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…

A systematic review of stakeholder engagement in comparative effectiveness and patient-centered outcomes research.

PubMed

Concannon, Thomas W; Fuster, Melissa; Saunders, Tully; Patel, Kamal; Wong, John B; Leslie, Laurel K; Lau, Joseph

2014-12-01

We conducted a review of the peer-reviewed literature since 2003 to catalogue reported methods of stakeholder engagement in comparative effectiveness research and patient-centered outcomes research. We worked with stakeholders before, during and after the review was conducted to: define the primary and key research questions; conduct the literature search; screen titles, abstracts and articles; abstract data from the articles; and analyze the data. The literature search yielded 2,062 abstracts. The review was conducted on 70 articles that reported on stakeholder engagement in individual research projects or programs. Reports of stakeholder engagement are highly variable in content and quality. We found frequent engagement with patients, modestly frequent engagement with clinicians, and infrequent engagement with stakeholders in other key decision-making groups across the healthcare system. Stakeholder engagement was more common in earlier (prioritization) than in later (implementation and dissemination) stages of research. The roles and activities of stakeholders were highly variable across research and program reports. To improve on the quality and content of reporting, we developed a 7-Item Stakeholder Engagement Reporting Questionnaire. We recommend three directions for future research: 1) descriptive research on stakeholder-engagement in research; 2) evaluative research on the impact of stakeholder engagement on the relevance, transparency and adoption of research; and 3) development and validation of tools that can be used to support stakeholder engagement in future work.

Patient and provider perspectives on the design and implementation of an electronic consultation system for kidney care delivery in Canada: a focus group study.

PubMed

Bello, Aminu K; Molzahn, Anita E; Girard, Louis P; Osman, Mohamed A; Okpechi, Ikechi G; Glassford, Jodi; Thompson, Stephanie; Keely, Erin; Liddy, Clare; Manns, Braden; Jinda, Kailash; Klarenbach, Scott; Hemmelgarn, Brenda; Tonelli, Marcello

2017-03-02

We assessed stakeholder perceptions on the use of an electronic consultation system (e-Consult) to improve the delivery of kidney care in Alberta. We aim to identify acceptability, barriers and facilitators to the use of an e-Consult system for ambulatory kidney care delivery. This was a qualitative focus group study using a thematic analysis design. Eight focus groups were held in four locations in the province of Alberta, Canada. In total, there were 72 participants in two broad stakeholder categories: patients (including patients' relatives) and providers (including primary care physicians, nephrologists, other care providers and policymakers). The e-Consult system was generally acceptable across all stakeholder groups. The key barriers identified were length of time required for referring physicians to complete the e-Consult due to lack of integration with current electronic medical records, and concerns that increased numbers of requests might overwhelm nephrologists and lead to a delayed response or an unsustainable system. The key facilitators identified were potential improvement of care coordination, dissemination of best practice through an educational platform, comprehensive data to make decisions without the need for face-to-face consultation, timely feedback to primary care providers, timeliness/reduced delays for patients' rapid triage and identification of cases needing urgent care and improved access to information to facilitate decision-making in patient care. Stakeholder perceptions regarding the e-Consult system were favourable, and the key barriers and facilitators identified will be considered in design and implementation of an acceptable and sustainable electronic consultation system for kidney care delivery. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Relationship Quality in Higher Education Marketing: The Role of Social Media Engagement

ERIC Educational Resources Information Center

Clark, Melissa; Fine, Monica B.; Scheuer, Cara-Lynn

2017-01-01

The landscape in consumer marketing is changing due to the rise in popularity of social media. This shift has also affected how higher education institutions build relationships with their stakeholders. This study explores how social media engagement impacts relationship quality between the university and one of its key stakeholder groups,…

Investigating Stakeholder Attitudes and Opinions on School-Based Human Papillomavirus Vaccination Programs

ERIC Educational Resources Information Center

Nodulman, Jessica A.; Starling, Randall; Kong, Alberta S.; Buller, David B.; Wheeler, Cosette M.; Woodall, W. Gill

2015-01-01

Background: In several countries worldwide, school-based human papillomavirus (HPV) vaccination programs have been successful; however, little research has explored US stakeholders' acceptance toward school-based HPV vaccination programs. Methods: A total of 13 focus groups and 12 key informant interviews (N?=?117; 85% females; 66% racial/ethnic…

Video or In-Clinic Consultation? Selection of Attributes as Preparation for a Discrete Choice Experiment Among Key Stakeholders.

PubMed

Chudner, Irit; Goldfracht, Margalit; Goldblatt, Hadass; Drach-Zahavy, Anat; Karkabi, Khaled

2018-06-09

Video consultations (VCs) provide increased accessibility of primary care to remote areas and overall improved care for chronic patients. They also contribute to higher patient satisfaction and improved resource management. Despite these benefits, VC integration into the health system is complex and slow. Understanding the VC-related preferences of three key stakeholders-patients, primary care physicians (PCPs) and policy makers (PMs)-is crucial for achieving optimal implementation. The aim of this study was to select relevant attributes and levels for a discrete choice experiment (DCE) of stakeholders' choice-VC or traditional in-clinic consultation (I-CC) in primary care. Ten semi-structured focus group interviews and 24 semi-structured individual interviews were conducted. Data analysis was performed inductively, using a thematic content analysis method. An attribute-ranking exercise was then conducted based on the results gleaned from the interviews. The most important attributes when choosing either VC or I-CC, for both patients and PMs, were: (1) time to next available appointment; (2) time in line before consultation; (3) relationship to PCP; and (4) quality of consultation. For PCPs, the most important attributes were: (1) time in line before consultation; (2) patient's self-management ability; (3) consultation purpose; (4) quality of consultation. This qualitative study identified attributes and levels for a DCE quantitative stage among three key stakeholder groups. It adds to the literature of examples of developing DCE attributes, and to literature about the stakeholder benefits in the area of telemedicine in healthcare.

Community Advisory Boards Guiding Engaged Research Efforts within a Clinical Translational Sciences Award: Key Contextual Factors Explored.

PubMed

Halladay, Jacqueline R; Donahue, Katrina E; Sleath, Betsy; Reuland, Dan; Black, Adina; Mitchell, C Madeline; Breland, Carol E; Coyne-Beasley, Tamera; Mottus, Kathleen; Watson, Sable Noelle; Lewis, Virginia; Wynn, Mysha; Corbie-Smith, Giselle

2017-01-01

Engaging stakeholders in research carries the promise of enhancing the research relevance, transparency, and speed of getting findings into practice. By describing the context and functional aspects of stakeholder groups, like those working as community advisory boards (CABs), others can learn from these experiences and operationalize their own CABs. Our objective is to describe our experiences with diverse CABs affiliated with our community engagement group within our institution's Clinical Translational Sciences Award (CTSA). We identify key contextual elements that are important to administering CABs. A group of investigators, staff, and community members engaged in a 6-month collaboration to describe their experiences of working with six research CABs. We identified the key contextual domains that illustrate how CABS are developed and sustained. Two lead authors, with experience with CABs and identifying contextual domains in other work, led a team of 13 through the process. Additionally, we devised a list of key tips to consider when devising CABs. The final domains include (1) aligned missions among stakeholders (2) resources/support, (3) defined operational processes/shared power, (4) well-described member roles, and (5) understanding and mitigating challenges. The tips are a set of actions that support the domains. Identifying key contextual domains was relatively easy, despite differences in the respective CAB's condition of focus, overall mission, or patient demographics represented. By contextualizing these five domains, other research and community partners can take an informed approach to move forward with CAB planning and engaged research.

Overview of a multi-stakeholder dialogue around Shared Services for Health: the Digital Health Opportunity in Bangladesh.

PubMed

Ashraf, Sania; Moore, Carolyn; Gupta, Vaibhav; Chowdhury, Anir; Azad, Abul K; Singh, Neelu; Hagan, David; Labrique, Alain B

2015-12-09

National level policymaking and implementation includes multiple stakeholders with varied interests and priorities. Multi-stakeholder dialogues (MSDs) can facilitate consensus building through collective identification of challenges, recognition of shared goals and interests, and creation of solution pathways. This can shape joint planning and implementation for long-term efficiency in health and other sectors. Scaling up the effective use of information and communication technologies (ICTs) requires cohesive strategic planning towards a shared goal. In Bangladesh, the government and partners convened an MSD in March 2015 to increase stakeholder engagement in policymaking and implementation of a national ICT or electronic or mobile health (eHealth or mHealth) strategy, which seeks to incorporate ICTs into the national health system, aligning with the Digital Bangladesh Vision 2021. Relevant stakeholders were identified and key priorities and challenges were mapped through key informant interviews. An MSD was conducted with key stakeholders in Dhaka, Bangladesh. The MSD included presentations, group option generation, agreement and prioritization of barriers to scaling up ICTs. The MSD approach to building consensus on key priorities highlights the value of dialogue and collaboration with relevant stakeholders to encourage country ownership of nationwide efforts such as ICT scale-up. This MSD showed the dynamic context in which stakeholders operate, including those from academia, donors and foundations, healthcare professionals, associations, multilateral organizations, non-governmental organizations, partner countries and the private sector. Through this MSD, participants improved understanding of each other's contributions and interests, identified existing relationships, and agreed on policy and implementation gaps that needed to be filled. Collaboration among stakeholders in ICT efforts and research can promote a cohesive approach to scaling up, as well as improve policymaking by integrating interests and feedback of different key cross sectoral actors. MSDs can align stakeholders to identify challenges and solution pathways, and lead to coordinated action and accountability for resources and results. In addition, the MSD template and approach has been useful to guide ICT scale up in Bangladesh and could be replicated in other contexts to facilitate multi-constituency, multi-sector collaboration.

Stakeholder analysis and social-biophysical interdependencies for common pool resource management: La Brava Wetland (Argentina) as a case study.

PubMed

Romanelli, Asunción; Massone, Héctor E; Escalante, Alicia H

2011-09-01

This article gives an account of the implementation of a stakeholder analysis framework at La Brava Wetland Basin, Argentina, in a common-pool resource (CPR) management context. Firstly, the context in which the stakeholder framework was implemented is described. Secondly, a four-step methodology is applied: (1) stakeholder identification, (2) stakeholder differentiation-categorization, (3) investigation of stakeholders' relationships, and (4) analysis of social-biophysical interdependencies. This methodology classifies stakeholders according to their level of influence on the system and their potential in the conservation of natural resources. The main influential stakeholders are La Brava Village residents and tourism-related entrepreneurs who are empowered to make the more important decisions within the planning process of the ecosystem. While these key players are seen as facilitators of change, there are other groups (residents of the inner basin and fishermen) which are seen mainly as key blockers. The applied methodology for the Stakeholder Analysis and the evaluation of social-biophysical interdependencies carried out in this article can be seen as an encouraging example for other experts in natural sciences to learn and use these methods developed in social sciences. Major difficulties and some recommendations of applying this method in the practice by non-experts are discussed.

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.

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.

Stakeholders' views on the ethical challenges of pragmatic trials investigating pharmaceutical drugs.

PubMed

Kalkman, Shona; van Thiel, Ghislaine J M W; Grobbee, Diederick E; Meinecke, Anna-Katharina; Zuidgeest, Mira G P; van Delden, Johannes J M

2016-08-22

We explored the views of key stakeholders to identify the ethical challenges of pragmatic trials investigating pharmaceutical drugs. A secondary aim was to capture stakeholders' attitudes towards the implementation of pragmatic trials in the drug development process. We conducted semistructured, in-depth interviews among individuals from different key stakeholder groups (academia and independent research institutions, the pharmaceutical industry, regulators, Health Technology Assessment (HTA) agencies and patients' organizations) through telephone or face-to-face sessions. Interviews were structured around the question "what challenges were experienced or perceived during the design, conduct and/or review of pragmatic trials." Respondents were additionally asked about their views on implementation of pragmatic trials in the drug development process. Thematic analysis was used to identify the ethically relevant features across data sets. We interviewed 34 stakeholders in 25 individual sessions and four group sessions. The four perceived challenges of ethical relevance were: (1) less controlled conditions creating safety concerns, (2) comparison with usual care potentially compromising clinical equipoise, (3) tailored or waivers of informed consent affecting patient autonomy, and (4) minimal interference with "real-world" practice reducing the knowledge value of trial results. We identified stakeholder concerns regarding risk assessment, use of suboptimal usual care as a comparator, tailoring of informed consent procedures and ensuring the social value of pragmatic trials. These concerns increased when respondents were asked about pragmatic trials conducted before market authorization.

Lessons from the Canadian national health information technology plan for the United States: opinions of key Canadian experts.

PubMed

Zimlichman, Eyal; Rozenblum, Ronen; Salzberg, Claudia A; Jang, Yeona; Tamblyn, Melissa; Tamblyn, Robyn; Bates, David W

2012-01-01

To summarize the Canadian health information technology (HIT) policy experience and impart lessons learned to the US as it determines its policy in this area. Qualitative analysis of interviews with identified key stakeholders followed by an electronic survey. We conducted semi-structured interviews with 29 key Canadian HIT policy and opinion leaders and used a grounded theory approach to analyze the results. The informant sample was chosen to provide views from different stakeholder groups including national representatives and regional representatives from three Canadian provinces. Canadian informants believed that much of the current US direction is positive, especially regarding incentives and meaningful use, but that there are key opportunities for the US to emphasize direct engagement with providers, define a clear business case for them, sponsor large scale evaluations to assess HIT impact in a broad array of settings, determine standards but also enable access to resources needed for mid-course corrections of standards when issues are identified, and, finally, leverage implementation of digital imaging systems. Not all stakeholder groups were included, such as providers or patients. In addition, as in all qualitative research, a selection bias could be present due to the relatively small sample size. Based on Canadian experience with HIT policy, stakeholders identified as lessons for the US the need to increase direct engagement with providers and the importance of defining the business case for HIT, which can be achieved through large scale evaluations, and of recognizing and leveraging successes as they emerge.

