Evaluating use and outcomes of mobility technology: a multiple stakeholder analysis.

PubMed

Hammel, Joy; Southall, Kenneth; Jutai, Jeffrey; Finlayson, Marcia; Kashindi, Gabriel; Fok, Daniel

2013-07-01

This qualitative, multi-site study compared and contrasted the outcomes of mobility technology (MT) and the factors influencing these outcomes from the perspective of MT users, caregivers, and professionals involved in MT service delivery. Qualitative focus groups were held in the USA and Canada with multiple stakeholder groups (consumer: n = 45, caregiver: n = 10, service provider: n = 10). Data were analyzed thematically. MT outcomes were conceptualized by participants as a match between expectations for MT and the actual outcomes experienced. Several factors influenced the match including a) MT features, b) environmental factors (e.g. built/physical environment, societal context of acceptance, MT delivery systems/policies), and c) the ability to self-manage the interaction across person, technology and environment, which involved constant negotiation and strategizing. Stakeholders identified MT outcomes that corresponded to ICF levels including body structure and function, activity, and participation across environments; however, varied on their importance and influence on MT impact. The conceptual fit model and factors related to self-management of MT represent new knowledge and provide a framework for stakeholder-based evaluation of MT outcomes. Implications for MT assessment, service delivery, outcomes research, and interventions are discussed.

Mapping the Views of Adolescent Health Stakeholders.

PubMed

Ewan, Lindsay A; McLinden, Daniel; Biro, Frank; DeJonckheere, Melissa; Vaughn, Lisa M

2016-01-01

Health research that includes youth and family stakeholders increases the contextual relevance of findings, which can benefit both the researchers and stakeholders involved. The goal of this study was to identify youth and family adolescent health priorities and to explore strategies to address these concerns. Stakeholders identified important adolescent health concerns, perceptions of which were then explored using concept mapping. Concept mapping is a mixed-method participatory research approach that invites input from various stakeholders. In response to prompts, stakeholders suggested ways to address the identified health conditions. Adolescent participants then sorted the statements into groups based on content similarity and rated the statements for importance and feasibility. Multidimensional scaling and cluster analysis were then applied to create the concept maps. Stakeholders identified sexually transmitted infections (STIs) and obesity as the health conditions they considered most important. The concept map for STIs identified 7 clusters: General sex education, support and empowerment, testing and treatment, community involvement and awareness, prevention and protection, parental involvement in sex education, and media. The obesity concept map portrayed 8 clusters: Healthy food choices, obesity education, support systems, clinical and community involvement, community support for exercise, physical activity, nutrition support, and nutrition education. Ratings were generally higher for importance than for feasibility. The concept maps demonstrate stakeholder-driven ideas about approaches to target STIs and obesity in this context. Strategies at multiple social ecological levels were emphasized. The concept maps can be used to generate discussion regarding these topics and to identify interventions. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

The Stakeholder Model of voice research: Acknowledging barriers to human rights of all stakeholders in a communicative exchange.

PubMed

Madill, Catherine; Warhurst, Samantha; McCabe, Patricia

2018-02-01

The act of communication is a complex, transient and often abstract phenomenon that involves many stakeholders, each of whom has their own perspective: the speaker, the listener, the observer and the researcher. Current research practices in voice disorder are frequently framed through a single lens - that of the researcher/clinician or their participant/patient. This single lens approach risks overlooking significant barriers to the basic human right of freedom of expression for those with a voice disorder as it omits consideration of the impact of voice disorder on the listener, and consideration of the wider impact of the voice in the occupational context. Recent research in the area of voice has developed a multiple lens and subsequent Stakeholder Model that acknowledges the experience and reality of multiple stakeholders viewing the same phenomenon, the voice. This research paradigm is built on Article 19 of the Universal Declaration of Human Rights as it considers the realities of all stakeholders in forming a deeper understanding of the causality, impact and aspects of communication disorder. The Stakeholder Model will be presented as a suggestion for future investigations of communication disorders more widely.

Stakeholders' perceptions of programme sustainability: findings from a community-based fall prevention programme.

PubMed

Hanson, H M; Salmoni, A W

2011-08-01

Sustainability of health promotion and injury prevention programmes is a goal of practitioners and an increasingly common requirement of funding bodies. However, less is known about the views held by individual stakeholders involved in such programmes regarding their perceptions of facilitators and barriers to achieving sustainability. This paper aims to share the perceptions of programme sustainability held by key stakeholders involved in a community-based fall prevention programme in three Ontario demonstration communities in Canada. A qualitative case study research design. A holistic multiple case study method was employed. In total, 45 stakeholders involved in various aspects of the project participated from three demonstration sites. Stakeholders' perceptions were gathered on the individual actions they took in an effort to promote sustainability, and the barriers they perceived as preventing or limiting sustainability. Stakeholders reported taking a number of actions to aid programme sustainability, with some actions deemed to be more functional in aiding sustainability than others. Common actions reported by stakeholders included partnership formation, networking and increasing community capacity. Stakeholders also perceived a number of barriers to achieving sustainability, including insufficient human and financial resources, lack of co-ordination and buy-in, heavy reliance on volunteers and an inability to mobilize physicians. Stakeholders' perceptions of sustainability were used to develop recommendations for sustainability for both communities and funding bodies. The views and experiences shared by the stakeholders in this project can serve as lessons learnt to aid in the sustainability of other health promotion and injury prevention programmes in the future. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

Stakeholder-focused evaluation of an online course for health care providers.

PubMed

Dunet, Diane O; Reyes, Michele

2006-01-01

Different people who have a stake or interest in a training course (stakeholders) may have markedly different definitions of what constitutes "training success" and how they will use evaluation results. Stakeholders at multiple levels within and outside of the organization guided the development of an evaluation plan for a Web-based training course on hemochromatosis. Stakeholder interests and values were reflected in the type, level, and rigor of evaluation methods selected. Our mixed-method evaluation design emphasized small sample sizes and repeated measures. Limited resources for evaluation were leveraged by focusing on the data needs of key stakeholders, understanding how they wanted to use evaluation results, and collecting data needed for stakeholder decision making. Regular feedback to key stakeholders provided opportunities for updating the course evaluation plan to meet emerging needs for new or different information. Early and repeated involvement of stakeholders in the evaluation process also helped build support for the final product. Involving patient advocacy groups, managers, and representative course participants improved the course and enhanced product dissemination. For training courses, evaluation planning is an opportunity to tailor methods and data collection to meet the information needs of particular stakeholders. Rigorous evaluation research of every training course may be infeasible or unwarranted; however, course evaluations can be improved by good planning. A stakeholder-focused approach can build a picture of the results and impact of training while fostering the practical use of evaluation data.

Ideals, practices, and future prospects of stakeholder involvement in sustainability science

PubMed Central

Vermaßen, Hannah; Ellenbeck, Saskia

2017-01-01

This paper evaluates current stakeholder involvement (SI) practices in science through a web-based survey among scholars and researchers engaged in sustainability or transition research. It substantiates previous conceptual work with evidence from practice by building on four ideal types of SI in science. The results give an interesting overview of the varied landscape of SI in sustainability science, ranging from the kinds of topics scientists work on with stakeholders, over scientific trade-offs that arise in the field, to improvements scientists wish for. Furthermore, the authors describe a discrepancy between scientists’ ideals and practices when working with stakeholders. On the conceptual level, the data reflect that the democratic type of SI is the predominant one concerning questions on the understanding of science, the main goal, the stage of involvement in the research process, and the science–policy interface. The fact that respondents expressed agreement to several types shows they are guided by multiple and partly conflicting ideals when working with stakeholders. We thus conclude that more conceptual exchange between practitioners, as well as more qualitative research on the concepts behind practices, is needed to better understand the stakeholder–scientist nexus. PMID:29162698

How stakeholder roles, power, and negotiation impact natural resource policy: A political economy view

USGS Publications Warehouse

Caughlan, L.

2002-01-01

Natural resource management decisions are complicated by multiple property rights, management objectives, and stakeholders with varying degrees of influence over the decision making process. In order to make efficient decisions, managers must incorporate the opinions and values of the involved stakeholders as well as understand the complex institutional constraints and opportunities that influence the decision-making process. Often this type of information is not understood until after a decision has been made, which can result in wasted time and effort.The purpose of my dissertation was to show how institutional frameworks and stakeholder involvement influence the various phases of the resource management decision-making process in a public choice framework. The intent was to assist decision makers and stakeholders by developing a methodology for formally incorporating stakeholders'' objectives and influence into the resource management planning process and to predict the potential success of rent-seeking activity based on stakeholder preferences and level of influence. Concepts from decision analysis, institutional analysis, and public choice economics were used in designing this interdisciplinary framework. The framework was then applied to an actual case study concerning elk and bison management on the National Elk Refuge and Grand Teton National Park near Jackson, Wyoming. The framework allowed for the prediction of the level of support and conflict for all relevant policy decisions, and the identification of each stakeholder''s level of support or opposition for each management decision.

Multiple Aims in the Development of a Major Reform of the National Curriculum for Science in England

NASA Astrophysics Data System (ADS)

Ryder, Jim; Banner, Indira

2011-03-01

In the context of a major reform of the school science curriculum for 14-16-year-olds in England, we examine the aims ascribed to the reform, the stakeholders involved, and the roles of differing values and authority in its development. This reform includes an emphasis on socioscientific issues and the nature of science; curriculum trends of international relevance. Our analysis identifies largely 'instrumental' aims, with little emphasis on 'intrinsic' aims and associated values. We identify five broad categories of stakeholders focusing on different aims with, for example, a social, individual, political, or economic emphasis. We suggest that curriculum development projects reflecting largely social and individual aims were appropriated by other stakeholders to serve political and economic aims. We argue that a curriculum reform body representing all stakeholder interests is needed to ensure that multiple aims are considered throughout the curriculum reform process. Within such a body, the differentiated character of the science teaching community would need to be represented.

Identifying non-traditional stakeholders with whom to engage, when mitigating antimicrobial resistance in foodborne pathogens (Canada).

PubMed

Majowicz, Shannon E; Parmley, E Jane; Carson, Carolee; Pintar, Katarina

2018-03-12

Antimicrobial resistance (AMR) is a critical public health issue that involves interrelationships between people, animals, and the environment. Traditionally, interdisciplinary efforts to mitigate AMR in the food chain have involved public health, human and veterinary medicine, and agriculture stakeholders. Our objective was to identify a more diverse range of stakeholders, beyond those traditionally engaged in AMR mitigation efforts, via diagramming both proximal and distal factors impacting, or impacted by, use and resistance along the Canadian food chain. We identified multiple stakeholders that are not traditionally engaged by public health when working to mitigate AMR in the food chain, including those working broadly in the area of food (e.g., nutrition, food security, international market economists) and health (e.g., health communication, program evaluation), as well as in domains as diverse as law, politics, demography, education, and social innovation. These findings can help researchers and policymakers who work on issues related to AMR in the food chain to move beyond engaging the 'traditional' agri-food stakeholders (e.g., veterinarians, farmers), to also engage those from the wider domains identified here, as potential stakeholders in their AMR mitigation efforts.

Communicating nutraceuticals: A multi-stakeholder perspective from a developing nation.

PubMed

Jain, Varsha; Roy, Subhadip; Damle, Neha; Jagani, Khyati

2016-01-01

Nutraceuticals, a combination of nutrition and pharmaceutical, have grown rapidly as a product globally. Nutraceuticals can be advertised directly to consumers as well as prescribed, and thus involve multiple stakeholders in the marketing communication process. The present study investigates the marketing communication aspects of nutraceuticals using 216 semistructured in-depth interviews including all stakeholders in the process such as company/brand, physicians, pharmacists, and consumers. The findings bring out the role of each participant in the communication process and a comprehensive picture of the same. The insights would facilitate the nutraceutical brands to understand and implement marketing effective communication strategies.

Therapist, Parent, and Youth Perspectives of Treatment Barriers to Family-Focused Community Outpatient Mental Health Services

PubMed Central

Jenkins, Melissa M.; Haine-Schlagel, Rachel

2012-01-01

This exploratory qualitative study describes treatment barriers to receiving family-focused child mental health services for youths with disruptive behavior problems from multiple perspectives. Data were collected during a series of focus groups and interviews, including: 4 therapist focus groups, 3 parent focus groups, and 10 youth semi-structured interviews. Therapist, parent, and youth stakeholder participants discussed perceived barriers to effective treatment, the problems with current child outpatient therapy, and desired changes (i.e., policy, intervention, etc.) to improve mental health services. Results indicate similar themes around treatment barriers and dissatisfaction with services within and across multiple stakeholder groups, including inadequate support and lack of family involvement; however, parents and therapists, in particular, identified different contributing factors to these barriers. Overall, stakeholders reported much frustration and dissatisfaction with current community-based outpatient child therapy services. Study findings can inform service provision, intervention development, and future research. PMID:24019737

Three nested randomized controlled trials of peer-only or multiple stakeholder group feedback within Delphi surveys during core outcome and information set development.

PubMed

Brookes, Sara T; Macefield, Rhiannon C; Williamson, Paula R; McNair, Angus G; Potter, Shelley; Blencowe, Natalie S; Strong, Sean; Blazeby, Jane M

2016-08-17

Methods for developing a core outcome or information set require involvement of key stakeholders to prioritise many items and achieve agreement as to the core set. The Delphi technique requires participants to rate the importance of items in sequential questionnaires (or rounds) with feedback provided in each subsequent round such that participants are able to consider the views of others. This study examines the impact of receiving feedback from different stakeholder groups, on the subsequent rating of items and the level of agreement between stakeholders. Randomized controlled trials were nested within the development of three core sets each including a Delphi process with two rounds of questionnaires, completed by patients and health professionals. Participants rated items from 1 (not essential) to 9 (absolutely essential). For round 2, participants were randomized to receive feedback from their peer stakeholder group only (peer) or both stakeholder groups separately (multiple). Decisions as to which items to retain following each round were determined by pre-specified criteria. Whilst type of feedback did not impact on the percentage of items for which a participant subsequently changed their rating, or the magnitude of change, it did impact on items retained at the end of round 2. Each core set contained discordant items retained by one feedback group but not the other (3-22 % discordant items). Consensus between patients and professionals in items to retain was greater amongst those receiving multiple group feedback in each core set (65-82 % agreement for peer-only feedback versus 74-94 % for multiple feedback). In addition, differences in round 2 scores were smaller between stakeholder groups receiving multiple feedback than between those receiving peer group feedback only. Variability in item scores across stakeholders was reduced following any feedback but this reduction was consistently greater amongst the multiple feedback group. In the development of a core outcome or information set, providing feedback within Delphi questionnaires from all stakeholder groups separately may influence the final core set and improve consensus between the groups. Further work is needed to better understand how participants rate and re-rate items within a Delphi process. The three randomized controlled trials reported here were each nested within the development of a core information or outcome set to investigate processes in core outcome and information set development. Outcomes were not health-related and therefore trial registration was not applicable.

An integrated decision making approach for assessing healthcare waste treatment technologies from a multiple stakeholder.

PubMed

Shi, Hua; Liu, Hu-Chen; Li, Ping; Xu, Xue-Guo

2017-01-01

With increased worldwide awareness of environmental issues, healthcare waste (HCW) management has received much attention from both researchers and practitioners over the past decade. The task of selecting the optimum treatment technology for HCWs is a challenging decision making problem involving conflicting evaluation criteria and multiple stakeholders. In this paper, we develop an integrated decision making framework based on cloud model and MABAC method for evaluating and selecting the best HCW treatment technology from a multiple stakeholder perspective. The introduced framework deals with uncertain linguistic assessments of alternatives by using interval 2-tuple linguistic variables, determines decision makers' relative weights based on the uncertainty and divergence degrees of every decision maker, and obtains the ranking of all HCW disposal alternatives with the aid of an extended MABAC method. Finally, an empirical example from Shanghai, China, is provided to illustrate the feasibility and effectiveness of the proposed approach. Results indicate that the methodology being proposed is more suitable and effective to handle the HCW treatment technology selection problem under vague and uncertain information environment. Copyright © 2016 Elsevier Ltd. All rights reserved.

Enhancing stakeholder involvement in environmental decision making: Active Response Geographic Information System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Faber, B.G.; Thomas, V.L.; Thomas, M.R.

This paper describes a spatial decision support system that facilitates land-related negotiations and resolving conflicts. This system, called Active Response Geographic Information System (AR/GIS), uses a geographic information system to examine land resource management issues which involve multiple stakeholder groups. In this process, participants are given the opportunity and tools needed to share ideas in a facilitated land resource allocation negotiation session. Participants are able to assess current land status, develop objectives, propose alternative planning scenarios, and evaluate the effects or impacts of each alternative. AR/GIS is a unique tool that puts geographic information directly at the fingertips of non-technicalmore » policy analysts, decision makers, and representatives of stakeholder groups during the negotiation process. AR/GIS enhances individual comprehension and ownership of the decision making process and increasing the efficiency and effectiveness of group debate. It is most beneficial to planning tasks which are inherently geographic in nature, which require consideration of a large number of physical constraints and economic implications, and which involve publicly sensitive tradeoffs.« less

Integrated Knowledge Translation and Grant Development: Addressing the Research Practice Gap through Stakeholder-informed Research.

PubMed

Henderson, Joanna; Brownlie, Elizabeth; Rosenkranz, Susan; Chaim, Gloria; Beitchman, Joseph

2013-11-01

We describe our stakeholder engagement process for grant application development that occurred as part of our integrated knowledge translation plan and make recommendations for researchers. In phase 1, a stakeholder consultation group was developed. In phase 2, surveys regarding knowledge gathering, research agenda, and research collaboration preferences were sent to 333 cross-sectoral youth-serving organizations in Ontario, including family and consumer organizations. In phase 1, 28 stakeholders from six sectors participated in the consultation group and provided input on multiple aspects of the proposal. Through this process, 19 stakeholders adopted formal roles within the project. In phase 2, 206 surveys were received (response rate = 62%). Survey responses supported the grant focus (concurrent youth mental health and substance use problems). Respondents also prioritized project goals and provided specific feedback on research and knowledge translation. Finally, although some stakeholders chose greater involvement, most survey respondents indicated a preference for a moderate level of participation in research rather than full team membership. Despite short timelines and feasibility challenges, stakeholders can be meaningfully engaged in and contribute to the grant proposal development process. Consideration is needed for the practical challenges that stakeholder organizations face in supporting and participating in research.

Are Higher Education Institutions Prepared for Learning Analytics?

ERIC Educational Resources Information Center

Ifenthaler, Dirk

2017-01-01

Higher education institutions and involved stakeholders can derive multiple benefits from learning analytics by using different data analytics strategies to produce summative, real-time, and predictive insights and recommendations. However, are institutions and academic as well as administrative staff prepared for learning analytics? A learning…

Lay and professional stakeholder involvement in scoping palliative care issues: Methods used in seven European countries.

PubMed

Brereton, Louise; Ingleton, Christine; Gardiner, Clare; Goyder, Elizabeth; Mozygemba, Kati; Lysdahl, Kristin Bakke; Tummers, Marcia; Sacchini, Dario; Leppert, Wojciech; Blaževičienė, Aurelija; van der Wilt, Gert Jan; Refolo, Pietro; De Nicola, Martina; Chilcott, James; Oortwijn, Wija

2017-02-01

Stakeholders are people with an interest in a topic. Internationally, stakeholder involvement in palliative care research and health technology assessment requires development. Stakeholder involvement adds value throughout research (from prioritising topics to disseminating findings). Philosophies and understandings about the best ways to involve stakeholders in research differ internationally. Stakeholder involvement took place in seven countries (England, Germany, Italy, Lithuania, the Netherlands, Norway and Poland). Findings informed a project that developed concepts and methods for health technology assessment and applied these to evaluate models of palliative care service delivery. To report on stakeholder involvement in the INTEGRATE-HTA project and how issues identified informed project development. Using stakeholder consultation or a qualitative research design, as appropriate locally, stakeholders in seven countries acted as 'advisors' to aid researchers' decision making. Thematic analysis was used to identify key issues across countries. A total of 132 stakeholders (82 professionals and 50 'lay' people) aged ⩾18 participated in individual face-to-face or telephone interviews, consultation meetings or focus groups. Different stakeholder involvement methods were used successfully to identify key issues in palliative care. A total of 23 issues common to three or more countries informed decisions about the intervention and comparator of interest, sub questions and specific assessments within the health technology assessment. Stakeholders, including patients and families undergoing palliative care, can inform project decision making using various involvement methods according to the local context. Researchers should consider local understandings about stakeholder involvement as views of appropriate and feasible methods vary. Methods for stakeholder involvement, especially consultation, need further development.

Future Research in Agile Systems Development: Applying Open Innovation Principles Within the Agile Organisation

NASA Astrophysics Data System (ADS)

Conboy, Kieran; Morgan, Lorraine

A particular strength of agile approaches is that they move away from ‘introverted' development and intimately involve the customer in all areas of development, supposedly leading to the development of a more innovative and hence more valuable information system. However, we argue that a single customer representative is too narrow a focus to adopt and that involvement of stakeholders beyond the software development itself is still often quite weak and in some cases non-existent. In response, we argue that current thinking regarding innovation in agile development needs to be extended to include multiple stakeholders outside the business unit. This paper explores the intra-organisational applicability and implications of open innovation in agile systems development. Additionally, it argues for a different perspective of project management that includes collaboration and knowledge-sharing with other business units, customers, partners, and other relevant stakeholders pertinent to the business success of an organisation, thus embracing open innovation principles.

Policy Driven Development: Flexible Policy Insertion for Large Scale Systems.

PubMed

Demchak, Barry; Krüger, Ingolf

2012-07-01

The success of a software system depends critically on how well it reflects and adapts to stakeholder requirements. Traditional development methods often frustrate stakeholders by creating long latencies between requirement articulation and system deployment, especially in large scale systems. One source of latency is the maintenance of policy decisions encoded directly into system workflows at development time, including those involving access control and feature set selection. We created the Policy Driven Development (PDD) methodology to address these development latencies by enabling the flexible injection of decision points into existing workflows at runtime , thus enabling policy composition that integrates requirements furnished by multiple, oblivious stakeholder groups. Using PDD, we designed and implemented a production cyberinfrastructure that demonstrates policy and workflow injection that quickly implements stakeholder requirements, including features not contemplated in the original system design. PDD provides a path to quickly and cost effectively evolve such applications over a long lifetime.

A Seat Around the Table: Participatory Data Analysis With People Living With Dementia.

PubMed

Clarke, Charlotte L; Wilkinson, Heather; Watson, Julie; Wilcockson, Jane; Kinnaird, Lindsay; Williamson, Toby

2018-05-01

The involvement of "people with experience" in research has developed considerably in the last decade. However, involvement as co-analysts at the point of data analysis and synthesis has received very little attention-in particular, there is very little work that involves people living with dementia as co-analysts. In this qualitative secondary data analysis project, we (a) analyzed data through two theoretical lenses: Douglas's cultural theory of risk and Tronto's Ethic of Care, and (b) analyzed data in workshops with people living with dementia. The design involved cycles of presenting, interpreting, representing and reinterpreting the data, and findings between multiple stakeholders. We explore ways of involving people with experience as co-analysts and explore the role of reflexivity, multiple voicing, literary styling, and performance in participatory data analysis.

Future of applied watershed science at regional scales

Treesearch

Lee Benda; Daniel Miller; Steve Lanigan; Gordon Reeves

2009-01-01

Resource managers must deal increasingly with land use and conservation plans applied at large spatial scales (watersheds, landscapes, states, regions) involving multiple interacting federal agencies and stakeholders. Access to a geographically focused and application-oriented database would allow users in different locations and with different concerns to quickly...

Sustainability: Why the Language and Ethics of Sustainability Matter in the Geoscience Classroom

ERIC Educational Resources Information Center

Metzger, Ellen P.; Curren, Randall R.

2017-01-01

Because challenges to sustainability arise at the intersection of human and biophysical systems they are inescapably embedded in social contexts and involve multiple stakeholders with diverse and often conflicting needs and value systems. Addressing complex and solution-resistant problems such as climate change, biodiversity loss, and…

STakeholder-Objective Risk Model (STORM): Determining the aggregated risk of multiple contaminant hazards in groundwater well catchments

NASA Astrophysics Data System (ADS)

Enzenhoefer, R.; Binning, P. J.; Nowak, W.

2015-09-01

Risk is often defined as the product of probability, vulnerability and value. Drinking water supply from groundwater abstraction is often at risk due to multiple hazardous land use activities in the well catchment. Each hazard might or might not introduce contaminants into the subsurface at any point in time, which then affects the pumped quality upon transport through the aquifer. In such situations, estimating the overall risk is not trivial, and three key questions emerge: (1) How to aggregate the impacts from different contaminants and spill locations to an overall, cumulative impact on the value at risk? (2) How to properly account for the stochastic nature of spill events when converting the aggregated impact to a risk estimate? (3) How will the overall risk and subsequent decision making depend on stakeholder objectives, where stakeholder objectives refer to the values at risk, risk attitudes and risk metrics that can vary between stakeholders. In this study, we provide a STakeholder-Objective Risk Model (STORM) for assessing the total aggregated risk. Or concept is a quantitative, probabilistic and modular framework for simulation-based risk estimation. It rests on the source-pathway-receptor concept, mass-discharge-based aggregation of stochastically occuring spill events, accounts for uncertainties in the involved flow and transport models through Monte Carlo simulation, and can address different stakeholder objectives. We illustrate the application of STORM in a numerical test case inspired by a German drinking water catchment. As one may expect, the results depend strongly on the chosen stakeholder objectives, but they are equally sensitive to different approaches for risk aggregation across different hazards, contaminant types, and over time.

Speaking Up: How Patient and Physician Voices Shaped a Trial to Improve Goals-of-Care Discussions.

PubMed

Solomon, Rachel; Smith, Cardinale; Kallio, Jay; Fenollosa, Amy; Benerofe, Barbara; Jones, Laurence; Adelson, Kerin; Gonsky, Jason P; Messner, Carolyn; Bickell, Nina A

2017-08-01

Patients with advanced cancer benefit from early goals-of-care (GoC) conversations, but few facilitators are known. We describe the process and outcomes of involving patient and physician stakeholders in the design and development of a trial, funded by the Patient-Centered Outcomes Research Institute (PCORI), to enhance oncologists' communication skills and their propensity to facilitate productive, meaningful GoC discussions with patients with advanced cancer. We recruited oncologists, palliative care physicians, and patient stakeholders to participate in proposal development, intervention design and modification, identification of outcome measures, and refinement of study tools. Formats for exchange included 1:1 structured interviews, workshops, and stakeholder meetings. Patient and physician voices helped craft and implement a study of an intervention to enhance oncologists' ability to facilitate GoC discussions with patients with advanced cancer. Physician inputs guided the creation of an oncologist and palliative care physician "joint visit" intervention at a turning point in disease management. Patient inputs impacted on the language used, outcome measures assessed, and approaches used to introduce patients to the intervention visit. Stakeholder input informed the development of a novel intervention that physicians seemed to find both valuable and in sync with their needs and their practice schedules. Where communication about difficult subjects and shared decision making are involved, including multiple stakeholder groups in study design, implementation, and outcomes measurement may have far-reaching effects.

More Than Just Accuracy: A Novel Method to Incorporate Multiple Test Attributes in Evaluating Diagnostic Tests Including Point of Care Tests.

PubMed

Thompson, Matthew; Weigl, Bernhard; Fitzpatrick, Annette; Ide, Nicole

2016-01-01

Current frameworks for evaluating diagnostic tests are constrained by a focus on diagnostic accuracy, and assume that all aspects of the testing process and test attributes are discrete and equally important. Determining the balance between the benefits and harms associated with new or existing tests has been overlooked. Yet, this is critically important information for stakeholders involved in developing, testing, and implementing tests. This is particularly important for point of care tests (POCTs) where tradeoffs exist between numerous aspects of the testing process and test attributes. We developed a new model that multiple stakeholders (e.g., clinicians, patients, researchers, test developers, industry, regulators, and health care funders) can use to visualize the multiple attributes of tests, the interactions that occur between these attributes, and their impacts on health outcomes. We use multiple examples to illustrate interactions between test attributes (test availability, test experience, and test results) and outcomes, including several POCTs. The model could be used to prioritize research and development efforts, and inform regulatory submissions for new diagnostics. It could potentially provide a way to incorporate the relative weights that various subgroups or clinical settings might place on different test attributes. Our model provides a novel way that multiple stakeholders can use to visualize test attributes, their interactions, and impacts on individual and population outcomes. We anticipate that this will facilitate more informed decision making around diagnostic tests.

Managing the University Campus: Exploring Models for the Future and Supporting Today's Decisions

ERIC Educational Resources Information Center

den Heijer, Alexandra

2012-01-01

Managing contemporary campuses and taking decisions that will impact on those of tomorrow is a complex task for universities worldwide. It involves strategic, financial, functional and physical aspects as well as multiple stakeholders. This article summarises the conclusions of a comprehensive PhD research project which was enriched with lessons…

Developing dimensions for a multicomponent multidisciplinary approach to obesity management: a qualitative study.

PubMed

Cochrane, Anita J; Dick, Bob; King, Neil A; Hills, Andrew P; Kavanagh, David J

2017-10-16

There have been consistent recommendations for multicomponent and multidisciplinary approaches for obesity management. However, there is no clear agreement on the components, disciplines or processes to be considered within such an approach. In this study, we explored multicomponent and multidisciplinary approaches through an examination of knowledge, skills, beliefs, and recommendations of stakeholders involved in obesity management. These stakeholders included researchers, practitioners, educators, and patients. We used qualitative action research methods, including convergent interviewing and observation, to assist the process of inquiry. The consensus was that a multicomponent and multidisciplinary approach should be based on four central meta-components (patient, practitioner, process, and environmental factors), and specific components of these factors were identified. Psychologists, dieticians, exercise physiologists and general practitioners were nominated as key practitioners to be included. A complex condition like obesity requires that multiple components be addressed, and that both patients and multiple disciplines are involved in developing solutions. Implementing cycles of continuous improvement to deal with complexity, instead of trying to control for it, offers an effective way to deal with complex, changing multisystem problems like obesity.

Developing AN Emergency Response Model for Offshore Oil Spill Disaster Management Using Spatial Decision Support System (sdss)

NASA Astrophysics Data System (ADS)

Balogun, Abdul-Lateef; Matori, Abdul-Nasir; Wong Toh Kiak, Kelvin

2018-04-01

Environmental resources face severe risks during offshore oil spill disasters and Geographic Information System (GIS) Environmental Sensitivity Index (ESI) maps are increasingly being used as response tools to minimize the huge impacts of these spills. However, ESI maps are generally unable to independently harmonize the diverse preferences of the multiple stakeholders' involved in the response process, causing rancour and delay in response time. This paper's Spatial Decision Support System (SDSS) utilizes the Analytic Hierarchy Process (AHP) model to perform tradeoffs in determining the most significant resources to be secured considering the limited resources and time available to perform the response operation. The AHP approach is used to aggregate the diverse preferences of the stakeholders and reach a consensus. These preferences, represented as priority weights, are incorporated in a GIS platform to generate Environmental sensitivity risk (ESR) maps. The ESR maps provide a common operational platform and consistent situational awareness for the multiple parties involved in the emergency response operation thereby minimizing discord among the response teams and saving the most valuable resources.

Identifying and understanding the concerns of business: a systematic approach to the development of the Australian WorkHealth Program - Arthritis.

PubMed

Reavley, Nicola; Livingston, Jenni; Buchbinder, Rachelle; Osborne, Richard

2012-07-01

The aim of the Australian WorkHealth Program - Arthritis was to develop and test an education program designed to minimise risk of arthritis and prevent or reduce absenteeism and presenteeism. The objective of the current study was to use a wide-ranging, multifaceted and interactive approach to engage with stakeholders in order to inform the content and delivery of the intervention. Methods used to inform program design included a concept mapping workshop, interviews, surveys, a steering committee and an industry advisory group. Engaging with a wide range of stakeholders in multiple ways early in program development allowed for the comparison and verification of data to obtain a better overall picture of the needs of participants. It also offered the opportunity to share 'ownership' of the program with stakeholders by generating a program that was tailored to their ethos and needs. The stakeholder engagement process was instrumental in building commitment to the program and establishing an overarching model of action. Interview and survey data indicated that awareness of arthritis was low and musculoskeletal disorders more generally were of greater concern. It was agreed that programs should be relevant, evidence-based, involve senior management education, incorporate a business case, and involve tailored implementation and marketing strategies. The qualitative preparatory phase as well as all the engagement work was key to informing program design. The approach taken in this study has the potential to inform a wide range of workplace interventions. Engaging with a wide range of stakeholders in multiple ways from program inception allowed for the comparison and verification of information to permit the generation of a model of intervention that had the highest possible chance of success. It offered the opportunity to not only define program content and implementation processes, but to build genuine 'ownership' of the program.

Recruitment of multiple stakeholders to health services research: lessons from the front lines.

PubMed

Kho, Michelle E; Rawski, Ellen; Makarski, Julie; Brouwers, Melissa C

2010-05-13

Self-administered surveys are an essential methodological tool for health services and knowledge translation research, and engaging end-users of the research is critical. However, few documented accounts of the efforts invested in recruitment of multiple different stakeholders to one health services research study exist. Here, we highlight the challenges of recruiting key stakeholders (policy-makers, clinicians, guideline developers) to a Canadian Institutes of Health Research (CIHR) funded health services research (HSR) study aimed to develop an updated and refined version of a guideline appraisal tool, the AGREE. Using evidence-based methods of recruitment, our goal was to recruit 192 individuals: 80 international guideline developers, 80 Canadian clinicians and 32 Canadian policy/decision-makers. We calculated the participation rate and the recruitment efficiency. We mailed 873 invitation letters. Of 838 approached, our participation rate was 29%(240) and recruitment efficiency, 19%(156). One policy-maker manager did not allow policy staff to participate in the study. Based on the results from this study, we suggest that future studies aiming to engage similar stakeholders in HSR over sample by at least 5 times to achieve their target sample size and allow for participant withdrawals. We need continued efforts to communicate the value of research between researchers and end-users of research (policy-makers, clinicians, and other researchers), integration of participatory research strategies, and promotion of the value of end-user involvement in research. Future research to understand methods of improving recruitment efficiency and engaging key stakeholders in HSR is warranted.

STAKEHOLDER INVOLVEMENT THROUGHOUT HEALTH TECHNOLOGY ASSESSMENT: AN EXAMPLE FROM PALLIATIVE CARE.

PubMed

Brereton, Louise; Wahlster, Philip; Mozygemba, Kati; Lysdahl, Kristin Bakke; Burns, Jake; Polus, Stephanie; Tummers, Marcia; Refolo, Pietro; Sacchini, Dario; Leppert, Wojciech; Chilcott, James; Ingleton, Christine; Gardiner, Clare; Goyder, Elizabeth

2017-01-01

Internationally, funders require stakeholder involvement throughout health technology assessment (HTA). We report successes, challenges, and lessons learned from extensive stakeholder involvement throughout a palliative care case study that demonstrates new concepts and methods for HTA. A 5-step "INTEGRATE-HTA Model" developed within the INTEGRATE-HTA project guided the case study. Using convenience or purposive sampling or directly / indirectly identifying and approaching individuals / groups, stakeholders participated in qualitative research or consultation meetings. During scoping, 132 stakeholders, aged ≥ 18 years in seven countries (England, Italy, Germany, The Netherlands, Norway, Lithuania, and Poland), highlighted key issues in palliative care that assisted identification of the intervention and comparator. Subsequently stakeholders in four countries participated in face-face, telephone and / or video Skype meetings to inform evidence collection and / or review assessment results. An applicability assessment to identify contextual and implementation barriers and enablers for the case study findings involved twelve professionals in the three countries. Finally, thirteen stakeholders participated in a mock decision-making meeting in England. Views about the best methods of stakeholder involvement vary internationally. Stakeholders make valuable contributions in all stages of HTA; assisting decision making about interventions, comparators, research questions; providing evidence and insights into findings, gap analyses and applicability assessments. Key challenges exist regarding inclusivity, time, and resource use. Stakeholder involvement is feasible and worthwhile throughout HTA, sometimes providing unique insights. Various methods can be used to include stakeholders, although challenges exist. Recognition of stakeholder expertise and further guidance about stakeholder consultation methods is needed.

Facilitating evaluations of innovative, competence-based assessments: creating understanding and involving multiple stakeholders.

PubMed

Gulikers, Judith T M; Baartman, Liesbeth K J; Biemans, Harm J A

2010-05-01

Schools are held more responsible for evaluating, quality assuring and improving their student assessments. Teachers' lack of understanding of new, competence-based assessments as well as the lack of key stakeholders' involvement, hamper effective and efficient self-evaluations by teachers of innovative, competence-based assessments (CBAs). While evaluating two CBAs in Agricultural Vocational Education and Training institutions, two interventions in the evaluation process aimed to tackle these problems were examined: (1) starting with explicating the CBA in the teacher team using a concrete explication format and (2) qualitatively involving key stakeholders (i.e., teachers, students and employers) in the evaluation of the CBA through mixed-group interviews. Quantitative and qualitative analysis, as well as stakeholders' perceptions are used to find indications for the added value of these interventions for evaluation and further improvement of the CBAs. Results show that external facilitation is needed to make both interventions work. However, under this condition, explicating the CBA led to more complete, concrete and shared understandings of the actual CBA among teachers and mixed-groups interviews resulted in more concrete and elaborate evaluations of the CBAs' quality and more ideas for improvement. Both interventions can facilitate building up elaborate, more valid and concrete arguments for CBA quality in self-evaluations, certainly in the case of evaluating innovative assessments. Lessons learned will provide guidelines for incorporating the interventions into other evaluations of innovative programs. Copyright 2009 Elsevier Ltd. All rights reserved.

Design Requirements for Communication-Intensive Interactive Applications

NASA Astrophysics Data System (ADS)

Bolchini, Davide; Garzotto, Franca; Paolini, Paolo

Online interactive applications call for new requirements paradigms to capture the growing complexity of computer-mediated communication. Crafting successful interactive applications (such as websites and multimedia) involves modeling the requirements for the user experience, including those leading to content design, usable information architecture and interaction, in profound coordination with the communication goals of all stakeholders involved, ranging from persuasion to social engagement, to call for action. To face this grand challenge, we propose a methodology for modeling communication requirements and provide a set of operational conceptual tools to be used in complex projects with multiple stakeholders. Through examples from real-life projects and lessons-learned from direct experience, we draw on the concepts of brand, value, communication goals, information and persuasion requirements to systematically guide analysts to master the multifaceted connections of these elements as drivers to inform successful communication designs.

A framework for multi-stakeholder decision-making and conflict resolution

EPA Science Inventory

We propose a decision-making framework to compute compromise solutions that balance conflicting priorities of multiple stakeholders on multiple objectives. In our setting, we shape the stakeholder dis-satisfaction distribution by solving a conditional-value-at-risk (CVaR) minimiz...

Stakeholders in nursing education: their role and involvement.

PubMed

Virgolesi, M; Marchetti, A; Piredda, M; Pulimeno, A M L; Rocco, G; Stievano, A; De Marinis, M G

2014-01-01

In literature, there is evidence that all stakeholders need to be involved in the curricula building process to make sure that health professionals are "educated" to meet the stakeholders' "demands". In Italy, the involvement of stakeholders in the definition of university curricula is ratified by various regulations. To describe the major experiences of stakeholder involvement in nursing education, identify the main stakeholders for nursing education, and the processes in which they are involved. The search strategy included an electronic exploration of the relevant databases. The search terms were: Stakeholders, Curriculum, Nursing Education combined with Boolean operators. The references of the retrieved articles were hand searched for additional related studies. Most of the studies identified were from the United Kingdom, Australia, and the USA. In Italy, no relevant studies were found. The most frequently identified stakeholders were: students, clinicians, educators, nurse managers. They were mainly involved during profound changes in the curricula and the implementation of new educational approaches. Stakeholders are mostly involved in countries with a private funding system for universities. Such funding systems have probably developed in the academia a greater propensity to involve stakeholders, to provide recognition of success when starting new programs, and are perceived more as marketing research. This seems contrary to the spirit of the Italian and European regulatory interventions, which instead, provide a structured commitment to consolidating and expanding the collaboration among universities, users, and the world of labor. This latter collaboration should facilitate internship activities, lifelong learning, and employability of the newly-graduated professionals.

The Transition to Kindergarten for Children with and without Disabilities: An Investigation of Parent and Teacher Concerns and Involvement

ERIC Educational Resources Information Center

Welchons, Leah Wildenger; McIntyre, Laura Lee

2015-01-01

The transition to kindergarten is regarded as a critical early childhood developmental milestone with important implications for later school outcomes. Despite its importance, few empirical studies examine kindergarten transition and fewer examine transition from the perspective of multiple stakeholders. The goal of the current study was to…

Stakeholder Bias.

ERIC Educational Resources Information Center

House, Ernest R.

2003-01-01

Discusses the nature of stakeholder participation in evaluation and contrasts E. House's commitment to involving all stakeholders to ensure that interests of all are included with other theorists' preference to involve a few stakeholders more intensely. (SLD)

[Adoption of new technologies by health services: the challenge of analyzing relevant factors].

PubMed

Trindade, Evelinda

2008-05-01

The exponential increase in the incorporation of health technologies has been considered a key factor in increased expenditures by the health sector. Such decisions involve multiple levels and stakeholders. Decentralization has multiplied the decision-making levels, with numerous difficult choices and limited resources. The interrelationship between stakeholders is complex, in creative systems with multiple determinants and confounders. The current review discusses the interaction between the factors influencing the decisions to incorporate technologies by health services, and proposes a structure for their analysis. The application and intensity of these factors in decision-making and the incorporation of products and programs by health services shapes the installed capacity of local and regional networks and modifies the health system. Empirical observation of decision-making and technology incorporation in Brazilian health services poses an important challenge. The structured recognition and measurement of these variables can assist proactive planning of health services.

From community preferences to design: Investigation of human-centered optimization algorithms in web-based, democratic planning of watershed restoration

NASA Astrophysics Data System (ADS)

Babbar-Sebens, M.; Mukhopadhyay, S.

2014-12-01

Web 2.0 technologies are useful resources for reaching out to larger stakeholder communities and involve them in policy making and planning efforts. While these technologies have been used in the past to support education and communication endeavors, we have developed a novel, web-based, interactive planning tool that involves the community in using science-based methods for the design of potential runoff management strategies on their landscape. The tool, Watershed REstoration using Spatio-Temporal Optimization of Resources (WRESTORE), uses a democratic voting process coupled with visualization interfaces, computational simulation and optimization models, and user modeling techniques to support a human-centered design approach. The tool can be used to engage diverse watershed stakeholders and landowners via the internet, thereby improving opportunities for outreach and collaborations. Users are able to (a) design multiple types of conservation practices at their field-scale catchment and at the entire watershed scale, (b) examine impacts and limitations of their decisions on their neighboring catchments and on the entire watershed, (c) compare alternatives via a cost-benefit analysis, (d) vote on their "favorite" designs based on their preferences and constraints, and (e) propose their "favorite" alternatives to policy makers and other stakeholders. In this presentation, we will demonstrate the effectiveness of WRESTORE for designing alternatives of conservation practices to reduce peak flows in a Midwestern watershed, present results on multiple approaches for engaging with larger communities, and discuss potential for future developments.

Community‐Academic Partnerships: A Systematic Review of the State of the Literature and Recommendations for Future Research

PubMed Central

MEZA, ROSEMARY D.; BRIKHO, BRIGITTE; NAAF, MEGHAN; ESTABILLO, JASPER A.; GOMEZ, EMILY D.; VEJNOSKA, SARAH F.; DUFEK, SARAH; STAHMER, AUBYN C.; AARONS, GREGORY A.

2016-01-01

Policy Points: Communities, funding agencies, and institutions are increasingly involving community stakeholders as partners in research, to provide firsthand knowledge and insight.Based on our systematic review of major literature databases, we recommend using a single term, community‐academic partnership (CAP), and a conceptual definition to unite multiple research disciplines and strengthen the field.Interpersonal and operational factors that facilitate or hinder the collaborative process have been consistently identified, including “trust among partners” and “respect among partners” (facilitating interpersonal factors) and “excessive time commitment” (hindering operational factor).Once CAP processes and characteristics are better understood, the effectiveness of collaborative partner involvement can be tested. Context Communities, funding agencies, and institutions are increasingly involving community stakeholders as partners in research. Community stakeholders can provide firsthand knowledge and insight, thereby increasing research relevance and feasibility. Despite the greater emphasis and use of community‐academic partnerships (CAP) across multiple disciplines, definitions of partnerships and methodologies vary greatly, and no systematic reviews consolidating this literature have been published. The purpose of this article, then, is to facilitate the continued growth of this field by examining the characteristics of CAPs and the current state of the science, identifying the facilitating and hindering influences on the collaborative process, and developing a common term and conceptual definition for use across disciplines. Methods Our systematic search of 6 major literature databases generated 1,332 unique articles, 50 of which met our criteria for inclusion and provided data on 54 unique CAPs. We then analyzed studies to describe CAP characteristics and to identify the terms and methods used, as well as the common influences on the CAP process and distal outcomes. Findings CAP research spans disciplines, involves a variety of community stakeholders, and focuses on a large range of study topics. CAP research articles, however, rarely report characteristics such as membership numbers or duration. Most studies involved case studies using qualitative methods to collect data on the collaborative process. Although various terms were used to describe collaborative partnerships, few studies provided conceptual definitions. Twenty‐three facilitating and hindering factors influencing the CAP collaboration process emerged from the literature. Outcomes from the CAPs most often included developing or refining tangible products. Conclusions Based on our systematic review, we recommend using a single term, community‐academic partnership, as well as a conceptual definition to unite multiple research disciplines. In addition, CAP characteristics and methods should be reported more systematically to advance the field (eg, to develop CAP evaluation tools). We have identified the most common influences that facilitate and hinder CAPs, which in turn should guide their development and sustainment. PMID:26994713

Patient involvement in research programming and implementation: A responsive evaluation of the Dialogue Model for research agenda setting.

PubMed

Abma, Tineke A; Pittens, Carina A C M; Visse, Merel; Elberse, Janneke E; Broerse, Jacqueline E W

2015-12-01

The Dialogue Model for research agenda-setting, involving multiple stakeholders including patients, was developed and validated in the Netherlands. However, there is little insight into whether and how patient involvement is sustained during the programming and implementation of research agendas. To understand how the Dialogue Model can be optimised by focusing on programming and implementation, in order to stimulate the inclusion of (the perspectives of) patients in research. A responsive evaluation of the programming and implementation phases of nine agenda-setting projects that had used the Dialogue Model for agenda-setting was conducted. Fifty-four semi-structured interviews were held with different stakeholders (patients, researchers, funding agencies). Three focus groups with patients, funding agencies and researchers (16 participants) were organized to validate the findings. Patient involvement in programming and implementation of the research agendas was limited. This was partly related to poor programming and implementation, partly to pitfalls in earlier phases of the agenda-setting. Optimization of the Dialogue Model is possible by attending to the nature of the agenda and its intended use in earlier phases. Attention should also be given to the ambassadors and intended users of agenda topics. Support is needed during programming and implementation to organize patient involvement and adapt organizational structures like review procedures. In all phases the attitude to patient involvement, stakeholder participation, especially of researchers, and formal and informal relationships between parties need to be addressed to build a strong relationship with a shared goal. Patient involvement in agenda-setting is not automatically followed by patient involvement in programming and implementation. More attention should be paid, in earlier stages, to the attitude and engagement of researchers and funding agencies. © 2014 John Wiley & Sons Ltd.

Converting science to policy through stakeholder involvement: an analysis of the European Marine Strategy Directive.

PubMed

Fletcher, Stephen

2007-12-01

The Marine Strategy Directive requires European Union Member States to develop science-based marine strategies with the involvement of stakeholders, in order that Europe's marine environment reaches 'good environmental status' by 2021. The scientific requirements of marine strategies are clearly defined within the Directive, however, the requirements related to stakeholder involvement are not. This paper presents a critical analysis of the provisions for stakeholder involvement with in the Marine Strategy Directive. In particular, the paper is focused upon the definition of stakeholder, the sequencing of involvement, and the form and purpose of involvement. The critique is set within an evaluative framework that considers policy-making to be a social process, rather than a purely scientific one. It is concluded that the Marine Strategy Directive lacks coherency with respect to stakeholder involvement which may perpetuate the traditional tension between marine science and policy. This in turn may compromise the ability of the Directive to protect Europe's marine environment.

Governance of environmental risk: new approaches to managing stakeholder involvement.

PubMed

Benn, Suzanne; Dunphy, Dexter; Martin, Andrew

2009-04-01

Disputes concerning industrial legacies such as the disposal of toxic wastes illustrate changing pressures on corporations and governments. Business and governments are now confronted with managing the expectations of a society increasingly aware of the social and environmental impacts and risks associated with economic development and demanding more equitable distribution and democratic management of such risks. The closed managerialist decision-making of the powerful bureaucracies and corporations of the industrial era is informed by traditional management theory which cannot provide a framework for the adequate governance of these risks. Recent socio-political theories have conceptualised some key themes that must be addressed in a more fitting approach to governance. We identify more recent management and governance theory which addresses these themes and develop a process-based approach to governance of environmental disputes that allows for the evolving nature of stakeholder relations in a highly complex multiple stakeholder arena.

Integration at the round table: marine spatial planning in multi-stakeholder settings.

PubMed

Olsen, Erik; Fluharty, David; Hoel, Alf Håkon; Hostens, Kristian; Maes, Frank; Pecceu, Ellen

2014-01-01

Marine spatial planning (MSP) is often considered as a pragmatic approach to implement an ecosystem based management in order to manage marine space in a sustainable way. This requires the involvement of multiple actors and stakeholders at various governmental and societal levels. Several factors affect how well the integrated management of marine waters will be achieved, such as different governance settings (division of power between central and local governments), economic activities (and related priorities), external drivers, spatial scales, incentives and objectives, varying approaches to legislation and political will. We compared MSP in Belgium, Norway and the US to illustrate how the integration of stakeholders and governmental levels differs among these countries along the factors mentioned above. Horizontal integration (between sectors) is successful in all three countries, achieved through the use of neutral 'round-table' meeting places for all actors. Vertical integration between government levels varies, with Belgium and Norway having achieved full integration while the US lacks integration of the legislature due to sharp disagreements among stakeholders and unsuccessful partisan leadership. Success factors include political will and leadership, process transparency and stakeholder participation, and should be considered in all MSP development processes.

Integration at the Round Table: Marine Spatial Planning in Multi-Stakeholder Settings

PubMed Central

Olsen, Erik; Fluharty, David; Hoel, Alf Håkon; Hostens, Kristian; Maes, Frank; Pecceu, Ellen

2014-01-01

Marine spatial planning (MSP) is often considered as a pragmatic approach to implement an ecosystem based management in order to manage marine space in a sustainable way. This requires the involvement of multiple actors and stakeholders at various governmental and societal levels. Several factors affect how well the integrated management of marine waters will be achieved, such as different governance settings (division of power between central and local governments), economic activities (and related priorities), external drivers, spatial scales, incentives and objectives, varying approaches to legislation and political will. We compared MSP in Belgium, Norway and the US to illustrate how the integration of stakeholders and governmental levels differs among these countries along the factors mentioned above. Horizontal integration (between sectors) is successful in all three countries, achieved through the use of neutral ‘round-table’ meeting places for all actors. Vertical integration between government levels varies, with Belgium and Norway having achieved full integration while the US lacks integration of the legislature due to sharp disagreements among stakeholders and unsuccessful partisan leadership. Success factors include political will and leadership, process transparency and stakeholder participation, and should be considered in all MSP development processes. PMID:25299595

Implementation of Point-of-Care Diagnostics in Rural Primary Healthcare Clinics in South Africa: Perspectives of Key Stakeholders.

PubMed

Mashamba-Thompson, Tivani P; Jama, Ngcwalisa A; Sartorius, Benn; Drain, Paul K; Thompson, Rowan M

2017-01-08

Key stakeholders' involvement is crucial to the sustainability of quality point-of-care (POC) diagnostics services in low-and-middle income countries. The aim of this study was to explore key stakeholder perceptions on the implementation of POC diagnostics in rural primary healthcare (PHC) clinics in South Africa. We conducted a qualitative study encompassing in-depth interviews with multiple key stakeholders of POC diagnostic services for rural and resource-limited PHC clinics. Interviews were digitally recorded and transcribed verbatim prior to thematic content analysis. Thematic content analysis was conducted using themes guided by the World Health Organisation (WHO) quality-ASSURED (Affordable, Sensitive, Specific, User friendly, Rapid and to enable treatment at first visit and Robust, Equipment free and Delivered to those who need it) criteria for POC diagnostic services in resource-limited settings. 11 key stakeholders participated in the study. All stakeholders perceived the main advantage of POC diagnostics as enabling access to healthcare for rural patients. Stakeholders perceived the current POC diagnostic services to have an ability to meet patients' needs, but recommended further improvement of the following areas: research on cost-effectiveness; improved quality management systems; development of affordable POC diagnostic and clinic-based monitoring and evaluation. Key stakeholders of POC diagnostics in rural PHC clinics in South Africa highlighted the need to assess affordability and ensure quality assurance of current services before adopting new POC diagnostics and scaling up current POC diagnostics.

Who, when, and how? Marine planning stakeholder involvement preferences--a case study of the Solent, United Kingdom.

PubMed

Maguire, Bernadine; Potts, Jonathan; Fletcher, Stephen

2011-11-01

The introduction of a marine planning system throughout English territorial waters over the next decade provides an opportunity for stakeholder input to the management of the marine environment. Stakeholder involvement has been identified as an important component of successful development and subsequent implementation of marine planning but it has to be recognised that the views and interest of stakeholders can vary greatly, thus the desire for involvement with the process is unlikely to be uniform. This paper presents the views of stakeholders within the Solent, United Kingdom on their potential involvement with the marine planning process. Interestingly, it highlights a strong variability of views within and across sectors. Assuming the situation in the Solent is typical of groups of stakeholders throughout the country, the lack of uniformity in the potential involvement from different stakeholders may present a challenge in achieving a representative and truly collaborative marine planning process. Copyright © 2011 Elsevier Ltd. All rights reserved.

Stakeholder involvement in water management: necessity or luxury?

PubMed

Morrison, K

2003-01-01

Stakeholder involvement in water management is widely recognized as an important component of the design and implementation of sustainable water management initiatives. Despite this, there remains a deep-rooted resistance to the widespread implementation of programs to prioritize such involvement (as witnessed by, for example, the low priority given to the public involvement element of the European Union Water Framework Directive). This paper addresses the issue of stakeholder involvement by first confronting the fact that it is not a water issue, per se. Such diverse fields as economics, agriculture, public health, pollution prevention, business and education have also identified stakeholder involvement as a difficult but necessary component of successful action in their fields. For the water sector, the issue of stakeholder involvement as either a necessity for sustainable water management, or a luxury to be used to complement traditional approaches, is discussed.

Why social science matters in river management: involvement of local stakeholders in monitoring the effects of room for the river measures in the Netherlands

NASA Astrophysics Data System (ADS)

Verbrugge, Laura; van den Born, Riyan

2015-04-01

The Netherlands is a densely populated delta region with a long tradition in flood protection and river management. In response to climate change, adaptive measures are implemented to create more room for the river (and thus increasing water discharge capacity) while at the same time maintaining the multifunctional use of the river system. These functions include for example navigation, water supply, housing and spatial quality, nature development and recreation. The incorporation of social aspects in water management is vital for the development and implementation of sustainable solutions in environmental planning. Active stakeholder involvement has major benefits in terms of trust, public support, social learning and creative decision making. In practice, however, stakeholder involvement is often confined to one-way communication (e.g. information on websites and public hearings) instead of establishing a dialogue with the relevant local stakeholders. Moreover, stakeholders are often involved too late. Our study focusses on stakeholder perceptions and the opportunities for stakeholder participation and collaboration in river management. One way to actively involve stakeholders and invest in a dialogue is through participatory monitoring, i.e. to involve local stakeholders in collecting, analyzing and evaluating monitoring data. Currently, a pilot engineering intervention (2013-2015) is carried out in the Waal river, i.e. the main Rhine branch in The Netherlands. This intervention comprises the substitution of traditional groynes by a 10 km longitudinal dam and will change the appearance of the fluvial landscape dramatically. An interdisciplinary team of scientists, government representatives and other public and private parties is involved in monitoring the hydrological, ecological and socio-economic effects of the longitudinal dam with the aim to develop and improve models, guidelines and tools for integrative river management. This also provides unique opportunities for stakeholder involvement. Within this project, a pilot for participatory monitoring is initiated for three important stakeholder groups: local residents, recreational anglers and boaters, and those working in the inland shipping industry. Our study aims (1) to unfold stakeholder perceptions with respect to the longitudinal dam, (2) to explore how and to what extent local stakeholders can be involved in the monitoring program and (3) to carry out a pilot project for participatory monitoring. For each stakeholder group we will discuss survey results regarding their perceptions, as well as the possibilities for participatory monitoring. In cases where involvement in monitoring is not a feasible option, we will advise on alternative forms of public participation. Overall, we stress the importance of stakeholder involvement and aim to identify optimal ways for public participation in river management.

Stakeholder involvement in systematic reviews: a protocol for a systematic review of methods, outcomes and effects.

PubMed

Pollock, Alex; Campbell, Pauline; Struthers, Caroline; Synnot, Anneliese; Nunn, Jack; Hill, Sophie; Goodare, Heather; Watts, Chris; Morley, Richard

2017-01-01

Researchers are expected to actively involve stakeholders (including patients, the public, health professionals, and others) in their research. Although researchers increasingly recognise that this is good practice, there is limited practical guidance about how to involve stakeholders. Systematic reviews are a research method in which international literature is brought together, using carefully designed and rigorous methods to answer a specified question about healthcare. We want to investigate how researchers have involved stakeholders in systematic reviews, and how involvement has potentially affected the quality and impact of reviews. We plan to bring this information together by searching and reviewing the literature for reports of stakeholder involvement in systematic reviews. This paper describes in detail the methods that we plan to use to do this. After carrying out comprehensive searches for literature, we will: 1. Provide an overview of identified reports, describing key information such as types of stakeholders involved, and how. 2. Pick out reports of involvement which include detailed descriptions of how researchers involved people in a systematic review and summarise the methods they used. We will consider who was involved, how people were recruited, and how the involvement was organised and managed. 3. Bring together any reports which have explored the effect, or impact, of involving stakeholders in a systematic review. We will assess the quality of these reports, and summarise their findings. Once completed, our review will be used to produce training resources aimed at helping researchers to improve ways of involving stakeholders in systematic reviews. Background There is an expectation for stakeholders (including patients, the public, health professionals, and others) to be involved in research. Researchers are increasingly recognising that it is good practice to involve stakeholders in systematic reviews. There is currently a lack of evidence about (A) how to do this and (B) the effects, or impact, of such involvement. We aim to create a map of the evidence relating to stakeholder involvement in systematic reviews, and use this evidence to address the two points above. Methods We will complete a mixed-method synthesis of the evidence, first completing a scoping review to create a broad map of evidence relating to stakeholder involvement in systematic reviews, and secondly completing two contingent syntheses. We will use a stepwise approach to searching; the initial step will include comprehensive searches of electronic databases, including CENTRAL, AMED, Embase, Medline, Cinahl and other databases, supplemented with pre-defined hand-searching and contacting authors. Two reviewers will undertake each review task (i.e., screening, data extraction) using standard systematic review processes. For the scoping review, we will include any paper, regardless of publication status or study design, which investigates, reports or discusses involvement in a systematic review. Included papers will be summarised within structured tables. Criteria for judging the focus and comprehensiveness of the description of methods of involvement will be applied, informing which papers are included within the two contingent syntheses. Synthesis A will detail the methods that have been used to involve stakeholders in systematic reviews. Papers from the scoping review that are judged to provide an adequate description of methods or approaches will be included. Details of the methods of involvement will be extracted from included papers using pre-defined headings, presented in tables and described narratively. Synthesis B will include studies that explore the effect of stakeholder involvement on the quality, relevance or impact of a systematic review, as identified from the scoping review. Study quality will be appraised, data extracted and synthesised within tables. Discussion This review should help researchers select, improve and evaluate methods of involving stakeholders in systematic reviews. Review findings will contribute to Cochrane training resources.

Defining Success in Adult Basic Education Settings: Multiple Stakeholders, Multiple Perspectives

ERIC Educational Resources Information Center

Tighe, Elizabeth L.; Barnes, Adrienne E.; Connor, Carol M.; Steadman, Sharilyn C.

2013-01-01

This study employed quantitative and qualitative research approaches to investigate what constitutes success in adult basic education (ABE) programs from the perspectives of multiple educational stakeholders: the state funding agency, the teachers, and the students. Success was defined in multiple ways. In the quantitative section of the study, we…

Strengthening stakeholder involvement in health workforce governance: why we need to talk about power.

PubMed

Kuhlmann, Ellen; Burau, Viola

2018-01-01

There is now widespread agreement on the benefits of an integrated, people-centred health workforce, but the implementation of new models is difficult. We argue that we need to think about stakeholders and power, if we want to ensure change in the health workforce. We discuss these issues from a governance perspective and suggest a critical approach to stakeholder involvement as an indicator of good governance. Three models of involving stakeholders in health workforce governance can be identified: corporatist professional involvement either in a continental European model of conservative corporatism or in a Nordic model of public corporatism; managerialist and market-centred involvement of professions as organizational agents; and a more inclusive, network-based involvement of plural professional experts at different levels of governance. The power relations embedded in these models of stakeholder involvement have different effects on capacity building for an integrated health workforce.

Involvement of stakeholders in determining health priorities of adolescents in rural South Africa.

PubMed

Twine, Rhian; Kahn, Kathleen; Scholtz, Alexandra; Norris, Shane A

2016-01-01

When developing intervention research, it is important to explore issues from the community perspective. Interventions that promote adolescent health in South Africa are urgently needed, and Project Ntshembo ('hope') aims to improve the health of young women and their offspring in the Agincourt sub-district of rural northeast South Africa, actively using stakeholder involvement throughout the research process. This study aimed to determine adolescent health priorities according to key stakeholders, to align stakeholder and researcher priorities, and to form a stakeholder forum, which would be active throughout the intervention. Thirty-two stakeholders were purposefully identified as community members interested in the health of adolescents. An adapted Delphi incorporating face-to-face discussions, as well as participatory visualisation, was used in a series of three workshops. Consensus was determined through non-parametric analysis. Stakeholders and researchers agreed that peer pressure and lack of information, or having information but not acting on it, were the root causes of adolescent health problems. Pregnancy, HIV, school dropout, alcohol and drug abuse, not accessing health services, and unhealthy lifestyle (leading to obesity) were identified as priority adolescent health issues. A diagram was developed showing how these eight priorities relate to one another, which was useful in the development of the intervention. A stakeholder forum was founded, comprising 12 of the stakeholders involved in the stakeholder involvement process. The process brought researchers and stakeholders to consensus on the most important health issues facing adolescents, and a stakeholder forum was developed within which to address the issues. Stakeholder involvement as part of a research engagement strategy can be of mutual benefit to the researchers and the community in which the research is taking place.

The impact of stakeholder involvement in hospital policy decision-making: a study of the hospital's business processes.

PubMed

Malfait, Simon; Van Hecke, Ann; Hellings, Johan; De Bodt, Griet; Eeckloo, Kristof

2017-02-01

In many health care systems, strategies are currently deployed to engage patients and other stakeholders in decisions affecting hospital services. In this paper, a model for stakeholder involvement is presented and evaluated in three Flemish hospitals. In the model, a stakeholder committee advises the hospital's board of directors on themes of strategic importance. To study the internal hospital's decision processes in order to identify the impact of a stakeholder involvement committee on strategic themes in the hospital decision processes. A retrospective analysis of the decision processes was conducted in three hospitals that implemented a stakeholder committee. The analysis consisted of process and outcome evaluation. Fifteen themes were discussed in the stakeholder committees, whereof 11 resulted in a considerable change. None of these were on a strategic level. The theoretical model was not applied as initially developed, but was altered by each hospital. Consequentially, the decision processes differed between the hospitals. Despite alternation of the model, the stakeholder committee showed a meaningful impact in all hospitals on the operational level. As a result of the differences in decision processes, three factors could be identified as facilitators for success: (1) a close interaction with the board of executives, (2) the inclusion of themes with a more practical and patient-oriented nature, and (3) the elaboration of decisions on lower echelons of the organization. To effectively influence the organization's public accountability, hospitals should involve stakeholders in the decision-making process of the organization. The model of a stakeholder committee was not applied as initially developed and did not affect the strategic decision-making processes in the involved hospitals. Results show only impact at the operational level in the participating hospitals. More research is needed connecting stakeholder involvement with hospital governance.

Effects of stakeholder involvement in river management

NASA Astrophysics Data System (ADS)

Buchecker, M.; Menzel, S.

2012-04-01

In the last decades, in many parts of Europe involving local stakeholders or the local public in river management has become a standard procedure. For many decision makers, the purpose of involving other interest groups is limited to achieving a sufficient local acceptance of the project, and accordingly they adopt minimal forms of involvement. Theoretical literature and first empirical studies, however, suggest that stakeholder involvement can have, if done in appropriate quality, have much more far-reaching benefits for a sustainable river management such as a better consensus, social learning and social capital building. But there is so far only little reliable evidence that and under which conditions such benefits or effects in fact result from stakeholder involvement processes. The reason for this is that such involvement processes represent very complex social interventions, and all"affordable"effect measurement methods have their weaknesses. In our project we wanted to find out which were the really robust social effects of stakeholder involvement in river management. We therefore evaluated a number of real Swiss case studies of participatory river management using three different approaches of effect measurements: a quasi-experimental approach using repeated standardized measurement of stakeholders' attitudes, a qualitative long-term ex-post measurement approach based on interviews with stakeholders of five participatory river projects, and a comparative analysis approach based on data of residents effect assessments of participatory river planning gathered in a Swiss national survey. The analysis of all three evaluation studies confirmed that stakeholder involvement in river management projects have substantive social effects. The comparison of the results of the three measurement approaches revealed that social learning and acceptance building were the most robust effects of stakeholder involvement, as they were confirmed by all the three measurement approaches. Social capital building, however, was not found to be a relevant effect in the long-term qualitative ex-post measurement of stakeholder processes in river management. The data suggested that social capital was "only" maintained or reproduced by the involvement process. The results will be discussed, and implications for the practice as well as for future research will be drawn.

Multiple Aims in the Development of a Major Reform of the National Curriculum for Science in England

ERIC Educational Resources Information Center

Ryder, Jim; Banner, Indira

2011-01-01

In the context of a major reform of the school science curriculum for 14-16-year-olds in England, we examine the aims ascribed to the reform, the stakeholders involved, and the roles of differing values and authority in its development. This reform includes an emphasis on socioscientific issues and the nature of science; curriculum trends of…

Using Principal-Agent Theory as a Framework for Analysis in Evaluating the Multiple Stakeholders Involved in the Accreditation and Quality Assurance of International Medical Branch Campuses

ERIC Educational Resources Information Center

Borgos, Jill E.

2013-01-01

This article applies the theoretical framework of principal-agent theory in order to better understand the complex organisational relationships emerging between entities invested in the establishment and monitoring of cross-border international branch campus medical schools. Using the key constructs of principal-agent theory, information asymmetry…

Stakeholder involvement: how to do it right: article 9 in Integrating and coordinating efforts in COPD guideline development. An official ATS/ERS workshop report.

PubMed

Cluzeau, Françoise; Wedzicha, Jadwiga A; Kelson, Marcia; Corn, Judy; Kunz, Regina; Walsh, John; Schünemann, Holger J

2012-12-01

Professional societies, like many other organizations around the world, have recognized the need to use more rigorous processes to ensure that healthcare recommendations are informed by the best available research evidence with input from appropriate stakeholders. This is the ninth of a series of 14 articles that were prepared by an international panel to advise guideline developers in respiratory and other diseases on approaches for guideline development. We updated a review of the literature on stakeholder involvement, focusing on six key questions. In this review we addressed the following questions. (1) What are "stakeholders"? (2) Why involve stakeholders in guidelines? (3) At what stage should stakeholders contribute to guidelines? (4) What are the potential barriers to integrating stakeholder involvement? (5) How can stakeholders be involved effectively? (6) Should anyone be excluded from the process? We searched PubMed and other databases of methodological studies for existing systematic reviews and relevant methodological research. We did not conduct our own systematic reviews. Our conclusions are based on available evidence, the experience of guideline developers, and workshop discussions. Stakeholders are all those who have a legitimate interest in a guideline. They include healthcare professionals, patients and caregivers, public and private funding bodies, managers, employers, and manufacturers. Their engagement is justified for several reasons, including limitations of evidence, principles of transparency and democracy, ownership, and potential policy implications. They have a role to play at different points of guideline development, but their involvement can be complex. To be successful, stakeholder engagement needs to be inclusive, equitable, and adequately resourced.

Business Modeling to Implement an eHealth Portal for Infection Control: A Reflection on Co-Creation With Stakeholders.

PubMed

van Limburg, Maarten; Wentzel, Jobke; Sanderman, Robbert; van Gemert-Pijnen, Lisette

2015-08-13

It is acknowledged that the success and uptake of eHealth improve with the involvement of users and stakeholders to make technology reflect their needs. Involving stakeholders in implementation research is thus a crucial element in developing eHealth technology. Business modeling is an approach to guide implementation research for eHealth. Stakeholders are involved in business modeling by identifying relevant stakeholders, conducting value co-creation dialogs, and co-creating a business model. Because implementation activities are often underestimated as a crucial step while developing eHealth, comprehensive and applicable approaches geared toward business modeling in eHealth are scarce. This paper demonstrates the potential of several stakeholder-oriented analysis methods and their practical application was demonstrated using Infectionmanager as an example case. In this paper, we aim to demonstrate how business modeling, with the focus on stakeholder involvement, is used to co-create an eHealth implementation. We divided business modeling in 4 main research steps. As part of stakeholder identification, we performed literature scans, expert recommendations, and snowball sampling (Step 1). For stakeholder analyzes, we performed "basic stakeholder analysis," stakeholder salience, and ranking/analytic hierarchy process (Step 2). For value co-creation dialogs, we performed a process analysis and stakeholder interviews based on the business model canvas (Step 3). Finally, for business model generation, we combined all findings into the business model canvas (Step 4). Based on the applied methods, we synthesized a step-by-step guide for business modeling with stakeholder-oriented analysis methods that we consider suitable for implementing eHealth. The step-by-step guide for business modeling with stakeholder involvement enables eHealth researchers to apply a systematic and multidisciplinary, co-creative approach for implementing eHealth. Business modeling becomes an active part in the entire development process of eHealth and starts an early focus on implementation, in which stakeholders help to co-create the basis necessary for a satisfying success and uptake of the eHealth technology.

Tackling wicked problems in infection prevention and control: a guideline for co-creation with stakeholders.

PubMed

van Woezik, Anne F G; Braakman-Jansen, Louise M A; Kulyk, Olga; Siemons, Liseth; van Gemert-Pijnen, Julia E W C

2016-01-01

Infection prevention and control can be seen as a wicked public health problem as there is no consensus regarding problem definition and solution, multiple stakeholders with different needs and values are involved, and there is no clear end-point of the problem-solving process. Co-creation with stakeholders has been proposed as a suitable strategy to tackle wicked problems, yet little information and no clear step-by-step guide exist on how to do this. The objectives of this study were to develop a guideline to assist developers in tackling wicked problems using co-creation with stakeholders, and to apply this guideline to practice with an example case in the field of infection prevention and control. A mixed-method approach consisting of the integration of both quantitative and qualitative research was used. Relevant stakeholders from the veterinary, human health, and public health sectors were identified using a literature scan, expert recommendations, and snowball sampling. The stakeholder salience approach was used to select key stakeholders based on 3 attributes: power, legitimacy, and urgency. Key values of stakeholders (N = 20) were derived by qualitative semi-structured interviews and quantitatively weighted and prioritized using an online survey. Our method showed that stakeholder identification and analysis are prerequisites for understanding the complex stakeholder network that characterizes wicked problems. A total of 73 stakeholders were identified of which 36 were selected as potential key stakeholders, and only one was seen as a definite stakeholder. In addition, deriving key stakeholder values is a necessity to gain insights into different problem definitions, solutions and needs stakeholders have regarding the wicked problem. Based on the methods used, we developed a step-by-step guideline for co-creation with stakeholders when tackling wicked problems. The mixed-methods guideline presented here provides a systematic, transparent method to identify, analyze, and co-create with stakeholders, and to recognize and prioritize their values, problem definitions, and solutions in the context of wicked problems. This guideline consists of a general framework and although it was applied in an eHealth context, may be relevant outside of eHealth as well.

The Data Party: Involving Stakeholders in Meaningful Data Analysis

ERIC Educational Resources Information Center

Franz, Nancy K.

2013-01-01

A hallmark of Extension includes the involvement of stakeholders in research and program needs assessment, design, implementation, evaluation, and reporting. A data party can be used to enhance this stakeholder involvement specifically in data analysis. This type of event can not only increase client participation in Extension programming and…

Implementation of Point-of-Care Diagnostics in Rural Primary Healthcare Clinics in South Africa: Perspectives of Key Stakeholders

PubMed Central

Mashamba-Thompson, Tivani P.; Jama, Ngcwalisa A.; Sartorius, Benn; Drain, Paul K.; Thompson, Rowan M.

2017-01-01

Introduction: Key stakeholders’ involvement is crucial to the sustainability of quality point-of-care (POC) diagnostics services in low-and-middle income countries. The aim of this study was to explore key stakeholder perceptions on the implementation of POC diagnostics in rural primary healthcare (PHC) clinics in South Africa. Method: We conducted a qualitative study encompassing in-depth interviews with multiple key stakeholders of POC diagnostic services for rural and resource-limited PHC clinics. Interviews were digitally recorded and transcribed verbatim prior to thematic content analysis. Thematic content analysis was conducted using themes guided by the World Health Organisation (WHO) quality-ASSURED (Affordable, Sensitive, Specific, User friendly, Rapid and to enable treatment at first visit and Robust, Equipment free and Delivered to those who need it) criteria for POC diagnostic services in resource-limited settings. Results: 11 key stakeholders participated in the study. All stakeholders perceived the main advantage of POC diagnostics as enabling access to healthcare for rural patients. Stakeholders perceived the current POC diagnostic services to have an ability to meet patients’ needs, but recommended further improvement of the following areas: research on cost-effectiveness; improved quality management systems; development of affordable POC diagnostic and clinic-based monitoring and evaluation. Conclusions: Key stakeholders of POC diagnostics in rural PHC clinics in South Africa highlighted the need to assess affordability and ensure quality assurance of current services before adopting new POC diagnostics and scaling up current POC diagnostics. PMID:28075337

Development and testing of a novel survey to assess Stakeholder-driven Community Diffusion of childhood obesity prevention efforts.

