tenure associated with innovation diffusion. We also examine the association of innovation diffusion with perceived value of one type of care delivery innovation – artificial intelligence (AI) – for assisting clinicians in their clinical work. Responses indicate that less than two-thirds of clinicians were knowledgeable about and aware of relevant value-enhancing care delivery innovations. Clinicians with broader professional purview, more supervisory responsibility, and stronger financial incentives had higher innovation diffusion scores, indicating greater knowledge and awareness of value-enhancing, care delivery innovations. Higher levels of knowledge of the innovations and awareness of their implementation were associated with higher perceptions of the value of AI-based technology. Our study contributes to our knowledge of diffusion of innovation in healthcare delivery and highlights potential mechanisms for speeding innovation diffusion.

The rise of the regulatory state during the Gilded Age was closely associated with the development of institutionalist ideas in American academia. In their analysis of the emergent regulatory environment, institutionalists like John Commons operated with a fundamentally marginalist theory of value and distribution. This engagement is a central explanation for the ultimate ascendancy of neoclassical economics, and the limitations of the regulatory environment that emerged in the Progressive Era. The eventual rise of the Chicago School and its deregulatory ambitions did constitute a rupture, but one achieved without rejecting preceding conceptions of competition and value. The substantial compatibility of the view of markets underlying both the regulatory and deregulatory periods is stressed, casting doubt about the transformative potential of the resurgent regulatory impulse in the New Gilded Age.