Principles to guide sustainable implementation of extended-scope-of-practice physiotherapy workforce redesign initiatives in Australia: stakeholder perspectives, barriers, supports, and incentives

PubMed Central

Morris, Joanne; Grimmer, Karen; Gilmore, Lisa; Perera, Chandima; Waddington, Gordon; Kyle, Greg; Ashman, Bryan; Murphy, Karen

2014-01-01

Sustainable implementation of new workforce redesign initiatives requires strategies that minimize barriers and optimize supports. Such strategies could be provided by a set of guiding principles. A broad understanding of the concerns of all the key stakeholder groups is required before effective strategies and initiatives are developed. Many new workforce redesign initiatives are not underpinned by prior planning, and this threatens their uptake and sustainability. This study reports on a cross-sectional qualitative study that sought the perspectives of representatives of key stakeholders in a new workforce redesign initiative (extended-scope-of-practice physiotherapy) in one Australian tertiary hospital. The key stakeholder groups were those that had been involved in some way in the development, management, training, funding, and/or delivery of the initiative. Data were collected using semistructured questions, answered individually by interview or in writing. Responses were themed collaboratively, using descriptive analysis. Key identified themes comprised: the importance of service marketing; proactively addressing barriers; using readily understood nomenclature; demonstrating service quality and safety, monitoring adverse events, measuring health and cost outcomes; legislative issues; registration; promoting viable career pathways; developing, accrediting, and delivering a curriculum supporting physiotherapists to work outside of the usual scope; and progression from “a good idea” to established service. Health care facilities planning to implement new workforce initiatives that extend scope of usual practice should consider these issues before instigating workforce/model of care changes. PMID:25018637

Principles to guide sustainable implementation of extended-scope-of-practice physiotherapy workforce redesign initiatives in Australia: stakeholder perspectives, barriers, supports, and incentives.

PubMed

Morris, Joanne; Grimmer, Karen; Gilmore, Lisa; Perera, Chandima; Waddington, Gordon; Kyle, Greg; Ashman, Bryan; Murphy, Karen

2014-01-01

Sustainable implementation of new workforce redesign initiatives requires strategies that minimize barriers and optimize supports. Such strategies could be provided by a set of guiding principles. A broad understanding of the concerns of all the key stakeholder groups is required before effective strategies and initiatives are developed. Many new workforce redesign initiatives are not underpinned by prior planning, and this threatens their uptake and sustainability. This study reports on a cross-sectional qualitative study that sought the perspectives of representatives of key stakeholders in a new workforce redesign initiative (extended-scope-of-practice physiotherapy) in one Australian tertiary hospital. The key stakeholder groups were those that had been involved in some way in the development, management, training, funding, and/or delivery of the initiative. Data were collected using semistructured questions, answered individually by interview or in writing. Responses were themed collaboratively, using descriptive analysis. Key identified themes comprised: the importance of service marketing; proactively addressing barriers; using readily understood nomenclature; demonstrating service quality and safety, monitoring adverse events, measuring health and cost outcomes; legislative issues; registration; promoting viable career pathways; developing, accrediting, and delivering a curriculum supporting physiotherapists to work outside of the usual scope; and progression from "a good idea" to established service. Health care facilities planning to implement new workforce initiatives that extend scope of usual practice should consider these issues before instigating workforce/model of care changes.

Stakeholders' analysis of the medical tourism industry: development strategies in Isfahan.

PubMed

Jabbari, Alireza; Ferdosi, Masoud; Keyvanara, Mahmoud; Agharahimi, Zahra

2013-01-01

Policy makers and decision makers must identify the stakeholders in medical tourism, who will be affected by and/or affect this industry, and determine their status for partnership. The aim of this study was to identify the main stakeholders in Isfahan's medical tourism, analyze them, and provide strategies for developing this industry. A qualitative study was conducted in 2011. At first, the key stakeholders in medical tourism were identified in accordance with the experts' idea and literature review. Then we interviewed the key stakeholders. Data analysis was conducted using the stakeholders' analyses, which helped in developing strategies. The result showed that the key stakeholders were made up of nine groups. They included the provincial governance of Isfahan, the Cultural Heritage and Tourism Organization of Isfahan, the Chamber of Commerce, the Medical Council, the Isfahan University of Medical Sciences, health service providers, tourism services providers, investors, and the Tosea Saderat Bank. The rate of knowledge of the Cultural Heritage and Tourism Organization of Isfahan, clinic and international relationship of Isfahan University of Medical Sciences from government policy about medical tourism were very much. Private Hospitals, the Medical Council, investors, and the University of Medical Sciences had great power. Private hospitals, clinics, the Cultural Heritage and Tourism Organization of Isfahan, and the University of Medical Sciences were in the supporter position. The effected strategies were the included strategies, focused on increasing power; increasing support, and on maintaining the position. There are different stakeholders in the medical tourism industry. Thus, policy makers can plan, make a policy and decision, and use effective strategies to develop medical tourism by designing a medical tourism stakeholders' network, a medical tourism provincial council, and clarify the roles and responsibilities of stakeholders.

Collaborating with Youth to Inform and Develop Tools for Psychotropic Decision Making

PubMed Central

Murphy, Andrea; Gardner, David; Kutcher, Stan; Davidson, Simon; Manion, Ian

2010-01-01

Introduction: Youth oriented and informed resources designed to support psychopharmacotherapeutic decision-making are essentially unavailable. This article outlines the approach taken to design such resources, the product that resulted from the approach taken, and the lessons learned from the process. Methods: A project team with psychopharmacology expertise was assembled. The project team reviewed best practices regarding medication educational materials and related tools to support decisions. Collaboration with key stakeholders who were thought of as primary end-users and target groups occurred. A graphic designer and a plain language consultant were also retained. Results: Through an iterative and collaborative process over approximately 6 months, Med Ed and Med Ed Passport were developed. Literature and input from key stakeholders, in particular youth, was instrumental to the development of the tools and materials within Med Ed. A training program utilizing a train-the-trainer model was developed to facilitate the implementation of Med Ed in Ontario, which is currently ongoing. Conclusion: An evidence-informed process that includes youth and key stakeholder engagement is required for developing tools to support in psychopharmacotherapeutic decision-making. The development process fostered an environment of reciprocity between the project team and key stakeholders. PMID:21037916

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.

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.

The views of key stakeholders in Zimbabwe on the introduction of postgraduate family medicine training: A qualitative study.

PubMed

Sururu, Cherifa; Mash, Robert

2017-09-12

Strengthening primary health care (PHC) is a priority for all effective health systems, and family physicians are seen as a key member of the PHC team. Zimbabwe has joined a number of African countries that are seriously considering the introduction of postgraduate family medicine training. Implementation of training, however, has not yet happened. To explore the views of key stakeholders on the introduction of postgraduate family medicine training. Key academic, governmental and professional stakeholders in Zimbabwean health and higher education systems. Twelve semi-structured interviews were conducted with purposively selected key stakeholders. Data were recorded, transcribed and analysed using the framework method. Anticipated benefits: More effective functioning of PHC and district health services with reduced referrals, improved access to more comprehensive services and improved clinical outcomes. Opportunities: International trend towards family medicine training, government support, availability of a small group of local trainers, need to revise PHC policy. Anticipated barriers: Family medicine is unattractive as a career choice because it is largely unknown to newly qualified doctors and may not be recognised in private sector. There is concern that advocacy is mainly coming from the private sector. Threats: Economic conditions, poor remuneration, lack of funding for resources and new initiatives, resistance from other specialists in private sector. Stakeholders anticipated significant benefits from the introduction of family medicine training and identified a number of opportunities that support this, but also recognised the existence of major barriers and threats to successful implementation.

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.

A qualitative study of the perspectives of key stakeholders on the delivery of clinical academic training in the East Midlands.

PubMed

Green, Ruth H; Evans, Val; MacLeod, Sheona; Barratt, Jonathan

2018-02-01

Major changes in the design and delivery of clinical academic training in the United Kingdom have occurred yet there has been little exploration of the perceptions of integrated clinic academic trainees or educators. We obtained the views of a range of key stakeholders involved in clinical academic training in the East Midlands. A qualitative study with inductive iterative thematic content analysis of findings from trainee surveys and facilitated focus groups. The East Midlands School of Clinical Academic Training. Integrated Clinical Academic Trainees, clinical and academic educators involved in clinical academic training. The experience, opinions and beliefs of key stakeholders about barriers and enablers in the delivery of clinical academic training. We identified key themes many shared by both trainees and educators. These highlighted issues in the systems and process of the integrated academic pathways, career pathways, supervision and support, the assessment process and the balance between clinical and academic training. Our findings help inform the future development of integrated academic training programmes.

Stakeholder Perspectives on Barriers and Facilitators of Inclusive Education in the Solomon Islands

ERIC Educational Resources Information Center

Sharma, Umesh; Loreman, Tim; Simi, Janine

2017-01-01

This paper reports perceived barriers and facilitators of disability-inclusive education, and outcomes of an effective system of inclusive education in the Solomon Islands. Data were gathered from a variety of stakeholder group participants (n = 10) and individual key informants (n = 2), ranging from parents of children with disabilities to…

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.

Stakeholder perceptions of a nurse led walk-in centre.

PubMed

Parker, Rhian M; Desborough, Jane L; Forrest, Laura E

2012-11-05

As many countries face primary care medical workforce shortages and find it difficult to provide timely and affordable care they seek to find new ways of delivering first point of contact health care through developing new service models. In common with other areas of rural and regional Australia, the Australian Capital Territory (ACT) is currently experiencing a general practitioner (GP) workforce shortage which impacts significantly on the ability of patients to access GP led primary care services. The introduction of a nurse led primary care Walk-in Centre in the ACT aimed to fulfill an unmet health care need in the community and meet projected demand for health care services as well as relieve pressure on the hospital system. Stakeholders have the potential to influence health service planning and policy, to advise on the potential of services to meet population health needs and to assess how acceptable health service innovation is to key stakeholder groups. This study aimed to ascertain the views of key stakeholders about the Walk-in Centre. Stakeholders were purposively selected through the identification of individuals and organisations which had organisational or professional contact with the Walk-in Centre. Semi structured interviews around key themes were conducted with seventeen stakeholders. Stakeholders were generally supportive of the Walk-in Centre but identified key areas which they considered needed to be addressed. These included the service's systems, full utilisation of the nurse practitioner role and adequate education and training. It was also suggested that a doctor could be available to the Centre as a source of referral for patients who fall outside the nurses' scope of practice. The location of the Centre was seen to impact on patient flows to the Emergency Department. Nurse led Walk-in Centres are one response to addressing primary health care medical workforce shortages. Whilst some stakeholders have reservations about the model others are supportive and see the potential the model has to provide accessible primary health care. Any further developments of nurse-led Walk-in Centres need to take into account the views of key stakeholders so as to ensure that the model is acceptable and sustainable.

Integrated Healthcare Delivery: A Qualitative Research Approach to Identifying and Harmonizing Perspectives of Integrated Neglected Tropical Disease Programs

PubMed Central

Jacobson, Julie; Mosher, Aryc W.; Walson, Judd L.

2016-01-01

Background While some evidence supports the beneficial effects of integrating neglected tropical disease (NTD) programs to optimize coverage and reduce costs, there is minimal information regarding when or how to effectively operationalize program integration. The lack of systematic analyses of integration experiences and of integration processes may act as an impediment to achieving more effective NTD programming. We aimed to learn about the experiences of NTD stakeholders and their perceptions of integration. Methodology We evaluated differences in the definitions, roles, perceived effectiveness, and implementation experiences of integrated NTD programs among a variety of NTD stakeholder groups, including multilateral organizations, funding partners, implementation partners, national Ministry of Health (MOH) teams, district MOH teams, volunteer rural health workers, and community members participating in NTD campaigns. Semi-structured key informant interviews were conducted. Coding of themes involved a mix of applying in-vivo open coding and a priori thematic coding from a start list. Findings In total, 41 interviews were conducted. Salient themes varied by stakeholder, however dominant themes on integration included: significant variations in definitions, differential effectiveness of specific integrated NTD activities, community member perceptions of NTD programs, the influence of funders, perceived facilitators, perceived barriers, and the effects of integration on health system strength. In general, stakeholder groups provided unique perspectives, rather than contrarian points of view, on the same topics. The stakeholders identified more advantages to integration than disadvantages, however there are a number of both unique facilitators and challenges to integration from the perspective of each stakeholder group. Conclusions Qualitative data suggest several structural, process, and technical opportunities that could be addressed to promote more effective and efficient integrated NTD elimination programs. We highlight a set of ten recommendations that may address stakeholder concerns and perceptions regarding these key opportunities. For example, public health stakeholders should embrace a broader perspective of community-based health needs, including and beyond NTDs, and available platforms for addressing those needs. PMID:27776127

Talent development: linking the stakeholders to the process.