PubMed

Korn, Ariella R; Hennessy, Erin; Hammond, Ross A; Allender, Steven; Gillman, Matthew W; Kasman, Matt; McGlashan, Jaimie; Millar, Lynne; Owen, Brynle; Pachucki, Mark C; Swinburn, Boyd; Tovar, Alison; Economos, Christina D

2018-05-31

Involving groups of community stakeholders (e.g., steering committees) to lead community-wide health interventions appears to support multiple outcomes ranging from policy and systems change to individual biology. While numerous tools are available to measure stakeholder characteristics, many lack detail on reliability and validity, are not context specific, and may not be sensitive enough to capture change over time. This study describes the development and reliability of a novel survey to measure Stakeholder-driven Community Diffusion via assessment of stakeholders' social networks, knowledge, and engagement about childhood obesity prevention. This study was completed in three phases. Phase 1 included conceptualization and online survey development through literature reviews and expert input. Phase 2 included a retrospective study with stakeholders from two completed whole-of-community interventions. Between May-October 2015, 21 stakeholders from the Shape Up Somerville and Romp & Chomp interventions recalled their social networks, knowledge, and engagement pre-post intervention. We also assessed one-week test-retest reliability of knowledge and engagement survey modules among Shape Up Somerville respondents. Phase 3 included survey modifications and a second prospective reliability assessment. Test-retest reliability was assessed in May 2016 among 13 stakeholders involved in ongoing interventions in Victoria, Australia. In Phase 1, we developed a survey with 7, 20 and 50 items for the social networks, knowledge, and engagement survey modules, respectively. In the Phase 2 retrospective study, Shape Up Somerville and Romp & Chomp networks included 99 and 54 individuals. Pre-post Shape Up Somerville and Romp & Chomp mean knowledge scores increased by 3.5 points (95% CI: 0.35-6.72) and (- 0.42-7.42). Engagement scores did not change significantly (Shape Up Somerville: 1.1 points (- 0.55-2.73); Romp & Chomp: 0.7 points (- 0.43-1.73)). Intraclass correlation coefficients (ICCs) for knowledge and engagement were 0.88 (0.67-0.97) and 0.97 (0.89-0.99). In Phase 3, the modified knowledge and engagement survey modules included 18 and 25 items, respectively. Knowledge and engagement ICCs were 0.84 (0.62-0.95) and 0.58 (0.23-0.86). The survey measures upstream stakeholder properties-social networks, knowledge, and engagement-with good test-retest reliability. Future research related to Stakeholder-driven Community Diffusion should focus on prospective change and survey validation for intervention effectiveness.

Rapid Assessment of Stakeholder Concerns about Public Health. An Introduction to a Fast and Inexpensive Approach Applied on Health Concerns about Intensive Animal Production Systems

PubMed Central

van der Ree, Joost; Lebret, Erik

2017-01-01

To effectively manage environmental health risks, stakeholders often need to act collectively. Stakeholders vary in their desire to act due to many factors, such as knowledge, risk perception, interests, and worldviews. Understanding their perceptions of the issues at stake is crucial to support the risk governance process. Even though concern assessment is a pivotal element of risk governance, few tools for rapid assessment are reported in the literature. We tested a rapid and relatively cheap approach, taking the Dutch debate on Intensive Animal Production Systems (IAPS) and health as an example. Dutch policy-oriented publications on IAPS and health and ten semi-structured in-depth interviews with a variety of stakeholders were analyzed to identify stakeholders and concerns involved in the Dutch debate about IAPS and health. Concerns were mapped and a stakeholder network was derived. Three classes of concerns were recognized in the discussions about IAPS and health: concerns related to health risks, concerns regarding the activity causing the risks (IAPS), and concerns about the process to control the risks. The notions of ‘trust’ and ‘scientific uncertainty’ appeared as important themes in the discussions. Argumentation based on concerns directly related to health risks, the activity causing the risk (IAPS), and its risk management can easily become muddled up in a societal debate, limiting the development of effective action perspectives. Acknowledging these multiple stakeholder concerns can clarify the positions taken by stakeholders and allow for more and other action perspectives to develop. PMID:29232902

Rapid Assessment of Stakeholder Concerns about Public Health. An Introduction to a Fast and Inexpensive Approach Applied on Health Concerns about Intensive Animal Production Systems.

PubMed

Kraaij-Dirkzwager, Marleen; van der Ree, Joost; Lebret, Erik

2017-12-11

To effectively manage environmental health risks, stakeholders often need to act collectively. Stakeholders vary in their desire to act due to many factors, such as knowledge, risk perception, interests, and worldviews. Understanding their perceptions of the issues at stake is crucial to support the risk governance process. Even though concern assessment is a pivotal element of risk governance, few tools for rapid assessment are reported in the literature. We tested a rapid and relatively cheap approach, taking the Dutch debate on Intensive Animal Production Systems (IAPS) and health as an example. Dutch policy-oriented publications on IAPS and health and ten semi-structured in-depth interviews with a variety of stakeholders were analyzed to identify stakeholders and concerns involved in the Dutch debate about IAPS and health. Concerns were mapped and a stakeholder network was derived. Three classes of concerns were recognized in the discussions about IAPS and health: concerns related to health risks, concerns regarding the activity causing the risks (IAPS), and concerns about the process to control the risks. The notions of 'trust' and 'scientific uncertainty' appeared as important themes in the discussions. Argumentation based on concerns directly related to health risks, the activity causing the risk (IAPS), and its risk management can easily become muddled up in a societal debate, limiting the development of effective action perspectives. Acknowledging these multiple stakeholder concerns can clarify the positions taken by stakeholders and allow for more and other action perspectives to develop.

Stakeholder analysis in the management of irrigation in Kampili area

NASA Astrophysics Data System (ADS)

Jumiati; Ali, M. S. S.; Fahmid, I. M.; Mahyuddin

2018-05-01

Irrigation has appreciable contribution in building food security, particularly rice crops. This study aims to analyze the role of stakeholders involved in distributing of irrigation water. The study was conducted in the Kampili Irrigation Area in South Sulawesi Province Indonesia, the data were obtained through observation and interviews with stakeholders involved, and analysed by stakeholder analysis, based on the interests and power held by the actors. This analysis is intended to provide an optimal picture of the expected role of each stakeholder in the management of irrigation resources. The results show that there were many stakeholders involved in irrigation management. In the arrangement of irrigation distribution there was overlapping authority of the stakeholders to its management, every stakeholder had different interests and power between each other. The existence have given positive and negative values in distributing irrigation water management, then in the stakeholder collaboration there was contestation between them. This contestation took place between the agriculture department, PSDA province, the Jeneberang River Region Hall, the Farmers Group and the P3A.

Are phase 1 trials therapeutic? Risk, ethics, and division of labor.

PubMed

Anderson, James A; Kimmelman, Jonathan

2014-03-01

Despite their crucial role in the translation of pre-clinical research into new clinical applications, phase 1 trials involving patients continue to prompt ethical debate. At the heart of the controversy is the question of whether risks of administering experimental drugs are therapeutically justified. We suggest that prior attempts to address this question have been muddled, in part because it cannot be answered adequately without first attending to the way labor is divided in managing risk in clinical trials. In what follows, we approach the question of therapeutic justification for phase 1 trials from the viewpoint of five different stakeholders: the drug regulatory authority, the IRB, the clinical investigator, the referring physician, and the patient. Our analysis shows that the question of therapeutic justification actually raises multiple questions corresponding to the roles and responsibilities of the different stakeholders involved. By attending to these contextual differences, we provide more coherent guidance for the ethical negotiation of risk in phase 1 trials involving patients. We close by discussing the implications of our argument for various perennial controversies in phase 1 trial practice. © 2012 John Wiley & Sons Ltd.

Urban Stormwater Governance: The Need for a Paradigm Shift.

PubMed

Dhakal, Krishna P; Chevalier, Lizette R

2016-05-01

Traditional urban stormwater management involves rapid removal of stormwater through centralized conveyance systems of curb-gutter-pipe networks. This results in many adverse impacts on the environment including hydrological disruption, groundwater depletion, downstream flooding, receiving water quality degradation, channel erosion, and stream ecosystem damage. In order to mitigate these adverse impacts, urban stormwater managers are increasingly using green infrastructure that promote on-site infiltration, restore hydrological functions of the landscape, and reduce surface runoff. Existing stormwater governance, however, is centralized and structured to support the conventional systems. This governance approach is not suited to the emerging distributed management approach, which involves multiple stakeholders including parcel owners, government agencies, and non-governmental organizations. This incongruence between technology and governance calls for a paradigm shift in the governance from centralized and technocratic to distributed and participatory governance. This paper evaluates how five US cities have been adjusting their governance to address the discord. Finally, the paper proposes an alternative governance model, which provides a mechanism to involve stakeholders and implement distributed green infrastructure under an integrative framework.

Patient and Stakeholder Engagement in the PCORI Pilot Projects: Description and Lessons Learned.

PubMed

Forsythe, Laura P; Ellis, Lauren E; Edmundson, Lauren; Sabharwal, Raj; Rein, Alison; Konopka, Kristen; Frank, Lori

2016-01-01

Patients and healthcare stakeholders are increasingly becoming engaged in the planning and conduct of biomedical research. However, limited research characterizes this process or its impact. We aimed to characterize patient and stakeholder engagement in the 50 Pilot Projects funded by the Patient-Centered Outcomes Research Institute (PCORI), and identify early contributions and lessons learned. A self-report instrument was completed by researchers between 6 and 12 months following project initiation. Forty-seven principal investigators or their designees (94 % response rate) participated in the study. MAIN MEASURES Self-report of types of stakeholders engaged, stages and levels of engagement, facilitators and barriers to engagement, lessons learned, and contributions from engagement were measured. Most (83 %) reported engaging more than one stakeholder in their project. Among those, the most commonly reported groups were patients (90 %), clinicians (87 %), health system representatives (44 %), caregivers (41 %), and advocacy organizations (41 %). Stakeholders were commonly involved in topic solicitation, question development, study design, and data collection. Many projects engaged stakeholders in data analysis, results interpretation, and dissemination. Commonly reported contributions included changes to project methods, outcomes or goals; improvement of measurement tools; and interpretation of qualitative data. Investigators often identified communication and shared leadership strategies as "critically important" facilitators (53 and 44 % respectively); lack of stakeholder time was the most commonly reported challenge (46 %). Most challenges were only partially resolved. Early lessons learned included the importance of continuous and genuine partnerships, strategic selection of stakeholders, and accommodation of stakeholders' practical needs. PCORI Pilot Projects investigators report engaging a variety of stakeholders across many stages of research, with specific changes to their research attributed to engagement. This study identifies early lessons and barriers that should be addressed to facilitate engagement. While this research suggests potential impact of stakeholder engagement, systematic characterization and evaluation of engagement at multiple stages of research is needed to build the evidence base.

Stakeholder influence in public sector information systems strategy implementation-The case of public hospitals in South Africa.

PubMed

Hwabamungu, Boroto; Brown, Irwin; Williams, Quentin

2018-01-01

Recent literature on organisational strategy has called for greater emphasis on individuals (stakeholders) and what they do in the process of strategizing. Public sector organisations have to engage with an array of heterogeneous stakeholders in fulfilling their mandate. The public health sector in particular needs to engage with a diversity of stakeholders at local, regional and national levels when strategising. The purpose of this study is to investigate the influence of stakeholder relations on the implementation of Information Systems (IS) strategy in public hospitals in South Africa. An interpretive approach using two provinces was employed. The Activity Analysis and Development (ActAD) framework, an enhanced form of activity theory, was used as the theoretical framework. Data was collected using semi-structured interviews, meetings, documents analysis, physical artefacts and observation. The collected data was analysed using thematic analysis. Findings reveal that IS strategy implementation in public hospitals involves a large and complex network of stakeholder groups at different levels, and over different time periods. These stakeholder groups act in accordance with formal and informal roles, rules and modalities. Various contextual conditions together with the actions of, and interactions between stakeholder groups give rise to the situationality of stakeholder relations dynamics and strategy implementation. The multiple actions and interactions over time lead to the realisation of some aspects of the IS strategy in public hospitals. Given the complexity and dynamism of the context there are also certain unplanned implementations as well. These relationships are captured in a Stakeholder Relations Influence (SRI) framework. The SRI framework can be assistive in the assessment and mapping of stakeholders and stakeholder relations, and the assessment of the implications of these relations for effective IS strategy implementation in public hospitals. The framework can also provide the basis for the development of appropriate corrective measures in the implementation of strategies and policies in public institutions such as public hospitals. Copyright © 2017 Elsevier B.V. All rights reserved.

Universal Health Insurance Coverage in Vietnam: A Stakeholder Analysis From Policy Proposal (1989) to Implementation (2014).

PubMed

Hoang, Chi K; Hill, Peter; Nguyen, Huong T

In 1989, health insurance (HI) was introduced in Vietnam and began to be implemented in 1992. There was limited progress until the 2014 Law on HI that was revised with the aim of universal health insurance coverage (UHIC) by 2020. This article explores stakeholder roles and positions from the initial introduction of HI to the implementation of the Master Plan accelerating UHIC. To better understand the influence of stakeholders in accelerating UHIC to achieve equity in health care. Using a qualitative study design, we conducted content analysis of HI-related documents and interviewed social security and health system key informants, government representatives, and community stakeholders to determine their positions and influence on UHIC. Our findings demonstrate different levels of support of stakeholders that influence in the HI formulation and implementation, from opposition when HI was first introduced in 1989 to collaboration of stakeholders from 2013 when the Master Plan for UHIC was implemented. Despite an initial failure to secure the support of the Parliament for a Law on HI, a subsequent series of alternative legislative strategies brought limited increases in HI coverage. With government financial subsidization, the involvement of multiple stakeholders, political commitment, and flexible working mechanisms among stakeholders have remained important, with an increasing recognition that HI is not only a technical aspect of the health system but also a broader socioeconomic and governance issue. The different levels of power and influence among stakeholders, together with their commercial and political interests and their different perceptions of HI, have influenced stakeholders' support or opposition to HI policies. Despite high-level policy support, stakeholders' positions may vary, depending on their perceptions of the policy implications. A shift in government stakeholder positions, especially at the provincial level, has been necessary to accelerate UHIC progress and build institutional capacity.

The State of the Empirical Research Literature on Stakeholder Involvement in Program Evaluation

ERIC Educational Resources Information Center

Brandon, Paul R.; Fukunaga, Landry L.

2014-01-01

Evaluators widely agree that stakeholder involvement is a central aspect of effective program evaluation. With the exception of articles on collaborative evaluation approaches, however, a systematic review of the breadth and depth of the literature on stakeholder involvement has not been published. In this study, we examine peer-reviewed empirical…

OysterFutures: Integrating Stakeholder Objectives with Natural System Models to Promote Sustainable Natural Resource Policy

NASA Astrophysics Data System (ADS)

North, E. W.; Blair, J.; Cornwell, J. C.; Freitag, A. E.; Gawde, R. K.; Hartley, T. W.; Hood, R. R.; Jones, R. M.; Miller, T. J.; Thomas, J. E.; Wainger, L. A.; Wilberg, M. J.

2016-02-01

Achieving effective natural resource management is challenged by multiple and often competing objectives, a restricted set of policy options, and uncertainty in the performance of those options. Yet, managers need policies that allow continued use of natural resources while ensuring access for future generations and maintenance of ecosystem services. Formal approaches are needed that will assist managers and stakeholders in choosing policy options that have a high likelihood of achieving social, ecological, and economic goals. The goal of this project, OysterFutures, is to address this need by improving the use of predictive models to support sustainable natural resource policy and management. A stakeholder-centered process will be used to build an integrated model that combines estuarine physics, oyster life history, and the ecosystem services that oysters provide (e.g., harvest, water quality) to forecast outcomes under alternative management strategies. Through a series of facilitated meetings, stakeholders will participate in a science-based collaborative process which will allow them to project how well policies are expected to meet their objectives using the integrated model. This iterative process will ensure that the model will incorporate the complex human uses of the ecosystem as well as focus on the outcomes most important to the stakeholders. In addition, a study of the socioeconomic drivers of stakeholder involvement, information flow, use and influence, and policy formation will be undertaken to improve the process, enhance implementation success of recommended policies, and provide new ideas for integrating natural and social sciences, and scientists, in sustainable resource management. In this presentation, the strategy for integrating natural system models, stakeholder views, and sociological studies as well as methods for selecting stakeholders and facilitating stakeholder meetings will be described and discussed.

What does it mean to manage sky survey data? A model to facilitate stakeholder conversations

NASA Astrophysics Data System (ADS)

Sands, Ashley E.; Darch, Peter T.

2016-06-01

Astronomy sky surveys, while of great scientific value independently, can be deployed even more effectively when multiple sources of data are combined. Integrating discrete datasets is a non-trivial exercise despite investments in standard data formats and tools. Creating and maintaining data and associated infrastructures requires investments in technology and expertise. Combining data from multiple sources necessitates a common understanding of data, structures, and goals amongst relevant stakeholders.We present a model of Astronomy Stakeholder Perspectives on Data. The model is based on 80 semi-structured interviews with astronomers, computational astronomers, computer scientists, and others involved in the building or use of the Sloan Digital Sky Survey (SDSS) and Large Synoptic Survey Telescope (LSST). Interviewees were selected to ensure a range of roles, institutional affiliations, career stages, and level of astronomy education. Interviewee explanations of data were analyzed to understand how perspectives on astronomy data varied by stakeholder.Interviewees described sky survey data either intrinsically or extrinsically. “Intrinsic” descriptions of data refer to data as an object in and of itself. Respondents with intrinsic perspectives view data management in one of three ways: (1) “Medium” - securing the zeros and ones from bit rot; (2) “Scale” - assuring that changes in state are documented; or (3) “Content” - ensuring the scientific validity of the images, spectra, and catalogs.“Extrinsic” definitions, in contrast, define data in relation to other forms of information. Respondents with extrinsic perspectives view data management in one of three ways: (1) “Source” - supporting the integrity of the instruments and documentation; (2) “Relationship” - retaining relationships between data and their analytical byproducts; or (3) “Use” - ensuring that data remain scientifically usable.This model shows how data management can mean different things to different stakeholders at different times. The model is valuable to those who build and maintain infrastructures because it can be used as a tool to facilitate recognition, understanding, and thus communication between relevant astronomy data stakeholders.

A Collaborative Approach for Scoping Ecosystem Services with Stakeholders: The Case of Arrábida Natural Park.

PubMed

Lopes, Rita; Videira, Nuno

2016-08-01

This paper presents an innovative approach for conducting collaborative scoping processes aiming to elicit multiple values of ecosystem services. The proposed methodology rests on three steps combining different participatory tools that promote a comprehensive examination of the perceptions hold by relevant stakeholder groups. The first step consists of an institutional and stakeholder analysis developed in the study area. The second includes a participatory workshop, where a sequence of scoping exercises is conducted with the active collaboration of the invited stakeholders. The final step aims to validate scoping results and develop dependency networks between organizations and the identified ecosystem services. The approach was tested in the Arrábida Natural Park, a marine and coastal protected area in Portugal. Invited participants were able to identify an extensive list of ecosystem services in the natural area, establish linkages between those services and human wellbeing, identify drivers of change and perform a preliminary screening of the associated ecological, social, and economic values. The case study evaluation provided positive feedback on the usefulness of the approach, which advances the existing set of methods for participatory identification of ecosystem services and sets the scene for involvement of stakeholder groups in assessment and management processes.

A Collaborative Approach for Scoping Ecosystem Services with Stakeholders: The Case of Arrábida Natural Park

NASA Astrophysics Data System (ADS)

Lopes, Rita; Videira, Nuno

2016-08-01

This paper presents an innovative approach for conducting collaborative scoping processes aiming to elicit multiple values of ecosystem services. The proposed methodology rests on three steps combining different participatory tools that promote a comprehensive examination of the perceptions hold by relevant stakeholder groups. The first step consists of an institutional and stakeholder analysis developed in the study area. The second includes a participatory workshop, where a sequence of scoping exercises is conducted with the active collaboration of the invited stakeholders. The final step aims to validate scoping results and develop dependency networks between organizations and the identified ecosystem services. The approach was tested in the Arrábida Natural Park, a marine and coastal protected area in Portugal. Invited participants were able to identify an extensive list of ecosystem services in the natural area, establish linkages between those services and human wellbeing, identify drivers of change and perform a preliminary screening of the associated ecological, social, and economic values. The case study evaluation provided positive feedback on the usefulness of the approach, which advances the existing set of methods for participatory identification of ecosystem services and sets the scene for involvement of stakeholder groups in assessment and management processes.

'New' and distributed leadership in quality and safety in health care, or 'old' and hierarchical? An interview study with strategic stakeholders.

PubMed

McKee, Lorna; Charles, Kathryn; Dixon-Woods, Mary; Willars, Janet; Martin, Graham

2013-10-01

We aimed to explore the views of strategic level stakeholders on leadership for quality and safety in the UK National Health Service. We interviewed 107 stakeholders with close involvement in quality and safety as professionals, managers, policy makers or commentators. Analysis was based on the constant comparative method. Participants identified the crucial role of leadership in ensuring safe, high quality care. Consistent with the academic literature, participants distinguished between traditional hierarchical 'concentrated' leadership associated with particular positions, and distributed leadership involving those with particular skills and abilities across multiple institutional levels. They clearly and explicitly saw a role for distributed leadership, emphasizing that all staff had responsibility for leading on patient safety and quality. They described the particular value of leadership coalitions between managers and clinicians. However, concern was expressed that distributed leadership could mean confusion about who was in charge, and that at national level it risked creating a vacuum of authority, mixed messages, and conflicting expectations and demands. Participants also argued that hierarchically based leadership was needed to complement distributed leadership, not least to provide focus, practical support and expertise, and managerial clout. Strategic level stakeholders see the most effective form of leadership for quality and safety as one that blends distributed and concentrated leadership. Policy and academic prescriptions about leadership may benefit from the sophisticated and pragmatic know-how of insiders who work in organizations that remain permeated by traditional structures, cleavages and power relationships.

Resolving a Prickly Situation: Involving Stakeholders in Invasive Cactus Management in South Africa

NASA Astrophysics Data System (ADS)

Novoa, Ana; Kaplan, Haylee; Wilson, John R. U.; Richardson, David M.

2016-05-01

The regulation and management of alien species can be contentious, particularly when the stakeholders who benefit from alien species are different from those who suffer the costs. We propose a consultative process involving relevant stakeholders in invasive species management decisions. The process involves (1) the identification of relevant stakeholders, (2) assessing their perceptions, (3) enhancing interaction between stakeholders, (4) assessing changes in stakeholders' perceptions following interactions with other stakeholders, and (5) developing management recommendations in collaboration with stakeholders. We demonstrate the application of the process using the family Cactaceae (`cacti') in South Africa. Many species of cacti have been introduced to the country over the past two centuries, mostly for horticulture, food and fodder, and hundreds of other species have been introduced in the past few decades (or are likely to be introduced soon) for horticulture. Using the proposed process enabled the negotiation and participation of all stakeholders in decision making and helped minimize contentious situations by clarifying stakeholder's beliefs and exploring consensus solutions. Consequently, management objectives were broadly supported by all stakeholders. These results will be included in a national cactus management strategy for South Africa.

Resolving a Prickly Situation: Involving Stakeholders in Invasive Cactus Management in South Africa.

PubMed

Novoa, Ana; Kaplan, Haylee; Wilson, John R U; Richardson, David M

2016-05-01

The regulation and management of alien species can be contentious, particularly when the stakeholders who benefit from alien species are different from those who suffer the costs. We propose a consultative process involving relevant stakeholders in invasive species management decisions. The process involves (1) the identification of relevant stakeholders, (2) assessing their perceptions, (3) enhancing interaction between stakeholders, (4) assessing changes in stakeholders' perceptions following interactions with other stakeholders, and (5) developing management recommendations in collaboration with stakeholders. We demonstrate the application of the process using the family Cactaceae ('cacti') in South Africa. Many species of cacti have been introduced to the country over the past two centuries, mostly for horticulture, food and fodder, and hundreds of other species have been introduced in the past few decades (or are likely to be introduced soon) for horticulture. Using the proposed process enabled the negotiation and participation of all stakeholders in decision making and helped minimize contentious situations by clarifying stakeholder's beliefs and exploring consensus solutions. Consequently, management objectives were broadly supported by all stakeholders. These results will be included in a national cactus management strategy for South Africa.

Business Modeling to Implement an eHealth Portal for Infection Control: A Reflection on Co-Creation With Stakeholders

PubMed Central

Wentzel, Jobke; Sanderman, Robbert; van Gemert-Pijnen, Lisette

2015-01-01

Background It is acknowledged that the success and uptake of eHealth improve with the involvement of users and stakeholders to make technology reflect their needs. Involving stakeholders in implementation research is thus a crucial element in developing eHealth technology. Business modeling is an approach to guide implementation research for eHealth. Stakeholders are involved in business modeling by identifying relevant stakeholders, conducting value co-creation dialogs, and co-creating a business model. Because implementation activities are often underestimated as a crucial step while developing eHealth, comprehensive and applicable approaches geared toward business modeling in eHealth are scarce. Objective This paper demonstrates the potential of several stakeholder-oriented analysis methods and their practical application was demonstrated using Infectionmanager as an example case. In this paper, we aim to demonstrate how business modeling, with the focus on stakeholder involvement, is used to co-create an eHealth implementation. Methods We divided business modeling in 4 main research steps. As part of stakeholder identification, we performed literature scans, expert recommendations, and snowball sampling (Step 1). For stakeholder analyzes, we performed “basic stakeholder analysis,” stakeholder salience, and ranking/analytic hierarchy process (Step 2). For value co-creation dialogs, we performed a process analysis and stakeholder interviews based on the business model canvas (Step 3). Finally, for business model generation, we combined all findings into the business model canvas (Step 4). Results Based on the applied methods, we synthesized a step-by-step guide for business modeling with stakeholder-oriented analysis methods that we consider suitable for implementing eHealth. Conclusions The step-by-step guide for business modeling with stakeholder involvement enables eHealth researchers to apply a systematic and multidisciplinary, co-creative approach for implementing eHealth. Business modeling becomes an active part in the entire development process of eHealth and starts an early focus on implementation, in which stakeholders help to co-create the basis necessary for a satisfying success and uptake of the eHealth technology. PMID:26272510

When the user is not the chooser: learning from stakeholder involvement in technology adoption decisions in infection control.

PubMed

Ahmad, R; Kyratsis, Y; Holmes, A

2012-07-01

Health systems need efficient and effective innovation decisions to provide maximum benefit to patients, particularly in a climate of financial constraints. Although evidence-based innovations exist for helping to address healthcare-associated infections, the uptake and implementation of these is highly variable and in some cases very slow. To investigate innovation adoption decisions and implementation processes from an organizational perspective, focusing on the implications of stakeholder involvement during the innovation process. Thirty-eight technology adoption decisions and implementation processes were examined through 121 qualitative interviews in 12 National Health Service healthcare organizations across England. Stakeholder involvement varied across organizations with decisions highly exclusive to the infection prevention and control (IPC) team, to highly inclusive of wider organizational members. The context, including organizational culture, previous experience, and logistical factors influenced the level of stakeholder engagement. The timing of stakeholder involvement in the process impacted on: (i) the range of innovations considered; (ii) the technologies selected, and (iii) the success of technology implementation. Cases of non-adoption, discontinued adoption, and of successful implementation are presented to share learning. The potential benefits of stakeholder involvement for 'successful' innovation adoption are presented including a goal-oriented framework for involvement. Key stakeholder involvement can lead to innovation adoption and implementation compatible with structural and cultural contexts, particularly when involvement crosses the phases of initiation, decision-making and implementation. Involving members of the wider healthcare organization can raise the profile of IPC and reinforce efforts to make IPC everybody's business. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Stakeholder analysis methodologies resource book

DOE Office of Scientific and Technical Information (OSTI.GOV)

Babiuch, W.M.; Farhar, B.C.

1994-03-01

Stakeholder analysis allows analysts to identify how parties might be affected by government projects. This process involves identifying the likely impacts of a proposed action and stakeholder groups affected by that action. Additionally, the process involves assessing how these groups might be affected and suggesting measures to mitigate any adverse effects. Evidence suggests that the efficiency and effectiveness of government actions can be increased and adverse social impacts mitigated when officials understand how a proposed action might affect stakeholders. This report discusses how to conduct useful stakeholder analyses for government officials making decisions on energy-efficiency and renewable-energy technologies and theirmore » commercialization. It discusses methodological issues that may affect the validity and reliability of findings, including sampling, generalizability, validity, ``uncooperative`` stakeholder groups, using social indicators, and the effect of government regulations. The Appendix contains resource directories and a list of specialists in stakeholder analysis and involvement.« less

What it Takes to Successfully Implement Technology for Aging in Place: Focus Groups With Stakeholders.

PubMed

Peek, Sebastiaan Theodorus Michaël; Wouters, Eveline J M; Luijkx, Katrien G; Vrijhoef, Hubertus J M

2016-05-03

There is a growing interest in empowering older adults to age in place by deploying various types of technology (ie, eHealth, ambient assisted living technology, smart home technology, and gerontechnology). However, initiatives aimed at implementing these technologies are complicated by the fact that multiple stakeholder groups are involved. Goals and motives of stakeholders may not always be transparent or aligned, yet research on convergent and divergent positions of stakeholders is scarce. To provide insight into the positions of stakeholder groups involved in the implementation of technology for aging in place by answering the following questions: What kind of technology do stakeholders see as relevant? What do stakeholders aim to achieve by implementing technology? What is needed to achieve successful implementations? Mono-disciplinary focus groups were conducted with participants (n=29) representing five groups of stakeholders: older adults (6/29, 21%), care professionals (7/29, 24%), managers within home care or social work organizations (5/29, 17%), technology designers and suppliers (6/29, 21%), and policy makers (5/29, 17%). Transcripts were analyzed using thematic analysis. Stakeholders considered 26 different types of technologies to be relevant for enabling independent living. Only 6 out of 26 (23%) types of technology were mentioned by all stakeholder groups. Care professionals mentioned fewer different types of technology than other groups. All stakeholder groups felt that the implementation of technology for aging in place can be considered a success when (1) older adults' needs and wishes are prioritized during development and deployment of the technology, (2) the technology is accepted by older adults, (3) the technology provides benefits to older adults, and (4) favorable prerequisites for the use of technology by older adults exist. While stakeholders seemed to have identical aims, several underlying differences emerged, for example, with regard to who should pay for the technology. Additionally, each stakeholder group mentioned specific steps that need to be taken to achieve successful implementation. Collectively, stakeholders felt that they need to take the leap (ie, change attitudes, change policies, and collaborate with other organizations); bridge the gap (ie, match technology with individuals and stimulate interdisciplinary education); facilitate technology for the masses (ie, work on products and research that support large-scale rollouts and train target groups on how to use technology); and take time to reflect (ie, evaluate use and outcomes). Stakeholders largely agree on the direction in which they should be heading; however, they have different perspectives with regard to the technologies that can be employed and the work that is needed to implement them. Central to these issues seems to be the tailoring of technology or technologies to the specific needs of each community-dwelling older adult and the work that is needed by stakeholders to support this type of service delivery on a large scale.

What it Takes to Successfully Implement Technology for Aging in Place: Focus Groups With Stakeholders

PubMed Central

Wouters, Eveline JM; Luijkx, Katrien G; Vrijhoef, Hubertus JM

2016-01-01

Background There is a growing interest in empowering older adults to age in place by deploying various types of technology (ie, eHealth, ambient assisted living technology, smart home technology, and gerontechnology). However, initiatives aimed at implementing these technologies are complicated by the fact that multiple stakeholder groups are involved. Goals and motives of stakeholders may not always be transparent or aligned, yet research on convergent and divergent positions of stakeholders is scarce. Objective To provide insight into the positions of stakeholder groups involved in the implementation of technology for aging in place by answering the following questions: What kind of technology do stakeholders see as relevant? What do stakeholders aim to achieve by implementing technology? What is needed to achieve successful implementations? Methods Mono-disciplinary focus groups were conducted with participants (n=29) representing five groups of stakeholders: older adults (6/29, 21%), care professionals (7/29, 24%), managers within home care or social work organizations (5/29, 17%), technology designers and suppliers (6/29, 21%), and policy makers (5/29, 17%). Transcripts were analyzed using thematic analysis. Results Stakeholders considered 26 different types of technologies to be relevant for enabling independent living. Only 6 out of 26 (23%) types of technology were mentioned by all stakeholder groups. Care professionals mentioned fewer different types of technology than other groups. All stakeholder groups felt that the implementation of technology for aging in place can be considered a success when (1) older adults’ needs and wishes are prioritized during development and deployment of the technology, (2) the technology is accepted by older adults, (3) the technology provides benefits to older adults, and (4) favorable prerequisites for the use of technology by older adults exist. While stakeholders seemed to have identical aims, several underlying differences emerged, for example, with regard to who should pay for the technology. Additionally, each stakeholder group mentioned specific steps that need to be taken to achieve successful implementation. Collectively, stakeholders felt that they need to take the leap (ie, change attitudes, change policies, and collaborate with other organizations); bridge the gap (ie, match technology with individuals and stimulate interdisciplinary education); facilitate technology for the masses (ie, work on products and research that support large-scale rollouts and train target groups on how to use technology); and take time to reflect (ie, evaluate use and outcomes). Conclusions Stakeholders largely agree on the direction in which they should be heading; however, they have different perspectives with regard to the technologies that can be employed and the work that is needed to implement them. Central to these issues seems to be the tailoring of technology or technologies to the specific needs of each community-dwelling older adult and the work that is needed by stakeholders to support this type of service delivery on a large scale. PMID:27143097

Exploring the integration of internationally educated occupational therapists into the workforce.

PubMed

Mulholland, Susan J; Dietrich, Tracy A; Bressler, Sandra I; Corbett, Kathy G

2013-02-01

British Columbia (BC) is a popular Canadian work destination for occupational therapists from around the world. This study explored the experiences of stakeholders involved in the integration of internationally educated occupational therapists (IEOTs) into the BC workforce. Semi-structured interviews were conducted with the three primary stakeholder groups (40 IEOTs, 12 supervising occupational therapists, seven managers), as well as with seven key informants. Participants were purposively sampled and thematic analysis was applied to the data. Three themes were identified that fit sequentially along a workforce-integration continuum: "coming to Canada," "registering with the college," and "integrating into the workplace." Within those themes, findings were organized into two categories, "ingredients for success" and "stumbling block," and multiple subcategories. The findings suggest that hiring IEOTs can bring benefits to the workplace and clients. However, changes made along the continuum would facilitate workforce integration, ultimately benefiting all stakeholders. These findings may be of interest to IEOTs, occupational therapists, and managers as well as individuals working in regulation and policy.

What is a new drug worth? An innovative model for performance-based pricing.

PubMed

Dranitsaris, G; Dorward, K; Owens, R C; Schipper, H

2015-05-01

This article focuses on a novel method to derive prices for new pharmaceuticals by making price a function of drug performance. We briefly review current models for determining price for a new product and discuss alternatives that have historically been favoured by various funding bodies. The progressive approach to drug pricing, proposed herein, may better address the views and concerns of multiple stakeholders in a developed healthcare system by acknowledging and incorporating input from disparate parties via comprehensive and successive negotiation stages. In proposing a valid construct for performance-based pricing, the following model seeks to achieve several crucial objectives: earlier and wider access to new treatments; improved transparency in drug pricing; multi-stakeholder involvement through phased pricing negotiations; recognition of innovative product performance and latent changes in value; an earlier and more predictable return for developers without sacrificing total return on investment (ROI); more involved and informed risk sharing by the end-user. © 2014 John Wiley & Sons Ltd.

Social Networks and Community-Based Natural Resource Management

NASA Astrophysics Data System (ADS)

Lauber, T. Bruce; Decker, Daniel J.; Knuth, Barbara A.

2008-10-01

We conducted case studies of three successful examples of collaborative, community-based natural resource conservation and development. Our purpose was to: (1) identify the functions served by interactions within the social networks of involved stakeholders; (2) describe key structural properties of these social networks; and (3) determine how these structural properties varied when the networks were serving different functions. The case studies relied on semi-structured, in-depth interviews of 8 to 11 key stakeholders at each site who had played a significant role in the collaborative projects. Interview questions focused on the roles played by key stakeholders and the functions of interactions between them. Interactions allowed the exchange of ideas, provided access to funding, and enabled some stakeholders to influence others. The exchange of ideas involved the largest number of stakeholders, the highest percentage of local stakeholders, and the highest density of interactions. Our findings demonstrated the value of tailoring strategies for involving stakeholders to meet different needs during a collaborative, community-based natural resource management project. Widespread involvement of local stakeholders may be most appropriate when ideas for a project are being developed. During efforts to exert influence to secure project approvals or funding, however, involving specific individuals with political connections or influence on possible sources of funds may be critical. Our findings are consistent with past work that has postulated that social networks may require specific characteristics to meet different needs in community-based environmental management.

Service delivery under translation: multi-stakeholder accountability in the non-profit community sector in New Zealand.

PubMed

Boon, Bronwyn; Greatbanks, Richard; Munro, Jenny; Gaffney, Michael

2017-03-01

This paper addresses the challenge reported in the research literature of providing adequate accounts of service quality and value to multiple stakeholders. Rather than starting with a particular accountability practice, we examine the accounts of complex service delivery and results from the perspective of five key stakeholder groups. The case study at the empirical centre of this research is a small New Zealand non-profit organisation that provides community-based wraparound casework to young people, and their families, with multiple and complex needs. This paper reports on data collected during 2009-2012 through interviews with five key stakeholders of this service: the young people, the caseworkers, the co-providers, the managers and the funders. Drawing on translation theory, the different points of reference and the consequential shifts in focus, content and meaning within the multiple stakeholder accounts are traced. The findings show that while each stakeholder group brings a unique point of reference to the service delivery, there are degrees of overlap in the focus and content of the accounts. This is particularly evident in the 'relationship' dimension. While overlaps may exist, points of invisibility are also revealed. Accountability tensions can be traced directly to these points of invisibility. As a result of this analysis, it is argued that more explicit attention to the impact of multiple stakeholders at the level of epistemology provides a mechanism for addressing some of the tensions routinely raised. © 2015 John Wiley & Sons Ltd.

Knowledge, data and interests: Challenges in participation of diverse stakeholders in HIA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Negev, Maya, E-mail: negevm@bgu.ac.il

2012-02-15

Stakeholder participation is considered an integral part of HIA. However, the challenges that participation implies in a multi-disciplinary and multi-ethnic society are less studied. This paper presents the manifestations of the multiplicity of sectors and population groups in HIA and discusses the challenges that such diversity imposes. Specifically, there is no common ground between participants, as their positions entail contradictory knowledge regarding the current situation, reliance on distinct data and conflicting interests. This entails usage of multiple professional and ethnic languages, disagreements regarding the definition of health and prioritizing health issues in HIA, and divergent perceptions of risk. These differencesmore » between participants are embedded culturally, socially, individually and, maybe most importantly, professionally. This complex picture of diverse stakeholder attributes is grounded in a case study of stakeholder participation in HIA, regarding zoning of a hazardous industry site in Israel. The implication is that participatory HIAs should address the multiplicity of stakeholders and types of knowledge, data and interests in a more comprehensive way. - Highlights: Black-Right-Pointing-Pointer This paper analyses challenges in participation of diverse stakeholders in HIA. Black-Right-Pointing-Pointer The multiplicity of disciplines and population groups raises fundamental challenges. Black-Right-Pointing-Pointer Stakeholders possess distinct and often contradictory knowledge, data and interests. Black-Right-Pointing-Pointer They speak different languages, and differ on approaches to health and risk perceptions. Black-Right-Pointing-Pointer Substantial amendments to diverse participation are needed, in HIA and generally.« less

Web-based GIS for collaborative planning and public participation: an application to the strategic planning of wind farm sites.

PubMed

Simão, Ana; Densham, Paul J; Haklay, Mordechai Muki

2009-05-01

Spatial planning typically involves multiple stakeholders. To any specific planning problem, stakeholders often bring different levels of knowledge about the components of the problem and make assumptions, reflecting their individual experiences, that yield conflicting views about desirable planning outcomes. Consequently, stakeholders need to learn about the likely outcomes that result from their stated preferences; this learning can be supported through enhanced access to information, increased public participation in spatial decision-making and support for distributed collaboration amongst planners, stakeholders and the public. This paper presents a conceptual system framework for web-based GIS that supports public participation in collaborative planning. The framework combines an information area, a Multi-Criteria Spatial Decision Support System (MC-SDSS) and an argumentation map to support distributed and asynchronous collaboration in spatial planning. After analysing the novel aspects of this framework, the paper describes its implementation, as a proof of concept, in a system for Web-based Participatory Wind Energy Planning (WePWEP). Details are provided on the specific implementation of each of WePWEP's four tiers, including technical and structural aspects. Throughout the paper, particular emphasis is placed on the need to support user learning throughout the planning process.

The Legacy Ecosystem Management Framework: From Theory to Application in the Detention Pond Case Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Coty, J; Stevenson, M; Vogt, K A

The Detention Pond is a constructed and lined storm water treatment basin at Lawrence Livermore National Laboratory that serves multiple stakeholder objectives and programmatic goals. This paper examines the process and outcome involved in the development of a new management plan for the Detention Pond. The plan was created using a new ecosystem management tool, the Legacy Framework. This stakeholder-driven conceptual framework provides an interdisciplinary methodology for determining ecosystem health, appropriate management strategies, and sensitive indicators. The conceptual framework, the Detention Ponds project, and the use of the framework in the context of the project, are described and evaluated, andmore » evaluative criteria for this and other ecosystem management frameworks are offered. The project benefited in several ways from use of the Legacy Framework, although refinements to the framework are suggested. The stakeholder process created a context and environment in which team members became receptive to using an ecosystem management approach to evaluate and support management alternatives previously not considered. This allowed for the unanimous agreement to pursue support from upper management and organizational funding to implement a progressive management strategy. The greatly improved stakeholder relations resulted in upper management support for the project.« less

Expert stakeholder attitudes and support for alternative water sources in a groundwater depleted region.

PubMed

Boyer, Treavor H; Overdevest, Christine; Christiansen, Lisa; Ishii, Stephanie K L

2012-10-15

The main objectives of this research were to quantify the risks/benefits and impacts of alternative water sources (AWSs) as perceived by expert stakeholders and to evaluate the overall support for multiple AWSs by expert stakeholders. The St. Johns River (SJR) basin, FL, USA was chosen as a case study for AWSs because it is a fresh groundwater depleted region and there are ongoing activities related to water supply planning. Expert stakeholders included federal, state, and local governments, public utilities, consulting engineering and industry, and environmental and social non-governmental organizations. AWSs under consideration in the SJR basin include surface water, desalination, water reclamation, and water conservation. A two-phase research approach was followed that focused on expert stakeholders. First, an elicitation study was used to identify salient beliefs about AWSs. Open-ended questions were asked about the risks/benefits of AWSs in terms of the three pillars of sustainability: ecological, economic, and human health impacts. Second, an online survey was constructed using beliefs identified during the elicitation study. The online survey was used to quantify attitudes toward and overall support for AWSs. The salient beliefs of expert stakeholders were dominated by the ecological pillar of sustainability. The support of expert stakeholders for AWSs, from least favorable to most favorable, was surface water withdrawals

The Road to Tomorrow's Teachers: Planning, Implementing, and Evaluating a State-Based Special Education Workforce Development Initiative. Lessons Learned from the National Pilot Sites Project for Recruitment and Retention. Developing the Special Education Workforce.

ERIC Educational Resources Information Center

National Clearinghouse for Professions in Special Education, Arlington, VA.

This document describes the National Pilot Sites Project for Recruitment and Retention, an effort to recruit, prepare, and retain highly qualified diverse educators and related services personnel for children and youth with disabilities by involving multiple stakeholder groups within selected states (Alabama, Colorado, Georgia, New Jersey, Oregon,…

Using an Evaluation Hotline to Promote Stakeholder Involvement

ERIC Educational Resources Information Center

Skolits, Gary J.; Boser, Judith A.

2008-01-01

This article addresses the design and application of a hotline to promote broader community-wide participation in a public school evaluation. Evaluations of community resources such as public schools present evaluators with challenges from the perspective of promoting stakeholder involvement. Although many evaluation stakeholders are readily…

STAKEHOLDER INVOLVEMENT IN HEALTH TECHNOLOGY ASSESSMENT AT NATIONAL LEVEL: A STUDY FROM IRAN.

PubMed

Yazdizadeh, Bahareh; Shahmoradi, Safoura; Majdzadeh, Reza; Doaee, Shila; Bazyar, Mohammad; Souresrafil, Aghdas; Olyaeemanesh, Alireza

2016-01-01

This study was carried out to evaluate the opinions of stakeholders on their roles in health technology assessment (HTA) in Iran and to determine the barriers and facilitators existing in the organizations to help increase their involvement in the HTA program. The study was conducted in two stages, semi-structured interviews, and "policy dialogue" with stakeholders. The data were analyzed through the framework approach. The interviews were held with ten stakeholder representatives from various organizations. In addition, Twenty-one representatives participated in the policy dialogue. Based on the findings, all the stakeholder organizations considered themselves as interest groups in all the stages of the HTA process; however, their tendencies and methods of involvement differed from one another. According to the participants, the most important issue to be considered in the context of HTA was that the structures, stages, and procedures of the HTA process must be made transparent. Stakeholder involvement in the HTA program cannot readily take place. Various stakeholders have different interests, responsibilities, infrastructures, and barriers. If a program does not meet these considerations, its chances of succeeding will substantially decrease. Therefore, to prevent overlooking the needs and expectations of stakeholders from the HTA process, it is essential to create opportunities in which their thoughts and ideas are taken into account.

NextGen Future Safety Assessment Game

NASA Technical Reports Server (NTRS)

Ancel, Ersin; Gheorghe, Adian; Jones, Sharon Monica

2010-01-01

The successful implementation of the next generation infrastructure systems requires solid understanding of their technical, social, political and economic aspects along with their interactions. The lack of historical data that relate to the long-term planning of complex systems introduces unique challenges for decision makers and involved stakeholders which in turn result in unsustainable systems. Also, the need to understand the infrastructure at the societal level and capture the interaction between multiple stakeholders becomes important. This paper proposes a methodology in order to develop a holistic approach aiming to provide an alternative subject-matter expert (SME) elicitation and data collection method for future sociotechnical systems. The methodology is adapted to Next Generation Air Transportation System (NextGen) decision making environment in order to demonstrate the benefits of this holistic approach.

NextGen Future Safety Assessment Game

NASA Technical Reports Server (NTRS)

Ancel, Ersin; Gheorghe, Adrian; Jones, Sharon Monica

2011-01-01

The successful implementation of the next generation infrastructure systems requires solid understanding of their technical, social, political and economic aspects along with their interactions. The lack of historical data that relate to the long-term planning of complex systems introduces unique challenges for decision makers and involved stakeholders which in turn result in unsustainable systems. Also, the need to understand the infrastructure at the societal level and capture the interaction between multiple stakeholders becomes important. This paper proposes a methodology in order to develop a holistic approach aiming to provide an alternative subject-matter expert (SME) elicitation and data collection method for future sociotechnical systems. The methodology is adapted to Next Generation Air Transportation System (NextGen) decision making environment in order to demonstrate the benefits of this holistic approach.

The management of stakeholder and public participation at US and binational AOCs: Overcoming challenges and looking beyond delisting

EPA Science Inventory

Although stakeholder and public participation has been important throughout the history of the AOC program, the process of involving stakeholders in preparing and implementing RAPs—along with the challenges involved with this process—has varied both historically and g...

Towards a Multi-Stakeholder-Driven Model for Excellence in Higher Education Curriculum Development

ERIC Educational Resources Information Center

Meyer, M. H.; Bushney, M. J.

2008-01-01

A multi-stakeholder-driven model for excellence in higher education curriculum development has been developed. It is based on the assumption that current efforts to curriculum development take place within a framework of limited stakeholder consultation. A total of 18 multiple stakeholders are identified, including learners, alumni, government,…

A participatory approach for selecting cost-effective measures in the WFD context: the Mar Menor (SE Spain).

PubMed

Perni, Angel; Martínez-Paz, José M

2013-08-01

Achieving a good ecological status in water bodies by 2015 is one of the objectives established in the European Water Framework Directive. Cost-effective analysis (CEA) has been applied for selecting measures to achieve this goal, but this appraisal technique requires technical and economic information that is not always available. In addition, there are often local insights that can only be identified by engaging multiple stakeholders in a participatory process. This paper proposes to combine CEA with the active involvement of stakeholders for selecting cost-effective measures. This approach has been applied to the case study of one of the main coastal lagoons in the European Mediterranean Sea, the Mar Menor, which presents eutrophication problems. Firstly, face-to-face interviews were conducted to estimate relative effectiveness and relative impacts of a set of measures by means of the pairwise comparison technique. Secondly, relative effectiveness was used to estimate cost-effectiveness ratios. The most cost-effective measures were the restoration of watercourses that drain into the lagoon and the treatment of polluted groundwater. Although in general the stakeholders approved the former, most of them stated that the latter involved some uncertainties, which must be addressed before implementing it. Stakeholders pointed out that the PoM would have a positive impact not only on water quality, but also on fishing, agriculture and tourism in the area. This approach can be useful to evaluate other programmes, plans or projects related to other European environmental strategies. Copyright © 2013 Elsevier B.V. All rights reserved.

Evaluating taboo trade-offs in ecosystems services and human well-being.

PubMed

Daw, Tim M; Coulthard, Sarah; Cheung, William W L; Brown, Katrina; Abunge, Caroline; Galafassi, Diego; Peterson, Garry D; McClanahan, Tim R; Omukoto, Johnstone O; Munyi, Lydiah

2015-06-02

Managing ecosystems for multiple ecosystem services and balancing the well-being of diverse stakeholders involves different kinds of trade-offs. Often trade-offs involve noneconomic and difficult-to-evaluate values, such as cultural identity, employment, the well-being of poor people, or particular species or ecosystem structures. Although trade-offs need to be considered for successful environmental management, they are often overlooked in favor of win-wins. Management and policy decisions demand approaches that can explicitly acknowledge and evaluate diverse trade-offs. We identified a diversity of apparent trade-offs in a small-scale tropical fishery when ecological simulations were integrated with participatory assessments of social-ecological system structure and stakeholders' well-being. Despite an apparent win-win between conservation and profitability at the aggregate scale, food production, employment, and well-being of marginalized stakeholders were differentially influenced by management decisions leading to trade-offs. Some of these trade-offs were suggested to be "taboo" trade-offs between morally incommensurable values, such as between profits and the well-being of marginalized women. These were not previously recognized as management issues. Stakeholders explored and deliberated over trade-offs supported by an interactive "toy model" representing key system trade-offs, alongside qualitative narrative scenarios of the future. The concept of taboo trade-offs suggests that psychological bias and social sensitivity may exclude key issues from decision making, which can result in policies that are difficult to implement. Our participatory modeling and scenarios approach has the potential to increase awareness of such trade-offs, promote discussion of what is acceptable, and potentially identify and reduce obstacles to management compliance.

Engaging stakeholders in rehabilitation research: a scoping review of strategies used in partnerships and evaluation of impacts.

PubMed

Camden, Chantal; Shikako-Thomas, Keiko; Nguyen, Tram; Graham, Emma; Thomas, Aliki; Sprung, Jennifer; Morris, Christopher; Russell, Dianne J

2015-01-01

To describe how stakeholder engagement has been undertaken and evaluated in rehabilitation research. A scoping review of the scientific literature using five search strategies. Quantitative and qualitative analyses using extracted data. Interpretation of results was iteratively discussed within the team, which included a parent stakeholder. Searches identified 101 candidate papers; 28 were read in full to assess eligibility and 19 were included in the review. People with disabilities and their families were more frequently involved compared to other stakeholders. Stakeholders were often involved in planning and evaluating service delivery. A key issue was identifying stakeholders; strategies used to support their involvement included creating committees, organizing meetings, clarifying roles and offering training. Communication, power sharing and resources influenced how stakeholders could be engaged in the research. Perceived outcomes of stakeholder engagement included the creation of partnerships, facilitating the research process and the application of the results, and empowering stakeholders. Stakeholder engagement outcomes were rarely formally evaluated. There is a great interest in rehabilitation to engage stakeholders in the research process. However, further evidence is needed to identify effective strategies for meaningful stakeholder engagement that leads to more useful research that positively impacts practice. Implications for Rehabilitation Using several strategies to engage various stakeholders throughout the research process is thought to increase the quality of the research and the rehabilitation process by developing proposals and programs responding better to their needs. Engagement strategies need to be better reported and evaluated in the literature. Engagement facilitate uptake of research findings by increasing stakeholders' awareness of the evidence, the resources available and their own ability to act upon a situation. Factors influencing opportunities for stakeholder engagement need to be better understood.

Involvement of External Stakeholders in Local Health Policymaking Process: A Case Study from Odense Municipality, Denmark

ERIC Educational Resources Information Center

Karlsson, Leena Eklund; Jakobsen, Mette Winge; Winblad, Malin; Aro, Arja R.

2017-01-01

Collaboration between research and policy is an essential element for knowledge-based public health. However, only half of the Danish municipalities have experience with collaborating with researchers or other stakeholders. Through content analysis of interviews and policy documents the study explores the involvement of external stakeholders in…

Stakeholder Involvement in the Higher Education Sector in Cambodia

ERIC Educational Resources Information Center

Sam, Chanphirun; Dahles, Heidi

2017-01-01

This article examines how stakeholders involve themselves in the higher education (HE) sector in donor-dependent Cambodia and to what extent and with what result these stakeholders succeed to collaborate, or fail to do so. This study is based on qualitative data from semi-structured interviews with 46 key research participants from relevant…

Unleashing the power of human genetic variation knowledge: New Zealand stakeholder perspectives.

PubMed

Gu, Yulong; Warren, James Roy; Day, Karen Jean

2011-01-01

This study aimed to characterize the challenges in using genetic information in health care and to identify opportunities for improvement. Taking a grounded theory approach, semistructured interviews were conducted with 48 participants to collect multiple stakeholder perspectives on genetic services in New Zealand. Three themes emerged from the data: (1) four service delivery models were identified in operation, including both those expected models involving genetic counselors and variations that do not route through the formal genetic service program; (2) multiple barriers to sharing and using genetic information were perceived, including technological, organizational, institutional, legal, ethical, and social issues; and (3) impediments to wider use of genetic testing technology, including variable understanding of genetic test utilities among clinicians and the limited capacity of clinical genetic services. Targeting these problems, information technologies and knowledge management tools have the potential to support key tasks in genetic services delivery, improve knowledge processes, and enhance knowledge networks. Because of the effect of issues in genetic information and knowledge management, the potential of human genetic variation knowledge to enhance health care delivery has been put on a "leash."

Acceptability and Perceived Benefits and Risks of Public and Patient Involvement in Health Care Policy: A Delphi Survey in Belgian Stakeholders.

PubMed

Cleemput, Irina; Christiaens, Wendy; Kohn, Laurence; Léonard, Christian; Daue, François; Denis, Alain

2015-06-01

In systems with public health insurance, coverage decisions should reflect social values. Deliberation among stakeholders could achieve this goal, but rarely involves patients and citizens directly. This study aimed at evaluating the acceptability, and the perceived benefits and risks, of public and patient involvement (PPI) in coverage decision making to Belgian stakeholders. A two-round Delphi survey was conducted among all stakeholder groups. The survey was constructed on the basis of interviews with 10 key stakeholders and a review of the literature on participation models. Consensus was defined as 65% or more of the respondents agreeing with a statement and less than 15% disagreeing. Eighty stakeholders participated in both rounds. They were defined as the Delphi panel. Belgian stakeholders are open toward PPI in coverage decision processes. Benefits are expected to exceed risks. The preferred model for involvement is to consult citizens or patients, within the existing decision-making structures and at specific milestones in the process. Consulting citizens and patients is a higher level of involvement than merely informing them and a lower level than letting them participate actively. Consultation involves asking nonbinding advice on (parts of) the decision problem. According to the Delphi panel, the benefits of PPI could be increasing awareness among members of the general public and patients about the challenges and costs of health care, and enriched decision processes with expertise by experience from patients. Potential risks include subjectivity, insufficient resources to participate and weigh on the process, difficulties in finding effective ways to express a collective opinion, the risk of manipulation, and lobbying or power games of other stakeholders. PPI in coverage decision-making processes is acceptable to Belgian stakeholders, be it in different ways for different types of decisions. Benefits are expected to outweigh risks. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Does the knowledge-to-action (KTA) framework facilitate physical demands analysis development for firefighter injury management and return-to-work planning?

PubMed

Sinden, Kathryn; MacDermid, Joy C

2014-03-01

Employers are tasked with developing injury management and return-to-work (RTW) programs in response to occupational health and safety policies. Physical demands analyses (PDAs) are the cornerstone of injury management and RTW development. Synthesizing and contextualizing policy knowledge for use in occupational program development, including PDAs, is challenging due to multiple stakeholder involvement. Few studies have used a knowledge translation theoretical framework to facilitate policy-based interventions in occupational contexts. The primary aim of this case study was to identify how constructs of the knowledge-to-action (KTA) framework were reflected in employer stakeholder-researcher collaborations during development of a firefighter PDA. Four stakeholder meetings were conducted with employee participants who had experience using PDAs in their occupational role. Directed content analysis informed analyses of meeting minutes, stakeholder views and personal reflections recorded throughout the case. Existing knowledge sources including local data, stakeholder experiences, policies and priorities were synthesized and tailored to develop a PDA in response to the barriers and facilitators identified by the firefighters. The flexibility of the KTA framework and synthesis of multiple knowledge sources were identified strengths. The KTA Action cycle was useful in directing the overall process but insufficient for directing the specific aspects of PDA development. Integration of specific PDA guidelines into the process provided explicit direction on best practices in tailoring the PDA and knowledge synthesis. Although the themes of the KTA framework were confirmed in our analysis, order modification of the KTA components was required. Despite a complex context with divergent perspectives successful implementation of a draft PDA was achieved. The KTA framework facilitated knowledge synthesis and PDA development but specific standards and modifications to the KTA framework were needed to enhance process structure. Flexibility for modification and integration of PDA practice guidelines were identified as assets of the KTA framework during its application.

The SUSTAIN Project: A European Study on Improving Integrated Care for Older People Living at Home

PubMed Central

Stoop, Annerieke; Billings, Jenny; Leichsenring, Kai; Ruppe, Georg; Tram, Nhu; Barbaglia, María Gabriela; Ambugo, Eliva A.; Zonneveld, Nick; Paat-Ahi, Gerli; Hoffmann, Henrik; Khan, Usman; Stein, Viktoria; Wistow, Gerald; Lette, Manon; Jansen, Aaltje P.D.; Nijpels, Giel; Baan, Caroline A.

2018-01-01

Introduction: Integrated care programmes are increasingly being put in place to provide care to older people who live at home. Knowledge of how to further develop integrated care and how to transfer successful initiatives to other contexts is still limited. Therefore, a cross-European research project, called Sustainable Tailored Integrated Care for Older People in Europe (SUSTAIN), has been initiated with a twofold objective: 1. to collaborate with local stakeholders to support and monitor improvements to established integrated care initiatives for older people with multiple health and social care needs. Improvements focus on person-centredness, prevention orientation, safety and efficiency; 2. to make these improvements applicable and adaptable to other health and social care systems, and regions in Europe. This paper presents the overall structure and approach of the SUSTAIN project. Methods: SUSTAIN uses a multiple embedded case study design. In three phases, SUSTAIN partners: (i) conduct interviews and workshops with stakeholders from fourteen established integrated care initiatives to understand where they would prefer improvements to existing ways of working; (ii) collaborate with local stakeholders to support the design and implementation of improvement plans, evaluate implementation progress and outcomes per initiative, and carry out overarching analyses to compare the different initiatives, and; (iii) translate knowledge and experience to an online roadmap. Discussion: SUSTAIN aims to generate evidence on how to improve integrated care, and apply and transfer the knowledge gained to other health and social care systems, and regions. Lessons learned will be brought together in practical tools to inform and support policy-makers and decision-makers, as well as other stakeholders involved in integrated care, to manage and improve care for older people living at home. PMID:29632456

From micronutrient recommendations to policy: consumer and stakeholder involvement.

PubMed

Timotijevic, L; Raats, M M; Barnett, J; Brown, K; Shepherd, R; Fernandez, L; Dömölki, L; Ruprich, J; Sonne, A-M; Hermoso, M; Koletzko, B; Frost-Andersen, L; Timmer, A

2010-06-01

To achieve the nutritional goals stipulated by micronutrient recommendations, greater attention must be paid to the behavioural routes to such nutritional outcomes. Coopting stakeholders and consumers into decisions regarding micronutrient recommendations is an important step towards achieving a greater link between micronutrient recommendations and behaviour. This study aims to examine the rationale and processes associated with consumer and stakeholder involvement in setting micronutrient recommendations across Europe. Using the contacts established through the Eurreca network of excellence (commissioned by the European Commission), the research involved in-depth desk research of key documents and communication channels linked to the process of setting micronutrient recommendations across seven countries: the United Kingdom, Norway, Denmark, Germany, Spain, the Czech Republic and Hungary. Stakeholder engagement is recognized by most countries as an important aspect of the process of setting micronutrient recommendations and their translation into policy, although there is notable variation in the extent to which this has been achieved across the seven countries and its effect on final decisions. Stakeholders were not involved at the outset of the process ('framing' of the problem) in any of the countries, and there was no evidence of consumer involvement and open public fora. Some of the key explanatory factors for diversity in the degree of involvement include historical sociopolitical context; the extent to which food and nutrition are key policy agenda; and the relative power of stakeholders in influencing food and nutrition policy.

A Multiple Streams analysis of the decisions to fund gender-neutral HPV vaccination in Canada.

PubMed

Shapiro, Gilla K; Guichon, Juliet; Prue, Gillian; Perez, Samara; Rosberger, Zeev

2017-07-01

In Canada, the human papillomavirus (HPV) vaccine is licensed and recommended for females and males. Although all Canadian jurisdictions fund school-based HPV vaccine programs for girls, only six jurisdictions fund school-based HPV vaccination for boys. The research aimed to analyze the factors that underpin government decisions to fund HPV vaccine for boys using a theoretical policy model, Kingdon's Multiple Streams framework. This approach assesses policy development by examining three concurrent, but independent, streams that guide analysis: Problem Stream, Policy Stream, and Politics Stream. Analysis from the Problem Stream highlights that males are affected by HPV-related diseases and are involved in transmitting HPV infection to their sexual partners. Policy Stream analysis makes clear that while the inclusion of males in HPV vaccine programs is suitable, equitable, and acceptable; there is debate regarding cost-effectiveness. Politics Stream analysis identifies the perspectives of six different stakeholder groups and highlights the contribution of government officials at the provincial and territorial level. Kingdon's Multiple Streams framework helps clarify the opportunities and barriers for HPV vaccine policy change. This analysis identified that the interpretation of cost-effectiveness models and advocacy of stakeholders such as citizen-advocates and HPV-affected politicians have been particularly important in galvanizing policy change. Copyright © 2017 Elsevier Inc. All rights reserved.

Decision-making for foot-and-mouth disease control: Objectives matter

USGS Publications Warehouse

Probert, William J. M.; Shea, Katriona; Fonnesbeck, Christopher J.; Runge, Michael C.; Carpenter, Tim E.; Durr, Salome; Garner, M. Graeme; Harvey, Neil; Stevenson, Mark A.; Webb, Colleen T.; Werkman, Marleen; Tildesley, Michael J.; Ferrari, Matthew J.

2016-01-01

Formal decision-analytic methods can be used to frame disease control problems, the first step of which is to define a clear and specific objective. We demonstrate the imperative of framing clearly-defined management objectives in finding optimal control actions for control of disease outbreaks. We illustrate an analysis that can be applied rapidly at the start of an outbreak when there are multiple stakeholders involved with potentially multiple objectives, and when there are also multiple disease models upon which to compare control actions. The output of our analysis frames subsequent discourse between policy-makers, modellers and other stakeholders, by highlighting areas of discord among different management objectives and also among different models used in the analysis. We illustrate this approach in the context of a hypothetical foot-and-mouth disease (FMD) outbreak in Cumbria, UK using outputs from five rigorously-studied simulation models of FMD spread. We present both relative rankings and relative performance of controls within each model and across a range of objectives. Results illustrate how control actions change across both the base metric used to measure management success and across the statistic used to rank control actions according to said metric. This work represents a first step towards reconciling the extensive modelling work on disease control problems with frameworks for structured decision making.

Consumer involvement in dietary guideline development: opinions from European stakeholders.

PubMed

Brown, Kerry A; Hermoso, Maria; Timotijevic, Lada; Barnett, Julie; Lillegaard, Inger Therese L; Řehůřková, Irena; Larrañaga, Ainhoa; Lončarević-Srmić, Azra; Andersen, Lene Frost; Ruprich, Jiří; Fernández-Celemín, Laura; Raats, Monique M

2013-05-01

The involvement of consumers in the development of dietary guidelines has been promoted by national and international bodies. Yet, few best practice guidelines have been established to assist with such involvement. Qualitative semi-structured interviews explored stakeholders' beliefs about consumer involvement in dietary guideline development. Interviews were conducted in six European countries: the Czech Republic, Germany, Norway, Serbia, Spain and the UK. Seventy-seven stakeholders were interviewed. Stakeholders were grouped as government, scientific advisory body, professional and academic, industry or non-government organisations. Response rate ranged from 45 % to 95 %. Thematic analysis was conducted with the assistance of NVivo qualitative software. Analysis identified two main themes: (i) type of consumer involvement and (ii) pros and cons of consumer involvement. Direct consumer involvement (e.g. consumer organisations) in the decision-making process was discussed as a facilitator to guideline communication towards the end of the process. Indirect consumer involvement (e.g. consumer research data) was considered at both the beginning and the end of the process. Cons to consumer involvement included the effect of vested interests on objectivity; consumer disinterest; and complications in terms of time, finance and technical understanding. Pros related to increased credibility and trust in the process. Stakeholders acknowledged benefits to consumer involvement during the development of dietary guidelines, but remained unclear on the advantage of direct contributions to the scientific content of guidelines. In the absence of established best practice, clarity on the type and reasons for consumer involvement would benefit all actors.

Involving patients in health technology funding decisions: stakeholder perspectives on processes used in Australia.

PubMed

Lopes, Edilene; Street, Jackie; Carter, Drew; Merlin, Tracy

2016-04-01

Governments use a variety of processes to incorporate public perspectives into policymaking, but few studies have evaluated these processes from participants' point of view. The objective of this study was twofold: to understand the perspectives of selected stakeholders with regard to involvement processes used by Australian Advisory Committees to engage the public and patients; and to identify barriers and facilitators to participation. Twelve semi-structured interviews were conducted with representatives of different stakeholder groups involved in health technology funding decisions in Australia. Data were collected and analysed using a theoretical framework created by Rowe and Frewer, but adapted to more fully acknowledge issues of power and influence. Stakeholder groups disagreed as to what constitutes effective and inclusive patient involvement. Barriers reported by interviewees included poor communication, a lack of transparency, unworkable deadlines, and inadequate representativeness. Also described were problems associated with defining the task for patients and their advocates and with the timing of patient input in the decision-making process. Interviewees suggested that patient participation could be improved by increasing the number of patient organizations engaged in processes and including those organizations at different stages of decision making, especially earlier. The different evaluations made by stakeholder groups appear to be underpinned by contrasting conceptions of public involvement and its value, in line with Graham Martin's work which distinguishes between 'technocratic' and 'democratic' public involvement. Understanding stakeholders' perspectives and the contrasting conceptions of public involvement could foster future agreement on which processes should be used to involve the public in decision making. © 2015 John Wiley & Sons Ltd.

Patient-centred outcomes research: perspectives of patient stakeholders.

PubMed

Chhatre, Sumedha; Gallo, Joseph J; Wittink, Marsha; Schwartz, J Sanford; Jayadevappa, Ravishankar

2017-11-01

To elicit patient stakeholders' experience and perspectives about patient-centred care. Qualitative. A large urban healthcare system. Four patient stakeholders who are prostate cancer survivors. Experience and perspectives of patient stakeholders regarding patient-centred care and treatment decisions. Our patient stakeholders represented a diverse socio-demographic group. The patient stakeholders identified engagement and dialogue with physicians as crucial elements of patient-centred care model. The degree of patient-centred care was observed to be dependent on the situations. High severity conditions warranted a higher level of patient involvement, compared to mild conditions. They agreed that patient-centred care should not mean that patients can demand inappropriate treatments. An important attribute of patient-centred outcomes research model is the involvement of stakeholders. However, we have limited knowledge about the experience of patient stakeholders in patient-centred outcomes research. Our study indicates that patient stakeholders offer a unique perspective as researchers and policy-makers aim to precisely define patient-centred research and care.

Stakeholder participation in comparative effectiveness research: defining a framework for effective engagement

PubMed Central

Deverka, Patricia A; Lavallee, Danielle C; Desai, Priyanka J; Esmail, Laura C; Ramsey, Scott D; Veenstra, David L; Tunis, Sean R

2012-01-01

Aims Stakeholder engagement is fundamental to comparative effectiveness research (CER), but lacks consistent terminology. This paper aims to define stakeholder engagement and present a conceptual model for involving stakeholders in CER. Materials & methods The definitions and model were developed from a literature search, expert input and experience with the Center for Comparative Effectiveness Research in Cancer Genomics, a proof-of-concept platform for stakeholder involvement in priority setting and CER study design. Results Definitions for stakeholder and stakeholder engagement reflect the target constituencies and their role in CER. The ‘analytic-deliberative’ conceptual model for stakeholder engagement illustrates the inputs, methods and outputs relevant to CER. The model differentiates methods at each stage of the project; depicts the relationship between components; and identifies outcome measures for evaluation of the process. Conclusion While the definitions and model require testing before being broadly adopted, they are an important foundational step and will be useful for investigators, funders and stakeholder groups interested in contributing to CER. PMID:22707880

Stakeholder participation in comparative effectiveness research: defining a framework for effective engagement.

PubMed

Deverka, Patricia A; Lavallee, Danielle C; Desai, Priyanka J; Esmail, Laura C; Ramsey, Scott D; Veenstra, David L; Tunis, Sean R

2012-03-01

AIMS: Stakeholder engagement is fundamental to comparative effectiveness research (CER), but lacks consistent terminology. This paper aims to define stakeholder engagement and present a conceptual model for involving stakeholders in CER. MATERIALS #ENTITYSTARTX00026; METHODS: The definitions and model were developed from a literature search, expert input and experience with the Center for Comparative Effectiveness Research in Cancer Genomics, a proof-of-concept platform for stakeholder involvement in priority setting and CER study design. RESULTS: Definitions for stakeholder and stakeholder engagement reflect the target constituencies and their role in CER. The 'analytic-deliberative' conceptual model for stakeholder engagement illustrates the inputs, methods and outputs relevant to CER. The model differentiates methods at each stage of the project; depicts the relationship between components; and identifies outcome measures for evaluation of the process. CONCLUSION: While the definitions and model require testing before being broadly adopted, they are an important foundational step and will be useful for investigators, funders and stakeholder groups interested in contributing to CER.

The application of an industry level participatory ergonomics approach in developing MSD interventions.

PubMed

Tappin, D C; Vitalis, A; Bentley, T A

2016-01-01

Participatory ergonomics projects are traditionally applied within one organisation. In this study, a participative approach was applied across the New Zealand meat processing industry, involving multiple organisations and geographical regions. The purpose was to develop interventions to reduce musculoskeletal disorder (MSD) risk. This paper considers the value of an industry level participatory ergonomics approach in achieving this. The main rationale for a participative approach included the need for industry credibility, and to generate MSD interventions that address industry level MSD risk factors. An industry key stakeholder group became the primary vehicle for formal participation. The study resulted in an intervention plan that included the wider work system and industry practices. These interventions were championed across the industry by the key stakeholder group and have extended beyond the life of the study. While this approach helped to meet the study aim, the existence of an industry-supported key stakeholder group and a mandate for the initiative are important prerequisites for success. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Health care networks implementation and regional governance challenges in the Legal Amazon Region: an analysis of the QualiSUS-Rede Project.

PubMed

Casanova, Angela Oliveira; Cruz, Marly Marques; Giovanella, Ligia; Alves, Glaydes Dos Reis; Cardoso, Gisela Cordeiro Pereira

2017-04-01

This paper aims to analyze the potential, limits and challenges of regional governance in the implementation process of health care networks in three Brazilian regions: Alto Solimões (Amazonas), Belém (Pará) and an interstate region comprising Tocantins, Pará and Maranhão states (Topama). The study is based on the evaluation study on the implementation of the Quality Health Care Network Development and Improvement Project (QualiSUS-Rede). This is a qualitative multiple case study with the analysis of official documents and use of semi-structured interviews with key stakeholders conducted from July to December 2014. Governance review encompassed three components: stakeholders involved, especially local steering groups and their regional coordination capacity; strategies used for strengthening regional governance, anchored on the intervention's modeling; and implementation of local health care networks. Results point that the regional managing commissions were the main governance strategy and that the QualiSUS-Rede Project strengthened regional governance and integration differently in every case, depending on stakeholders' administration and consensus capacity on regional and political priorities.

I’m Positive, But I’m Negative

PubMed Central

Lindegger, Graham; Slack, Catherine; Wallace, Melissa; Newman, Peter

2015-01-01

HIV vaccine trials (HVTs) are ethically complex, and sound informed consent processes should facilitate optimal decision-making for participants. This study aimed to explore representations of critical HVT-related concepts to enhance the consent process. Four focus group discussions were conducted with participants from key constituencies at a South African HVT site. Thematic analysis was employed to identify representations of key HVT-related concepts. The findings suggest that (potential) participants may negotiate multiple, competing versions of HVT-related concepts in a somewhat unrecognized process, which may have significant implications for the consent process. Stakeholders involved in consent and engagement activities at sites should be assisted to elicit, engage, and resolve competing representations of HVT-related concepts. More empirical research is needed to explore how such stakeholders address competing representations in their interactions with potential participants. PMID:25819758

The effects of stakeholder involvement on perceptions of an evaluation's credibility.

PubMed

Jacobson, Miriam R; Azzam, Tarek

2018-06-01

This article presents a study of the effects of stakeholder involvement on perceptions of an evaluation's credibility. Crowdsourced members of the public and a group of educational administrators read a description of a hypothetical program and two evaluations of the program: one conducted by a researcher and one conducted by program staff (i.e. program stakeholders). Study participants were randomly assigned versions of the scenario with different levels of stakeholder credibility and types of findings. Results showed that both samples perceived the researcher's evaluation findings to be more credible than the program staff's, but that this difference was significantly reduced when the program staff were described to be highly credible. The article concludes with implications for theory and research on evaluation dissemination and stakeholder involvement. Copyright © 2018 Elsevier Ltd. All rights reserved.

May Stakeholders be Involved in Design Without Informed Consent? The Case of Hidden Design.

PubMed

Pols, A J K

2017-06-01

Stakeholder involvement in design is desirable from both a practical and an ethical point of view. It is difficult to do well, however, and some problems recur again and again, both of a practical nature, e.g. stakeholders acting strategically rather than openly, and of an ethical nature, e.g. power imbalances unduly affecting the outcome of the process. Hidden Design has been proposed as a method to deal with the practical problems of stakeholder involvement. It aims to do so by taking the observation of stakeholder actions, rather than the outcomes of a deliberative process, as its input. Furthermore, it hides from stakeholders the fact that a design process is taking place so that they will not behave differently than they otherwise would. Both aspects of Hidden Design have raised ethical worries. In this paper I make an ethical analysis of what it means for a design process to leave participants uninformed or deceived rather than acquiring their informed consent beforehand, and to use observation of actions rather than deliberation as input for design, using Hidden Design as a case study. This analysis is based on two sets of normative guidelines: the ethical guidelines for psychological research involving deception or uninformed participants from two professional psychological organisations, and Habermasian norms for a fair and just (deliberative) process. It supports the conclusion that stakeholder involvement in design organised in this way can be ethically acceptable, though under a number of conditions and constraints.

