Policy and behavioral response to shock events: An agent-based model of the effectiveness and equity of policy design features

Measure Twice, Change Once: Using Simulation to Support Change Management in Rural Healthcare Delivery

Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower health literacy, rural healthcare systems also experience significant resource shortages, as well as issues with recruitment and retention of healthcare providers, particularly specialists. These factors combined result in complex change management-focused challenges for rural healthcare systems. Change management initiatives are often resource intensive, and in rural health organizations already strapped for resources, it may be particularly risky to embark on change initiatives. One way to address these change management concerns is by leveraging socio-technical simulation models to estimate techno-economic feasibility (e.g., is it technologically feasible, and is it economical?) as well as socio-utility feasibility (e.g., how will the changes be utilized?). We present a framework for how healthcare systems can integrate modeling and simulation techniques from systems engineering into a change management process. Modeling and simulation are particularly useful for investigating the amount of uncertainty about potential outcomes, guiding decision-making that considers different scenarios, and validating theories to determine if they accurately reflect real-life processes. The results of these simulations can be integrated into critical change management recommendations related to developing readiness for change and addressing resistance to change. As part of our integration, we present a case study showcasing how simulation modeling has been used to determine feasibility and potential resistance to change considerations for implementing a mobile radiation oncology unit. Recommendations and implications are discussed.

Predicting firm creation in rural Texas: A multi-model machine learning approach to a complex policy problem

Rural and urban America have becoming increasingly divided, both politically and economically. Entrepreneurship can help rural communities catch back up by jumpstarting economic growth, creating jobs, and building resilience to economic shocks. However, less is known about firm creation in rural areas compared to urban areas. To that end, in this paper we ask: What factors predict firm creation in rural America? Our analysis, based on a comparative framework involving multiple machine learning modeling techniques, helps addresses three gaps in academic literature on rural firm creation. First, entrepreneurship research stretches across disciplines, often using econometric methods to identify the effect of a specific variable, rather than comparing the predictive importance of multiple variables. Second, research on firm creation centers on high-tech, urban firms. Third, modern machine learning techniques have not yet been applied in an integrated way to address rural entrepreneurship, a complex economic and policy problem that defies simple, monocausal claims. In this paper, we apply four machine learning methods (subset selection, lasso, random forest, and extreme gradient boosting) to a novel dataset to examine what social and economic factors are predictive of firm growth in rural Texas counties from 2008-2018. Our results suggest that some factors commonly discussed as promoting entrepreneurship (e.g., access to broadband and patents) may not be as predictive as socioeconomic ones (age distribution, ethnic diversity, social capital, and immigration). We also find that the strength of specific industries (oil, wind, healthcare, and elder/childcare) predicts firm growth, as does the number of local banks. Most factors predictive of firm growth in rural counties are distinct from those in urban counties, supporting the argument that rural entrepreneurship is a distinct phenomenon worthy of distinct focus. More broadly, this multi-model approach can offer initial, focusing guidance to policymakers seeking to address similarly complex policy problems.

Self-Isolation and Testing Behaviour During the COVID-19 Pandemic: An Agent-Based Model

Since the beginning of the COVID-19 pandemic, various models of virus spread have been proposed. While most of these models focused on the replication of the interaction processes through which the virus is passed on from infected agents to susceptible ones, less effort has been devoted to the process through which agents modify their behaviour as they adapt to the risks posed by the pandemic. Understanding the way agents respond to COVID-19 spread is important, as this behavioural response affects the dynamics of virus spread by modifying interaction patterns. In this article, we present an agent-based model that includes a behavioural module determining agent testing and isolation propensity in order to understand the role of various behavioural parameters in the spread of COVID-19.