PubMed

Pankhurst, Anne; Collins, Dave; Macnamara, Áine

2013-01-01

The three stakeholders (coaches, parents and the National Governing Body) in Talent Identification and Development (TID) are important factors in athlete development. How each of them perceive the key constructs of Talent Identification and Development (i.e. sport specialisation and selection, practice, athlete development, junior and adult success, and the role of the stakeholders), and the coherence of that understanding is not well understood. This study focuses on junior performance tennis and investigates the perceptions of coaches, parents and sports organisations (a National Governing Body) of the five key constructs of Talent Identification and Development. We were interested in examining (a) the extent to which stakeholder perceptions relate to research, (b) the coherence of each stakeholder's perceptions and (c) the extent to which there is coherence between what stakeholders understand each other thinks. Seventy-five coaches, parents, and National Governing Body staff completed a questionnaire that asked participants to rate their degree of agreement/disagreement with researched 'principles' of Talent Identification and Development. The results suggest that stakeholders do not strongly agree with the research supporting principles of Talent Identification and Development. Furthermore, a significant lack of coherence of stakeholder perceptions was evident. This lack of coherence was also evident in each group's understanding of what the other stakeholders believed. The impact of these results on the Talent Identification and Development process is discussed.

Key stakeholder perspectives on the development of walkable neighbourhoods

PubMed Central

Clark, Marianne I.; Berry, Tanya R.; Spence, John C.; Nykiforuk, Candace; Carlson, Marie; Blanchard, Christopher

2016-01-01

Evidence supports the link between the built environment and physical activity. This study investigated factors that influence the decisions made by key stakeholders as they relate to neighbourhood development. Seventeen stakeholders including public health and municipal employees (n = 9), city councillors (n = 3), and the private sector (e.g., land developers, food retailers) (n = 5), participated in interviews. Private sector participants considered healthy lifestyle choices (e.g., PA) to be related more to individual choice than did other groups. All groups agreed that consumer behaviour is essential to invoking change but did not agree on who is responsible for invoking change. Common barriers included financial costs, car dependency, and social norms. Facilitators included growing awareness of health and environmental issues and increasing buy-in from governing bodies for innovative neighbourhood development. More work is needed that acknowledges the differences between while integrating the diverse perspectives of those responsible for the planning of neighbourhoods that are conducive for physical activity. PMID:19733495

Stakeholder understandings of wildfire mitigation: A case of shared and contested meanings

Treesearch

Joseph G. Champ; Jeffrey J. Brooks; Daniel R. Williams

2012-01-01

This article identifies and compares meanings of wildfire risk mitigation for stakeholders in the Front Range of Colorado, USA. We examine the case of a collaborative partnership sponsored by government agencies and directed to decrease hazardous fuels in interface areas. Data were collected by way of key informant interviews and focus groups. The analysis is guided by...

A Core Outcome Set for Evaluation of Interventions to Prevent Preterm Birth.

PubMed

van ʼt Hooft, Janneke; Duffy, James M N; Daly, Mandy; Williamson, Paula R; Meher, Shireen; Thom, Elizabeth; Saade, George R; Alfirevic, Zarko; Mol, Ben Willem J; Khan, Khalid S

2016-01-01

To develop a consensus on a set of key clinical outcomes for the evaluation of preventive interventions for preterm birth in asymptomatic pregnant women. A two-stage web-based Delphi survey and a face-to-face meeting of key stakeholders were used to develop a consensus on a set of critical and important outcomes. We approached five stakeholder groups (parents, midwives, obstetricians, neonatologists, and researchers) from middle- and high-income countries. Outcomes subjected to the Delphi survey were identified by systematic literature review and stakeholder input. Survey participants scored each outcome on a 9-point Likert scale anchored between 1 (limited importance) and 9 (critical importance). They had the opportunity to reflect on total and stakeholder subgroup feedback between survey stages. For consensus, defined a priori, outcomes required at least 70% of participants of each stakeholder group to score them as "critical" and less than 15% as "limited." A total of 228 participants from five stakeholder groups from three lower middle-income countries, seven upper middle-income countries, and 17 high-income countries were asked to score 31 outcomes. Of these participants, 195 completed the first survey and 174 the second. Consensus was reached on 13 core outcomes: four were related to pregnant women: maternal mortality, maternal infection or inflammation, prelabor rupture of membranes, and harm to mother from intervention. Nine were related to offspring: gestational age at birth, offspring mortality, birth weight, early neurodevelopmental morbidity, late neurodevelopmental morbidity, gastrointestinal morbidity, infection, respiratory morbidity, and harm to offspring from intervention. This core outcome set for studies that evaluate prevention of preterm birth developed with an international multidisciplinary perspective will ensure that data from trials that assess prevention of preterm birth can be compared and combined. COMET Initiative, http://www.comet-initiative.org/studies/details/603, REGISTRATION NUMBER: 603.

Factors influencing the adoption and implementation of teledentistry in the UK, with a focus on orthodontics.

PubMed

Patel, Reena N; Antonarakis, Gregory S

2013-10-01

Utilizing Rogers' diffusion of innovation theory, this study aims to develop a better understanding of the challenges faced in teledental projects, and outline the factors that impact upon the adoption and implementation of teledental projects, with a focus on orthodontics, thus attempting to provide an explanation for the low uptake in the UK, as well as to suggest factors to encourage success. A literature search was carried out to obtain information concerning teledentistry (and telemedicine) from both primary and secondary research sources. Using the relevant information obtained, Rogers' diffusion of innovation theory was used as a framework, which was subsequently applied to the key stakeholder groups of a healthcare organization. The model describes five characteristics of an innovation: relative advantage, compatibility, complexity, trialability and observability. These attributes are discussed in the context of key stakeholder groups within a healthcare organization: clinicians, patients, hospital managers, and healthcare decision-makers and funders. Each stakeholder group is motivated by different values and experiences, which in turn influence their decision to adopt a new technology. Implementing teledental applications necessitates full comprehension and consideration of the healthcare environment and also a commitment to completely integrate teledentistry within that environment. This is a process that demands strategic alignment with clinical and organizational goals, clinical engagement and strong political support. The challenges within each stakeholder group must be specifically targeted. © 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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.

Hospital Patient Room Design: The Issues Facing 23 Occupational Groups Who Work in Medical/Surgical Patient Rooms.

PubMed

Lavender, Steven A; Sommerich, Carolyn M; Patterson, Emily S; Sanders, Elizabeth B-N; Evans, Kevin D; Park, Sanghyun; Umar, Radin Zaid Radin; Li, Jing

2015-01-01

The aim of this study was to learn from a wide range of hospital staff members about how the design of the patient room in which they work adversely affects their ergonomics or hinders their job performance. In addition to providing a healing space for patients, hospital patient rooms need to serve as functional workplaces for the people who provide clinical care, to clean, or to maintain room functions. Therefore, from a design perspective, it is important to understand the needs of all the users of hospital patient rooms with regard to room design. One hundred forty-seven people, representing 23 different occupational stakeholder groups, participated in either focus groups or interviews in which they were asked to identify room design issues that affect the performance of their work tasks. Key issues shared across multiple stakeholder groups included an inability to have eye contact with the patient when entering the room, inadequate space around the bed for the equipment used by stakeholders, the physical demands experienced as stakeholders move furnishings to accomplish their activities or access equipment, and a lack of available horizontal surfaces. Unique issues were also identified for a number of stakeholder groups. There are a number of issues that should be addressed in the next generation of hospital patient rooms, or when refurbishing existing facilities, so that all occupational stakeholder groups can work effectively, efficiently, and without undue physical stress. © The Author(s) 2015.

Internet safety education for youth: stakeholder perspectives.

PubMed

Moreno, Megan A; Egan, Katie G; Bare, Kaitlyn; Young, Henry N; Cox, Elizabeth D

2013-06-05

Internet use is nearly ubiquitous among US youth; risks to internet use include cyberbullying, privacy violations and unwanted solicitation. Internet safety education may prevent these negative consequences; however, it is unclear at what age this education should begin and what group is responsible for teaching this topic. Surveys were distributed to key stakeholders in youth safety education including public school teachers, clinicians, parents and adolescents. Surveys assessed age at which internet safety education should begin, as well as experiences teaching and learning internet safety. Surveys of adults assessed willingness to teach internet safety. Finally, participants were asked to identify a group whose primary responsibility it should be to teach internet safety. A total of 356 participants completed the survey (93.4% response rate), including 77 teachers, 111 clinicians, 72 parents and 96 adolescents. Stakeholders felt the optimal mean age to begin teaching internet safety was 7.2 years (SD = 2.5), range 2-15. Internet safety was regularly taught by some teachers (20.8%), few clinicians (2.6%) and many parents (40.3%). The majority of teachers, clinicians and parents were willing to teach internet safety, but all groups surveyed identified parents as having primary responsibility for teaching this topic. Findings suggest agreement among key stakeholders for teaching internet safety at a young age, and for identifying parents as primary teachers of this topic. Clinicians have a unique opportunity to support parents by providing resources, guidance and support.

A qualitative study of the perspectives of key stakeholders on the delivery of clinical academic training in the East Midlands

PubMed Central

Evans, Val; MacLeod, Sheona

2018-01-01

Objective Major changes in the design and delivery of clinical academic training in the United Kingdom have occurred yet there has been little exploration of the perceptions of integrated clinic academic trainees or educators. We obtained the views of a range of key stakeholders involved in clinical academic training in the East Midlands. Design A qualitative study with inductive iterative thematic content analysis of findings from trainee surveys and facilitated focus groups. Setting The East Midlands School of Clinical Academic Training. Participants Integrated Clinical Academic Trainees, clinical and academic educators involved in clinical academic training. Main outcome measures The experience, opinions and beliefs of key stakeholders about barriers and enablers in the delivery of clinical academic training. Results We identified key themes many shared by both trainees and educators. These highlighted issues in the systems and process of the integrated academic pathways, career pathways, supervision and support, the assessment process and the balance between clinical and academic training. Conclusions Our findings help inform the future development of integrated academic training programmes. PMID:29487745

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.

Stakeholder Perspectives on Optimizing Communication in a School-Centered Asthma Program.

PubMed

Snieder, Hylke M; Nickels, Sarah; Gleason, Melanie; McFarlane, Arthur; Szefler, Stanley J; Allison, Mandy A

2017-12-01

School-centered asthma programs (SAPs) can be an effective intervention to improve asthma control for underserved populations but little is known about how key stakeholders communicate within these programs. Therefore, our aim was to identify key components of effective communication in a SAP. Primary care providers (PCPs), parents and school nurses associated with a SAP in Denver, Colorado participated in interviews and focus groups about their views on effective communication. Interview and focus group guides were developed using an appreciative inquiry approach and transcripts were analyzed via an iterative coding approach. We conducted 3 focus groups with school nurses (N = 13), interviews with parents (N = 12) and PCPs (N = 10). Stakeholders identified multiple themes that enable communication, namely personal relationships, clear roles, integration of technology, adequate resources, and accessibility. Communication in SAPs is most effective when there are clearly delineated roles with the school being the focal point for education and monitoring of asthmatic students and PCPs being the focal point for diagnosis and changes in care. Communication should take place using modern technology that is integrated into existing workflow. Information sharing is most likely to be successful if there is deliberate relationship building. © 2017, American School Health Association.

HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT IN IRAN.

PubMed

Mohtasham, Farideh; Majdzadeh, Reza; Jamshidi, Ensiyeh

2017-01-01

Hospitals with health technology assessment (HTA) programs have reported its positive effects on the management of resources and costs. This study aimed to identify the barriers faced by hospital-based HTA (HBHTA) in Iran by inductive content analysis of stakeholders' and decision-makers' points of view. The key individuals and organizations that could provide rich, relevant, and diverse data in response to the research question were purposively selected for the interviews and focus group discussion. Twelve stakeholders from seven public hospitals participated in the interviews. Another eighteen stakeholders from twelve HBHTA-related organizations took part in the focus group discussion. Most of the hospitals' senior management team did not feel the need for HBHTA and believed that in Iran a systematic process like HTA faces many challenges. The stakeholders participating in this study highlighted the significance of certain points that needed to be addressed before establishing HBHTA in Iran.

Key Working for Families with Young Disabled Children

PubMed Central

Carter, Bernie; Thomas, Megan

2011-01-01

For families with a disabled child, the usual challenges of family life can be further complicated by the need to access a wide range of services provided by a plethora of professionals and agencies. Key working aims to support children and their families in navigating these complexities ensuring easy access to relevant, high quality, and coordinated care. The aim of this paper is to explore the key worker role in relation to “being a key worker” and “having a key worker”. The data within this paper draw on a larger evaluation study of the Blackpool Early Support Pilot Programme. The qualitative study used an appreciative and narrative approach and utilised mixed methods (interviews, surveys and a nominal group workshop). Data were collected from 43 participants (parents, key workers, and other stakeholders). All stakeholders who had been involved with the service were invited to participate. In the paper we present and discuss the ways in which key working made a difference to the lives of children and their families. We also consider how key working transformed the perspectives of the key workers creating a deeper and richer understanding of family lives and the ways in which other disciplines and agencies worked. Key working contributed to the shift to a much more family-centred approach, and enhanced communication and information sharing between professionals and agencies improved. This resulted in families feeling more informed. Key workers acted in an entrepreneurial fashion, forging new relationships with families and between families and other stakeholders. Parents of young disabled children and their service providers benefited from key working. Much of the benefit accrued came from strong, relational, and social-professional networking which facilitated the embedding of new ways of working into everyday practice. Using an appreciative inquiry approach provided an effective and relevant way of engaging with parents, professionals, and other stakeholders to explore what was working well with key working within an Early Support Pilot Programme. PMID:21994827

Canadian 24-Hour Movement Guidelines for Children and Youth: Exploring the perceptions of stakeholders regarding their acceptability, barriers to uptake, and dissemination.