Designing for Multiple Stakeholder Interests within the Humanitarian Market: The Case of Off-Grid Energy Devices

ERIC Educational Resources Information Center

Nielsen, Brita Fladvad; Rodrigues Santos, Ana Laura

2013-01-01

A "humanitarian market" for off-grid renewable energy technologies for displaced populations in remote areas has emerged. Within this market, there are multiple stakeholder agendas. End-user needs and sustainable development goals are currently not considered through the customer-enterprise relationship and the applied product and…

A Literature Review and Compilation of Nuclear Waste Management System Attributes for Use in Multi-Objective System Evaluations.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kalinina, Elena Arkadievna; Samsa, Michael

The purpose of this work was to compile a comprehensive initial set of potential nuclear waste management system attributes. This initial set of attributes is intended to serve as a starting point for additional consideration by system analysts and planners to facilitate the development of a waste management system multi-objective evaluation framework based on the principles and methodology of multi-attribute utility analysis. The compilation is primarily based on a review of reports issued by the Canadian Nuclear Waste Management Organization (NWMO) and the Blue Ribbon Commission on America's Nuclear Future (BRC), but also an extensive review of the available literaturemore » for similar and past efforts as well. Numerous system attributes found in different sources were combined into a single objectives-oriented hierarchical structure. This study provides a discussion of the data sources and the descriptions of the hierarchical structure. A particular focus of this study was on collecting and compiling inputs from past studies that involved the participation of various external stakeholders. However, while the important role of stakeholder input in a country's waste management decision process is recognized in the referenced sources, there are only a limited number of in-depth studies of the stakeholders' differing perspectives. Compiling a comprehensive hierarchical listing of attributes is a complex task since stakeholders have multiple and often conflicting interests. The BRC worked for two years (January 2010 to January 2012) to "ensure it has heard from as many points of view as possible." The Canadian NWMO study took four years and ample resources, involving national and regional stakeholders' dialogs, internet-based dialogs, information and discussion sessions, open houses, workshops, round tables, public attitude research, website, and topic reports. The current compilation effort benefited from the distillation of these many varied inputs conducted by the previous studies.« less

Evidence-informed recommendations to reduce dissemination bias in clinical research: conclusions from the OPEN (Overcome failure to Publish nEgative fiNdings) project based on an international consensus meeting

PubMed Central

Meerpohl, Joerg J; Schell, Lisa K; Bassler, Dirk; Gallus, Silvano; Kleijnen, Jos; Kulig, Michael; La Vecchia, Carlo; Marušić, Ana; Ravaud, Philippe; Reis, Andreas; Schmucker, Christine; Strech, Daniel; Urrútia, Gerard; Antes, Gerd

2015-01-01

Background Dissemination bias in clinical research severely impedes informed decision-making not only for healthcare professionals and patients, but also for funders, research ethics committees, regulatory bodies and other stakeholder groups that make health-related decisions. Decisions based on incomplete and biased evidence cannot only harm people, but may also have huge financial implications by wasting resources on ineffective or harmful diagnostic and therapeutic measures, and unnecessary research. Owing to involvement of multiple stakeholders, it remains easy for any single group to assign responsibility for resolving the problem to others. Objective To develop evidence-informed general and targeted recommendations addressing the various stakeholders involved in knowledge generation and dissemination to help overcome the problem of dissemination bias on the basis of previously collated evidence. Methods Based on findings from systematic reviews, document analyses and surveys, we developed general and targeted draft recommendations. During a 2-day workshop in summer 2013, these draft recommendations were discussed with external experts and key stakeholders, and refined following a rigorous and transparent methodological approach. Results Four general, overarching recommendations applicable to all or most stakeholder groups were formulated, addressing (1) awareness raising, (2) implementation of targeted recommendations, (3) trial registration and results posting, and (4) systematic approaches to evidence synthesis. These general recommendations are complemented and specified by 47 targeted recommendations tailored towards funding agencies, pharmaceutical and device companies, research institutions, researchers (systematic reviewers and trialists), research ethics committees, trial registries, journal editors and publishers, regulatory agencies, benefit (health technology) assessment institutions and legislators. Conclusions Despite various recent examples of dissemination bias and several initiatives to reduce it, the problem of dissemination bias has not been resolved. Tailored recommendations based on a comprehensive approach will hopefully help increase transparency in biomedical research by overcoming the failure to disseminate negative findings. PMID:25943371

Methods guiding stakeholder engagement in planning a pragmatic study on changing stroke systems of care.

PubMed

Gesell, Sabina B; Klein, Karen Potvin; Halladay, Jacqueline; Bettger, Janet Prvu; Freburger, Janet; Cummings, Doyle M; Lutz, Barbara J; Coleman, Sylvia; Bushnell, Cheryl; Rosamond, Wayne; Duncan, Pamela W

2017-04-01

The Comprehensive Post-Acute Stroke Services (COMPASS) Study is one of the first large pragmatic randomized-controlled clinical trials using comparative effectiveness research methods, funded by the Patient-Centered Outcomes Research Institute. In the COMPASS Study, we compare the effectiveness of a patient-centered, transitional care intervention versus usual care for stroke patients discharged home from acute care. Outcomes include stroke patient post-discharge functional status and caregiver strain 90 days after discharge, and hospital readmissions. A central tenet of Patient-Centered Outcomes Research Institute-funded research is stakeholder engagement throughout the research process. However, evidence on how to successfully implement a pragmatic trial that changes systems of care in combination with robust stakeholder engagement is limited. This combination is not without challenges. We present our approach for broad-based stakeholder engagement in the context of a pragmatic trial with the participation of patients, caregivers, community stakeholders, including the North Carolina Stroke Care Collaborative hospital network, and policy makers. To maximize stakeholder engagement throughout the COMPASS Study, we employed a conceptual model with the following components: (1) Patient and Other Stakeholder Identification and Selection; (2) Patient and Other Stakeholder Involvement Across the Spectrum of Research Activities; (3) Dedicated Resources for Patient and Other Stakeholder Involvement; (4) Support for Patient and Other Stakeholder Engagement Through Organizational Processes; (5) Communication with Patients and Other Stakeholders; (6) Transparent Involvement Processes; (7) Tracking of Engagement; and (8) Evaluation of Engagement. In this paper, we describe how each component of the model is being implemented and how this approach addresses existing gaps in the literature on strategies for engaging stakeholders in meaningful and useful ways when conducting pragmatic trials.

Negotiating multisectoral evidence: a qualitative study of knowledge exchange at the intersection of transport and public health.

PubMed

Guell, Cornelia; Mackett, Roger; Ogilvie, David

2017-01-05

For the prevention and control of chronic diseases, two strategies are frequently highlighted: that public health should be evidence based, and that it should develop a multisectoral approach. At the end of a natural experimental study of the health impacts of new transport infrastructure, we took the opportunity of a knowledge exchange forum to explore how stakeholders assessed, negotiated and intended to apply multisectoral evidence in policy and practice at the intersection of transport and health. We aimed to better understand the challenges they faced in knowledge exchange, as well as their everyday experiences with working in multisectoral remits. In 2015, we conducted participant observation during an interactive event with 41 stakeholders from national and local government, the third sector and academia in Cambridge, UK. Formal and informal interactions between stakeholders were recorded in observational field notes. We also conducted 18 semistructured interviews reflecting on the event and on knowledge exchange in general. We found that stakeholders negotiated a variety of challenges. First, stakeholders had to negotiate relatively new formal and informal multisectoral remits; and how to reconcile the differing expectations of transport specialists, who tended to emphasise the importance of precedence in guiding action, and health specialists' concern for the rigour and synthesis of research evidence. Second, research in this field involved complex study designs, and often produced evidence with uncertain transferability to other settings. Third, health outcomes of transport schemes had political traction and were used strategically but not easily translated into cost-benefit ratios. Finally, knowledge exchange meant multiple directions of influence. Stakeholders were concerned that researchers did not always have skills to translate their findings into understandable evidence, and some stakeholders would welcome opportunities to influence research agendas. This case study of stakeholders' experiences indicates that multisectoral research, practice and policymaking requires the ability and capacity to locate, understand and communicate complex evidence from a variety of disciplines, and integrate different types of evidence into clear business cases beyond sectoral boundaries.

Disparities in new graduate transition from multiple stakeholder perspectives.

PubMed

Adamack, Monica; Rush, Kathy L

2014-09-01

The purpose of this qualitative study was to understand multiple stakeholder perspectives of new graduate (NG) transition programs. It was part of a larger mixed-methods study (2011) designed to provide a comprehensive assessment of new graduate nurse transition best practices, across six British Columbia health authorities. Data collection involved individual interviews with academic nurse educators (n=4) and separate focus groups with new graduate (n=48) and front-line nurse leaders (n=69). Disparity emerged as the overriding theme and described differences between stakeholder group perspectives, between expectations and reality, and within and across programs. Four disparities emerged: entry-level education and practice, perspectives on employment and career planning, transition program elements and support. Despite general satisfaction with undergraduate preparation, theory-practice gaps were identified. New Graduates experienced misalignments between their employment expectations and their realities. The employed student nurse program in which many new graduates had participated did not always yield employment, but when it did, differences in transitional expectations arose between new graduates and leaders. There was considerable variation across and within provincial new graduate programs with respect to orientation, supernumerary time and preceptorship characteristics, including lack of training. Disparities arose in the nature, amount of and access to support and the monitoring of new graduate progress. Findings reinforced organizational complexities and the importance of communication across education and practice sectors. This paper uncovers the tensions between the perspectives of new graduates and nurse leaders about transitional programs and opens the opportunity to collaborate in aligning the perspectives.

Exploring Stakeholder Definitions within the Aerospace Industry: A Qualitative Case Study

NASA Astrophysics Data System (ADS)

Hebert, Jonathan R.

A best practice in the discipline of project management is to identify all key project stakeholders prior to the execution of a project. When stakeholders are properly identified, they can be consulted to provide expert advice on project activities so that the project manager can ensure the project stays within the budget and schedule constraints. The problem addressed by this study is that managers fail to properly identify key project stakeholders when using stakeholder theory because there are multiple conflicting definitions for the term stakeholder. Poor stakeholder identification has been linked to multiple negative project outcomes such as budget and schedules overruns, and this problem is heightened in certain industries such as aerospace. The purpose of this qualitative study was to explore project managers' and project stakeholders' perceptions of how they define and use the term stakeholder within the aerospace industry. This qualitative exploratory single-case study had two embedded units of analysis: project managers and project stakeholders. Six aerospace project managers and five aerospace project stakeholders were purposively selected for this study. Data were collected through individual semi-structured interviews with both project managers and project stakeholders. All data were analyzed using Yin's (2011) five-phased cycle approach for qualitative research. The results indicated that the aerospace project managers and project stakeholder define the term stakeholder as "those who do the work of a company." The participants build upon this well-known concept by adding that, "a company should list specific job titles" that correspond to their company specific-stakeholder definition. Results also indicated that the definition of the term stakeholder is used when management is assigning human resources to a project to mitigate or control project risk. Results showed that project managers tended to include the customer in their stakeholder definitions while project stakeholders included a wider range of stakeholders from young employees to union workers. Practical application recommendations, based on the study's findings, include that companies start to develop company-specific definitions of the term stakeholder. Recommendations for future research should focus on exploring how CEOs, executive members, new hires, and hourly workers define and use the term stakeholder in the aerospace industry.

The Process and Impact of Stakeholder Engagement in Developing a Pediatric Intensive Care Unit Communication and Decision-Making Intervention.

PubMed

Michelson, Kelly N; Frader, Joel; Sorce, Lauren; Clayman, Marla L; Persell, Stephen D; Fragen, Patricia; Ciolino, Jody D; Campbell, Laura C; Arenson, Melanie; Aniciete, Danica Y; Brown, Melanie L; Ali, Farah N; White, Douglas

2016-12-01

Stakeholder-developed interventions are needed to support pediatric intensive care unit (PICU) communication and decision-making. Few publications delineate methods and outcomes of stakeholder engagement in research. We describe the process and impact of stakeholder engagement on developing a PICU communication and decision-making support intervention. We also describe the resultant intervention. Stakeholders included parents of PICU patients, healthcare team members (HTMs), and research experts. Through a year-long iterative process, we involved 96 stakeholders in 25 meetings and 26 focus groups or interviews. Stakeholders adapted an adult navigator model by identifying core intervention elements and then determining how to operationalize those core elements in pediatrics. The stakeholder input led to PICU-specific refinements, such as supporting transitions after PICU discharge and including ancillary tools. The resultant intervention includes navigator involvement with parents and HTMs and navigator-guided use of ancillary tools. Subsequent research will test the feasibility and efficacy of our intervention.

Perspectives of Patients, Clinicians, and Health System Leaders on Changes Needed to Improve the Health Care and Outcomes of Older Adults With Multiple Chronic Conditions.

PubMed

Ferris, Rosie; Blaum, Caroline; Kiwak, Eliza; Austin, Janet; Esterson, Jessica; Harkless, Gene; Oftedahl, Gary; Parchman, Michael; Van Ness, Peter H; Tinetti, Mary E

2018-06-01

To ascertain perspectives of multiple stakeholders on contributors to inappropriate care for older adults with multiple chronic conditions. Perspectives of 36 purposively sampled patients, clinicians, health systems, and payers were elicited. Data analysis followed a constant comparative method. Structural factors triggering burden and fragmentation include disease-based quality metrics and need to interact with multiple clinicians. The key cultural barrier identified is the assumption that "physicians know best." Inappropriate decision making may result from inattention to trade-offs and adherence to multiple disease guidelines. Stakeholders recommended changes in culture, structure, and decision making. Care options and quality metrics should reflect a focus on patients' priorities. Clinician-patient partnerships should reflect patients knowing their health goals and clinicians knowing how to achieve them. Access to specialty expertise should not require visits. Stakeholders' recommendations suggest health care redesigns that incorporate patients' health priorities into care decisions and realign relationships across patients and clinicians.

Developing objectives with multiple stakeholders: adaptive management of horseshoe crabs and Red Knots in the Delaware Bay

USGS Publications Warehouse

McGowan, Conor P.; Lyons, James E.; Smith, David

2015-01-01

Structured decision making (SDM) is an increasingly utilized approach and set of tools for addressing complex decisions in environmental management. SDM is a value-focused thinking approach that places paramount importance on first establishing clear management objectives that reflect core values of stakeholders. To be useful for management, objectives must be transparently stated in unambiguous and measurable terms. We used these concepts to develop consensus objectives for the multiple stakeholders of horseshoe crab harvest in Delaware Bay. Participating stakeholders first agreed on a qualitative statement of fundamental objectives, and then worked to convert those objectives to specific and measurable quantities, so that management decisions could be assessed. We used a constraint-based approach where the conservation objectives for Red Knots, a species of migratory shorebird that relies on horseshoe crab eggs as a food resource during migration, constrained the utility of crab harvest. Developing utility functions to effectively reflect the management objectives allowed us to incorporate stakeholder risk aversion even though different stakeholder groups were averse to different or competing risks. While measurable objectives and quantitative utility functions seem scientific, developing these objectives was fundamentally driven by the values of the participating stakeholders.

Developing Objectives with Multiple Stakeholders: Adaptive Management of Horseshoe Crabs and Red Knots in the Delaware Bay

NASA Astrophysics Data System (ADS)

McGowan, Conor P.; Lyons, James E.; Smith, David R.

2015-04-01

Structured decision making (SDM) is an increasingly utilized approach and set of tools for addressing complex decisions in environmental management. SDM is a value-focused thinking approach that places paramount importance on first establishing clear management objectives that reflect core values of stakeholders. To be useful for management, objectives must be transparently stated in unambiguous and measurable terms. We used these concepts to develop consensus objectives for the multiple stakeholders of horseshoe crab harvest in Delaware Bay. Participating stakeholders first agreed on a qualitative statement of fundamental objectives, and then worked to convert those objectives to specific and measurable quantities, so that management decisions could be assessed. We used a constraint-based approach where the conservation objectives for Red Knots, a species of migratory shorebird that relies on horseshoe crab eggs as a food resource during migration, constrained the utility of crab harvest. Developing utility functions to effectively reflect the management objectives allowed us to incorporate stakeholder risk aversion even though different stakeholder groups were averse to different or competing risks. While measurable objectives and quantitative utility functions seem scientific, developing these objectives was fundamentally driven by the values of the participating stakeholders.

Stakeholder perceptions of Environmental Management Plans as an environmental protection tool for major developments in the UK

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bennett, Sophie; Kemp, Simon; Hudson, Malcolm D., E-mail: mdh@soton.ac.uk

Insufficient implementation and the lack of legislative requirements for follow-up measures following the approval of projects are consistently highlighted as major shortcomings of Environmental Impact Assessment (EIA). Although adopted over 15 years ago by the World Bank, Environmental Management Plans (EMPs) were only semi-formalised in the UK in 2008 and arguably provide a continuous link or ‘bridge’ between the EIA process pre-consent and an Environmental Management System (EMS) post-consent. Drawing on twenty-one semi-structured interviews with stakeholders and thematic analysis of their responses, and a broad-scale practitioner survey, this study aimed to assess the effectiveness of EMPs as an environmental protectionmore » tool across the project lifecycle for major developments. The findings revealed a mixed picture of EMP effectiveness in practice, with EMPs only partially fulfilling a bridging role between EIA and EMS. There is no ‘gold standard’ terminology for EMPs, all having slightly different uses, thus presenting different focuses to different stakeholders and further enhancing variation in practice. For many stakeholders, the effectiveness was simply not known, due to the lack of communication and follow-up that still exists. EMP–EMS linkages were shown to be effective from the developer's perspective when a single organisation has involvement across all project phases, though weaknesses occur when multiple parties are involved. Among other stakeholders, knowledge varied significantly; whilst some were in agreement that the linkages worked, many were unaware of the connections and thought of them as two quite separate tools. Stakeholders advocated for the need to make EMPs a legal requirement; for improved communication between stakeholders during EMP implementation and increased documentation of project outcomes; and for EMPs to be consistently written by environmental professionals. Furthermore, weak links in the current process may be improved by providing detailed guidance for organisations on the potential for EMP–EMS linkages, with the additional aim of encouraging stakeholders to broaden their current specialist knowledge on environmental protection tools. - Highlights: • We assessed the effectiveness of Environmental Management Plans (EMPs) for major developments, focusing on delivery of mitigation and monitoring. • EIA and Environmental Management Systems (EMS) post-consent are weakly linked. • The use of EMPs varies significantly in practise, partly due to the range of terminology used. • Linkages are hampered by poor communication and follow-up • More detailed guidance on how EMPs can successfully link with EMS is required.« less

Unravelling networks in local public health policymaking in three European countries - a systems analysis.

PubMed

Spitters, Hilde P E M; Lau, Cathrine J; Sandu, Petru; Quanjel, Marcel; Dulf, Diana; Glümer, Charlotte; van Oers, Hans A M; van de Goor, Ien A M

2017-02-03

Facilitating and enhancing interaction between stakeholders involved in the policymaking process to stimulate collaboration and use of evidence, is important to foster the development of effective Health Enhancing Physical Activity (HEPA) policies. Performing an analysis of real-world policymaking processes will help reveal the complexity of a network of stakeholders. Therefore, the main objectives were to unravel the stakeholder network in the policy process by conducting three systems analyses, and to increase insight into the similarities and differences in the policy processes of these European country cases. A systems analysis of the local HEPA policymaking process was performed in three European countries involved in the 'REsearch into POlicy to enhance Physical Activity' (REPOPA) project, resulting in three schematic models showing the main stakeholders and their relationships. The models were used to compare the systems, focusing on implications with respect to collaboration and use of evidence in local HEPA policymaking. Policy documents and relevant webpages were examined and main stakeholders were interviewed. The systems analysis in each country identified the main stakeholders involved and their position and relations in the policymaking process. The Netherlands and Denmark were the most similar and both differed most from Romania, especially at the level of accountability of the local public authorities for local HEPA policymaking. The categories of driving forces underlying the relations between stakeholders were formal relations, informal interaction and knowledge exchange. A systems analysis providing detailed descriptions of positions and relations in the stakeholder network in local level HEPA policymaking is rather unique in this area. The analyses are useful when a need arises for increased interaction, collaboration and use of knowledge between stakeholders in the local HEPA network, as they provide an overview of the stakeholders involved and their mutual relations. This information can be an important starting point to enhance the uptake of evidence and build more effective public health policies.

Doctors on the move: a European case study on the key characteristics of national recertification systems

PubMed Central

Govaerts, Marjan J; Mitchell, Sharon; Rohde, Gernot G U; Smeenk, Frank W J M; Driessen, Erik W

2018-01-01

Objectives With increased cross-border movement, ensuring safe and high-quality healthcare has gained primacy. The purpose of recertification is to ensure quality of care through periodically attesting doctors’ professional proficiency in their field. Professional migration and facilitated cross-border recognition of qualifications, however, make us question the fitness of national policies for safeguarding patient care and the international accountability of doctors. Design and setting We performed document analyses and conducted 19 semistructured interviews to identify and describe key characteristics and effective components of 10 different European recertification systems, each representing one case (collective case study). We subsequently compared these systems to explore similarities and differences in terms of assessment criteria used to determine process quality. Results Great variety existed between countries in terms and assessment formats used, targeting cognition, competence and performance (Miller’s assessment pyramid). Recertification procedures and requirements also varied significantly, ranging from voluntary participation in professional development modules to the mandatory collection of multiple performance data in a competency-based portfolio. Knowledge assessment was fundamental to recertification in most countries. Another difference concerned the stakeholders involved in the recertification process: while some systems exclusively relied on doctors’ self-assessment, others involved multiple stakeholders but rarely included patients in assessment of doctors’ professional competence. Differences between systems partly reflected different goals and primary purposes of recertification. Conclusion Recertification systems differ substantially internationally with regard to the criteria they apply to assess doctors’ competence, their aims, requirements, assessment formats and patient involvement. In the light of professional mobility and associated demands for accountability, we recommend that competence assessment includes patients’ perspectives, and recertification practices be shared internationally to enhance transparency. This can help facilitate cross-border movement, while guaranteeing high-quality patient care. PMID:29666131

Balancing Competing Rights: A Stakeholder Model for Democratic Schools

ERIC Educational Resources Information Center

Shariff, Shaheen

2006-01-01

In this article, I discuss a Canadian public school controversy and Supreme Court of Canada decision involving competing stakeholder rights to freedom of religion, safety and equality. Policy considerations that allowed one group of stakeholders to express their constitutional rights raised concerns among other stakeholders. A policy vacuum and a…

Creating Shared Mental Models: The Support of Visual Language

NASA Astrophysics Data System (ADS)

Landman, Renske B.; van den Broek, Egon L.; Gieskes, José F. B.

Cooperative design involves multiple stakeholders that often hold different ideas of the problem, the ways to solve it, and to its solutions (i.e., mental models; MM). These differences can result in miscommunication, misunderstanding, slower decision making processes, and less chance on cooperative decisions. In order to facilitate the creation of a shared mental model (sMM), visual languages (VL) are often used. However, little scientific foundation is behind this choice. To determine whether or not this gut feeling is justified, a research was conducted in which various stakeholders had to cooperatively redesign a process chain, with and without VL. To determine whether or not a sMM was created, scores on agreement in individual MM, communication, and cooperation were analyzed. The results confirmed the assumption that VL can indeed play an important role in the creation of sMM and, hence, can aid the processes of cooperative design and engineering.

Infection of the Invisible: Impressions of a Tuberculosis Intervention Program for Migrants in Istanbul.

PubMed

Yasin, Yesim; Biehl, Kristen; Erol, Maral

2015-10-01

This paper reviews the experience of the Istanbul Tuberculosis Aid Program, which targeted tuberculosis (TB) disease in the growing irregular migrant populations of Istanbul. This experience illustrated the importance of community-based public health interventions when dealing with an infectious disease like TB among vulnerable groups. Our data is derived primarily from a qualitative study carried out with program stakeholders. We summarize lessons for success of ITAP as: (1) Strengthening impact and outreach of TB intervention among irregular migrant communities through involvement of multiple stakeholders (2) Increasing TB awareness through a community targeted approach (3) Increasing TB contact tracing and treatment success among infected irregular migrants, and, (4) Improving overall health seeking behavior of irregular migrants through empowerment and trust. Given these particularities we list our policy suggestions for revision of regulations regarding TB control and healthcare needs of irregular migrant populations.

Innovation management based on proactive engagement of customers: A case study on LEGO Group. Part II: Challenge of engaging the digital customer

NASA Astrophysics Data System (ADS)

Avasilcăi, S.; Rusu, G.

2015-11-01

To foster the development of innovative products and new technologies, nowadays companies use an open innovation system, encouraging stakeholders to contribute, using the companies’ online platforms for open innovation or social media, bringing and sharing creative solutions and ideas in order to respond to challenging needs the company directly expresses. Accordingly, the current research continues the analysis of the LEGO Group innovation efforts, aiming to provide a case study approach based on describing the most important projects and online instruments company uses to interact with customers and other external stakeholders. Thus, by analysing the experience of the company in developing projects of involving stakeholders in the innovation processes, the article emphasizes the objective of these past projects developed by LEGO Group, outlining their objectives regarding the focus on the product or process innovation, the team management and stakeholders involved in the innovation actions and the results they obtained. Moreover, the case study highlights the features of the most important online instruments LEGO Group uses at the moment for engaging LEGO fans, children, parents, and other external stakeholders in developing new LEGO sets. Thus, LEGO online instruments provide the opportunity for customers to be creative and to respond to LEGO management team challenges. Accordingly, LEGO involve customers in bringing innovative ideas for LEGO sets through LEGO Ideas instrument, which aims to engage customers in submitting projects, voting and supporting ideas and also sharing them on social media. Also, the research emphasizes the role of supporting the open dialogue and interaction with customers and other external stakeholders through LEGO.com Create & Share Galleries instrument, using their creativity to upload innovative models in the public galleries. The continuous challenges LEGO launches for their fans create a long-term connection between company and its customers, supporting the value co-creation process, as the submitted ideas can materialize in new LEGO products which can be found on the market. As a consequence, customers’ engagement in the co-creation process facilitated by the multiple online instruments provided by LEGO, resulted in positive outcomes for the company regarding new product development for the sets launched on the market to satisfy changing needs of their customers. The results provided by this case study approach can be useful for the business environment and academia as well in order to understand the role of engaging customers in the open innovation process, creating a competitive advantage on the market for companies.

When Stakeholders Rebel: Lessons from a Safe Schools Program

ERIC Educational Resources Information Center

Gastic, Billie; Irby, Decoteau J.; Zdanis, Maureen

2008-01-01

In this essay, we describe our experiences working with a rebellious primary stakeholder, Sylvia, as evaluators of a district-wide safe schools program. Given the breadth of the program and its multiple target constituencies, we were confronted with the challenges of managing a large number of stakeholders, or those individuals and groups that…

Stakeholder-Focused Evaluation of an Online Course for Health Care Providers

ERIC Educational Resources Information Center

Dunet, Diane O.; Reyes, Michele

2006-01-01

Introduction: Different people who have a stake or interest in a training course (stakeholders) may have markedly different definitions of what constitutes "training success" and how they will use evaluation results. Methods: Stakeholders at multiple levels within and outside of the organization guided the development of an evaluation plan for a…

Dementia-friendly communities: challenges and strategies for achieving stakeholder involvement.

PubMed

Heward, Michelle; Innes, Anthea; Cutler, Clare; Hambidge, Sarah

2017-05-01

Dementia-friendly communities (DFCs) are a UK policy initiative that aims to enable people with dementia to feel supported and included within their local community. Current approaches to DFC creation rely on stakeholder involvement, often requiring volunteer assistance. There is though a lack of evidence that examines the reality of achieving this. This paper critically assesses the challenges and strategies for achieving stakeholder involvement in DFCs. The evidence base is drawn from an inter-agency project funded by the National Health Service in the South of England where seven DFCs were developed by steering group partners and four part-time project workers (PWs). Data from the independent evaluation undertaken in the first year (2013-2014) of the project were analysed: 14 semi-structured interviews and a focus group examined PWs' experiences; while progress and key milestones are determined from monthly progress forms, good news stories, locality steering group minutes and press releases. Analysis was undertaken using a directed content analysis method, whereby data content for each locality was matched to the analytical framework that was drawn from Alzheimer's Society guidance. Challenges to achieving stakeholder involvement were identified as: establishing networks and including people representative of the local community; involving people affected by dementia; and gaining commitment from organisations. Strategies for achieving stakeholder involvement were recognised as: a sustainable approach; spreading the word; and sharing of ideas. By highlighting these challenges and the approaches that have been used within communities to overcome them, these findings form the foundation for the creation of DFC initiatives that will become embedded within communities. Stakeholder involvement is unpredictable and changeable; therefore, reliance on this approach questions the long-term sustainability of DFCs, and must be considered in future policies designed to enhance quality of life for people affected by dementia. © 2016 John Wiley & Sons Ltd.

Prospects for Enabling Middle School Student Success: Families as Stakeholders

ERIC Educational Resources Information Center

Saddler, Patricia

2016-01-01

Educators, government officials, and other stakeholders of schools have an interest in whether family involvement affects the academic achievement of students. While some research has shown that children whose parents are involved in their education from early childhood perform academically better than do children whose parents are less involved,…

COMPREHENSIVE ASSESSMENT OF COMPLEX TECHNOLOGIES: INTEGRATING VARIOUS ASPECTS IN HEALTH TECHNOLOGY ASSESSMENT.

PubMed

Lysdahl, Kristin Bakke; Mozygemba, Kati; Burns, Jacob; Brönneke, Jan Benedikt; Chilcott, James B; Ward, Sue; Hofmann, Bjørn

2017-01-01

Despite recent development of health technology assessment (HTA) methods, there are still methodological gaps for the assessment of complex health technologies. The INTEGRATE-HTA guidance for effectiveness, economic, ethical, socio-cultural, and legal aspects, deals with challenges when assessing complex technologies, such as heterogeneous study designs, multiple stakeholder perspectives, and unpredictable outcomes. The objective of this article is to outline this guidance and describe the added value of integrating these assessment aspects. Different methods were used to develop the various parts of the guidance, but all draw on existing, published knowledge and were supported by stakeholder involvement. The guidance was modified after application in a case study and in response to feedback from internal and external reviewers. The guidance consists of five parts, addressing five core aspects of HTA, all presenting stepwise approaches based on the assessment of complexity, context, and stakeholder involvement. The guidance on effectiveness, health economics and ethics aspects focus on helping users choose appropriate, or further develop, existing methods. The recommendations are based on existing methods' applicability for dealing with problems arising with complex interventions. The guidance offers new frameworks to identify socio-cultural and legal issues, along with overviews of relevant methods and sources. The INTEGRATE-HTA guidance outlines a wide range of methods and facilitates appropriate choices among them. The guidance enables understanding of how complexity matters for HTA and brings together assessments from disciplines, such as epidemiology, economics, ethics, law, and social theory. This indicates relevance for a broad range of technologies.

Investigating the role of Clinical Nurse Consultants in one health district from multiple stakeholder perspectives: a cooperative inquiry.

PubMed

Walsh, Kenneth; Bothe, Janine; Edgar, Denise; Beaven, Geraldine; Burgess, Bernadette; Dickson, Vhari; Dunn, Stephen; Horning, Lynda; Jensen, Janice; Kandl, Bronia; Nonu, Miriam; Owen, Fran; Moss, Cheryle

2015-01-01

The impetus for this research came from a group of 11 Clinical Nurse Consultants (CNCs) within a health service in NSW, Australia, who wanted to investigate the CNC role from multiple stakeholder perspectives. With support from academic researchers, the CNCs designed and implemented the study. The aim of this research project was to investigate the role of the CNC from the multiple perspectives of CNCs and other stakeholders who work with CNCs in the Health District. This was a co-operative inquiry that utilised qualitative descriptive research approach. Co-operative inquiry methods enabled 11 CNCs to work as co-researchers and to conduct the investigation. The co-researchers implemented a qualitative descriptive design for the research and used interviews (7) and focus groups (16) with CNC stakeholders (n = 103) to gather sufficient data to investigate the role of the CNC in the organisation. Thematic analysis was undertaken to obtain the results. The CNC role is invaluable to all stakeholders and it was seen as the "glue" which holds teams together. Stakeholder expectations of the CNC role were multiple and generally agreed. Five themes derived from the data are reported as "clinical leadership as core", "making a direct difference to patient care", "service development as an outcome", "role breadth or narrowness and boundaries", and "career development". There was clear appreciation of the work that CNCs do in their roles, and the part that the CNC role plays in achieving quality health outcomes. The role of the CNC is complex and the CNCs themselves often negotiate these complexities to ensure beneficial outcomes for the patient and organisation. For the wider audience this study has given further insights into the role of these nurses and the perspectives of those with whom they work.

STAKEHOLDER INVOLVEMENT IN THE HEALTH TECHNOLOGY ASSESSMENT PROCESS IN LATIN AMERICA.

PubMed

Pichon-Riviere, Andres; Soto, Natalie; Augustovski, Federico; Sampietro-Colom, Laura

2018-06-11

Latin American countries are taking important steps to expand and strengthen universal health coverage, and health technology assessment (HTA) has an increasingly prominent role in this process. Participation of all relevant stakeholders has become a priority in this effort. Key issues in this area were discussed during the 2017 Latin American Health Technology Assessment International (HTAi) Policy Forum. The Forum included forty-one participants from Latin American HTA agencies; public, social security, and private insurance sectors; and the pharmaceutical and medical device industry. A background paper and presentations by invited experts and Forum members supported discussions. This study presents a summary of these discussions. Stakeholder involvement in HTA remains inconsistently implemented in the region and few countries have established formal processes. Participants agreed that stakeholder involvement is key to improve the HTA process, but the form and timing of such improvements must be adapted to local contexts. The legitimization of both HTA and decision-making processes was identified as one of the main reasons to promote stakeholder involvement; but to be successful, the entire system of assessment and decision making must be properly staffed and organized, and certain basic conditions must be met, including transparency in the HTA process and a clear link between HTA and decision making. Participants suggested a need for establishing clear rules of participation in HTA that would protect HTA producers and decision makers from potentially distorting external influences. Such rules and mechanisms could help foster trust and credibility among stakeholders, supporting actual involvement in HTA processes.

Does Joint Fact-finding work for Water-energy-food Nexus Issues? A Role of Scientific Evidence in Policy Process

NASA Astrophysics Data System (ADS)

Baba, K.

2014-12-01

A quite famous phrase in risk management "How safe is enough safe?" implies there exists a framing gap among experts, the general public and stakeholders. Scientific evidence that experts provide usually contains uncertainty, while the public tends to have the other type of qualitative local knowledge. As there is no zero-risk society, we have to build consensus on acceptable level of risk and trade-offs of risks based on expert knowledge and local knowledge. Therefore having a dialogue among them in the early stage of the policy process such as problem definition and agenda setting is essential to cultivate trust and to integrate their knowledge. To this end, we especially pay attention to Joint Fact-finding (JFF). The tentative definition of JFF is that a promising strategy for experts, decision makers, and key public rights-holders and stakeholders from opposing sides of an issue to work together to resolve or narrow factual disputes over public policy issues. JFF process usually begins with identifying stakeholders and holding interviews with them to determine their interests. We call this step stakeholder analysis. Then we define the scope of the study including the required scientific evidence and the preliminary list of experts. After that, stakeholders jointly select experts to participate in the study, then they work together on what they would like to clear about scientific evidence. They finally get the common understanding and findings through these collaboration. We applied the stakeholder analysis to the issue of groundwater in Obama City and the issues of hot spring water and geothermal power in Beppu City in Japan. We drew conclusions from these case studies to some extent but at the same time we found that the analysis method has a limitation in applying it to multiple nexus issues because the method based on stakeholders' cognition. For example, in Obama case, we identified a lack of cooperation among stakeholders that especially agricultural sector who should have positive relationship with groundwater in nature is not involved in groundwater issue thoroughly. However, we could not enough furnish stakeholders with the framing of trade-offs between resources. Accordingly we need to raise awareness of stakeholders with scientific evidence of experts on the way of the stakeholder analysis.

Work Disability Prevention: A Primer for Occupational Therapists.

PubMed

McDougall, Alicia; Nowrouzi-Kia, Behdin

An estimated 313 million workplace accidents resulting in injury occur worldwide every year. Therefore, the burden of workplace injury and disability is present at the individual and the societal level and involves several stakeholders. There has been a shift in paradigm from workplace disability and injury treatment to workplace disability prevention. Occupational therapy practitioners are well positioned to address this multifaceted societal issue. Opening communication lines among stakeholders allows for a more holistic, collaborative, and comprehensive approach to disability, injury, and pain management. The positive results researchers have found at the individual level when using a holistic approach translate to benefits for all of the stakeholders involved. Occupational therapy practitioners may espouse a work disability prevention approach to reduce work disability rates and provide timely return-to-work outcomes for clients. The transition to the preventative model requires collaboration among stakeholders but would be beneficial to all stakeholders involved in the workplace. Copyright © 2017 by the American Occupational Therapy Association, Inc.

Building Adaptive Capacity of Pathways in Technology Early College High School Stakeholders: A Multiple-Case Study on the Influence of Performance, Leadership, and Organizational Learning

ERIC Educational Resources Information Center

Michaud-Wells, Amy

2016-01-01

The purpose of this qualitative study was to explore the perceptions and beliefs of Pathways in Technology Early College High School (P-TECH) leaders and stakeholders regarding the personal and professional experiences that contributed to the development of adaptive capacity. This embedded multiple-case study was anchored by the interrelated…

Education Leaders' Decision-Making Processes about Educational Facilities in a University Multiple Stakeholder Environment

ERIC Educational Resources Information Center

Kelting, Scott

2011-01-01

This research is a retrospective case study designed to document and analyze the process of decision-making by educational leaders and stakeholders at a four-year university. For this study, educational leaders and key stakeholders agreed to extensive interviews about the decisions made during the design, construction, and post-occupancy phases of…

Conversation on Saving Historical Communities: A Participatory Renewal and Preservation Platform

NASA Astrophysics Data System (ADS)

Zhang, Xu

2017-10-01

What if stakeholders, architects, and developers/bureaucrats could be in a conversation about preservation? By comparing two preservation case studies in Hong Kong and mainland China, and their different results, based on the different levels of democratic involvement and collaboration, the problems of preserving community heritage in mainland China are obvious: lack of authority, financial support, knowledge of preservation, and requests for development. Residents, students, and citizens want to preserve the history and living environment of the community, but bureaucrats want to demolish entire communities and rebuild for economic development. Architects do not often have enough input and rarely collaborate with each other, while preservationists try to save every piece of historical heritage. Thus, a platform is proposed here, to bring together voices from all the relevant participants, to promote democratic communication between politicians and ordinary people, to create multiple architectural proposals for development reference based on crowdsourced materials. Furthermore, to establish an experienceable digital world, archived from the evidence uploaded by stakeholders of heritages marked by bureaucrats for demolition. In the end, win or lose, the stakeholders will have a digital archive and exploring tool of the (former) building.

Innovation in cardiovascular disease in Europe with focus on arrhythmias: current status, opportunities, roadblocks, and the role of multiple stakeholders.

PubMed

Prinzen, Frits W; Dagres, Nikolaos; Bollmann, Andreas; Arnar, David O; Bove, Sylvie; Camm, John; Casadei, Barbara; Kirchhof, Paulus; Kuck, Karl-Heinz; Lumens, Joost; Michel, Martin C; Schwartz, Peter J; Van Vleymen, Betty; Vardas, Panos; Hindricks, Gerhard

2018-05-01

The European Heart Rhythm Association (EHRA) held an Innovation Forum in February 2016, to consider issues around innovation. The objective of the forum was to extend the innovation debate outside of the narrow world of arrhythmia specialists and cardiology in general, and seek input from all stakeholders including regulators, strategists, technologists, industry, academia, health providers, medical societies, payers, and patients. Innovation is indispensable for a continuing improvement in health care, preferably at higher efficacy and lower costs. It requires people who have been trained in a good scientific environment, high-quality research for achieving ground breaking inventions and the certainty of return on innovation investments. In the context of cardiovascular disease, innovation can imply better risk assessment and stratification, device technology, drug development, and process design. Several areas of promising developments were identified as well as several roadblocks to innovation. To drive innovation forward all stakeholders need to play a significant role. In a globalized and extremely competitive world, the leading role of Europe in medical innovation can only be achieved through a combined and well-coordinated effort from all involved parties.

Potential scenarios for broadening stakeholder involvement in the implementing geological disposal technology platform

DOE Office of Scientific and Technical Information (OSTI.GOV)

Martell, Meritxell; Bergmans, Anne

This paper analyses the potential for the involvement of different types of stakeholders in the Implementing Geological Disposal Technology Platform (IGD-TP). This analysis was conducted as part of the InSOTEC project, a three-year (2011- 2014) collaborative research project funded under the 7. Euratom Framework Programme (Grant Agreement nr. 269906). In our analysis, we consider the extent to which the IGDTP's practice as regards to stakeholder involvement matches its discourse, and what potential for improvement exists given its structural organisation as a European Technology Platform (ETPs). Technology Platforms (TPs) can be understood as knowledge networks, deliberately set up to influence (research)more » policy in a specific domain. We therefore use knowledge networks as a conceptual approach and look at the IGD-TP as a complex network which includes actors, knowledge and practices across different countries, focusing on a very specific topic (i.e. implementing geological disposal). We compare the way different stakeholders are involved in the IGD-TP to the practice of other ETPs, and explore how the IGD-TP is viewed by its members and by outsiders to the platform Applying Callon's framework of knowledge co-production (1999) we come to define different degrees of interaction between science, society and policy in view of defining research and development (R and D) priorities [1]. Subsequently we describe how these interactions could be conceptualised and interpreted for the IGD-TP. The current approach of the IGDTP can be mainly understood as classical model involving mainly expert stakeholders and scientists. Where there seems to be a good representation among IGD-TP members of industry, research institutes, and some members of the academic community this is not the case for other types of stakeholders, such as public authorities or civil society. At this stage, the overall approach of the IGD-TP would seem to restrict the scope of stakeholder involvement, as it narrows participation down to uniquely technology experts, hindering socio-technical manifestations. Our analysis nevertheless shows that there is room for engaging with a broader range of stakeholders in the field of radioactive waste management, if this is the intention of the IGD-TP. However, this would require a commitment to developing a common knowledge base including other stakeholders through a process of mutual adjustment and negotiation. (authors)« less

Perspectives on Research Participation and Facilitation Among Dialysis Patients, Clinic Personnel, and Medical Providers: A Focus Group Study.

PubMed

Flythe, Jennifer E; Narendra, Julia H; Dorough, Adeline; Oberlander, Jonathan; Ordish, Antoinette; Wilkie, Caroline; Dember, Laura M

2017-12-19

Most prospective studies involving individuals receiving maintenance dialysis have been small, and many have had poor clinical translatability. Research relevance can be enhanced through stakeholder engagement. However, little is known about dialysis clinic stakeholders' perceptions of research participation and facilitation. The objective of this study was to characterize the perspectives of dialysis clinic stakeholders (patients, clinic personnel, and medical providers) on: (1) research participation by patients and (2) research facilitation by clinic personnel and medical providers. We also sought to elucidate stakeholder preferences for research communication. Qualitative study. 7 focus groups (59 participants: 8 clinic managers, 14 nurses/patient care technicians, 8 social workers/dietitians, 11 nephrologists/advanced practice providers, and 18 patients/care partners) from 7 North Carolina dialysis clinics. Clinics and participants were purposively sampled. Focus groups were recorded and transcribed. Thematic analysis. We identified 11 themes that captured barriers to and facilitators of research participation by patients and research facilitation by clinic personnel and medical providers. We collapsed these themes into 4 categories to create an organizational framework for considering stakeholder (narrow research understanding, competing personal priorities, and low patient literacy and education levels), relationship (trust, buy-in, and altruistic motivations), research design (convenience, follow-up, and patient incentives), and dialysis clinic (professional demands, teamwork, and communication) aspects that may affect stakeholder interest in participating in or facilitating research. These themes appear to shape the degree of research readiness of a dialysis clinic environment. Participants preferred short research communications delivered in multiple formats. Potential selection bias and inclusion of English-speaking participants only. Our findings revealed patient interest in participating in research and clinical personnel and medical provider interest in facilitating research. Overall, our results suggest that dialysis clinic research readiness may be enhanced through increased stakeholder research knowledge and alignment of clinical and research activities. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Acadia National Park ITS field operational test : key informant interviews

DOT National Transportation Integrated Search

2003-03-01

This document reflects the ideas and opinions of a group of key informants and stakeholders involved in the Field Operational Test of ITS components in and around Acadia National Park from 1999 through 2002. The stakeholders were involved in the plan...

A Holistic Theoretical Approach to Intellectual Disability: Going Beyond the Four Current Perspectives.

PubMed

Schalock, Robert L; Luckasson, Ruth; Tassé, Marc J; Verdugo, Miguel Angel

2018-04-01

This article describes a holistic theoretical framework that can be used to explain intellectual disability (ID) and organize relevant information into a usable roadmap to guide understanding and application. Developing the framework involved analyzing the four current perspectives on ID and synthesizing this information into a holistic theoretical framework. Practices consistent with the framework are described, and examples are provided of how multiple stakeholders can apply the framework. The article concludes with a discussion of the advantages and implications of a holistic theoretical approach to ID.

International benchmarking of specialty hospitals. A series of case studies on comprehensive cancer centres.

PubMed

van Lent, Wineke A M; de Beer, Relinde D; van Harten, Wim H

2010-08-31

Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the benchmarking process and the success factors of benchmarking in international specialized cancer centres. Three independent international benchmarking studies on operations management in cancer centres were conducted. The first study included three comprehensive cancer centres (CCC), three chemotherapy day units (CDU) were involved in the second study and four radiotherapy departments were included in the final study. Per multiple case study a research protocol was used to structure the benchmarking process. After reviewing the multiple case studies, the resulting description was used to study the research objectives. We adapted and evaluated existing benchmarking processes through formalizing stakeholder involvement and verifying the comparability of the partners. We also devised a framework to structure the indicators to produce a coherent indicator set and better improvement suggestions. Evaluating the feasibility of benchmarking as a tool to improve hospital processes led to mixed results. Case study 1 resulted in general recommendations for the organizations involved. In case study 2, the combination of benchmarking and lean management led in one CDU to a 24% increase in bed utilization and a 12% increase in productivity. Three radiotherapy departments of case study 3, were considering implementing the recommendations.Additionally, success factors, such as a well-defined and small project scope, partner selection based on clear criteria, stakeholder involvement, simple and well-structured indicators, analysis of both the process and its results and, adapt the identified better working methods to the own setting, were found. The improved benchmarking process and the success factors can produce relevant input to improve the operations management of specialty hospitals.

International benchmarking of specialty hospitals. A series of case studies on comprehensive cancer centres

PubMed Central

2010-01-01

Background Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the benchmarking process and the success factors of benchmarking in international specialized cancer centres. Methods Three independent international benchmarking studies on operations management in cancer centres were conducted. The first study included three comprehensive cancer centres (CCC), three chemotherapy day units (CDU) were involved in the second study and four radiotherapy departments were included in the final study. Per multiple case study a research protocol was used to structure the benchmarking process. After reviewing the multiple case studies, the resulting description was used to study the research objectives. Results We adapted and evaluated existing benchmarking processes through formalizing stakeholder involvement and verifying the comparability of the partners. We also devised a framework to structure the indicators to produce a coherent indicator set and better improvement suggestions. Evaluating the feasibility of benchmarking as a tool to improve hospital processes led to mixed results. Case study 1 resulted in general recommendations for the organizations involved. In case study 2, the combination of benchmarking and lean management led in one CDU to a 24% increase in bed utilization and a 12% increase in productivity. Three radiotherapy departments of case study 3, were considering implementing the recommendations. Additionally, success factors, such as a well-defined and small project scope, partner selection based on clear criteria, stakeholder involvement, simple and well-structured indicators, analysis of both the process and its results and, adapt the identified better working methods to the own setting, were found. Conclusions The improved benchmarking process and the success factors can produce relevant input to improve the operations management of specialty hospitals. PMID:20807408

An analysis of stakeholder views on children's mental health services.

PubMed

Rodríguez, Adriana; Southam-Gerow, Michael A; O'Connor, Mary Katherine; Allin, Robert B

2014-01-01

The purpose was to examine the perspectives of mental health stakeholders as a means to guide the adaptation of evidence-based treatments. The Mental Health System Ecological (MHSE) model was used to organize therapist, administrator, and parent perspectives gathered using qualitative methods. The MHSE model posits the influences of client-level, provider-level, intervention-specific, service delivery, organizational, and service system characteristics on implementation. Focus groups and interviews were conducted with community mental health stakeholders and included parents, therapists, and administrators (N = 21). Participants included 11 primarily Caucasian (90.48%) female participants, ranging in ages between 31 and 57 years. Data were analyzed according to the MHSE model. Frequency counts were tabulated for each theme and stakeholder group differences were determined using the Mann-Whitney test. Stakeholder groups mentioned needs at each level of the MHSE model. Stakeholder group differences most notably emerged with child and family themes, which included complexity of mental health issues, parenting differences, and family stressors. Stakeholders identified challenges for optimal mental health services for children across multiple levels of an ecological model. Implications of the findings are discussed, including the continued relevance of adapting mental health interventions by increasing their flexible application across multiple target problems and the promise of partnership approaches.

Multi-stakeholder perspectives in defining health-services quality in cataract care.

PubMed

Stolk-Vos, Aline C; van de Klundert, Joris J; Maijers, Niels; Zijlmans, Bart L M; Busschbach, Jan J V

2017-08-01

To develop a method to define a multi-stakeholder perspective on health-service quality that enables the expression of differences in systematically identified stakeholders' perspectives, and to pilot the approach for cataract care. Mixed-method study between 2014 and 2015. Cataract care in the Netherlands. Stakeholder representatives. We first identified and classified stakeholders using stakeholder theory. Participants established a multi-stakeholder perspective on quality of cataract care using concept mapping, this yielded a cluster map based on multivariate statistical analyses. Consensus-based quality dimensions were subsequently defined in a plenary stakeholder session. Stakeholders and multi-stakeholder perspective on health-service quality. Our analysis identified seven definitive stakeholders, as follows: the Dutch Ophthalmology Society, ophthalmologists, general practitioners, optometrists, health insurers, hospitals and private clinics. Patients, as dependent stakeholders, were considered to lack power by other stakeholders; hence, they were not classified as definitive stakeholders. Overall, 18 stakeholders representing ophthalmologists, general practitioners, optometrists, health insurers, hospitals, private clinics, patients, patient federations and the Dutch Healthcare Institute sorted 125 systematically collected indicators into the seven following clusters: patient centeredness and accessibility, interpersonal conduct and expectations, experienced outcome, clinical outcome, process and structure, medical technical acting and safety. Importance scores from stakeholders directly involved in the cataract service delivery process correlated strongly, as did scores from stakeholders not directly involved in this process. Using a case study on cataract care, the proposed methods enable different views among stakeholders concerning quality dimensions to be systematically revealed, and the stakeholders jointly agreed on these dimensions. The methods helped to unify different quality definitions and facilitated operationalisation of quality measurement in a way that was accepted by relevant stakeholders. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Project Stakeholder Management in the Clinical Research Environment: How to Do it Right

PubMed Central

Pandi-Perumal, Seithikurippu R.; Akhter, Sohel; Zizi, Ferdinard; Jean-Louis, Girardin; Ramasubramanian, Chellamuthu; Edward Freeman, R.; Narasimhan, Meera

2015-01-01

This review introduces a conceptual framework for understanding stakeholder management (ShM) in the clinical and community-based research environment. In recent years, an evolution in practice has occurred in many applicants for public and non-governmental funding of public health research in hospital settings. Community health research projects are inherently complex, have sought to involve patients and other stakeholders in the center of the research process. Substantial evidence has now been provided that stakeholder involvement is essential for management effectiveness in clinical research. Feedback from stakeholders has critical value for research managers inasmuch as it alerts them to the social, environmental, and ethical implications of research activities. Additionally, those who are directly affected by program development and clinical research, the patients, their families, and others, almost universally have a strong motivation to be involved in the planning and execution of new program changes. The current overview introduces a conceptual framework for ShM in the clinical research environment and offers practical suggestions for fostering meaningful stakeholder engagement. The fifth edition of PMBOK® of the Project Management Institute, has served as basis for many of the suggested guidelines that are put forward in this article. PMID:26042053

Project Stakeholder Management in the Clinical Research Environment: How to Do it Right.

PubMed

Pandi-Perumal, Seithikurippu R; Akhter, Sohel; Zizi, Ferdinard; Jean-Louis, Girardin; Ramasubramanian, Chellamuthu; Edward Freeman, R; Narasimhan, Meera

2015-01-01

This review introduces a conceptual framework for understanding stakeholder management (ShM) in the clinical and community-based research environment. In recent years, an evolution in practice has occurred in many applicants for public and non-governmental funding of public health research in hospital settings. Community health research projects are inherently complex, have sought to involve patients and other stakeholders in the center of the research process. Substantial evidence has now been provided that stakeholder involvement is essential for management effectiveness in clinical research. Feedback from stakeholders has critical value for research managers inasmuch as it alerts them to the social, environmental, and ethical implications of research activities. Additionally, those who are directly affected by program development and clinical research, the patients, their families, and others, almost universally have a strong motivation to be involved in the planning and execution of new program changes. The current overview introduces a conceptual framework for ShM in the clinical research environment and offers practical suggestions for fostering meaningful stakeholder engagement. The fifth edition of PMBOK(®) of the Project Management Institute, has served as basis for many of the suggested guidelines that are put forward in this article.

Community-based school feeding during Indonesia's economic crisis: implementation, benefits, and sustainability.

PubMed

Studdert, Lisa J; Soekirman; Rasmussen, Kathleen M; Habicht, Jean-Pierre

2004-06-01

The Indonesian Government initiated a community-based national school-feeding program in 1996. Implementation was decentralized and involved multiple participants. In 1998 we evaluated the implementation of the program and the perceived benefits for community stakeholders using a survey of principals in 143 randomly selected schools and follow-up with in-depth interviews and observations in a subsample of 16 communities. The evaluation covered the period of the 1998 Asian economic crisis, affording the opportunity to assess its impact on the program. The program was implemented in all targeted schools, with excellent community participation. Feeding was sustained through the crisis, in spite of a dramatic escalation in food costs. The families of schoolchildren, farmers, and those who prepared food received economic benefits. The snacks replaced those sold at schools and were of better nutritional value. The children benefited because the snacks compensated for losses in the home diet resulting from the economic crisis. Characteristics of the program that may be important in explaining its success include the involvement of a range of community stakeholders, engagement with existing village administrative structures, scope for local community adaptation and innovation, and the use of local foods that dispersed benefits and ensured sustained implementation during the crisis.

Challenges in designing an All-Wales professional development programme to empower ward sisters and charge nurses.

PubMed

Jasper, Melanie A; Grundy, Lynne; Curry, Esther; Jones, Lynne

2010-09-01

To discuss the challenges of designing a professional development programme for ward managers working in in-patient facilities in Wales. In 2008, the Minister of Health launched the Free to Lead, Free to Care initiative to empower ward managers. One work-stream involved the creation of a universal professional development programme to ensure they had the skills and knowledge to function effectively in their roles in the newly restructured NHS in Wales. A collaborative, staged approach, involving multiple stakeholders, resulted in the design of a programme founded in principles of action and work-based learning tailored to the needs of the individual in attaining accredited competencies. Achieving buy-in and ownership from stakeholders are essential to ensure standardization and consistency of implementation of a universal programme. Shared responsibility and acceptance of key principles underpinning an individualized, work-based programme are fundamental to ensuring equity of outcome achievement. IMPLICATIONS FOR MANAGEMENT: Managerially facilitated cultural change is needed to embed individual work-based professional development programmes in the clinical environment, with practitioners supported through a variety of learning strategies appropriate to their learning needs. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

From Communicate to Educate - how a project structure and philosophy leads to engagement that influences organisational behaviours and decision making

NASA Astrophysics Data System (ADS)

Gaynor, Suzie; Corney, Stuart; Ling, Fiona; Bindoff, Nathan

2010-05-01

Climate Futures for Tasmania is an interdisciplinary and inter-institutional collaboration of twelve core participating partners (both national and state organisations) who are contributing more than 7.5 million in cash and in-kind over the three-year life of the project. The project is led by the Antarctic Climate and Ecosystems Cooperative Research Centre at the University of Tasmania, with significant contributions by CSIRO, Australia's national research organisation, Tasmania's major power generation company, Hydro Tasmania and the Tasmanian State government, through the Department of Primary Industries, Parks, Water and the Environment. The coordination, community interaction and management of the project are unique within the university environment. The project has required multiple levels of engagement to achieve end-user driven research that delivers highly practical and usable outcomes to stakeholders who are relatively new to climate change concepts. The project is generating new information on climate change in the 21st century for local communities in Tasmania, by dynamically downscaling global climate models. It focuses on the information interests of Tasmanian communities, businesses, industries and governments through analysis of general climate, agriculture, water and catchments, and extreme events. We are engaging with more than 50 end user organisations and to date have been involved in more than 700 engagement activities. The governance structure provides purpose to our stakeholders and given us opportunity to communicate and educate. From this opportunity has come invites and introductions to take our science further into the stakeholders' organisations and to new organisations. From these invites and introductions has come new partnerships and more opportunity to educate and influence organisational behaviour. Our approach to engagement and communication fosters a learning environment that encompasses adult education principles. We have structured our formal and informal engagement activities to encourage active involvement, thus learning. We are providing early preliminary results and tailored products for our end-users to ‘trial' and learn along the way. As we have struggled with difficult climate change science decisions, we have asked our stakeholders to be involved and develop the solution with us. We have actively avoided the traditional information transfer approach of one-size fits all with regards to activities and products. We sit with our stakeholders, listen to what their information needs are, understand how their organisation works and functions, and involve them. Our stakeholders inform, guide and drive our research and the engagement activities. We go to their board rooms, their offices, their paddocks. Our engagement activities are as much about us learning from them, as it is us ‘teaching' them about climate science. It has been highly effective to start an educational journey with them from the beginning of our research, rather than deliver challenging concepts and conclusions at the end. The key element of our communication and education strategy has been continual engagement with relevant state and national government departments, and other major stakeholders. This ongoing engagement introduces critical and often hard-to-understand climate science concepts to stakeholders early in the project, thus allowing such concepts to become familiar over the length of the project. This strategy ensures that in the conclusive reporting stage, our stakeholders are well-versed in the language and concepts necessary to engage with the conclusions, and consequently change behaviours. Our stakeholders have become advocates for our research and climate change science. Early engagement has encouraged a sense of ownership and familiarity of the climate science. This is crucial in the climate change space, where results can be controversial, difficult to appreciate and often ignored. What has been clearly important and successful has been providing the right information, at the right time, to the right people.

Defining Success in Adult Basic Education Settings: Multiple Stakeholders, Multiple Perspectives

PubMed Central

Tighe, Elizabeth L.; Barnes, Adrienne E.; Connor, Carol M.; Steadman, Sharilyn C.

2015-01-01

This study employed quantitative and qualitative research approaches to investigate what constitutes “success” in Adult Basic Education (ABE) programs from the perspectives of multiple educational stakeholders: the state funding agency, the teachers, and the students. Success was defined in multiple ways. In the quantitative section of the study, we computed classroom value-added scores (used as a metric of the state’s definition of success) to identify more and less effective ABE classrooms in two Florida counties. In the qualitative section of the study, we observed and conducted interviews with teachers and students in the selected classrooms to investigate how these stakeholders defined success in ABE. Iterative consideration of the qualitative data revealed three principal markers of success: (a) instructional strategies and teacher-student interactions; (b) views on standardized testing; and (c) student motivational factors. In general, classrooms with higher value-added scores were characterized by multiple instructional approaches, positive and collaborative teacher-student interactions, and students engaging in goal setting and citing motivational factors such as family and personal fulfillment. The implications for ABE programs are discussed. PMID:26279590

Stakeholder involvement in the design of a patient-centered comparative effectiveness trial of the “On the Move” group exercise program in community-dwelling older adults

PubMed Central

Brach, Jennifer S.; Perera, Subashan; Gilmore, Sandra; VanSwearingen, Jessie M.; Brodine, Deborah; Wert, David; Nadkarni, Neelesh K.; Ricci, Edmund

2016-01-01

Background Group exercise programs for older adults often exclude the timing and coordination of movement. Stakeholder involvement in the research process is strongly encouraged and improves the relevance and adoption of findings. We describe stakeholder involvement in the design of a clinical trial of a group-based exercise program that incorporates timing and coordination of movement into the exercises. Methods The study was a cluster randomized, single-blind intervention trial to compare the effects on function, disability and mobility of a standard group exercise program and the “On the Move” group exercise program in older adults residing in independent living facilities and senior apartment buildings, and attending community centers. Exercise classes were twice weekly for 12 weeks delivered by study exercise leaders and facility activity staff personnel. Outcomes The primary outcomes function, disability and mobility were assessed at baseline and post-intervention. Function and disability were assessed using the Late Life Function and Disability Instrument, and mobility using the Six-Minute Walk Test and gait speed. Stakeholders Patient and provider stakeholders had significant input into the study aims, design, sample, intervention, outcomes and operational considerations. Summary A community-based exercise program to improve walking can be developed to address both investigator identified missing components in current exercise to improve walking and stakeholder defined needs and interest for the activity program. Involvement of stakeholders substantially improves the relevance of research questions, increases the transparency of research activities and may accelerate the adoption of research into practice. PMID:27521806

Creating a multidisciplinary low back pain guideline: anatomy of a guideline adaptation process.

PubMed

Harstall, Christa; Taenzer, Paul; Angus, Donna K; Moga, Carmen; Schuller, Tara; Scott, N Ann

2011-08-01

A collaborative, multidisciplinary guideline adaptation process was developed to construct a single overarching, evidence-based clinical practice guideline (CPG) for all primary care practitioners responsible for the management of low back pain (LBP) to curb the use of ineffective treatments and improve patient outcomes. The adaptation strategy, which involved multiple committees and partnerships, leveraged existing knowledge transfer connections to recruit guideline development group (GDG) members and ensure that all stakeholders had a voice in the guideline development process. Videoconferencing was used to coordinate the large, geographically dispersed GDG. Information services and health technology assessment experts were used throughout the process to lighten the GDG's workload. The GDG reviewed seven seed guidelines and drafted an Alberta-specific guideline during 10 half-day meetings over a 12-month period. The use of ad hoc subcommittees to resolve uncertainties or disagreements regarding evidence interpretation expedited the process. Challenges were encountered in dealing with subjectivity, guideline appraisal tools, evidence source limitations and inconsistencies, and the lack of sophisticated evidence analysis inherent in guideline adaptation. Strategies for overcoming these difficulties are discussed. Guideline adaptation is useful when resources are limited and good-quality seed CPGs exist. The Ambassador Program successfully utilized existing stakeholder interest to create an overarching guideline that aligned guidance for LBP management across multiple primary care disciplines. Unforeseen challenges in guideline adaptation can be overcome with credible seed guidelines, a consistently applied and transparent methodology, and clear documentation of the subjective contextualization process. Multidisciplinary stakeholder input and an open, trusting relationship among all contributors will ensure that the end product is clinically meaningful. © 2010 Blackwell Publishing Ltd.

The nature of context-sensitive solutions, stakeholder involvement and critical issues in the urban context.

DOT National Transportation Integrated Search

2011-12-01

Over the last several decades many transportation and planning agencies have experienced conflicting demands emerging from the need to develop projects in an expeditious manner while at the same time involving stakeholders in the decision-making proc...

Integrative practice policy in Recife, northeastern Brazil: an analysis of stakeholder involvement.

PubMed

Santos, Francisco Assis da Silva; Sousa, Islândia Maria Carvalho de; Gurgel, Idê Gomes Dantas; Bezerra, Adriana Falangola Benjamin; Barros, Nelson Filice de

2011-12-01

To examine the involvement of stakeholders in the implementation of a local policy of integrative practices. Qualitative study conducted in the city of Recife, Northeastern Brazil. Data was collected from local health board records between 2004 and 2009, interviews with managers and key informants and focus groups with providers and users. The analysis was performed using the condensation of meaning model. The results were grouped into four categories of stakeholders according to their influence and interest, namely: subjects; population; leaders; and players. Five years after the policy was implemented in Recife, only a single service offered integrative practices. The population, or users, did not have any effective involvement and did not make any contributions to the policy, and health providers, despite their willingness to participate in the process, were not involved. The leaders included the local health board, managers and medical organizations; the latter two were also players as they were effectively involved in the formulation of the policy. The involvement of few stakeholders in the formulation of an integrative practice policy makes it difficult its implementation and widens the gap between formulation and implementation, hindering the achievement of expected results.

Stakeholder Engagement in HIV Cure Research: Lessons Learned from Other HIV Interventions and the Way Forward

PubMed Central

Chu, Carissa; Ananworanich, Jintanat; Excler, Jean-Louis; Tucker, Joseph D.

2015-01-01

Abstract Clinical and basic science advances have raised considerable hope for achieving an HIV cure by accelerating research. This research is dominated primarily by issues about the nature and design of current and future clinical trials. Stakeholder engagement for HIV cure remains in its early stages. Our analysis examines timing and mechanisms of historical stakeholder engagement in other HIV research areas for HIV-uninfected individuals [vaccine development and pre-exposure prophylaxis (PrEP)], and HIV-infected individuals (treatment as prevention, prevention of mother-to-child transmission, and treatment of acute HIV infection) and articulate a plan for HIV cure stakeholder engagement. The experience from HIV vaccine development shows that early engagement of stakeholders helped manage expectations, mitigating the failure of several vaccine trials, while paving the way for subsequent trials. The relatively late engagement of HIV stakeholders in PrEP research may partly explain some of the implementation challenges. The treatment-related stakeholder engagement was strong and community-led from the onset and helped translation from research to implementation. We outline five steps to initiate and sustain stakeholder engagement in HIV cure research and conclude that stakeholder engagement represents a key investment in which stakeholders mutually agree to share knowledge, benefits, and risk of failure. Effective stakeholder engagement prevents misconceptions. As HIV cure research advances from early trials involving subjects with generally favorable prognosis to studies involving greater risk and uncertainty, success may depend on early and deliberate engagement of stakeholders. PMID:26061668

Stakeholder Engagement in HIV Cure Research: Lessons Learned from Other HIV Interventions and the Way Forward.

PubMed

Lo, Ying-Ru; Chu, Carissa; Ananworanich, Jintanat; Excler, Jean-Louis; Tucker, Joseph D

2015-07-01

Clinical and basic science advances have raised considerable hope for achieving an HIV cure by accelerating research. This research is dominated primarily by issues about the nature and design of current and future clinical trials. Stakeholder engagement for HIV cure remains in its early stages. Our analysis examines timing and mechanisms of historical stakeholder engagement in other HIV research areas for HIV-uninfected individuals [vaccine development and pre-exposure prophylaxis (PrEP)], and HIV-infected individuals (treatment as prevention, prevention of mother-to-child transmission, and treatment of acute HIV infection) and articulate a plan for HIV cure stakeholder engagement. The experience from HIV vaccine development shows that early engagement of stakeholders helped manage expectations, mitigating the failure of several vaccine trials, while paving the way for subsequent trials. The relatively late engagement of HIV stakeholders in PrEP research may partly explain some of the implementation challenges. The treatment-related stakeholder engagement was strong and community-led from the onset and helped translation from research to implementation. We outline five steps to initiate and sustain stakeholder engagement in HIV cure research and conclude that stakeholder engagement represents a key investment in which stakeholders mutually agree to share knowledge, benefits, and risk of failure. Effective stakeholder engagement prevents misconceptions. As HIV cure research advances from early trials involving subjects with generally favorable prognosis to studies involving greater risk and uncertainty, success may depend on early and deliberate engagement of stakeholders.

Assessment Measures Showing Institutional Effectiveness in Relation to External Stakeholder Expectations for Accountability

ERIC Educational Resources Information Center

Clites, Mona Lynn

2013-01-01

Community colleges face a growing demand from a wide range of stakeholders for more transparent accountability but struggle to select appropriate measures and to use them in effective ways. The multiple demands of various stakeholders, and the calls to respond to those demands in effective and appropriate ways, are leading to a confusing array of…

The nature of context-sensitive solutions, stakeholder involvement and critical issues in the urban context : [research brief].

DOT National Transportation Integrated Search

2011-12-01

Over the last several decades many transportation and planning agencies have experienced conflicting demands emerging from the need to develop projects in an expeditious manner while at the same time involving stakeholders in the decision-making proc...

Evidence-informed recommendations to reduce dissemination bias in clinical research: conclusions from the OPEN (Overcome failure to Publish nEgative fiNdings) project based on an international consensus meeting.

PubMed

Meerpohl, Joerg J; Schell, Lisa K; Bassler, Dirk; Gallus, Silvano; Kleijnen, Jos; Kulig, Michael; La Vecchia, Carlo; Marušić, Ana; Ravaud, Philippe; Reis, Andreas; Schmucker, Christine; Strech, Daniel; Urrútia, Gerard; Wager, Elizabeth; Antes, Gerd

2015-05-05

Dissemination bias in clinical research severely impedes informed decision-making not only for healthcare professionals and patients, but also for funders, research ethics committees, regulatory bodies and other stakeholder groups that make health-related decisions. Decisions based on incomplete and biased evidence cannot only harm people, but may also have huge financial implications by wasting resources on ineffective or harmful diagnostic and therapeutic measures, and unnecessary research. Owing to involvement of multiple stakeholders, it remains easy for any single group to assign responsibility for resolving the problem to others. To develop evidence-informed general and targeted recommendations addressing the various stakeholders involved in knowledge generation and dissemination to help overcome the problem of dissemination bias on the basis of previously collated evidence. Based on findings from systematic reviews, document analyses and surveys, we developed general and targeted draft recommendations. During a 2-day workshop in summer 2013, these draft recommendations were discussed with external experts and key stakeholders, and refined following a rigorous and transparent methodological approach. Four general, overarching recommendations applicable to all or most stakeholder groups were formulated, addressing (1) awareness raising, (2) implementation of targeted recommendations, (3) trial registration and results posting, and (4) systematic approaches to evidence synthesis. These general recommendations are complemented and specified by 47 targeted recommendations tailored towards funding agencies, pharmaceutical and device companies, research institutions, researchers (systematic reviewers and trialists), research ethics committees, trial registries, journal editors and publishers, regulatory agencies, benefit (health technology) assessment institutions and legislators. Despite various recent examples of dissemination bias and several initiatives to reduce it, the problem of dissemination bias has not been resolved. Tailored recommendations based on a comprehensive approach will hopefully help increase transparency in biomedical research by overcoming the failure to disseminate negative findings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Motivation of university and non-university stakeholders to change medical education in Vietnam.

PubMed

Luu, Ngoc Hoat; Nguyen, Lan Viet; van der Wilt, G J; Broerse, J; Ruitenberg, E J; Wright, E P

2009-07-24

Both university and non-university stakeholders should be involved in the process of curriculum development in medical schools, because all are concerned with the competencies of the graduates. That may be difficult unless appropriate strategies are used to motivate each stakeholder. From 1999 to 2006, eight medical schools in Vietnam worked together to change the curriculum and teaching for general medical students to make it more community oriented. This paper describes the factors that motivated the different stakeholders to participate in curriculum change and teaching in Vietnamese medical schools and the activities to address those factors and have sustainable contributions from all relevant stakeholders. Case study analysis of contributions to the change process, using reports, interviews, focus group discussions and surveys and based on Herzberg's Motivation Theory to analyze involvement of different stakeholders. Different stakeholders were motivated by selected activities, such as providing opportunities for non-university stakeholders to share their opinions, organizing interactions among university stakeholders, stimulating both bottom-up and top-down inputs, focusing on learning from each other, and emphasizing self-motivation factors. The Herzberg Motivation theory helped to identify suitable approaches to ensure that teaching topics, materials and assessment methods more closely reflected the health care needs of the community. Other medical schools undertaking a reform process may learn from this experience.

Stakeholder Participation in System Change: A New Conceptual Model.

PubMed

O'Rourke, Tammy; Higuchi, Kathryn S; Hogg, William

2016-08-01

A recent change in Canada's primary care system led to the introduction of Nurse Practitioner-Led clinics. The literature suggests that stakeholders can influence system change initiatives. However, very little is known about healthcare stakeholder motivations, particularly stakeholders who are seen as resistors to change. To examine stakeholder participation in the system change process that led to the introduction of the first Nurse Practitioner-Led clinic in Ontario. This single case study included two site visits, semistructured individual tape-recorded interviews, and the examination of relevant public documents. Qualitative content analysis was used to analyze the data. Sixteen individuals from different healthcare sectors and professions participated in the interviews and 20 documents were reviewed. Six key themes emerged from the data. Linking Evidence to Action The findings from the study present a new perspective on stakeholder participation that includes both those who supported the proposed change and those who advocated for a different change. The findings identify stakeholder activities used to shape, share, and protect their visions for system change. The conceptual model presented in this study adds to the understanding of challenges and complexities involved in healthcare system change. Understanding why and how stakeholders participate in change can help healthcare leaders in planning activities to enhance stakeholder involvement in healthcare system change. © 2016 Sigma Theta Tau International.

Planning that works: Empowerment through stakeholder focused interactive planning (SFIP)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Beck, J.E.; Ison, S.A.

1994-12-31

This paper describes a powerful planning tool that can enable government, private industries, and public interest organizations to actualize their visions through sound decision making. The stakeholder focused interactive planning model is designed to integrate and ultimately gain stakeholder investment in the success of attainment of their vision. The only concessions required of the planning organization using this process is the acceptance of the premise that sustained vision success requires the support of both internal and external stakeholders and that each step in the process must be used as a validation of the previous step and essential to the completionmore » of the next step. What is stakeholder/public involvement? It is the process in which the stakeholders (both internal and external) values, interests and expectations are included in decision-making processes. The primary goal of public involvement efforts is to include all those who have a stake in the decision, whether or not they have already been identified. Stakeholders are individuals, contractors, clients, suppliers, public organizations, state and local governments, Indian tribes, federal agencies, and other parties affected by decisions.« less

Perspectives on health policy dialogue: definition, perceived importance and coordination.

PubMed

Nabyonga-Orem, Juliet; Ousman, Kevin; Estrelli, Yolanda; Rene, Adzodo K M; Yakouba, Zina; Gebrikidane, Mesfin; Mamoud, Drave; Kwamie, Aku

2016-07-18

Countries in the World Health Organization African Region have witnessed an increase in global health initiatives in the recent past. Although these have provided opportunities for expanding coverage of health interventions; their poor alignment with the countries' priorities and weak coordination, are among the challenges that have affected their impact. A well-coordinated health policy dialogue provides an opportunity to address these challenges, but calls for common understanding among stakeholders of what policy dialogue entails. This paper seeks to assess stakeholders' understanding and perceived importance of health policy dialogue and of policy dialogue coordination. This was a cross-sectional descriptive study using qualitative methods. Interviews were conducted with 90 key informants from the national and sub-national levels in Lusophone Cabo Verde, Francophone Chad, Guinea and Togo, and Anglophone Liberia using an open-ended interview guide. The interviews were transcribed verbatim, coded and then put through inductive thematic content analysis using QRS software Version 10. There were variations in the definition of policy dialogue that were not necessarily linked to the linguistic leaning of respondents' countries or whether the dialogue took place at the national or sub-national level. The definitions were grouped into five categories based on whether they had an outcome, operational, process, forum or platform, or interactive and evidence-sharing orientation. The stakeholders highlighted multiple benefits of policy dialogue including ensuring stakeholder participation, improving stakeholder harmonisation and alignment, supporting implementation of health policies, fostering continued institutional learning, providing a guiding framework and facilitating stakeholder analysis. Policy dialogue offers the opportunity to improve stakeholder participation in policy development and promote aid effectiveness. However, conceptual clarity is needed to ensure pursuance of common objectives. While it is clear that stakeholder involvement is an important component of policy dialogue, numbers must be manageable for meaningful dialogue. Ownership and coordination of the policy dialogue are important aspects of the process, and building the institutional capacity of the ministry of health requires a comprehensive approach as opposed to strengthening selected departments within it. Likewise, capacity for policy dialogue needs to be built at the sub-national level, alongside improving the bottom-up approach in policy processes.

Designing an accompanying ecosystem to foster entrepreneurship among agronomic and forestry engineering students. Opinion and commitment of university lecturers

NASA Astrophysics Data System (ADS)

Ortiz-Medina, L.; Fernández-Ahumada, E.; Lara-Vélez, P.; Taguas, E. V.; Gallardo-Cobos, R.; del Campillo, M. C.; Guerrero-Ginel, J. E.