PubMed

Faulkner, Guy; White, Lauren; Riazi, Negin; Latimer-Cheung, Amy E; Tremblay, Mark S

2016-06-01

Engaging stakeholders in the development of guidelines and plans for implementation is vital. The purpose of this study was to examine stakeholders' (parents, teachers, exercise professionals, paediatricians, and youth) perceptions of the Canadian 24-Hour Movement Behaviour Guidelines for Children and Youth ("Movement Guidelines"). Stakeholders (n = 104) engaged in semi-structured focus groups or interviews to discuss the perceived acceptability of the guidelines, potential barriers to implementation, and preferred methods and messengers of dissemination. A thematic analysis was conducted. Overall, there was consistent support across all stakeholder groups, with the exception of youth participants, for the Movement Guidelines. Stakeholders identified a range of barriers to the uptake of the guidelines including concerns with accurately defining key terms such as "recreational" screen time; everyday challenges such as financial and time constraints; and the possibility of the Movement Guidelines becoming just another source of stress and guilt for already busy and overwhelmed parents. Participants identified a range of recommended methods and messengers for future dissemination. School and medical settings were the most commonly recommended settings through which dissemination efforts should be delivered. Overall, participants representing a range of stakeholder groups were receptive to the new Movement Guidelines and endorsed their value. In complementing the Movement Guidelines, messaging and resources will need to be developed that address common concerns participants had regarding their dissemination and implementation.

Medicine in the 21st century: recommended essential geriatrics competencies for internal medicine and family medicine residents.

PubMed

Williams, Brent C; Warshaw, Gregg; Fabiny, Anne Rebecca; Lundebjerg Mpa, Nancy; Medina-Walpole, Annette; Sauvigne, Karen; Schwartzberg, Joanne G; Leipzig, Rosanne M

2010-09-01

Physician workforce projections by the Institute of Medicine require enhanced training in geriatrics for all primary care and subspecialty physicians. Defining essential geriatrics competencies for internal medicine and family medicine residents would improve training for primary care and subspecialty physicians. The objectives of this study were to (1) define essential geriatrics competencies common to internal medicine and family medicine residents that build on established national geriatrics competencies for medical students, are feasible within current residency programs, are assessable, and address the Accreditation Council for Graduate Medical Education competencies; and (2) involve key stakeholder organizations in their development and implementation. Initial candidate competencies were defined through small group meetings and a survey of more than 100 experts, followed by detailed item review by 26 program directors and residency clinical educators from key professional organizations. Throughout, an 8-member working group made revisions to maintain consistency and compatibility among the competencies. Support and participation by key stakeholder organizations were secured throughout the project. The process identified 26 competencies in 7 domains: Medication Management; Cognitive, Affective, and Behavioral Health; Complex or Chronic Illness(es) in Older Adults; Palliative and End-of-Life Care; Hospital Patient Safety; Transitions of Care; and Ambulatory Care. The competencies map directly onto the medical student geriatric competencies and the 6 Accreditation Council for Graduate Medical Education Competencies. Through a consensus-building process that included leadership and members of key stakeholder organizations, a concise set of essential geriatrics competencies for internal medicine and family medicine residencies has been developed. These competencies are well aligned with concerns for residency training raised in a recent Medicare Payment Advisory Commission report to Congress. Work is underway through stakeholder organizations to disseminate and assess the competencies among internal medicine and family medicine residency programs.

Engaging migrants and other stakeholders to improve communication in cross-cultural consultation in primary care: a theoretically informed participatory study.

PubMed

Lionis, Christos; Papadakaki, Maria; Saridaki, Aristoula; Dowrick, Christopher; O'Donnell, Catherine A; Mair, Frances S; van den Muijsenbergh, Maria; Burns, Nicola; de Brún, Tomas; O'Reilly de Brún, Mary; van Weel-Baumgarten, Evelyn; Spiegel, Wolfgang; MacFarlane, Anne

2016-07-22

Guidelines and training initiatives (G/TIs) are available to support communication in cross-cultural consultations but are rarely implemented in routine practice in primary care. As part of the European Union RESTORE project, our objective was to explore whether the available G/TIs make sense to migrants and other key stakeholders and whether they could collectively choose G/TIs and engage in their implementation in primary care settings. As part of a comparative analysis of 5 linked qualitative case studies, we used purposeful and snowball sampling to recruit migrants and other key stakeholders in primary care settings in Austria, England, Greece, Ireland and the Netherlands. A total of 78 stakeholders participated in the study (Austria 15, England 9, Ireland 11, Greece 16, Netherlands 27), covering a range of groups (migrants, general practitioners, nurses, administrative staff, interpreters, health service planners). We combined Normalisation Process Theory (NPT) and Participatory Learning and Action (PLA) research to conduct a series of PLA style focus groups. Using a standardised protocol, stakeholders' discussions about a set of G/TIs were recorded on PLA commentary charts and their selection process was recorded through a PLA direct-ranking technique. We performed inductive and deductive thematic analysis to investigate sensemaking and engagement with the G/TIs. The need for new ways of working was strongly endorsed by most stakeholders. Stakeholders considered that they were the right people to drive the work forward and were keen to enrol others to support the implementation work. This was evidenced by the democratic selection by stakeholders in each setting of one G/TI as a local implementation project. This theoretically informed participatory approach used across 5 countries with diverse healthcare systems could be used in other settings to establish positive conditions for the start of implementation journeys for G/TIs to improve healthcare for migrants. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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

Exploring Stakeholder Relationships in a University Internship Program: A Qualitative Study

ERIC Educational Resources Information Center

Hoyle, Jeffrey A.

2013-01-01

This study explores stakeholder relationships between the key stakeholders of a public university, private employers, and university students in a marketing undergraduate internship program. By exploring these relationships through the process of stakeholder analysis a deeper understanding of the power dynamics between key stakeholders emerged.…

Defining the medical home: the Oregon experience.

PubMed

Stenger, Robert J; Smith, Jeanene; McMullan, J Bart; Rodriguez, Glenn S; Dorr, David A; Minniti, Mary; Jaffe, Arthur; Pollack, David; Anderson, Mitchell; Kilo, Charles M; Saultz, John W

2012-01-01

The patient-centered medical home (PCMH) is emerging as a key strategy to improve health outcomes, reduce total costs, and strengthen primary care, but a myriad of operational measures of the PCMH have emerged. In 2009, the state of Oregon convened a public, legislatively mandated committee charged with developing PCMH measures. We report on the process of, outcomes of, and lessons learned by this committee. The Oregon PCMH advisory committee was appointed by the director of the Oregon Department of Human Services and held 7 public meetings between October 2009 and February 2010. The committee engaged a diverse group of Oregon stakeholders, including a variety of practicing primary care physicians. The committee developed a PCMH measurement framework, including 6 core attributes, 15 standards, and 27 individual measures. Key successes of the committee's work were to describe PCMH core attributes and functions in patient-centered language and to achieve consensus among a diverse group of stakeholders. Oregon's PCMH advisory committee engaged local stakeholders in a process that resulted in a shared PCMH measurement framework and addressed stakeholders' concerns. The state of Oregon now has implemented a PCMH program using the framework developed by the PCMH advisory committee. The Oregon experience demonstrates that a brief public process can be successful in producing meaningful consensus on PCMH roles and functions and advancing PCMH policy.

Stakeholders' Perceptions of Agronomic Iodine Biofortification: A SWOT-AHP Analysis in Northern Uganda.

PubMed

Olum, Solomon; Gellynck, Xavier; Okello, Collins; Webale, Dominic; Odongo, Walter; Ongeng, Duncan; De Steur, Hans

2018-03-24

Agronomic biofortification (i.e., the application of fertilizer to elevate micronutrient concentrations in staple crops) is a recent strategy recommended for controlling Iodine Deficiency Disorders (IDDs). However, its success inevitably depends on stakeholders' appreciation and acceptance of it. By taking Northern Uganda as a case, this study aimed to capture and compare the perceptions of seven key stakeholder groups with respect to agronomic iodine biofortification. Therefore, we employed a SWOT (Strength, Weaknesses, Opportunities & Threats) analysis in combination with an Analytical Hierarchy Process (AHP). Findings show that stakeholders ( n = 56) are generally positive about agronomic iodine biofortification in Uganda, as its strengths and opportunities outweighed weaknesses and threats. Cultural acceptance and effectiveness are considered the most important strengths while the high IDD prevalence rate and the availability of iodine deficient soils are key opportunities for further developing agronomic iodine biofortification. Environmental concerns about synthetic fertilizers as well as the time needed to supply iodine were considered crucial weaknesses. The limited use of fertilizer in Uganda was the main threat. While this study provides insight into important issues and priorities for iodine biofortification technology in Uganda, including differences in stakeholder views, the application of the SWOT-AHP method will guide future researchers and health planners conducting stakeholder analysis in similar domains.

Stakeholders’ analysis of the medical tourism industry: development strategies in Isfahan

PubMed Central

Jabbari, Alireza; Ferdosi, Masoud; Keyvanara, Mahmoud; Agharahimi, Zahra

2013-01-01

Introduction: Policy makers and decision makers must identify the stakeholders in medical tourism, who will be affected by and/or affect this industry, and determine their status for partnership. The aim of this study was to identify the main stakeholders in Isfahan's medical tourism, analyze them, and provide strategies for developing this industry. Materials and Methods: A qualitative study was conducted in 2011. At first, the key stakeholders in medical tourism were identified in accordance with the experts’ idea and literature review. Then we interviewed the key stakeholders. Data analysis was conducted using the stakeholders’ analyses, which helped in developing strategies. Results: The result showed that the key stakeholders were made up of nine groups. They included the provincial governance of Isfahan, the Cultural Heritage and Tourism Organization of Isfahan, the Chamber of Commerce, the Medical Council, the Isfahan University of Medical Sciences, health service providers, tourism services providers, investors, and the Tosea Saderat Bank. The rate of knowledge of the Cultural Heritage and Tourism Organization of Isfahan, clinic and international relationship of Isfahan University of Medical Sciences from government policy about medical tourism were very much. Private Hospitals, the Medical Council, investors, and the University of Medical Sciences had great power. Private hospitals, clinics, the Cultural Heritage and Tourism Organization of Isfahan, and the University of Medical Sciences were in the supporter position. The effected strategies were the included strategies, focused on increasing power; increasing support, and on maintaining the position. Conclusion: There are different stakeholders in the medical tourism industry. Thus, policy makers can plan, make a policy and decision, and use effective strategies to develop medical tourism by designing a medical tourism stakeholders’ network, a medical tourism provincial council, and clarify the roles and responsibilities of stakeholders. PMID:24251280

Disparate stakeholder management: the case of elk and bison feeding in southern Greater Yellowstone

USGS Publications Warehouse

Koontz, Lynne; Hoag, Dana; DeLong, Don

2012-01-01

For resource decisions to make the most possible progress toward achieving agency mandates, managers must work with stakeholders and may need to at least partially accommodate some of their key underlying interests. To accommodate stakeholder interests, while also substantively working toward fulfilling legal mandates, managers must understand the sociopolitical factors that influence the decision-making process. We coin the phrase disparate stakeholder management (DSM) to describe situations with disparate stakeholders and disparate management solutions. A DSM approach (DSMA) requires decision makers to combine concepts from many sciences, thus releasing them from disciplinary bonds that often constrain innovation and effectiveness. We combined three distinct approaches to develop a DSMA that assisted in developing a comprehensive range of elk and bison management alternatives in the Southern Greater Yellowstone Area. The DSMA illustrated the extent of compromise between meeting legal agency mandates and accommodating the preferences of certain stakeholder groups.

Participatory research for chronic disease prevention in Inuit communities.

PubMed

Gittelsohn, Joel; Roache, Cindy; Kratzmann, Meredith; Reid, Rhonda; Ogina, Julia; Sharma, Sangita

2010-01-01

To develop a community-based chronic disease prevention program for Inuit in Nunavut, Canada. Stake-holders contributed to intervention development through formative research (in-depth interviews (n = 45), dietary recalls (n = 42)), community workshops, group feedback and implementation training. Key cultural themes included the perceived healthiness of country foods, food sharing, and importance of family. During community workshops, key problem foods for intervention were identified as well as healthier culturally and economically acceptable alternatives for these foods. Behaviors for promotion were identified and prioritized. This approach resulted in project acceptance, stakeholder collaboration, and a culturally appropriate program in stores, worksites, and other community venues.

Engaging migrants and other stakeholders to improve communication in cross-cultural consultation in primary care: a theoretically informed participatory study

PubMed Central

Lionis, Christos; Papadakaki, Maria; Saridaki, Aristoula; Dowrick, Christopher; O'Donnell, Catherine A; Mair, Frances S; van den Muijsenbergh, Maria; Burns, Nicola; de Brún, Tomas; O'Reilly de Brún, Mary; van Weel-Baumgarten, Evelyn; Spiegel, Wolfgang; MacFarlane, Anne

2016-01-01

Objectives Guidelines and training initiatives (G/TIs) are available to support communication in cross-cultural consultations but are rarely implemented in routine practice in primary care. As part of the European Union RESTORE project, our objective was to explore whether the available G/TIs make sense to migrants and other key stakeholders and whether they could collectively choose G/TIs and engage in their implementation in primary care settings. Setting As part of a comparative analysis of 5 linked qualitative case studies, we used purposeful and snowball sampling to recruit migrants and other key stakeholders in primary care settings in Austria, England, Greece, Ireland and the Netherlands. Participants A total of 78 stakeholders participated in the study (Austria 15, England 9, Ireland 11, Greece 16, Netherlands 27), covering a range of groups (migrants, general practitioners, nurses, administrative staff, interpreters, health service planners). Primary and secondary outcome measures We combined Normalisation Process Theory (NPT) and Participatory Learning and Action (PLA) research to conduct a series of PLA style focus groups. Using a standardised protocol, stakeholders' discussions about a set of G/TIs were recorded on PLA commentary charts and their selection process was recorded through a PLA direct-ranking technique. We performed inductive and deductive thematic analysis to investigate sensemaking and engagement with the G/TIs. Results The need for new ways of working was strongly endorsed by most stakeholders. Stakeholders considered that they were the right people to drive the work forward and were keen to enrol others to support the implementation work. This was evidenced by the democratic selection by stakeholders in each setting of one G/TI as a local implementation project. Conclusions This theoretically informed participatory approach used across 5 countries with diverse healthcare systems could be used in other settings to establish positive conditions for the start of implementation journeys for G/TIs to improve healthcare for migrants. PMID:27449890

Acceptability and Feasibility of a Shared Decision-Making Model in Work Rehabilitation: A Mixed-Methods Study of Stakeholders' Perspectives.

PubMed

Coutu, Marie-France; Légaré, France; Durand, Marie-José; Stacey, Dawn; Labrecque, Marie-Elise; Corbière, Marc; Bainbridge, Lesley

2018-04-16

Purpose To establish the acceptability and feasibility of implementing a shared decision-making (SDM) model in work rehabilitation. Methods We used a sequential mixed-methods design with diverse stakeholder groups (representatives of private and public employers, insurers, and unions, as well as workers having participated in a work rehabilitation program). First, a survey using a self-administered questionnaire enabled stakeholders to rate their level of agreement with the model's acceptability and feasibility and propose modifications, if necessary. Second, eight focus groups representing key stakeholders (n = 34) and four one-on-one interviews with workers were conducted, based on the questionnaire results. For each stakeholder group, we computed the percentage of agreement with the model's acceptability and feasibility and performed thematic analyses of the transcripts. Results Less than 50% of each stakeholder group initially agreed with the overall acceptability and feasibility of the model. Stakeholders proposed 37 modifications to the objectives, 17 to the activities, and 39 to improve the model's feasibility. Based on in-depth analysis of the transcripts, indicators were added to one objective, an interview guide was added as proposed by insurers to ensure compliance of the SDM process with insurance contract requirements, and one objective was reformulated. Conclusion Despite initially low agreement with the model's acceptability on the survey, subsequent discussions led to three minor changes and contributed to the model's ultimate acceptability and feasibility. Later steps will involve assessing the extent of implementation of the model in real rehabilitation settings to see if other modifications are necessary before assessing its impact.

Breathe Easy at Home

PubMed Central

Rosofsky, Anna; Reid, Margaret; Sandel, Megan; Zielenbach, Molly; Murphy, Johnna; Scammell, Madeleine K.

2016-01-01

The Breathe Easy at Home Program enables clinicians to refer asthmatic patients to Boston Inspectional Services Department (ISD) if they suspect housing conditions trigger symptoms. The authors conducted one-on-one interviews with clinicians (n = 10) who referred patients, and focus groups with inspectors from the ISD (n = 9) and a variety of stakeholders (n = 13), to gain insight into program function and implementation. Clinician interviews revealed inconsistencies in enrollment approaches, dissatisfaction with the web-based system, and patient follow-up difficulties. Inspectors identified barriers to working effectively with residents and landlords, and the stakeholder focus group highlighted successes of an unusual institutional collaboration. Interviews and focus groups identified strong and personal rapport between clinicians, inspectors, and patients as key to program retention, and that participating families required additional support throughout the process. Despite recommendations for improvement in program implementation, clinicians, inspectors, and stakeholders felt that the program overall improved both the home environment and asthma outcomes. PMID:28462348

Study protocol: developing a decision system for inclusive housing: applying a systematic, mixed-method quasi-experimental design.

PubMed

Zeeman, Heidi; Kendall, Elizabeth; Whitty, Jennifer A; Wright, Courtney J; Townsend, Clare; Smith, Dianne; Lakhani, Ali; Kennerley, Samantha

2016-03-15

Identifying the housing preferences of people with complex disabilities is a much needed, but under-developed area of practice and scholarship. Despite the recognition that housing is a social determinant of health and quality of life, there is an absence of empirical methodologies that can practically and systematically involve consumers in this complex service delivery and housing design market. A rigorous process for making effective and consistent development decisions is needed to ensure resources are used effectively and the needs of consumers with complex disability are properly met. This 3-year project aims to identify how the public and private housing market in Australia can better respond to the needs of people with complex disabilities whilst simultaneously achieving key corporate objectives. First, using the Customer Relationship Management framework, qualitative (Nominal Group Technique) and quantitative (Discrete Choice Experiment) methods will be used to quantify the housing preferences of consumers and their carers. A systematic mixed-method, quasi-experimental design will then be used to quantify the development priorities of other key stakeholders (e.g., architects, developers, Government housing services etc.) in relation to inclusive housing for people with complex disabilities. Stakeholders randomly assigned to Group 1 (experimental group) will participate in a series of focus groups employing Analytical Hierarchical Process (AHP) methodology. Stakeholders randomly assigned to Group 2 (control group) will participate in focus groups employing existing decision making processes to inclusive housing development (e.g., Risk, Opportunity, Cost, Benefit considerations). Using comparative stakeholder analysis, this research design will enable the AHP methodology (a proposed tool to guide inclusive housing development decisions) to be tested. It is anticipated that the findings of this study will enable stakeholders to incorporate consumer housing preferences into commercial decisions. Housing designers and developers will benefit from the creation of a parsimonious set of consumer-led housing preferences by which to make informed investments in future housing and contribute to future housing policy. The research design has not been applied in the Australian research context or elsewhere, and will provide a much needed blueprint for market investment to develop viable, consumer directed inclusive housing options for people with complex disability.

Social Work Continuing Education: A Statewide Case Study

ERIC Educational Resources Information Center

Gianino, Mark; Ruth, Betty J.; Miyake Geron, Scott

2016-01-01

This article presents findings from a 2013 qualitative study of social work continuing education (CE) in Massachusetts. Eleven focus groups were conducted with 75 participants from key stakeholder groups: practitioners, educators, licensing board members, and agency administrators. Although positive perspectives surfaced--such as diversity of CE…

Defining Value in Cancer Care: AVBCC 2013 Steering Committee Report.

PubMed

Zweigenhaft, Burt; Bosserman, Linda; Kenney, James T; Lawless, Grant D; Marsland, Thomas A; Deligdish, Craig K; Burgoyne, Douglas S; Knopf, Kevin B; Long, Douglas M; McKercher, Patrick; Owens, Gary M; Hennessy, John E; Lang, James R; Malin, Jennifer; Natelson, Leonard; Palmgren, Matthew C; Slotnik, Jayson; Shockney, Lillie D; Vogenberg, F Randy

2013-07-01

The AVBCC Annual Meeting experiences exponential growth in attendance and participation as oncologists, payers, employers, managed care executives, patient advocates, and drug manufacturers convened in Hollywood, FL, on May 2-5, 2013, for the Third Annual Conference of the Association for Value-Based Cancer Care (AVBCC). The conference presented an all-inclusive open forum for stakeholder dialogue and integration across the cancer care continuum, facilitating an open dialogue among the various healthcare stakeholders to align their perspectives around the urgent need to address value in cancer care, costs, patient education, safety, outcomes, and quality. The AVBCC 2013 Steering Committee was held on the first day of the conference to define value in cancer care. The committee was divided into 7 groups, each representing a key stakeholder in oncology. The goal of the Steering Committee was to define value from the particular point of view of each of the stakeholder groups and to suggest how that particular perspective can contribute to the value proposition in oncology, by balancing cost, quality, and access to care to improve overall patient outcomes. The following summary highlights the major points addressed by each group.

Failure Impact Analysis of Key Management in AMI Using Cybernomic Situational Assessment (CSA)

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

Abercrombie, Robert K; Sheldon, Frederick T; Hauser, Katie R

2013-01-01

In earlier work, we presented a computational framework for quantifying the security of a system in terms of the average loss a stakeholder stands to sustain as a result of threats to the system. We named this system, the Cyberspace Security Econometrics System (CSES). In this paper, we refine the framework and apply it to cryptographic key management within the Advanced Metering Infrastructure (AMI) as an example. The stakeholders, requirements, components, and threats are determined. We then populate the matrices with justified values by addressing the AMI at a higher level, rather than trying to consider every piece of hardwaremore » and software involved. We accomplish this task by leveraging the recently established NISTR 7628 guideline for smart grid security. This allowed us to choose the stakeholders, requirements, components, and threats realistically. We reviewed the literature and selected an industry technical working group to select three representative threats from a collection of 29 threats. From this subset, we populate the stakes, dependency, and impact matrices, and the threat vector with realistic numbers. Each Stakeholder s Mean Failure Cost is then computed.« less

Working Group Reports and Presentations: Mars Settlement and Society

NASA Technical Reports Server (NTRS)

McKay, Chris

2006-01-01

The long-term implications of space exploration must be considered early in the process. With this in mind, the Mars Settlement and Society Group focused on five key areas: Philosophical Framework, Community Infrastructure and Government, Creating Stakeholders, Human Subsystems, and Habitat Design. The team proposes long and short term goals to support getting to and then staying long-term on Mars. All objectives shared the theme that they should engage, inspire, and educate the public with the intent of fostering stakeholders in the exploration of Mars. The objectives of long-term settlement on Mars should not neglect group dynamics, issues of reproduction, and a strong philosophical framework for the establishment of a society.

A framework for engaging stakeholders on the management of alien species.

PubMed

Novoa, Ana; Shackleton, Ross; Canavan, Susan; Cybèle, Cathleen; Davies, Sarah J; Dehnen-Schmutz, Katharina; Fried, Jana; Gaertner, Mirijam; Geerts, Sjirk; Griffiths, Charles L; Kaplan, Haylee; Kumschick, Sabrina; Le Maitre, David C; Measey, G John; Nunes, Ana L; Richardson, David M; Robinson, Tamara B; Touza, Julia; Wilson, John R U

2018-01-01

Alien species can have major ecological and socioeconomic impacts in their novel ranges and so effective management actions are needed. However, management can be contentious and create conflicts, especially when stakeholders who benefit from alien species are different from those who incur costs. Such conflicts of interests mean that management strategies can often not be implemented. There is, therefore, increasing interest in engaging stakeholders affected by alien species or by their management. Through a facilitated workshop and consultation process including academics and managers working on a variety of organisms and in different areas (urban and rural) and ecosystems (terrestrial and aquatic), we developed a framework for engaging stakeholders in the management of alien species. The proposed framework for stakeholder engagement consists of 12 steps: (1) identify stakeholders; (2) select key stakeholders for engagement; (3) explore key stakeholders' perceptions and develop initial aims for management; (4) engage key stakeholders in the development of a draft management strategy; (5) re-explore key stakeholders' perceptions and revise the aims of the strategy; (6) co-design general aims, management objectives and time frames with key stakeholders; (7) co-design a management strategy; (8) facilitate stakeholders' ownership of the strategy and adapt as required; and (9) implement the strategy and monitor management actions to evaluate the need for additional or future actions. In case additional management is needed after these actions take place, some extra steps should be taken: (10) identify any new stakeholders, benefits, and costs; (11) monitor engagement; and (12) revise management strategy. Overall, we believe that our framework provides an effective approach to minimize the impact of conflicts created by alien species management. Copyright © 2017 Elsevier Ltd. All rights reserved.

Investigating Stakeholder Attitudes and Opinions on School-Based Human Papillomavirus Vaccination Programs

PubMed Central

Nodulman, Jessica A.; Starling, Randall; Kong, Alberta S.; Buller, David B.; Wheeler, Cosette M.; Woodall, W. Gill

2015-01-01

BACKGROUND In several countries worldwide, school-based human papillomavirus (HPV) vaccination programs have been successful; however, little research has explored US stakeholders’ acceptance toward school-based HPV vaccination programs. METHODS A total of 13 focus groups and 12 key informant interviews (N = 117; 85% females; 66% racial/ethnic minority) were conducted with 5 groups of stakeholders: parents of adolescent girls, parents of adolescent boys, adolescent girls, middle school nurses, and middle school administrators throughout the 5 public health regions of New Mexico. RESULTS All groups of stakeholders lacked knowledge on HPV and HPV vaccines. Stakeholders were interested in—but apprehensive about—the benefits of HPV vaccination. Despite previous literature showing the benefits of using middle schools as an HPV vaccination site, stakeholders did not deem middle schools as a viable site for vaccination. Nurses reported that using the school as an HPV vaccination site had not occurred to them; parents and adolescents stated they were uncertain about using this type of program. School administrators indicated that they lacked implementation authority. CONCLUSIONS Our study uncovered barriers to using middle schools as a site of HPV vaccination. Resources should be directed toward increased support and education for middle school nurses who function as opinion leaders relevant to the uptake of HPV vaccination. PMID:25846308

Using causal loop diagrams for the initialization of stakeholder engagement in soil salinity management in agricultural watersheds in developing countries: a case study in the Rechna Doab watershed, Pakistan.