2016-07-01

In the Higher School of Agronomic and Forestry Engineering of the University of Cordoba, a collective project conceived as an 'ecosystem to support and accompany entrepreneurs' has been proposed. The approach aims to spread and consolidate the entrepreneurial spirit and to respond to the demands of possible stakeholders involved in the whole process of training, as well as the subsequent integration of graduates into the labour market. Putting into practice this initiative, which involves multiple actors, is a complex and difficult task. For this reason, prior to its implementation, the authors considered it necessary to listen to main stakeholders' opinions and evaluate their degree of commitment and the requirements they consider important for the viability and sustainability of the initiative. This paper focuses on the faculty's opinions, gathered by means of a survey conducted with the entire faculty (N = 128, response rate = 45%) and semi-structured interviews held with 20 members of the School board. The results suggest that there is a general consensus on the suitability of this collective project and that there is a core of teachers willing to get involved. Evidently, guidelines need to be produced to facilitate taking on such tasks. However, the main drawbacks are related with the conflict between formal requirements of professor professional profile and the steps needed to establish the ecosystem.

Applying theories to better understand socio-political challenges in implementing evidence-based work disability prevention strategies.

PubMed

Ståhl, Christian; Costa-Black, Katia; Loisel, Patrick

2018-04-01

This article explores and applies theories for analyzing socio-political aspects of implementation of work disability prevention (WDP) strategies. For the analysis, theories from political science are explained and discussed in relation to case examples from three jurisdictions (Sweden, Brazil and Québec). Implementation of WDP strategies may be studied through a conceptual framework that targets: (1) the institutional system in which policy-makers and other stakeholders reside; (2) the ambiguity and conflicts regarding what to do and how to do it; (3) the bounded rationality, path dependency and social systems of different stakeholders; and (4) coalitions formed by different stakeholders and power relations between them. In the case examples, the design of social insurance systems, the access to and infrastructure of healthcare systems, labor market policies, employers' level of responsibility, the regulatory environment, and the general knowledge of WDP issues among stakeholders played different roles in the implementation of policies based on scientific evidence. Future research may involve participatory approaches focusing on building coalitions and communities of practice with policy-makers and stakeholders, in order to build trust, facilitate cooperation, and to better promote evidence utilization. Implications for Rehabilitation Implementation of work disability prevention policies are subject to contextual influences from the socio-political setting and from relationships between stakeholders Stakeholders involved in implementing strategies are bound to act based on their interests and previous courses of action To promote research uptake on the policy level, stakeholders and researchers need to engage in collaboration and translational activities Political stakeholders at the government and community levels need to be more directly involved as partners in the production and utilization of evidence.

Mind the gap! Lessons from science-based stakeholder dialogue in climate-adapted management of wetlands.

PubMed

Grygoruk, Mateusz; Rannow, Sven

2017-01-15

Effective stakeholder involvement is crucial for the management of protected areas, especially when new challenges like adaptation to climate change need to be addressed. Under these circumstances, science-based stakeholder involvement is required. However, there is often a gap between the information produced by science and the need for information from stakeholders. Along with the design and implementation of adaptive management strategies and policies, efforts must be taken to adjust messages about conservation and adaptation issues, to make them easier to understand, relevant and acceptable for stakeholders. In this paper, the experience of closing the gap between scientific information and the user needs of stakeholders in the Biebrza Valley is documented. The requirements of efficient stakeholder dialogue and the raising of awareness are then indicated. We conclude that many attempts to raise awareness of environmental conservation require improvements. Messages often need to be adjusted for different stakeholders and their various perception levels to efficiently anticipate the potential impacts of the changing climate on ecosystem management. We also revealed that the autonomous adaptation measures implemented by stakeholders to mitigate impacts of climatic change often contradict adaptive management planned and implemented by environmental authorities. We conclude that there is a demand for boundary spanners that can build a bridge between complex scientific outputs and stakeholder needs. Copyright © 2016 Elsevier Ltd. All rights reserved.

Stakeholder involvement in agri-environmental policy making--learning from a local- and a state-level approach in Germany.

PubMed

Prager, Katrin; Freese, Jan

2009-02-01

Recent European regulations for rural development emphasise the requirement to involve stakeholder groups and other appropriate bodies in the policy-making process. This paper presents two cases involving stakeholder participation in agri-environmental development and policy making, targeted at different policy-making levels. One study was undertaken in Lower Saxony where a local partnership developed and tested an agri-environmental prescription, which was later included in the state's menu of agri-environmental schemes. In Sachsen-Anhalt, state-facilitated stakeholder workshops including a mathematical model were used to optimise the programme planning and budget allocation at the state level. Both studies aimed at improving the acceptance of agri-environmental schemes. The authors gauge the effectiveness of the two approaches and discuss what lessons can be learned. The experience suggests that the approaches can complement one another and could also be applied to rural policy making.

Empowerment through public involvement functional interactive planning (PIFIP)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Beck, J. E.; Davidson, S. A.

1993-05-01

This paper constructs a planning process that will enable private industries, government, and public interest organizations to actualize their visions. The public involvement functional interactive planning (PIFIP) model can facilitate these groups in actualizing their visions by forcing them to recognize their stakeholder`s values, interests and expectations.

Your View or Mine: Spatially Quantifying CO2 Storage Risk from Various Stakeholder Perspectives

NASA Astrophysics Data System (ADS)

Bielicki, J. M.; Pollak, M.; Wilson, E.; Elliot, T. R.; Guo, B.; Nogues, J. P.; Peters, C. A.

2011-12-01

CO2 capture and storage involves injecting captured CO2 into geologic formations, such as deep saline aquifers. This injected CO2 is to be "stored" within the rock matrix for hundreds to thousands of years, but injected CO2, or the brine it displaces, may leak from the target reservoir. Such leakage could interfere with other subsurface activities-water production, energy production, energy storage, and waste disposal-or migrate to the surface. Each of these interferences will incur multiple costs to a variety of stakeholders. Even if injected or displaced fluids do not interfere with other subsurface activities or make their way to the surface, costs will be incurred to find and fix the leak. Consequently, the suitability of a site for CO2 storage must therefore include an assessment of the risk of leakage and interference with various other activities within a three-dimensional proximity of where CO2 is being injected. We present a spatial analysis of leakage and interference risk associated with injecting CO2 into a portion of the Mount Simon sandstone in the Michigan Basin. Risk is the probability of an outcome multiplied by the impact of that outcome (Ro=po*Io). An outcome is the result of the leakage (e.g., interference with oil production), and the impact is the cost associated with the outcome. Each outcome has costs that will vary by stakeholder. Our analysis presents CO2 storage risk for multiple outcomes in a spatially explicit manner that varies by stakeholder. We use the ELSA semi-analytical model for estimating CO2 and brine leakage from aquifers to determine plume and pressure front radii, and CO2 and brine leakage probabilities for the Mount Simon sandstone and multiple units above it. Results of ELSA simulations are incorporated into RISCS: the Risk Interference Subsurface CO2 Storage model. RISCS uses three-dimensional data on subsurface geology and the locations of wells and boreholes to spatially estimate risks associated with CO2 leakage from injection reservoirs. Where plumes probabilistically intersect subsurface activities, reach groundwater, or reach the surface, RISCS uses cost estimates from the Leakage Impact Valuation framework to estimate CO2 storage leakage and interference risk in monetary terms. This framework estimates costs that might be incurred if CO2 leaks from an injection reservoir. Such leakage could beget a variety of costs, depending on the nature and extent of the impacts. The framework identifies multiple costs under headings of: (a) finding and fixing the leak, (b) business disruption, and (c) cleaning up and paying for damages. The framework also enumerates the distribution of costs between ten different stakeholders, and allocates these costs along four leakage scenarios: 1) No interference, 2) interference with a subsurface activity, 3) interference with groundwater, and 4) migration to the surface. Our methodology facilitates research along two lines. First, it allows a probabilistic assessment of leakage costs to an injection operator, and thus what the effect of leakage might be on CCS market effectiveness. Second, it allows a broader inquiry about injection site prioritization from the point of view of various stakeholders.

Using role analysis to plan for stakeholder involvement: a Wyoming case study

USGS Publications Warehouse

Burkardt, Nina; Ponds, Phadrea D.

2006-01-01

Prior to implementing laws and policies regulating water, wildlife, wetlands, endangered species, and recreation, natural resource managers often solicit public input. Concomitantly, managers are continually seeking more effective ways to involve stakeholders. In the autumn of 1999, the Wyoming Game and Fish Department sought to develop a state management plan for its portion of the Yellowstone grizzly bear (Ursus arctos horribilis) population if it was removed from the federal threatened species list. A key aspect of developing this plan was the involvement of federal, state, and local agencies, representatives from nongovernmental organizations, and citizens. Wyoming wildlife managers asked researchers from the United States Geological Survey to demonstrate how the Legal-Institutional Analysis Model could be used to initiate this process. To address these needs, we conducted similar workshops for a group of state and federal managers or staffers and a broad group of stakeholders. Although we found similarities among the workshop groups, we also recorded differences in perspective between stakeholder groups. The managers group acknowledged the importance of varied stakeholders but viewed the grizzly bear planning process as one centered on state interests, influenced by state policies, and amenable to negotiation. The other workshops identified many stakeholders and viewed the decision process as diffuse, with many opportunities for entry into the process. These latter groups were less certain about the chance for a successful negotiation. We concluded that if these assumptions and differences were not reconciled, the public involvement effort was not likely to succeed.

I have my own lease-So why the service plan again? Perspectives on service planning in supportive housing.

PubMed

Choy-Brown, Mimi; Hamovitch, Emily K; Cuervo, Carolina; Stanhope, Victoria

2016-12-01

This study aimed to understand multiple stakeholder perspectives implementing a recovery-oriented approach to service planning in supportive housing programs serving people with lived experience of mental illnesses. Multiple stakeholders (N = 57) were recruited to participate in focus groups (N = 8), including 4 with tenants, 2 with service coordinators, 1 with supervisors, and 1 with leadership. Supportive housing programs were purposively sampled from a recovery-oriented organization serving 1,500 people annually. Stakeholders' experiences with service planning and implementing a recovery-oriented approach to service planning were explored. The authors conducted inductive thematic analyses combined with a conceptual matrix, which yielded themes across and within multiple stakeholder focus groups. Three themes emerged: (a) an institutional reminder-service planning experiences elicited negative emotions and served to remind people of experiences in institutional settings, (b) one-size-fits-all service planning-stakeholders perceived the use of quality assurance tools within the planning process as rigid to others' interests beyond their own, and (c) rules and regulations-reconciling funder requirements (e.g., completion dates) while also tailoring services to tenants' particular situations challenged providers. Even in a recovery-oriented organization, findings suggest that service planning in supportive housing has limitations in responding to each tenant's iterative recovery process. Further, in this context where people can make their home, stakeholders questioned whether the very presence of ongoing service planning activities is problematic. However, tenant-service coordinator relationships predicated on mutual respect and esteem overcame some service planning limitations. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Crafting interactivity for stakeholder engagement: transforming assumptions about communication in science and policy.

PubMed

Aakhus, Mark

2011-11-01

The International Radiation Protection Association's guiding principles for stakeholder engagement focus on fostering, facilitating, and enabling interaction among stakeholders that is inclusive and fosters competent decision making. Implicit in these standards is a call to cultivate knowledge and competence in designing communication for stakeholder engagement among radiation protection professionals. Communication as design is an approach to risk communication in science and policy that differs from, yet complements, the more well-known communication practices of informing and persuading. Design focuses on the recurring practical problem faced by professionals in making communication possible among stakeholders where it has otherwise been difficult, impossible, or even unimagined. The knowledge and competence associated with design involves principles for crafting interactivity across a variety of mediated and non-mediated encounters among stakeholders. Risk communication can be improved by cultivating expertise in scalable communication design that embraces the demands of involvement without abandoning the need for competence in science and policy communication.

Multi-criteria decision making in flood risk management: research progress and the challenge of handling uncertainty and stakeholder participation

NASA Astrophysics Data System (ADS)

Madruga de Brito, Mariana; Evers, Mariele

2016-04-01

Multi-Criteria Decision Making (MCDM) methods have received much attention from researchers and practitioners for solving flood risk management problems in the last decades due to its capacity to deal with multiple criteria, conflicting objectives as well as the knowledge arising from the participation of several actors. In order to consolidate recent research conducted in this area, this study presents a state-of-the-art literature review of MCDM applications to flood risk management, seeking to provide a better understanding of the current status of how participatory MCDM is being conducted and the way uncertainties are included in the decision-making process. Totally, 128 peer-reviewed papers published from 1995 to June 2015 in 72 different journals were systematically analyzed. Results indicated that the number of flood MCDM publications has exponentially grown during this period, with over 82% of all papers published since 2009. A wide range of application areas was identified, with most papers focusing on ranking alternatives for flood mitigation (22.78% of the total) followed by risk (21.11%) and vulnerability assessment (15%). The Analytical Hierarchy Process (AHP) was the most popular MCDM method (42.72%) followed by Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS) (13.33%) and Weighted Sum Method (WSM) (12.73%). Although significant improvements have been made over the last decades, shortcomings remain in handling the uncertainty. Only eight papers (6.25%) have conducted uncertainty analysis, suggesting that a general procedure for performing it in MCDM does not yet exist. Researchers have applied the Monte Carlo simulation, Taylor's series error propagation method or assessed the uncertainty in qualitative ways, by describing its main sources or analyzing the stakeholders' degree of confidence. In addition, 35 articles (27.34%) have performed a sensitivity analysis of the criteria weights. Three distinct approaches were identified: one-way, global, and probabilistic sensitivity analysis. About half of the studies have acknowledged the involvement of multiple stakeholders. However, participation was fragmented and focused on particular stages of the decision-making process such as the elicitation of criteria weights. This segmentation may be related to methodological and time constraints since participatory decision making is time-consuming and costly. Policy makers and experts were the most participated stakeholders, with few papers considering the involvement of local community members. Another issue is that only four studies seek to obtain consensus and that decisions were often made by majority vote or averaging approaches. Therefore, greater rigor in addressing the uncertainties around stakeholders' judgments as well as in endorsing an active participation in all stages of the decision-making process should be undertaken in future applications. This could help to increase the quality of decisions and subsequent implementation of chosen measures.

A comparison of policy and direct practice stakeholder perceptions of factors affecting evidence-based practice implementation using concept mapping

PubMed Central

2011-01-01

Background The goal of this study was to assess potential differences between administrators/policymakers and those involved in direct practice regarding factors believed to be barriers or facilitating factors to evidence-based practice (EBP) implementation in a large public mental health service system in the United States. Methods Participants included mental health system county officials, agency directors, program managers, clinical staff, administrative staff, and consumers. As part of concept mapping procedures, brainstorming groups were conducted with each target group to identify specific factors believed to be barriers or facilitating factors to EBP implementation in a large public mental health system. Statements were sorted by similarity and rated by each participant in regard to their perceived importance and changeability. Multidimensional scaling, cluster analysis, descriptive statistics and t-tests were used to analyze the data. Results A total of 105 statements were distilled into 14 clusters using concept-mapping procedures. Perceptions of importance of factors affecting EBP implementation varied between the two groups, with those involved in direct practice assigning significantly higher ratings to the importance of Clinical Perceptions and the impact of EBP implementation on clinical practice. Consistent with previous studies, financial concerns (costs, funding) were rated among the most important and least likely to change by both groups. Conclusions EBP implementation is a complex process, and different stakeholders may hold different opinions regarding the relative importance of the impact of EBP implementation. Implementation efforts must include input from stakeholders at multiple levels to bring divergent and convergent perspectives to light. PMID:21899754

A comparison of policy and direct practice stakeholder perceptions of factors affecting evidence-based practice implementation using concept mapping.

PubMed

Green, Amy E; Aarons, Gregory A

2011-09-07

The goal of this study was to assess potential differences between administrators/policymakers and those involved in direct practice regarding factors believed to be barriers or facilitating factors to evidence-based practice (EBP) implementation in a large public mental health service system in the United States. Participants included mental health system county officials, agency directors, program managers, clinical staff, administrative staff, and consumers. As part of concept mapping procedures, brainstorming groups were conducted with each target group to identify specific factors believed to be barriers or facilitating factors to EBP implementation in a large public mental health system. Statements were sorted by similarity and rated by each participant in regard to their perceived importance and changeability. Multidimensional scaling, cluster analysis, descriptive statistics and t-tests were used to analyze the data. A total of 105 statements were distilled into 14 clusters using concept-mapping procedures. Perceptions of importance of factors affecting EBP implementation varied between the two groups, with those involved in direct practice assigning significantly higher ratings to the importance of Clinical Perceptions and the impact of EBP implementation on clinical practice. Consistent with previous studies, financial concerns (costs, funding) were rated among the most important and least likely to change by both groups. EBP implementation is a complex process, and different stakeholders may hold different opinions regarding the relative importance of the impact of EBP implementation. Implementation efforts must include input from stakeholders at multiple levels to bring divergent and convergent perspectives to light.

Community Engagement in a complex intervention to improve access to primary mental health care for hard-to-reach groups.

PubMed

Lamb, Jonathan; Dowrick, Christopher; Burroughs, Heather; Beatty, Susan; Edwards, Suzanne; Bristow, Kate; Clarke, Pam; Hammond, Jonathan; Waheed, Waquas; Gabbay, Mark; Gask, Linda

2015-12-01

Despite the availability of effective evidence-based treatments for depression and anxiety, many 'harder-to-reach' social and patient groups experience difficulties accessing treatment. We developed a complex intervention, the AMP (Improving Access to Mental Health in Primary Care) programme, which combined community engagement (CE), tailored (individual and group) psychosocial interventions and primary care involvement. To develop and evaluate a model for community engagement component of the complex intervention. This paper focuses on the development of relationships between stakeholders, their engagement with the issue of access to mental health and with the programme through the CE model. Our evaluation draws on process data, qualitative interviews and focus groups, brought together through framework analysis to evaluate the issues and challenges encountered. A case study of the South Asian community project carried out in Longsight in Greater Manchester, United Kingdom. Complex problems require multiple local stakeholders to work in concert. Assets based approaches implicitly make demands on scarce time and resources. Community development approaches have many benefits, but perceptions of open-ended investment are a barrier. The time-limited nature of a CE intervention provides an impetus to 'do it now', allowing stakeholders to negotiate their investment over time and accommodating their wider commitments. Both tangible outcomes and recognition of process benefits were vital in maintaining involvement. CE interventions can play a key role in improving accessibility and acceptability by engaging patients, the public and practitioners in research and in the local service ecology. © 2014 John Wiley & Sons Ltd.

A qualitative case study of the legislative process of the hygienist-therapist bill in a large Midwestern state.

PubMed

Dollins, Haley E; Bray, Kimberly Krust; Gadbury-Amyot, Cynthia C

2013-10-01

Inequitable access to dental care contributes to oral health disparities. Midlevel dental provider models are utilized across the globe as a way to bridge the gap between preventive and restorative dental professionals and increase access to dental care. The purpose of this study was threefold: to examine lessons learned from the state legislative process related to creation of the hygienist-therapist in a Midwestern state, to improve understanding of the relationship between alternative oral health delivery models and public policy and to inform the development and passage of future policies aimed at addressing the unmet dental needs of the public. This research investigation utilized a qualitative research methodology to examine the process of legislation relating to an alternative oral health delivery model (hygienist-therapist) through the eyes of key stakeholders. Interview data was analyzed and then triangulated with 3 data sources: interviews with key stakeholders, documents and researcher participant field notes. Data analysis resulted in consensus on 3 emergent themes with accompanying categories. The themes that emerged included social justice, partnerships and coalitions, and the legislative process. This qualitative case study suggests that the creation of a new oral health workforce model was a long and arduous process involving multiple stakeholders and negotiation between the parties involved. The creation of this new workforce model was recognized as a necessary step to increasing access to dental care at the state and national level. The research in this case study may serve to inform advocates of access to oral health care as other states pursue their own workforce models.

Worlds apart? A scoping review addressing different stakeholder perspectives on barriers to family involvement in the care for persons with severe mental illness.

PubMed

Landeweer, Elleke; Molewijk, Bert; Hem, Marit Helene; Pedersen, Reidar

2017-05-15

Empirical evidence shows that family involvement (FI) can play a pivotal role in the coping and recovery of persons with severe mental illness (SMI). Nevertheless, various studies demonstrate that FI in mental healthcare services is often not (sufficiently) realized. In order to develop more insights, this scoping review gives an overview of how various stakeholders conceptualize, perceive and experience barriers to FI. Central questions are: 1) What are the main barriers to FI reported by the different key stakeholders (i.e. the persons with SMI, their families and the professionals, and 2) What are the differences and similarities between the various stakeholders' perspectives on these barriers. A systematic search into primary studies regarding FI was conducted in four databases: Medline/Pubmed, Cinahl, PsychInfo and Web of Knowledge with the use of a PICO scheme. Thematic analysis focused on stakeholder perspectives (i.e. which stakeholder group reports the barrier) and types of barriers (i.e. which types of barriers are addressed). Thirty three studies were included. The main barriers reported by the stakeholder groups reveal important similarities and differences between the stakeholder groups and were related to: 1) the person with SMI, 2) the family, 3) the professionals, 4) the organization of care and 5) the culture-paradigm. Our stakeholder approach elicits the different stakeholders' concepts, presuppositions and experiences of barriers to FI, and gives fundamental insights on how to deal with barriers to FI. The stakeholders differing interpretations and perceptions of the barriers related to FI is closely related to the inherent complexity involved in FI in itself. In order to deal better with these barriers, openly discussing and reflecting upon each other's normative understandings of barriers is needed. Differences in perceptions of barriers to FI can itself be a barrier. To deal with barriers to FI, a dialogical approach on how the different stakeholders perceive and value FI and its barriers is required. Methods such as moral case deliberation or systematic ethics reflections can be useful.

A Mixed-Methods Approach to Understanding Community Participation in Community Health Needs Assessments.

PubMed

Pennel, Cara L; McLeroy, Kenneth R; Burdine, James N; Matarrita-Cascante, David; Wang, Jia

Nonprofit hospitals are exempt from paying taxes. To maintain this status, they must provide benefit to the community they serve. In an attempt to improve accountability to these communities and the federal government, the Patient Protection and Affordable Care Act of 2010 includes a provision that requires all nonprofit hospitals to conduct a community health needs assessment (CHNA) and implement strategies to address identified health priorities every 3 years. This Act's provision, operationalized by a regulation developed and enforced by the Internal Revenue Service, mandates the involvement of public health agencies and other community stakeholders in the completion of the CHNA. To better understand community participation in nonprofit hospital-directed community health assessment and health improvement planning activities. Using a 2-phased, mixed-methods study design, we (1) conducted content analysis of 95 CHNA/implementation plan reports and (2) interviewed hospital and health system key informants, consultants, and community stakeholders involved in CHNA and planning processes. Community participation was assessed in terms of types of stakeholders involved and the depth of their involvement. Our findings suggest that many hospitals engaged and involved community stakeholders in certain aspects of the assessment process, but very few engaged a broad array of community stakeholder and community members in meaningful participation throughout the CHNA and health improvement planning process. Vast improvements in community participation and collaborative assessment and planning can be made in future CHNAs. On the basis of the findings, recommendations are made for further research. Practice implications include expanding community engagement and participation by stakeholder and activity type and using a common community health improvement model that better aligns hospital CHNA processes and implementation strategies with other organizations and agencies.

Using Participatory Learning & Action (PLA) research techniques for inter-stakeholder dialogue in primary healthcare: an analysis of stakeholders' experiences.

PubMed

de Brún, T; O'Reilly-de Brún, M; Van Weel-Baumgarten, E; Burns, N; Dowrick, C; Lionis, C; O'Donnell, C; Mair, F S; Papadakaki, M; Saridaki, A; Spiegel, W; Van Weel, C; Van den Muijsenbergh, M; MacFarlane, A

2017-01-01

It is important for health care workers to know the needs and expectations of their patients. Therefore, service users have to be involved in research. To achieve a meaningful dialogue between service users, healthcare workers and researchers, participatory methods are needed. This paper describes how the application of a specific participatory methodology, Participatory Learning and Action (PLA) can lead to such a meaningful dialogue. In PLA all stakeholders are regarded as equal partners and collaborators in research.During 2011-2015, a European project called RESTORE used PLA in Austria, Greece, Ireland, The Netherlands and the UK to investigate how communication between primary health care workers and their migrant patients could be improved.Seventy eight migrants, interpreters, doctors, nurses and other key stakeholders (see Table 2) participated in 62 PLA sessions. These dialogues (involving discussions, activities, PLA techniques and evaluations) were generally 2-3 h long and were recorded and analysed by the researchers.Participants reported many positive experiences about their dialogues with other stakeholders. There was a positive, trusting atmosphere in which all stakeholders could express their views despite differences in social power. This made for better understanding within and across stakeholder groups. For instance a doctor changed her view on the use of interpreters after a migrant explained why this was important. Negative experiences were rare: some doctors and healthcare workers thought the PLA sessions took a lot of time; and despite the good dialogue, there was disappointment that very few migrants used the new interpreting service. Background In order to be effective, primary healthcare must understand the health needs, values and expectations of the population it serves. Recent research has shown that the involvement of service users and other stakeholders and gathering information on their perspectives can contribute positively to many aspects of primary healthcare. Participatory methodologies have the potential to support engagement and dialogue between stakeholders from academic, migrant community and health service settings. This paper focuses on a specific participatory research methodology, Participatory Learning and Action (PLA) in which all stakeholders are regarded as equal partners and collaborators in research.Our research question for this paper was: "Does the application of PLA lead to meaningful engagement of all stakeholders, and if so, what elements contribute to a positive and productive inter-stakeholder dialogue?". Methods We explored the use of PLA in RESTORE, a European FP7-funded project, during 2011-2015 in 5 countries: Austria, Greece, Ireland, the Netherlands and the UK. The objective of RESTORE was to investigate and support the implementation of guidelines and training initiatives (G/TIs) to enhance communication in cross-cultural primary care consultations with migrants.Seventy eight stakeholders (migrants, interpreters, doctors, nurses and others - see Table 2) participated in a total of 62 PLA sessions (discussions, activities, evaluations) of approximately 2-3 h' duration across the five sites. During the fieldwork, qualitative data were generated about stakeholders' experiences of engagement in this dialogue, by means of various methods including participatory evaluations, researchers' fieldwork reports and researcher interviews. These were analysed following the principles of thematic analysis. Results Stakeholders involved in PLA inter-stakeholder dialogues reported a wide range of positive experiences of engagement, and very few negative experiences. A positive atmosphere during early research sessions helped to create a sense of safety and trust. This enabled stakeholders from very different backgrounds, with different social status and power, to offer their perspectives in a way that led to enhanced learning in the group - they learned with and from each other. This fostered shifts in understanding - for example, a doctor changed her view on interpreted consultations because of the input of the migrant service-users. Conclusion PLA successfully promoted stakeholder involvement in meaningful and productive inter-stakeholder dialogues. This makes it an attractive approach to enhance the further development of health research partnerships to advance primary healthcare.

Stakeholder involvement for management of the coastal zone.

PubMed

Oen, Amy Mp; Bouma, Geiske M; Botelho, Maria; Pereira, Patrícia; Haeger-Eugensson, Marie; Conides, Alexis; Przedrzymirska, Joanna; Isaksson, Ingela; Wolf, Christina; Breedveld, Gijs D; Slob, Adriaan

2016-10-01

The European Union (EU) has taken the lead to promote the management of coastal systems. Management strategies are implemented by the Water Framework Directive (WFD) and the Marine Strategy Framework Directive (MSFD), as well as the recent Maritime Spatial Planning (MSP) Directive. Most EU directives have a strong focus on public participation; however, a recent review found that the actual involvement of stakeholders was variable. The "Architecture and roadmap to manage multiple pressures on lagoons" (ARCH) research project has developed and implemented participative methodologies at different case study sites throughout Europe. These cases represent a broad range of coastal systems, and they highlight different legislative frameworks that are relevant for coastal zone management. Stakeholder participation processes were subsequently evaluated at 3 case study sites in order to assess the actual implementation of participation in the context of their respective legislative frameworks: 1) Byfjorden in Bergen, Norway, in the context of the WFD; 2) Amvrakikos Gulf, Greece, in the context of the MSFD; and 3) Nordre Älv Estuary, Sweden, in the context of the MSP Directive. An overall assessment of the evaluation criteria indicates that the ARCH workshop series methodology of focusing first on the current status of the lagoon or estuary, then on future challenges, and finally on identifying management solutions provided a platform that was conducive for stakeholder participation. Results suggest that key criteria for a good participatory process were present and above average at the 3 case study sites. The results also indicate that the active engagement that was initiated at the 3 case study sites has led to capacity building among the participants, which is an important intermediary outcome of public participation. A strong connection between participatory processes and policy can ensure the legacy of the intermediary outcomes, which is an important and necessary start toward more permanent resource management outcomes such as ecological and economic improvement. Integr Environ Assess Manag 2016;12:701-710. © 2016 SETAC. © 2016 SETAC.

Can thermostable vaccines help address cold-chain challenges? Results from stakeholder interviews in six low- and middle-income countries

PubMed Central

Kristensen, Debra D.; Lorenson, Tina; Bartholomew, Kate; Villadiego, Shirley

2016-01-01

Introduction This study captures the perspectives of stakeholders at multiple levels of the vaccine supply chain regarding their assessment of challenges with storing vaccines within recommended temperature ranges and their perceptions on the benefits of having vaccines with improved stability, including the potential short-term storage and transport of vaccines in a controlled-temperature chain. Methods Semi-structured interviews were undertaken with 158 immunization stakeholders in six countries. Interviewees included national decision-makers and advisors involved in vaccine purchasing decisions, national Expanded Programme on Immunization managers, and health and logistics personnel at national, subnational, and health facility levels. Results Challenges with both heat and freeze-exposure of vaccines were recognized in all countries, with heat-exposure being a greater concern. Conditions leading to freeze-exposure including ice build-up due to poor refrigerator performance and improper icepack conditioning were reported by 53% and 28% of participants, respectively. Respondents were interested in vaccine products with improved heat/freeze-stability characteristics. The majority of those involved in vaccine purchasing indicated they would be willing to pay a US$0.05 premium per dose for a freeze-stable pentavalent vaccine (68%) or a heat-stable rotavirus vaccine (59%), although most (53%) preferred not to pay the premium for a heat-stable pentavalent vaccine if the increased stability required changing from a liquid to a lyophilized product. Most respondents (73%) were also interested in vaccines labeled for short-term use in a controlled-temperature chain. The majority (115/158) recognized the flexibility this would provide during outreach or should cold-chain breaks occur. Respondents were also aware that possible confusion might arise and additional training would be required if handling conditions were changed for some, but not all vaccines. Conclusion Participating immunization stakeholders recognized the benefits of vaccine products with improved stability characteristics and of labeling vaccines for controlled-temperature chain use as a means to help address cold-chain issues in their immunization programs. PMID:26778422

Translating three states of knowledge--discovery, invention, and innovation

PubMed Central

2010-01-01

Background Knowledge Translation (KT) has historically focused on the proper use of knowledge in healthcare delivery. A knowledge base has been created through empirical research and resides in scholarly literature. Some knowledge is amenable to direct application by stakeholders who are engaged during or after the research process, as shown by the Knowledge to Action (KTA) model. Other knowledge requires multiple transformations before achieving utility for end users. For example, conceptual knowledge generated through science or engineering may become embodied as a technology-based invention through development methods. The invention may then be integrated within an innovative device or service through production methods. To what extent is KT relevant to these transformations? How might the KTA model accommodate these additional development and production activities while preserving the KT concepts? Discussion Stakeholders adopt and use knowledge that has perceived utility, such as a solution to a problem. Achieving a technology-based solution involves three methods that generate knowledge in three states, analogous to the three classic states of matter. Research activity generates discoveries that are intangible and highly malleable like a gas; development activity transforms discoveries into inventions that are moderately tangible yet still malleable like a liquid; and production activity transforms inventions into innovations that are tangible and immutable like a solid. The paper demonstrates how the KTA model can accommodate all three types of activity and address all three states of knowledge. Linking the three activities in one model also illustrates the importance of engaging the relevant stakeholders prior to initiating any knowledge-related activities. Summary Science and engineering focused on technology-based devices or services change the state of knowledge through three successive activities. Achieving knowledge implementation requires methods that accommodate these three activities and knowledge states. Accomplishing beneficial societal impacts from technology-based knowledge involves the successful progression through all three activities, and the effective communication of each successive knowledge state to the relevant stakeholders. The KTA model appears suitable for structuring and linking these processes. PMID:20205873

Usability Analysis within The DataONE Network of Collaborators

NASA Astrophysics Data System (ADS)

Budden, A. E.; Frame, M. T.; Tenopir, C.; Volentine, R.

2014-12-01

DataONE was conceived as a 10-year project to enable new science and knowledge creation through universal access to data about life on Earth and the environment that sustains it. In Phase I (2009-2014) more than 300 DataONE participants designed, developed and deployed a robust cyberinfrastructure (CI) with innovative services, and directly engaged and educated a broad stakeholder community. DataONE provides a resilient, scalable infrastructure using Member Nodes (data repositories), Coordinating Nodes, and an Investigator Toolkit to support the data access and data management needs of biological, Earth, and environmental science researchers in the U.S. and across the globe. DataONE collaborators, such as the U.S. Geological Survey, University of New Mexico, and the University of Tennessee, perform research to measure both the current data practices and opinions of DataONE stakeholders and the usability of DataONE for these stakeholders. Stakeholders include scientists, data managers, librarians, and educators among others. The DataONE Usability and Assessment Working Group, which includes members from multiple sectors, does research, development, and implementation projects on DataONE processes, systems, and methods. These projects are essential to insure that DataONE products and services meet network goals, include appropriate community involvement, and demonstrate progress and achievements of DataONE. This poster will provide an overview of DataONE's usability analysis and assessment methodologies, benefits to DataONE and its collaborators, and current tools/techniques being utilized by the participants.

Analysing the diffusion and adoption of mobile IT across social worlds.

PubMed

Nielsen, Jeppe Agger; Mengiste, Shegaw Anagaw

2014-06-01

The diffusion and adoption of information technology innovations (e.g. mobile information technology) in healthcare organizations involves a dynamic process of change with multiple stakeholders with competing interests, varying commitments, and conflicting values. Nevertheless, the extant literature on mobile information technology diffusion and adoption has predominantly focused on organizations and individuals as the unit of analysis, with little emphasis on the environment in which healthcare organizations are embedded. We propose the social worlds approach as a promising theoretical lens for dealing with this limitation together with reports from a case study of a mobile information technology innovation in elderly home care in Denmark including both the sociopolitical and organizational levels in the analysis. Using the notions of social worlds, trajectories, and boundary objects enables us to show how mobile information technology innovation in Danish home care can facilitate negotiation and collaboration across different social worlds in one setting while becoming a source of tension and conflicts in others. The trajectory of mobile information technology adoption was shaped by influential stakeholders in the Danish home care sector. Boundary objects across multiple social worlds legitimized the adoption, but the use arrangement afforded by the new technology interfered with important aspects of home care practices, creating resistance among the healthcare personnel.

Effectiveness guidance document (EGD) for Chinese medicine trials: a consensus document

PubMed Central

2014-01-01

Background There is a need for more Comparative Effectiveness Research (CER) on Chinese medicine (CM) to inform clinical and policy decision-making. This document aims to provide consensus advice for the design of CER trials on CM for researchers. It broadly aims to ensure more adequate design and optimal use of resources in generating evidence for CM to inform stakeholder decision-making. Methods The Effectiveness Guidance Document (EGD) development was based on multiple consensus procedures (survey, written Delphi rounds, interactive consensus workshop, international expert review). To balance aspects of internal and external validity, multiple stakeholders, including patients, clinicians, researchers and payers were involved in creating this document. Results Recommendations were developed for “using available data” and “future clinical studies”. The recommendations for future trials focus on randomized trials and cover the following areas: designing CER studies, treatments, expertise and setting, outcomes, study design and statistical analyses, economic evaluation, and publication. Conclusion The present EGD provides the first systematic methodological guidance for future CER trials on CM and can be applied to single or multi-component treatments. While CONSORT statements provide guidelines for reporting studies, EGDs provide recommendations for the design of future studies and can contribute to a more strategic use of limited research resources, as well as greater consistency in trial design. PMID:24885146

Stakeholder validation of a model of readiness for transition to adult care.

PubMed

Schwartz, Lisa A; Brumley, Lauren D; Tuchman, Lisa K; Barakat, Lamia P; Hobbie, Wendy L; Ginsberg, Jill P; Daniel, Lauren C; Kazak, Anne E; Bevans, Katherine; Deatrick, Janet A

2013-10-01

That too few youth with special health care needs make the transition to adult-oriented health care successfully may be due, in part, to lack of readiness to transfer care. There is a lack of theoretical models to guide development and implementation of evidence-based guidelines, assessments, and interventions to improve transition readiness. To further validate the Social-ecological Model of Adolescent and Young Adult Readiness to Transition (SMART) via feedback from stakeholders (patients, parents, and providers) from a medically diverse population in need of life-long follow-up care, survivors of childhood cancer. Mixed-methods participatory research design. A large Mid-Atlantic children's hospital. Adolescent and young adult survivors of childhood cancer (n = 14), parents (n = 18), and pediatric providers (n = 10). Patients and parents participated in focus groups; providers participated in individual semi-structured interviews. Validity of SMART was assessed 3 ways: (1) ratings on importance of SMART components for transition readiness using a 5-point scale (0-4; ratings >2 support validity), (2) nominations of 3 "most important" components, and (3) directed content analysis of focus group/interview transcripts. Qualitative data supported the validity of SMART, with minor modifications to definitions of components. Quantitative ratings met criteria for validity; stakeholders endorsed all components of SMART as important for transition. No additional SMART variables were suggested by stakeholders and the "most important" components varied by stakeholders, thus supporting the comprehensiveness of SMART and need to involve multiple perspectives. SMART represents a comprehensive and empirically validated framework for transition research and program planning, supported by survivors of childhood cancer, parents, and pediatric providers. Future research should validate SMART among other populations with special health care needs.

IVF policy and global/local politics: the making of multiple-embryo transfer regulation in Taiwan.

PubMed

Wu, Chia-Ling

2012-08-01

This paper analyzes the regulatory trajectory of multiple-embryo transfer in in-vitro fertilization (IVF) in Taiwan. Taking a latecomer to policy-making as the case, it argues the importance of conceptualizing the global/local dynamics in policy-making for assisted reproductive technology (ART). The conceptual framework is built upon recent literature on standardization, science policy, and global assemblage. I propose three interrelated features that reveal the "global in the local": (1) the power relationships among stakeholders, (2) the selected global form that involved actors drew upon, and (3) the re-contextualized assemblage made of local networks. Data included archives, interviews, and participant observation. In different historical periods the specific stakeholders selected different preferred global forms for Taiwan, such as Britain's code of ethics in the 1990s, the American guideline in the early 2000s, and the European trend in the mid-2000s. The global is heterogeneous. The failure to transfer the British regulation, the revision of the American guideline by adding one more embryo than it specified, and the gap between the cited European trend and the "no more than four" in Taiwan's 2007 Human Reproduction Law all show that the local network further transforms the selected global form, confining it to rhetoric only or tailoring it to local needs. Overall, Taiwanese practitioners successfully maintained their medical autonomy to build a 'flexible standardization'. Multiple pregnancy remains the most common health risk of IVF in Taiwan. Copyright © 2012 Elsevier Ltd. All rights reserved.

Mobilizing cross-sector community partnerships to address the needs of criminal justice-involved older adults: a framework for action.

PubMed

Metzger, Lia; Ahalt, Cyrus; Kushel, Margot; Riker, Alissa; Williams, Brie

2017-09-11

Purpose The rapidly increasing number of older adults cycling through local criminal justice systems (jails, probation, and parole) suggests a need for greater collaboration among a diverse group of local stakeholders including professionals from healthcare delivery, public health, and criminal justice and directly affected individuals, their families, and advocates. The purpose of this paper is to develop a framework that local communities can use to understand and begin to address the needs of criminal justice-involved older adults. Design/methodology/approach The framework included solicit input from community stakeholders to identify pressing challenges facing criminal justice-involved older adults, conduct needs assessments of criminal justice-involved older adults and professionals working with them; implement quick-response interventions based on needs assessments; share findings with community stakeholders and generate public feedback; engage interdisciplinary group to develop an action plan to optimize services. Findings A five-step framework for creating an interdisciplinary community response is an effective approach to action planning and broad stakeholder engagement on behalf of older adults cycling through the criminal justice system. Originality/value This study proposes the Criminal Justice Involved Older Adults in Need of Treatment Initiative Framework for establishing an interdisciplinary community response to the growing population of medically and socially vulnerable criminal justice-involved older adults.

Collaborative Response and Recovery from a Foot-and-Mouth Disease Animal Health Emergency: Supporting Decision Making in a Complex Environment with Multiple Stakeholders

DTIC Science & Technology

2013-12-01

RESPONSE AND RECOVERY FROM A FOOT-AND- MOUTH DISEASE ANIMAL HEALTH EMERGENCY: SUPPORTING DECISION MAKING IN A COMPLEX ENVIRONMENT WITH MULTIPLE...Thesis 4. TITLE AND SUBTITLE COLLABORATIVE RESPONSE AND RECOVERY FROM A FOOT-AND- MOUTH DISEASE ANIMAL HEALTH EMERGENCY: SUPPORTING DECISION MAKING...200 words ) This thesis recommends ways to support decision makers who must operate within the multi-stakeholder complex situation of response and

Defining ecological and economical hydropoweroperations: a framework for managing dam releasesto meet multiple conflicting objectives

USGS Publications Warehouse

Irwin, Elise R.

2014-01-01

Hydroelectric dams are a flexible source of power, provide flood control, and contribute to the economic growth of local communities through real-estate and recreation. Yet the impoundment of rivers can alter and fragment miles of critical riverine habitat needed for other competing needs such as downstream consumptive water use, fish and wildlife population viability, or other forms of recreation. Multiple conflicting interests can compromise progressive management especially with recognized uncertainties related to whether management actions will fulfill the objectives of policy makers, resource managers and/or facility owners. Decision analytic tools were used in a stakeholder-driven process to develop and implement a template for evaluation and prediction of the effects of water resource management of multiple-use systems under the context provided by R.L. Harris Dam on the Tallapoosa River, Alabama, USA. The approach provided a transparent and structured framework for decision-making and incorporated both existing and new data to meet multiple management objectives. Success of the template has been evaluated by the stakeholder governing body in an adaptive resource management framework since 2005 and is ongoing. Consequences of management of discharge at the dam were evaluated annually relative to stakeholder satisfaction to allow for adjustment of both management scenarios and objectives. This template can be applied to attempt to resolve conflict inherent in many dam-regulated systems where management decisions impact diverse values of stakeholders.

Software Quality Perceptions of Stakeholders Involved in the Software Development Process

ERIC Educational Resources Information Center

Padmanabhan, Priya

2013-01-01

Software quality is one of the primary determinants of project management success. Stakeholders involved in software development widely agree that quality is important (Barney and Wohlin 2009). However, they may differ on what constitutes software quality, and which of its attributes are more important than others. Although, software quality…

Stakeholder Perspectives on Citation and Peer-Based Rankings of Higher Education Journals

ERIC Educational Resources Information Center

Wilkins, Stephen; Huisman, Jeroen

2015-01-01

The purpose of this article is to identify and discuss the possible uses of higher education journal rankings, and the associated advantages and disadvantages of using them. The research involved 40 individuals--lecturers, university managers, journal editors and publishers--who represented a range of stakeholders involved with research into…

Stakeholders' Responses to CSR Tradeoffs: When Other-Orientation and Trust Trump Material Self-Interest

PubMed Central

Bridoux, Flore; Stofberg, Nicole; Den Hartog, Deanne

2016-01-01

When investing in corporate social responsibility (CSR), managers may strive for a win-win scenario where all stakeholders end up better off, but they may not always be able to avoid trading off stakeholders' interests. To provide guidance to managers who have to make tradeoffs, this study used a vignette-based experiment to explore stakeholders' intention to associate with a firm (i.e., buy from or become an employee) that trades off CSR directed at the stakeholders' own group (self-directed CSR) and CSR directed at another stakeholder group (other-directed CSR). Results show that stakeholders were not systematically more attracted to a firm that favors their own group over another stakeholder group. Specifically, stakeholders' other-orientation moderated their reaction to tradeoffs: stakeholders higher on other-orientation were willing to forego some material benefits to associate with a firm that treated suppliers in developing countries significantly better than its competitors, whereas stakeholders lower on other-orientation were more attracted to a firm favoring their own stakeholder group. Other-orientation also moderated reactions to tradeoffs involving the environment, although high CSR directed at the environment did not compensate for low self-directed CSR even for stakeholders higher on other-orientation. Second, the vignette study showed that trust mediated the relationship between tradeoffs and stakeholders' reactions. The study contributes first and foremost to the burgeoning literature on CSR tradeoffs and to the multimotive approach to CSR, which claims that other motives can drive stakeholders' reactions to CSR in addition to self-interest. First, it provides further evidence that studying CSR tradeoffs is important to understand both (prospective) employees' and customers' reactions to CSR-related activities. Second, it identifies other-orientation as a motive-related individual difference that explains heterogeneity in stakeholders' reactions to CSR. These findings suggest several avenues for future research for organizational psychologists interested in organizational justice. Third, it investigates trust as a mediating mechanism. Fourth, it reveals differences in stakeholders' reactions depending on which other stakeholder group is involved in the tradeoff. For practice, the findings suggest that tradeoffs are important because they influence which stakeholders are attracted to the firm. PMID:26834657

Stakeholders' Responses to CSR Tradeoffs: When Other-Orientation and Trust Trump Material Self-Interest.

PubMed

Bridoux, Flore; Stofberg, Nicole; Den Hartog, Deanne

2015-01-01

When investing in corporate social responsibility (CSR), managers may strive for a win-win scenario where all stakeholders end up better off, but they may not always be able to avoid trading off stakeholders' interests. To provide guidance to managers who have to make tradeoffs, this study used a vignette-based experiment to explore stakeholders' intention to associate with a firm (i.e., buy from or become an employee) that trades off CSR directed at the stakeholders' own group (self-directed CSR) and CSR directed at another stakeholder group (other-directed CSR). Results show that stakeholders were not systematically more attracted to a firm that favors their own group over another stakeholder group. Specifically, stakeholders' other-orientation moderated their reaction to tradeoffs: stakeholders higher on other-orientation were willing to forego some material benefits to associate with a firm that treated suppliers in developing countries significantly better than its competitors, whereas stakeholders lower on other-orientation were more attracted to a firm favoring their own stakeholder group. Other-orientation also moderated reactions to tradeoffs involving the environment, although high CSR directed at the environment did not compensate for low self-directed CSR even for stakeholders higher on other-orientation. Second, the vignette study showed that trust mediated the relationship between tradeoffs and stakeholders' reactions. The study contributes first and foremost to the burgeoning literature on CSR tradeoffs and to the multimotive approach to CSR, which claims that other motives can drive stakeholders' reactions to CSR in addition to self-interest. First, it provides further evidence that studying CSR tradeoffs is important to understand both (prospective) employees' and customers' reactions to CSR-related activities. Second, it identifies other-orientation as a motive-related individual difference that explains heterogeneity in stakeholders' reactions to CSR. These findings suggest several avenues for future research for organizational psychologists interested in organizational justice. Third, it investigates trust as a mediating mechanism. Fourth, it reveals differences in stakeholders' reactions depending on which other stakeholder group is involved in the tradeoff. For practice, the findings suggest that tradeoffs are important because they influence which stakeholders are attracted to the firm.

Citizen science in natural resources: Lessons learned from stakeholder engagement in participatory research using collaborative adaptive management

USDA-ARS?s Scientific Manuscript database

Under the traditional “loading-dock” model of research, stakeholders are involved in determining priorities prior to research activities and then recieve one-way communication about findings after research is completed. This approach lacks iterative engagement of stakeholders during the research pro...

Examining Stakeholder Expectations for Guiding School Reform: Including Students

ERIC Educational Resources Information Center

Strom, Paris S.; Strom, Robert D.; Beckert, Troy

2011-01-01

Improving the quality of secondary education in public schools requires involving all stakeholders in identifying and applying appropriate expectations. Many adult stakeholders are seeking action to eliminate the disparity between state and federal estimates of student achievement and to enable comparisons between the performance of students and…

Value of decision analysis in stakeholder interactions for the restoration and recovery from the Gulf of Mexico oil spill

EPA Science Inventory

The importance of stakeholder involvement in the management of watersheds is receiving greater recognition than in the past; however, interacting with stakeholders is frequently accomplished using informal procedures. It is essential to structure elicitations so that they can be ...

Pareto frontier analyses based decision making tool for transportation of hazardous waste.

PubMed

Das, Arup; Mazumder, T N; Gupta, A K

2012-08-15

Transportation of hazardous wastes through a region poses immense threat on the development along its road network. The risk to the population, exposed to such activities, has been documented in the past. However, a comprehensive framework for routing hazardous wastes has often been overlooked. A regional Hazardous Waste Management scheme should incorporate a comprehensive framework for hazardous waste transportation. This framework would incorporate the various stakeholders involved in decision making. Hence, a multi-objective approach is required to safeguard the interest of all the concerned stakeholders. The objective of this study is to design a methodology for routing of hazardous wastes between the generating units and the disposal facilities through a capacity constrained network. The proposed methodology uses posteriori method with multi-objective approach to find non-dominated solutions for the system consisting of multiple origins and destinations. A case study of transportation of hazardous wastes in Kolkata Metropolitan Area has also been provided to elucidate the methodology. Copyright © 2012 Elsevier B.V. All rights reserved.

Motivation of university and non-university stakeholders to change medical education in Vietnam

PubMed Central

Hoat, Luu Ngoc; Lan Viet, Nguyen; van der Wilt, GJ; Broerse, J; Ruitenberg, EJ; Wright, EP

2009-01-01

Background Both university and non-university stakeholders should be involved in the process of curriculum development in medical schools, because all are concerned with the competencies of the graduates. That may be difficult unless appropriate strategies are used to motivate each stakeholder. From 1999 to 2006, eight medical schools in Vietnam worked together to change the curriculum and teaching for general medical students to make it more community oriented. This paper describes the factors that motivated the different stakeholders to participate in curriculum change and teaching in Vietnamese medical schools and the activities to address those factors and have sustainable contributions from all relevant stakeholders. Methods Case study analysis of contributions to the change process, using reports, interviews, focus group discussions and surveys and based on Herzberg's Motivation Theory to analyze involvement of different stakeholders. Results Different stakeholders were motivated by selected activities, such as providing opportunities for non-university stakeholders to share their opinions, organizing interactions among university stakeholders, stimulating both bottom-up and top-down inputs, focusing on learning from each other, and emphasizing self-motivation factors. Conclusion The Herzberg Motivation theory helped to identify suitable approaches to ensure that teaching topics, materials and assessment methods more closely reflected the health care needs of the community. Other medical schools undertaking a reform process may learn from this experience. PMID:19630961

A conceptual model to empower software requirements conflict detection and resolution with rule-based reasoning

NASA Astrophysics Data System (ADS)

Ahmad, Sabrina; Jalil, Intan Ermahani A.; Ahmad, Sharifah Sakinah Syed

2016-08-01

It is seldom technical issues which impede the process of eliciting software requirements. The involvement of multiple stakeholders usually leads to conflicts and therefore the need of conflict detection and resolution effort is crucial. This paper presents a conceptual model to further improve current efforts. Hence, this paper forwards an improved conceptual model to assist the conflict detection and resolution effort which extends the model ability and improves overall performance. The significant of the new model is to empower the automation of conflicts detection and its severity level with rule-based reasoning.

Return-to-work success despite conflicts: an exploration of decision-making during a work rehabilitation program.

PubMed

Gouin, Marie-Michelle; Coutu, Marie-France; Durand, Marie-José

2017-11-12

Collective decision-making by stakeholders appears important to return-to-work success, yet few studies have explored the processes involved. This study aims to explore the influence of decision-making on return-to-work for workers with musculoskeletal or common mental disorders. This study is a secondary analysis using data from three earlier multiple-case studies that documented decision-making during similar and comparable work rehabilitation programs. Individual interviews were conducted at the end of the program with stakeholders, namely, the disabled workers and representatives of health care professionals, employers, unions and insurers. Verbatims were analysed inductively. The 28 decision-making processes (cases) led to 115 different decisions-making instances and included the following components: subjects of the decisions, stakeholders' concerns and powers, and types of decision-making. No differences were found in decision-making processes relative to the workers' diagnoses or return-to-work status. However, overall analysis of decision-making revealed that stakeholder agreement on a return-to-work goal and acceptance of an intervention plan in which the task demands aligned with the worker's capacities were essential for return-to-work success. These results support the possibility of return-to-work success despite conflictual decision-making processes. In addition to facilitating consensual decisions, future studies should be aimed at facilitating negotiated decisions. Implications for rehabilitation Facilitating decision-making, with the aim of obtaining agreement from all stakeholders on a return-to-work goal and their acceptance of an intervention plan that respects the worker's capacities, is important for return-to-work success. Rehabilitation professionals should constantly be on the lookout for potential conflicts, which may either complicate the reach of an agreement between the stakeholders or constrain return-to-work possibilities. Rehabilitation professionals should also be constantly watching for workers' and employers' return-to-work concerns, as they may change during work rehabilitation, potentially challenging a reached agreement.

Science, policy, and stakeholders: developing a consensus science plan for Amchitka Island, Aleutians, Alaska.

PubMed

Burger, Joanna; Gochfeld, Michael; Kosson, David S; Powers, Charles W; Friedlander, Barry; Eichelberger, John; Barnes, David; Duffy, Lawrence K; Jewett, Stephen C; Volz, Conrad D

2005-05-01

With the ending of the Cold War, the US Department of Energy is responsible for the remediation of radioactive waste and disposal of land no longer needed for nuclear material production or related national security missions. The task of characterizing the hazards and risks from radionuclides is necessary for assuring the protection of health of humans and the environment. This is a particularly daunting task for those sites that had underground testing of nuclear weapons, where the radioactive contamination is currently inaccessible. Herein we report on the development of a Science Plan to characterize the physical and biological marine environment around Amchitka Island in the Aleutian chain of Alaska, where three underground nuclear tests were conducted (1965-1971). Information on the ecology, geology, and current radionuclide levels in biota, water, and sediment is necessary for evaluating possible current contamination and to serve as a baseline for developing a plan to ensure human and ecosystem health in perpetuity. Other information required includes identifying the location of the salt water/fresh water interface where migration to the ocean might occur in the future and determining groundwater recharge balances, as well as assessing other physical/geological features of Amchitka near the test sites. The Science Plan is needed to address the confusing and conflicting information available to the public about radionuclide risks from underground nuclear blasts in the late 1960s and early 1970s, as well as the potential for volcanic or seismic activity to disrupt shot cavities or accelerate migration of radionuclides into the sea. Developing a Science Plan involved agreement among regulators and other stakeholders, assignment of the task to the Consortium for Risk Evaluation with Stakeholder Participation, and development of a consensus Science Plan that dealt with contentious scientific issues. Involvement of the regulators (State of Alaska), resource trustees (U S Fish and Wildlife Service), representatives of the Aleut and Pribilof Island communities, and other stakeholders was essential for plan development and approval, although this created tensions because of the different objectives of each group. The complicated process of developing a Science Plan involved iterations and interactions with multiple agencies and organizations, scientists in several disciplines, regulators, and the participation of Aleut people in their home communities, as well as the general public. The importance of including all parties in all phases of the development of the Science Plan was critical to its acceptance by a broad range of regulators, agencies, resource trustees, Aleutian/Pribilof communities, and other stakeholders.

Creating a Regional Drought Early Warning System (DEWS) for California and Nevada: Building Off of Information Gathered and Lessons Learned after 5 Years of Drought

NASA Astrophysics Data System (ADS)

Sheffield, A. M.; Marrs, A.; Wall, T. U.; Cayan, D.; Kalansky, J.; Redmond, K. T.; Huntington, J. L.; McEvoy, D.

2016-12-01

In California and Nevada, a diverse set of sectors and regional variation amidst a 5-year spell of drought presents multiple needs, gaps and challenges in providing usable available information for drought preparedness. In response to the findings of Governor Sandoval's Nevada Drought Forum and a series of stakeholder meetings and drought and climate outlooks in California, NOAA's National Integrated Drought Information System (NIDIS) has created the California-Nevada DEWS to leverage the activities of the existing California DEWS to better reflect the needs of the region after five years of unprecedented drought. In addition to presenting timely drought status and outlooks, these stakeholder-oriented meetings and listening sessions explored local drought impacts and drought informational needs. The information gathered will be integrated into a strategic plan for California-Nevada DEWS. This strategic plan will provide a roadmap of planned research and activities to enhance the ability of stakeholders in the region to better plan, prepare for and mitigate the impacts of drought. The implementation will involve key partners from a diverse network of federal, regional, tribal, state and local agencies and interests and will result in regionally specific deliverables to advance the California-Nevada DEWS.

Community stakeholders' perceptions of barriers to childhood obesity prevention in low-income families, Massachusetts 2012-2013.

PubMed

Ganter, Claudia; Chuang, Emmeline; Aftosmes-Tobio, Alyssa; Blaine, Rachel E; Giannetti, Mary; Land, Thomas; Davison, Kirsten K

2015-03-26

The etiology of childhood obesity is multidimensional and includes individual, familial, organizational, and societal factors. Policymakers and researchers are promoting social-ecological approaches to obesity prevention that encompass multiple community sectors. Programs that successfully engage low-income families in making healthy choices are greatly needed, yet little is known about the extent to which stakeholders understand the complexity of barriers encountered by families. The objective of this study was to contextually frame barriers faced by low-income families reported by community stakeholders by using the Family Ecological Model (FEM). From 2012 through 2013, we conducted semistructured interviews with 39 stakeholders from 2 communities in Massachusetts that were participating in a multisector intervention for childhood obesity prevention. Stakeholders represented schools; afterschool programs; health care; the Special Supplemental Nutrition Program for Women, Infants, and Children; and early care and education. Interviews were audio-recorded, transcribed, coded, and summarized. Stakeholder reports of the barriers experienced by low-income families had a strong degree of overlap with FEM and reflected awareness of the broader contextual factors (eg, availability of community resources, family culture, education) and social and emotional dynamics within families (eg, parent knowledge, social norms, distrust of health care providers, chronic life stressors) that could affect family adoption of healthy lifestyle behaviors. Furthermore, results illustrated a level of consistency in stakeholder awareness across multiple community sectors. The congruity of stakeholder perspectives with those of low-income parents as summarized in FEM and across community sectors illustrates potential for synergizing the efforts necessary for multisector, multilevel community interventions for the prevention of childhood obesity.

Stakeholder involvement in the design of a patient-centered comparative effectiveness trial of the "On the Move" group exercise program in community-dwelling older adults.

PubMed

Brach, Jennifer S; Perera, Subashan; Gilmore, Sandra; VanSwearingen, Jessie M; Brodine, Deborah; Wert, David; Nadkarni, Neelesh K; Ricci, Edmund

2016-09-01

Group exercise programs for older adults often exclude the timing and coordination of movement. Stakeholder involvement in the research process is strongly encouraged and improves the relevance and adoption of findings. We describe stakeholder involvement in the design of a clinical trial of a group-based exercise program that incorporates timing and coordination of movement into the exercises. The study was a cluster randomized, single-blind intervention trial to compare the effects on function, disability and mobility of a standard group exercise program and the "On the Move" group exercise program in older adults residing in independent living facilities and senior apartment buildings, and attending community centers. Exercise classes were twice weekly for 12weeks delivered by study exercise leaders and facility activity staff personnel. The primary outcomes function, disability and mobility were assessed at baseline and post-intervention. Function and disability were assessed using the Late Life Function and Disability Instrument, and mobility using the Six-Minute Walk Test and gait speed. Patient and provider stakeholders had significant input into the study aims, design, sample, intervention, outcomes and operational considerations. A community-based exercise program to improve walking can be developed to address both investigator identified missing components in current exercise to improve walking and stakeholder defined needs and interest for the activity program. Involvement of stakeholders substantially improves the relevance of research questions, increases the transparency of research activities and may accelerate the adoption of research into practice. Copyright © 2016 Elsevier Inc. All rights reserved.

An asthma action plan created by physician, educator and patient online collaboration with usability and visual design optimization.

PubMed

Gupta, Samir; Wan, Flora T; Hall, Susan E; Straus, Sharon E

2012-01-01

Asthma action plans (AAPs), which decrease hospitalizations and improve symptom control, are recommended in guidelines, but are seldom delivered to patients. Existing AAPs have been developed by experts, without the inclusion of all stakeholders (such as patients with asthma) and without specifically addressing usability and visual design. Our objective was to develop a more usable AAP by involving all stakeholders and considering design preferences. We created a Wiki-based system for multiuser AAP development. Pulmonologists, primary care physicians, asthma educators and patients used the system to collaboratively compile a single AAP by making multiple online selections over 1 week. We combined common elements from 3 AAPs developed in this way into 1, optimized visual design features and tested face validity in focus groups. A total of 41 participants averaged 646 selections/week over a login-time of 28.8 h/week. Of 35 participants, 28 (80%) were satisfied with the final AAP and 32 (91%) perceived that they would be able to use it. The plans created by the 3 groups were very similar, with a unanimous or majority agreement in the handling of 100/110 (91%) AAP options. Inclusion of multiple stakeholders and focus on design preferences predict enhanced usability and uptake of medical tools. The validity of our AAP is further supported by the similarity between the AAPs created by each group, user engagement and satisfaction with the plan and agreement with existing validity criteria proposed by experts. This AAP can be implemented in care with a concurrent measurement of uptake and health impact. Copyright © 2012 S. Karger AG, Basel.

Research for better health: the Panamanian priority-setting experience and the need for a new process

PubMed Central

2014-01-01

Background Panama is, economically, the fastest growing country in Central America and is making efforts to improve management mechanisms for research and innovation. However, due to contextual factors, the Panamanian Health Research System is not well developed and is poorly coordinated with the Health System. Likewise, despite recent efforts to define a National Health Research Agenda, implementing this agenda and aligning it with Panamanians’ health needs remains difficult. This articles aims to review Panama’s experience in health research priority setting by analyzing the fairness of previous prioritization processes in order to promote an agreed-upon national agenda aligned with public health needs. Methods The three health research prioritization processes performed in Panama between 2006 and 2011 were analyzed based on the guidelines established by the four “Accountability for Reasonableness” principles, namely “relevance”, “publicity”, “revision”, and “enforcement”, which provide a framework for evaluating priority-setting fairness. Results The three health research priority-setting events performed in Panama during the reference period demonstrated a heterogeneous pattern of decision-making strategies, stakeholder group composition, and prioritization outcomes. None of the three analyzed events featured an open discussion process with the scientific community, health care providers, or civil society in order to reach consensus. Conclusions This investigation makes evident the lack of a strategy to encourage open discussion by the multiple stakeholders and interest groups that should be involved during the priority-setting process. The analysis reveals the need for a new priority-setting exercise that validates the National Agenda, promotes its implementation by the National Secretariat for Science, Technology and Innovation in conjunction with the Ministry of Health, and empowers multiple stakeholders; such an exercise would, in turn, favor the implementation of the agenda. PMID:25117661

Engaging Stakeholders in Patient-Centered Outcomes Research Regarding School-Based Sealant Programs.

PubMed

Chi, Donald L; Milgrom, Peter; Gillette, Jane

2018-02-01

Purpose: The purpose of this study was to use qualitative methods to describe the key lessons learned during the stakeholder engagement stage of planning a randomized clinical trial comparing outcomes of silver diamine fluoride (SDF) as an alternative to pit-and-fissure sealants in a school-based delivery system. Methods: Eighteen caregivers and community-based stakeholders with involvement in the school-based sealant program Sealants for Smiles from the state of Montana, were recruited for this qualitative study. United States (U.S.) Patient-Centered Outcomes Research Institute (PCORI) methodology standards were used to develop two semi-structured interview guides consisting of 6 questions. One interview guide was used for telephone interviews with caregivers and the second was used for a stakeholder focus group. Content analytic methods were used to analyze the data. Results: All participants believed that a study comparing SDF and sealants was clinically relevant. Non-caregiver stakeholders agreed with the proposed primary outcome of the study (caries prevention) whereas caregivers also emphasized the importance of child-centered outcomes such as minimizing dental anxiety associated with dental care. Stakeholders described potential concerns associated with SDF such as staining and perceptions of safety and discussed ways to address these concerns through community engagement, appropriate framing of the study, proper consent procedures, and ongoing safety monitoring during the trial. Finally, stakeholders suggested dissemination strategies such as direct communication of findings through professional organizations and encouraging insurance plans to incentivize SDF use by reimbursing dental providers. Conclusions: Involving key stakeholders in early planning is essential in developing patient-centered research questions, outcomes measures, study protocols, and dissemination plans for oral health research involving a school-based delivery system. Copyright © 2018 The American Dental Hygienists’ Association.

Understanding the perceptions, roles and interactions of stakeholder networks managing health-care waste: A case study of the Gaza Strip.

PubMed

Caniato, M; Tudor, T; Vaccari, M

2015-01-01

The sustainable management of waste requires a holistic approach involving a range of stakeholders. What can often be difficult is to understand the manner in which different types of stakeholder networks are composed and work, and how best to enhance their effectiveness. Using social network analysis and stakeholder analysis of healthcare waste management stakeholders in the case study region of the Gaza Strip, this study aimed to understand and examine the manner in which the networks functioned. The Ministry of Health was found to be the most important stakeholder, followed by municipalities and solid waste management councils. Some international agencies were also mentioned, with specific roles, while other local institutions had a limited influence. Finally while health-care facilities had a strong interest in waste management, they were generally poorly informed and had limited links to each other. The manner in which the networks operated was complicated and influenced by differences in perception, sharing of information, access to finance and levels of awareness. The lack of a clear legal framework generated various mistakes about roles and responsibilities in the system, and evidently regulation was not an effective driver for improvement. Finally stakeholders had different priorities according to the waste management issues they were involved with, however segregation at the source was identified as a key requirement by most. Areas for improving the effectiveness of the networks are suggested. The analysis utilized an innovative methodology, which involved a large number of stakeholders. Such an approach served to raise interest and awareness at different levels (public authorities, health providers, supporting actors, others), stimulate the discussion about the adoption of specific policies, and identify the effective way forward. Copyright © 2014 Elsevier Ltd. All rights reserved.

Physiotherapy Research Priorities in Switzerland: Views of the Various Stakeholders.

PubMed

Nast, Irina; Tal, Amir; Schmid, Stefan; Schoeb, Veronika; Rau, Barbara; Barbero, Marco; Kool, Jan

2016-09-01

Research priorities, defined by multiple stakeholders, can proximally facilitate the coordination of research projects and national and international cooperation and distally further improve the quality of physiotherapy practice. The aim of this study was therefore to establish physiotherapy research priorities in Switzerland considering multiple stakeholders' opinions. A mixed methods design was chosen. For a qualitative identification of physiotherapy research topics, 18 focus group discussions and 23 semi-structured interviews/written commentaries were conducted. For the quantitative analysis, 420 participants prioritized research topics using a two-round Delphi questionnaire survey. The following stakeholder groups were surveyed in the German-speaking, French-speaking and Italian-speaking regions of Switzerland: physiotherapy researchers, practitioners and educators, representatives of patient organizations, public health organizations, health insurers, physicians, nurses, occupational therapists and other health professionals, as well as physical educators. The top five overall physiotherapy research priorities identified were as follows: physiotherapy treatment, physiotherapy assessment and diagnosis, prevention, physiotherapist-patient interaction and physiotherapy professional education at the bachelor level. With regard to diagnostic groups, the highest priorities were placed on musculoskeletal disorders, neurology, orthopaedics, geriatrics and ergonomics/occupational health. Consensus was moderate to high, and only few differences between stakeholder groups were revealed. Research directly related to physiotherapy treatment is of highest priority. It should focus on diagnostic groups related to chronicity in anticipation of demographic changes. Multidisciplinary networks for research and practice, alongside sound coordination of research projects, should increase the impact of physiotherapy research. An accurate dissemination of research priorities, defined and supported by multiple stakeholder groups, might strengthen their impact on research and practice. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Supporting multi-stakeholder environmental decisions.

PubMed

Hajkowicz, Stefan A

2008-09-01

This paper examines how multiple criteria analysis (MCA) can be used to support multi-stakeholder environmental management decisions. It presents a study through which 48 stakeholders from environmental, primary production and community interest groups used MCA to prioritise 30 environmental management problems in the Mackay-Whitsunday region of Queensland, Australia. The MCA model, with procedures for aggregating multi-stakeholder output, was used to inform a final decision on the priority of the region's environmental management problems. The result was used in the region's environmental management plan as required under Australia's Natural Heritage Trust programme. The study shows how relatively simple MCA methods can help stakeholders make group decisions, even when they hold strongly conflicting preferences.

Recording and accounting for stakeholder involvement in systematic reviews.

PubMed

Saan, Marieke C; Boeije, Hennie R; Sattoe, Jane N T; Bal, Marjolijn I; Missler, Marjolein; van Wesel, Floryt

2015-06-01

The use of stakeholders in systematic reviews is increasingly valued, but their influence on the systematicity of the review is often unclear. The aim of this study was to describe some of the processes of involvement of stakeholders and to demonstrate a Tool for Recording and Accounting for Stakeholder Involvement (TRASI). We demonstrate the TRASI in two worked examples. In one project, the reviewers collaborated with the end-user and an expert during the literature search. In the other project, experts were consulted to generate keywords before searching the literature. In the first project, disagreements about keywords to identify studies for the research topic were solved by informal discussion. In the second project, difficulties arose in reaching agreement between experts and reviewers about the core construct and the meaningful keywords associated with it. The TRASI aids researchers to systematically and transparently account for the decisions taken. The TRASI supports information specialists and librarians to shape the search strategy to match the objectives of the review. We propose the TRASI as a first step in resolving the challenges of detecting and reconstructing stakeholder influences. Potential new applications of the TRASI are discussed. © 2015 Health Libraries Group.

Enhancing School HIV and AIDS Strategic Plan through Expanded Stakeholder Involvement

ERIC Educational Resources Information Center

Mgomezulu, V. Y.; Kruger, A. G.

2011-01-01

This article focuses on the need for expanded stakeholder involvement as a means of enhancing the Botswana Department of Secondary Education (DSE) HIV and AIDS strategic plan. Research has indicated that the effects of HIV and AIDS on the supply of and demand for education are considerable. Using a questionnaire and interviews, the research has…

Nursing Home Stakeholder Views of Resident Involvement in Medical Care Decisions

PubMed Central

Garcia, Theresa J.; Harrison, Tracie C.; Goodwin, James S.

2017-01-01

Demand by nursing home residents for involvement in their medical care, or, patient-centered care, is expected to increase as baby boomers begin seeking long-term care for their chronic illnesses. To explore the needs in meeting this proposed demand, we used a qualitative descriptive method with content analysis to obtain the joint perspective of key stakeholders on the current state of person-centered medical care in the nursing home. We interviewed 31 nursing home stakeholders: 5 residents, 7 family members, 8 advanced practice registered nurses, 5 physicians, and 6 administrators. Our findings revealed constraints placed by the long-term care system limited medical involvement opportunities and created conflicting goals for patient-centered medical care. Resident participation in medical care was perceived as low, but important. The creation of supportive educational programs for all stakeholders to facilitate a common goal for nursing home admission and to provide assistance through the long-term care system was encouraged. PMID:25721717

Stakeholder Partnerships as Collaborative Policymaking: Evaluation Criteria Applied to Watershed Management in California and Washington

ERIC Educational Resources Information Center

Leach, William D.; Pelkey, Neil W.; Sabatier, Paul A.

2002-01-01

Public policymaking and implementation in the United States are increasingly handled through local, consensus-seeking partnerships involving most affected stakeholders. This paper formalizes the concept of a stakeholder partnership, and proposes techniques for using interviews, surveys, and documents to measure each of six evaluation criteria.…

More Stake, Less Gravy? Issues of Knowledge and Power in Higher Education.

ERIC Educational Resources Information Center

Bak, Nelleke; Paterson, Andrew

1997-01-01

Two perspectives on higher education's stakeholders and their involvement in the development of knowledge in universities are examined and contrasted: (1) that the "stakeholder" notion of knowledge doesn't allow for critical engagement with knowledge, and (2) that the "stakeholder" view of knowledge acknowledges clear links between knowledge and…

Enterprise Education Programmes in Secondary Schools in Ireland: A Multi-Stakeholder Perspective

ERIC Educational Resources Information Center

Birdthistle, Naomi; Hynes, Briga; Fleming, Patricia

2007-01-01

Purpose: The aim of this paper is to examine the perceptions and attitudes towards enterprise education at secondary level in Ireland from a multi-stakeholder perspective. The key stakeholders involved in enterprise education are teachers, principals, pupils and parents. The examination encompassed profiling the Irish educational system and the…

The Skinny on Big Data in Education: Learning Analytics Simplified

ERIC Educational Resources Information Center

Reyes, Jacqueleen A.

2015-01-01

This paper examines the current state of learning analytics (LA), its stakeholders and the benefits and challenges these stakeholders face. LA is a field of research that involves the gathering, analyzing and reporting of data related to learners and their environments with the purpose of optimizing the learning experience. Stakeholders in LA are…

The Perspectives of Major Stakeholders on Video Enriched Problem-Based Learning for Chinese Teacher Education

ERIC Educational Resources Information Center

Ma, Angela Kit Fong; O'Toole, John Mitchell

2013-01-01

The study described in this paper investigated how the major stakeholders of a teacher education institution responded to a particular suite of educational products that involved video-based educational learning objects. It aims to look into stakeholder attitudes to potential technological development in fostering student-centred learning in…

Incorporating bioenergy into sustainable landscape designs

DOE PAGES

Dale, Virginia H.; Kline, Keith L.; Buford, Marilyn A.; ...

2015-12-30

In this paper, we describe an approach to landscape design that focuses on integrating bioenergy production with other components of environmental, social and economic systems. Landscape design as used here refers to a spatially explicit, collaborative plan for management of landscapes and supply chains. Landscape design can involve multiple scales and build on existing practices to reduce costs or enhance services. Appropriately applied to a specific context, landscape design can help people assess trade-offs when making choices about locations, types of feedstock, transport, refining and distribution of bioenergy products and services. The approach includes performance monitoring and reporting along themore » bioenergy supply chain. Examples of landscape design applied to bioenergy production systems are presented. Barriers to implementation of landscape design include high costs, the need to consider diverse land-management objectives from a wide array of stakeholders, up-front planning requirements, and the complexity and level of effort needed for successful stakeholder involvement. A landscape design process may be stymied by insufficient data or participation. An impetus for coordination is critical, and incentives may be required to engage landowners and the private sector. In conclusion, devising and implementing landscape designs for more sustainable outcomes require clear communication of environmental, social, and economic opportunities and concerns.« less

Prevention of work disability due to musculoskeletal disorders: the challenge of implementing evidence.

PubMed

Loisel, Patrick; Buchbinder, Rachelle; Hazard, Rowland; Keller, Robert; Scheel, Inger; van Tulder, Maurits; Webster, Barbara

2005-12-01

The process of returning disabled workers to work presents numerous challenges. In spite of the growing evidence regarding work disability prevention, little uptake of this evidence has been observed. One reason for limited dissemination of evidence is the complexity of the problem, as it is subject to multiple legal, administrative, social, political, and cultural challenges. A literature review and collection of experts' opinion is presented, on the current evidence for work disability prevention, and barriers to evidence implementation. Recommendations are presented for enhancing implementation of research results. The current evidence regarding work disability prevention shows that some clinical interventions (advice to return to modified work and graded activity programs) and some non-clinical interventions (at a service and policy/community level but not at a practice level) are effective in reducing work absenteeism. Implementation of evidence in work disability is a major challenge because intervention recommendations are often imprecise and not yet practical for immediate use, many barriers exist, and many stakeholders are involved. Future studies should involve all relevant stakeholders and aim at developing new strategies that are effective, efficient, and have a potential for successful implementation. These studies should be based upon a clearer conceptualization of the broader context and inter-relationships that determine return to work outcomes.

Incorporating bioenergy into sustainable landscape designs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dale, Virginia H.; Kline, Keith L.; Buford, Marilyn A.