PubMed

Inam, Azhar; Adamowski, Jan; Halbe, Johannes; Prasher, Shiv

2015-04-01

Over the course of the last twenty years, participatory modeling has increasingly been advocated as an integral component of integrated, adaptive, and collaborative water resources management. However, issues of high cost, time, and expertise are significant hurdles to the widespread adoption of participatory modeling in many developing countries. In this study, a step-wise method to initialize the involvement of key stakeholders in the development of qualitative system dynamics models (i.e. causal loop diagrams) is presented. The proposed approach is designed to overcome the challenges of low expertise, time and financial resources that have hampered previous participatory modeling efforts in developing countries. The methodological framework was applied in a case study of soil salinity management in the Rechna Doab region of Pakistan, with a focus on the application of qualitative modeling through stakeholder-built causal loop diagrams to address soil salinity problems in the basin. Individual causal loop diagrams were developed by key stakeholder groups, following which an overall group causal loop diagram of the entire system was built based on the individual causal loop diagrams to form a holistic qualitative model of the whole system. The case study demonstrates the usefulness of the proposed approach, based on using causal loop diagrams in initiating stakeholder involvement in the participatory model building process. In addition, the results point to social-economic aspects of soil salinity that have not been considered by other modeling studies to date. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Safe and Effective Use of Shared Data Underpinned by Stakeholder Engagement and Evaluation Practice.

PubMed

Georgiou, Andrew; Magrabi, Farah; Hypponen, Hannele; Wong, Zoie Shui-Yee; Nykänen, Pirkko; Scott, Philip J; Ammenwerth, Elske; Rigby, Michael

2018-04-22

 The paper draws attention to: i) key considerations involving the confidentiality, privacy, and security of shared data; and ii) the requirements needed to build collaborative arrangements encompassing all stakeholders with the goal of ensuring safe, secure, and quality use of shared data.  A narrative review of existing research and policy approaches along with expert perspectives drawn from the International Medical Informatics Association (IMIA) Working Group on Technology Assessment and Quality Development in Health Care and the European Federation for Medical Informatics (EFMI) Working Group for Assessment of Health Information Systems.  The technological ability to merge, link, re-use, and exchange data has outpaced the establishment of policies, procedures, and processes to monitor the ethics and legality of shared use of data. Questions remain about how to guarantee the security of shared data, and how to establish and maintain public trust across large-scale shared data enterprises. This paper identifies the importance of data governance frameworks (incorporating engagement with all stakeholders) to underpin the management of the ethics and legality of shared data use. The paper also provides some key considerations for the establishment of national approaches and measures to monitor compliance with best practice. Data sharing endeavours can help to underpin new collaborative models of health care which provide shared information, engagement, and accountability amongst all stakeholders. We believe that commitment to rigorous evaluation and stakeholder engagement will be critical to delivering health data benefits and the establishment of collaborative models of health care into the future. Georg Thieme Verlag KG Stuttgart.

General practitioners and sickness certification for injury in Australia.

PubMed

Mazza, Danielle; Brijnath, Bianca; Singh, Nabita; Kosny, Agnieszka; Ruseckaite, Rasa; Collie, Alex

2015-08-15

Strong evidence supports an early return to work after injury as a way to improve recovery. In Australia, General Practitioners (GPs) see about 96 % of injured workers, making them the main gatekeepers to workers' entitlements. Most people with compensable injuries in Australia are certified as "unfit to work" by their GP, with a minority of patients certified for modified work duties. The reasons for this apparent dissonance between evidence and practice remain unexplored. Little is known about the factors that influence GP sickness certification behaviour in Australia. The aim of this study is to describe the factors influencing Australian GPs certification practice through qualitative interviews with four key stakeholders. From September to December 2012, 93 semi-structured interviews were undertaken in Melbourne, Australia. Participants included GPs, injured workers, employers and compensation agents. Data were thematically analysed. Five themes describing factors influencing GP certification were identified: 1. Divergent stakeholder views about the GP's role in facilitating return to work; 2. Communication between the four stakeholder groups; 3. Conflict between the stakeholder groups; 4. Allegations of GPs and injured workers misusing the compensation system and 5. The layout and content of the sickness certificate itself. By exploring GP certification practice from the perspectives of four key stakeholders, this study suggests that certification is an administrative and clinical task underpinned by a host of social and systemic factors. The findings highlight opportunities such as practice guideline development and improvements to the sickness certificate itself that may be targeted to improve GP sickness certification behaviour and return to work outcomes in an Australian context.

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.

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.

Factors Associated with Faculty Use of Student Data for Instructional Improvement

ERIC Educational Resources Information Center

Svinicki, Marilla D.; Williams, Kyle; Rackley, Kadie; Sanders, Anke J. Z.; Pine, Lisa; Stewart, Julie

2016-01-01

Much is being said in education about the value of adopting data-based or analytics approaches to instructional improvement. One important group of stakeholders in this effort is the faculty. "In many cases, the key constituency group is faculty, whose powerful voice and genuine participation often determine the success or failure of…

A responsive evaluation of an Aboriginal nursing education access program.

PubMed

Curran, Vernon; Solberg, Shirley; LeFort, Sandra; Fleet, Lisa; Hollett, Ann

2008-01-01

Nursing education access programs have been introduced in a number of countries to address the shortage of healthcare providers of Aboriginal descent. An evaluation study of a nursing education access program in Labrador, Canada, was undertaken using a Responsive Evaluation approach. Interviews and focus groups with program stakeholders were conducted. Program effectiveness was influenced by culturally relevant curriculum, experiential and authentic learning opportunities, academic and social support, and the need for partnership building between stakeholders. The authors report key findings resulting from the Responsive Evaluation.

Improving informed consent: Stakeholder views.

PubMed

Anderson, Emily E; Newman, Susan B; Matthews, Alicia K

2017-01-01

Innovation will be required to improve the informed consent process in research. We aimed to obtain input from key stakeholders-research participants and those responsible for obtaining informed consent-to inform potential development of a multimedia informed consent "app." This descriptive study used a mixed-methods approach. Five 90-minute focus groups were conducted with volunteer samples of former research participants and researchers/research staff responsible for obtaining informed consent. Participants also completed a brief survey that measured background information and knowledge and attitudes regarding research and the use of technology. Established qualitative methods were used to conduct the focus groups and data analysis. We conducted five focus groups with 41 total participants: three groups with former research participants (total n = 22), and two groups with researchers and research coordinators (total n = 19). Overall, individuals who had previously participated in research had positive views regarding their experiences. However, further discussion elicited that the informed consent process often did not meet its intended objectives. Findings from both groups are presented according to three primary themes: content of consent forms, experience of the informed consent process, and the potential of technology to improve the informed consent process. A fourth theme, need for lay input on informed consent, emerged from the researcher groups. Our findings add to previous research that suggests that the use of interactive technology has the potential to improve the process of informed consent. However, our focus-group findings provide additional insight that technology cannot replace the human connection that is central to the informed consent process. More research that incorporates the views of key stakeholders is needed to ensure that multimedia consent processes do not repeat the mistakes of paper-based consent forms.

The Cultural and Social Context of Oral and Pharyngeal Cancer Risk and Control among Hispanics in New York

PubMed Central

Cruz, Gustavo D.; Shulman, Lawrence C.; Kumar, Jayanth V.; Salazar, Christian R.

2007-01-01

New York City (NYC) has one of the highest incidence and mortality rates of oral and pharyngeal cancer (OPC) for Hispanics of any major U.S. city. This qualitative assessment explores OPC awareness, attitudes, and screening practices among at-risk Hispanics, health care providers, and community leaders in a Hispanic neighborhood of NYC. Four focus groups (N=39) were conducted with at-risk Hispanics. Structured interviews were conducted with ten health care providers (four physicians, four dentists, two dental hygienists) and three key community leaders. Results showed major gaps in OPC awareness across all key stakeholders. Focus group participants expressed difficulty in accessing appropriate health care. Health care providers were not familiar with OPC prevention and early detection practices. Community leaders lacked the knowledge and resources necessary for advocating prevention and early detection for their constituencies. All participants reported cultural, social, and structural barriers to prevention. There is a need for developing a comprehensive, culturally competent health communication program that targets all key stakeholders in the at-risk Hispanic community of NYC. PMID:17982210

Breathe Easy at Home: A Qualitative Evaluation of a Pediatric Asthma Intervention.

PubMed

Rosofsky, Anna; Reid, Margaret; Sandel, Megan; Zielenbach, Molly; Murphy, Johnna; Scammell, Madeleine K

2016-01-01

The Breathe Easy at Home Program enables clinicians to refer asthmatic patients to Boston Inspectional Services Department (ISD) if they suspect housing conditions trigger symptoms. The authors conducted one-on-one interviews with clinicians ( n = 10) who referred patients, and focus groups with inspectors from the ISD ( n = 9) and a variety of stakeholders ( n = 13), to gain insight into program function and implementation. Clinician interviews revealed inconsistencies in enrollment approaches, dissatisfaction with the web-based system, and patient follow-up difficulties. Inspectors identified barriers to working effectively with residents and landlords, and the stakeholder focus group highlighted successes of an unusual institutional collaboration. Interviews and focus groups identified strong and personal rapport between clinicians, inspectors, and patients as key to program retention, and that participating families required additional support throughout the process. Despite recommendations for improvement in program implementation, clinicians, inspectors, and stakeholders felt that the program overall improved both the home environment and asthma outcomes.

Universal financial protection through National Health Insurance: a stakeholder analysis of the proposed one-time premium payment policy in Ghana.

PubMed

Abiiro, Gilbert Abotisem; McIntyre, Di

2013-05-01

Extending coverage to the informal sector is a key challenge to achieving universal coverage through contributory health insurance schemes. Ghana introduced a mandatory National Health Insurance system in 2004 to provide financial protection for both the formal and informal sectors through a combination of taxes and annual premium payments. As part of its election promise in 2008, the current government (then in opposition) promised to make the payment of premiums 'one-time'. This has been a very controversial policy issue in Ghana. This study sought to contribute to assessing the feasibility of the proposed policy by exploring the understandings of various stakeholders on the policy, their interests or concerns, potential positions, power and influences on it, as well as the general prospects and challenges for its implementation. Data were gathered from a review of relevant documents in the public domain, 28 key informant interviews and six focus group discussions with key stakeholders in Accra and two other districts. The results show that there is a lot of confusion in stakeholders' understanding of the policy issue, and, because of the uncertainties surrounding it, most powerful stakeholders are yet to take clear positions on it. However, stakeholders raised concerns that revolved around issues such as: the meaning of a one-time premium within an insurance scheme context, the affordability of the one-time premium, financing sources and sustainability of the policy, as well as the likely impact of the policy on equity in access to health care. Policy-makers need to clearly explain the meaning of the one-time premium policy and how it will be funded, and critically consider the concerns raised by stakeholders before proceeding with further attempts to implement it. For other countries planning universal coverage reforms, it is important that the terminology of their reforms clearly reflects policy objectives.

Defining Value in Cancer Care: AVBCC 2013 Steering Committee Report

PubMed Central

Zweigenhaft, Burt; Bosserman, Linda; Kenney, James T.; Lawless, Grant D.; Marsland, Thomas A.; Deligdish, Craig K.; Burgoyne, Douglas S.; Knopf, Kevin B.; Long, Douglas M.; McKercher, Patrick; Owens, Gary M.; Hennessy, John E.; Lang, James R.; Malin, Jennifer; Natelson, Leonard; Palmgren, Matthew C.; Slotnik, Jayson; Shockney, Lillie D.; Vogenberg, F. Randy

2013-01-01

The AVBCC Annual Meeting experiences exponential growth in attendance and participation as oncologists, payers, employers, managed care executives, patient advocates, and drug manufacturers convened in Hollywood, FL, on May 2–5, 2013, for the Third Annual Conference of the Association for Value-Based Cancer Care (AVBCC). The conference presented an all-inclusive open forum for stakeholder dialogue and integration across the cancer care continuum, facilitating an open dialogue among the various healthcare stakeholders to align their perspectives around the urgent need to address value in cancer care, costs, patient education, safety, outcomes, and quality. The AVBCC 2013 Steering Committee was held on the first day of the conference to define value in cancer care. The committee was divided into 7 groups, each representing a key stakeholder in oncology. The goal of the Steering Committee was to define value from the particular point of view of each of the stakeholder groups and to suggest how that particular perspective can contribute to the value proposition in oncology, by balancing cost, quality, and access to care to improve overall patient outcomes. The following summary highlights the major points addressed by each group. PMID:24991360

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.

Setting research priorities in tobacco control: a stakeholder engagement project

PubMed Central

Lindson, Nicola; Richards‐Doran, Dan; Heath, Laura

2017-01-01

Abstract Background and Aims The Cochrane Tobacco Addiction Group (TAG) conducts systematic reviews of the evidence for tobacco cessation and prevention interventions. In 2016 TAG conducted a priority‐setting, stakeholder engagement project to identify where further research is needed in the areas of tobacco control and smoking cessation. Design The project comprised two surveys and a workshop. A range of stakeholders participated, including members of the public (smokers and ex‐smokers), clinicians, researchers, research funders, health‐care commissioners and public health organizations. The first survey phase identified unanswered research questions in the field of tobacco control. The second phase asked participants to rank these, with overall rankings calculated by combining scores across participants. The workshop allowed attendees to discuss prioritization of topics and questions in more depth. Workshop discussions were transcribed and analysed thematically, and a final voting activity at the close of the workshop allowed participants to choose topics to prioritize and to de‐prioritize. Findings A total of 304 stakeholders (researchers, health professionals, smokers and ex‐smokers, guideline developers, research funders and policymakers, representing 28 countries) identified 183 unanswered research questions. These were categorized into 15 research categories. A total of 175 participants prioritized categories and questions in the second survey phase, with ‘electronic cigarettes’; ‘addressing inequalities’; and ‘mental health and other substance abuse’ prioritized as the top three categories. Forty‐three stakeholders attended the workshop and discussed reasons for and against category prioritization. Prioritized research categories largely mirrored those in the survey stage, although ‘treatment delivery’ also emerged as a key category. Five cross‐cutting themes emerged: efficacy; relative efficacy; cost effectiveness; addressing inequalities; and different types of evidence. Conclusions There are many unanswered questions in the field of tobacco control. Stakeholders highlighted electronic cigarettes, addressing inequalities and mental health and other substance abuse as key areas for further research, and efficacy, relative efficacy, cost‐effectiveness and use of non‐randomized studies as important themes cutting across research areas. Future prioritization work would benefit from targeting non‐US and non‐UK stakeholders explicitly and from examining where priorities may differ based on stakeholder group. PMID:28879662

Setting research priorities in tobacco control: a stakeholder engagement project.