In this paper, we describe an approach to landscape design that focuses on integrating bioenergy production with other components of environmental, social and economic systems. Landscape design as used here refers to a spatially explicit, collaborative plan for management of landscapes and supply chains. Landscape design can involve multiple scales and build on existing practices to reduce costs or enhance services. Appropriately applied to a specific context, landscape design can help people assess trade-offs when making choices about locations, types of feedstock, transport, refining and distribution of bioenergy products and services. The approach includes performance monitoring and reporting along themore » bioenergy supply chain. Examples of landscape design applied to bioenergy production systems are presented. Barriers to implementation of landscape design include high costs, the need to consider diverse land-management objectives from a wide array of stakeholders, up-front planning requirements, and the complexity and level of effort needed for successful stakeholder involvement. A landscape design process may be stymied by insufficient data or participation. An impetus for coordination is critical, and incentives may be required to engage landowners and the private sector. In conclusion, devising and implementing landscape designs for more sustainable outcomes require clear communication of environmental, social, and economic opportunities and concerns.« less

Differentiating innovation priorities among stakeholder in hospital care.

PubMed

Lambooij, Mattijs S; Hummel, Marjan J

2013-08-16

Decisions to adopt a particular innovation may vary between stakeholders because individual stakeholders may disagree on the costs and benefits involved. This may translate to disagreement between stakeholders on priorities in the implementation process, possibly explaining the slow diffusion of innovations in health care. In this study, we explore the differences in stakeholder preferences for innovations, and quantify the difference in stakeholder priorities regarding costs and benefits. The decision support technique called the analytic hierarchy process was used to quantify the preferences of stakeholders for nine information technology (IT) innovations in hospital care. The selection of the innovations was based on a literature review and expert judgments. Decision criteria related to the costs and benefits of the innovations were defined. These criteria were improvement in efficiency, health gains, satisfaction with care process, and investments required. Stakeholders judged the importance of the decision criteria and subsequently prioritized the selected IT innovations according to their expectations of how well the innovations would perform for these decision criteria. The stakeholder groups (patients, nurses, physicians, managers, health care insurers, and policy makers) had different preference structures for the innovations selected. For instance, self-tests were one of the innovations most preferred by health care insurers and managers, owing to their expected positive impacts on efficiency and health gains. However, physicians, nurses and patients strongly doubted the health gains of self-tests, and accordingly ranked self-tests as the least-preferred innovation. The various stakeholder groups had different expectations of the value of the nine IT innovations. The differences are likely due to perceived stakeholder benefits of each innovation, and less to the costs to individual stakeholder groups. This study provides a first exploratory quantitative insight into stakeholder positions concerning innovation in health care, and presents a novel way to study differences in stakeholder preferences. The results may be taken into account by decision makers involved in the implementation of innovations.

Differentiating innovation priorities among stakeholder in hospital care

PubMed Central

2013-01-01

Background Decisions to adopt a particular innovation may vary between stakeholders because individual stakeholders may disagree on the costs and benefits involved. This may translate to disagreement between stakeholders on priorities in the implementation process, possibly explaining the slow diffusion of innovations in health care. In this study, we explore the differences in stakeholder preferences for innovations, and quantify the difference in stakeholder priorities regarding costs and benefits. Methods The decision support technique called the analytic hierarchy process was used to quantify the preferences of stakeholders for nine information technology (IT) innovations in hospital care. The selection of the innovations was based on a literature review and expert judgments. Decision criteria related to the costs and benefits of the innovations were defined. These criteria were improvement in efficiency, health gains, satisfaction with care process, and investments required. Stakeholders judged the importance of the decision criteria and subsequently prioritized the selected IT innovations according to their expectations of how well the innovations would perform for these decision criteria. Results The stakeholder groups (patients, nurses, physicians, managers, health care insurers, and policy makers) had different preference structures for the innovations selected. For instance, self-tests were one of the innovations most preferred by health care insurers and managers, owing to their expected positive impacts on efficiency and health gains. However, physicians, nurses and patients strongly doubted the health gains of self-tests, and accordingly ranked self-tests as the least-preferred innovation. Conclusions The various stakeholder groups had different expectations of the value of the nine IT innovations. The differences are likely due to perceived stakeholder benefits of each innovation, and less to the costs to individual stakeholder groups. This study provides a first exploratory quantitative insight into stakeholder positions concerning innovation in health care, and presents a novel way to study differences in stakeholder preferences. The results may be taken into account by decision makers involved in the implementation of innovations. PMID:23947398

Ethical considerations of worksite health promotion: an exploration of stakeholders' views.

PubMed

van Berkel, Jantien; Meershoek, Agnes; Janssens, Rien M J P A; Boot, Cécile R L; Proper, Karin I; van der Beek, Allard J

2014-05-16

Developing, implementing and evaluating worksite health promotion requires dealing with all stakeholders involved, such as employers, employees, occupational physicians, insurance companies, providers, labour unions and research and knowledge institutes. Although worksite health promotion is becoming more common, empirical research on ethical considerations of worksite health promotion is scarce. We explored the views of stakeholders involved in worksite health promotion in focus group discussions and we described the ethical considerations that result from differences between these views. The focus group discussions were organised per stakeholder group. Data were analysed according to the constant comparison method. Our analyses show that although the definition of occupational health is the same for all stakeholders, namely 'being able to perform your job', there seem to be important differences in the views on what constitutes a risk factor to occupational health. According to the employees, risk factors to occupational health are prevailingly job-related. Labour unions agree with them, but other stakeholders, including the employer, particularly see employee-related issues such as lifestyle behaviour as risk factors to occupational health. The difference in definition of occupational health risk factors translates into the same categorisation of worksite health promotion; employee-related activities and work-related activities. The difference in conceptualisation of occupational health risk factors and worksite health promotion resonates in the way stakeholders understand 'responsibility' for lifestyle behaviour. Even though all stakeholders agree on whose responsibility lifestyle behaviour is, namely that of the employee, the meaning of 'responsibility' differs between employees, and employers. For employees, responsibility means autonomy, while for employers and other stakeholders, responsibility equals duty. This difference may in turn contribute to ambivalent relationships between stakeholders. All stakeholders, including employees, should be given a voice in developing, implementing and evaluating worksite health promotion. Moreover, since stakeholders agree on lifestyle being the responsibility of the employee, but disagree on what this responsibility means (duty versus autonomy), it is of utmost importance to examine the discourse of stakeholders. This way, ambivalence in relationships between stakeholders could be prevented.

Quantifying ecosystem service trade-offs: the case of an urban floodplain in Vienna, Austria.

PubMed

Sanon, Samai; Hein, Thomas; Douven, Wim; Winkler, Peter

2012-11-30

Wetland ecosystems provide multiple functions and services for the well-being of humans. In urban environments, planning and decision making about wetland restoration inevitably involves conflicting objectives, trade-offs, uncertainties and conflicting value judgments. This study applied trade-off and multi criteria decision analysis to analyze and quantify the explicit trade-offs between the stakeholder's objectives related to management options for the restoration of an urban floodplain, the Lobau, in Vienna, Austria. The Lobau has been disconnected from the main channel of the Danube River through flood protection schemes 130 years ago that have reduced the hydraulic exchange processes. Urban expansion has also changed the adjacent areas and led to increased numbers of visitors, which hampers the maximum potential for ecosystem development and exerts additional pressure on the sensitive habitats in the national park area. The study showed that increased hydraulic connectivity would benefit several stakeholders that preferred the ecological development of the floodplain habitats. However, multiple uses including fishery, agriculture and recreation, exploring the maximum potential in line with national park regulations, were also possible under the increased hydraulic connectivity options. The largest trade-offs were quantified to be at 0.50 score between the ecological condition of the aquatic habitats and the drinking water production and 0.49 score between the ecological condition of the terrestrial habitats and the drinking water production. At this point, the drinking water production was traded-off with 0.40 score, while the ecological condition of the aquatic habitats and the ecological condition of the terrestrial habitats were traded off with 0.30 and 0.23 score, respectively. The majority of the stakeholders involved preferred the management options that increased the hydraulic connectivity compared with the current situation which was not preferred by any stakeholders. These findings highlight the need for targeted restoration measures. By that, it is recommended that additional measures to ensure reliable drinking water production should be developed, if the higher connectivity options would be implemented. In the next step it is recommended to include cost and flood risk criteria in the decision matrix for more specific developed measures. The research showed that pair-wise trade-off figures provided a useful means to elaborate and quantify the real trade-offs. Finally, the research also showed that the use of multi criteria decision analyses should be based on a participatory approach, in which the process of arriving at the final ranking should be equal or more important than the outcome of the ranking itself. Copyright © 2012 Elsevier Ltd. All rights reserved.

Influencing organizations to promote health: applying stakeholder theory.

PubMed

Kok, Gerjo; Gurabardhi, Zamira; Gottlieb, Nell H; Zijlstra, Fred R H

2015-04-01

Stakeholder theory may help health promoters to make changes at the organizational and policy level to promote health. A stakeholder is any individual, group, or organization that can influence an organization. The organization that is the focus for influence attempts is called the focal organization. The more salient a stakeholder is and the more central in the network, the stronger the influence. As stakeholders, health promoters may use communicative, compromise, deinstitutionalization, or coercive methods through an ally or a coalition. A hypothetical case study, involving adolescent use of harmful legal products, illustrates the process of applying stakeholder theory to strategic decision making. © 2015 Society for Public Health Education.

Doctors on the move: a European case study on the key characteristics of national recertification systems.

PubMed

Sehlbach, Carolin; Govaerts, Marjan J; Mitchell, Sharon; Rohde, Gernot G U; Smeenk, Frank W J M; Driessen, Erik W

2018-04-17

With increased cross-border movement, ensuring safe and high-quality healthcare has gained primacy. The purpose of recertification is to ensure quality of care through periodically attesting doctors' professional proficiency in their field. Professional migration and facilitated cross-border recognition of qualifications, however, make us question the fitness of national policies for safeguarding patient care and the international accountability of doctors. We performed document analyses and conducted 19 semistructured interviews to identify and describe key characteristics and effective components of 10 different European recertification systems, each representing one case (collective case study). We subsequently compared these systems to explore similarities and differences in terms of assessment criteria used to determine process quality. Great variety existed between countries in terms and assessment formats used, targeting cognition, competence and performance (Miller's assessment pyramid). Recertification procedures and requirements also varied significantly, ranging from voluntary participation in professional development modules to the mandatory collection of multiple performance data in a competency-based portfolio. Knowledge assessment was fundamental to recertification in most countries. Another difference concerned the stakeholders involved in the recertification process: while some systems exclusively relied on doctors' self-assessment, others involved multiple stakeholders but rarely included patients in assessment of doctors' professional competence. Differences between systems partly reflected different goals and primary purposes of recertification. Recertification systems differ substantially internationally with regard to the criteria they apply to assess doctors' competence, their aims, requirements, assessment formats and patient involvement. In the light of professional mobility and associated demands for accountability, we recommend that competence assessment includes patients' perspectives, and recertification practices be shared internationally to enhance transparency. This can help facilitate cross-border movement, while guaranteeing high-quality patient care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A Randomized Trial Comparing Classical Participatory Design to VandAID, an Interactive CrowdSourcing Platform to Facilitate User-centered Design.

PubMed

Dufendach, Kevin R; Koch, Sabine; Unertl, Kim M; Lehmann, Christoph U

2017-10-26

Early involvement of stakeholders in the design of medical software is particularly important due to the need to incorporate complex knowledge and actions associated with clinical work. Standard user-centered design methods include focus groups and participatory design sessions with individual stakeholders, which generally limit user involvement to a small number of individuals due to the significant time investments from designers and end users. The goal of this project was to reduce the effort for end users to participate in co-design of a software user interface by developing an interactive web-based crowdsourcing platform. In a randomized trial, we compared a new web-based crowdsourcing platform to standard participatory design sessions. We developed an interactive, modular platform that allows responsive remote customization and design feedback on a visual user interface based on user preferences. The responsive canvas is a dynamic HTML template that responds in real time to user preference selections. Upon completion, the design team can view the user's interface creations through an administrator portal and download the structured selections through a REDCap interface. We have created a software platform that allows users to customize a user interface and see the results of that customization in real time, receiving immediate feedback on the impact of their design choices. Neonatal clinicians used the new platform to successfully design and customize a neonatal handoff tool. They received no specific instruction and yet were able to use the software easily and reported high usability. VandAID, a new web-based crowdsourcing platform, can involve multiple users in user-centered design simultaneously and provides means of obtaining design feedback remotely. The software can provide design feedback at any stage in the design process, but it will be of greatest utility for specifying user requirements and evaluating iterative designs with multiple options.

Bilevel formulation of a policy design problem considering multiple objectives and incomplete preferences

NASA Astrophysics Data System (ADS)

Hawthorne, Bryant; Panchal, Jitesh H.

2014-07-01

A bilevel optimization formulation of policy design problems considering multiple objectives and incomplete preferences of the stakeholders is presented. The formulation is presented for Feed-in-Tariff (FIT) policy design for decentralized energy infrastructure. The upper-level problem is the policy designer's problem and the lower-level problem is a Nash equilibrium problem resulting from market interactions. The policy designer has two objectives: maximizing the quantity of energy generated and minimizing policy cost. The stakeholders decide on quantities while maximizing net present value and minimizing capital investment. The Nash equilibrium problem in the presence of incomplete preferences is formulated as a stochastic linear complementarity problem and solved using expected value formulation, expected residual minimization formulation, and the Monte Carlo technique. The primary contributions in this article are the mathematical formulation of the FIT policy, the extension of computational policy design problems to multiple objectives, and the consideration of incomplete preferences of stakeholders for policy design problems.

Social Media Strategies for School Principals

ERIC Educational Resources Information Center

Cox, Dan; McLeod, Scott

2014-01-01

The purpose of this qualitative study was to describe, analyze, and interpret the experiences of school principals who use multiple social media tools with stakeholders as part of their comprehensive communications practices. Additionally, it examined why school principals have chosen to communicate with their stakeholders through social media.…

Subjective experience or objective process: understanding the gap between values and practice for involving patients in designing patient-centred care.

PubMed

Lord, Laura; Gale, Nicola

2014-01-01

Patient-centred care and patient involvement are increasingly central concepts in health policy in the UK and elsewhere. However, there is little consensus regarding their definition or how to achieve "patient-centred" care in everyday practice or how to involve patients in service redesign initiatives. The purpose of this paper is to explore these issues from the perspective of key stakeholders within National Health Service (NHS) hospitals in the UK. Semi-structured interviews, covering a range of topics related to service redesign, were conducted with 77 key stakeholders across three NHS Trusts in the West Midlands. In total, 20 of these stakeholders were re-interviewed 18 months later. Data were managed and analysed using the Framework Method. While patient-centred care and patient involvement were regularly cited as important to the stakeholders, a gap persisted between values and reported practice. This gap is explained through close examination of the ways in which the concepts were used by stakeholders, and identifying the way in which they were adapted to fit other organizational priorities. The value placed on positive subjective experience changed to concerns about objective measurement of the patients as they move through the system. Increased awareness and reflection on the conceptual tensions between objective processes and subjective experiences could highlight reasons why patient-centred values fail to translate into improved practice. The paper describes and explains a previously unarticulated tension in health organisations between values and practice in patient centred care and patient involvement in service redesign.

Making Knowledge from Numbers : The Shale Network as an Honest Broker for Evaluating and Educating about the Impacts of Hydraulic Fracturing in the Marcellus Shale Region

NASA Astrophysics Data System (ADS)

Pollak, J.; Brantley, S.; Williams, J.; Dykhoff, S.; Brazil, L. I.

2015-12-01

The Marcellus Shale Network is an NSF-funded project that investigates the impacts of hydraulic fracturing for shale gas development on water resources in and around the state of Pennsylvania. It is a collaborative effort that aims to be an honest broker in the shale gas conversation by involving multiple entities (including universities, government agencies, industry groups, nonprofits, etc.) to collect, analyze, and disseminate data that describe the past and current conditions of water in the Marcellus shale region. A critical component of this project has been to engage multiple types of stakeholders - academia, government agencies, industry, and citizen science groups - in annual workshops to present and discuss how to ensure the integrity of water resources in light of the challenges that natural gas extraction can present. Each workshop has included a hands-on activity that allows participants to access water quality data using the tools provided by the CUAHSI Water Data Center. One of these tools is HydroDesktop, which is an open source GIS application that can be used in formal and informal education settings as a geoscience research tool. In addition to being a GIS, HydroDesktop accesses CUAHSI's large catalog of water data thus enabling students, professional researchers, and citizen scientists to discover data that can expand the understanding of water quality issues in one's local environment and beyond. This presentation will highlight the goals of the Shale Network project and the stakeholders involved in addition to how cyberinfrastructure is being used to create a democratic, data-driven conversation about the relationship between energy production from shale gas and our water resources.

Stakeholder engagement opportunities in systematic reviews: knowledge transfer for policy and practice.

PubMed

Keown, Kiera; Van Eerd, Dwayne; Irvin, Emma

2008-01-01

Knowledge transfer and exchange is the process of increasing the awareness and use of research evidence in policy or practice decision making by nonresearch audiences or stakeholders. One way to accomplish this end is through ongoing interaction between researchers and interested nonresearch audiences, which provides an opportunity for the two groups to learn more about one another. The purpose of this article is to describe and discuss various stakeholder engagement opportunities that we employ throughout the stages of conducting a systematic review, to increase knowledge utilization within these audiences. Systematic reviews of the literature on a particular topic can provide an unbiased overview of the state of the literature. The engagement opportunities we have identified are topic consultation, feedback meetings during the review, member of review team, and involvement in dissemination. The potential benefits of including stakeholders in the process of a systematic review include increased relevance, clarity, and awareness of systematic review findings. A further benefit is the potential for increased dissemination of the findings. Challenges that researchers face are that stakeholder interactions can be time- and resource-intensive, it can be difficult balancing stakeholder desires with scientific rigor, and stakeholders may have difficulties accepting findings with which they do not agree. Despite these challenges we have included stakeholder involvement as a permanent step in the procedure of conducting a systematic review.

Evaluating taboo trade-offs in ecosystems services and human well-being

PubMed Central

Coulthard, Sarah; Cheung, William W. L.; Brown, Katrina; Abunge, Caroline; Galafassi, Diego; Peterson, Garry D.; McClanahan, Tim R.; Omukoto, Johnstone O.; Munyi, Lydiah

2015-01-01

Managing ecosystems for multiple ecosystem services and balancing the well-being of diverse stakeholders involves different kinds of trade-offs. Often trade-offs involve noneconomic and difficult-to-evaluate values, such as cultural identity, employment, the well-being of poor people, or particular species or ecosystem structures. Although trade-offs need to be considered for successful environmental management, they are often overlooked in favor of win-wins. Management and policy decisions demand approaches that can explicitly acknowledge and evaluate diverse trade-offs. We identified a diversity of apparent trade-offs in a small-scale tropical fishery when ecological simulations were integrated with participatory assessments of social–ecological system structure and stakeholders’ well-being. Despite an apparent win-win between conservation and profitability at the aggregate scale, food production, employment, and well-being of marginalized stakeholders were differentially influenced by management decisions leading to trade-offs. Some of these trade-offs were suggested to be “taboo” trade-offs between morally incommensurable values, such as between profits and the well-being of marginalized women. These were not previously recognized as management issues. Stakeholders explored and deliberated over trade-offs supported by an interactive “toy model” representing key system trade-offs, alongside qualitative narrative scenarios of the future. The concept of taboo trade-offs suggests that psychological bias and social sensitivity may exclude key issues from decision making, which can result in policies that are difficult to implement. Our participatory modeling and scenarios approach has the potential to increase awareness of such trade-offs, promote discussion of what is acceptable, and potentially identify and reduce obstacles to management compliance. PMID:26038547

Cooperation of return-to-work professionals: the challenges of multi-actor work disability management.

PubMed

Liukko, Jyri; Kuuva, Niina

2017-07-01

This article explores which concrete factors hinder or facilitate the cooperation of return-to-work (RTW) professionals in a complex system of multiple stakeholders. The empirical material consists of in-depth interviews with 24 RTW professionals from various organizations involved in work disability management in Finland. The interviews were analyzed using thematic content analysis. The study revealed several kinds of challenges in the cooperation of the professionals. These were related to two partly interrelated themes: communication and distribution of responsibility. The most difficult problems were connected to the cooperation between public employment offices and other stakeholders. However, the study distinguished notable regional differences depending primarily on the scale of the local network. The main areas of improvement proposed by the interviewees were related to better networking of case managers and expansion of expertise. The article argues for the importance of systematic networking and stresses the role of public employment services in the multi-actor management of work disabilities. The article contributes to existing work disability case management models by suggesting the employment administration system as an important component in addition to health care, workplace and insurance systems. The study also highlights the need for expansion of expertise in the field. Implications for Rehabilitation Cooperation between RTW professionals in public employment offices and other organizations involved in work disability management was considered inadequate. In order to improve the cooperation of RTW professionals, the stakeholders need to create more systematic ways of communication and networking with professionals in other organizations. There is a need to expand the expertise in work disability management and rehabilitation, partly by increasing the role of other professionals than physicians.

Chartered Society of Physiotherapy's identification of national research priorities for physiotherapy using a modified Delphi technique.

PubMed

Rankin, Gabrielle; Rushton, Alison; Olver, Pat; Moore, Ann

2012-09-01

To define research priorities to strategically inform the evidence base for physiotherapy practice. A modified Delphi method using SurveyMonkey software identified priorities for physiotherapy research through national consensus. An iterative process of three rounds provided feedback. Round 1 requested five priorities using pre-defined prioritisation criteria. Content analysis identified research themes and topics. Round 2 requested rating of the importance of the research topics using a 1-5 Likert scale. Round 3 requested a further process of rating. Quantitative and qualitative data informed decision-making. Level of consensus was established as mean rating ≥ 3.5, coefficient of variation ≤ 30%, and ≥ 55% agreement. Consensus across participants was evaluated using Kendall's W. Four expert panels (n=40-61) encompassing a range of stakeholders and reflecting four core areas of physiotherapy practice were established by steering groups (n=204 participants overall). Response rates of 53-78% across three rounds were good. The identification of 24/185 topics for musculoskeletal, 43/174 for neurology, 30/120 for cardiorespiratory and medical rehabilitation, and 30/113 for mental and physical health and wellbeing as priorities demonstrated discrimination of the process. Consensus between participants was good for most topics. Measurement validity of the research topics was good. The involvement of multiple stakeholders as participants ensured the current context of the intended use of the priorities. From a process of national consensus involving key stakeholders, including service users, physiotherapy research topics have been identified and prioritised. Setting priorities provides a vision of how research can contribute to the developing research base in physiotherapy to maximise focus. Copyright © 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Assessing risk from a stakeholder perspective

NASA Technical Reports Server (NTRS)

Cooper, L. P.

2003-01-01

Planetary exploration missions are subject to a vast array of interpretations of 'success' based on the concerns of multiple stakeholder groups. While project risk management generally focuses on issues of cost/schedule constraints or reliability issues, a broader interpretation of 'risk' as it applies to stakeholders such as sponsors (e.g., NASA), the public at large, the scientific community, the home organization, and the project team itself can provide important insights into the full spectrum of risk that needs to be managed. This paper presents a stakeholder view of risk which is divided into failure, not-a-failure, success, and stunning-success zones. Using the Mars Pathfinder mission as an example, an alternative interpretation of the risks to that mission is presented from the view of key stakeholders. The implications of the stakeholder perspective to project risk management are addressed.

In search of common ground among diverse forest stakeholders: A contextual content analysis of online text

Treesearch

Jennifer A. Cuff; David N. Bengston; Donald G. McTavish

2000-01-01

Managing public forest collaboratively requires an understanding of differences between and similarities among diverse stakeholder groups. The Minnesota Contextual Content Analysis (MCCA) computer program was used to analyze text obtained from World Wide Web sites expressing the views of seven diverse stakeholder groups involved in forest planning and managemnet....

Public Hearing or `Hearing Public'? An Evaluation of the Participation of Local Stakeholders in Environmental Impact Assessment of Ghana's Jubilee Oil Fields

NASA Astrophysics Data System (ADS)

Bawole, Justice Nyigmah

2013-08-01

This article investigates the involvement of local stakeholders in the environmental impact assessment (EIA) processes of Ghana's first off-shore oil fields (the Jubilee fields). Adopting key informants interviews and documentary reviews, the article argues that the public hearings and the other stakeholder engagement processes were cosmetic and rhetoric with the view to meeting legal requirements rather than a purposeful interest in eliciting inputs from local stakeholders. It further argues that the operators appear to lack the social legitimacy and social license that will make them acceptable in the project communities. A rigorous community engagement along with a commitment to actively involving local stakeholders in the corporate social responsibility (CSR) programmes of the partners may enhance the image of the partners and improve their social legitimacy. Local government agencies should be capacitated to actively engage project organisers; and government must mitigate the impact of the oil projects through well-structured social support programmes.

Engagement of stakeholders in the development of a Theory of Change for handwashing and sanitation behaviour change.

PubMed

De Buck, Emmy; Hannes, Karin; Cargo, Margaret; Van Remoortel, Hans; Vande Veegaete, Axel; Mosler, Hans-Joachim; Govender, Thashlin; Vandekerckhove, Philippe; Young, Taryn

2018-02-01

A Theory of Change (ToC) is an approach to map programmes aimed at inducing change in a specific context, with the goal of increasing their impact. We applied this approach to the specific case of handwashing and sanitation practices in low- and middle-income countries and developed a ToC as part of a systematic review exercise. Different existing sources of information were used to inform the initial draft of the ToC. In addition, stakeholder involvement occurred and peer review took place. Our stakeholders included methodological (ToC/quantitative and qualitative research) and content experts (WASH (Water, Sanitation, Hygiene)/behaviour change), as well as end-users/practitioners, policy-makers and donors. In conclusion, the development of a ToC, and the involvement of stakeholders in its development, was critical in terms of understanding the context in which the promotional programmes are being implemented. We recommend ToC developers to work with stakeholders to create a ToC relevant for practice.

Public hearing or 'hearing public'? an evaluation of the participation of local stakeholders in environmental impact assessment of Ghana's Jubilee oil fields.

PubMed

Bawole, Justice Nyigmah

2013-08-01

This article investigates the involvement of local stakeholders in the environmental impact assessment (EIA) processes of Ghana's first off-shore oil fields (the Jubilee fields). Adopting key informants interviews and documentary reviews, the article argues that the public hearings and the other stakeholder engagement processes were cosmetic and rhetoric with the view to meeting legal requirements rather than a purposeful interest in eliciting inputs from local stakeholders. It further argues that the operators appear to lack the social legitimacy and social license that will make them acceptable in the project communities. A rigorous community engagement along with a commitment to actively involving local stakeholders in the corporate social responsibility (CSR) programmes of the partners may enhance the image of the partners and improve their social legitimacy. Local government agencies should be capacitated to actively engage project organisers; and government must mitigate the impact of the oil projects through well-structured social support programmes.

A Bottom-up Vulnerability Analysis of Water Systems with Decentralized Decision Making and Demographic Shifts- the Case of Jordan.

NASA Astrophysics Data System (ADS)

Lachaut, T.; Yoon, J.; Klassert, C. J. A.; Talozi, S.; Mustafa, D.; Knox, S.; Selby, P. D.; Haddad, Y.; Gorelick, S.; Tilmant, A.

2016-12-01

Probabilistic approaches to uncertainty in water systems management can face challenges of several types: non stationary climate, sudden shocks such as conflict-driven migrations, or the internal complexity and dynamics of large systems. There has been a rising trend in the development of bottom-up methods that place focus on the decision side instead of probability distributions and climate scenarios. These approaches are based on defining acceptability thresholds for the decision makers and considering the entire range of possibilities over which such thresholds are crossed. We aim at improving the knowledge on the applicability and relevance of this approach by enlarging its scope beyond climate uncertainty and single decision makers; thus including demographic shifts, internal system dynamics, and multiple stakeholders at different scales. This vulnerability analysis is part of the Jordan Water Project and makes use of an ambitious multi-agent model developed by its teams with the extensive cooperation of the Ministry of Water and Irrigation of Jordan. The case of Jordan is a relevant example for migration spikes, rapid social changes, resource depletion and climate change impacts. The multi-agent modeling framework used provides a consistent structure to assess the vulnerability of complex water resources systems with distributed acceptability thresholds and stakeholder interaction. A proof of concept and preliminary results are presented for a non-probabilistic vulnerability analysis that involves different types of stakeholders, uncertainties other than climatic and the integration of threshold-based indicators. For each stakeholder (agent) a vulnerability matrix is constructed over a multi-dimensional domain, which includes various hydrologic and/or demographic variables.

Good governance in national solid waste management policy (NSWMP) implementation: A case study of Malaysia

NASA Astrophysics Data System (ADS)

Wee, Seow Ta; Abas, Muhamad Azahar; Mohamed, Sulzakimin; Chen, Goh Kai; Zainal, Rozlin

2017-10-01

The National Solid Waste Management Policy (NSWMP) was introduced in 2007 under the Act 672. The execution of NSWMP involves stakeholders from various government agencies and a collaboration with the private sectors. Despite the initiatives taken by the stakeholders, the objectives of NSWMP failed to materialise. One of the major constraints is weak governance among stakeholders with regards to the NSWMP implementation. This paper will explore the good governance practices implemented by the stakeholders. Identifying the current good governance practices implemented by the stakeholders is crucial as it will serve as a guideline to improve good governance practice in the future. An exploratory research approach is applied in this study through in-depth interviews with several government agencies and concessionaires involved in the NSWMP implementation. A total of six respondents took part in this study. The findings of this study show that there are several good governance practices implemented in policy promotion, participation of stakeholders, and capacity enhancement programme for the staff. This study also proposed some points on good governance practices in the context of policy promotion and staff development. A paradigm shift by the stakeholders is imperative so as to enhance the good governance practice in NSWMP implementation towards an efficient solid waste management in Malaysia.

A Participatory Action Research Approach To Evaluating Inclusive School Programs.

ERIC Educational Resources Information Center

Dymond, Stacy K.

2001-01-01

This article proposes a model for evaluating inclusive schools. Key elements of the model are inclusion of stakeholders in the evaluation process through a participatory action research approach, analysis of program processes and outcomes, use of multiple methods and measures, and obtaining perceptions from diverse stakeholder groups. (Contains…

The Missing Stakeholder Group: Why Patients Should be Involved in Health Economic Modelling.

PubMed

van Voorn, George A K; Vemer, Pepijn; Hamerlijnck, Dominique; Ramos, Isaac Corro; Teunissen, Geertruida J; Al, Maiwenn; Feenstra, Talitha L

2016-04-01

Evaluations of healthcare interventions, e.g. new drugs or other new treatment strategies, commonly include a cost-effectiveness analysis (CEA) that is based on the application of health economic (HE) models. As end users, patients are important stakeholders regarding the outcomes of CEAs, yet their knowledge of HE model development and application, or their involvement therein, is absent. This paper considers possible benefits and risks of patient involvement in HE model development and application for modellers and patients. An exploratory review of the literature has been performed on stakeholder-involved modelling in various disciplines. In addition, Dutch patient experts have been interviewed about their experience in, and opinion about, the application of HE models. Patients have little to no knowledge of HE models and are seldom involved in HE model development and application. Benefits of becoming involved would include a greater understanding and possible acceptance by patients of HE model application, improved model validation, and a more direct infusion of patient expertise. Risks would include patient bias and increased costs of modelling. Patient involvement in HE modelling seems to carry several benefits as well as risks. We claim that the benefits may outweigh the risks and that patients should become involved.

Experiments in evaluation capacity building: Enhancing brain disorders research impact in Ontario.

PubMed

Nylen, Kirk; Sridharan, Sanjeev

2017-05-08

This paper is the introductory paper on a forum on evaluation capacity building for enhancing impacts of research on brain disorders. It describes challenges and opportunities of building evaluation capacity among community-based organizations in Ontario involved in enhancing brain health and supporting people living with a brain disorder. Using an example of a capacity building program called the "Evaluation Support Program", which is run by the Ontario Brain Institute, this forum discusses multiple themes including evaluation capacity building, evaluation culture and evaluation methodologies appropriate for evaluating complex community interventions. The goal of the Evaluation Support Program is to help community-based organizations build the capacity to demonstrate the value that they offer in order to improve, sustain, and spread their programs and activities. One of the features of this forum is that perspectives on the Evaluation Support Program are provided by multiple stakeholders, including the community-based organizations, evaluation team members involved in capacity building, thought leaders in the fields of evaluation capacity building and evaluation culture, and the funders. Copyright © 2017. Published by Elsevier Ltd.

Cross-Sector Collaboration in the High-Poverty Setting: Qualitative Results from a Community-Based Diabetes Intervention.

PubMed

Tung, Elizabeth L; Gunter, Kathryn E; Bergeron, Nyahne Q; Lindau, Stacy Tessler; Chin, Marshall H; Peek, Monica E

2018-01-22

To characterize the motivations of stakeholders from diverse sectors who engaged in cross-sector collaboration with an academic medical center. Primary qualitative data (2014-2015) were collected from 22 organizations involved in a cross-sector diabetes intervention on the South Side of Chicago. In-depth, semistructured interviews; participants included leaders from all stakeholder organization types (e.g., businesses, community development, faith-based) involved in the intervention. Data were transcribed verbatim from audio and video recordings. Analysis was conducted using the constant comparison method, derived from grounded theory. All stakeholders described collaboration as an opportunity to promote community health in vulnerable populations. Among diverse motivations across organization types, stakeholders described collaboration as an opportunity for: financial support, brand enhancement, access to specialized skills or knowledge, professional networking, and health care system involvement in community-based efforts. Based on our findings, we propose a framework for implementing a working knowledge of stakeholder motivations to facilitate effective cross-sector collaboration. We identified several factors that motivated collaboration across diverse sectors with health care systems to promote health in a high-poverty, urban setting. Understanding these motivations will be foundational to optimizing meaningful cross-sector collaboration and improving diabetes outcomes in the nation's most vulnerable communities. © Health Research and Educational Trust.

Perceptions of family-centred services in a paediatric rehabilitation programme: strengths and complexities from multiple stakeholders.

PubMed

Arcuri, G G; McMullan, A E; Murray, A E; Silver, L K; Bergthorson, M; Dahan-Oliel, N; Coutinho, F

2016-03-01

Family-centred services (FCS) are best practice in paediatric rehabilitation and describe philosophies and approaches to medical care that emphasize the partnership and involvement of parents. While evidence supports FCS, there are complexities to its successful implementation. This mixed-methods study aimed to measure the extent to which parents and the healthcare provider (HCP) perceive service provision as being family centred, and to describe barriers and facilitators to the delivery of FCS. Parents of children participating in a rehabilitation programme and HCPs providing services participated in this study. Parents completed the measure of processes of care-20 and participated in interviews, while HCPs completed the measure of processes of care-service providers and participated in a focus group. Quantitative analysis revealed that parents were mostly satisfied with features of FCS, which included communication and support between parents and HCPs, respect of diversity and parental collaboration and participation. Parents identified communication methods and psychosocial needs as areas that facilitated but sometimes detracted from FCS. Institutional barriers led to the identification of areas for improvement identified by multiple stakeholders. HCPs identified more areas for improvement than parents. When considering these barriers, it is evident that implementation is a complex process, impacted by institutional barriers. FCS needs to be investigated further, and systemic interventions should be used to facilitate its implementation. © 2015 John Wiley & Sons Ltd.

Relationship marketing and disadvantaged health care segments: using internal marketing to improve the vocational rehabilitation process.

PubMed

Peltier, James W; Scovotti, Carol

2004-01-01

The purpose of vocational rehabilitation (VR) is to provide disabled individuals with the training and support services needed to assimilate into the workforce. This study incorporates concepts developed in the relationship marketing and internal marketing literature to determine the factors that influence overall satisfaction of vocational training services. Results underscore the importance of social and structural bonds that develop among the multiple stakeholders involved in the VR process. Satisfaction is also influenced by the design and equipment used in the facilities and the efficiency of initiating VR services. A highly reliable instrument to measure VR participant satisfaction is presented.

Playing, sitting out, and observing the game: an investigation of faculty members' perspectives on political behavior in ethical decision making.

PubMed

Medeiros, Kelsey E; Gibson, Carter; Mecca, Jensen T; Giorgini, Vincent; Connelly, Shane; Mumford, Michael D

2015-01-01

Ethical dilemmas are inherently ambiguous, complex, and ill-defined. Additionally, these dilemmas involve multiple stakeholders. These characteristics may induce political behavior as a resolution tactic. Thus, the goal of the present effort was to investigate perspectives on politics among researchers in an ethical decision-making context. A qualitative analysis of interviews with university faculty members revealed that faculty members' perspectives on political behavior in an ethical decision-making context fall into a number of categories, including positive, negative, and realistic views of political activity. The implications of these varying perspectives on ethical decision making are discussed.

Stakeholders' opinions and expectations of the Global Fund and their potential economic implications.

PubMed

Galárraga, Omar; Bertozzi, Stefano M

2008-07-01

To analyse stakeholder opinions and expectations of the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and to discuss their potential economic and financial implications. The Global Fund commissioned an independent study, the '360 degrees Stakeholder Survey', to canvas feedback on the organization's reputation and performance with an on-line survey of 909 respondents representing major stakeholders worldwide. We created a proxy for expectations based on categorical responses for specific Global Fund attributes' importance to the stakeholders and current perceived performance. Using multivariate regression, we analysed 23 unfulfilled expectations related to: resource mobilization; impact measurement; harmonization and inclusion; effectiveness of the Global Fund partner environment; and portfolio characteristics. The independent variables are personal and regional-level characteristics that affect expectations. The largest unfulfilled expectations relate to: mobilization of private sector resources; efficiency in disbursing funds; and assurance that people affected by the three diseases are reached. Stakeholders involved with the fund through the country coordinating mechanisms, those working in multilateral organizations and persons living with HIV are more likely to have unfulfilled expectations. In contrast, higher levels of involvement with the fund correlate with fulfilled expectations. Stakeholders living in sub-Saharan Africa were less likely to have their expectations met. Stakeholders' unfulfilled expectations result largely from factors external to them, but also from factors over which they have influence. In particular, attributes related to partnership score poorly even though stakeholders have influence in that area. Joint efforts to address perceived performance gaps may improve future performance and positively influence investment levels and economic viability.

A Multi-Level Examination of Stakeholder Perspectives of Implementation of Evidence-Based Practices in a Large Urban Publicly-Funded Mental Health System

PubMed Central

Beidas, Rinad S.; Stewart, Rebecca E.; Adams, Danielle R.; Fernandez, Tara; Lustbader, Susanna; Powell, Byron J.; Aarons, Gregory; Hoagwood, Kimberly E.; Evans, Arthur C.; Hurford, Matthew O.; Rubin, Ronnie; Hadley, Trevor; Mandell, David; Barg, Frances

2015-01-01

Our goal was to identify barriers and facilitators to the implementation of evidence-based practices from the perspectives of multiple stakeholders in a large publicly funded mental health system. We completed 56 interviews with three stakeholder groups: treatment developers (n = 7), agency administrators (n = 33), and system leadership (n = 16). The three stakeholder groups converged on the importance of inner (e.g., agency competing resources and demands, therapist educational background) and outer context (e.g., funding) factors as barriers to implementation. Potential threats to implementation and sustainability included the fiscal landscape of community mental health clinics and an evolving workforce. Intervention characteristics were rarely endorsed as barriers. Inner context, outer context, and intervention characteristics were all seen as important facilitators. All stakeholders endorsed the importance of coordinated collaboration across stakeholder groups within the system to successfully implement evidence-based practices. PMID:26658692

Facilitating Factors and Barriers to the Use of Emerging Technologies for Suicide Prevention in Europe: Multicountry Exploratory Study

PubMed Central

Delgado, Carmen; Sánchez-Prada, Andrés; Parra-Vidales, Esther; de Leo, Diego; Franco-Martín, Manuel

2018-01-01

Background This study provides an analysis on the use of emerging technologies for the prevention of suicide in 8 different European countries. Objective The objective of this study was to analyze the potentiality of using emerging technologies in the area of suicide prevention based on the opinion of different professionals involved in suicide prevention. Methods Opinions of 3 groups of stakeholders (ie, relevant professionals in suicide field) were gathered using a specifically designed questionnaire to explore dimensions underlying perceptions of facilitating factors and barriers in relation to the use of emerging technologies for suicide prevention. Results Goal 1 involved facilitating factors for the use of emerging technologies in suicide prevention. Northern European countries, except for Belgium, attach greater relevance to those that optimize implementation and benefits. On the other hand, Southern European countries attach greater importance to professionally oriented and user-centered facilitating factors. According to different stakeholders, the analysis of these facilitating factors suggest that professionals in the field of social work attach greater relevance to those that optimize implementation and benefits. However, professionals involved in the area of mental health, policy makers, and political decision makers give greater importance to professionally oriented and user-centered facilitating factors. Goal 2 was related to barriers to the usability of emerging technologies for suicide prevention. Both countries and stakeholders attach greater importance to barriers associated with resource constraints than to those centered on personal limitations. There are no differences between countries or between stakeholders. Nevertheless, there is a certain stakeholders-countries interaction that indicates that the opinions on resource constraints expressed by different stakeholders do not follow a uniform pattern in different countries, but they differ depending on the country. Conclusions Although all countries and stakeholders agree in identifying resource constraints as the main barrier to the use of emerging technologies, factors facilitating their use in suicide prevention differ among countries and among stakeholders. PMID:29367183

What Are the Professional, Political, and Ethical Challenges of Co-Creating Health Care Systems?

PubMed

Singh, Guddi; Owens, John; Cribb, Alan

2017-11-01

Co-creation is seen by many as a means of meeting the multiple challenges facing contemporary health care systems by involving institutions, professionals, patients, and stakeholders in new roles, relationships, and collaborative practices. While co-creation has the potential to positively transform health care systems, it generates a number of political and ethical challenges that should not be overlooked. We suggest that those involved in envisioning and implementing co-creation initiatives pay close attention to significant questions of equity, power, and justice and to the fundamental challenge of securing a common vision of the aims of and agendas for health care systems. While such initiatives present significant opportunities for improvement, they need to be viewed in light of their accompanying professional, political, and ethical challenges. © 2017 American Medical Association. All Rights Reserved.

Redispensing of medicines unused by patients: a qualitative study among stakeholders.

PubMed

Bekker, Charlotte L; Gardarsdottir, Helga; Egberts, Toine C G; Bouvy, Marcel L; van den Bemt, Bart J F

2017-02-01

Background Medication waste has undesirable economic and environmental consequences. This waste is partly unavoidable, but might be reduced by redispensing medicines unused by patients. However, there is little knowledge of stakeholders' views on the redispensing. Objective To identify the stakeholders' views on the redispensing of medicines unused by patients. Setting Dutch healthcare system. Method Semi-structured interviews were conducted with 19 Dutch stakeholders from September 2014 until April 2015. The interview guide included two themes: medication waste and redispensing of unused medicines. The latter included qualitative-, legal- and financial aspects and stakeholder involvement, with specific attention to the patient. Interview transcripts were subjected to thematic content analysis. Main outcome measure Requirements related to the redispensing of unused medicines. Results All stakeholders considered the redispensing of medicines desirable if the implementation is feasible and the requirements for the safe redispensing are met. All of them pointed out that the product quality of redispensed medicines should be guaranteed and that it should be clear who is responsible for the quality of redispensed medicines. The stakeholders stated that transparent communication to patients is essential to guarantee trust in the redispensing system and that patients should be willing to use redispensed medicines. Moreover, the redispensing system's benefits should outweigh the costs and a minimal economic value of medicines suitable for redispensing should be determined. Conclusion Redispensing unused medicines could decrease medication waste if several requirements are met. For successful implementation of a redispensing system, all relevant stakeholders should be involved and cooperate as a joint-force.

Developing research and recruitment while fostering stakeholder engagement in a National Institutes of Mental Health-funded Interventions and Practice Research Infrastructure Programs grant for depression.

PubMed

Stirman, Shannon Wiltsey; Goldstein, Lizabeth A; Wrenn, Glenda; Barrett, Marna; Gibbons, Mary Beth Connolly; Casiano, Delane; Thompson, Donald; Green, Patricia P; Heintz, Laura; Barber, Jacques P; Crits-Christoph, Paul

2010-01-01

In the context of a National Institutes of Mental Health-funded Interventions and Practice Research Infrastructure Programs (IP-RISP) grant for the treatment of depression, a partnership was developed between a community mental health organization and a team of researchers. This paper describes the collaborative process, key challenges, and strategies employed to meet the goals of the first phase of the grant, which included development of a working and sustainable partnership and building capacity for recruitment and research. This paper was developed through the use of qualitative interviews and discussion with a variety of IP-RISP partners. Communication with multiple stakeholders through varied channels, feedback from stakeholders on research procedures, and employing a research liaison at the clinic have been key strategies in the first phase of the grant. The strategies we employed allowed multiple stakeholders to contribute to the larger mission of the IP-RISP and helped to establish an ongoing research program within the mental health organization.

Navigating complexity through knowledge coproduction: Mainstreaming ecosystem services into disaster risk reduction.

PubMed

Reyers, Belinda; Nel, Jeanne L; O'Farrell, Patrick J; Sitas, Nadia; Nel, Deon C

2015-06-16

Achieving the policy and practice shifts needed to secure ecosystem services is hampered by the inherent complexities of ecosystem services and their management. Methods for the participatory production and exchange of knowledge offer an avenue to navigate this complexity together with the beneficiaries and managers of ecosystem services. We develop and apply a knowledge coproduction approach based on social-ecological systems research and assess its utility in generating shared knowledge and action for ecosystem services. The approach was piloted in South Africa across four case studies aimed at reducing the risk of disasters associated with floods, wildfires, storm waves, and droughts. Different configurations of stakeholders (knowledge brokers, assessment teams, implementers, and bridging agents) were involved in collaboratively designing each study, generating and exchanging knowledge, and planning for implementation. The approach proved useful in the development of shared knowledge on the sizable contribution of ecosystem services to disaster risk reduction. This knowledge was used by stakeholders to design and implement several actions to enhance ecosystem services, including new investments in ecosystem restoration, institutional changes in the private and public sector, and innovative partnerships of science, practice, and policy. By bringing together multiple disciplines, sectors, and stakeholders to jointly produce the knowledge needed to understand and manage a complex system, knowledge coproduction approaches offer an effective avenue for the improved integration of ecosystem services into decision making.

Navigating complexity through knowledge coproduction: Mainstreaming ecosystem services into disaster risk reduction

PubMed Central

Reyers, Belinda; Nel, Jeanne L.; O’Farrell, Patrick J.; Sitas, Nadia; Nel, Deon C.

2015-01-01

Achieving the policy and practice shifts needed to secure ecosystem services is hampered by the inherent complexities of ecosystem services and their management. Methods for the participatory production and exchange of knowledge offer an avenue to navigate this complexity together with the beneficiaries and managers of ecosystem services. We develop and apply a knowledge coproduction approach based on social–ecological systems research and assess its utility in generating shared knowledge and action for ecosystem services. The approach was piloted in South Africa across four case studies aimed at reducing the risk of disasters associated with floods, wildfires, storm waves, and droughts. Different configurations of stakeholders (knowledge brokers, assessment teams, implementers, and bridging agents) were involved in collaboratively designing each study, generating and exchanging knowledge, and planning for implementation. The approach proved useful in the development of shared knowledge on the sizable contribution of ecosystem services to disaster risk reduction. This knowledge was used by stakeholders to design and implement several actions to enhance ecosystem services, including new investments in ecosystem restoration, institutional changes in the private and public sector, and innovative partnerships of science, practice, and policy. By bringing together multiple disciplines, sectors, and stakeholders to jointly produce the knowledge needed to understand and manage a complex system, knowledge coproduction approaches offer an effective avenue for the improved integration of ecosystem services into decision making. PMID:26082541

Examining critical factors affecting graduate retention from an emergency training program in Addis Ababa, Ethiopia: a qualitative study of stakeholder perspectives.

PubMed

Kuipers, Meredith; Eapen, Amira; Lockwood, Joel; Berman, Sara; Vaillancourt, Samuel; Maskalyk, James; Azazh, Aklilu; Landes, Megan

2017-04-01

In Ethiopia, improvement and innovation of the emergency care system is hindered by lack of specialist doctors trained in emergency medicine, underdeveloped emergency care infrastructure, and resource limitations. Our aim was to examine the critical factors affecting retention of graduates from the Addis Ababa University (AAU) post-graduate emergency medicine (EM) training program within the Ethiopian health care system. One post-graduate trainee and one program manager from the AAU and the University of Toronto (UT) partnership conducted qualitative interviews with current AAU EM residents and stakeholders in Ethiopian EM. Qualitative inductive thematic analysis was performed. Resident and stakeholder participants identified critical factors in three domains: the individual condition, the occupational environment, and the national context. Within each domain, priority themes emerged from the responses, including the importance of career satisfaction over the career continuum (individual condition), the opportunity to be involved in the developing EM program and challenges associated with resource, economic, and employment constraints (occupational environment), and perceptions regarding the state of awareness of EM and the capacity for change at the societal level (national context). This work underscores the need to continue to address multiple systemic and cultural issues within the Ethiopian health care landscape in order to address EM graduate retention. It also highlights the potential success of a retention strategy focused on the career ambitions of keen EM doctors.

IMPACCT Kids’ Care: a real-world example of stakeholder involvement in comparative effectiveness research

PubMed Central

Likumahuwa-Ackman, Sonja; Angier, Heather; Sumic, Aleksandra; Harding, Rose L; Cottrell, Erika K; Cohen, Deborah J; Nelson, Christine A; Burdick, Timothy E; Wallace, Lorraine S; Gallia, Charles; DeVoe, Jennifer E

2015-01-01

The Patient-Centered Outcomes Research Institute has accelerated conversations about the importance of actively engaging stakeholders in all aspects of comparative effectiveness research (CER). Other scientific disciplines have a history of stakeholder engagement, yet few empirical examples exist of how these stakeholders can inform and enrich CER. Here we present a case study which includes the methods used to engage stakeholders, what we learned from them, and how we incorporated their ideas in a CER project. We selected stakeholders from key groups, built relationships with them and collected their feedback through interviews, observation and ongoing meetings during the four research process phases: proposal development, adapting study methods, understanding the context and information technology tool design and refinement. PMID:26274796

IMPACCT Kids' Care: a real-world example of stakeholder involvement in comparative effectiveness research.

PubMed

Likumahuwa-Ackman, Sonja; Angier, Heather; Sumic, Aleksandra; Harding, Rose L; Cottrell, Erika K; Cohen, Deborah J; Nelson, Christine A; Burdick, Timothy E; Wallace, Lorraine S; Gallia, Charles; DeVoe, Jennifer E

2015-08-01

The Patient-Centered Outcomes Research Institute has accelerated conversations about the importance of actively engaging stakeholders in all aspects of comparative effectiveness research (CER). Other scientific disciplines have a history of stakeholder engagement, yet few empirical examples exist of how these stakeholders can inform and enrich CER. Here we present a case study which includes the methods used to engage stakeholders, what we learned from them, and how we incorporated their ideas in a CER project. We selected stakeholders from key groups, built relationships with them and collected their feedback through interviews, observation and ongoing meetings during the four research process phases: proposal development, adapting study methods, understanding the context and information technology tool design and refinement.

AMCP Partnership Forum: Biosimilars--Ready, Set, Launch.

PubMed

2016-04-01

Through 2020, reference biologic products will lose patent protection that will be worth $54 billion to the U.S. economy. Consequently, interest in biosimilars is intensifying across the health care industry. Managed care organizations (MCOs) are depending on the savings opportunity that bio-similars promise. After the first FDA approval of a biosimilar in March 2015, the Academy of Managed Care Pharmacy (AMCP) convened a biosimilar Partnership Forum on June 10-11, 2015. The goal of this forum was to address current readiness of MCOs to optimize biosimilars; identify gaps, challenges, and opportunities with regard to biosimilars; and recommend education and training content to help AMCP best meet the needs of its members and stakeholders. The forum brought together multiple stakeholders from MCOs, pharmacy benefit managers, specialty pharmacies, integrated delivery networks, federal government and standards setting organizations, consumer advocacy groups, and the pharmaceutical industry. Through a series of 4 one-hour webinars and a 1.5-day live workgroup session, participants identified current challenges and readiness issues in addressing biosimilars. These challenges included lack of a consolidated educational strategy for incorporating biosimilars into the clinical decision-making process; deficiencies in current levels of federal (e.g., the FDA) or state (e.g., departments of insurance) guidance; limited intelligence on pricing strategies and consideration of stakeholder contracting alignment and risk sharing; and operational implementation issues. Participants identified necessary tactics for executing a successful bio-similar strategy. These tactics included creating a broad multiple stakeholder coalition to support educational efforts to gain public, provider, and other stakeholder acceptance; aligning utilization incentives through reimbursement policies and programs; encouraging benefit design and stakeholder collaboration; advancing the coding and technology infrastructure to support operations, contracting, billing, reimbursement, and reporting needs; and having appropriate active surveillance mechanisms to enable assessment of the clinical performance of biosimilars and their innovator products. Participants recommended guidance for AMCP to optimally support its membership and stakeholders with educational and training programs at multiple venues; a platform for regular communications and updates; and advocacy, community promotion, and education. The AMCP Partnership Forum entitled "Biosimilars-Ready, Set, Launch" and the development of this report were supported by Abbvie, Amgen, Apotex, Boehringer, Merck, Momenta, and Sandoz.

NGO Partnerships in Using Ecotourism for Conservation: Systematic Review and Meta-Analysis.

PubMed

Romero-Brito, Tania P; Buckley, Ralf C; Byrne, Jason

2016-01-01

We analyse 214 cases worldwide where non-governmental organisations (NGOs) use ecotourism for conservation. Other stakeholders in these initiatives include local communities, the private sector, and government agencies. Stakeholder relationships determine NGO roles and project management structures and governance. We classified cases into 10 structural categories based on the initiating stakeholder and the NGO role, and used these categories to analyze geographic patterns and success factors. Most of the 214 cases are community-based (~170; 79%); most are in developing countries (190; 89%); and most are in protected areas (196; 91%). Frequencies of structural categories differ between continents. More cases in Latin America and Asia are initiated by NGOs and local communities, and more in Africa by the private sector. Case-study authors used a range of economic, socio-cultural and environmental criteria to judge whether projects were successful. At global scale, we found no significant association between project success and the involvement of private tourism entrepreneurs. Projects involving either local or international NGOs had higher success rates than those that involved both simultaneously. Future research could adopt political ecology approaches to examine: the factors that lead NGOs to adopt ecotourism enterprises; their internal decision-making processes and strategies; their interactions with the stakeholders involved; and their conservation goals and outcomes.

NGO Partnerships in Using Ecotourism for Conservation: Systematic Review and Meta-Analysis

PubMed Central

Romero-Brito, Tania P.; Byrne, Jason

2016-01-01

We analyse 214 cases worldwide where non-governmental organisations (NGOs) use ecotourism for conservation. Other stakeholders in these initiatives include local communities, the private sector, and government agencies. Stakeholder relationships determine NGO roles and project management structures and governance. We classified cases into 10 structural categories based on the initiating stakeholder and the NGO role, and used these categories to analyze geographic patterns and success factors. Most of the 214 cases are community-based (~170; 79%); most are in developing countries (190; 89%); and most are in protected areas (196; 91%). Frequencies of structural categories differ between continents. More cases in Latin America and Asia are initiated by NGOs and local communities, and more in Africa by the private sector. Case-study authors used a range of economic, socio-cultural and environmental criteria to judge whether projects were successful. At global scale, we found no significant association between project success and the involvement of private tourism entrepreneurs. Projects involving either local or international NGOs had higher success rates than those that involved both simultaneously. Future research could adopt political ecology approaches to examine: the factors that lead NGOs to adopt ecotourism enterprises; their internal decision-making processes and strategies; their interactions with the stakeholders involved; and their conservation goals and outcomes. PMID:27893800

Energy Justice and the Stakeholders Involved: A Case Study of Solar Power in Rural Haiti

NASA Astrophysics Data System (ADS)

Romulus, Elijah Rey Asse

This paper explores and analyzes energy justice and the stakeholders involved. Energy insecurity, specifically the lack of access to electricity effects over 1.3 billion people worldwide and energy justice is a way to address it. This paper is supported by a case study with data collected in the southern rural regions of Haiti regarding energy justice communities. Three cities were studied: Les Cayes, Anse-a-Veau, and Les Anglais. It examines how solar businesses can aid energy justice communities seeking access to electricity. Stakeholders such as the communities themselves, solar businesses, and nonprofits in the region are studied and analyzed. The paper concludes solar businesses are helping said communities but needs participation from other stakeholders to be successful. Finally, there are five recommendations to build capacity, develop infrastructure in the region, explore the possibility of solar cooperatives, strengthen the solar economy in Haiti, and demand reparations.

Effort to Accelerate MBSE Adoption and Usage at JSC

NASA Technical Reports Server (NTRS)

Wang, Lui; Izygon, Michel; Okron, Shira; Garner, Larry; Wagner, Howard

2016-01-01

This paper describes the authors' experience in adopting Model Based System Engineering (MBSE) at the NASA/Johnson Space Center (JSC). Since 2009, NASA/JSC has been applying MBSE using the Systems Modeling Language (SysML) to a number of advanced projects. Models integrate views of the system from multiple perspectives, capturing the system design information for multiple stakeholders. This method has allowed engineers to better control changes, improve traceability from requirements to design and manage the numerous interactions between components. As the project progresses, the models become the official source of information and used by multiple stakeholders. Three major types of challenges that hamper the adoption of the MBSE technology are described. These challenges are addressed by a multipronged approach that includes educating the main stakeholders, implementing an organizational infrastructure that supports the adoption effort, defining a set of modeling guidelines to help engineers in their modeling effort, providing a toolset that support the generation of valuable products, and providing a library of reusable models. JSC project case studies are presented to illustrate how the proposed approach has been successfully applied.

Clinical imaging guidelines part 4: challenges in identifying, engaging and collaborating with stakeholders.

PubMed

Bettmann, Michael A; Oikarinen, Helja; Rehani, Madan; Holmberg, Ola; del Rosario Perez, Maria; Naidoo, Anusha; Do, Kyung-Hyun; Dreyer, Keith; Ebdon-Jackson, Steve

2015-04-01

The effective development and use of clinical imaging guidelines requires an understanding of who the stakeholders are, what their interests in the process are, and what roles they should play. If the appropriate stakeholders are not engaged in the right roles, it is unlikely that clinical imaging guidelines will be successfully developed, relied on, and actually used. Some stakeholders are obvious: for the development of clinical imaging guidelines, both imagers and those who request examinations, such as general practitioners, internists, and medical specialists, must be involved. To gain acceptance, other relevant groups are stakeholders, including medical societies, other health care professionals, insurers, health IT experts and vendors, and patients. The role of stakeholders must be dictated by their specific interest. For some, involvement in the creation of guidelines is the right role. For others, such as regulators or insurers, reviews or invitations to comment are required, and for others, such as medical educators, it is probably sufficient to provide information and create awareness. Only through a careful consideration of who the stakeholders are and what are their interests are the successful development, acceptance, and use of clinical imaging guidelines likely to occur. Future efforts must focus on collaboration, particularly among groups that create clinical imaging guidelines and those that can support their use, and on regulatory roles and mandates. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Public voices in pharmaceutical deliberations: negotiating "clinical benefit" in the FDA's Avastin Hearing.

PubMed

Teston, Christa B; Graham, S Scott; Baldwinson, Raquel; Li, Andria; Swift, Jessamyn

2014-06-01

This article offers a hybrid rhetorical-qualitative discourse analysis of the FDA's 2011 Avastin Hearing, which considered the revocation of the breast cancer indication for the popular cancer drug Avastin. We explore the multiplicity of stakeholders, the questions that motivated deliberations, and the kinds of evidence presented during the hearing. Pairing our findings with contemporary scholarship in rhetorical stasis theory, Mol's (2002) construct of multiple ontologies, and Callon, Lascoumes, and Barthe's (2011) "hybrid forums," we demonstrate that the FDA's deliberative procedures elides various sources of evidence and the potential multiplicity of definitions for "clinical benefit." Our findings suggest that while the FDA invited multiple stakeholders to offer testimony, there are ways that the FDA might have more meaningfully incorporated public voices in the deliberative process. We conclude with suggestions for how a true hybrid forum might be deployed.

Stakeholder engagement in policy development: challenges and opportunities for human genomics

PubMed Central

Lemke, Amy A.; Harris-Wai, Julie N.

2015-01-01

Along with rapid advances in human genomics, policies governing genomic data and clinical technologies have proliferated. Stakeholder engagement is widely lauded as an important methodology for improving clinical, scientific, and public health policy decision making. The purpose of this paper is to examine how stakeholder engagement is used to develop policies in genomics research and public health areas, as well as to identify future priorities for conducting evidence-based stakeholder engagements. We focus on exemplars in biobanking and newborn screening to illustrate a variety of current stakeholder engagement in policy-making efforts. Each setting provides an important context for examining the methods of obtaining and integrating informed stakeholder voices into the policy-making process. While many organizations have an interest in engaging stakeholders with regard to genomic policy issues, there is broad divergence with respect to the stakeholders involved, the purpose of engagements, when stakeholders are engaged during policy development, methods of engagement, and the outcomes reported. Stakeholder engagement in genomics policy development is still at a nascent stage. Several challenges of using stakeholder engagement as a tool for genomics policy development remain, and little evidence regarding how to best incorporate stakeholder feedback into policy-making processes is currently available. PMID:25764215

Stakeholder engagement in policy development: challenges and opportunities for human genomics.

PubMed

Lemke, Amy A; Harris-Wai, Julie N

2015-12-01

Along with rapid advances in human genomics, policies governing genomic data and clinical technologies have proliferated. Stakeholder engagement is widely lauded as an important methodology for improving clinical, scientific, and public health policy decision making. The purpose of this paper is to examine how stakeholder engagement is used to develop policies in genomics research and public health areas, as well as to identify future priorities for conducting evidence-based stakeholder engagements. We focus on exemplars in biobanking and newborn screening to illustrate a variety of current stakeholder engagement in policy-making efforts. Each setting provides an important context for examining the methods of obtaining and integrating informed stakeholder voices into the policy-making process. While many organizations have an interest in engaging stakeholders with regard to genomic policy issues, there is broad divergence with respect to the stakeholders involved, the purpose of engagements, when stakeholders are engaged during policy development, methods of engagement, and the outcomes reported. Stakeholder engagement in genomics policy development is still at a nascent stage. Several challenges of using stakeholder engagement as a tool for genomics policy development remain, and little evidence regarding how to best incorporate stakeholder feedback into policy-making processes is currently available.

Decisional needs assessment of patients with complex care needs in primary care: a participatory systematic mixed studies review protocol

PubMed Central

Pluye, Pierre; Légaré, France; Haggerty, Jeannie; Gore, Genevieve C; Sherif, Reem El; Poitras, Marie-Ève; Beaulieu, Marie-Claude; Beaulieu, Marie-Dominique; Bush, Paula L; Couturier, Yves; Débarges, Béatrice; Gagnon, Justin; Giguère, Anik; Grad, Roland; Granikov, Vera; Goulet, Serge; Hudon, Catherine; Kremer, Bernardo; Kröger, Edeltraut; Kudrina, Irina; Lebouché, Bertrand; Loignon, Christine; Lussier, Marie-Thérèse; Martello, Cristiano; Nguyen, Quynh; Pratt, Rebekah; Rihoux, Benoit; Rosenberg, Ellen; Samson, Isabelle; Senn, Nicolas; Li Tang, David; Tsujimoto, Masashi; Vedel, Isabelle; Ventelou, Bruno; Wensing, Michel; Bigras, Magali

2017-01-01

Introduction Patients with complex care needs (PCCNs) often suffer from combinations of multiple chronic conditions, mental health problems, drug interactions and social vulnerability, which can lead to healthcare services overuse, underuse or misuse. Typically, PCCNs face interactional issues and unmet decisional needs regarding possible options in a cascade of interrelated decisions involving different stakeholders (themselves, their families, their caregivers, their healthcare practitioners). Gaps in knowledge, values clarification and social support in situations where options need to be deliberated hamper effective decision support interventions. This review aims to (1) assess decisional needs of PCCNs from the perspective of stakeholders, (2) build a taxonomy of these decisional needs and (3) prioritise decisional needs with knowledge users (clinicians, patients and managers). Methods and analysis This review will be based on the interprofessional shared decision making (IP-SDM) model and the Ottawa Decision Support Framework. Applying a participatory research approach, we will identify potentially relevant studies through a comprehensive literature search; select relevant ones using eligibility criteria inspired from our previous scoping review on PCCNs; appraise quality using the Mixed Methods Appraisal Tool; conduct a three-step synthesis (sequential exploratory mixed methods design) to build taxonomy of key decisional needs; and integrate these results with those of a parallel PCCNs’ qualitative decisional need assessment (semistructured interviews and focus group with stakeholders). Ethics and dissemination This systematic review, together with the qualitative study (approved by the Centre Intégré Universitaire de Santé et Service Sociaux du Saguenay-Lac-Saint-Jean ethical committee), will produce a working taxonomy of key decisional needs (ontological contribution), to inform the subsequent user-centred design of a support tool for addressing PCCNs’ decisional needs (practical contribution). We will adapt the IP-SDM model, normally dealing with a single decision, for PCCNs who experience cascade of decisions involving different stakeholders (theoretical contribution). Knowledge users will facilitate dissemination of the results in the Canadian primary care network. PROSPERO registration number CRD42015020558. PMID:29133314

Decisional needs assessment of patients with complex care needs in primary care: a participatory systematic mixed studies review protocol.

PubMed

Bujold, Mathieu; Pluye, Pierre; Légaré, France; Haggerty, Jeannie; Gore, Genevieve C; Sherif, Reem El; Poitras, Marie-Eve; Beaulieu, Marie-Claude; Beaulieu, Marie-Dominique; Bush, Paula L; Couturier, Yves; Débarges, Beatrice; Gagnon, Justin; Giguère, Anik; Grad, Roland; Granikov, Vera; Goulet, Serge; Hudon, Catherine; Kremer, Bernardo; Kröger, Edeltraut; Kudrina, Irina; Lebouché, Bertrand; Loignon, Christine; Lussier, Marie-Therese; Martello, Cristiano; Nguyen, Quynh; Pratt, Rebekah; Rihoux, Benoit; Rosenberg, Ellen; Samson, Isabelle; Senn, Nicolas; Li Tang, David; Tsujimoto, Masashi; Vedel, Isabelle; Ventelou, Bruno; Wensing, Michel

2017-11-12

Patients with complex care needs (PCCNs) often suffer from combinations of multiple chronic conditions, mental health problems, drug interactions and social vulnerability, which can lead to healthcare services overuse, underuse or misuse. Typically, PCCNs face interactional issues and unmet decisional needs regarding possible options in a cascade of interrelated decisions involving different stakeholders (themselves, their families, their caregivers, their healthcare practitioners). Gaps in knowledge, values clarification and social support in situations where options need to be deliberated hamper effective decision support interventions. This review aims to (1) assess decisional needs of PCCNs from the perspective of stakeholders, (2) build a taxonomy of these decisional needs and (3) prioritise decisional needs with knowledge users (clinicians, patients and managers). This review will be based on the interprofessional shared decision making (IP-SDM) model and the Ottawa Decision Support Framework. Applying a participatory research approach, we will identify potentially relevant studies through a comprehensive literature search; select relevant ones using eligibility criteria inspired from our previous scoping review on PCCNs; appraise quality using the Mixed Methods Appraisal Tool; conduct a three-step synthesis (sequential exploratory mixed methods design) to build taxonomy of key decisional needs; and integrate these results with those of a parallel PCCNs' qualitative decisional need assessment (semistructured interviews and focus group with stakeholders). This systematic review, together with the qualitative study (approved by the Centre Intégré Universitaire de Santé et Service Sociaux du Saguenay-Lac-Saint-Jean ethical committee), will produce a working taxonomy of key decisional needs (ontological contribution), to inform the subsequent user-centred design of a support tool for addressing PCCNs' decisional needs (practical contribution). We will adapt the IP-SDM model, normally dealing with a single decision, for PCCNs who experience cascade of decisions involving different stakeholders (theoretical contribution). Knowledge users will facilitate dissemination of the results in the Canadian primary care network. CRD42015020558. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Can thermostable vaccines help address cold-chain challenges? Results from stakeholder interviews in six low- and middle-income countries.

PubMed

Kristensen, Debra D; Lorenson, Tina; Bartholomew, Kate; Villadiego, Shirley

2016-02-10

This study captures the perspectives of stakeholders at multiple levels of the vaccine supply chain regarding their assessment of challenges with storing vaccines within recommended temperature ranges and their perceptions on the benefits of having vaccines with improved stability, including the potential short-term storage and transport of vaccines in a controlled-temperature chain. Semi-structured interviews were undertaken with 158 immunization stakeholders in six countries. Interviewees included national decision-makers and advisors involved in vaccine purchasing decisions, national Expanded Programme on Immunization managers, and health and logistics personnel at national, subnational, and health facility levels. Challenges with both heat and freeze-exposure of vaccines were recognized in all countries, with heat-exposure being a greater concern. Conditions leading to freeze-exposure including ice build-up due to poor refrigerator performance and improper icepack conditioning were reported by 53% and 28% of participants, respectively. Respondents were interested in vaccine products with improved heat/freeze-stability characteristics. The majority of those involved in vaccine purchasing indicated they would be willing to pay a US$0.05 premium per dose for a freeze-stable pentavalent vaccine (68%) or a heat-stable rotavirus vaccine (59%), although most (53%) preferred not to pay the premium for a heat-stable pentavalent vaccine if the increased stability required changing from a liquid to a lyophilized product. Most respondents (73%) were also interested in vaccines labeled for short-term use in a controlled-temperature chain. The majority (115/158) recognized the flexibility this would provide during outreach or should cold-chain breaks occur. Respondents were also aware that possible confusion might arise and additional training would be required if handling conditions were changed for some, but not all vaccines. Participating immunization stakeholders recognized the benefits of vaccine products with improved stability characteristics and of labeling vaccines for controlled-temperature chain use as a means to help address cold-chain issues in their immunization programs. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Participatory development of incentives to coexist with jaguars and pumas.

PubMed

Amit, Ronit; Jacobson, Susan K

2018-01-22

Reducing costs and increasing benefits for rural communities coexisting with large carnivores is necessary for conservation of jaguar (Panthera onca) and puma (Puma concolor). To design acceptable incentives, stakeholders must be involved in the process. We conducted an innovative, structured, group communication process based on a Delphi technique as a template for identifying potential incentives. Community workshops with 133 members of 7 communities and surveys with 25 multidisciplinary experts from government, nongovernmental organizations, and academia provided iterative data to design a plan of incentives through 4 rounds of discussion. The final product integrated 862 ideas into 6 types of incentives: organization of communities, mechanisms for improved dialogue, citizen technical assistance, green labeling for community products, payment for the ecosystem service of biodiversity, and an assessment of financial alternatives. We used quantitative and qualitative techniques to indicate support for decisions about the design of incentives, which reduced researcher subjectivity. The diverse incentives developed and the cooperation from multiple stakeholders resulted in an incentive plan that integrated issues of governance, equity, and social norms. © 2018 Society for Conservation Biology.

Games for Health for Children—Current Status and Needed Research

PubMed Central

Blumberg, Fran; Buday, Richard; DeSmet, Ann; Fiellin, Lynn E.; Green, C. Shawn; Kato, Pamela M.; Lu, Amy Shirong; Maloney, Ann E.; Mellecker, Robin; Morrill, Brooke A.; Peng, Wei; Shegog, Ross; Simons, Monique; Staiano, Amanda E.; Thompson, Debbe; Young, Kimberly

2016-01-01

Abstract Videogames for health (G4H) offer exciting, innovative, potentially highly effective methods for increasing knowledge, delivering persuasive messages, changing behaviors, and influencing health outcomes. Although early outcome results are promising, additional research is needed to determine the game design and behavior change procedures that best promote G4H effectiveness and to identify and minimize possible adverse effects. Guidelines for ideal use of different types of G4H by children and adolescents should be elucidated to enhance effectiveness and minimize adverse effects. G4H stakeholders include organizational implementers, policy makers, players and their families, researchers, designers, retailers, and publishers. All stakeholders should be involved in G4H development and have a voice in setting goals to capitalize on their insights to enhance effectiveness and use of the game. In the future, multiple targeted G4H should be available to meet a population's diverse health needs in developmentally appropriate ways. Substantial, consistent, and sophisticated research with appropriate levels of funding is needed to realize the benefits of G4H. PMID:26262772

Weather and resource information as tools for dealing with farmer-pastoralist conflicts in the Sahel

NASA Astrophysics Data System (ADS)

Mertz, Ole; Rasmussen, Kjeld; Vang Rasmussen, Laura

2016-12-01

Conflicts between pastoralists and farmers in the Sahel mainly arise from competition over land and water resources or because of livestock damage to crops. Rather than being linked to larger environmental change processes such as climate change, conflicts are often caused by inappropriate zoning of land, governance and unequal power relations between stakeholders. However, conflicts may be affected by more short-term weather and resource information that guide mobility of pastoralists. In this paper, we therefore explore if improved weather and resource information and improvement in its communication could prevent conflicts or reduce their severity. Based on a survey of key stakeholders involved in dissemination of weather and resource information and studies on pastoral access to and use of information, we conclude that improved information may both reduce and increase the level of conflict, depending on the context. Communication of information will need to go beyond just the weather and resource information and also include the multiple options for herd movements as well as providing information on herd crowding and potential conflict areas.

Games for Health for Children-Current Status and Needed Research.

PubMed

Baranowski, Tom; Blumberg, Fran; Buday, Richard; DeSmet, Ann; Fiellin, Lynn E; Green, C Shawn; Kato, Pamela M; Lu, Amy Shirong; Maloney, Ann E; Mellecker, Robin; Morrill, Brooke A; Peng, Wei; Shegog, Ross; Simons, Monique; Staiano, Amanda E; Thompson, Debbe; Young, Kimberly

2016-02-01

Videogames for health (G4H) offer exciting, innovative, potentially highly effective methods for increasing knowledge, delivering persuasive messages, changing behaviors, and influencing health outcomes. Although early outcome results are promising, additional research is needed to determine the game design and behavior change procedures that best promote G4H effectiveness and to identify and minimize possible adverse effects. Guidelines for ideal use of different types of G4H by children and adolescents should be elucidated to enhance effectiveness and minimize adverse effects. G4H stakeholders include organizational implementers, policy makers, players and their families, researchers, designers, retailers, and publishers. All stakeholders should be involved in G4H development and have a voice in setting goals to capitalize on their insights to enhance effectiveness and use of the game. In the future, multiple targeted G4H should be available to meet a population's diverse health needs in developmentally appropriate ways. Substantial, consistent, and sophisticated research with appropriate levels of funding is needed to realize the benefits of G4H.

Planning for post disaster recovery: Lesson learnt from flood events in Kelantan Malaysia

NASA Astrophysics Data System (ADS)

Rani, Wan Nurul Mardiah Wan Mohd; Nifa, Faizatul Akmar Abdul; Ismail, Mohd Noorizhar; Khalid, Khairin Norhashidah

2017-10-01

As the frequency of disaster occurrence increases, the world cities today are getting more difficult in terms of the management of the event. One of the most discussed issues today is the management of the post-disaster recovery that involves several stages such as the planning, management of multiple stakeholders, restoration, reconstruction and delivery. It is important to note that input from related stakeholders is necessary to make the right decision during this most critical period. In the process of building back after a disaster, it is important to ensure the newly constructed infrastructures are built to be more resilient and able to withstand a certain level of disaster recurrence. Elements of disaster risk reduction should be incorporated in the planning, redesign, construction and the operation of the built environment. In Malaysia, the disaster management has been the responsibility of the Disaster Management and Relief Committee that consists of agencies at the central, state and local levels. This is to ensure that all aspects are being considered and to be more effective in managing the situation.