PubMed

Lindson, Nicola; Richards-Doran, Dan; Heath, Laura; Hartmann-Boyce, Jamie

2017-12-01

The Cochrane Tobacco Addiction Group (TAG) conducts systematic reviews of the evidence for tobacco cessation and prevention interventions. In 2016 TAG conducted a priority-setting, stakeholder engagement project to identify where further research is needed in the areas of tobacco control and smoking cessation. The project comprised two surveys and a workshop. A range of stakeholders participated, including members of the public (smokers and ex-smokers), clinicians, researchers, research funders, health-care commissioners and public health organizations. The first survey phase identified unanswered research questions in the field of tobacco control. The second phase asked participants to rank these, with overall rankings calculated by combining scores across participants. The workshop allowed attendees to discuss prioritization of topics and questions in more depth. Workshop discussions were transcribed and analysed thematically, and a final voting activity at the close of the workshop allowed participants to choose topics to prioritize and to de-prioritize. A total of 304 stakeholders (researchers, health professionals, smokers and ex-smokers, guideline developers, research funders and policymakers, representing 28 countries) identified 183 unanswered research questions. These were categorized into 15 research categories. A total of 175 participants prioritized categories and questions in the second survey phase, with 'electronic cigarettes'; 'addressing inequalities'; and 'mental health and other substance abuse' prioritized as the top three categories. Forty-three stakeholders attended the workshop and discussed reasons for and against category prioritization. Prioritized research categories largely mirrored those in the survey stage, although 'treatment delivery' also emerged as a key category. Five cross-cutting themes emerged: efficacy; relative efficacy; cost effectiveness; addressing inequalities; and different types of evidence. There are many unanswered questions in the field of tobacco control. Stakeholders highlighted electronic cigarettes, addressing inequalities and mental health and other substance abuse as key areas for further research, and efficacy, relative efficacy, cost-effectiveness and use of non-randomized studies as important themes cutting across research areas. Future prioritization work would benefit from targeting non-US and non-UK stakeholders explicitly and from examining where priorities may differ based on stakeholder group. © 2017 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

Stakeholder views on factors influencing the wellbeing and health sector engagement of young Asian New Zealanders.

PubMed

Peiris-John, Roshini; Wong, Agnes; Sobrun-Maharaj, Amritha; Ameratunga, Shanthi

2016-03-01

INTRODUCTION In New Zealand, while the term 'Asians' in popular discourse means East and South-east Asian peoples, Statistics New Zealand's definition includes people of many nationalities from East, South and South-east Asia, all with quite different cultural norms, taboos and degrees of conservatism. In a context where 'Asian' youth data are typically presented in aggregate form, there are notable gaps in knowledge regarding the contextual determinants of health in this highly heterogeneous group. This qualitative study explored key stakeholder views on issues that would be most useful to explore on the health and wellbeing of Asian youth and processes that would foster engagement of Asian youth in health research. METHODS Interviews were conducted with six key stakeholders whose professional activities were largely focused on the wellbeing of Asian people. The general inductive approach was used to identify and analyse themes in the qualitative text data. FINDINGS Six broad themes were identified from the key stakeholder interviews framed as priority areas that need further exploration: cultural identity, integration and acculturation; barriers to help-seeking; aspects to consider when engaging Asian youth in research (youth voice, empowerment and participatory approach to research); parental influence and involvement in health research; confidentiality and anonymity; and capacity building and informing policy. CONCLUSION With stakeholders strongly advocating the engagement of Asian youth in the health research agenda this study highlights the importance of engaging youth alongside service providers to collaborate on research and co-design responsive primary health care services in a multicultural setting. KEYWORDS Asian youth; New Zealand; health research; minority health; Community and social participation.

An Exploration of Edible Palm Weevil Larvae (Akokono) as a Source of Nutrition and Livelihood: Perspectives From Ghanaian Stakeholders.

PubMed

Laar, Amos; Kotoh, Agnes; Parker, Megan; Milani, Peiman; Tawiah, Charlotte; Soor, Shobhita; Anankware, Jacob P; Kalra, Nikhila; Manu, Grace; Tandoh, Akua; Zobrist, Stephanie; Engmann, Cyril; Pelto, Gretel

2017-12-01

Meeting the nutritive needs of infants and young children is a challenge in Ghana. Alternative animal source foods, including insects, could enhance infant and young child dietary quality while also improving livelihoods. To investigate the perspectives of Ghanaian stakeholders on the acceptability of the palm weevil larvae ( akokono) as a food source and the feasibility of micro-farming this local edible insect as a complementary food for infants and young children. We conducted an ethnographic study in the Brong-Ahafo Region of Ghana. First, 48 caregivers were asked questions about feeding and care practices, including attitudes toward production and consumption of akokono. Then, a selection of previously interviewed respondents joined 1 of 8 focus group discussions to provide further insight on key themes that emerged from earlier interviews. Concurrently, interviews with 25 other key local stakeholders were conducted. Respondents generally had favorable perceptions of akokono as a nutritious food. A small minority would not consume akokono for religious reasons. Key factors positively influencing the acceptability of akokono as a complementary food were familiarity with the consumption of akokono by the primary caregiver and health worker endorsement of akokono. Stakeholders consider the larvae farmable and were open to its domestication. Anticipated barriers to scaling up akokono micro-farming include a need for greater familiarity with and acceptance of the insect as food for infants and young children and creation of a sustainable market. Engagement with stakeholders, including health workers, will facilitate use of akokono as a complementary food.

The End-of-Life Experience in Long-Term Care: Five Themes Identified from Focus Groups with Residents, Family Members, and Staff

ERIC Educational Resources Information Center

Munn, Jean C.; Dobbs, Debra; Meier, Andrea; Williams, Christianna S.; Biola, Holly; Zimmerman, Sheryl

2008-01-01

Purpose: We designed this study to examine the end-of-life (EOL) experience in long-term care (LTC) based on input from key stakeholders. Design and Methods: The study consisted of 10 homogeneous focus groups drawn from a purposive sample of LTC residents (2 groups; total n = 11), family caregivers (2 groups; total n = 19), paraprofessional staff…

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.

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.

Efficient and equitable design of marine protected areas in Fiji through inclusion of stakeholder-specific objectives in conservation planning.

PubMed

Gurney, Georgina G; Pressey, Robert L; Ban, Natalie C; Álvarez-Romero, Jorge G; Jupiter, Stacy; Adams, Vanessa M

2015-10-01

The efficacy of protected areas varies, partly because socioeconomic factors are not sufficiently considered in planning and management. Although integrating socioeconomic factors into systematic conservation planning is increasingly advocated, research is needed to progress from recognition of these factors to incorporating them effectively in spatial prioritization of protected areas. We evaluated 2 key aspects of incorporating socioeconomic factors into spatial prioritization: treatment of socioeconomic factors as costs or objectives and treatment of stakeholders as a single group or multiple groups. Using as a case study the design of a system of no-take marine protected areas (MPAs) in Kubulau, Fiji, we assessed how these aspects affected the configuration of no-take MPAs in terms of trade-offs between biodiversity objectives, fisheries objectives, and equity in catch losses among fisher stakeholder groups. The achievement of fisheries objectives and equity tended to trade-off concavely with increasing biodiversity objectives, indicating that it is possible to achieve low to mid-range biodiversity objectives with relatively small losses to fisheries and equity. Importantly, the extent of trade-offs depended on the method used to incorporate socioeconomic data and was least severe when objectives were set for each fisher stakeholder group explicitly. We found that using different methods to incorporate socioeconomic factors that require similar data and expertise can result in plans with very different impacts on local stakeholders. © 2015 Society for Conservation Biology.

Engaging blind and partially sighted stakeholders in transformational change.

PubMed

Pearson, Victoria

2016-09-01

For non-profit organizations in the disability sector, engaging stakeholders with disabilities on matters of strategic planning is both a responsibility and an expectation. As part of our current strategic plan, which calls for organizational and systemic transformation, the Canadian National Institute for the Blind (CNIB) has engaged blind and partially sighted stakeholders alongside other interest groups to build and advocate for a more holistic model of vision healthcare and rehabilitation. This article describes the CNIB's multi-year process, including early-stage consultations, collaborative strategy development, and political advocacy and shares our organization's key success factors and learnings in creating meaningful, mutually beneficial engagement. © 2016 The Canadian College of Health Leaders.

Ocean Research Priorities: Similarities and Differences among Scientists, Policymakers, and Fishermen in the United States

PubMed Central

Mason, Julia G.; Rudd, Murray A.; Crowder, Larry B.

2017-01-01

Abstract Understanding and solving complex ocean conservation problems requires cooperation not just among scientific disciplines but also across sectors. A recently published survey that probed research priorities of marine scientists, when provided to ocean stakeholders, revealed some agreement on priorities but also illuminated key differences. Ocean acidification, cumulative impacts, bycatch effects, and restoration effectiveness were in the top 10 priorities for scientists and stakeholder groups. Significant priority differences were that scientists favored research questions about ocean acidification and marine protected areas; policymakers prioritized questions about habitat restoration, bycatch, and precaution; and fisheries sector resource users called for the inclusion of local ecological knowledge in policymaking. These results quantitatively demonstrate how different stakeholder groups approach ocean issues and highlight the need to incorporate other types of knowledge in the codesign of solutions-oriented research, which may facilitate cross-sectoral collaboration. PMID:28533565

Ocean Research Priorities: Similarities and Differences among Scientists, Policymakers, and Fishermen in the United States.

PubMed

Mason, Julia G; Rudd, Murray A; Crowder, Larry B

2017-05-01

Understanding and solving complex ocean conservation problems requires cooperation not just among scientific disciplines but also across sectors. A recently published survey that probed research priorities of marine scientists, when provided to ocean stakeholders, revealed some agreement on priorities but also illuminated key differences. Ocean acidification, cumulative impacts, bycatch effects, and restoration effectiveness were in the top 10 priorities for scientists and stakeholder groups. Significant priority differences were that scientists favored research questions about ocean acidification and marine protected areas; policymakers prioritized questions about habitat restoration, bycatch, and precaution; and fisheries sector resource users called for the inclusion of local ecological knowledge in policymaking. These results quantitatively demonstrate how different stakeholder groups approach ocean issues and highlight the need to incorporate other types of knowledge in the codesign of solutions-oriented research, which may facilitate cross-sectoral collaboration.

Developing biodiversity indicators on a stakeholders' opinions basis: the gypsum industry Key Performance Indicators framework.

PubMed

Pitz, Carline; Mahy, Grégory; Vermeulen, Cédric; Marlet, Christine; Séleck, Maxime

2016-07-01

This study aims to establish a common Key Performance Indicators (KPIs) framework for reporting about the gypsum industry biodiversity at the European level. In order to integrate different opinions and to reach a consensus framework, an original participatory process approach has been developed among different stakeholder groups: Eurogypsum, European and regional authorities, university scientists, consulting offices, European and regional associations for the conservation of nature, and the extractive industry. The strategy is developed around four main steps: (1) building of a maximum set of indicators to be submitted to stakeholders based on the literature (Focus Group method); (2) evaluating the consensus about indicators through a policy Delphi survey aiming at the prioritization of indicator classes using the Analytic Hierarchy Process method (AHP) and of individual indicators; (3) testing acceptability and feasibility through analysis of Environmental Impact Assessments (EIAs) and visits to three European quarries; (4) Eurogypsum final decision and communication. The resulting framework contains a set of 11 indicators considered the most suitable for all the stakeholders. Our KPIs respond to European legislation and strategies for biodiversity. The framework aims at improving sustainability in quarries and at helping to manage biodiversity as well as to allow the creation of coherent reporting systems. The final goal is to allow for the definition of the actual biodiversity status of gypsum quarries and allow for enhancing it. The framework is adaptable to the local context of each gypsum quarry.

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.

Navigating HIV prevention policy and Islam in Malaysia: contention, compatibility or reconciliation? Findings from in-depth interviews among key stakeholders.

PubMed

Barmania, Sima; Aljunid, Syed Mohamed

2016-07-07

Malaysia is a multicultural society, predominantly composed of a Muslim majority population, where Islam is influential. Malaysia has a concentrated HIV epidemic amongst high risk groups, such as, Intravenous Drug Users (IVDU), sex workers, transgender women and Men who have sex with Men (MSM). The objective of this study is to understand how Islam shapes HIV prevention strategies in Malaysia by interviewing the three key stakeholder groups identified as being influential, namely the Ministry of Health, Religious leaders and People living with HIV. Thirty-Five in depth semi structured interviews were undertaken with religious leaders, Ministry of Health and People living with HIV in the last half of 2013 using purposive sampling. Interviews adhered to a topic guide, were audiotaped, and transcribed verbatim and analyzed using a framework analysis. Themes including the importance of Islam to health, stakeholder relationships and opinions on HIV prevention emerged. Islam was seen to play a pivotal role in shaping strategies relating to HIV prevention in Malaysia both directly and indirectly. Stakeholders often held different approaches to HIV prevention, which had to be sensitively considered, with some favouring promotion of Islamic principles, whilst others steering towards a more public health centred approach. The study suggests that Islam indeed plays an important role in shaping health policies and strategies related to HIV prevention in Malaysia. Certainly, stakeholders do hold differing viewpoints, such as stances of what constitutes the right approach to HIV prevention. However there are also areas of broad consensus, such as the importance in Islamic tradition to prevent harm and disease, which can be crafted into existing and future HIV prevention strategies in Malaysia, as well as the wider Muslim world.