Section 4: Requirements Intertwining

NASA Astrophysics Data System (ADS)

Loucopoulos, Pericles

Business analysts are being asked to develop increasingly complex and varied business systems that need to cater to the changing and dynamic market conditions of the new economy. This is particularly acute in today’s turbulent business environment where powerful forces such as deregulation, globalisation, mergers, advances in information and telecommunications technologies, and increasing education of people provide opportunities for organising work in ways that have never before been possible. Enterprises attempt to create wealth either by getting better at improving their products and services or by harnessing creativity and human-centred management to create innovative solutions. In these business settings, requirements become critical in bridging system solutions to organisational and societal problems. They intertwine organisational, social, cognitive, and implementation considerations and they can provide unique insights to change in systems and their business context. Such design situations often involve multiple stakeholders from different participating organisations, subcontractors, divisions, etc., who may have a diversity of expertise, come from different organisational cultures and often have competing goals. The success or failure of many projects depends, to a large extent, on understanding the contextual setting of requirements and their interaction amongst a diverse population of stakeholders.

Ethical considerations of worksite health promotion: an exploration of stakeholders’ views

PubMed Central

2014-01-01

Background Developing, implementing and evaluating worksite health promotion requires dealing with all stakeholders involved, such as employers, employees, occupational physicians, insurance companies, providers, labour unions and research and knowledge institutes. Although worksite health promotion is becoming more common, empirical research on ethical considerations of worksite health promotion is scarce. Methods We explored the views of stakeholders involved in worksite health promotion in focus group discussions and we described the ethical considerations that result from differences between these views. The focus group discussions were organised per stakeholder group. Data were analysed according to the constant comparison method. Results Our analyses show that although the definition of occupational health is the same for all stakeholders, namely ‘being able to perform your job’, there seem to be important differences in the views on what constitutes a risk factor to occupational health. According to the employees, risk factors to occupational health are prevailingly job-related. Labour unions agree with them, but other stakeholders, including the employer, particularly see employee-related issues such as lifestyle behaviour as risk factors to occupational health. The difference in definition of occupational health risk factors translates into the same categorisation of worksite health promotion; employee-related activities and work-related activities. The difference in conceptualisation of occupational health risk factors and worksite health promotion resonates in the way stakeholders understand ‘responsibility’ for lifestyle behaviour. Even though all stakeholders agree on whose responsibility lifestyle behaviour is, namely that of the employee, the meaning of ‘responsibility’ differs between employees, and employers. For employees, responsibility means autonomy, while for employers and other stakeholders, responsibility equals duty. This difference may in turn contribute to ambivalent relationships between stakeholders. Conclusion All stakeholders, including employees, should be given a voice in developing, implementing and evaluating worksite health promotion. Moreover, since stakeholders agree on lifestyle being the responsibility of the employee, but disagree on what this responsibility means (duty versus autonomy), it is of utmost importance to examine the discourse of stakeholders. This way, ambivalence in relationships between stakeholders could be prevented. PMID:24886339

Stakeholder discussion to reduce population-wide sodium intake and decrease sodium in the food supply: a conference report from the American Heart Association Sodium Conference 2013 Planning Group.

PubMed

Antman, Elliott M; Appel, Lawrence J; Balentine, Douglas; Johnson, Rachel K; Steffen, Lyn M; Miller, Emily Ann; Pappas, Antigoni; Stitzel, Kimberly F; Vafiadis, Dorothea K; Whitsel, Laurie

2014-06-24

A 2-day interactive forum was convened to discuss the current status and future implications of reducing sodium in the food supply and to identify opportunities for stakeholder collaboration. Participants included 128 stakeholders engaged in food research and development, food manufacturing and retail, restaurant and food service operations, regulatory and legislative activities, public health initiatives, healthcare, academia and scientific research, and data monitoring and surveillance. Presentation topics included scientific evidence for sodium reduction and public health policy recommendations; consumer sodium intakes, attitudes, and behaviors; food technologies and solutions for sodium reduction and sensory implications; experiences of the food and dining industries; and translation and implementation of sodium intake recommendations. Facilitated breakout sessions were conducted to allow for sharing of current practices, insights, and expertise. A well-established body of scientific research shows that there is a strong relationship between excess sodium intake and high blood pressure and other adverse health outcomes. With Americans getting >75% of their sodium from processed and restaurant food, this evidence creates mounting pressure for less sodium in the food supply. The reduction of sodium in the food supply is a complex issue that involves multiple stakeholders. The success of new technological approaches for reducing sodium will depend on product availability, health effects (both intended and unintended), research and development investments, quality and taste of reformulated foods, supply chain management, operational modifications, consumer acceptance, and cost. The conference facilitated an exchange of ideas and set the stage for potential collaboration opportunities among stakeholders with mutual interest in reducing sodium in the food supply and in Americans' diets. Population-wide sodium reduction remains a critically important component of public health efforts to promote cardiovascular health and prevent cardiovascular disease and will remain a priority for the American Heart Association. © 2014 American Heart Association, Inc.

A shared experience of fragmentation: making sense of foster placement breakdown.

PubMed

Rostill-Brookes, Helen; Larkin, Michael; Toms, Amy; Churchman, Clare

2011-01-01

Multiple placement transitions have been associated with poorer psychosocial outcomes for children growing up in local authority care. However, although there is an expanding literature examining the risk and protective factors connected with placement breakdown, very few studies have explored the quality of the move experience for those most closely involved with it. Our study considered how young people, foster carers and social workers made sense of unplanned placements' endings. Bringing together the lived experiences of these key stakeholders in the placement system added a novel dimension to existing research knowledge. What emerged from our analysis was evidence of a pervasive and shared emotional experience; all of the participants were affected by the breakdown irrespective of age, experience, or professional role. However, despite many commonalities, there was also a strong sense of fragmentation between the groups, which was characterised by discourses of mistrust and miscommunication. This meant that emotional reactions to the breakdown were often suppressed or dismissed, resentments built-up and attempts to find a solution were thwarted by silence or angry recrimination. These findings raise real challenges for practice and policy development. In particular, they stress the importance of shared and meaningful dialogue between all key stakeholders within the social care system, the need for more effective and timely support when placements are in crisis and opportunities for those most closely involved with the placement breakdown to process the emotional experience.

Lightning Impacts on Airports - Challenges of Balancing Safety & Efficiency

NASA Astrophysics Data System (ADS)

Steiner, Matthias; Deierling, Wiebke; Nelson, Eric; Stone, Ken

2013-04-01

Thunderstorms and lightning pose a safety risk to personnel working outdoors, such as people maintaining airport grounds (e.g., mowing grass or repairing runway lighting) or servicing aircraft on ramps (handling baggage, food service, refueling, tugging and guiding aircraft from/to gates, etc.). Since lightning strikes can cause serious injuries or death, it is important to provide timely alerts to airport personnel so that they can get to safety when lightning is imminent. This presentation discusses the challenges and uncertainties involved in using lightning information and stakeholder procedures to ensure safety of outdoor personnel while keeping ramp operations as efficient as possible considering thunderstorm impacts. The findings presented are based on extensive observations of airline operators under thunderstorm impacts. These observations reveal a complex picture with substantial uncertainties related to the (1) source of lightning information (e.g., sensor type, network, data processing) used to base ramp closure decisions on, (2) uncertainties involved in the safety procedures employed by various stakeholders across the aviation industry (yielding notably different rules being applied by multiple airlines even at a single airport), and (3) human factors issues related to the use of decision support tools and the implementation of safety procedures. This research is supported by the United States Federal Aviation Administration (FAA). The views expressed are those of the authors and do not necessarily represent the official policy or position of the FAA.

Community Stakeholders’ Perceptions of Barriers to Childhood Obesity Prevention in Low-Income Families, Massachusetts 2012–2013

PubMed Central

Chuang, Emmeline; Aftosmes-Tobio, Alyssa; Blaine, Rachel E.; Giannetti, Mary; Land, Thomas; Davison, Kirsten K.

2015-01-01

Introduction The etiology of childhood obesity is multidimensional and includes individual, familial, organizational, and societal factors. Policymakers and researchers are promoting social–ecological approaches to obesity prevention that encompass multiple community sectors. Programs that successfully engage low-income families in making healthy choices are greatly needed, yet little is known about the extent to which stakeholders understand the complexity of barriers encountered by families. The objective of this study was to contextually frame barriers faced by low-income families reported by community stakeholders by using the Family Ecological Model (FEM). Methods From 2012 through 2013, we conducted semistructured interviews with 39 stakeholders from 2 communities in Massachusetts that were participating in a multisector intervention for childhood obesity prevention. Stakeholders represented schools; afterschool programs; health care; the Special Supplemental Nutrition Program for Women, Infants, and Children; and early care and education. Interviews were audio-recorded, transcribed, coded, and summarized. Results Stakeholder reports of the barriers experienced by low-income families had a strong degree of overlap with FEM and reflected awareness of the broader contextual factors (eg, availability of community resources, family culture, education) and social and emotional dynamics within families (eg, parent knowledge, social norms, distrust of health care providers, chronic life stressors) that could affect family adoption of healthy lifestyle behaviors. Furthermore, results illustrated a level of consistency in stakeholder awareness across multiple community sectors. Conclusion The congruity of stakeholder perspectives with those of low-income parents as summarized in FEM and across community sectors illustrates potential for synergizing the efforts necessary for multisector, multilevel community interventions for the prevention of childhood obesity. PMID:25811497

Understanding animal health communication networks among smallholder livestock producers in Australia using stakeholder analysis.

PubMed

Hayes, L; Woodgate, R; Rast, L; Toribio, J-A L M L; Hernández-Jover, M

2017-09-01

Smallholder livestock producers are a diverse population with wide ranging motivations for keeping livestock. The biosecurity risk posed by smallholders has been the subject of much conjecture, with comparisons often made between the level of animal health and biosecurity knowledge of smallholders, versus that of commercial livestock producers. This research aimed to gain a better understanding of current knowledge of smallholder production in Australia, particularly in relation to biosecurity and emergency animal disease, and to investigate the relationships that exist between smallholders and the organisations and individuals from which they seek information, assistance and support. Engagement with stakeholders is an important component of an effective biosecurity communication strategy as the dissemination of biosecurity related information from a single source cannot be expected to satisfy the needs of such a broad ranging population. A qualitative study involving a review of literature, semi-structured interviews with government and non-government stakeholders and the development of smallholder and stakeholder influence and interest grids was undertaken. This paper forms part of a broader mixed methods research project among smallholders. Results from the stakeholder analysis showed variation in the parameters used to define smallholders and in the level of stakeholder involvement. Smallholders identified breeding consultants, other producers, private veterinarians and family, friends and colleagues as having a significant to high level of interest and potential to influence their practices. Government agencies were perceived to only have some level of interest but significant influence. Industry stakeholders and rural suppliers were positioned in the quadrant reflecting perceived low levels of interest and influence. The interest and influence grid developed from stakeholder's perspectives demonstrate a clustering around the mid points for both interest and influence, with the exception of those from industry who described low levels of interest and influence. Commonwealth and State government stakeholders reported a higher level of interest than influence. Veterinarians, both government and private, reported some to significant levels of interest and influence. In contrast to the results from the smallholder grid, rural suppliers reported relatively high levels of both interest and influence. The current study demonstrates that to maximise the effectiveness of biosecurity communication, there is a need for government and industry organisations to further engage with all stakeholders involved with smallholders. Copyright © 2017 Elsevier B.V. All rights reserved.

Perceptions and Cost-Analysis of a Multiple Mini-Interview in a Pharmacy School Admissions Process.

PubMed

Corelli, Robin L; Muchnik, Michael A; Beechinor, Ryan J; Fong, Gary; Vogt, Eleanor M; Cocohoba, Jennifer M; Tsourounis, Candy; Hudmon, Karen Suchanek

2015-11-25

To improve the quality of admissions interviews for a doctor of pharmacy program, using a multiple mini-interview (MMI) in place of the standard interview. Stakeholders completed an anonymous web-based survey. This study characterized perceptions of the MMI format across 3 major stakeholders (candidates, interviewers, admissions committee members) and included comparative cost estimates.Costs were estimated using human and facility resources from the 2012 cycle (standard format) and the 2013 cycle (MMI format). Most candidates (65%), interviewers (86%), and admissions committee members (79%) perceived the MMI format as effective for evaluating applicants, and most (59% of candidates, 84% of interviewers, 77% of committee members) agreed that the MMI format should be continued. Cost per candidate interviewed was $136.34 (standard interview) vs $75.30 (MMI). Perceptions of the MMI process were favorable across stakeholder groups, and this format was less costly per candidate interviewed.

Analysis of stakeholders networks of infant and young child nutrition programmes in Sri Lanka, India, Nepal, Bangladesh and Pakistan.

PubMed

Uddin, Shahadat; Mahmood, Hana; Senarath, Upul; Zahiruddin, Quazi; Karn, Sumit; Rasheed, Sabrina; Dibley, Michael

2017-06-13

Effective public policies are needed to support appropriate infant and young child feeding (IYCF) to ensure adequate child growth and development, especially in low and middle income countries. The aim of this study was to: (i) capture stakeholder networks in relation to funding and technical support for IYCF policy across five countries in South Asia (i.e. Sri Lanka, India, Nepal, Bangladesh and Pakistan); and (ii) understand how stakeholder networks differed between countries, and identify common actors and their patterns in network engagement across the region. The Net-Map method, which is an interview-based mapping technique to visualise and capture connections among different stakeholders that collaborate towards achieving a focused goal, has been used to map funding and technical support networks in all study sites. Our study was conducted at the national level in Bangladesh, India, Nepal, and Sri Lanka, as well as in selected states or provinces in India and Pakistan during 2013-2014. We analysed the network data using a social network analysis software (NodeXL). The number of stakeholders identified as providing technical support was higher than the number of stakeholders providing funding support, across all study sites. India (New Delhi site - national level) site had the highest number of influential stakeholders for both funding (43) and technical support (86) activities. Among all nine study sites, India (New Delhi - national level) and Sri Lanka had the highest number of participating government stakeholders (22) in their respective funding networks. Sri Lanka also had the highest number of participating government stakeholders for technical support (34) among all the study sites. Government stakeholders are more engaged in technical support activities compared with their involvement in funding activities. The United Nations Children's Emergency Fund (UNICEF) and the World Health Organization (WHO) were highly engaged stakeholders for both funding and technical support activities across all study sites. International stakeholders were highly involved in both the funding and technical support activities related to IYCF practices across these nine study sites. Government stakeholders received more support for funding and technical support activities from other stakeholders compared with the support that they offered. Stakeholders were, in general, more engaged for technical support activities compared with the funding activities.

Geospatial optimization of siting large-scale solar projects

USGS Publications Warehouse

Macknick, Jordan; Quinby, Ted; Caulfield, Emmet; Gerritsen, Margot; Diffendorfer, James E.; Haines, Seth S.

2014-01-01

guidelines by being user-driven, transparent, interactive, capable of incorporating multiple criteria, and flexible. This work provides the foundation for a dynamic siting assistance tool that can greatly facilitate siting decisions among multiple stakeholders.

Research Project Evaluation-Learnings from the PATHWAYS Project Experience.

PubMed

Galas, Aleksander; Pilat, Aleksandra; Leonardi, Matilde; Tobiasz-Adamczyk, Beata

2018-05-25

Every research project faces challenges regarding how to achieve its goals in a timely and effective manner. The purpose of this paper is to present a project evaluation methodology gathered during the implementation of the Participation to Healthy Workplaces and Inclusive Strategies in the Work Sector (the EU PATHWAYS Project). The PATHWAYS project involved multiple countries and multi-cultural aspects of re/integrating chronically ill patients into labor markets in different countries. This paper describes key project's evaluation issues including: (1) purposes, (2) advisability, (3) tools, (4) implementation, and (5) possible benefits and presents the advantages of a continuous monitoring. Project evaluation tool to assess structure and resources, process, management and communication, achievements, and outcomes. The project used a mixed evaluation approach and included Strengths (S), Weaknesses (W), Opportunities (O), and Threats (SWOT) analysis. A methodology for longitudinal EU projects' evaluation is described. The evaluation process allowed to highlight strengths and weaknesses and highlighted good coordination and communication between project partners as well as some key issues such as: the need for a shared glossary covering areas investigated by the project, problematic issues related to the involvement of stakeholders from outside the project, and issues with timing. Numerical SWOT analysis showed improvement in project performance over time. The proportion of participating project partners in the evaluation varied from 100% to 83.3%. There is a need for the implementation of a structured evaluation process in multidisciplinary projects involving different stakeholders in diverse socio-environmental and political conditions. Based on the PATHWAYS experience, a clear monitoring methodology is suggested as essential in every multidisciplinary research projects.

Social Work's Role in Medicaid Reform: A Qualitative Study.

PubMed

Bachman, Sara S; Wachman, Madeline; Manning, Leticia; Cohen, Alexander M; Seifert, Robert W; Jones, David K; Fitzgerald, Therese; Nuzum, Rachel; Riley, Patricia

2017-12-01

To critically analyze social work's role in Medicaid reform. We conducted semistructured interviews with 46 stakeholders from 10 US states that use a range of Medicaid reform approaches. We identified participants using snowball and purposive sampling. We gathered data in 2016 and analyzed them using qualitative methods. Multiple themes emerged: (1) social work participates in Medicaid reform through clinical practice, including care coordination and case management; (2) there is a gap between social work's practice-level and systems-level involvement in Medicaid innovations; (3) factors hindering social work's involvement in systems-level practice include lack of visibility, insufficient clarity on social work's role and impact, and too few resources within professional organizations; and (4) social workers need more training in health transformation payment models and policy. Social workers have unique skills that are valuable to building health systems that promote population health and reduce health inequities. Although there is considerable opportunity for social work to increase its role in Medicaid reform, there is little social work involvement at the systems level.

Effectively engaging stakeholders and the public in developing violence prevention messages.

PubMed

Boyko, Jennifer A; Wathen, C Nadine; Kothari, Anita

2017-05-11

Preventing family violence requires that stakeholders and the broader public be involved in developing evidence-based violence prevention strategies. However, gaps exist in between what we know (knowledge), what we do (action), and the structures supporting practice (policy). We discuss the broad challenge of mobilizing knowledge-for-action in family violence, with a primary focus on the issue of how stakeholders and the public can be effectively engaged when developing and communicating evidence-based violence prevention messages. We suggest that a comprehensive approach to stakeholder and public engagement in developing violence prevention messages includes: 1) clear and consistent messaging; 2) identifying and using, as appropriate, lessons from campaigns that show evidence of reducing specific types of violence; and 3) evidence-informed approaches for communicating to specific groups. Components of a comprehensive approach must take into account the available research evidence, implementation feasibility, and the context-specific nature of family violence. While strategies exist for engaging stakeholders and the public in messaging about family violence prevention, knowledge mobilization must be informed by evidence, dialogue with stakeholders, and proactive media strategies. This paper will be of interest to public health practitioners or others involved in planning and implementing violence prevention programs because it highlights what is known about the issue, potential solutions, and implementation considerations.

'It looks like you just want them when things get rough': civil society perspectives on negative trial results and stakeholder engagement in HIV prevention trials.

PubMed

Koen, Jennifer; Essack, Zaynab; Slack, Catherine; Lindegger, Graham; Newman, Peter A

2013-12-01

Civil society organizations (CSOs) have significantly impacted on the politics of health research and the field of bioethics. In the global HIV epidemic, CSOs have served a pivotal stakeholder role. The dire need for development of new prevention technologies has raised critical challenges for the ethical engagement of community stakeholders in HIV research. This study explored the perspectives of CSO representatives involved in HIV prevention trials (HPTs) on the impact of premature trial closures on stakeholder engagement. Fourteen respondents from South African and international CSOs representing activist and advocacy groups, community mobilisation initiatives, and human and legal rights groups were purposively sampled based on involvement in HPTs. Interviews were conducted from February-May 2010. Descriptive analysis was undertaken across interviews and key themes were developed inductively. CSO representatives largely described positive outcomes of recent microbicide and HIV vaccine trial terminations, particularly in South Africa, which they attributed to improvements in stakeholder engagement. Ongoing challenges to community engagement included the need for principled justifications for selective stakeholder engagement at strategic time-points, as well as the need for legitimate alternatives to CABs as mechanisms for engagement. Key issues for CSOs in relation to research were also raised. © 2012 John Wiley & Sons Ltd.

Cognitive mapping tools: review and risk management needs.

PubMed

Wood, Matthew D; Bostrom, Ann; Bridges, Todd; Linkov, Igor

2012-08-01

Risk managers are increasingly interested in incorporating stakeholder beliefs and other human factors into the planning process. Effective risk assessment and management requires understanding perceptions and beliefs of involved stakeholders, and how these beliefs give rise to actions that influence risk management decisions. Formal analyses of risk manager and stakeholder cognitions represent an important first step. Techniques for diagramming stakeholder mental models provide one tool for risk managers to better understand stakeholder beliefs and perceptions concerning risk, and to leverage this new understanding in developing risk management strategies. This article reviews three methodologies for assessing and diagramming stakeholder mental models--decision-analysis-based mental modeling, concept mapping, and semantic web analysis--and assesses them with regard to their ability to address risk manager needs. © 2012 Society for Risk Analysis.

Return-to-work activities in a Chinese cultural context.

PubMed

Cheng, Andy S K; Loisel, Patrick; Feuerstein, Michael

2011-03-01

Several studies have been conducted in the West showing that return to work (RTW) coordination is a key element to facilitate RTW of injured workers and to prevent work disabilities. However, no study has been carried out to investigate the scope of RTW activities in China. The purpose of this study was to explore the views of key RTW stakeholders on necessary activities for RTW coordination. A cross-sectional survey was conducted in Guangdong province of China. A three-tiered approach including focus group discussions and panel reviews was used to collect RTW activities, analyze the content validity, and classify domains. Descriptive statistics and intra-class correlation (ICC) were used to describe the importance of RTW activities and the degree of agreement on the classification of different domains. A Kruskal-Wallis test with subsequent post-hoc analysis using multiple Mann-Whitney U tests was carried out to check for any differences in the domains of different RTW activities among RTW stakeholders. The domains of RTW activities in China were similar to those in the West and included workplace assessment and mediation, social problem solving, role and liability clarification, and medical advice. Good agreement (ICC: 0.729-0.844) on the classification of RTW activities into different domains was found. The domains of the RTW activities of healthcare providers differed from those of employers (P = 0.002) and injured workers (P = 0.001). However, there was no significant difference between employers and injured workers. This study indicated that differences among stakeholders were observed in terms of areas of relative priority. There is a clear need for research and training in China to establish a nation-wide terminology for RTW coordination, facilitate cross-provincial studies and work toward a more integrated system addressing the diverse perspectives of stakeholders involved in the RTW process.

Development of a Nationally Coordinated Evaluation Plan for the Ghana National Strategy for Key Populations

PubMed Central

Reynolds, Heidi W; Atuahene, Kyeremeh; Sutherland, Elizabeth; Amenyah, Richard; Kwao, Isaiah Doe; Larbi, Emmanuel Tettey

2015-01-01

Objective Just as HIV prevention programs need to be tailored to the local epidemic, so should evaluations be country-owned and country-led to ensure use of those results in decision making and policy. The objective of this paper is to describe the process undertaken in Ghana to develop a national evaluation plan for the Ghana national strategy for key populations. Methods This was a participatory process that involved meetings between the Ghana AIDS Commission (GAC), other partners in Ghana working to prevent HIV among key populations, and MEASURE Evaluation. The process included three two-day, highly structured yet participatory meetings over the course of 12 months during which participants shared information about on-going and planned data and identified research questions and methods. Results An evaluation plan was prepared to inform stakeholders about which data collection activities need to be prioritized for funding, who would implement the study, the timing of data collection, the research question the data will help answer, and the analysis methods. The plan discusses various methods that can be used including the recommendation for the study design using multiple data sources. It has an evaluation conceptual model, proposed analyses, proposed definition of independent variables, estimated costs for filling data gaps, roles and responsibilities of stakeholders to carry out the plan, and considerations for ethics, data sharing and authorship. Conclusion The experience demonstrates that it is possible to design an evaluation responsive to national strategies and priorities with country leadership, regardless of stakeholders' experiences with evaluations. This process may be replicable elsewhere, where stakeholders want to plan and implement an evaluation of a large-scale program at the national or subnational level that is responsive to national priorities and part of a comprehensive monitoring and evaluation system. PMID:26120495

Stakeholder Analysis in Utilizing of Environmental Services and Natural Attractions in Tuk Semuncar Utilization Zone of Gunung Merbabu National Park: A literature review

NASA Astrophysics Data System (ADS)

Setiawan, Muhammad Arif; Muhammad, Fuad

2018-02-01

Many stakeholders in the utilizing of environmental services and natural attraction of Tuk Semuncar Utilization Zone needs to get the attention of the Gunung Merbabu National Park Officer. The existence of natural resources has an important role for the life of the community, making the complexity of the relationship between various parties who have interests in natural resource management. The existence of stakeholders and their interests should receive attention and be considered to be accommodated as an effort to prevent the occurrence of losses to the conservation area of Gunung Merbabu National Park. Every stakeholder's interest can have a positive and negative impact on other stakeholders. Stakeholder analysis can help in understanding the conflict on the utilizing of environmental services and natural attraction that is happening, as well as input strategy in involving stakeholders for the achievement of goals.

Nuclear waste transportation: case studies of identifying stakeholder risk information needs.

PubMed Central

Drew, Christina H; Grace, Deirdre A; Silbernagel, Susan M; Hemmings, Erin S; Smith, Alan; Griffith, William C; Takaro, Timothy K; Faustman, Elaine M

2003-01-01

The U.S. Department of Energy (DOE) is responsible for the cleanup of our nation's nuclear legacy, involving complex decisions about how and where to dispose of nuclear waste and how to transport it to its ultimate disposal site. It is widely recognized that a broad range of stakeholders and tribes should be involved in this kind of decision. All too frequently, however, stakeholders and tribes are only invited to participate by commenting on processes and activities that are near completion; they are not included in the problem formulation stages. Moreover, it is often assumed that high levels of complexity and uncertainty prevent meaningful participation by these groups. Considering the types of information that stakeholders and tribes need to be able to participate in the full life cycle of decision making is critical for improving participation and transparency of decision making. Toward this objective, the Consortium for Risk Evaluation with Stakeholder Participation (CRESP) participated in three public processes relating to nuclear waste transportation and disposal in 1997-1998. First, CRESP organized focus groups to identify concerns about nuclear waste transportation. Second, CRESP conducted exit surveys at regional public workshops held by DOE to get input from stakeholders on intersite waste transfer issues. Third, CRESP developed visual tools to synthesize technical information and allow stakeholders and tribes with varying levels of knowledge about nuclear waste to participate in meaningful discussion. In this article we share the results of the CRESP findings, discuss common themes arising from these interactions, and comment on special considerations needed to facilitate stakeholder and tribal participation in similar decision-making processes. PMID:12611653

STAKEHOLDERS’ OPINIONS AND EXPECTATIONS OF THE GLOBAL FUND AND THEIR POTENTIAL ECONOMIC IMPLICATIONS

PubMed Central

Galárraga, Omar; Bertozzi, Stefano M.

2009-01-01

Objective To analyze stakeholder opinions and expectations of the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and to discuss their potential economic and financial implications. Design The Global Fund commissioned an independent study, the “360° Stakeholder Assessment,” to canvas feedback on the organization’s reputation and performance with an on-line survey of 909 respondents representing major stakeholders worldwide. We created a proxy for expectations based on categorical responses for specific Global Fund attributes’ importance to the stakeholders, and current perceived performance. Methods Using multivariate regression, we analyzed 23 unfulfilled expectations related to: resource mobilization; impact measurement; harmonization and inclusion; effectiveness of the Global Fund partner environment; and portfolio characteristics. The independent variables are personal- and regional-level characteristics that affect expectations. Results The largest unfulfilled expectations relate to: mobilization of private sector resources; efficiency in disbursing funds; and assurance that people affected by the three diseases are reached. Stakeholders involved with the Fund through the Country Coordinating Mechanisms, those working in multilateral organizations, and persons living with HIV are more likely to have unfulfilled expectations. In contrast, higher levels of involvement with the Fund correlate with fulfilled expectations. Stakeholders living in sub-Saharan Africa were less likely to have their expectations met. Conclusions Stakeholders unfulfilled expectations result largely from factors external to them, but also from factors over which they have influence. In particular, attributes related to partnership score poorly even though stakeholders have influence in that area. Joint efforts to address perceived performance gaps may improve future performance, and positively influence investment levels and economic viability. PMID:18664957

The development of a national nutrition and mental health research agenda with comparison of priorities among diverse stakeholders.

PubMed

Davison, Karen M; D'Andreamatteo, Carla; Mitchell, Scott; Vanderkooy, Pat

2017-03-01

To develop a national nutrition and mental health research agenda based on the engagement of diverse stakeholders and to assess research priorities by stakeholder groups. A staged, integrated and participatory initiative was implemented to structure a national nutrition and mental health research agenda that included: (i) national stakeholder consultations to prioritize research questions; (ii) a workshop involving national representatives from research, policy and practice to further define priorities; (iii) triangulation of data to formulate the agenda; and (iv) test hypotheses about stakeholder influences on decision making. Canada. Diverse stakeholders including researchers, academics, administrators, service providers, policy makers, practitioners, non-profit, industry and funding agency representatives, front-line workers, individuals with lived experience of a mental health condition and those who provide care for them. This first-of-its-kind research priority-setting initiative showed points of agreement among diverse stakeholders (n 899) on research priorities aimed at service provision; however, respondents with lived experience of a mental health condition (themselves or a family member) placed emphasis on prevention and mental health promotion-based research. The final integrated agenda identified four research priorities, including programmes and services, service provider roles, the determinants of health and knowledge translation and exchange. These research priorities aim to identify effective models of care, enhance collaboration, inform policy makers and foster knowledge dissemination. Since a predictor of research uptake is the involvement of relevant stakeholders, a sustained and deliberate effort must continue to engage collaboration that will lead to the optimization of nutrition and mental health-related outcomes.

Power relations and contrasting conceptions of evidence in patient-involvement processes used to inform health funding decisions in Australia.

PubMed

Lopes, Edilene; Carter, Drew; Street, Jackie

2015-06-01

We collected and analysed views of key stakeholders on the processes used to involve patient organisations in health care funding decision making in Australia. We conducted 12 semi-structured interviews with patient organisation representatives and members of Advisory Committees that provide advice to the Australian Department of Health and employ Health Technology Assessment (HTA) as an evaluation framework. Using two theoretical frameworks, we analysed structural and contextual elements pertaining to the involvement processes. The findings reported in this article relate to interviewees' perspectives on contextual elements, analysed using a Foucauldian lens. These elements include: the perspectives of marginalised voices; the diversity of views on what ought to be considered valid evidence in a HTA setting; and the relationships between stakeholders, along with how these relationships impact on involvement processes and the outcomes of those processes. The findings demonstrate that the involvement processes currently used are deemed inadequate by both patient organisation representatives and Advisory Committee members, but for different reasons connected to how different stakeholders conceptualise evidence. Advisory Committee members viewed evidence as encompassing clinical outcomes and patient preferences, whereas patient organisation representatives tended to view evidence as encompassing aspects not directly related to a disease entity, such as the social and emotional aspects of patients' experiences in living with illness. Patient organisation representatives reported interacting with other stakeholders (especially industry) to increase the influence of their conception of evidence on decision making. The use of this strategy by interviewees illustrates how power struggles occur in government decision-making processes which involve both medical expertise and patients' accounts. Such struggles, and the power differentials they reflect, need to be considered by those responsible for designing and implementing meaningful public- and patient-involvement processes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Integrating Stakeholders and Users into the Geography Discipline's Research Process

USGS Publications Warehouse

Hermans, Caroline M.; Taketa, Richard

2006-01-01

Future research priorities of Geography emphasize the discipline's leadership role in the U.S. Geological Survey (USGS) in multidisciplinary and integrated research on human and environmental systems and how these systems are interrelated and respond to change Geography's research priorities also emphasize providing science that is usable to society and creating decision support products applicable to given customer problems. To achieve these goals, we must understand the relationship between our research and our customer, and how to integrate the customer into the research process. This report details the elements of the research process that help achieve the degree of stakeholder involvement necessary to ensure a successful end-product. It offers suggestions that can help researchers better understand stakeholders and customers and involve them in the research process more effectively, while preserving the integrity of the science. Its aim is to help researchers understand the problems and challenges faced by our customers and communicate the ways in which Geography can help address their problems. Adopting these guidelines can improve the efficiency of the research process and lead to higher quality output. We will be able to conduct better research because we will have an improved understanding of the research problem and the stakeholders involved. This report covers a broad range of topics, from identifying and communicating with stakeholders and users, to the use of language, to how to effectively present scientific information to the user. It does not offer a 'one size fits all' method. Instead, perhaps only specific sections are suitable for a given project and customers, depending on project scope and needs. This report is based on the objectives of Geography's strategic plan, U. S. Geological Survey's strategic plan, and Department of Interior's strategic plan. Section 2 of these guidelines describes the purpose of the research process in Geography and the need for better user involvement in the process. Section 3 explains how to conduct a stakeholder analysis. Section 4 explains how to conduct a user-needs assessment.

Focusing on Cause or Cure?: Priorities and Stakeholder Presence in Childhood Psychiatry Research.

PubMed

Milner, Lauren C; Cho, Mildred K

2014-01-01

Biomedical research is influenced by many factors, including the involvement of stakeholder groups invested in research outcomes. Stakeholder involvement in research efforts raise questions of justice as their specific interests and motivations play a role in directing research resources that ultimately produce knowledge shaping how different conditions (and affected individuals) are understood and treated by society. This issue is highly relevant to child psychiatry research where diagnostic criteria and treatment strategies are often controversial. Biological similarities and stakeholder differences between attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) provide an opportunity to explore this issue by comparing research foci and stakeholder involvement in these conditions. A subset of ADHD and ASD research articles published between 1970-2010 were randomly selected from the PubMed database and coded for research focus, funding source(s), and author-reported conflicts of interest (COIs). Chi-square analyses were performed to identify differences between and within ADHD and ASD research across time. The proportion of ADHD research dedicated to basic, description, and treatment research was roughly similar and remained stable over time, while ASD research showed a significant increase in basic research over the past decade. Government was the primary research funder for both conditions, but for-profit funders were a notable presence in ADHD research, while joint-funding efforts between non-profit and government funders were a notable presence in ASD research. Lastly, COIs were noted more frequently in ADHD than in ASD research. Our study shows significant differences in research foci and funding sources between the conditions, and identifies the specific involvement of for-profit and non-profit groups in ADHD and ASD, respectively. Our findings highlight the relationship between stakeholders outside the research community and research trajectories and suggest that examinations of these relationships must be included in broader considerations of biomedical research ethics.

Values Engagement in Evaluation: Ideas, Illustrations, and Implications

ERIC Educational Resources Information Center

Hall, Jori N.; Ahn, Jeehae; Greene, Jennifer C.

2012-01-01

Values-engagement in evaluation involves both describing stakeholder values and prescribing certain values. Describing stakeholder values is common practice in responsive evaluation traditions. Prescribing or advocating particular values is only "explicitly" part of democratic, culturally responsive, critical, and other openly…

Using an innovative criteria weighting tool for stakeholders involvement to rank MSW facility sites with the AHP.

PubMed

De Feo, Giovanni; De Gisi, Sabino

2010-11-01

The main aim of this study was to verify the efficacy of using an innovative criteria weighting tool (the "priority scale") for stakeholders involvement to rank a list of suitable municipal solid waste (MSW) facility sites with the multi-criteria decision-making (MCDM) technique known as analytic hierarchy process (AHP). One of the main objectives of the study was to verify the behaviour of the "priority scale" with both technical and non-technical decision-makers. All over the world, the siting of MSW treatment or disposal plants is a complex process involving politicians, technicians as well as citizens, where stakeholders who are not effectively involved strongly oppose (or even obstruct) the realization of new facilities. In this study, in order to pursue both the technical (select the best site) and social aims (all the stakeholders have to give their aware contribution), the use of the "priority scale" is suggested as a tool to easily collect non-contradictory criteria preferences by the various decision-makers. Every decision-maker filled in "priority scale", which was subsequently uploaded in the AHP tool in order to indirectly calculate the individual priority of alternatives given by each stakeholder (not using group aggregation techniques). The proposed method was applied to the siting of a composting plant in an area suffering from a serious MSW emergency, which has lasted for over 15 years, in the Campania Region, in Southern Italy. The best site (the "first choice") was taken as the one that appeared the most times at the first place of each decision-maker ranking list. The involved technical and non-technical decision-makers showed the same behaviour in (indirectly) selecting the best site as well as in terms of the most appraised criteria ("absence of areas of the highest value for natural habitats and species of plants and animals"). Moreover, they showed the same AHP inconsistency ratio as well as the same behaviour in comparison with a "balanced decision-maker" (who assigns identical weights to all the considered criteria). Therefore, the proposed criteria weighting tool could be widely as well as easily used for stakeholders involvement to rank MSW facility sites (or other kinds of alternatives) with the AHP or with other MCDM techniques, taking or not into consideration group aggregation methods. Copyright © 2010 Elsevier Ltd. All rights reserved.

The national response for preventing healthcare-associated infections: system capacity and sustainability for improvement.

PubMed

Mendel, Peter; Weinberg, Daniel A; Gall, Elizabeth M; Leuschner, Kristin J; Kahn, Katherine L

2014-02-01

Strengthening capacity across the healthcare system for improvement is critical to ensuring that past efforts and investments establish a foundation for sustaining progress in patient safety. The objective of this analysis was to identify key system capacity issues for sustainability from evaluation of the Action Plan to prevent healthcare-associated infections, a major national initiative launched by the US Department of Health and Human Services in 2009. The analysis involves the review and synthesis of results across the components of a 3-year evaluation of the Action Plan, as described in the evaluation framework and detailed in separate analyses elsewhere in this special issue. Data collection methods included interviews with government and private stakeholders, document and literature reviews, and observations of meetings and conferences at multiple time points. Key developments in healthcare-associated infection prevention system capacity were extracted on the basis of "major activities" identified through multiple methods and organized into the level of progress based on perspectives of multiple stakeholders. Activities within each level were then examined and compared according to our evaluation's framework of 4 system functions and 5 system properties. Key system capacity and sustainability issues for the Action Plan to be addressed centered on coordination and alignment (among participating agencies, with other federal initiatives, and across levels of healthcare), infrastructure for data and accountability (including more efficient technologies and unintended consequences), cultural embedding of prevention practices, and uncertainty and variability in resources. Sustainability depends on improvements across system functions and properties and how they reinforce each other. Change is more robust if different system elements support and incentivize behavior in similar directions.

A multi-disciplinary approach for the integrated assessment of multiple risks in delta areas.

NASA Astrophysics Data System (ADS)

Sperotto, Anna; Torresan, Silvia; Critto, Andrea; Marcomini, Antonio

2016-04-01

The assessment of climate change related risks is notoriously difficult due to the complex and uncertain combinations of hazardous events that might happen, the multiplicity of physical processes involved, the continuous changes and interactions of environmental and socio-economic systems. One important challenge lies in predicting and modelling cascades of natural and man -made hazard events which can be triggered by climate change, encompassing different spatial and temporal scales. Another regard the potentially difficult integration of environmental, social and economic disciplines in the multi-risk concept. Finally, the effective interaction between scientists and stakeholders is essential to ensure that multi-risk knowledge is translated into efficient adaptation and management strategies. The assessment is even more complex at the scale of deltaic systems which are particularly vulnerable to global environmental changes, due to the fragile equilibrium between the presence of valuable natural ecosystems and relevant economic activities. Improving our capacity to assess the combined effects of multiple hazards (e.g. sea-level rise, storm surges, reduction in sediment load, local subsidence, saltwater intrusion) is therefore essential to identify timely opportunities for adaptation. A holistic multi-risk approach is here proposed to integrate terminology, metrics and methodologies from different research fields (i.e. environmental, social and economic sciences) thus creating shared knowledge areas to advance multi risk assessment and management in delta regions. A first testing of the approach, including the application of Bayesian network analysis for the assessment of impacts of climate change on key natural systems (e.g. wetlands, protected areas, beaches) and socio-economic activities (e.g. agriculture, tourism), is applied in the Po river delta in Northern Italy. The approach is based on a bottom-up process involving local stakeholders early in different stages of the multi-risk assessment process (i.e. identification of objectives, collection of data, definition of risk thresholds and indicators). The results of the assessment will allow the development of multi-risk scenarios enabling the evaluation and prioritization of risk management and adaptation options under changing climate conditions.

Managing the transition (ManTra): a resource for persons with secondary progressive multiple sclerosis and their health professionals: protocol for a mixed-methods study in Italy

PubMed Central

Giordano, Andrea; Pietrolongo, Erika; Confalonieri, Paolo; De Luca, Giovanna; Tortorella, Carla; Trojano, Maria; Messmer Uccelli, Michele; Torri Clerici, Valentina; Gitto, Lara; Köpke, Sascha; Borreani, Claudia; Heesen, Christoph; Solari, Alessandra

2017-01-01

Introduction 15 years after clinical onset, about 50% of patients with relapsing-remitting multiple sclerosis convert to secondary progressive multiple sclerosis (SPMS). Notwithstanding the importance of this transition, knowledge of the experiences and needs of patients and carers is fragmentary, and targeted interventions are not available. Managing the Transition to SPMS (ManTra) is a mixed methodology project to develop and test a user-led resource for newly diagnosed patients with SPMS. Here, we describe the developmental phase, consisting of a literature review and a new research study involving key stakeholders, in which we construct the resource. Methods and analysis Round 1: The literature review and study will be conducted in parallel. The latter will identify patient needs using a qualitative approach consisting of: personal semistructured interviews with >15 recently diagnosed patients with SPMS; three focus group meetings (one with significant others of patients, one with neurologists and one with other health professionals caring for patients with SPMS). An online survey (>200 recently diagnosed Italian patients with SPMS) will follow to verify needs in a larger independent sample. An expert panel will outline a set of candidate resources/interventions that aim to satisfy the needs thus identified. Round 2: Consensus on the final resource will be obtained in a 1-day meeting of recently diagnosed patients with SPMS, significant others, health professionals and other stakeholders, using the nominal group technique. The expert panel will refine the resource, identify the outcome measures to assess its efficacy and ascertain the most suitable comparator (ManTra Phase 2, not part of this protocol). Ethics and dissemination The study protocol was approved by the ethics committees of each of the involved centres: Foundation IRCCS Neurological Institute C Besta, Milan; G D’Annunzio University of Chieti-Pescara and the Aldo Moro University of Bari. The results will be published in peer-reviewed journals, presented at conferences and a lay summary sent to participants. PMID:28838904

A Multi-Level Examination of Stakeholder Perspectives of Implementation of Evidence-Based Practices in a Large Urban Publicly-Funded Mental Health System.

PubMed

Beidas, Rinad S; Stewart, Rebecca E; Adams, Danielle R; Fernandez, Tara; Lustbader, Susanna; Powell, Byron J; Aarons, Gregory A; Hoagwood, Kimberly E; Evans, Arthur C; Hurford, Matthew O; Rubin, Ronnie; Hadley, Trevor; Mandell, David S; Barg, Frances K

2016-11-01

Our goal was to identify barriers and facilitators to the implementation of evidence-based practices from the perspectives of multiple stakeholders in a large publicly funded mental health system. We completed 56 interviews with three stakeholder groups: treatment developers (n = 7), agency administrators (n = 33), and system leadership (n = 16). The three stakeholder groups converged on the importance of inner (e.g., agency competing resources and demands, therapist educational background) and outer context (e.g., funding) factors as barriers to implementation. Potential threats to implementation and sustainability included the fiscal landscape of community mental health clinics and an evolving workforce. Intervention characteristics were rarely endorsed as barriers. Inner context, outer context, and intervention characteristics were all seen as important facilitators. All stakeholders endorsed the importance of coordinated collaboration across stakeholder groups within the system to successfully implement evidence-based practices.

Barriers and Facilitators Affecting Patient Portal Implementation from an Organizational Perspective: Qualitative Study.

PubMed Central

Kooij, Laura; Groen, Wim G

2018-01-01

Background The number of patient portals is rising, and although portals can have positive effects, their implementation has major impacts on the providing health care institutions. However, little is known about the organizational factors affecting successful implementation. Knowledge of the specific barriers to and facilitators of various stakeholders is likely to be useful for future implementations. Objective The objective of this study was to identify the barriers to and facilitators of patient portal implementation facing various stakeholders within hospital organizations in the Netherlands. Methods Purposive sampling was used to select hospitals of various types. A total of 2 university medical centers, 3 teaching hospitals, and 2 general hospitals were included. For each, 3 stakeholders were interviewed: (1) medical professionals, (2) managers, and (3) information technology employees. In total, 21 semistructured interviews were conducted using the Grol and Wensing model, which describes barriers to and facilitators of change in health care practice at 6 levels: (1) innovation; (2) individual professional; (3) patient; (4) social context; (5) organizational context; and (6) economic and political context. Two researchers independently selected and coded quotes by applying this model using a (deductive) directed content approach. Additional factors related to technical and portal characteristics were added using the model of McGinn et al, developed for implementation of electronic health records. Results In total, we identified 376 quotes, 26 barriers, and 28 facilitators. Thirteen barriers and 12 facilitators were common for all stakeholder groups. The facilitators’ perceived usefulness (especially less paperwork) was mentioned by all the stakeholders, followed by subjects’ positive attitude. The main barriers were lack of resources (namely, lack of staff and materials), financial difficulties (especially complying with high costs, lack of reimbursements), and guaranteeing privacy and security (eg, strict regulations). Both similarities and differences were found between stakeholder groups and hospital types. For example, managers and information technology employees mainly considered guaranteeing privacy and security as a predominant barrier. Financial difficulties were particularly mentioned by medical professionals and managers. Conclusions Patient portal implementation is a complex process and is not only a technical process but also affects the organization and its staff. Barriers and facilitators occurred at various levels and differed among hospital types (eg, lack of accessibility) and stakeholder groups (eg, sufficient resources) in terms of several factors. Our findings underscore the importance of involving multiple stakeholders in portal implementations. We identified a set of barriers and facilitators that are likely to be useful in making strategic and efficient implementation plans. PMID:29752253

Who to Blame: Irrational Decision-Makers or Stupid Modelers? (Arne Richter Award for Outstanding Young Scientists Lecture)

NASA Astrophysics Data System (ADS)

Madani, Kaveh

2016-04-01

Water management benefits from a suite of modelling tools and techniques that help simplifying and understanding the complexities involved in managing water resource systems. Early water management models were mainly concerned with optimizing a single objective, related to the design, operations or management of water resource systems (e.g. economic cost, hydroelectricity production, reliability of water deliveries). Significant improvements in methodologies, computational capacity, and data availability over the last decades have resulted in developing more complex water management models that can now incorporate multiple objectives, various uncertainties, and big data. These models provide an improved understanding of complex water resource systems and provide opportunities for making positive impacts. Nevertheless, there remains an alarming mismatch between the optimal solutions developed by these models and the decisions made by managers and stakeholders of water resource systems. Modelers continue to consider decision makers as irrational agents who fail to implement the optimal solutions developed by sophisticated and mathematically rigours water management models. On the other hand, decision makers and stakeholders accuse modelers of being idealist, lacking a perfect understanding of reality, and developing 'smart' solutions that are not practical (stable). In this talk I will have a closer look at the mismatch between the optimality and stability of solutions and argue that conventional water resources management models suffer inherently from a full-cooperation assumption. According to this assumption, water resources management decisions are based on group rationality where in practice decisions are often based on individual rationality, making the group's optimal solution unstable for individually rational decision makers. I discuss how game theory can be used as an appropriate framework for addressing the irrational "rationality assumption" of water resources management models and for better capturing the social aspects of decision making in water management systems with multiple stakeholders.

Community-based participatory research (CBPR) in South Africa: engaging multiple constituents to shape the research question.

PubMed

Mosavel, Maghboeba; Simon, Christian; van Stade, Debbie; Buchbinder, Mara

2005-12-01

Community engagement is an on-going, arduous, and necessary process for developing effective health promotion programs. The challenges are amplified when the particular health issue or research question is not prominent in the consciousness of the targeted community. In this paper, we explore the community-based participatory research (CBPR) model as a means to negotiate a mutual agenda between communities and researchers. The paper is focused on the (perceived) need for cervical cancer screening in an under-resourced community in Cape Town, South Africa. Cervical cancer is a significant health problem in this community and elsewhere in South Africa. Unlike HIV-AIDS, however, many Black South Africans have not been educated about cervical cancer and the importance of obtaining screening. Many may not consider screening a priority in their lives. Our research included extensive consultations and informal interviews with diverse community and regional stakeholders. Following these, we conducted 27 focus groups and 106 demographic surveys with randomly selected youth, parents, local health care personnel, educators and school staff. Focus group data were summarized and analyzed cross-sectionally. Community stakeholders were involved throughout this research. Our consultations, interviews, and focus group data were key in identifying the concerns and priorities of the community. By engaging community stakeholders, we developed a research framework that incorporated the community's concerns and priorities, and stressed the intersecting roles of poverty, violence, and other cultural forces in shaping community members' health and wellbeing. Community members helped to refocus our research from cervical cancer to 'cervical health,' a concept that acknowledged the impact on women's bodies and lives of HIV-AIDS and STDs, sexual violence, poverty, and multiple social problems. We conclude that the research agenda and questions in community-based health research should not be considered immutable. They need to be open to negotiation, creativity, and constant reinvention.

'Including health in systems responsible for urban planning': a realist policy analysis research programme.

PubMed

Harris, Patrick; Friel, Sharon; Wilson, Andrew

2015-07-23

Realist methods are increasingly being used to investigate complex public health problems. Despite the extensive evidence base clarifying the built environment as a determinant of health, there is limited knowledge about how and why land-use planning systems take on health concerns. Further, the body of research related to the wider determinants of health suffers from not using political science knowledge to understand how to influence health policy development and systems. This 4-year funded programme of research investigates how the land-use planning system in New South Wales, Australia, incorporates health and health equity at multiple levels. The programme uses multiple qualitative methods to develop up to 15 case studies of different activities of the New South Wales land-use planning system. Comparison cases from other jurisdictions will be included where possible and useful. Data collection includes publicly available documentation and purposively sampled stakeholder interviews and focus groups of up to 100 participants across the cases. The units of analysis in each case are institutional structures (rules and mandates constraining and enabling actors), actors (the stakeholders, organisations and networks involved, including health-focused agencies), and ideas (policy content, information, and framing). Data analysis will focus on and develop propositions concerning the mechanisms and conditions within and across each case leading to inclusion or non-inclusion of health. Data will be refined using additional political science and sociological theory. Qualitative comparative analysis will compare cases to develop policy-relevant propositions about the necessary and sufficient conditions needed to include health issues. Ethics has been approved by Sydney University Human Research Ethics Committee (2014/802 and 2015/178). Given the nature of this research we will incorporate stakeholders, often as collaborators, throughout. We outline our research translation strategies following best practice approaches. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Community-based participatory research (CBPR) in South Africa: Engaging multiple constituents to shape the research question

PubMed Central

Mosavel, Maghboeba; Simon, Christian; van Stade, Debbie; Buchbinder, Mara

2011-01-01

Community engagement is an on-going, arduous, and necessary process for developing effective health promotion programs. The challenges are amplified when the particular health issue or research question is not prominent in the consciousness of the targeted community. In this paper, we explore the community-based participatory research (CBPR) model as a means to negotiate a mutual agenda between communities and researchers. The paper is focused on the (perceived) need for cervical cancer screening in an under-resourced community in Cape Town, South Africa. Cervical cancer is a significant health problem in this community and elsewhere in South Africa. Unlike HIV-AIDS, however, many Black South Africans have not been educated about cervical cancer and the importance of obtaining screening. Many may not consider screening a priority in their lives. Our research included extensive consultations and informal interviews with diverse community and regional stakeholders. Following these, we conducted 27 focus groups and 106 demographic surveys with randomly selected youth, parents, local health care personnel, educators and school staff. Focus group data were summarized and analyzed cross-sectionally. Community stakeholders were involved throughout this research. Our consultations, interviews, and focus group data were key in identifying the concerns and priorities of the community. By engaging community stakeholders, we developed a research framework that incorporated the community’s concerns and priorities, and stressed the intersecting roles of poverty, violence, and other cultural forces in shaping community members’ health and wellbeing. Community members helped to refocus our research from cervical cancer to ‘cervical health,’ a concept that acknowledged the impact on women’s bodies and lives of HIV-AIDS and STDs, sexual violence, poverty, and multiple social problems. We conclude that the research agenda and questions in community-based health research should not be considered immutable. They need to be open to negotiation, creativity, and constant reinvention. PMID:15955605

Understanding the Needs of All the Stakeholders: Issues of Training and Preparation for Health Work Students and Their Clinical Educators

ERIC Educational Resources Information Center

Horstmanshof, Louise; Moore, Keri

2016-01-01

Work-integrated learning (WIL) is vital for preparing health-work students for practice. WIL activities have multiple stakeholders, each with their own set of expectations and requirements, both explicit and implicit. Negotiations to provide these learning experiences for students happen at many levels and those at the coalface are often unaware…

Walk a Mile in My Shoes: Stakeholder Accounts of Testing Experience with a Computer-Administered Test

ERIC Educational Resources Information Center

Fox, Janna; Cheng, Liying

2015-01-01

In keeping with the trend to elicit multiple stakeholder responses to operational tests as part of test validation, this exploratory mixed methods study examines test-taker accounts of an Internet-based (i.e., computer-administered) test in the high-stakes context of proficiency testing for university admission. In 2013, as language testing…

Facilitating ethical reflection among scientists using the ethical matrix.

PubMed

Jensen, Karsten Klint; Forsberg, Ellen-Marie; Gamborg, Christian; Millar, Kate; Sandøe, Peter

2011-09-01

Several studies have indicated that scientists are likely to have an outlook on both facts and values that are different to that of lay people in important ways. This is one significant reason it is currently believed that in order for scientists to exercise a reliable ethical reflection about their research it is necessary for them to engage in dialogue with other stakeholders. This paper reports on an exercise to encourage a group of scientists to reflect on ethical issues without the presence of external stakeholders. It reports on the use of a reflection process with scientists working in the area of animal disease genomics (mainly drawn from the EADGENE EC Network of Excellence). This reflection process was facilitated by using an ethical engagement framework, a modified version of the Ethical Matrix. As judged by two criteria, a qualitative assessment of the outcomes and the participants' own assessment of the process, this independent reflective exercise was deemed to be successful. The discussions demonstrated a high level of complexity and depth, with participants demonstrating a clear perception of uncertainties and the context in which their research operates. Reflection on stakeholder views and values appeared to be embedded within the discussions. The finding from this exercise seems to indicate that even without the involvement of the wider stakeholder community, valuable reflection and worthwhile discourse can be generated from ethical reflection processes involving only scienitific project partners. Hence, the previous assumption that direct stakeholder engagement is necessary for ethical reflection does not appear to hold true in all cases; however, other reasons for involving a broad group of stakeholders relating to governance and social accountability of science remain.

Addressing wild turkey population declines using structured decision making

USGS Publications Warehouse

Robinson, Kelly F.; Fuller, Angela K.; Schiavone, Michael V.; Swift, Bryan L.; Diefenbach, Duane R.; Siemer, William F.; Decker, Daniel J.

2017-01-01

We present a case study from New York, USA, of the use of structured decision making (SDM) to identify fall turkey harvest regulations that best meet stakeholder objectives, in light of recent apparent declines in abundance of wild turkeys in the northeastern United States. We used the SDM framework to incorporate the multiple objectives associated with turkey hunting, stakeholder desires, and region-specific ecological and environmental factors that could influence fall harvest. We identified a set of 4 fall harvest regulations, composed of different season lengths and bag limits, and evaluated their relative achievement of the objectives. We used a stochastic turkey population model, statistical modeling, and expert elicitation to evaluate the consequences of each harvest regulation on each of the objectives. We conducted a statewide mail survey of fall turkey hunters in New York to gather the necessary information to evaluate tradeoffs among multiple objectives associated with hunter satisfaction. The optimal fall harvest regulation was a 2-week season and allowed for the harvest of 1 bird/hunter. This regulation was the most conservative of those evaluated, reflecting the concerns about recent declines in turkey abundance among agency wildlife biologists and the hunting public. Depending on the region of the state, the 2-week, 1-bird regulation was predicted to result in 7–32% more turkeys on the landscape after 5 years. The SDM process provided a transparent framework for setting fall turkey harvest regulations and reduced potential stakeholder conflict by explicitly taking the multiple objectives of different stakeholder groups into account.

Ethical Issues in Sports Medicine

PubMed Central

Greenfield, Bruce H.; West, Charles Robert

2012-01-01

Ethical issues present a challenge for health care professionals working with athletes of sports teams. Health care professionals—including the team physician, the physical therapist, and the athletic trainer—are faced with the challenge of returning an athlete to competition as quickly as possible but as safely as possible. Conflicts of interest arise due to conflicting obligations of the team physician to the athlete and other members of the sports organization, including coaches and the team owner. The multiple stakeholders involved in sports teams challenge the traditional notion of confidentiality and autonomy. The aims of this article are to explicate the ethics of sports medicine, highlight the ethical issues, and provide some strategies and suggestions for ethical decision making. PMID:24179585

Understanding the perceptions, roles and interactions of stakeholder networks managing health-care waste: A case study of the Gaza Strip

DOE Office of Scientific and Technical Information (OSTI.GOV)

Caniato, M., E-mail: marcocaniato@gmail.com; Tudor, T.; Vaccari, M.

Highlights: • We systematically review scientific literature about health-care waste management. • We identify and discuss gaps, trends, efforts, and key-factors. • We suggest areas for improvement and best practices reported in literature. • We include recommendations for policy makers, practitioners and researchers. • We promote a holistic and harmonized approach to health-care waste management. - Abstract: The sustainable management of waste requires a holistic approach involving a range of stakeholders. What can often be difficult is to understand the manner in which different types of stakeholder networks are composed and work, and how best to enhance their effectiveness. Usingmore » social network analysis and stakeholder analysis of healthcare waste management stakeholders in the case study region of the Gaza Strip, this study aimed to understand and examine the manner in which the networks functioned. The Ministry of Health was found to be the most important stakeholder, followed by municipalities and solid waste management councils. Some international agencies were also mentioned, with specific roles, while other local institutions had a limited influence. Finally while health-care facilities had a strong interest in waste management, they were generally poorly informed and had limited links to each other. The manner in which the networks operated was complicated and influenced by differences in perception, sharing of information, access to finance and levels of awareness. The lack of a clear legal framework generated various mistakes about roles and responsibilities in the system, and evidently regulation was not an effective driver for improvement. Finally stakeholders had different priorities according to the waste management issues they were involved with, however segregation at the source was identified as a key requirement by most. Areas for improving the effectiveness of the networks are suggested. The analysis utilized an innovative methodology, which involved a large number of stakeholders. Such an approach served to raise interest and awareness at different levels (public authorities, health providers, supporting actors, others), stimulate the discussion about the adoption of specific policies, and identify the effective way forward.« less

Facilitating Factors and Barriers to the Use of Emerging Technologies for Suicide Prevention in Europe: Multicountry Exploratory Study.

PubMed

Muñoz-Sánchez, Juan-Luis; Delgado, Carmen; Parra-Vidales, Esther; Franco-Martín, Manuel

2018-01-24

This study provides an analysis on the use of emerging technologies for the prevention of suicide in 8 different European countries. The objective of this study was to analyze the potentiality of using emerging technologies in the area of suicide prevention based on the opinion of different professionals involved in suicide prevention. Opinions of 3 groups of stakeholders (ie, relevant professionals in suicide field) were gathered using a specifically designed questionnaire to explore dimensions underlying perceptions of facilitating factors and barriers in relation to the use of emerging technologies for suicide prevention. Goal 1 involved facilitating factors for the use of emerging technologies in suicide prevention. Northern European countries, except for Belgium, attach greater relevance to those that optimize implementation and benefits. On the other hand, Southern European countries attach greater importance to professionally oriented and user-centered facilitating factors. According to different stakeholders, the analysis of these facilitating factors suggest that professionals in the field of social work attach greater relevance to those that optimize implementation and benefits. However, professionals involved in the area of mental health, policy makers, and political decision makers give greater importance to professionally oriented and user-centered facilitating factors. Goal 2 was related to barriers to the usability of emerging technologies for suicide prevention. Both countries and stakeholders attach greater importance to barriers associated with resource constraints than to those centered on personal limitations. There are no differences between countries or between stakeholders. Nevertheless, there is a certain stakeholders-countries interaction that indicates that the opinions on resource constraints expressed by different stakeholders do not follow a uniform pattern in different countries, but they differ depending on the country. Although all countries and stakeholders agree in identifying resource constraints as the main barrier to the use of emerging technologies, factors facilitating their use in suicide prevention differ among countries and among stakeholders. ©Juan-Luis Muñoz-Sánchez, Carmen Delgado, Esther Parra-Vidales, Manuel Franco-Martín. Originally published in JMIR Mental Health (http://mental.jmir.org), 24.01.2018.

Engaging stakeholders for adaptive management using structured decision analysis

USGS Publications Warehouse

Irwin, Elise R.; Kathryn, D.; Kennedy, Mickett

2009-01-01

Adaptive management is different from other types of management in that it includes all stakeholders (versus only policy makers) in the process, uses resource optimization techniques to evaluate competing objectives, and recognizes and attempts to reduce uncertainty inherent in natural resource systems. Management actions are negotiated by stakeholders, monitored results are compared to predictions of how the system should respond, and management strategies are adjusted in a “monitor-compare-adjust” iterative routine. Many adaptive management projects fail because of the lack of stakeholder identification, engagement, and continued involvement. Primary reasons for this vary but are usually related to either stakeholders not having ownership (or representation) in decision processes or disenfranchisement of stakeholders after adaptive management begins. We present an example in which stakeholders participated fully in adaptive management of a southeastern regulated river. Structured decision analysis was used to define management objectives and stakeholder values and to determine initial flow prescriptions. The process was transparent, and the visual nature of the modeling software allowed stakeholders to see how their interests and values were represented in the decision process. The development of a stakeholder governance structure and communication mechanism has been critical to the success of the project.

Survivorship care plans: are randomized controlled trials assessing outcomes that are relevant to stakeholders?

PubMed

Birken, Sarah A; Urquhart, Robin; Munoz-Plaza, Corrine; Zizzi, Alexandra R; Haines, Emily; Stover, Angela; Mayer, Deborah K; Hahn, Erin E

2018-03-23

The purpose of this study was to compare outcomes assessed in extant randomized controlled trials (RCTs) to outcomes that stakeholders expect from survivorship care plans (SCPs). To facilitate the transition from active treatment to follow-up care for the 15.5 million US cancer survivors, many organizations require SCP use. However, results of several RCTs of SCPs' effectiveness have been null, possibly because they have evaluated outcomes on which SCPs should be expected to have limited influence. Stakeholders (e.g., survivors, oncologists) may expect outcomes that differ from RCTs' outcomes. We identified RCTs' outcomes using a PubMed literature review. We identified outcomes that stakeholders expect from SCPs using semistructured interviews with stakeholders in three healthcare systems in the USA and Canada. Finally, we mapped RCTs' outcomes onto stakeholder-identified outcomes. RCT outcomes did not fully address outcomes that stakeholders expected from SCPs, and RCTs assessed outcomes that stakeholders did not expect from SCPs. RCTs often assessed outcomes only from survivors' perspectives. RCTs of SCPs' effectiveness have not assessed outcomes that stakeholders expect. To better understand SCPs' effectiveness, future RCTs should assess outcomes of SCP use that are relevant from the perspective of multiple stakeholders. SCPs' effectiveness may be optimized when used with an eye toward outcomes that stakeholders expect from SCPs. For survivors, this means using SCPs as a map to guide them with respect to what kind of follow-up care they should seek, when they should seek it, and from whom they should seek it.

Postapproval Development Options in COPD: A Case Study in Value-Based Healthcare Systems.

PubMed

Murphy, Michael F; Antonini, Paola; Lai, Zhihong Vicki

2011-01-01

Research and development activities in an era of globalization encounter a mosaic of providers, products, services, and intermediaries; regulatory and other government institutions; and consumers. The introduction of novel therapeutics into this environment mandates research programs that are relevant to the registration process, payers and purchasers, transparent pricing, and rule-driven business practices, while providing data relevant to marketing initiatives internationally. To outline an example for clinical development programs that incorporate the perspective of multiple stakeholders into a portfolio of study designs to provide optimal data platforms that can resonate with diverse recipients. A contract research organization directly involved in the design, execution, and analysis of clinical trials for new drugs and devices across pharmaceutical and biotechnology companies provides a unique perspective regarding opportunities and challenges within the international clinical research environment. Drs Murphy, Antonini, and Lai, representing Worldwide Clinical Trials, utilize chronic obstructive pulmonary disease as a demonstration project exploiting its prevalence, direct and indirect costs, and the rapid infusion/diffusion of innovative therapy into practice as a rationale for focus, and illustrate methods of informing registration and technology assessments during a prototypical development process. By virtue of its chronicity, prevalence, and pattern of healthcare utilization, chronic obstructive pulmonary disease provides an ideal case for illustrating the application of clinical trial methodology that can facilitate data evaluation through the prism of multiple stakeholders. Adding an international dimension exacerbates system complexity and serves to illustrate the breadth of issues that can be addressed within this therapeutic area.

The passage of tobacco control law 174 in Lebanon: reflections on the problem, policies and politics.

PubMed

Nakkash, R T; Torossian, L; El Hajj, T; Khalil, J; Afifi, R A

2018-06-01

Progress in tobacco control policy making has occurred worldwide through advocacy campaigns involving multiple players- civil society groups, activists, academics, media and policymakers. The Framework Convention on Tobacco Control (FCTC)-the first ever global health treaty-outlines evidence-based tobacco control policies. Lebanon ratified the FCTC in 2005, but until 2011, tobacco control policies remained rudimentary and not evidence-based. Beginning in 2009, a concerted advocacy campaign was undertaken by a variety of stakeholders with the aim of accelerating the process of adopting a strong tobacco control policy. The campaign was successful, and Law 174 passed the Lebanese Parliament in August 2011. In this article, we analyse the policy making process that led to the adoption of Law 174 using Kingdon's model. The analysis relies on primary and secondary data sources including historical records of key governmental decisions, documentation of the activities of the concerted advocacy campaign and in-depth interviews with key stakeholders. We describe the opening of a window of opportunity as a result of the alignment of the problem, policy and politics streams. Furthermore, findings revealed that despite the challenge of persistent tobacco industry interference and established power relations between the industry, its allies and policymakers; policy entrepreneurs succeeded in supporting the alignment of the streams, and influencing the passage of the law. Kingdon's multiple stream approach was useful in explaining how tobacco control became an emerging policy issue at the front of the policy agenda in Lebanon.

Stakeholders' Views of Factors that Impact Successful Interagency Collaboration.

ERIC Educational Resources Information Center

Johnson, Lawrence J.; Tam, Brian Kai Yung; Zorn, Debbie; Lamontagne, Maggie; Johnson, Susan A.

2003-01-01

A study involving 33 stakeholders from nine early intervention state departments and three private social services agencies in Ohio investigated factors related to successful and unsuccessful collaborations. Significant differences were found between program chiefs and program specialists in two areas, factors jeopardizing interagency…

Real-time hydrological early warning system at national scale for surface water and groundwater with stakeholder involvement

NASA Astrophysics Data System (ADS)

He, X.; Stisen, S.; Henriksen, H. J.

2015-12-01

Hydrological models are important tools to support decision making in water resource management in the past few decades. Nowadays, frequent occurrence of extreme hydrological events has put focus on development of real-time hydrological modeling and forecasting systems. Among the various types of hydrological models, it is only the rainfall-runoff models for surface water that are commonly used in the online real-time fashion; and there is never a tradition to use integrated hydrological models for both surface water and groundwater with large scale perspective. At the Geological Survey of Denmark and Greenland (GEUS), we have setup and calibrated an integrated hydrological model that covers the entire nation, namely the DK-model. So far, the DK-model has only been used in offline mode for historical and future scenario simulations. Therefore, challenges arise when operating the DK-model in real-time mode due to lack of technical experiences and stakeholder awareness. In the present study, we try to demonstrate the process of bringing the DK-model online while actively involving the opinions of the stakeholders. Although the system is not yet fully operational, a prototype has been finished and presented to the stakeholders which can simulate groundwater levels, streamflow and water content in the root zone with a lead time of 48 hours and refreshed every 6 hours. The active involvement of stakeholders has provided very valuable insights and feedbacks for future improvements.

Innovation management based on proactive engagement of customers: A case study on LEGO Group. Part I: Innovation Management at Lego Group

NASA Astrophysics Data System (ADS)

Rusu, G.; Avasilcăi, S.

2015-11-01

Customers' proactive engagement in the innovation process represents a business priority for companies which adopt the open innovation business model. In such a context, it is of outmost importance for companies to use the online environment and social media, in order to create an interactive and open dialogue with customers and other important external stakeholders, achieving to gather creative solutions and innovative ideas by involving them in the process of co-creating value. Thus, the current paper is based on a case study approach, which aims to highlight the open innovation business model of the LEGO Group, one of the most successful and active company in engaging customers in submitting ideas and creative solutions for developing new products and new technologies, through online platforms. The study then proceeds to analyze the innovation management at LEGO Group, emphasizing the most important elements regarding the management team, the success and failures, the evolution of the LEGO products focusing on the innovation efforts of the company, its mission, vision, and values, emphasizing the innovation terms which guide the actions and objectives of the LEGO Group. Also, the research based on the case study approach, outlines the most important policies and strategies of the company, the organizational structure consisting of flat structures which facilitate the orientation of the team management on the innovation process and the proactive involvement of consumers and other external stakeholders in product development, highlighting also the most important activities developed by the management team in exploring the new opportunities which may occur on the market, involving customers in sharing their ideas at festivals, participating to discussions of adult fans on web-based platforms and establishing partnerships with the external stakeholders in order to create value. Moreover, the paper is focused on identifying the company's concerns regarding the competitive strategies, new technologies developed for sustainable development and innovation, emphasizing also the concerns of the LEGO Group for a long-term orientation strategy which implies developing innovative products, made by ecological materials, reducing the negative impact on the environment. In addition, the company aims to foster innovation maintaining a clear vision, multiple contacts with the internal and external environment, and the flat structures which enable the communication between innovative management teams and top management team. Consequently, the study provides the insights regarding the innovation management of the LEGO Group, emphasizing the role of engaging customers and other external stakeholders in the co-creation of value.

Analytical group decision making in natural resources: methodology and application

Treesearch

Daniel L. Schmoldt; David L. Peterson

2000-01-01

Group decision making is becoming increasingly important in natural resource management and associated scientific applications, because multiple values are treated coincidentally in time and space, multiple resource specialists are needed, and multiple stakeholders must be included in the decision process. Decades of social science research on decision making in groups...

The multiple resource inventory decision-making process

Treesearch

Victor A. Rudis

1993-01-01

A model of the multiple resource inventory decision-making process is presented that identifies steps in conducting inventories, describes the infrastructure, and points out knowledge gaps that are common to many interdisciplinary studies.Successful efforts to date suggest the need to bridge the gaps by sharing elements, maintain dialogue among stakeholders in multiple...

Discourse norms as default rules: structuring corporate speech to multiple stakeholders.

PubMed

Yosifon, David G

2011-01-01

This Article analyzes corporate speech problems through the framework of corporate law. The focus here is on the "discourse norms" that regulate corporate speech to various corporate stakeholders, including shareholders, workers, and consumers. I argue that these "discourse norms" should be understood as default terms in the "nexus-of-contracts" that comprises the corporation. Having reviewed the failure of corporate law as it bears on the interests of non-shareholding stakeholders such as workers and consumers, I urge the adoption of prescriptive discourse norms as an approach to reforming corporate governance in a socially useful manner.

Supporting return-to-work in the face of legislation: stakeholders' experiences with return-to-work after breast cancer in Belgium.

PubMed

Tiedtke, Corine; Donceel, Peter; Knops, Lieve; Désiron, Huget; Dierckx de Casterlé, Bernadette; de Rijk, Angelique

2012-06-01

The diagnosis of breast cancer increasingly implies a return-to-work (RTW) challenge as survival rates increase. RTW is regarded as a multidisciplinary process and a country's legislation affects the degree of involvement of the different stakeholders. We elucidated on bottlenecks and contributing factors and the relationship between policy and practice regarding RTW of employees with breast cancer as perceived by Belgian (Flemish) stakeholders. Three multidisciplinary groups (n = 7, n = 9, n = 10) were interviewed during a breast cancer conference. Treating physicians (n = 4), employers (n = 6), social security physicians (n = 3), occupational physicians (n = 4), survivors (n = 5) and representatives of patient associations (n = 4) were included. The major theme was the legal and practical role in the RTW process as experienced by the participants. Qualitative thematic analysis was performed to analyse stakeholders' experiences of women's RTW after breast cancer. The stakeholders reported different perspectives. Employees focus on treatment and feel ill-informed about the RTW options. Treating physicians do not feel competent about advising on work-related questions. Employers have to balance the interests of both the business and the employee. Social security physicians assess ability to work and facilitate RTW options. Occupational physicians see opportunities but the legislation does not support their involvement. Stakeholders expressed the need for coordination and reported finding ways to accommodate the employee's needs by being flexible with the legislation to support the RTW process. Two factors might hamper RTW for breast cancer patients: the varying stakeholder perspectives and Belgian legislation which emphasizes the patient or disability role, but not the employee role. When stakeholders are motivated they find ways to support RTW, but improved legislation could support the necessary coordination of RTW for these patients.

Experiences of using a participatory action research approach to strengthen district local capacity in Eastern Uganda

PubMed Central

Tetui, Moses; Coe, Anna-Britt; Hurtig, Anna-Karin; Ekirapa-Kiracho, Elizabeth; Kiwanuka, Suzanne N.

2017-01-01

ABSTRACT Background: To achieve a sustained improvement in health outcomes, the way health interventions are designed and implemented is critical. A participatory action research approach is applauded for building local capacity such as health management. Thereby increasing the chances of sustaining health interventions. Objective: This study explored stakeholder experiences of using PAR to implement an intervention meant to strengthen the local district capacity. Methods: This was a qualitative study featuring 18 informant interviews and a focus group discussion. Respondents included politicians, administrators, health managers and external researchers in three rural districts of eastern Uganda where PAR was used. Qualitative content analysis was used to explore stakeholders’ experiences. Results: ‘Being awakened’ emerged as an overarching category capturing stakeholder experiences of using PAR. This was described in four interrelated and sequential categories, which included: stakeholder involvement, being invigorated, the risk of wide stakeholder engagement and balancing the risk of wide stakeholder engagement. In terms of involvement, the stakeholders felt engaged, a sense of ownership, felt valued and responsible during the implementation of the project. Being invigorated meant being awakened, inspired and supported. On the other hand, risks such as conflict, stress and uncertainty were reported, and finally these risks were balanced through tolerance, risk-awareness and collaboration. Conclusions: The PAR approach was desirable because it created opportunities for building local capacity and enhancing continuity of interventions. Stakeholders were awakened by the approach, as it made them more responsive to systems challenges and possible local solutions. Nonetheless, the use of PAR should be considered in full knowledge of the undesirable and complex experiences, such as uncertainty, conflict and stress. This will enable adequate preparation and management of stakeholder expectations to maximize the benefits of the approach. PMID:28856974

Structured decision making as a framework for large-scale wildlife harvest management decisions

USGS Publications Warehouse

Robinson, Kelly F.; Fuller, Angela K.; Hurst, Jeremy E.; Swift, Bryan L.; Kirsch, Arthur; Farquhar, James F.; Decker, Daniel J.; Siemer, William F.

2016-01-01

Fish and wildlife harvest management at large spatial scales often involves making complex decisions with multiple objectives and difficult tradeoffs, population demographics that vary spatially, competing stakeholder values, and uncertainties that might affect management decisions. Structured decision making (SDM) provides a formal decision analytic framework for evaluating difficult decisions by breaking decisions into component parts and separating the values of stakeholders from the scientific evaluation of management actions and uncertainty. The result is a rigorous, transparent, and values-driven process. This decision-aiding process provides the decision maker with a more complete understanding of the problem and the effects of potential management actions on stakeholder values, as well as how key uncertainties can affect the decision. We use a case study to illustrate how SDM can be used as a decision-aiding tool for management decision making at large scales. We evaluated alternative white-tailed deer (Odocoileus virginianus) buck-harvest regulations in New York designed to reduce harvest of yearling bucks, taking into consideration the values of the state wildlife agency responsible for managing deer, as well as deer hunters. We incorporated tradeoffs about social, ecological, and economic management concerns throughout the state. Based on the outcomes of predictive models, expert elicitation, and hunter surveys, the SDM process identified management alternatives that optimized competing objectives. The SDM process provided biologists and managers insight about aspects of the buck-harvest decision that helped them adopt a management strategy most compatible with diverse hunter values and management concerns.

National Laboratory Planning: Developing Sustainable Biocontainment Laboratories in Limited Resource Areas.

PubMed

Yeh, Kenneth B; Adams, Martin; Stamper, Paul D; Dasgupta, Debanjana; Hewson, Roger; Buck, Charles D; Richards, Allen L; Hay, John

2016-01-01

Strategic laboratory planning in limited resource areas is essential for addressing global health security issues. Establishing a national reference laboratory, especially one with BSL-3 or -4 biocontainment facilities, requires a heavy investment of resources, a multisectoral approach, and commitments from multiple stakeholders. We make the case for donor organizations and recipient partners to develop a comprehensive laboratory operations roadmap that addresses factors such as mission and roles, engaging national and political support, securing financial support, defining stakeholder involvement, fostering partnerships, and building trust. Successful development occurred with projects in African countries and in Azerbaijan, where strong leadership and a clear management framework have been key to success. A clearly identified and agreed management framework facilitate identifying the responsibility for developing laboratory capabilities and support services, including biosafety and biosecurity, quality assurance, equipment maintenance, supply chain establishment, staff certification and training, retention of human resources, and sustainable operating revenue. These capabilities and support services pose rate-limiting yet necessary challenges. Laboratory capabilities depend on mission and role, as determined by all stakeholders, and demonstrate the need for relevant metrics to monitor the success of the laboratory, including support for internal and external audits. Our analysis concludes that alternative frameworks for success exist for developing and implementing capabilities at regional and national levels in limited resource areas. Thus, achieving a balance for standardizing practices between local procedures and accepted international standards is a prerequisite for integrating new facilities into a country's existing public health infrastructure and into the overall international scientific community.

Land-Use Planning in the Chaco Plain (Burruyacú, Argentina): Part 2: Generating a Consensus Plan to Mitigate Land-Use Conflicts and Minimize Land Degradation

NASA Astrophysics Data System (ADS)

Recatalá Boix, Luis; Zinck, Joseph Alfred

2008-08-01

The Burruyacú district (Tucumán province, Northwest Argentina) has been traditionally an area with rural activities based on the exploitation of the Chaco forest for timber and livestock browsing. Since the 1960s, local institutions started promoting soybean due to favorable land conditions and good market prices. Soybean extension, as from the 1970s, has resulted in important reduction of the Chaco forest and also caused physical soil degradation, especially soil compaction and erosion. A land-use-planning exercise was carried out using the Land-Use Planning and Information System (LUPIS) as a spatial decision support system. LUPIS facilitates the generation of alternative land-use plans by adjusting the relative importance attributed by multiple stakeholders to preference and avoidance policies. The system leads to the allocation of competing land uses to land map units in accordance with their preferred resource requirements, conditional upon the resource base of the area and the stakeholders’ demands. After generating a land use plan for each stakeholder category identified in the study area, including commercial farmers, conservative/conventional farmers, and conservationists, a consensus plan was established to address the land-use conflicts between mechanized agriculture, traditional agriculture and forest conservation, and to mitigate soil degradation caused by extensive dry-farming. Although the planning exercise did not directly involve the stakeholders, the results are sufficiently practical and realistic to suggest that the approach could be extended to the entire Chaco plain region.

Advancing Sustainable Bioenergy; Evolving Stakeholder Interests and the Relevance of Research

EPA Science Inventory

Sustainable bioenergy production depends on the resolution of both scientific and nontechnical barriers to its development. We focus on the need to recognize and manage stakeholder diversity as an example of the latter. As a complex issue domain, bioenergy involves a disparate se...

Exploring Cooperative Education Partnerships: A Case Study in Sport Tertiary Education

ERIC Educational Resources Information Center

Fleming, Jenny; Hickey, Chris

2013-01-01

Cooperative education can be expressed in terms of a partnership between students, university and industry. A stakeholder-integrated approach to cooperative education involves formalized sustainable relationships between stakeholders. This study investigated the motives and determinants for the formation of cooperative education partnerships.…

Music Makes You Smarter: A New Paradigm for Music Education? Perceptions and Perspectives from Four Groups of Elementary Education Stakeholders

ERIC Educational Resources Information Center

Vitale, John Luke

2011-01-01

Through 14 years of teaching music in the Greater Toronto Area, the "music makes you smarter" notion has imbued many of the conversations I have had with multiple stakeholders in public education. Such conversations have suggested that the ancillary benefits of teaching music have now become the principal reason why we teach music--what…

Stakeholders' perceptions of transferability criteria for health promotion interventions: a case study.

PubMed

Trompette, Justine; Kivits, Joëlle; Minary, Laetitia; Cambon, Linda; Alla, François

2014-11-04

The effects of health promotion interventions are the result not only of the interventions themselves, but also of the contexts in which they unfold. The objective of this study was to analyze, through stakeholders' discourse, the characteristics of an intervention that can influence its outcomes. This case study was based on semi-structured interviews with health promotion stakeholders involved in a regional program (PRALIMAP). General hypotheses on transferability and on how the intervention is presumed to produce its effects were used to construct an interview guide. Interviews were analyzed using thematic coding. Twenty-three stakeholders were interviewed. Results showed stakeholders made few references to population and environment characteristics. Three themes emerged as significant for the stakeholders: implementation modalities and methodology, modalities used to mobilize actors; and transferability-promoting factors and barriers. Our work contributes to a better understanding not only of transferability factors, but also of stakeholders' perceptions of them, which are just as important, because those perceptions themselves are a factor in mobilization of actors, implementation, and transferability.

Towards sustainable and multifunctional agriculture in farmland landscapes: Lessons from the integrative approach of a French LTSER platform.

PubMed

Bretagnolle, Vincent; Berthet, Elsa; Gross, Nicolas; Gauffre, Bertrand; Plumejeaud, Christine; Houte, Sylvie; Badenhausser, Isabelle; Monceau, Karine; Allier, Fabrice; Monestiez, Pascal; Gaba, Sabrina

2018-06-15

Agriculture is currently facing unprecedented challenges: ensuring food, fiber and energy production in the face of global change, maintaining the economic performance of farmers and preserving natural resources such as biodiversity and associated key ecosystem services for sustainable agriculture. Addressing these challenges requires innovative landscape scale farming systems that account for changing economic and environmental targets. These novel agricultural systems need to be recognized, accepted and promoted by all stakeholders, including local residents, and supported by public policies. Agroecosystems should be considered as socio-ecological systems and alternative farming systems should be based on ecological principles while taking societal needs into account. This requires an in-depth knowledge of the multiple interactions between sociological and ecological dynamics. Long Term Socio-Ecological Research platforms (LTSER) are ideal for acquiring this knowledge as they (i) are not constrained by traditional disciplinary boundaries, (ii) operate at a large spatial scale involving all stakeholders, and (iii) use systemic approaches to investigate biodiversity and ecosystem services. This study presents the socio-ecological research strategy from the LTSER "Zone Atelier Plaine & Val de Sèvre" (ZA PVS), a large study area where data has been sampled since 1994. Its global aim is to identify effective solutions for agricultural development and the conservation of biodiversity in farmlands. Three main objectives are targeted by the ZAPVS. The first objective is intensive monitoring of landscape features, the main taxa present and agricultural practices. The second objective is the experimental investigation, in real fields with local farmers, of important ecosystem functions and services, in relation to pesticide use, crop production and farming socio-economic value. The third aim is to involve stakeholders through participatory research, citizen science and the dissemination of scientific results. This paper underlines the relevance of LTSERs for addressing agricultural challenges, while acknowledging that there are some yet unsolved key challenges. Copyright © 2018 Elsevier B.V. All rights reserved.

Wellbeing: the challenge of 'operationalising' an holistic concept within a reductionist public health programme.

PubMed

Dooris, Mark; Farrier, Alan; Froggett, Lynn

2018-03-01

Wellbeing is a concept that, while contested, recognises individual and wider social, economic, political and environmental contextual influences - and is of growing interest and relevance locally and globally. In this article, we report on one aspect of an evaluative research study conducted on a public health programme in North West England. Within the context of a process evaluation that explored the delivery of a public health programme and sought to increase understanding of how and why different approaches worked well or not so well, this article focuses specifically on the concept of wellbeing, examining perceptions of multiple stakeholders. Interviews and focus groups were undertaken with 52 stakeholders involved in managing and facilitating the programme and its composite projects and with 90 community members involved as project participants. Data were subjected to thematic analysis, cross-check and refining. Results highlight stakeholders' diverse understandings of wellbeing, the complex relationship between health and wellbeing, and the perceived dissonance between the holistic concept of wellbeing and the reductionist design of the programme. Wellbeing was understood to be 'more than health' and 'more than happiness', concerned with effective functioning, sense of purpose and flourishing. Essentially holistic, wellbeing offers opportunities to transcend clinical/pathogenic conceptions of 'health' and resonate with individuals, communities and local authorities. This raises concerns about how wellbeing can be meaningfully realised without compromising the concept, particularly when programmes are structured in reductionist ways requiring monitoring against discrete outcomes. Implications for practice include the following: utilising wellbeing as a driver for cross-cutting public health in challenging economic and organisational contexts, acknowledging that wellbeing is essentially social as well as individual, appreciating that wellbeing is experienced in relation to contexts and surroundings, and recognising that wellbeing defined in terms of individual happiness risks compromising the future wellbeing of societies and the planet.

"What is meant by public?": Stakeholder views on strengthening impacts of public reporting of hospital performance data.

PubMed

Canaway, Rachel; Bismark, Marie; Dunt, David; Prang, Khic-Houy; Kelaher, Margaret

2018-04-01

Public reporting of hospital performance data is a developing area that is gaining increased attention. This is the first study to explore a range of stakeholder opinions on how such public reporting could be strengthened in Australia. Thirty-four semi-structured interviews were conducted with a purposive sample of expert healthcare consumer, provider and purchaser informants who worked in a variety of senior roles and had knowledge of or involvement in public reporting of hospital data within the public or private healthcare sectors. Informants from all Australian states, territory and national jurisdictions participated. Thematic analysis was used to gain an overview of experts' opinions to inform policy and systems-development for strengthening foundational frameworks for public reporting of health services performance. Themes arising were synthesised to generate explanatory figures to highlight key areas for strengthening public reporting. Our findings suggest that in Australia there is a lack of agreement on what the objectives and who the audience are for public reporting of hospital performance data. Without this shared understanding it is difficult to strengthen frameworks and impacts of public reporting. When developing frameworks for public reporting of hospital data in Australia, more explicit definition of what or who are the 'public' is needed along with identification of barriers, desired impacts, data needs, and data collection/reporting/feedback mechanisms. All relevant stakeholders should be involved in design of public reporting frameworks. Offering multiple systems of public reporting, each tailored to particular audiences, might enable greater impact of reporting towards improved hospital quality and safety, and consumer knowledge to inform treatment decisions. This study provides an overview of perspectives, but further research is warranted to develop PR frameworks that can generate greatest impacts for the needs of various audiences. Copyright © 2018 Elsevier Ltd. All rights reserved.

Understanding experiences of and preferences for service user and carer involvement in physical health care discussions within mental health care planning.

PubMed

Small, Nicola; Brooks, Helen; Grundy, Andrew; Pedley, Rebecca; Gibbons, Chris; Lovell, Karina; Bee, Penny

2017-04-13

People with severe mental illness suffer more physical comorbidity than the general population, which can require a tailored approach to physical health care discussions within mental health care planning. Although evidence pertaining to service user and carer involvement in mental health care planning is accumulating, current understanding of how physical health is prioritised within this framework is limited. Understanding stakeholder experiences of physical health discussions within mental health care planning, and the key domains that underpin this phenomena is essential to improve quality of care. Our study aimed to explore service user, carer and professional experiences of and preferences for service user and carer involvement in physical health discussions within mental health care planning, and develop a conceptual framework of effective user-led involvement in this aspect of service provision. Six focus groups and four telephone interviews were carried out with twelve service users, nine carers, three service users with a dual service user and carer role, and ten mental health professionals recruited from one mental health Trust in the United Kingdom. Data was analysed utilising a thematic approach, analysed separately for each stakeholder group, and combined to aid comparisons. No service users or carers recalled being explicitly involved in physical health discussions within mental health care planning. Six prerequisites for effective service user and carer involvement in physical care planning were identified. Three themes confirmed general mental health care planning requirements: tailoring a collaborative working relationship, maintaining a trusting relationship with a professional, and having access to and being able to edit a living document. Three themes were novel to feeling involved in physical health care planning discussions: valuing physical health equally with mental health; experiencing coordination of care between physical-mental health professionals, and having a physical health discussion that is personalised. High quality physical health care discussions within the care planning process demands action at multiple levels. A conceptual framework is presented which provides an evidence-based foundation for service level improvement. Further work is necessary to develop a new patient reported outcome measure to enable meaningful quantification of health care quality and patient experience.

In the public interest: assessing expert and stakeholder influence in public deliberation about biobanks.

PubMed

MacLean, Samantha; Burgess, Michael M

2010-07-01

Providing technical and experiential information without overwhelming participants' perspectives presents a major challenge to public involvement in policy decisions. This article reports the design and analysis of a case study on incorporating expert and stakeholder knowledge without including them as deliberators, while supporting deliberative participants' ability to introduce and critically assess different perspectives. Analysis of audio-recorded deliberations illustrates how expert and stakeholder knowledge was cited, criticized and incorporated into deliberations. In conclusion, separating experts and stakeholders from deliberations may be an important prima facie principle when the goal is to enhance citizen representation on technical issues and related policy.

How will it work? A qualitative study of strategic stakeholders' accounts of a patient safety initiative.

PubMed

Dixon-Woods, M; Tarrant, C; Willars, J; Suokas, A

2010-02-01

Implementation of quality improvement programmes may suffer if the stakeholders involved do not share a common understanding of the theory of change or do not accept it as legitimate. We aimed to identify how strategic stakeholders understood and responded to the first phase of the Health Foundation's Safer Patients Initiative, a programme aimed at making hospitals safer for patients in the UK. Semistructured telephone interviews were conducted with 60 strategic-level hospital stakeholders and with five stakeholders involved in commissioning, designing and introducing the initiative. Analysis was based on the constant comparative method. The aims of the initiative were seen as legitimate and sound by most hospital stakeholders, and the theory of change was generally understood and accepted, but seven hospital stakeholders were unable to describe it. Although participants had specific doubts, particularly relating to feasibility of implementation and scientific legitimacy of some elements of the initiative, overall there was a broadly shared vision and commitment to the principles and practices associated with the theory of change, and considerable enthusiasm and optimism. Contestations about the legitimacy and relevance of the initiative among front-line staff, local resistance to changes that went against established norms, and resource and structural issues were, however, seen as potentially threatening to implementation. It is possible to get strategic-level individuals, even when widely dispersed, to understand and agree upon a theory of change that can be used in their organisations. These individuals are also able to recognise the contexts of negotiation in which programmes of change are enacted.

Getting cold feet?: Why health care mergers are abandoned.

PubMed

Roos, Anne-Fleur; Postma, Jeroen

2016-01-01

Despite the frequent occurrence and sizeable consequences of merger abandonment in other sectors, there is no thorough understanding of merger abandonment in health care. The purpose of this study is to improve the understanding of determinants of health care merger abandonment. On the basis of the literature on merger abandonment, we formulated a framework on potential determinants of health care merger abandonment. We then constructed a survey that was sent to 70% of all executives of Dutch health care organizations (response rate = 35%, n = 291). We provide descriptive overviews of open, multiple-response, and multiple-choice questions on merger abandonment and use chi-square tests and Fisher's exact tests to test whether abandoned and completed merger processes differ. About 62% of the respondents were involved in at least one merger process during the period of 2005-2012. Thirty-eight percent of these respondents reported that their last merger case ended prematurely (n = 53). The most frequently mentioned determinants of merger abandonment are changing insights on the desirability and feasibility during merger processes, incompatibilities between executives, and insufficient support for the merger from internal stakeholders. We did not find significant relationships between merger abandonment and executives' previous merger experience, degree of organizational diversification, health care sector, size differences, or other organizational differences. Our findings partially confirm results from previous studies, especially with regard to the importance of changing insights and incompatibilities between the involved executives in merger abandonment. We also find that pressure from internal stakeholders, particularly nonexecutive directors, and distrust, fear, and animosity play an important role in merger abandonment. To minimize the organizational and societal costs of abandoned mergers, we advise executives who engage in mergers to construct backup plans with alternative strategies in case the merger is abandoned and to conduct a thorough analysis of pros and cons before the merger.

The impact of comparative effectiveness research on interventional pain management: evolution from Medicare Modernization Act to Patient Protection and Affordable Care Act and the Patient-Centered Outcomes Research Institute.

PubMed

Manchikanti, Laxmaiah; Falco, Frank J E; Benyamin, Ramsin M; Helm, Standiford; Parr, Allan T; Hirsch, Joshua A

2011-01-01

The Patient-Centered Outcomes Research Institute (PCORI) was established by the Affordable Care Act of 2010 to promote comparative effectiveness research (CER) to assist patients, clinicians, purchasers, and policy-makers in making informed health decisions by advancing the quality and relevance of evidence concerning the manner in which diseases, disorders, and other health conditions can effectively and appropriately be prevented, diagnosed, treated, monitored, and managed through research and evidence synthesis. The development of PCORI is vested in the Medicare Modernization Act (MMA) and the American Recovery and Reinvestment Act (ARRA). The framework of CER and PCORI describes multiple elements which are vested in all 3 regulations including stakeholder involvement, public participation, and open transparent decision-making process. Overall, PCORI is much more elaborate with significant involvement of stakeholders, transparency, public participation, and open decision-making. However, there are multiple issues concerning the operation of such agencies in the United States including the predecessor of Agency for Healthcare Research and Quality (AHRQ), the Agency for Healthcare Policy and Research (AHCPR), AHRQ Effectiveness Health Care programs, and others. The CER in the United States may be described at cross-roads or at the beginnings of a scientific era of CER and evidence-based medicine (EBM). However the United States suffers as other countries, including the United Kingdom with its National Health Services (NHS) and National Institute for Health and Clinical Excellence (NICE), with major misunderstandings of methodology, an inordinate focus on methodological assessment, lack of understanding of the study design (placebo versus active control), lack of involvement of clinicians, and misinterpretation of the evidence which continues to be disseminated. Consequently, PCORI and CER have been described as government-driven solutions without following the principles of EBM with an extensive focus on costs rather than quality. It also has been stated that the central planning which has been described for PCORI and CER, a term devised to be acceptable, will be used by third party payors to override the physician's best medical judgement and patient's best interest. Further, stakeholders in PCORI are not scientists, are not balanced, and will set an agenda with an ultimate problem of comparative effectiveness and PCORI that it is not based on medical science, but rather on political science and not even under congressional authority, leading to unprecedented negative changes to health care. Thus, PCORI is operating in an ad hoc manner that is incompatible with the principles of evidence-based practice.This manuscript describes the framework of PCORI, and the role of CER and its impact on interventional pain management.

Reducing the Observed Curriculum Perception Gaps between Stakeholders

ERIC Educational Resources Information Center

Chang, Amy; Churyk, Natalie Tatiana; Yu, Shaokun

2015-01-01

Developing a vibrant and relevant accounting curriculum requires involvement of many stakeholders such as interns, alumni, and firms. Each has a distinct perspective regarding the strengths and weaknesses of accounting education. Discussion of perception gaps between the three groups and the importance of aligning these perceptions are presented.…

Towards Typology of Stakeholders: A Case of Lithuanian Higher Education

ERIC Educational Resources Information Center

Švaikauskiene, Simona; Mikulskiene, Birute

2017-01-01

The purpose of this paper is to explore internal management, advocacy and partnerships of interest groups with the aim of representing their interests in public policy formation with a view to developing a stakeholder typology. This qualitative study involves eight in-depth, semi-structured interviews with representatives from stakeholder…

Tools for Achieving TQE.

ERIC Educational Resources Information Center

Latta, Raymond F.; Downey, Carolyn J.

This book presents a wide array of sophisticated problem-solving tools and shows how to use them in a humanizing way that involves all stakeholders in the process. Chapter 1 develops the rationale for educational stakeholders to consider quality tools. Chapter 2 highlights three quality group-process tools--brainstorming, the nominal group…

Negotiating designs of multi-purpose reservoir systems in international basins

NASA Astrophysics Data System (ADS)

Geressu, Robel; Harou, Julien

2016-04-01

Given increasing agricultural and energy demands, coordinated management of multi-reservoir systems could help increase production without further stressing available water resources. However, regional or international disputes about water-use rights pose a challenge to efficient expansion and management of many large reservoir systems. Even when projects are likely to benefit all stakeholders, agreeing on the design, operation, financing, and benefit sharing can be challenging. This is due to the difficulty of considering multiple stakeholder interests in the design of projects and understanding the benefit trade-offs that designs imply. Incommensurate performance metrics, incomplete knowledge on system requirements, lack of objectivity in managing conflict and difficulty to communicate complex issue exacerbate the problem. This work proposes a multi-step hybrid multi-objective optimization and multi-criteria ranking approach for supporting negotiation in water resource systems. The approach uses many-objective optimization to generate alternative efficient designs and reveal the trade-offs between conflicting objectives. This enables informed elicitation of criteria weights for further multi-criteria ranking of alternatives. An ideal design would be ranked as best by all stakeholders. Resource-sharing mechanisms such as power-trade and/or cost sharing may help competing stakeholders arrive at designs acceptable to all. Many-objective optimization helps suggests efficient designs (reservoir site, its storage size and operating rule) and coordination levels considering the perspectives of multiple stakeholders simultaneously. We apply the proposed approach to a proof-of-concept study of the expansion of the Blue Nile transboundary reservoir system.

Stakeholder's perspective: Sustainability of a community health worker program in Afghanistan.

PubMed

Najafizada, Said Ahmad Maisam; Labonté, Ronald; Bourgeault, Ivy Lynn

2017-02-01

The objectives of this study were two-fold: 1) to examine how different stakeholders define sustainability, and 2) to identify barriers to and facilitators of the sustainability of the Afghan CHW program. We interviewed 63 individual key informants, and conducted 11 focus groups [35 people] with policymakers, health managers, community health workers, and community members across Afghanistan. The participants were purposefully selected to provide a wide range of perspectives. Different stakeholders define sustainability differently. Policymakers emphasize financial resources; health managers, organizational operations; and community-level stakeholders, routine frontline activities. The facilitators they identify include integration into the health system, community support, and capable human resources. Barriers they noted include lack of financial resources, poor program design and implementation, and poor quality of services. Measures to ensure sustainability could be national revenue allocation, health-specific taxation, and community financing. Sustainability is complicated and has multiple facets. The plurality of understanding of sustainability among stakeholders should be addressed explicitly in the program design. To ensure sustainability, there is a need for a coordinated effort amongst all stakeholders. Copyright © 2016 Elsevier Ltd. All rights reserved.

Stakeholders' perspective on issues and challenges associated with care and treatment of aging-related cognitive impairment disorders in Singapore.

PubMed

Setia, Monika; Islam, Amina M; Thompson, James P; Matchar, David B

2011-11-01

An expanding elderly population poses challenges for the provision of care and treatment for age-related physical and mental disorders. Cognitive impairment (CI)/dementia is one such mental disorder that is on the rise in Singapore and has concomitant implications for social and health systems. The objective of this study is to understand the perspectives of prominent stakeholders about current and future issues and challenges associated with CI/dementia among the elderly in Singapore. Using indepth interviews, this qualitative study obtained the views of multiple stakeholders on issues and challenges associated with CI/dementia in Singapore. The 30 individuals interviewed as part of the study included clinicians, policy-makers, researchers, community workers, administrators, and caregivers. Using a framework approach, interview texts were indexed into domains and issues by utilizing NVivo 9.0 software. The stakeholders expressed concerns related to multiple domains of the CI/dementia care system: attitude and awareness, economics, education, family caregiving, inputs to care system, living arrangements, prevention, screening and diagnosis, and treatment and management of care. Within each domain, multiple issues and challenges were identified by respondents. The study identifies a complex set of inter-related issues and challenges that are associated with the care and treatment of people with CI/dementia. The results suggest that CI and dementia profoundly affect patients, families, and communities and that the issues related to the two disorders are truly system-wide. These findings lay the foundation for utilization of a systems approach to studying CI/dementia and provide an analytic framework for future research on complex health care issues.

Lecturers and students as stakeholders for education commissioning for learning disability nursing: focus group findings from a multiple method study.

PubMed

Gates, Bob; Statham, Mark

2013-10-01

In England, the numbers of learning disability nurses are declining; a need for urgent attention to workforce planning issues has been advocated. This paper considers views of lecturers, students and potential students as legitimate stakeholders for future education commissioning for this field of nursing. This project aimed to undertake a strategic review of learning disability nursing educational commissioning, to provide an 'evidence based' evaluation to inform future strategic commissioning of learning disability nursing for one Health Authority, UK. The project adopted a structured multiple methods approach to generate evidence from a number of data sources, this paper reports on the findings from one method [focus groups] used for two groups of stakeholders. Informants comprised 10 learning disability nursing students studying at a Higher Education Institution, 25 health and social care students studying at a Further Education College, and 6 academic staff from 5 universities; all informants were from the south of England. The method reported on in this paper is focus group methodology. Once completed, transcripts made were read in full, and subjected to content analysis. The process of content analysis led to the development of 11 theoretical categories that describe the multiplicity of views of informants, as to issues of importance for this element of the health workforce. The paper concludes by identifying key messages from these informants. It is suggested that both method and findings have national and international resonance, as stakeholder engagement is a universal issue in health care education commissioning. Copyright © 2013 Elsevier Ltd. All rights reserved.

A methodological framework to support the initiation, design and institutionalization of participatory modeling processes in water resources management

NASA Astrophysics Data System (ADS)

Halbe, Johannes; Pahl-Wostl, Claudia; Adamowski, Jan

2018-01-01

Multiple barriers constrain the widespread application of participatory methods in water management, including the more technical focus of most water agencies, additional cost and time requirements for stakeholder involvement, as well as institutional structures that impede collaborative management. This paper presents a stepwise methodological framework that addresses the challenges of context-sensitive initiation, design and institutionalization of participatory modeling processes. The methodological framework consists of five successive stages: (1) problem framing and stakeholder analysis, (2) process design, (3) individual modeling, (4) group model building, and (5) institutionalized participatory modeling. The Management and Transition Framework is used for problem diagnosis (Stage One), context-sensitive process design (Stage Two) and analysis of requirements for the institutionalization of participatory water management (Stage Five). Conceptual modeling is used to initiate participatory modeling processes (Stage Three) and ensure a high compatibility with quantitative modeling approaches (Stage Four). This paper describes the proposed participatory model building (PMB) framework and provides a case study of its application in Québec, Canada. The results of the Québec study demonstrate the applicability of the PMB framework for initiating and designing participatory model building processes and analyzing barriers towards institutionalization.

Preparing future fisheries professionals to make good decisions

USGS Publications Warehouse

Colvin, Michael E.; Peterson, James T.

2017-01-01

Future fisheries professionals will face decision-making challenges in an increasingly complex field of fisheries management. Though fisheries students are well trained in the use of the scientific method to understand the natural world, they are rarely exposed to structured decision making (SDM) as part of an undergraduate or graduate education. Specifically, SDM encourages users (e.g., students, managers) to think critically and communicate the problem and then identify specific, measurable objectives as they relate to the problem. Next, users must think critically and creatively about management alternatives that can be used to meet the objectives—there must be more than one alternative or there is no decision to be made. Lastly, the management alternatives are evaluated with regard to how likely they are to succeed in terms of multiple, possibly completing, objectives, such as how stakeholder groups value outcomes of management actions versus monetary cost. We believe that exposure to SDM and its elements is an important part of preparing future fisheries professional to meet the challenges they may face. These challenges include reduced budgets, the growth of potentially competing natural resource interest groups, and stakeholder desire to be involved in management decisions affecting public trust resources, just to name a few.

American Thoracic Society and National Heart, Lung, and Blood Institute Implementation Research Workshop Report.

PubMed

Bender, Bruce G; Krishnan, Jerry A; Chambers, David A; Cloutier, Michelle M; Riekert, Kristin A; Rand, Cynthia S; Schatz, Michael; Thomson, Carey C; Wilson, Sandra R; Apter, Andrea; Carson, Shannon S; George, Maureen; Gerald, Joe K; Gerald, Lynn; Goss, Christopher H; Okelo, Sande O; Mularski, Richard A; Nguyen, Huong Q; Patel, Minal R; Szefler, Stanley J; Weiss, Curtis H; Wilson, Kevin C; Freemer, Michelle

2015-12-01

To advance implementation research (IR) in respiratory, sleep, and critical care medicine, the American Thoracic Society and the Division of Lung Diseases from the NHLBI cosponsored an Implementation Research Workshop on May 17, 2014. The goals of IR are to understand the barriers and facilitators of integrating new evidence into healthcare practices and to develop and test strategies that systematically target these factors to accelerate the adoption of evidence-based care. Throughout the workshop, presenters provided examples of IR that focused on the rate of adoption of evidence-based practices, the feasibility and acceptability of interventions to patients and other stakeholders who make healthcare decisions, the fidelity with which practitioners use specific interventions, the effects of specific barriers on the sustainability of an intervention, and the implications of their research to inform policies to improve patients' access to high-quality care. During the discussions that ensued, investigators' experience led to recommendations underscoring the importance of identifying and involving key stakeholders throughout the research process, ensuring that those who serve as reviewers understand the tenets of IR, managing staff motivation and turnover, and tackling the challenges of scaling up interventions across multiple settings.

The tug-of-war: fidelity versus adaptation throughout the health promotion program life cycle.

PubMed

Bopp, Melissa; Saunders, Ruth P; Lattimore, Diana

2013-06-01

Researchers across multiple fields have described the iterative and nonlinear phases of the translational research process from program development to dissemination. This process can be conceptualized within a "program life cycle" framework that includes overlapping and nonlinear phases: development, adoption, implementation, maintenance, sustainability or termination, and dissemination or diffusion, characterized by tensions between fidelity to the original plan and adaptation for the setting and population. In this article, we describe the life cycle (phases) for research-based health promotion programs, the key influences at each phase, and the issues related to the tug-of-war between fidelity and adaptation throughout the process using a fictionalized case study based on our previous research. This article suggests the importance of reconceptualizing intervention design, involving stakeholders, and monitoring fidelity and adaptation throughout all phases to maintain implementation fidelity and completeness. Intervention fidelity should be based on causal mechanisms to ensure effectiveness, while allowing for appropriate adaption to ensure maximum implementation and sustainability. Recommendations for future interventions include considering the determinants of implementation including contextual factors at each phase, the roles of stakeholders, and the importance of developing a rigorous, adaptive, and flexible definition of implementation fidelity and completeness.

Bridging clinical researcher perceptions and health IT realities: A case study of stakeholder creep.

PubMed

Panyard, Daniel J; Ramly, Edmond; Dean, Shannon M; Bartels, Christie M

2018-02-01

We present a case report detailing a challenge in health information technology (HIT) project implementations we term "stakeholder creep": not thoroughly identifying which stakeholders need to be involved and why before starting a project, consequently not understanding the true effort, skill sets, social capital, and time required to complete the project. A root cause analysis was performed post-implementation to understand what led to stakeholder creep. HIT project stakeholders were given a questionnaire to comment on these misconceptions and a proposed implementation tool to help mitigate stakeholder creep. Stakeholder creep contributed to an unexpected increase in time (3-month delayed go-live) and effort (68% over expected HIT work hours). Four main clinician/researcher misconceptions were identified that contributed to the development of stakeholder creep: 1) that EHR IT is a single group; 2) that all EHR IT members know the entire EHR functionality; 3) that changes to an EHR need the input of just a single EHR IT member; and 4) that the technological complexity of a project mirrors the clinical complexity. HIT project stakeholders similarly perceived clinicians/researchers to hold these misconceptions. The proposed stakeholder planning tool was perceived to be feasible and helpful. Stakeholder creep can negatively affect HIT project implementations. Projects may be susceptible to stakeholder creep when clinicians/researchers hold misconceptions related to HIT organization and processes. Implementation tools, such as the proposed stakeholder checklist, could be helpful in preempting and mitigating the effect of stakeholder creep. Copyright © 2017 Elsevier B.V. All rights reserved.

Towards a Science of Community Stakeholder Engagement in Biomedical HIV Prevention Trials: An Embedded Four-Country Case Study.

PubMed

Newman, Peter A; Rubincam, Clara; Slack, Catherine; Essack, Zaynab; Chakrapani, Venkatesan; Chuang, Deng-Min; Tepjan, Suchon; Shunmugam, Murali; Roungprakhon, Surachet; Logie, Carmen; Koen, Jennifer; Lindegger, Graham

2015-01-01

Broad international guidelines and studies in the context of individual clinical trials highlight the centrality of community stakeholder engagement in conducting ethically rigorous HIV prevention trials. We explored and identified challenges and facilitators for community stakeholder engagement in biomedical HIV prevention trials in diverse global settings. Our aim was to assess and deepen the empirical foundation for priorities included in the GPP guidelines and to highlight challenges in implementation that may merit further attention in subsequent GPP iterations. From 2008-2012 we conducted an embedded, multiple case study centered in Thailand, India, South Africa and Canada. We conducted in-depth interviews and focus groups with respondents from different trial-related subsystems: civil society organization representatives, community advocates, service providers, clinical trialists/researchers, former trial participants, and key HIV risk populations. Interviews/focus groups were recorded, and coded using thematic content analysis. After intra-case analyses, we conducted cross-case analysis to contrast and synthesize themes and sub-themes across cases. Lastly, we applied the case study findings to explore and assess UNAIDS/AVAC GPP guidelines and the GPP Blueprint for Stakeholder Engagement. Across settings, we identified three cross-cutting themes as essential to community stakeholder engagement: trial literacy, including lexicon challenges and misconceptions that imperil sound communication; mistrust due to historical exploitation; and participatory processes: engaging early; considering the breadth of "community"; and, developing appropriate stakeholder roles. Site-specific challenges arose in resource-limited settings and settings where trials were halted. This multiple case study revealed common themes underlying community stakeholder engagement across four country settings that largely mirror GPP goals and the GPP Blueprint, as well as highlighting challenges in the implementation of important guidelines. GPP guidance documents could be strengthened through greater focus on: identifying and addressing the community-specific roots of mistrust and its impact on trial literacy activities; achieving and evaluating representativeness in community stakeholder groups; and addressing the impact of power and funding streams on meaningful engagement and independent decision-making.

Towards a Science of Community Stakeholder Engagement in Biomedical HIV Prevention Trials: An Embedded Four-Country Case Study

PubMed Central

Newman, Peter A.; Rubincam, Clara; Slack, Catherine; Essack, Zaynab; Chakrapani, Venkatesan; Chuang, Deng-Min; Tepjan, Suchon; Shunmugam, Murali; Roungprakhon, Surachet; Logie, Carmen; Koen, Jennifer; Lindegger, Graham

2015-01-01

Objectives Broad international guidelines and studies in the context of individual clinical trials highlight the centrality of community stakeholder engagement in conducting ethically rigorous HIV prevention trials. We explored and identified challenges and facilitators for community stakeholder engagement in biomedical HIV prevention trials in diverse global settings. Our aim was to assess and deepen the empirical foundation for priorities included in the GPP guidelines and to highlight challenges in implementation that may merit further attention in subsequent GPP iterations. Methods From 2008–2012 we conducted an embedded, multiple case study centered in Thailand, India, South Africa and Canada. We conducted in-depth interviews and focus groups with respondents from different trial-related subsystems: civil society organization representatives, community advocates, service providers, clinical trialists/researchers, former trial participants, and key HIV risk populations. Interviews/focus groups were recorded, and coded using thematic content analysis. After intra-case analyses, we conducted cross-case analysis to contrast and synthesize themes and sub-themes across cases. Lastly, we applied the case study findings to explore and assess UNAIDS/AVAC GPP guidelines and the GPP Blueprint for Stakeholder Engagement. Results Across settings, we identified three cross-cutting themes as essential to community stakeholder engagement: trial literacy, including lexicon challenges and misconceptions that imperil sound communication; mistrust due to historical exploitation; and participatory processes: engaging early; considering the breadth of “community”; and, developing appropriate stakeholder roles. Site-specific challenges arose in resource-limited settings and settings where trials were halted. Conclusions This multiple case study revealed common themes underlying community stakeholder engagement across four country settings that largely mirror GPP goals and the GPP Blueprint, as well as highlighting challenges in the implementation of important guidelines. GPP guidance documents could be strengthened through greater focus on: identifying and addressing the community-specific roots of mistrust and its impact on trial literacy activities; achieving and evaluating representativeness in community stakeholder groups; and addressing the impact of power and funding streams on meaningful engagement and independent decision-making. PMID:26295159

Creating a Culture of Continuous Assessment to Improve Student Learning through Curriculum Review

ERIC Educational Resources Information Center

Kalu, Frances; Dyjur, Patti

2018-01-01

This chapter describes a curriculum review framework that fosters continuous assessment through collaboration with multiple stakeholders, alignment with program level learning outcomes, evaluation based on multiple sources of evidence, and facilitated development of action plans to improve student learning.

Knowledge production and learning for sustainable landscapes: seven steps using social-ecological systems as laboratories.

PubMed

Angelstam, Per; Elbakidze, Marine; Axelsson, Robert; Dixelius, Malcolm; Törnblom, Johan

2013-03-01

There are multiple challenges regarding use and governance of landscapes' goods, functions and intangible values for ecosystem health and human well-being. One group of challenges is to measure and assess principal sustainability dimensions through performance targets, so stakeholders have transparent information about states and trends. Another group is to develop adaptive governance at multiple levels, and management of larger geographical areas across scales. Addressing these challenges, we present a framework for transdisciplinary research using multiple landscapes as place-based case studies that integrates multiple research disciplines and non-academic actors: (1) identify a suite of landscapes, and for each (2) review landscape history, (3) map stakeholders, use and non-use values, products and land use, (4) analyze institutions, policies and the system of governance, (5) measure ecological, economic, social and cultural sustainability, (6) assess sustainability dimensions and governance, and finally (7) make comparisons and synthesize. Collaboration, communication and dissemination are additional core features. We discuss barriers bridges and bridges for applying this approach.

Patient-centric Care and Chronic Disease Management: A Stakeholder Perspective.

PubMed

Stroetmann, Karl A

2015-01-01

By taking a stakeholder perspective, the paper explores reasons why the political commitment to patient-centric integrated care, facilitated by eHealth applications, is so difficult to meet. In spite of hundreds of pilots, still today there is a dearth of evidence on how to indeed successfully organise such services. Outcomes from a variety of implementation projects supported by the European Union were analysed, focusing on benefits and costs for the diverse stakeholder groups involved or impacted. The re-engineering of the services may result in a considerable shift in these variables between groups. Rendering both positive clinical impacts and a positive (overall) socio-economic return is not sufficient to assure wide acceptance and long-term sustainability. However motivated stakeholders may be, few will operate against their economic interests. Successfully establishing modern eHealth facilitated services is not so much a technical, but a social, organisational, and business innovation. We need to better understand in detail the benefits and costs, or the new 'business models' that go with integrated care for each involved stakeholder group, and the likely impacts for each of them, with a focus on how to best assure a win-win situation for all. Health policy has to respond to this, and a promising approach would be to promote organisational integration with shared budgets and outcome targets.

Relational responsibilities in responsive evaluation.

PubMed

Visse, Merel; Abma, Tineke A; Widdershoven, Guy A M

2012-02-01

This article explores how we can enhance our understanding of the moral responsibilities in daily, plural practices of responsive evaluation. It introduces an interpretive framework for understanding the moral aspects of evaluation practice. The framework supports responsive evaluators to better understand and handle their moral responsibilities. A case is introduced to illustrate our argument. Responsive evaluation contributes to the design and implementation of policy by working with stakeholders and coordinating the evaluation process as a relationally responsible practice. Responsive evaluation entails a democratic process in which the evaluator fosters and enters a partnership with stakeholders. The responsibilities of an evaluator generally involve issues such as 'confidentiality', 'accountability' and 'privacy'. The responsive evaluator has specific responsibilities, for example to include stakeholders and vulnerable groups and to foster an ongoing dialogue. In addition, responsive evaluation involves a relational responsibility, which becomes present in daily situations in which stakeholders express expectations and voice demands. In our everyday work as evaluators, it is difficult to respond to all these demands at the same time. In addition, this article demonstrates that novice evaluators experience challenges concerning over- and underidenfitication with stakeholders. Guidelines and quality criteria on how to act are helpful, but need interpretation and application to the unique situation at hand. Copyright © 2011 Elsevier Ltd. All rights reserved.

Stakeholder engagement in dredged material management decisions.

PubMed

Collier, Zachary A; Bates, Matthew E; Wood, Matthew D; Linkov, Igor

2014-10-15

Dredging and disposal issues often become controversial with local stakeholders because of their competing interests. These interests tend to manifest themselves in stakeholders holding onto entrenched positions, and deadlock can result without a methodology to move the stakeholder group past the status quo. However, these situations can be represented as multi-stakeholder, multi-criteria decision problems. In this paper, we describe a case study in which multi-criteria decision analysis was implemented in a multi-stakeholder setting in order to generate recommendations on dredged material placement for Long Island Sound's Dredged Material Management Plan. A working-group of representatives from various stakeholder organizations was formed and consulted to help prioritize sediment placement sites for each dredging center in the region by collaboratively building a multi-criteria decision model. The resulting model framed the problem as several alternatives, criteria, sub-criteria, and metrics relevant to stakeholder interests in the Long Island Sound region. An elicitation of values, represented as criteria weights, was then conducted. Results show that in general, stakeholders tended to agree that all criteria were at least somewhat important, and on average there was strong agreement on the order of preferences among the diverse groups of stakeholders. By developing the decision model iteratively with stakeholders as a group and soliciting their preferences, the process sought to increase stakeholder involvement at the front-end of the prioritization process and lead to increased knowledge and consensus regarding the importance of site-specific criteria. Published by Elsevier B.V.

Ethical issues in sports medicine: a review and justification for ethical decision making and reasoning.

PubMed

Greenfield, Bruce H; West, Charles Robert

2012-11-01

Ethical issues present a challenge for health care professionals working with athletes of sports teams. Health care professionals-including the team physician, the physical therapist, and the athletic trainer-are faced with the challenge of returning an athlete to competition as quickly as possible but as safely as possible. Conflicts of interest arise due to conflicting obligations of the team physician to the athlete and other members of the sports organization, including coaches and the team owner. The multiple stakeholders involved in sports teams challenge the traditional notion of confidentiality and autonomy. The aims of this article are to explicate the ethics of sports medicine, highlight the ethical issues, and provide some strategies and suggestions for ethical decision making.

Involving Stakeholders in Programme Theory Specification: Discussion of a Systematic, Consensus-Based Approach

ERIC Educational Resources Information Center

van Urk, Felix; Grant, Sean; Bonell, Chris

2016-01-01

The use of explicit programme theory to guide evaluation is widely recommended. However, practitioners and other partnering stakeholders often initiate programmes based on implicit theories, leaving researchers to explicate them before commencing evaluation. The current study aimed to apply a systematic method to undertake this process. We…

Volunteer Watershed Health Monitoring by Local Stakeholders: New Mexico Watershed Watch

ERIC Educational Resources Information Center

Fleming, William

2003-01-01

Volunteers monitor watershed health in more than 700 programs in the US, involving over 400,000 local stakeholders. New Mexico Watershed Watch is a student-based watershed monitoring program sponsored by the state's Department of Game and Fish which provides high school teachers and students with instruction on methods for water quality…

Tip Sheet for SEAs: Engaging Parents and Family Members in Postschool Outcome Stakeholder Groups

ERIC Educational Resources Information Center

National Post-School Outcomes Center, 2013

2013-01-01

Involving parents and other family representatives in the Indicator B-14 Post-School Outcomes (PSO) Survey activities can help State Education Agencies (SEAs) develop strategies to increase annual response rates, communicate results to stakeholders, and build support for program improvement and systems change. Perspectives expressed by families of…

The Living Labs: Innovation in Real-Life Settings

ERIC Educational Resources Information Center

Hawk, Nathan; Bartle, Gamin; Romine, Martha

2012-01-01

The living lab (LL) is an open innovation ecosystem serving to provide opportunities for local stakeholders to practice research and to experiment with meaningful improvements for cities and other organizations. Living labs aim at involving the user as a cocreator. In this article the relationship between the LLs and a variety of stakeholders is…

Stakeholder Perceptions of the Positive Benefits and Critical Challenges Involved in Student Service-Learning Experiences

ERIC Educational Resources Information Center

Hohenthal, K. Darcy

2010-01-01

The Bolman and Deal (2003) Four-Frame Model was adapted in this qualitative phenomenological research study to describe how stakeholders experience student service-learning. The study presents how students perceive the positive benefits and critical challenges encountered in their service-learning experience; how professors perceive the positive…

Cultivating Relationships with School Placement Stakeholders: The Perspective of the Cooperating Teacher

ERIC Educational Resources Information Center

Young, Ann-Marie; MacPhail, Ann

2016-01-01

The aim of this paper is to analyse Irish school placement cooperating teachers' supervisory experiences when involved in various structures of communities and explore factors which enabled or challenged them in cultivating relationships with school placement stakeholders where there is no formal system of supervision established in schools in the…

Public opinion and wood energy

Treesearch

Sarah Hitchner; John Schelhas; Teppo Hujala; J. Peter Brosius

2014-01-01

As wood-based bioenergy continues to develop around the world, it will utilize forestlands in new ways and will have different effects on a number of stakeholders, including forest landowners, local communities, extant industries, policymakers, investors, and others. As more stakeholders become involved in the wood energy web, and as the general public becomes more...

Strategies for Values Inquiry: An Exploratory Case Study

ERIC Educational Resources Information Center

Renger, Ralph; Bourdeau, Beth

2004-01-01

Values inquiry refers to systematic investigation of the values relevant to a program, including understanding those outcomes most prized by stakeholders. Although much attention has been given to stakeholder involvement, the literature on value inquiries per se as an approach is limited. This paper demonstrates how several of the steps used in…

Challenges for a Sustainable Financial Foundation for Antimicrobial Stewardship.

PubMed

Dik, Jan-Willem H; Sinha, Bhanu

2017-03-30

Antimicrobial resistance is a worldwide threat and a problem with large clinical and economic impact. Antimicrobial Stewardship Programs are a solution to curb resistance development. A problem of resistance is a separation of actions and consequences, financial and clinical. Such a separation makes it difficult to create support among stakeholders leading to a lack of sense of responsibility. To counteract the resistance development it is important to perform diagnostics and know how to interpret the results. One should see diagnostics, therapy and resistance as one single process. Within this process all involved stakeholders need to work together on a more institutional level. We suggest therefore a solution: combining diagnostics and therapy into one single financial product . Such a product should act as an incentive to perform correct diagnostics. It also makes it easier to cover the costs of an antimicrobial stewardship program, which is often overlooked. Finally, such a product involves all stakeholders in the process and does not lay the costs at one stakeholder and the benefits somewhere else, solving the misbalance that is present nowadays.

Involving Research Stakeholders in Developing Policy on Sharing Public Health Research Data in Kenya: Views on Fair Process for Informed Consent, Access Oversight, and Community Engagement.

PubMed

Jao, Irene; Kombe, Francis; Mwalukore, Salim; Bull, Susan; Parker, Michael; Kamuya, Dorcas; Molyneux, Sassy; Marsh, Vicki

2015-07-01

Increased global sharing of public health research data has potential to advance scientific progress but may present challenges to the interests of research stakeholders, particularly in low-to-middle income countries. Policies for data sharing should be responsive to public views, but there is little evidence of the systematic study of these from low-income countries. This qualitative study explored views on fair data-sharing processes among 60 stakeholders in Kenya with varying research experience, using a deliberative approach. Stakeholders' attitudes were informed by perceptions of benefit and concerns for research data sharing, including risks of stigmatization, loss of privacy, and undermining scientific careers and validity, reported in detail elsewhere. In this article, we discuss institutional trust-building processes seen as central to perceptions of fairness in sharing research data in this setting, including forms of community involvement, individual prior awareness and agreement to data sharing, independence and accountability of governance mechanisms, and operating under a national framework. © The Author(s) 2015.

Interactions among stakehoklders involved in return to work after sick leave due to mental disorders: a meta-ethnography.

PubMed

Neves, Robson da Fonseca; Nunes, Mônica de Oliveira; Magalhães, Lilian

2015-11-01

Mental disorders cause impact in the work environment. Investigations of interaction among stakeholders who are involved in the return to work are scarce. Meta-ethnography serves to synthesize qualitative studies by means of ongoing interpretation and comparison of the ideas presented in the articles. The goal of this study is to present a meta-ethnography of the interactions among the stakeholders involved in the return to work process after leave of absence due to mental disorders. It aims: (1) to investigate the interactions among stakeholders involved in return to work; (2) to identify enablers or obstacles for the return to work. The database search found 619 articles, 16 of which met the inclusion criteria. Analysis of the articles revealed six second-order concepts that resulted in two syntheses. The first is about performance ethos in the return to work, and the second shows return to work as a catalyst of new life styles. Models that favor the worker's performance ethos, as well as a perspective oriented by psychosocial aspects may enable return to work practices after leave of absence due to mental disorders.

Methods for engaging stakeholders in comparative effectiveness research: a patient-centered approach to improving diabetes care.

PubMed

Schmittdiel, Julie A; Desai, Jay; Schroeder, Emily B; Paolino, Andrea R; Nichols, Gregory A; Lawrence, Jean M; O'Connor, Patrick J; Ohnsorg, Kris A; Newton, Katherine M; Steiner, John F

2015-06-01

Engaging stakeholders in the research process has the potential to improve quality of care and the patient care experience. Online patient community surveys can elicit important topic areas for comparative effectiveness research. Stakeholder meetings with substantial patient representation, as well as representation from health care delivery systems and research funding agencies, are a valuable tool for selecting and refining pilot research and quality improvement projects. Giving patient stakeholders a deciding vote in selecting pilot research topics helps ensure their 'voice' is heard. Researchers and health care leaders should continue to develop best-practices and strategies for increasing patient involvement in comparative effectiveness and delivery science research.

'And when a certain health issue happen, they try to cover it': Stakeholder perspectives on the health of temporary foreign workers and their families.

PubMed

Salami, Bukola; Hegadoren, Kathleen; Kirova, Anna; Meherali, Salima; Nsaliwa, Christina; Chiu, Yvonne

2018-01-01

This study examines stakeholders' perspectives on the health and well-being of temporary foreign workers (TFWs) and their families in Alberta, Canada. We used a critically informed qualitative methodology. We interviewed 13 stakeholders, including service providers and policy makers. Stakeholders involved in providing services to TFWs perceived that the workers experience (1) barriers in accessing mental health services, (2) mental health challenges, (3) family health challenges, (4) occupational health challenges, and (5) income and social status as a social determinant of health. Immigration and class status intersect to influence the health of this vulnerable population in Canada.

U.S. Forest Service Leads Climate Change Adaptation in the Western United States

NASA Astrophysics Data System (ADS)

Halofsky, J.; Peterson, D. L.

2014-12-01

Effective climate change engagement on public lands is characterized by (1) an enduring science-management partnership, (2) involvement of key stakeholders, (3) consideration of broad landscapes with multiple landowners, (4) science-based, peer-reviewed assessments of sensitivity of natural resources to climate change, (5) adaptation strategies and tactics developed by resource managers, (6) leadership and a workforce motivated to implement climate-smart practices in resource planning and project management. Using this approach, the U.S. Forest Service, in partnership with other organizations, has developed climate change vulnerability assessments and adaptation plans for diverse ecosystems and multiple resources in national forests and other lands in the western United States, although implementation (step 6) has been slow in some cases. Hundreds of meetings, strategies, plans, and panels have focused on climate change adaptation over the past decade, but only direct engagement between scientists and resource managers (less research, less planning, more action) has resulted in substantive outcomes and increased organizational capacity for climate-smart management.

Social Work’s Role in Medicaid Reform: A Qualitative Study

PubMed Central

Wachman, Madeline; Manning, Leticia; Cohen, Alexander M.; Seifert, Robert W.; Jones, David K.; Fitzgerald, Therese; Nuzum, Rachel; Riley, Patricia

2017-01-01

Objectives. To critically analyze social work’s role in Medicaid reform. Methods. We conducted semistructured interviews with 46 stakeholders from 10 US states that use a range of Medicaid reform approaches. We identified participants using snowball and purposive sampling. We gathered data in 2016 and analyzed them using qualitative methods. Results. Multiple themes emerged: (1) social work participates in Medicaid reform through clinical practice, including care coordination and case management; (2) there is a gap between social work’s practice-level and systems-level involvement in Medicaid innovations; (3) factors hindering social work’s involvement in systems-level practice include lack of visibility, insufficient clarity on social work’s role and impact, and too few resources within professional organizations; and (4) social workers need more training in health transformation payment models and policy. Conclusions. Social workers have unique skills that are valuable to building health systems that promote population health and reduce health inequities. Although there is considerable opportunity for social work to increase its role in Medicaid reform, there is little social work involvement at the systems level. PMID:29236537

Essential Medicines in a High Income Country: Essential to Whom?

PubMed Central

2015-01-01

Objective To explore the perspectives of a diverse group of stakeholders engaged in medicines decision making around what constitutes an “essential” medicine, and how the Essential Medicines List (EML) concept functions in a high income country context. Methods In-depth qualitative semi-structured interviews were conducted with 32 Australian stakeholders, recognised as decision makers, leaders or advisors in the area of medicines reimbursement or supply chain management. Participants were recruited from government, pharmaceutical industry, pharmaceutical wholesale/distribution companies, medicines non-profit organisations, academic health disciplines, hospitals, and consumer groups. Perspectives on the definition and application of the EML concept in a high income country context were thematically analysed using grounded theory approach. Findings Stakeholders found it challenging to describe the EML concept in the Australian context because many perceived it was generally used in resource scarce settings. Stakeholders were unable to distinguish whether nationally reimbursed medicines were essential medicines in Australia. Despite frequent generic drug shortages and high prices paid by consumers, many struggled to describe how the EML concept applied to Australia. Instead, broad inclusion of consumer needs, such as rare and high cost medicines, and consumer involvement in the decision making process, has led to expansive lists of nationally subsidised medicines. Therefore, improved communication and coordination is needed around shared interests between stakeholders regarding how medicines are prioritised and guaranteed in the supply chain. Conclusions This study showed that decision-making in Australia around reimbursement of medicines has strayed from the fundamental utilitarian concept of essential medicines. Many stakeholders involved in medicine reimbursement decisions and management of the supply chain did not consider the EML concept in their approach. The wide range of views of what stakeholders considered were essential medicines, challenges whether the EML concept is out-dated or underutilised in high income countries. PMID:26650544

Essential Medicines in a High Income Country: Essential to Whom?

PubMed

Duong, Mai; Moles, Rebekah J; Chaar, Betty; Chen, Timothy F

2015-01-01

To explore the perspectives of a diverse group of stakeholders engaged in medicines decision making around what constitutes an "essential" medicine, and how the Essential Medicines List (EML) concept functions in a high income country context. In-depth qualitative semi-structured interviews were conducted with 32 Australian stakeholders, recognised as decision makers, leaders or advisors in the area of medicines reimbursement or supply chain management. Participants were recruited from government, pharmaceutical industry, pharmaceutical wholesale/distribution companies, medicines non-profit organisations, academic health disciplines, hospitals, and consumer groups. Perspectives on the definition and application of the EML concept in a high income country context were thematically analysed using grounded theory approach. Stakeholders found it challenging to describe the EML concept in the Australian context because many perceived it was generally used in resource scarce settings. Stakeholders were unable to distinguish whether nationally reimbursed medicines were essential medicines in Australia. Despite frequent generic drug shortages and high prices paid by consumers, many struggled to describe how the EML concept applied to Australia. Instead, broad inclusion of consumer needs, such as rare and high cost medicines, and consumer involvement in the decision making process, has led to expansive lists of nationally subsidised medicines. Therefore, improved communication and coordination is needed around shared interests between stakeholders regarding how medicines are prioritised and guaranteed in the supply chain. This study showed that decision-making in Australia around reimbursement of medicines has strayed from the fundamental utilitarian concept of essential medicines. Many stakeholders involved in medicine reimbursement decisions and management of the supply chain did not consider the EML concept in their approach. The wide range of views of what stakeholders considered were essential medicines, challenges whether the EML concept is out-dated or underutilised in high income countries.

A Novel Approach to River Basin Management that Utilizes a Multi-Day Forum to Educate Stakeholders

NASA Astrophysics Data System (ADS)

Langston, M. A.

2015-12-01

Large scale river basin management has long been a challenging task. Stakeholder involvement has often been posited as a means to provide a broad base of input and support for management decisions. This has been successful in some situations and not in others. The Desert Landscape Conservation Cooperative (LCC) has proposed a novel approach to large scale watershed management for conservation purposes by stakeholders. This approach involves conducting a multi-day stakeholder forum to gather interested parties, provide them science-based information about the watershed, and solicit their input regarding the research and management needs within the basin. Included within this forum is a Water Tournament patterned after those being developed by the U.S. Army Corps of Engineers' Institute for Water Resources. These tournaments bring stakeholders (such as the various water users, agencies, conservation organizations, and others) in small teams that develop watershed management scenarios (within appropriate constraints) that are then judged based on their merit for addressing the various issues within the basin. These tournaments serve to educate participants and to sensitize them to the perspectives of other participants. Another goal of the forum is to recruit a representative group of stakeholders who will provide guidance for further research to meet the basins management needs. The South Central Climate Science Center (SC CSC) has partnered with the Desert, Southern Rockies, Gulf Coast Prairie, Great Plains, and Gulf Coastal Plains and Ozarks LCCs to implement this approach in the Rio Grande and the Red River Basins. The LCCs are well positioned to convene stakeholders from across political boundaries and throughout these basins. The SC CSC's roles will be providing leadership, funding climate science for the effort, and evaluating the effectiveness of the forum-centered approach.

A cloud based tool for knowledge exchange on local scale flood risk.

PubMed

Wilkinson, M E; Mackay, E; Quinn, P F; Stutter, M; Beven, K J; MacLeod, C J A; Macklin, M G; Elkhatib, Y; Percy, B; Vitolo, C; Haygarth, P M

2015-09-15

There is an emerging and urgent need for new approaches for the management of environmental challenges such as flood hazard in the broad context of sustainability. This requires a new way of working which bridges disciplines and organisations, and that breaks down science-culture boundaries. With this, there is growing recognition that the appropriate involvement of local communities in catchment management decisions can result in multiple benefits. However, new tools are required to connect organisations and communities. The growth of cloud based technologies offers a novel way to facilitate this process of exchange of information in environmental science and management; however, stakeholders need to be engaged with as part of the development process from the beginning rather than being presented with a final product at the end. Here we present the development of a pilot Local Environmental Virtual Observatory Flooding Tool. The aim was to develop a cloud based learning platform for stakeholders, bringing together fragmented data, models and visualisation tools that will enable these stakeholders to make scientifically informed environmental management decisions at the local scale. It has been developed by engaging with different stakeholder groups in three catchment case studies in the UK and a panel of national experts in relevant topic areas. However, these case study catchments are typical of many northern latitude catchments. The tool was designed to communicate flood risk in locally impacted communities whilst engaging with landowners/farmers about the risk of runoff from the farmed landscape. It has been developed iteratively to reflect the needs, interests and capabilities of a wide range of stakeholders. The pilot tool combines cloud based services, local catchment datasets, a hydrological model and bespoke visualisation tools to explore real time hydrometric data and the impact of flood risk caused by future land use changes. The novel aspects of the pilot tool are; the co-evolution of tools on a cloud based platform with stakeholders, policy and scientists; encouraging different science disciplines to work together; a wealth of information that is accessible and understandable to a range of stakeholders; and provides a framework for how to approach the development of such a cloud based tool in the future. Above all, stakeholders saw the tool and the potential of cloud technologies as an effective means to taking a whole systems approach to solving environmental issues. This sense of community ownership is essential in order to facilitate future appropriate and acceptable land use management decisions to be co-developed by local catchment communities. The development processes and the resulting pilot tool could be applied to local catchments globally to facilitate bottom up catchment management approaches. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Barriers and Facilitators Affecting Patient Portal Implementation from an Organizational Perspective: Qualitative Study.

PubMed

Kooij, Laura; Groen, Wim G; van Harten, Wim H

2018-05-11

The number of patient portals is rising, and although portals can have positive effects, their implementation has major impacts on the providing health care institutions. However, little is known about the organizational factors affecting successful implementation. Knowledge of the specific barriers to and facilitators of various stakeholders is likely to be useful for future implementations. The objective of this study was to identify the barriers to and facilitators of patient portal implementation facing various stakeholders within hospital organizations in the Netherlands. Purposive sampling was used to select hospitals of various types. A total of 2 university medical centers, 3 teaching hospitals, and 2 general hospitals were included. For each, 3 stakeholders were interviewed: (1) medical professionals, (2) managers, and (3) information technology employees. In total, 21 semistructured interviews were conducted using the Grol and Wensing model, which describes barriers to and facilitators of change in health care practice at 6 levels: (1) innovation; (2) individual professional; (3) patient; (4) social context; (5) organizational context; and (6) economic and political context. Two researchers independently selected and coded quotes by applying this model using a (deductive) directed content approach. Additional factors related to technical and portal characteristics were added using the model of McGinn et al, developed for implementation of electronic health records. In total, we identified 376 quotes, 26 barriers, and 28 facilitators. Thirteen barriers and 12 facilitators were common for all stakeholder groups. The facilitators' perceived usefulness (especially less paperwork) was mentioned by all the stakeholders, followed by subjects' positive attitude. The main barriers were lack of resources (namely, lack of staff and materials), financial difficulties (especially complying with high costs, lack of reimbursements), and guaranteeing privacy and security (eg, strict regulations). Both similarities and differences were found between stakeholder groups and hospital types. For example, managers and information technology employees mainly considered guaranteeing privacy and security as a predominant barrier. Financial difficulties were particularly mentioned by medical professionals and managers. Patient portal implementation is a complex process and is not only a technical process but also affects the organization and its staff. Barriers and facilitators occurred at various levels and differed among hospital types (eg, lack of accessibility) and stakeholder groups (eg, sufficient resources) in terms of several factors. Our findings underscore the importance of involving multiple stakeholders in portal implementations. We identified a set of barriers and facilitators that are likely to be useful in making strategic and efficient implementation plans. ©Laura Kooij, Wim G Groen, Wim H van Harten. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 11.05.2018.

Public involvement, low budget can mean high effectiveness

DOT National Transportation Integrated Search

1998-09-16

Public involvement on a small budget can result in a more effective outreach : process. When an agency has more time than money, public involvement truly can : start at "the earliest possible moment." Once stakeholders and existing : organizations in...

Medical Students and informed consent: A consensus statement prepared by the Faculties of Medical and Health Science of the Universities of Auckland and Otago, Chief Medical Officers of District Health Boards, New Zealand Medical Students' Association and the Medical Council of New Zealand.

PubMed

Bagg, Warwick; Adams, John; Anderson, Lynley; Malpas, Phillipa; Pidgeon, Grant; Thorn, Michael; Tulloch, David; Zhong, Cathy; Merry, Alan F

2015-05-15

To develop a national consensus statement to promote a pragmatic, appropriate and unified approach to seeking consent for medical student involvement in patient care. A modified Delphi technique was used to develop the consensus statement involving stakeholders. Feedback from consultation and each stakeholder helped to shape the final consensus statement. The consensus statement is a nationally-agreed statement concerning medical student involvement in patient care, which will be useful for medical students, health care professionals and patients.

Prioritization in comparative effectiveness research: the CANCERGEN Experience.

PubMed

Thariani, Rahber; Wong, William; Carlson, Josh J; Garrison, Louis; Ramsey, Scott; Deverka, Patricia A; Esmail, Laura; Rangarao, Sneha; Hoban, Carolyn J; Baker, Laurence H; Veenstra, David L

2012-05-01

Systematic approaches to stakeholder-informed research prioritization are a central focus of comparative effectiveness research. Genomic testing in cancer is an ideal area to refine such approaches given rapid innovation and potentially significant impacts on patient outcomes. To develop and pilot test a stakeholder-informed approach to prioritizing genomic tests for future study in collaboration with the cancer clinical trials consortium SWOG. We conducted a landscape analysis to identify genomic tests in oncology using a systematic search of published and unpublished studies, and expert consultation. Clinically valid tests suitable for evaluation in a comparative study were presented to an external stakeholder group. Domains to guide the prioritization process were identified with stakeholder input, and stakeholders ranked tests using multiple voting rounds. A stakeholder group was created including representatives from patient-advocacy groups, payers, test developers, regulators, policy makers, and community-based oncologists. We identified 9 domains for research prioritization with stakeholder feedback: population impact; current standard of care, strength of association; potential clinical benefits, potential clinical harms, economic impacts, evidence of need, trial feasibility, and market factors. The landscape analysis identified 635 studies; of 9 tests deemed to have sufficient clinical validity, 6 were presented to stakeholders. Two tests in lung cancer (ERCC1 and EGFR) and 1 test in breast cancer (CEA/CA15-3/CA27.29) were identified as top research priorities. Use of a diverse stakeholder group to inform research prioritization is feasible in a pragmatic and timely manner. Additional research is needed to optimize search strategies, stakeholder group composition, and integration with existing prioritization mechanisms.

Prioritization in Comparative Effectiveness Research: The CANCERGEN Experience in Cancer Genomics

PubMed Central

Thariani, Rahber; Wong, William; Carlson, Josh J; Garrison, Louis; Ramsey, Scott; Deverka, Patricia A; Esmail, Laura; Rangarao, Sneha; Hoban, Carolyn J; Baker, Laurence H; Veenstra, David L

2012-01-01

Background Systematic approaches to stakeholder-informed research prioritization are a central focus of comparative effectiveness research. Genomic testing in cancer is an ideal area to refine such approaches given rapid innovation and potentially significant impacts on patient outcomes. Objective To develop and pilot-test a stakeholder-informed approach to prioritizing genomic tests for future study in collaboration with the cancer clinical trials consortium SWOG. Methods We conducted a landscape-analysis to identify genomic tests in oncology using a systematic search of published and unpublished studies, and expert consultation. Clinically valid tests suitable for evaluation in a comparative study were presented to an external stakeholder group. Domains to guide the prioritization process were identified with stakeholder input, and stakeholders ranked tests using multiple voting rounds. Results A stakeholder group was created including representatives from patient-advocacy groups, payers, test developers, regulators, policy-makers, and community-based oncologists. We identified nine domains for research prioritization with stakeholder feedback: population impact; current standard of care, strength of association; potential clinical benefits, potential clinical harms, economic impacts, evidence of need, trial feasibility, and market factors. The landscape-analysis identified 635 studies; of 9 tests deemed to have sufficient clinical validity, 6 were presented to stakeholders. Two tests in lung cancer (ERCC1 and EGFR) and one test in breast cancer (CEA/CA15-3/CA27.29) were identified as top research priorities. Conclusions Use of a diverse stakeholder group to inform research prioritization is feasible in a pragmatic and timely manner. Additional research is needed to optimize search strategies, stakeholder group composition and integration with existing prioritization mechanisms. PMID:22274803

A qualitative exploration of malaria operational research situation in Nigeria.

PubMed

Ajayi, IkeOluwapo O; Ughasoro, Maduka D; Ogunwale, Akintayo; Odeyinka, Oluwaseun; Babalola, Obafemi; Sharafadeen, Salami; Adamu, Al-Mukhtar Y; Ajumobi, Olufemi; Orimogunje, Taiwo; Nguku, Patrick

2017-01-01

Malaria, remains one of the leading causes of high morbidity and mortality in Nigeria despite implementation of several public health interventions for its control. Operational limitations and methodological gaps have been associated with malaria control interventions and research, and these have necessitated the need for a well-tailored Malaria Operational Research (MOR) agenda. However, there is paucity of evidence-based information on relevant stakeholders' experience, awareness, perceptions and use of MOR and suggestions on setting MOR agenda. As part of a larger study to provide data for national MOR agenda setting, we assessed the MOR research situation from the perspectives of key stakeholders in Nigeria and contribution of MOR to the malaria elimination agenda. We conducted key informant interviews among 40 purposively selected stakeholders from the six geo-political zones in Nigeria. Data was collected using a pre-tested key informant interview guide which comprised issues related to experience, awareness, use of MOR and MOR needs, and suggestions for MOR. We conducted a detailed content analysis. Half of the participants had participated in MOR. Participants perceived MOR as important. Only few were aware of existing framework for MOR in Nigeria while above half expressed that MOR is yet to be used to inform policy in Nigeria. Participants identified several MOR needs such as development of improved diagnostic techniques, and interventions for promoting early diagnosis, prompt treatment and quality programmatic data. Participants opined the need for country-specific prioritised MOR agenda that cut across malaria thematic areas including malaria prevention and case management. Participants suggested the involvement of various stakeholders and multi-disciplinary approach in setting MOR. Although some stakeholders have been involved in MOR, it is still rarely used to inform policy and several needs exist across thematic areas. A broad-based stakeholder involvement, multi-disciplinary approach to agenda setting and its wide dissemination have been suggested.

Mapping and Analyzing Stakeholders in China's Essential Drug System by Using a Circular Model: Who We Should Deal with Next?

PubMed

Shao, Hui; Li, Shixue; Xu, Lingzhong; Yang, Shuang; Thomas, Nicholas J; Mir, Mohammed Umer; Guo, Zhen; Ning, Bo; Shi, Lizheng

2015-05-01

To predict the prospects of the essential drug system by using the Stakeholder Impact Index (SII) and evaluate the current performance of each main stakeholder and suggested dangerous stakeholders and dormant stakeholders. A Delphi method was used, involving 36 experts with experience in implementation and evaluation of the essential drug policy, to construct the circular model as well as evaluate the performance of each stakeholder. The central government was a dominant stakeholder of the whole essential drug system. The provincial governments were definitive stakeholders, whereas local governments and medical institutions were dependent stakeholders. Furthermore, media and drug stores were dormant stakeholders and pharmaceutical manufacturers and delivery enterprises were dangerous stakeholders. Patients, community residents, and medical insurance programs were discretionary stakeholders. The SII for the essential drug system was positive (SII proj ⁎ = 2.72). The overall anticipation of the essential drug policy is optimistic. Letting definitive stakeholders (provincial governments) having more autonomy can efficiently accelerate the pace of implementation of the essential drug policy in the current situation. Central government, however, also needs to construct an experience exchange platform with the aim of building versatile methods for running the essential drug system in all provinces. Pharmaceutical manufacturers and delivery enterprises were dangerous stakeholders for the essential drug policy. Because of their potential threat to the implementation of the policy, the central government should motivate them to support the construction of the essential drug system spontaneously. In that case, provincial governments need to construct a fair, balanced, and self-stabilized bidding platform. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Implementing an organised cervical screening programme in the Republic of Moldova-Stakeholder identification and engagement.

PubMed

Davies, Philip; Valuta, Diana; Cojohari, Natalia; Sancho-Garnier, Helene

2017-10-01

Successfully implementing cervical screening programmes requires them to be adapted to the local context and have broad stakeholder support. This can be achieved by actively engaging local stakeholders in planning as well as implementing the programmes. The Moldovan government started implementing an organised cervical screening programme in 2010 with the first step being stakeholder identification and engagement. This process started by contacting easily identified stakeholders with each asked to recommend others and the process continued until no new ones were identified. Stakeholders were then involved in a series of individual and group meetings over a 2-year period to build confidence and encourage progressively greater engagement. In total, 87 individuals from 46 organisations were identified. Over the 2-year process, the individual and group meetings facilitated a change in stakeholder attitudes from disinterest, to acceptance and finally to active cooperation in designing the screening programme and preparing an implementation plan that were both well adapted to the Moldovan context. Developing the broad support needed to implement cervical screening programmes required ongoing interaction with stakeholders over an extended period. This interaction allowed stakeholder concerns to be identified and addressed, progress to be demonstrated, and stakeholders to be educated about organised screening programmes so they had the knowledge to progressively take greater responsibility and ownership. Copyright © 2017 Elsevier Ltd. All rights reserved.

Identifying the institutional decision process to introduce decentralized sanitation in the city of Kunming (China).

PubMed

Medilanski, Edi; Chuan, Liang; Mosler, Hans-Joachim; Schertenleib, Roland; Larsen, Tove A

2007-05-01

We conducted a study of the institutional barriers to introducing urine source separation in the urban area of Kunming, China. On the basis of a stakeholder analysis, we constructed stakeholder diagrams showing the relative importance of decision-making power and (positive) interest in the topic. A hypothetical decision-making process for the urban case was derived based on a successful pilot project in a periurban area. All our results were evaluated by the stakeholders. We concluded that although a number of primary stakeholders have a large interest in testing urine source separation also in an urban context, most of the key stakeholders would be reluctant to this idea. However, the success in the periurban area showed that even a single, well-received pilot project can trigger the process of broad dissemination of new technologies. Whereas the institutional setting for such a pilot project is favorable in Kunming, a major challenge will be to adapt the technology to the demands of an urban population. Methodologically, we developed an approach to corroborate a stakeholder analysis with the perception of the stakeholders themselves. This is important not only in order to validate the analysis but also to bridge the theoretical gap between stakeholder analysis and stakeholder involvement. We also show that in disagreement with the assumption of most policy theories, local stakeholders consider informal decision pathways to be of great importance in actual policy-making.

Identifying the Institutional Decision Process to Introduce Decentralized Sanitation in the City of Kunming (China)

NASA Astrophysics Data System (ADS)

Medilanski, Edi; Chuan, Liang; Mosler, Hans-Joachim; Schertenleib, Roland; Larsen, Tove A.

2007-05-01

We conducted a study of the institutional barriers to introducing urine source separation in the urban area of Kunming, China. On the basis of a stakeholder analysis, we constructed stakeholder diagrams showing the relative importance of decision-making power and (positive) interest in the topic. A hypothetical decision-making process for the urban case was derived based on a successful pilot project in a periurban area. All our results were evaluated by the stakeholders. We concluded that although a number of primary stakeholders have a large interest in testing urine source separation also in an urban context, most of the key stakeholders would be reluctant to this idea. However, the success in the periurban area showed that even a single, well-received pilot project can trigger the process of broad dissemination of new technologies. Whereas the institutional setting for such a pilot project is favorable in Kunming, a major challenge will be to adapt the technology to the demands of an urban population. Methodologically, we developed an approach to corroborate a stakeholder analysis with the perception of the stakeholders themselves. This is important not only in order to validate the analysis but also to bridge the theoretical gap between stakeholder analysis and stakeholder involvement. We also show that in disagreement with the assumption of most policy theories, local stakeholders consider informal decision pathways to be of great importance in actual policy-making.

What Constitutes Quality in Minority Education? A Multiple Embedded Case Study of Stakeholder Perspectives on Minority Linguistic and Cultural Content in School-Based Curriculum in Sunan Yughur Autonomous County, Gansu

ERIC Educational Resources Information Center

Bahry, Stephen A.

2012-01-01

While quality in education has long been a significant issue, definitions of quality are often taken for granted rather than argued for, allowing the possibility that the criteria used by researchers and planners to judge quality may differ from local stakeholders' perspectives, particularly regarding the place within quality education of the…

Effectiveness of additional self-care acupressure for women with menstrual pain compared to usual care alone: using stakeholder engagement to design a pragmatic randomized trial and study protocol.

PubMed

Blödt, Susanne; Schützler, Lena; Huang, Wenjing; Pach, Daniel; Brinkhaus, Benno; Hummelsberger, Josef; Kirschbaum, Barbara; Kuhlmann, Kirsten; Lao, Lixing; Liang, Fanrong; Mietzner, Anna; Mittring, Nadine; Müller, Sabine; Paul, Anna; Pimpao-Niederle, Carolina; Roll, Stephanie; Wu, Huangan; Zhu, Jiang; Witt, Claudia M

2013-04-11

Self-care acupressure might be successful in treating menstrual pain, which is common among young women. There is a need for comparative effectiveness research with stakeholder engagement in all phases seeking to address the needs of decision-makers. Our aim was to design a study on the effectiveness of additional self-care acupressure for menstrual pain comparing usual care alone using different methods of stakeholder engagement. The study was designed using multiple mixed methods for stakeholder engagement. Based on the results of a survey and focus group discussion, a stakeholder advisory group developed the study design. Stakeholder engagement resulted in a two-arm pragmatic randomized trial. Two hundred and twenty women aged 18 to 25 years with menstrual pain will be included in the study. Outcome measurement will be done using electronic questionnaires provided by a study specific mobile application (App). Primary outcome will be the mean pain intensity at the days of pain during the third menstruation after therapy start. Stakeholder engagement helped to develop a study design that better serves the needs of decision makers, including an App as a modern tool for both intervention and data collection in a young target group. Clinicaltrials.gov identifier http://NCT01582724.

Multi-faceted informatics system for digitising and streamlining the reablement care model.

PubMed

Bond, Raymond R; Mulvenna, Maurice D; Finlay, Dewar D; Martin, Suzanne

2015-08-01

Reablement is new paradigm to increase independence in the home amongst the ageing population. And it remains a challenge to design an optimal electronic system to streamline and integrate reablement into current healthcare infrastructure. Furthermore, given reablement requires collaboration with a range of organisations (including national healthcare institutions and community/voluntary service providers), such a system needs to be co-created with all stakeholders involved. Thus, the purpose of this study is, (1) to bring together stakeholder groups to elicit a comprehensive set of requirements for a digital reablement system, (2) to utilise emerging technologies to implement a system and a data model based on the requirements gathered and (3) to involve user groups in a usability assessment of the system. In this study we employed a mixed qualitative approach that included a series of stakeholder-involved activities. Collectively, 73 subjects were recruited to participate in an ideation event, a quasi-hackathon and a usability study. The study unveiled stakeholder-led requirements, which resulted in a novel cloud-based system that was created using emerging web technologies. The system is driven by a unique data model and includes interactive features that are necessary for streamlining the reablement care model. In summary, this system allows community based interventions (or services) to be prescribed to occupants whilst also monitoring the occupant's progress of independent living. Copyright © 2015 Elsevier Inc. All rights reserved.

Community Involvement Training Program

EPA Pesticide Factsheets

A dynamic training conference that brings together more than 450 people from EPA and the Agency’s partners and stakeholders who plan and implement environmental community involvement, partnership, stewardship, outreach, and education programs.

The development of integrated diabetes care in the Netherlands: a multiplayer self-assessment analysis.

PubMed

Zonneveld, Nick; Vat, Lidewij E; Vlek, Hans; Minkman, Mirella M N

2017-03-21

Since recent years Dutch diabetes care has increasingly focused on improving the quality of care by introducing the concept of care groups (in Dutch: 'zorggroepen'), care pathways and improving cooperation with involved care professionals and patients. This study examined how participating actors in care groups assess the development of their diabetes services and the differences and similarities between different stakeholder groups. A self-evaluation study was performed within 36 diabetes care groups in the Netherlands. A web-based self-assessment instrument, based on the Development Model for Integrated Care (DMIC), was used to collect data among stakeholders of each care group. The DMIC defines nine clusters of integrated care and four phases of development. Statistical analysis was used to analyze the data. Respondents indicated that the diabetes care groups work together in well-organized multidisciplinary teams and there is clarity about one another's expertise, roles and tasks. The care groups can still develop on elements related to the management and monitoring of performance, quality of care and patient-centeredness. The results show differences (p < 0.01) between three stakeholders groups in how they assess their integrated care services; (1) core players, (2) managers/directors/coordinators and (3) players at a distance. Managers, directors and coordinators assessed more implemented integrated care activities than the other two stakeholder groups. This stakeholder group also placed their care groups in a further phase of development. Players at a distance assessed significantly less present elements and assessed their care group as less developed. The results show a significant difference between stakeholder groups in the assessment of diabetes care practices. This reflects that the professional disciplines and the roles of stakeholders influence the way they asses the development of their integrated care setting, or that certain stakeholder groups could be less involved or informed.

Using social network analysis to examine the decision-making process on new vaccine introduction in Nigeria.

PubMed

Wonodi, C B; Privor-Dumm, L; Aina, M; Pate, A M; Reis, R; Gadhoke, P; Levine, O S

2012-05-01

The decision-making process to introduce new vaccines into national immunization programmes is often complex, involving many stakeholders who provide technical information, mobilize finance, implement programmes and garner political support. Stakeholders may have different levels of interest, knowledge and motivations to introduce new vaccines. Lack of consensus on the priority, public health value or feasibility of adding a new vaccine can delay policy decisions. Efforts to support country-level decision-making have largely focused on establishing global policies and equipping policy makers with the information to support decision-making on new vaccine introduction (NVI). Less attention has been given to understanding the interactions of policy actors and how the distribution of influence affects the policy process and decision-making. Social network analysis (SNA) is a social science technique concerned with explaining social phenomena using the structural and relational features of the network of actors involved. This approach can be used to identify how information is exchanged and who is included or excluded from the process. For this SNA of vaccine decision-making in Nigeria, we interviewed federal and state-level government officials, officers of bilateral and multilateral partner organizations, and other stakeholders such as health providers and the media. Using data culled from those interviews, we performed an SNA in order to map formal and informal relationships and the distribution of influence among vaccine decision-makers, as well as to explore linkages and pathways to stakeholders who can influence critical decisions in the policy process. Our findings indicate a relatively robust engagement of key stakeholders in Nigeria. We hypothesized that economic stakeholders and implementers would be important to ensure sustainable financing and strengthen programme implementation, but some economic and implementation stakeholders did not appear centrally on the map; this may suggest a need to strengthen the decision-making processes by engaging these stakeholders more centrally and earlier.

The Dutch Consumer Quality Index: an example of stakeholder involvement in indicator development

PubMed Central

2010-01-01

Background Like in several other Western countries, in the Dutch health care system regulated competition has been introduced. In order to make this work, comparable information is required about the performance of health care providers in terms of effectiveness, safety and patient experiences. Without further coordination, external actors will all try to force health care providers to be transparent. For health care providers this might result in a situation in which they have to deliver data for several sets of indicators, defined by different actors. Therefore, in the Netherlands an effort is made to define national sets of performance indicators and related measuring instruments. In this article, the following questions are addressed, using patient experiences as an example: - When and how are stakeholders involved in the development of indicators and instruments that measure the patients' experiences with health care providers? - Does this involvement lead to indicators and instruments that match stakeholders' information needs? Discussion The Dutch experiences show that it is possible to implement national indicator sets and to reach consensus about what needs to be measured. Preliminary evaluations show that for health care providers and health insurers the benefits of standardization outweigh the possible loss of tailor-made information. However, it has also become clear that particular attention should be given to the participation of patient/consumer organisations. Summary Stakeholder involvement is complex and time-consuming. However, it is the only way to balance the information needs of all the parties that ask for and benefit from transparency, without frustrating the health care system. PMID:20370925

Elephants Also Like Coffee: Trends and Drivers of Human-Elephant Conflicts in Coffee Agroforestry Landscapes of Kodagu, Western Ghats, India

NASA Astrophysics Data System (ADS)

Bal, P.; Nath, C. D.; Nanaya, K. M.; Kushalappa, C. G.; Garcia, C.

2011-05-01

Kodagu district produces 2% of the world's coffee, in complex, multistoried agroforestry systems. The forests of the district harbour a large population of the Asian elephant ( Elephas maximus). The combined effects of high elephant density and major landscape changes due to the expansion of coffee cultivation are the cause of human-elephant conflicts (HEC). Mitigation strategies, including electric fences and compensation schemes implemented by the Forest Department have met with limited success. Building on previous studies in the area, we assessed current spatial and temporal trends of conflict, analysed local stakeholders' perceptions and identified factors driving elephants into the estates. Our study, initiated in May 2007, shows that the intensity of HEC has increased over the last 10 years, exhibiting new seasonal patterns. Conflict maps and the lack of correlation between physical features of the coffee plantations and elephant visits suggest elephants move along corridors between the eastern and western forests of the district, opportunistically foraging when crossing the plantations. Dung analyses indicate elephants have selectively included ripe coffee berries in their diet. This is, to our knowledge, the first report of wild elephants feeding on coffee berries. If this new behaviour spreads through the population, it will compound an already severe conflict situation. The behavioural plasticity, the multiplicity of stakeholders involved, the difficulty in defining the problem and the limits of technical solutions already proposed suggest that HEC in Kodagu has the ingredients of a "wicked" problem whose resolution will require more shared understanding and problem solving work amongst the stakeholders.

Erratum: Erratum to: Elephants Also Like Coffee: Trends and Drivers of Human-Elephant Conflicts in Coffee Agroforestry Landscapes of Kodagu, Western Ghats, India

NASA Astrophysics Data System (ADS)

Bal, P.; Nath, C. D.; Nanaya, K. M.; Kushalappa, C. G.; Garcia, C.

2011-08-01

Kodagu district produces 2% of the world's coffee, in complex, multistoried agroforestry systems. The forests of the district harbour a large population of the Asian elephant ( Elephas maximus). The combined effects of high elephant density and major landscape changes due to the expansion of coffee cultivation are the cause of human-elephant conflicts (HEC). Mitigation strategies, including electric fences and compensation schemes implemented by the Forest Department have met with limited success. Building on previous studies in the area, we assessed current spatial and temporal trends of conflict, analysed local stakeholders' perceptions and identified factors driving elephants into the estates. Our study, initiated in May 2007, shows that the intensity of HEC has increased over the last 10 years, exhibiting new seasonal patterns. Conflict maps and the lack of correlation between physical features of the coffee plantations and elephant visits suggest elephants move along corridors between the eastern and western forests of the district, opportunistically foraging when crossing the plantations. Dung analyses indicate elephants have selectively included ripe coffee berries in their diet. This is, to our knowledge, the first report of wild elephants feeding on coffee berries. If this new behaviour spreads through the population, it will compound an already severe conflict situation. The behavioural plasticity, the multiplicity of stakeholders involved, the difficulty in defining the problem and the limits of technical solutions already proposed suggest that HEC in Kodagu has the ingredients of a "wicked" problem whose resolution will require more shared understanding and problem solving work amongst the stakeholders.

A Quality Improvement Initiative to Increase Colorectal Cancer (CRC) Screening: Collaboration between a Primary Care Clinic and Research Team.

PubMed

Green, Beverly B; Fuller, Sharon; Anderson, Melissa L; Mahoney, Christine; Mendy, Peter; Powell, Susan L

2017-01-01

Multiple randomized controlled trials have demonstrated that mailed fecal testing programs are effective in increasing colorectal cancer screening participation. However, few healthcare organization in the US have Implemented such programs. Stakeholders from one clinic in an integrated healthcare system in Washington State initiated collaboration with researchers with expertise in CRC screening, aiming to increase screening rates at their clinic. Age-eligible individuals who were overdue for CRC screening and had previously completed a fecal test were randomized to receive mailed fecal immunochemical test kits (FIT) at the start of the project (Early) or 6 months later (Late). Outcomes included comparing FIT completion at 6 months by randomization group, and overall CRC screening rates at 12 months. We also assessed implementation facilitators and challenges. Overall 2,421 FIT tests were mailed at a cost of $10,739. At 6 months, FIT completion was significantly higher among the Early compared to the Late group (62% vs.47%, p <0.001). By 12 months, after both groups had received mailings, 71% in each group had completed a FIT. The clinic's overall CRC screening rate was 75.1% at baseline and 78.0% 12 months later. Key constructs associated with successful program implementation included strong stakeholder involvement, use of evidence-based strategies, simplicity, and low cost. Challenges included lack of a plan for maintaining the program. Collaboration between clinic stakeholders and researchers led to a successful project that rapidly increased CRC screening rates. However, institutional normalization of the program would be required to maintain it.

A Quality Improvement Initiative to Increase Colorectal Cancer (CRC) Screening: Collaboration between a Primary Care Clinic and Research Team

PubMed Central

Green, Beverly B.; Fuller, Sharon; Anderson, Melissa L.; Mahoney, Christine; Mendy, Peter; Powell, Susan L.

2017-01-01

Background Multiple randomized controlled trials have demonstrated that mailed fecal testing programs are effective in increasing colorectal cancer screening participation. However, few healthcare organization in the US have Implemented such programs. Methods Stakeholders from one clinic in an integrated healthcare system in Washington State initiated collaboration with researchers with expertise in CRC screening, aiming to increase screening rates at their clinic. Age-eligible individuals who were overdue for CRC screening and had previously completed a fecal test were randomized to receive mailed fecal immunochemical test kits (FIT) at the start of the project (Early) or 6 months later (Late). Outcomes included comparing FIT completion at 6 months by randomization group, and overall CRC screening rates at 12 months. We also assessed implementation facilitators and challenges. Results Overall 2,421 FIT tests were mailed at a cost of $10,739. At 6 months, FIT completion was significantly higher among the Early compared to the Late group (62% vs.47%, p <0.001). By 12 months, after both groups had received mailings, 71% in each group had completed a FIT. The clinic’s overall CRC screening rate was 75.1% at baseline and 78.0% 12 months later. Key constructs associated with successful program implementation included strong stakeholder involvement, use of evidence-based strategies, simplicity, and low cost. Challenges included lack of a plan for maintaining the program. Discussion Collaboration between clinic stakeholders and researchers led to a successful project that rapidly increased CRC screening rates. However, institutional normalization of the program would be required to maintain it. PMID:29399669

National Laboratory Planning: Developing Sustainable Biocontainment Laboratories in Limited Resource Areas

PubMed Central

Adams, Martin; Stamper, Paul D.; Dasgupta, Debanjana; Hewson, Roger; Buck, Charles D.; Richards, Allen L.; Hay, John

2016-01-01

Strategic laboratory planning in limited resource areas is essential for addressing global health security issues. Establishing a national reference laboratory, especially one with BSL-3 or -4 biocontainment facilities, requires a heavy investment of resources, a multisectoral approach, and commitments from multiple stakeholders. We make the case for donor organizations and recipient partners to develop a comprehensive laboratory operations roadmap that addresses factors such as mission and roles, engaging national and political support, securing financial support, defining stakeholder involvement, fostering partnerships, and building trust. Successful development occurred with projects in African countries and in Azerbaijan, where strong leadership and a clear management framework have been key to success. A clearly identified and agreed management framework facilitate identifying the responsibility for developing laboratory capabilities and support services, including biosafety and biosecurity, quality assurance, equipment maintenance, supply chain establishment, staff certification and training, retention of human resources, and sustainable operating revenue. These capabilities and support services pose rate-limiting yet necessary challenges. Laboratory capabilities depend on mission and role, as determined by all stakeholders, and demonstrate the need for relevant metrics to monitor the success of the laboratory, including support for internal and external audits. Our analysis concludes that alternative frameworks for success exist for developing and implementing capabilities at regional and national levels in limited resource areas. Thus, achieving a balance for standardizing practices between local procedures and accepted international standards is a prerequisite for integrating new facilities into a country's existing public health infrastructure and into the overall international scientific community. PMID:27559843

Elephants also like coffee: trends and drivers of human-elephant conflicts in coffee agroforestry landscapes of Kodagu, Western Ghats, India.

PubMed

Bal, P; Nath, C D; Nanaya, K M; Kushalappa, C G; Garcia, C

2011-05-01

Kodagu district produces 2% of the world's coffee, in complex, multistoried agroforestry systems. The forests of the district harbour a large population of the Asian elephant (Elephas maximus). The combined effects of high elephant density and major landscape changes due to the expansion of coffee cultivation are the cause of human-elephant conflicts (HEC). Mitigation strategies, including electric fences and compensation schemes implemented by the Forest Department have met with limited success. Building on previous studies in the area, we assessed current spatial and temporal trends of conflict, analysed local stakeholders' perceptions and identified factors driving elephants into the estates. Our study, initiated in May 2007, shows that the intensity of HEC has increased over the last 10 years, exhibiting new seasonal patterns. Conflict maps and the lack of correlation between physical features of the coffee plantations and elephant visits suggest elephants move along corridors between the eastern and western forests of the district, opportunistically foraging when crossing the plantations. Dung analyses indicate elephants have selectively included ripe coffee berries in their diet. This is, to our knowledge, the first report of wild elephants feeding on coffee berries. If this new behaviour spreads through the population, it will compound an already severe conflict situation. The behavioural plasticity, the multiplicity of stakeholders involved, the difficulty in defining the problem and the limits of technical solutions already proposed suggest that HEC in Kodagu has the ingredients of a "wicked" problem whose resolution will require more shared understanding and problem solving work amongst the stakeholders.

Erratum to: Elephants also like coffee: Trends and drivers of human-elephant conflicts in coffee agroforestry landscapes of Kodagu, Western Ghats, India.

PubMed

Bal, P; Nath, C D; Nanaya, K M; Kushalappa, C G; Garcia, C

2011-08-01

Kodagu district produces 2% of the world's coffee, in complex, multistoried agroforestry systems. The forests of the district harbour a large population of the Asian elephant (Elephas maximus). The combined effects of high elephant density and major landscape changes due to the expansion of coffee cultivation are the cause of human-elephant conflicts (HEC). Mitigation strategies, including electric fences and compensation schemes implemented by the Forest Department have met with limited success. Building on previous studies in the area, we assessed current spatial and temporal trends of conflict, analysed local stakeholders' perceptions and identified factors driving elephants into the estates. Our study, initiated in May 2007, shows that the intensity of HEC has increased over the last 10 years, exhibiting new seasonal patterns. Conflict maps and the lack of correlation between physical features of the coffee plantations and elephant visits suggest elephants move along corridors between the eastern and western forests of the district, opportunistically foraging when crossing the plantations. Dung analyses indicate elephants have selectively included ripe coffee berries in their diet. This is, to our knowledge, the first report of wild elephants feeding on coffee berries. If this new behaviour spreads through the population, it will compound an already severe conflict situation. The behavioural plasticity, the multiplicity of stakeholders involved, the difficulty in defining the problem and the limits of technical solutions already proposed suggest that HEC in Kodagu has the ingredients of a "wicked" problem whose resolution will require more shared understanding and problem solving work amongst the stakeholders.

A hybrid health service accreditation program model incorporating mandated standards and continuous improvement: interview study of multiple stakeholders in Australian health care.

PubMed

Greenfield, David; Hinchcliff, Reece; Hogden, Anne; Mumford, Virginia; Debono, Deborah; Pawsey, Marjorie; Westbrook, Johanna; Braithwaite, Jeffrey

2016-07-01

The study aim was to investigate the understandings and concerns of stakeholders regarding the evolution of health service accreditation programs in Australia. Stakeholder representatives from programs in the primary, acute and aged care sectors participated in semi-structured interviews. Across 2011-12 there were 47 group and individual interviews involving 258 participants. Interviews lasted, on average, 1 h, and were digitally recorded and transcribed. Transcriptions were analysed using textual referencing software. Four significant issues were considered to have directed the evolution of accreditation programs: altering underlying program philosophies; shifting of program content focus and details; different surveying expectations and experiences and the influence of external contextual factors upon accreditation programs. Three accreditation program models were noted by participants: regulatory compliance; continuous quality improvement and a hybrid model, incorporating elements of these two. Respondents noted the compatibility or incommensurability of the first two models. Participation in a program was reportedly experienced as ranging on a survey continuum from "malicious compliance" to "performance audits" to "quality improvement journeys". Wider contextual factors, in particular, political and community expectations, and associated media reporting, were considered significant influences on the operation and evolution of programs. A hybrid accreditation model was noted to have evolved. The hybrid model promotes minimum standards and continuous quality improvement, through examining the structure and processes of organisations and the outcomes of care. The hybrid model appears to be directing organisational and professional attention to enhance their safety cultures. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

2009 Community Involvement Training Conference

EPA Pesticide Factsheets

A dynamic training conference that brings together more than 450 people from EPA and the Agency’s partners and stakeholders who plan and implement environmental community involvement, partnership, stewardship, outreach, and education programs.

2011 Community Involvement Training Conference

EPA Pesticide Factsheets

A dynamic training conference that brings together more than 450 people from EPA and the Agency’s partners and stakeholders who plan and implement environmental community involvement, partnership, stewardship, outreach, and education programs.

2006 Community Involvement Training Conference

EPA Pesticide Factsheets

A dynamic training conference that brings together more than 450 people from EPA and the Agency’s partners and stakeholders who plan and implement environmental community involvement, partnership, stewardship, outreach, and education programs.

2013 Community Involvement Training Conference

EPA Pesticide Factsheets

A dynamic training conference that brings together more than 450 people from EPA and the Agency’s partners and stakeholders who plan and implement environmental community involvement, partnership, stewardship, outreach, and education programs.

2007 Community Involvement Training Conference

EPA Pesticide Factsheets

A dynamic training conference that brings together more than 450 people from EPA and the Agency’s partners and stakeholders who plan and implement environmental community involvement, partnership, stewardship, outreach, and education programs.

The Use of Participatory Action Research within Education--Benefits to Stakeholders

ERIC Educational Resources Information Center

Jacobs, Steven

2016-01-01

This paper offers a brief history and the characteristics of the research methodology known as Participatory Action Research (PAR). This paper also states how PAR can be utilized within an educational environment and describes the benefits to all stakeholders such as teachers and students when they are involved in a research project using PAR as…

Key Characteristics of Collaborative Leadership in Elementary Schools: Understanding the Perceptions of Principals and Teachers

ERIC Educational Resources Information Center

Vitale, Margaret Elizabeth

2017-01-01

Collaborative leadership is a process of leadership that allows all stakeholders to be actively involved in the decision-making process. This leadership process incorporates the perspectives and insight of the stakeholders in order to sustain effective change. The review of the literature expresses that leadership within the organization must have…

How Do Stakeholders Engaged in School-University Partnerships Create Value for Their Own Organizations?

ERIC Educational Resources Information Center

Cuppett, Kevin S.

2014-01-01

The purpose of this study was to determine how stakeholders engaged in school-university partnerships, specifically in the work preparing future school administrators, created and captured value for their own organizations. These case studies examined three partnerships that involved three school systems who all partnered with the same college,…

Involvement of Heads of Departments in Strategic Planning in Schools in the Pinetown District

ERIC Educational Resources Information Center

Myende, Phumlani E.; Bhengu, Thamsanqa

2015-01-01

Strategic planning is crucial in facilitating sustainable development of schools. It enables schools to survive and cope with changes and challenges from government policies and market forces. There is broad agreement that all stakeholders need to be part of school strategic planning. In response to the lack of evidence suggesting stakeholders'…

Core Outcome Set-STAndards for Development: The COS-STAD recommendations.

PubMed

Kirkham, Jamie J; Davis, Katherine; Altman, Douglas G; Blazeby, Jane M; Clarke, Mike; Tunis, Sean; Williamson, Paula R

2017-11-01

The use of core outcome sets (COS) ensures that researchers measure and report those outcomes that are most likely to be relevant to users of their research. Several hundred COS projects have been systematically identified to date, but there has been no formal quality assessment of these studies. The Core Outcome Set-STAndards for Development (COS-STAD) project aimed to identify minimum standards for the design of a COS study agreed upon by an international group, while other specific guidance exists for the final reporting of COS development studies (Core Outcome Set-STAndards for Reporting [COS-STAR]). An international group of experienced COS developers, methodologists, journal editors, potential users of COS (clinical trialists, systematic reviewers, and clinical guideline developers), and patient representatives produced the COS-STAD recommendations to help improve the quality of COS development and support the assessment of whether a COS had been developed using a reasonable approach. An open survey of experts generated an initial list of items, which was refined by a 2-round Delphi survey involving nearly 250 participants representing key stakeholder groups. Participants assigned importance ratings for each item using a 1-9 scale. Consensus that an item should be included in the set of minimum standards was defined as at least 70% of the voting participants from each stakeholder group providing a score between 7 and 9. The Delphi survey was followed by a consensus discussion with the study management group representing multiple stakeholder groups. COS-STAD contains 11 minimum standards that are the minimum design recommendations for all COS development projects. The recommendations focus on 3 key domains: the scope, the stakeholders, and the consensus process. The COS-STAD project has established 11 minimum standards to be followed by COS developers when planning their projects and by users when deciding whether a COS has been developed using reasonable methods.

Stakeholders' perception on the organization of chronic care: a SWOT analysis to draft avenues for health care reforms.

PubMed

Van Durme, Thérèse; Macq, Jean; Anthierens, Sibyl; Symons, Linda; Schmitz, Olivier; Paulus, Dominique; Van den Heede, Koen; Remmen, Roy

2014-04-18

Adequate care for individuals living with chronic illnesses calls for a healthcare system redesign, moving from acute, disease-centered to patient-centered models. The aim of this study was to identify Belgian stakeholders' perceptions on the strengths, weaknesses, opportunities and threats of the healthcare system for people with chronic diseases in Belgium. Four focus groups were held with stakeholders from the micro and meso level, in addition to two interviews with stakeholders who could not attend the focus group sessions. Data collection and the discussion were based on the Chronic Care model. Thematic analysis of the transcripts allowed for the identification of the strengths, weaknesses, opportunities and threats of the current health care system with focus on chronic care. Informants stressed the overall good quality of the acute health care system and the level of reimbursement of care as an important strength of the current system. In contrast, the lack of integration of care was identified as one of the biggest weaknesses of today's health care system, along with the unclear definitions of the roles and functions of health professionals involved in care processes. Patient education to support self-management exists for patients with diabetes and/or terminal kidney failure but not for those living with other or multiple chronic conditions. The current overall fee-for-service system is a barrier to integrated care, as are the lack of incentives for integrated care. Attending multidisciplinary meetings, for example, is underfinanced to date. Finally, clinical information systems lack interoperability, which further impedes the information flow across settings and disciplines. Our study's methods allowed for the identification of problematic domains in the health system for people living with chronic conditions. These findings provided useful insights surrounding perceived priorities. This methodology may inspire other countries faced with the challenge of drafting reforms to tackle the issue of chronic care.

Evaluating stakeholder participation in water management: intermediary outcomes as potential indicators for future resource management outcomes

NASA Astrophysics Data System (ADS)

Carr, Gemma; Bloeschl, Guenter; Loucks, Daniel Pete

2013-04-01

Evaluation of participation programmes, projects and activities is essential to identify whether stakeholder involvement has been successful in achieving its aims. Aims may include an improvement in water resource management such as enhanced ecological functioning, an improvement in human wellbeing and economic conditions, or overcoming a conflict between interest groups. Evaluating against "interest-based" resource management criteria requires that a desirable outcome can be identified, agreed upon and be measured at the time of evaluation. In many water management situations where collaborative approaches are applied, multiple interests and objectives are present, or stakeholders have not yet identified their own positions and priorities. Even if a resource management objective has been identified and strategy agreed upon, resource management changes tend to emerge over longer timescales and evaluation frequently takes place before they can be recognised. Evaluating against resource management criteria may lead evaluators to conclude that a programme has failed because it has not achieved a resource management objective at the time of evaluation. This presents a critical challenge to researchers assessing the effectiveness of stakeholder participation programmes. One strategy to overcome this is to conduct "goal-free" evaluation to identify what the programme is actually achieving. An evaluation framework that includes intermediary outcomes that are both tangible achievements such as innovation, creation of new organisations, and shared information and knowledge, as well as intangible achievements such as trust and network development can be applied to more broadly assess a programme's success. Analysis of case-studies in the published literature for which a resource management outcome has been achieved shows that intermediary outcomes frequently precede resource management outcomes. They seem to emerge over shorter timescales than resource management outcomes. Furthermore, failure to achieve intermediary outcomes correlates to failure to achieve resource management outcomes. Evaluating intermediary outcomes leads to both a broader assessment of a programme's achievements at the time of evaluation, and can indicate whether a programme will go on to achieve resource management objectives in the future.

How can the struggling research community adapt to the information age?

NASA Astrophysics Data System (ADS)

Bouma, Johan

2017-04-01

The widespread use of internet and social media has fundamentally changed the relationship of research with society culminating in :"fact-free politics". Rather than operate from the position of distant experts who are graciously willing to serve mankind, expecting gratitude and admiration in return, scientists encounter knowledgeable stakeholders realizing :"citizen science". Some see science as just producing :"yet another opinion". It is time now to re-establish and advocate the basic power of the scientific effort, involving stakeholders systematically, by: analysing a problem, shaping it into a researchable item, applying scientifically sound data and methods, testing results statistically and presenting results, realizing that "the" truth does not exist. The seventeen UN Sustainable Development Goals (SDG's) provide an attractive focus for inter- and transdisciplinary research approaches defining a series of options covering several SDG's in a system's analysis. Involved stakeholders and policy makers remain responsible to select their favorite option.

Multiple-level stakeholder engagement in malaria clinical trials: addressing the challenges of conducting clinical research in resource-limited settings.

PubMed

Mtove, George; Kimani, Joshua; Kisinza, William; Makenga, Geofrey; Mangesho, Peter; Duparc, Stephan; Nakalembe, Miriam; Phiri, Kamija S; Orrico, Russell; Rojo, Ricardo; Vandenbroucke, Pol

2018-03-22

Multinational clinical trials are logistically complex and require close coordination between various stakeholders. They must comply with global clinical standards and are accountable to multiple regulatory and ethical bodies. In resource-limited settings, it is challenging to understand how to apply global clinical standards to international, national, and local factors in clinical trials, making multiple-level stakeholder engagement an important element in the successful conduct of these clinical trials. During the planning and implementation of a large multinational clinical trial for intermittent preventive treatment of malaria in pregnancy in resource-limited areas of sub-Saharan Africa, we encountered numerous challenges, which required implementation of a range of engagement measures to ensure compliance with global clinical and regulatory standards. These challenges included coordination with ongoing global malaria efforts, heterogeneity in national regulatory structures, sub-optimal healthcare infrastructure, local practices and beliefs, and perspectives that view healthcare providers with undue trust or suspicion. In addition to engagement with international bodies, such as the World Health Organization, the Malaria in Pregnancy Consortium, the Steve Biko Centre for Bioethics, and the London School of Hygiene and Tropical Medicine, in order to address the challenges just described, Pfizer Inc. and Medicines for Malaria Venture (the "Sponsoring Entities" for these studies) and investigators liaised with national- and district-level stakeholders such as health ministers and regional/local community health workers. Community engagement measures undertaken by investigators included local meetings with community leaders to explain the research aims and answer questions and concerns voiced by the community. The investigators also engaged with family members of prospective trial participants in order to be sensitive to local practices and beliefs. Engagement with key stakeholders at international and national levels enabled the Sponsoring Entities to address challenges by aligning the study design with the requirements of health and regulatory agencies and to understand and address healthcare infrastructure needs prior to trial initiation. Local stakeholder engagement, including community members, study participants, and family enabled the investigators to address challenges by ensuring that study design and conduct were adapted to local considerations and ensuring accurate information about the study aims was shared with the public. ClinicalTrials.gov, ID: NCT01103063 . Registered on 7 April 2010.

Stakeholder interaction within the ERICA Integrated Approach.

PubMed

Zinger, I; Oughton, D H; Jones, S R

2008-09-01

Within the ERICA project, stakeholder involvement has been addressed within three main areas: generic interactions throughout the project, specific consultation by means of attendance to events and considerations as part of the ERICA Integrated Approach and Assessment Tool. The word stakeholders meant namely any individual or group who may be affected by or have an interest in an issue, and to include experts, lay-people and the public. An End-Users-Group (EUG) was set up to facilitate the two-way dialogue between the ERICA Consortium and stakeholders. The ERICA EUG consisted of representatives of 60 organisations ranging from regulatory bodies, national advisory bodies, academia, non-governmental organisations, industry, consultants and inter-governmental organisations. Stakeholder interaction was included from the very start of the project. Inputs from the EUG were recorded and in most instances incorporated within the development of the project and thus influenced and helped to shape some of the ERICA deliverables.

The Regional Advisory Councils: what is their potential to incorporate stakeholder knowledge into fisheries governance?

PubMed

Linke, Sebastian; Dreyer, Marion; Sellke, Piet

2011-03-01

The protection of the Baltic Sea ecosystem is exacerbated by the social, environmental and economic complexities of governing European fisheries. Increased stakeholder participation and knowledge integration are suggested to improve the EU's Common Fisheries Policy (CFP), suffering from legitimacy, credibility and compliance problems. As a result, the CFP was revised in 2002 to involve fisheries representatives, NGOs and other stakeholders through so called Regional Advisory Councils (RACs) in the policy process. We address the RAC's task to incorporate stakeholder knowledge into the EU's fisheries governance system in empirical and theoretical perspectives. Drawing on a four-stage governance concept we subsequently suggest that a basic problem is a mismatch between participation purpose (knowledge inclusion) and the governance stage at which RACs are formally positioned (evaluation of management proposals). We conclude that, if the aim is to broaden the knowledge base of fisheries management, stakeholders need to be included earlier in the governance process.

Methods for Engaging Stakeholders in Comparative Effectiveness Research: A Patient-Centered Approach to Improving Diabetes Care

PubMed Central

Schmittdiel, Julie A.; Desai, Jay; Schroeder, Emily B.; Paolino, Andrea R.; Nichols, Gregory A.; Lawrence, Jean M.; O’Connor, Patrick J.; Ohnsorg, Kris A.; Newton, Katherine M.; Steiner, John F.

2016-01-01

ABSTRACT/Implementation Lessons Engaging stakeholders in the research process has the potential to improve quality of care and the patient care experience.Online patient community surveys can elicit important topic areas for comparative effectiveness research.Stakeholder meetings with substantial patient representation, as well as representation from health care delivery systems and research funding agencies, are a valuable tool for selecting and refining pilot research and quality improvement projects.Giving patient stakeholders a deciding vote in selecting pilot research topics helps ensure their ‘voice’ is heard.Researchers and health care leaders should continue to develop best-practices and strategies for increasing patient involvement in comparative effectiveness and delivery science research. PMID:26179728

Design and efficacy of an Ecohealth competency-based course on the prevention and control of vector diseases in Latin America.

PubMed

Magaña-Valladares, Laura; Rodríguez, Mario Henry; Betanzos-Reyes, Ángel Francisco; Riojas-Rodríguez, Horacio; Quezada-Jiménez, María Laura; Suárez-Conejero, Juana Elvira; Lamadrid-Figueroa, Héctor

2018-01-01

To design and analyze the efficacy of an Ecohealth competency-based course on the prevention and control of vector-borne-diseases for specific stakeholders. Multiple stakeholders and sectors of the region were consulted to identify Ecohealth group-specific competencies using an adjusted analysis matrix. Eight courses based on the competencies were implemented to train EA tutors. The effectiveness of the course was evaluated through the use of paired- t-tests by intervention group. Strategic, tactical, academia and community stakeholder groups and their competencies were identified. An overall gain of 43 percentage points (p<0.001) was observed in terms of competencies score in trained tutors, which further trained 1 033 people. The identification of the stakeholders and their competencies proved to be useful to guide training courses to significantly improve the initial competencies and create a critical mass to further advance the EA in the region.

Sustaining Public Involvement in Long Range Planning Using a Stakeholder Based Process: A Case Study from Eugene-Springfield ,Oregon

DOT National Transportation Integrated Search

1998-09-16

The Intermodal Surface Transportation Efficiency Act requires a proactive : public involvement process that provides complete information, timely public : notice, full public access to key decisions, and supports early and continuing : involvement of...

Policy and practice of work ability: a negotiation of responsibility in organizing return to work.

PubMed

Seing, Ida; Ståhl, Christian; Nordenfelt, Lennart; Bülow, Pia; Ekberg, Kerstin

2012-12-01

In welfare policy and practical work it is unclear what the concept of work ability involves and assessments may be different among involved actors, partly due to a lack of theoretical research in relation to regulations and practice. Based on theoretical and legal aspects of work ability the aim of the study is to analyze stakeholders' perspectives on work ability in local practice by studying multi-stakeholder meetings. The material comprises nine digitally recorded multi-stakeholder meetings. Apart from the sick-listed individual, representatives from the public Social Insurance Agency, health care, employers, public employment service and the union participated in the meeting. The material was analyzed using qualitative content analysis. Three perspectives on work ability were identified: a medical perspective, a workplace perspective and a regulatory perspective. The meetings developed into negotiations of responsibility concerning workplace adjustments, rehabilitation efforts and financial support. Medical assessments served as objective expert statements to legitimize stakeholders' perspectives on work ability and return to work. Although the formal goal of the status meeting was to facilitate stakeholder collaboration, the results demonstrates an unequal distribution of power among cooperating actors where the employers had the "trump card" due to their possibilities to offer workplace adjustments. The employer perspective often determined whether or not persons could return to work and if they had work ability.

Stakeholder engagement: a key component of integrating genomic information into electronic health records

PubMed Central

Hartzler, Andrea; McCarty, Catherine A.; Rasmussen, Luke V.; Williams, Marc S.; Brilliant, Murray; Bowton, Erica A.; Clayton, Ellen Wright; Faucett, William A.; Ferryman, Kadija; Field, Julie R.; Fullerton, Stephanie M.; Horowitz, Carol R.; Koenig, Barbara A.; McCormick, Jennifer B.; Ralston, James D.; Sanderson, Saskia C.; Smith, Maureen E.; Trinidad, Susan Brown

2014-01-01

Integrating genomic information into clinical care and the electronic health record can facilitate personalized medicine through genetically guided clinical decision support. Stakeholder involvement is critical to the success of these implementation efforts. Prior work on implementation of clinical information systems provides broad guidance to inform effective engagement strategies. We add to this evidence-based recommendations that are specific to issues at the intersection of genomics and the electronic health record. We describe stakeholder engagement strategies employed by the Electronic Medical Records and Genomics Network, a national consortium of US research institutions funded by the National Human Genome Research Institute to develop, disseminate, and apply approaches that combine genomic and electronic health record data. Through select examples drawn from sites of the Electronic Medical Records and Genomics Network, we illustrate a continuum of engagement strategies to inform genomic integration into commercial and homegrown electronic health records across a range of health-care settings. We frame engagement as activities to consult, involve, and partner with key stakeholder groups throughout specific phases of health information technology implementation. Our aim is to provide insights into engagement strategies to guide genomic integration based on our unique network experiences and lessons learned within the broader context of implementation research in biomedical informatics. On the basis of our collective experience, we describe key stakeholder practices, challenges, and considerations for successful genomic integration to support personalized medicine. PMID:24030437

How do stakeholders from multiple hierarchical levels of a large provincial health system define engagement? A qualitative study.

PubMed

Norris, Jill M; White, Deborah E; Nowell, Lorelli; Mrklas, Kelly; Stelfox, Henry T

2017-08-01

Engaging stakeholders from varied organizational levels is essential to successful healthcare quality improvement. However, engagement has been hard to achieve and to measure across diverse stakeholders. Further, current implementation science models provide little clarity about what engagement means, despite its importance. The aim of this study was to understand how stakeholders of healthcare improvement initiatives defined engagement. Participants (n = 86) in this qualitative thematic study were purposively sampled for individual interviews. Participants included leaders, core members, frontline clinicians, support personnel, and other stakeholders of Strategic Clinical Networks in Alberta Health Services, a Canadian provincial health system with over 108,000 employees. We used an iterative thematic approach to analyze participants' responses to the question, "How do you define engagement?" Regardless of their organizational role, participants defined engagement through three interrelated themes. First, engagement was active participation from willing and committed stakeholders, with levels that ranged from information sharing to full decision-making. Second, engagement centered on a shared decision-making process about meaningful change for everyone "around the table," those who are most impacted. Third, engagement was two-way interactions that began early in the change process, where exchanges were respectful and all stakeholders felt heard and understood. This study highlights the commonalities of how stakeholders in a large healthcare system defined engagement-a shared understanding and terminology-to guide and improve stakeholder engagement. Overall, engagement was an active and committed decision-making about a meaningful problem through respectful interactions and dialog where everyone's voice is considered. Our results may be used in conjunction with current implementation models to provide clarity about what engagement means and how to engage various stakeholders.

HIA, the next step: Defining models and roles

DOE Office of Scientific and Technical Information (OSTI.GOV)

Putters, Kim

If HIA is to be an effective instrument for optimising health interests in the policy making process it has to recognise the different contests in which policy is made and the relevance of both technical rationality and political rationality. Policy making may adopt a rational perspective in which there is a systematic and orderly progression from problem formulation to solution or a network perspective in which there are multiple interdependencies, extensive negotiation and compromise, and the steps from problem to formulation are not followed sequentially or in any particular order. Policy problems may be simple with clear causal pathways andmore » responsibilities or complex with unclear causal pathways and disputed responsibilities. Network analysis is required to show which stakeholders are involved, their support for health issues and the degree of consensus. From this analysis three models of HIA emerge. The first is the phases model which is fitted to simple problems and a rational perspective of policymaking. This model involves following structured steps. The second model is the rounds (Echternach) model that is fitted to complex problems and a network perspective of policymaking. This model is dynamic and concentrates on network solutions taking these steps in no particular order. The final model is the 'garbage can' model fitted to contexts which combine simple and complex problems. In this model HIA functions as a problem solver and signpost keeping all possible solutions and stakeholders in play and allowing solutions to emerge over time. HIA models should be the beginning rather than the conclusion of discussion the worlds of HIA and policymaking.« less

A spatial web/agent-based model to support stakeholders' negotiation regarding land development.

PubMed

Pooyandeh, Majeed; Marceau, Danielle J

2013-11-15

Decision making in land management can be greatly enhanced if the perspectives of concerned stakeholders are taken into consideration. This often implies negotiation in order to reach an agreement based on the examination of multiple alternatives. This paper describes a spatial web/agent-based modeling system that was developed to support the negotiation process of stakeholders regarding land development in southern Alberta, Canada. This system integrates a fuzzy analytic hierarchy procedure within an agent-based model in an interactive visualization environment provided through a web interface to facilitate the learning and negotiation of the stakeholders. In the pre-negotiation phase, the stakeholders compare their evaluation criteria using linguistic expressions. Due to the uncertainty and fuzzy nature of such comparisons, a fuzzy Analytic Hierarchy Process is then used to prioritize the criteria. The negotiation starts by a development plan being submitted by a user (stakeholder) through the web interface. An agent called the proposer, which represents the proposer of the plan, receives this plan and starts negotiating with all other agents. The negotiation is conducted in a step-wise manner where the agents change their attitudes by assigning a new set of weights to their criteria. If an agreement is not achieved, a new location for development is proposed by the proposer agent. This process is repeated until a location is found that satisfies all agents to a certain predefined degree. To evaluate the performance of the model, the negotiation was simulated with four agents, one of which being the proposer agent, using two hypothetical development plans. The first plan was selected randomly; the other one was chosen in an area that is of high importance to one of the agents. While the agents managed to achieve an agreement about the location of the land development after three rounds of negotiation in the first scenario, seven rounds were required in the second scenario. The proposed web/agent-based model facilitates the interaction and learning among stakeholders when facing multiple alternatives. Copyright © 2013 Elsevier Ltd. All rights reserved.

A Quality, Benefit, Cost, and Financial Framework for Health Information Technology, E-Prescribing: A Delphi Study.

PubMed

DeMuro, Paul R; Ash, Joan; Middleton, Blackford; Fletcher, Justin; Madison, Cecelia J

2017-01-01

Little research has been conducted about the quality, benefits, costs, and financial considerations associated with health information technology (HIT), particularly informatics technologies, such as e-prescribing, from the perspective of all its stakeholders. This research effort sought to identify the stakeholders involved in e-prescribing and to identify and rank-order the positives and the negatives from the perspective of the stakeholders to create a framework to assist in the development of incentives and payment mechanisms which result in better managed care. The Delphi method was employed by enlisting a panel of experts. They were presented with the results of initial research in an online survey of questions which sought to prioritize the quality, benefit, cost, and financial effects of e-prescribing from the perspective of each stakeholder. From the results of this study, a framework was presented to framework experts. The experts added stakeholders and positives and negatives to the initial lists and rank-ordered the positives and negatives of e-prescribing from the perspective of each stakeholder. The aggregate results were summarized by category of stakeholder. The framework experts evaluated the framework. Positives and negatives can be rank-ordered from the perspective of each stakeholder. A useful framework was created.

School Communications 2.0: A Social Media Strategy for K-12 Principals and Superintendents

ERIC Educational Resources Information Center

Cox, Daniel Dean

2012-01-01

The purpose of this qualitative, multiple-case study was two-fold: 1) to describe, analyze, and interpret the experiences of school principals and superintendents who use multiple social media tools such as blogs, microblogs, social networking sites, podcasts, and online videos with stakeholders as part of their comprehensive communications…

Multiple Perspectives on the State-Mandated Implementation of a High-Stakes Performance Assessment for Preservice English Teacher Candidates

ERIC Educational Resources Information Center

Chandler-Olcott, Kelly; Fleming, Sarah

2017-01-01

Drawing on situated learning and communities of practice, this teacher-research study examined multiple stakeholders' perspectives about the purpose, design, and inaugural implementation of the edTPA, a teacher performance assessment mandated for state certification. Participants included teacher candidates, mentor teachers, a field placement…

Interactive and Participatory Decision Support: Linking Cyberinfrastructure, Multi-Touch Interfaces, and Substantive Dialogue for Geothermal Systems

NASA Astrophysics Data System (ADS)

Malin, R.; Pierce, S. A.; Bass, B. J.

2012-12-01

Socio-technical approaches to complex, ill-structured decision problems are needed to identify adaptive responses for earth resource management. This research presents a hybrid approach to create decision tools and engender dialogue among stakeholders for geothermal development in Idaho, United States and El Tatio, Chile. Based on the scarcity of data, limited information availability, and tensions across stakeholder interests we designed and constructed a decision support model that allows stakeholders to rapidly collect, input, and visualize geoscientific data to assess geothermal system impacts and possible development strategies. We have integrated this decision support model into multi-touch interfaces that can be easily used by scientists and stakeholders alike. This toolkit is part of a larger cyberinfrastructure project designed to collect and present geoscientific information to support decision making processes. Consultation with stakeholders at the El Tatio geothermal complex of northern Chile—indigenous communities, local and national government agencies, developers, and geoscientists - informed the implementation of a sustained dialogue process. The El Tatio field case juxtaposes basic parameters such as pH, spring temperature, geochemical content, and FLIR imagery with stakeholder perceptions of risks due to mineral extraction and energy exploration efforts. The results of interviews and a participatory workshop are driving the creation of three initiatives within an indigenous community group; 1) microentrepreneurial efforts for science-based tourism, 2) design of a citizen-led environmental monitoring network in the Altiplano, and 3) business planning for an indigenous renewable energy cooperative. This toolkit is also being applied in the Snake River Plain of Idaho has as part of the DOE sponsored National Student Geothermal Competition. The Idaho case extends results from the Chilean case to implement a more streamlined system to analyze geothermal resource potential as well as integrate the decision support system with multi-touch interfaces which allow multiple stakeholders to view and interact with data. Beyond visual and tactile appeal, these interfaces also allow participants to dynamically update decision variables and decision preferences to create multiple scenarios and evaluate potential outcomes. Through this interactive scenario building, potential development sites can be targeted and stakeholders can interact with data to engage in substantive dialogue for related long-term planning or crisis response.

A Case Study on the Personal Constructs of How Stakeholders of a Regional Alternative Day School Facility Make Meaning of the Physical Plant

ERIC Educational Resources Information Center

Schultz, Penny D.

2011-01-01

This case study involved an examination of stakeholders' (parents, community members, staff members, students) perceptions of how they made meaning of a regional alternative day school located in the Commonwealth of Virginia. Individual interviews were conducted with the parents, community members, and students. One focus group interview was…

Use of Concept Mapping To Integrate the Different Perspectives of Designers and Other Stakeholders in the Development of E-Learning Materials.

ERIC Educational Resources Information Center

Hughes, Gwyneth; Hay, David

2001-01-01

Discussion of multidisciplinary teams and stakeholders involved in the production of electronic learning materials focuses on a constructivist methodology for course design. Explains concept mapping that provided the basis for an electronic learning development project at the University of Surrey (United Kingdom) and includes examples of concept…

Slash and Learn: Revealing Stakeholder Knowledge, Support, and Preferred Communication Methods Relative to Wood-Based Biofuels Projects

ERIC Educational Resources Information Center

Moroney, Jillian; Laninga, Tamara; Brooks, Randall

2016-01-01

The Northwest Advanced Renewables Alliance (NARA) is examining the feasibility of a woody biomass-to-biofuels supply chain in Idaho, Montana, Oregon, and Washington. A part of the ongoing feasibility study involved conducting a survey of informed stakeholders on the use of woody biomass from forest residuals in producing sustainable bioenergy.…

Building capacity in Australian interprofessional health education: perspectives from key health and higher education stakeholders.

PubMed

Matthews, Lynda R; Pockett, Rosalie B; Nisbet, Gillian; Thistlethwaite, Jill E; Dunston, Roger; Lee, Alison; White, Jill F

2011-05-01

A substantial literature engaging with the directions and experiences of stakeholders involved in interprofessional health education exists at the international level, yet almost nothing has been published that documents and analyses the Australian experience. Accordingly, this study aimed to scope the experiences of key stakeholders in health and higher education in relation to the development of interprofessional practice capabilities in health graduates in Australia. Twenty-seven semi-structured interviews and two focus groups of key stakeholders involved in the development and delivery of interprofessional health education in Australian higher education were undertaken. Interview data were coded to identify categories that were organised into key themes, according to principles of thematic analysis. Three themes were identified: the need for common ground between health and higher education, constraints and enablers in current practice, and the need for research to establish an evidence base. Five directions for national development were also identified. The study identified a range of interconnected changes that will be required to successfully mainstream interprofessional education within Australia, in particular, the importance of addressing issues of culture change and the need for a nationally coordinated and research informed approach. These findings reiterate those found in the international literature.

Evaluation utilization research--developing a theory and putting it to use.

PubMed

Neuman, Ari; Shahor, Neria; Shina, Ilan; Sarid, Anat; Saar, Zehava

2013-02-01

This article presents the findings of a two-stage study that had two key objectives: to develop a theory about evaluation utilization in an educational organization and to apply this theory to promote evaluation utilization within the organization. The first stage involved a theoretical conceptualization using a participatory method of concept mapping. This process identified the modes of evaluation utilization within the organization, produced a representation of the relationship between them and led to a theory. The second stage examined the practical implications of this conceptualization in terms of how different stakeholders in the organization perceive the actual and preferable state of evaluation utilization within the organization (i.e. to what extent is evaluation utilized and to what extent should it be utilized). The participatory process of the study promoted the evaluation utilization by involving stakeholders, thus giving them a sense of ownership and improving communication between the evaluation unit and the stakeholders. In addition, understanding the evaluation needs of the stakeholders in the organization helped generate relevant and realizable evaluation processes. On a practical level, the results are currently shaping the evaluation plan and the place of evaluations within the organization. Copyright © 2012 Elsevier Ltd. All rights reserved.

Identifying perceptions of academic reform in pharmacy using a four-frame organizational change model.

PubMed

Bajis, Dalia; Chaar, Betty; Basheti, Iman A; Moles, Rebekah

2017-11-10

In an ever-changing environment, pharmacy education is in the race to catch up and excel to produce competent pharmacists. Examining academic institutions, including schools of pharmacy, their internal systems and framework, it seems appropriate to view these institutions using multiple lenses. Bolman and Deal conceptualized a method to examine organizations using four constructs (structural, human resource, political, and symbolic). The Eastern Mediterranean Region (EMR), with deep-rooted pharmacy education and practice was the setting for this research. To explore factors affecting academic reform in undergraduate pharmacy education in the EMR from stakeholders' and students' perspectives; and to apply Bolman and Deal's four-frame organizational change model to explore how these issues might be viewed. A multiple-method approach was employed and involved collecting, analyzing and integrating qualitative semi-structured interview data with open-ended questions in a survey. Cross-sector stakeholder sample from various EMR countries was recruited and interviewed. Final year pharmacy students from one school of pharmacy in Jordan were surveyed. Emergent themes were indicative that academic reform was addressed by all frames of the Bolman and Deal model. Structural and political frames received substantial weighing pointing to the importance of curricular reform, collaboration and leadership. A need for skillful and role-model teaching academic staff was highlighted, and in harmony with the human resource frame. Issues within the symbolic frame were readily apparent in the data and spanned the other three frames in relation to heritage, customs and cultural barriers. Issues pertinent to academic reform in pharmacy were presented. Viewing change in pharmacy schools from multiple perspectives highlighted the need for structural changes to pharmacy programs, human resource management, political will, leadership, and collaboration. The importance of understanding cultural aspects of organizations is critical as it is these that provide identity to any organization and help reformers better manage change. Copyright © 2017 Elsevier Inc. All rights reserved.

Integration: valuing stakeholder input in setting priorities for socially sustainable egg production.

PubMed

Swanson, J C; Lee, Y; Thompson, P B; Bawden, R; Mench, J A

2011-09-01

Setting directions and goals for animal production systems requires the integration of information achieved through internal and external processes. The importance of stakeholder input in setting goals for sustainable animal production systems should not be overlooked by the agricultural animal industries. Stakeholders play an integral role in setting the course for many aspects of animal production, from influencing consumer preferences to setting public policy. The Socially Sustainable Egg Production Project (SSEP) involved the development of white papers on various aspects of egg production, followed by a stakeholder workshop to help frame the issues for the future of sustainable egg production. Representatives from the environmental, food safety, food retail, consumer, animal welfare, and the general farm and egg production sectors participated with members of the SSEP coordination team in a 1.5-d workshop to explore socially sustainable egg production. This paper reviews the published literature on values integration methodologies and the lessons learned from animal welfare assessment models. The integration method used for the SSEP stakeholder workshop and its outcome are then summarized. The method used for the SSEP stakeholder workshop can be used to obtain stakeholder input on sustainable production in other farm animal industries.

Restoration of degraded drylands in northern Chile: The need of local stakeholders' participation to prevent and combat desertification

NASA Astrophysics Data System (ADS)

Jorquera-Jaramillo, Carmen; Yáñez-Acevedo, Marcia; Gutiérrez, Julio R.; Cortés-Bugueño, José Luis; Pastén-Marambio, Víctor; Barraza-Cepeda, Claudia

2015-04-01

Desertification is one of the main factors determining poverty, long-term socio-economic problems, natural resources depletion and disturbances in rural communities living at the Coquimbo Region drylands (North-Central Chile). The Chilean State, along with private initiatives, have invested 473.6 Million dollars (1976 to 2008) to recover degraded areas through afforestation and soil management of 1,373,758 hectares. However, there is no information about the impact of the practices and changes experienced by the local stakeholders. Therefore, there is a need for a comprehensive evaluation considering both socioeconomic and biophysical aspects. To this end, a Protocol on Integrated Assessment (IAPro, PRACTICE project) was applied in two rural communities, involving communal afforested sites and their adjacent degraded drylands: El Sauce (ES, Limarí province) and Las Cañas (LC, Choapa province), Coquimbo Region. Participatory afforestation and soil conservation projects were implemented at both sites by the Chilean National Forestry Service (CONAF) in agreement with each local community (Jiménez y Tapia Agricultural Community at ES and Las Cañas de Choapa Peasant's Community at LC). The protocol involved 7 steps: (1) Stakeholder platform identification and engagement; (2) Baseline assessment and selection of site-specific indicators; (3) Integration and weighting of common and site-specific indicators; (4) Data collection; (5) Integrating and perspectives on a MCDA (Multi-Criteria Decision Analysis); (6) Collective Integrated assessment and knowledge sharing; (7) Dissemination. Interviews involved local and institutional stakeholders related to both sites' implementation, administration and/or local impacts. For the ES site, 5 actions were defined and assessed: No action (control); fences; mechanic and biological practices (soil stabilization, runoff control on slopes); runoff control in micro-basins, gullies and ravines; and footpath for educational and demonstration purposes. The same actions plus 'conservation and management of native forests/shrubs at strict exclosure' were identified at LC site. All of the stakeholders interviewed at both sites recognized the actions, but not all of them had specific knowledge about some of the practices. Afforestation was the most selected and valued practice, revealing deep knowledge about the actions and positive valuation of the site experience, but also a need of more support for maintenance. At ES, the main concerns were drought and derived unemployment; at LC, the main concerns were access to the site, prolonged droughts, local conflicts and lack of community commitment. At both sites, many stakeholders highlighted the need for more financial support, better management and assistance in solving local conflicts. External stakeholders value both sites as replicable models and their positive impacts in increasing afforestation and soil conservation experiences; they also identify a need for continuous financial support and the exploration of other models for site implementation and educational activities. The integrated assessment identified a match between the trends in biophysical indicators' results and the perspectives on those indicators expressed by stakeholders. It remained clear that every intervention to combat desertification requires an active involvement of local stakeholders and the implementation of educational modules to ensure the adoption of appropriate practices. Keywords: Land degradation - restoration actions - participatory approach - economic and environmental aspects - recovery of degraded drylands

A Second Opinion: A Case Narrative on Clinical Ethics Mediation.

PubMed

Weinstein, Michael S

2015-01-01

Contrasting traditional and common forms if ethics consultation with bioethics mediation. I describe the case of a "second opinion" consultation in the care of a patient with advanced cancer for whom treatment was futile. While the initial ethics consultation, performed by a colleague, let to a recommendation that some may deem ethical, the process failed to involve key stakeholders and failed to explore the underlying values and reasons for the opinions voiced by various stakeholders. The process of mediation ultimately led to creative solutions in which all stakeholders could reach consensus on a plan of care.

Environmental policy beliefs of stakeholders in protected area management.

PubMed

Hovardas, Tasos; Poirazidis, Kostas

2007-04-01

Although the importance of understanding stakeholder beliefs regarding environmental policy has been noted by many authors, research focusing on the heterogeneity of stakeholder views is still very scarce and concentrated on a product-oriented definition of stakeholders. The aim of the present study is to address this gap by examining environmental policy beliefs of stakeholder groups engaged in protected area management. Questionnaires containing 73 five-point Likert scale items were administered to eight different stakeholder groups involved in the management of Greek protected areas. Items referred to core beliefs on environmental policy, namely, the value framework and sustainable development, and secondary beliefs, that is, beliefs on social consensus and ecotourism development. Our study used as a starting point respondent recruitment on the basis of a traditional product-centered approach. We investigated whether environmental policy beliefs can be used to effectively segregate stakeholders in well-defined segments, which override the product-oriented definition of stakeholders. Indeed, K-means clustering revealed an innovation-introduction and an implementation-charged sample segment. The instrument utilized in this research proved quite reliable and valid in measuring stakeholder environmental policy beliefs. Furthermore, the methodology implied that stakeholder groups differ in a significant number of belief-system elements. On the other hand, stakeholder groups were effectively distinguished on a small set of both core and secondary beliefs. Therefore, the instrument used can be an effective tool for determining and monitoring environmental policy beliefs of stakeholders in protected area management. This is of considerable importance in the Greek case, given the recent establishment of 27 administrative bodies of protected areas, all of which are required to incorporate public consultation into management practices.

Environmental Policy Beliefs of Stakeholders in Protected Area Management

NASA Astrophysics Data System (ADS)

Hovardas, Tasos; Poirazidis, Kostas

2007-04-01

Although the importance of understanding stakeholder beliefs regarding environmental policy has been noted by many authors, research focusing on the heterogeneity of stakeholder views is still very scarce and concentrated on a product-oriented definition of stakeholders. The aim of the present study is to address this gap by examining environmental policy beliefs of stakeholder groups engaged in protected area management. Questionnaires containing 73 five-point Likert scale items were administered to eight different stakeholder groups involved in the management of Greek protected areas. Items referred to core beliefs on environmental policy, namely, the value framework and sustainable development, and secondary beliefs, that is, beliefs on social consensus and ecotourism development. Our study used as a starting point respondent recruitment on the basis of a traditional product-centered approach. We investigated whether environmental policy beliefs can be used to effectively segregate stakeholders in well-defined segments, which override the product-oriented definition of stakeholders. Indeed, K-means clustering revealed an innovation-introduction and an implementation-charged sample segment. The instrument utilized in this research proved quite reliable and valid in measuring stakeholder environmental policy beliefs. Furthermore, the methodology implied that stakeholder groups differ in a significant number of belief-system elements. On the other hand, stakeholder groups were effectively distinguished on a small set of both core and secondary beliefs. Therefore, the instrument used can be an effective tool for determining and monitoring environmental policy beliefs of stakeholders in protected area management. This is of considerable importance in the Greek case, given the recent establishment of 27 administrative bodies of protected areas, all of which are required to incorporate public consultation into management practices.

Employee health surveillance in the health care industry.

PubMed

Hood, Joyce; Larrañaga, Michael

2007-10-01

This article provides an overview of the fundamental and inherent challenges in developing a health surveillance program for a health care facility. These challenges are similar to those facing individuals responsible for developing health surveillance programs for multiple industries because several "mini-industries" exist within hospitals. Hazards can range from those that are regulated by the Occupational Safety and Health Administration to those that are unregulated but pose a threat to health care workers. Occupational hazards that are unique to the health care industry also exist. A health surveillance program can be developed with focused assessment and a strong occupational safety and health program. Implementation can occur within a health care setting with the buy-in of the many stakeholders involved, especially supervisors managing departments where chemical and other hazards are present.

Integrating Comparative Effectiveness Design Elements and Endpoints Into a Phase III, Randomized Clinical Trial (SWOG S1007) Evaluating OncotypeDX-Guided Management for Women With Breast Cancer Involving Lymph Nodes

PubMed Central

Ramsey, Scott D.; Barlow, William E.; Gonzalez-Angulo, Ana M.; Tunis, Sean; Baker, Laurence; Crowley, John; Deverka, Patricia; Veenstra, David; Hortobagyi, Gabriel N.

2012-01-01

Women with breast cancer involving the lymph nodes are typically treated with cytotoxic chemotherapy. Retrospective evaluations of prior studies suggest that the 21-gene test (OncotypeDX®), may allow identification of those who can safely avoid chemotherapy. To better understand the performance of the 21-gene test, the RxPONDER (Rx for Positive Node, Endocrine Responsive breast cancer) study was designed, a multicenter Phase III trial randomizing women with hormone receptor-positive and HER2-negative breast cancer involving 1–3 lymph nodes and a 21-gene assay recurrence score (RS) of 25 or less to endocrine therapy alone versus chemotherapy followed by endocrine therapy. As one of the first large-scale comparative-effectiveness studies in oncology, RxPONDER utilized an external stakeholder group to help inform the design of the trial. Stakeholders met with representatives of SWOG over several months through a structured discussion process. The stakeholder engagement process resulted in several changes being made to the trial design. In addition, stakeholder representatives from the health insurance industry provided guidance regarding a mechanism whereby the costs of OncotypeDX® would be paid by the majority of health insurers as part of the trial. The process may serve as a template for future studies evaluating the comparative effectiveness of genomic tests in oncology, particularly those that are conducted within cooperative clinical trials groups. PMID:23000081

How do local stakeholders respond to the uncertain implications of an innovative flood infrastructure project?

NASA Astrophysics Data System (ADS)

van den Hoek, Ronald; Brugnach, Marcela; Hoekstra, Arjen

2013-04-01

In the 20th century, flood management was dominated by rigid structures - such as dikes and dams - which intend to strictly regulate and control water systems. Although the application of these rigid structures has been successful in the recent past, their negative implications for ecosystems and natural processes is often not properly taken into account. Therefore, flood management practices are currently moving towards more nature-inclusive approaches. Building with Nature (BwN) is such a new approach of nature-inclusive flood management in the Netherlands, which aims to utilize natural dynamics (e.g., wind and currents) and natural materials (e.g., sediment and vegetation) for the realization of effective flood infrastructure, while providing opportunities for nature development. However, the natural dynamics driving a project based on BwN design principles are inherently unpredictable. Furthermore, our factual knowledge base regarding the socio-ecological system in which the BwN initiative is implemented is incomplete. Moreover, in recent years, it is increasingly aimed for by decision-makers to involve local stakeholders in the development of promising flood management initiatives. These stakeholders and other actors involved can have diverging views regarding the project, can perceive unanticipated implications and could choose unforeseen action paths. In short, while a project based on BwN design principles - like any human intervention - definitely has implications for the socio-ecological system, both the extent to which these particular implications will occur and the response of stakeholders are highly uncertain. In this paper, we study the Safety Buffer Oyster Dam case - a BwN pilot project - and address the interplay between the project's implications, the uncertainties regarding these implications and the action paths chosen by the local stakeholders and project team. We determine how the implications of the Safety Buffer project are viewed by local stakeholders, identify the frames and uncertainties related to these implications, and classify these uncertainties according to their nature and level. We describe which action paths are chosen by the local stakeholders and project team regarding the implications identified. Our research shows that there is a correspondence between the level of uncertainty about the implications identified and the action paths chosen by the actors involved. This suggests that the inherent deep uncertainty in projects based on BwN principles calls for more adaptable and flexible strategies to cope with the implications of these initiatives.

Perceptions of stakeholders about nontraditional cookstoves in Honduras

NASA Astrophysics Data System (ADS)

Ramirez, Sebastian; Dwivedi, Puneet; Bailis, Robert; Ghilardi, Adrian

2012-12-01

We used SWOT-AHP (strengths, weaknesses, opportunities and threats-analytical hierarchy process) technique to measure perceptions of four stakeholder groups: employees, local promoters, community leaders and end-users, about a nontraditional cookstove (NTCS) in Honduras. These stakeholder groups are part of an ongoing NTCS dissemination project led by Proyecto Mirador. We found that all stakeholder groups have a positive perception about the existing NTCS. Employees and local promoters stakeholder groups share similar perceptions. Smokeless cooking was selected as a prime strength, closely followed by reduction in forest logging and greenhouse gas emissions by all stakeholder groups. Availability of financial resources and responsible management were identified as crucial opportunities. Time spent in wood preparation and NTCS maintenance were identified as principal weaknesses. A long waiting time between a request and installation of NTCS and the risk of losing existing financial resources were acknowledged as major threats. Design improvements that can reduce maintenance and wood preparation time, a secure long-term source of funding through a market mechanism or direct/indirect government involvement, and early execution of pending orders will help in increasing adoption of NTCSs in rural Honduras.

Stakeholders' views on data sharing in multicenter studies.

PubMed

Mazor, Kathleen M; Richards, Allison; Gallagher, Mia; Arterburn, David E; Raebel, Marsha A; Nowell, W Benjamin; Curtis, Jeffrey R; Paolino, Andrea R; Toh, Sengwee

2017-09-01

To understand stakeholders' views on data sharing in multicenter comparative effectiveness research studies and the value of privacy-protecting methods. Semistructured interviews with five US stakeholder groups. We completed 11 interviews, involving patients (n = 15), researchers (n = 10), Institutional Review Board and regulatory staff (n = 3), multicenter research governance experts (n = 2) and healthcare system leaders (n = 4). Perceptions of the benefits and value of research were the strongest influences toward data sharing; cost and security risks were primary influences against sharing. Privacy-protecting methods that share summary-level data were acknowledged as being appealing, but there were concerns about increased cost and potential loss of research validity. Stakeholders were open to data sharing in multicenter studies that offer value and minimize security risks.

Making a move in exercise referral: co-development of a physical activity referral scheme.

PubMed

Buckley, B J R; Thijssen, D H J; Murphy, R C; Graves, L E F; Whyte, G; Gillison, F B; Crone, D; Wilson, P M; Watson, P M

2018-04-24

Translational research is required to ensure exercise referral schemes (ERSs) are evidence-based and reflect local needs. This article reports process data from the co-development phase of an ERS, providing an insight into (i) factors that must be considered when translating evidence to practice in an ERS setting, and (ii) challenges and facilitators of conducting participatory research involving multiple stakeholders. An ERS was iteratively co-developed by a multidisciplinary stakeholder group (commissioners, managers, practitioners, patients and academics) via five participatory meetings and an online survey. Audio data (e.g. group discussions) and visual data (e.g. whiteboard notes) were recorded and analysed using NVivo-10 electronic software. Factors to consider when translating evidence to practice in an ERS setting included (i) current ERS culture; (ii) skills, safety and accountability; and (iii) resources and capacity. The co-development process was facilitated by needs-analysis, open questions, multidisciplinary debate and reflective practice. Challenges included contrasting views, irregular attendance and (mis)perceptions of evaluation. The multidisciplinary co-development process highlighted cultural and pragmatic issues related to exercise referral provision, resulting in an evidence-based intervention framework designed to be implemented within existing infrastructures. Further work is required to establish the feasibility and effectiveness of the co-developed intervention in practice.

Testing an Adapted Modified Delphi Method: Synthesizing Multiple Stakeholder Ratings of Health Care Service Effectiveness.

PubMed

Escaron, Anne L; Chang Weir, Rosy; Stanton, Petra; Vangala, Sitaram; Grogan, Tristan R; Clarke, Robin M

2016-03-01

The Affordable Care Act incentivizes health systems for better meeting patient needs, but often guidance about patient preferences for particular health services is limited. All too often vulnerable patient populations are excluded from these decision-making settings. A community-based participatory approach harnesses the in-depth knowledge of those experiencing barriers to health care. We made three modifications to the RAND-UCLA appropriateness method, a modified Delphi approach, involving patients, adding an advisory council group to characterize existing knowledge in this little studied area, and using effectiveness rather than "appropriateness" as the basis for rating. As a proof of concept, we tested this method by examining the broadly delivered but understudied nonmedical services that community health centers provide. This method created discrete, new knowledge about these services by defining 6 categories and 112 unique services and by prioritizing among these services based on effectiveness using a 9-point scale. Consistent with the appropriateness method, we found statistical convergence of ratings among the panelists. Challenges include time commitment and adherence to a clear definition of effectiveness of services. This diverse stakeholder engagement method efficiently addresses gaps in knowledge about the effectiveness of health care services to inform population health management. © 2015 Society for Public Health Education.

Application of discrete choice experiments to enhance stakeholder engagement as a strategy for advancing implementation: a systematic review.

PubMed

Salloum, Ramzi G; Shenkman, Elizabeth A; Louviere, Jordan J; Chambers, David A

2017-11-23

One of the key strategies to successful implementation of effective health-related interventions is targeting improvements in stakeholder engagement. The discrete choice experiment (DCE) is a stated preference technique for eliciting individual preferences over hypothetical alternative scenarios that is increasingly being used in health-related applications. DCEs are a dynamic approach to systematically measure health preferences which can be applied in enhancing stakeholder engagement. However, a knowledge gap exists in characterizing the extent to which DCEs are used in implementation science. We conducted a systematic literature search (up to December 2016) of the English literature to identify and describe the use of DCEs in engaging stakeholders as an implementation strategy. We searched the following electronic databases: MEDLINE, Econlit, PsychINFO, and the CINAHL using mesh terms. Studies were categorized according to application type, stakeholder(s), healthcare setting, and implementation outcome. Seventy-five publications were selected for analysis in this systematic review. Studies were categorized by application type: (1) characterizing demand for therapies and treatment technologies (n = 32), (2) comparing implementation strategies (n = 22), (3) incentivizing workforce participation (n = 11), and (4) prioritizing interventions (n = 10). Stakeholders included providers (n = 27), patients (n = 25), caregivers (n = 5), and administrators (n = 2). The remaining studies (n = 16) engaged multiple stakeholders (i.e., combination of patients, caregivers, providers, and/or administrators). The following implementation outcomes were discussed: acceptability (n = 75), appropriateness (n = 34), adoption (n = 19), feasibility (n = 16), and fidelity (n = 3). The number of DCE studies engaging stakeholders as an implementation strategy has been increasing over the past decade. As DCEs are more widely used as a healthcare assessment tool, there is a wide range of applications for them in stakeholder engagement. The DCE approach could serve as a tool for engaging stakeholders in implementation science.

Understanding global health governance as a complex adaptive system.

PubMed

Hill, Peter S

2011-01-01

The transition from international to global health reflects the rapid growth in the numbers and nature of stakeholders in health, as well as the constant change embodied in the process of globalisation itself. This paper argues that global health governance shares the characteristics of complex adaptive systems, with its multiple and diverse players, and their polyvalent and constantly evolving relationships, and rich and dynamic interactions. The sheer quantum of initiatives, the multiple networks through which stakeholders (re)configure their influence, the range of contexts in which development for health is played out - all compound the complexity of this system. This paper maps out the characteristics of complex adaptive systems as they apply to global health governance, linking them to developments in the past two decades, and the multiple responses to these changes. Examining global health governance through the frame of complexity theory offers insight into the current dynamics of governance, and while providing a framework for making meaning of the whole, opens up ways of accessing this complexity through local points of engagement.

Stakeholder perceptions of indicators of tourism use and codes of conduct in a coastal protected area in Alaska

Treesearch

Emily F. Pomeranz; Mark D. Needham; Linda E. Kruger

2013-01-01

This article focuses on a collaborative approach for addressing impacts of watercraft-based tourism in Tracy Arm-Fords Terror Wilderness, Alaska. This approach is the Wilderness Best Management Practices (WBMP) and involves codes of conduct for managing use in this area. This article examines use-related indicators that stakeholders prioritize for inclusion in the WBMP...

Asbestos Ban in Italy: A Major Milestone, Not the Final Cut

PubMed Central

Marsili, Daniela; Bruno, Caterina; Marinaccio, Alessandro; Zona, Amerigo; Comba, Pietro

2017-01-01

Background and history: Italy was the main asbestos producer and one of the greatest consumers in 20th century Europe until the asbestos ban was introduced in 1992. Asbestos exposure affected the population in a wide range of working environments, namely mining and marketing of asbestos, asbestos cement production, shipyards and textile industries. This also determined a widespread environmental asbestos exposure affecting the surrounding communities. Methods: To investigate the drivers and difficulties of the process leading to the asbestos ban and its subsequent implementation, we focused on stakeholder involvement, environmental health policies, capacity building and communication. Results: In the past three decades, stakeholder involvement has been instrumental in advancing the industrial asbestos replacement process, prevention and remediation interventions. Furthermore, involvement also contributed to the integration of environmental and health policies at national, regional and local levels, including capacity building and communication. In a global public health perspective, international scientific cooperation has been established with countries using and producing asbestos. Discussion and Conclusions: Key factors and lessons learnt in Italy from both successful and ineffective asbestos policies are described to support the relevant stakeholders in countries still using asbestos contributing to the termination of its use. PMID:29137208

Asbestos Ban in Italy: A Major Milestone, Not the Final Cut.

PubMed

Marsili, Daniela; Angelini, Alessia; Bruno, Caterina; Corfiati, Marisa; Marinaccio, Alessandro; Silvestri, Stefano; Zona, Amerigo; Comba, Pietro

2017-11-13

Background and history: Italy was the main asbestos producer and one of the greatest consumers in 20th century Europe until the asbestos ban was introduced in 1992. Asbestos exposure affected the population in a wide range of working environments, namely mining and marketing of asbestos, asbestos cement production, shipyards and textile industries. This also determined a widespread environmental asbestos exposure affecting the surrounding communities. Methods: To investigate the drivers and difficulties of the process leading to the asbestos ban and its subsequent implementation, we focused on stakeholder involvement, environmental health policies, capacity building and communication. Results: In the past three decades, stakeholder involvement has been instrumental in advancing the industrial asbestos replacement process, prevention and remediation interventions. Furthermore, involvement also contributed to the integration of environmental and health policies at national, regional and local levels, including capacity building and communication. In a global public health perspective, international scientific cooperation has been established with countries using and producing asbestos. Discussion and Conclusions: Key factors and lessons learnt in Italy from both successful and ineffective asbestos policies are described to support the relevant stakeholders in countries still using asbestos contributing to the termination of its use.