The clinical role of lecturers in nursing in Ireland: perceptions from key stakeholder groups in nurse education on the role.

PubMed

Meskell, Pauline; Murphy, Kathleen; Shaw, David

2009-10-01

The clinical role of lecturers in nursing has been a focus of debate since the integration of nurse education into higher education institutions. The purpose of this paper is to report the findings from the preliminary phase of a study, undertaken to investigate the perceptions of key stakeholder groups in nurse education, regarding the current clinical role of nurse lecturers in Ireland. A descriptive exploratory design was used involving focus group and individual interviews, soliciting views of purposefully selected educationalists, clinicians, policy formulators and students. The issue was examined from a policy perspective, aiming to collectively represent views of all participant groups. This approach facilitated a more complete picture of perceptions of the role to emerge, to better inform future decision making. Twenty two focus group interviews and twenty one individual interviews were conducted. Content analysis was used to identify themes. All groups were in agreement that role definition was urgently required to dispel ambiguities surrounding what the clinical role should involve. Conflicting views were evident among groups regarding lecturers' clinical credibility, visibility and teaching effectiveness. Findings highlight the essential nature of nurse lecturers engaging with clinical areas to maintain their skills, demonstrate a value for the practice component of the role and provide a link between education and practice.

Establishing research priorities relating to the long-term impact of TIA and minor stroke through stakeholder-centred consensus.

PubMed

Turner, Grace M; Backman, Ruth; McMullan, Christel; Mathers, Jonathan; Marshall, Tom; Calvert, Melanie

2018-01-01

What is the problem and why is this important? Mini-strokes are similar to full strokes, but symptoms last less than 24 h. Many people (up to 70%) have long-term problems after a mini-stroke, such as anxiety; depression; problems with brain functioning (like memory loss); and fatigue (feeling tired). However, the current healthcare pathway only focuses on preventing another stroke and care for other long-term problems is not routinely given. Without proper treatment, people with long-term problems after a mini-stroke could have worse quality of life and may find it difficult to return to work and their social activities. What is the aim of the research? We wanted to understand the research priorities of patients, health care professionals and key stakeholders relating to the long-term impact of mini-stroke. How did we address the problem? We invited patients, clinicians, researchers and other stakeholders to attend a meeting. At the meeting people discussed the issues relating to the long-term impact of mini-stroke and came to an agreement on their research priorities. There were three stages: (1) people wrote down their individual research suggestions; (2) in smaller groups people came to an agreement on what their top research questions were; and (3) the whole group agreed final research priorities. What did we find? Eleven people attended who were representatives for patients, GPs, stroke consultants, stroke nurses, psychologists, the Stroke Association (charity) and stroke researchers, The group agreed on eleven research questions which they felt were the most important to improve health and well-being for people who have had a mini-stroke.The eleven research questions encompass a range of categories, including: understanding the existing care patients receive (according to diagnosis and geographical location); exploring what optimal care post-TIA/minor stroke should comprise (identifying and treating impairments, information giving and support groups) and how that care should be delivered (clinical setting and follow-up pathway); impact on family members; and education/training for health care professionals. Background Clinical management after transient ischaemic attack (TIA) and minor stroke focuses on stroke prevention. However, evidence demonstrates that many patients experience ongoing residual impairments. Residual impairments post-TIA and minor stroke may affect patients' quality of life and return to work or social activities. Research priorities of patients, health care professionals and key stakeholders relating to the long-term impact of TIA and minor stroke are unknown. Methods Our objective was to establish the top shared research priorities relating to the long-term impact of TIA and minor stroke through stakeholder-centred consensus. A one-day priority setting consensus meeting took place with representatives from different stakeholder groups in October 2016 (Birmingham, UK). Nominal group technique was used to establish research priorities. This involved three stages: (i) gathering research priorities from individual stakeholders; (ii) interim prioritisation in three subgroups; and (iii) final priority setting. Results The priority setting consensus meeting was attended by 11 stakeholders. The individual stakeholders identified 34 different research priorities. During the interim prioritisation exercise, the three subgroups generated 24 unique research priorities which were discussed as a whole group. Following the final consensus discussion, 11 shared research priorities were unanimously agreed.The 11 research questions encompass a range of categories, including: understanding the existing care patients receive (according to diagnosis and geographical location); exploring what optimal care post-TIA/minor stroke should comprise (identifying and treating impairments, information giving and support groups) and how that care should be delivered (clinical setting and follow-up pathway); impact on family members; and education/training for health care professionals. Conclusions Eleven different research priorities were established through stakeholder-centred consensus. These research questions could usefully inform the research agenda and policy decisions for TIA and minor stroke. Inclusion of stakeholders in setting research priorities is important to increase the relevance of research and reduce research waste.

Perspectives on multidrug-resistant organisms at the end of life : A focus group study of staff members and institutional stakeholders.

PubMed

Herbst, Franziska A; Heckel, Maria; Tiedtke, Johanna M; Adelhardt, Thomas; Sturm, Alexander; Stiel, Stephanie; Ostgathe, Christoph

2018-03-16

There is a lack of research into how hospital staff and institutional stakeholders (i. e. institutional representatives from public health authorities, hospital hygiene, and the departments of microbiology, palliative care, and geriatrics) engage with patients who are carriers of multidrug-resistant organisms and receiving end-of-life care. Knowledge of their experiences, workload, and needs should be considered in dealing with hospitalized carriers of multidrug-resistant organisms as well as staff education. This study explored and compared staff members' and stakeholders' perspectives on multidrug-resistant organisms and on provision of end-of-life care to carrier patients. In this study four focus groups consisting of hospital staff members and institutional stakeholders were formed within a mixed-methods parent study in a palliative care unit at a university clinic and a geriatric ward of a Catholic and academic teaching hospital. Participants discussed results from staff and stakeholder interviews from a former study phase. Data were analyzed according to Grounded Theory and perspectives of staff members and institutional stakeholders were compared and contrasted. Key issues debated by staff members (N = 19) and institutional stakeholders (N = 10) were 1) the additional workload, 2) reasons for uncertainty about handling carrier patients, 3) the format of continuing education, and 4) the preferred management approach for dealing with multidrug-resistant organism carrier patients. Although similar barriers (e. g. colleagues' ambiguous opinions) were identified, both groups drew different conclusions concerning the management of these barriers. While institutional stakeholders recommended making decisions on hygiene measures under consideration of the specific patient situation, staff members preferred the use of standardized hygiene measures which should be applied uniformly to all patients. Staff members and institutional stakeholders perceived similar barriers to practice caused by multidrug-resistant organisms and similar needs for continuing education. The staff members' preferred management approach might originate from an uncertainty about the multidrug-resistant organism infection risk. Experiences and visions of both groups should be included in a specific recommendation for end-of-life care to ensure behavioral confidence.

A tall order on a tight timeframe: stakeholder perspectives on comparative effectiveness research using electronic clinical data.

PubMed

Holve, Erin; Lopez, Marianne Hamilton; Scott, Lisa; Segal, Courtney

2012-09-01

BACKGROUND & SIGNIFICANCE: The AcademyHealth Electronic Data Methods Forum aims to advance the national dialogue on the use of electronic clinical data (ECD) for comparative effectiveness research (CER), patient-centered outcomes research, and quality improvement by facilitating exchange and collaboration among eleven research projects and external stakeholders. AcademyHealth conducted a mixed-method needs assessment with the Electronic Data Methods Forum's key stakeholders to assess: stakeholder views on developing new infrastructure for CER using ECD; current gaps in knowledge with respect to CER; and expectations for a learning health system. AcademyHealth conducted 50 stakeholder interviews between August 2011 and November 2011 with participants from the following seven stakeholder groups: government, business/payer, industry, healthcare delivery, patient/consumer, nonprofit/policy and research. With input from key collaborators, AcademyHealth designed a semi-structured interview guide and a short survey. Reviewers used the qualitative data analysis software NVivo to code the transcripts and to identify and manage complex concepts. Quantitative data from the questionnaire has been integrated with the final analysis as relevant. The analysis of recurring concepts in the interviews focus on five central themes: stakeholders have substantial expectations for CER using ECD, both with respect to addressing the limitations of traditional research studies, and generating meaningful evidence for decision-making and improving patient outcomes; stakeholders are aware of many challenges related to implementing CER with ECD, including the need to develop appropriate governance, assess and manage data quality, and develop methods to address confounding in observational data; stakeholders continue to struggle to define 'patient-centeredness' in CER using ECD, adding complexity to attaining this goal; stakeholders express that improving translation and dissemination of CER, and how research can be 'useful' at the point of care, can help mitigate negative perceptions of the CER 'brand'; and stakeholders perceive a need for a substantial 'culture shift' to facilitate collaborative science and new ways of conducting biomedical and outcomes research. Many stakeholders proposed approaches or solutions they felt might address the challenges identified.

Designing augmentative and alternative communication applications: the results of focus groups with speech-language pathologists and parents of children with autism spectrum disorder.

PubMed

Boster, Jamie B; McCarthy, John W

2018-05-01

The purpose of this study was to gain insight from speech-language pathologists (SLPs) and parents of children with autism spectrum disorder (ASD) regarding appealing features of augmentative and alternative communication (AAC) applications. Two separate 1-hour focus groups were conducted with 8 SLPs and 5 parents of children with ASD to identify appealing design features of AAC Apps, their benefits and potential concerns. Participants were shown novel interface designs for communication mode, play mode and incentive systems. Participants responded to poll questions and provided benefits and drawbacks of the features as part of structured discussion. SLPs and parents identified a range of appealing features in communication mode (customization, animation and colour-coding) as well as in play mode (games and videos). SLPs preferred interfaces that supported motor planning and instruction while parents preferred those features such as character assistants that would appeal to their child. Overall SLPs and parents agreed on features for future AAC Apps. SLPs and parents have valuable input in regards to future AAC app design informed by their experiences with children with ASD. Both groups are key stakeholders in the design process and should be included in future design and research endeavors. Implications for Rehabilitation AAC applications for the iPad are often designed based on previous devices without consideration of new features. Ensuring the design of new interfaces are appealing and beneficial for children with ASD can potentially further support their communication. This study demonstrates how key stakeholders in AAC including speech language pathologists and parents can provide information to support the development of future AAC interface designs. Key stakeholders may be an untapped resource in the development of future AAC interfaces for children with ASD.

Insights from an international stakeholder consultation to identify informational needs related to seafood safety.

PubMed

Tediosi, Alice; Fait, Gabriella; Jacobs, Silke; Verbeke, Wim; Álvarez-Muñoz, Diana; Diogene, Jorge; Reuver, Marieke; Marques, António; Capri, Ettore

2015-11-01

Food safety assessment and communication have a strong importance in reducing human health risks related to food consumption. The research carried out within the ECsafeSEAFOOD project aims to assess seafood safety issues, mainly related to non-regulated priority environmental contaminants, and to evaluate their impact on public health. In order to make the research results accessible and exploitable, and to respond to actual stakeholders' demands, a consultation with international stakeholders was performed by means of a survey. The focus was on policy and decision makers, food producers and processors, and agencies (i.e. EU and National or Regional agencies related to Food Safety or Public Health) and consumer organisations. The survey considered questions related to: seafood safety assessment and mitigation strategies, availability of data, such as the level of information on different contaminants, and communication among different stakeholder groups. Furthermore, stakeholders were asked to give their opinion on how they believe consumers perceive risks associated with environmental contaminants. The survey was distributed to 531 key stakeholders and 91 responses were received from stakeholders from 30 EU and non-EU countries. The main results show that communication between different groups of stakeholders needs to be improved and that there is a deficit of information and data in the field of seafood safety. This pertains mainly to the transfer of contaminants between the environment and seafood, and to the diversity of environmental contaminants such as plastic additives, algal toxins and hormones. On-line tools were perceived to be the most useful communication channel. Copyright © 2015 Elsevier Inc. All rights reserved.

Development of an Internet-Based Parent Training Intervention for Children with ASD

DTIC Science & Technology

2014-10-01

had mean pretests scores that were significantly lower than did individuals with master’s degrees, all three groups per- formed comparably on the...focus groups with 8-10 key stakeholders to gain feedback on the structural elements of the program. Focus group members will participate in two focus... groups , three months apart. In the first focus group , 9    we will obtain feedback on the structure of the online systems training and self-directed

Identifying Key Stakeholders in Blended Tertiary Environments: Experts' Perspectives

ERIC Educational Resources Information Center

Tuapawa, Kimberley

2017-01-01

Although key stakeholders in blended tertiary environments (BTEs) fulfil an extraordinary role in higher education, significant gaps in knowledge about their identities may be impeding the provision of stakeholder support, limiting their ability to promote effective learning and teaching. As online growth intensifies, it is critical that tertiary…

Collaborative mental health services in primary care systems in Latin America: contextualized evaluation needs and opportunities.

PubMed

Sapag, Jaime C; Rush, Brian; Ferris, Lorraine E

2016-02-01

This study examined Latin American evaluation needs regarding the development of a collaborative mental health care (CMHC) evaluation framework as seen by local key health-care leaders and professionals. Potential implementation challenges and opportunities were also identified. This multisite research study used an embedded mixed methods approach in three public health networks in Mexico, Nicaragua and Chile. Local stakeholders participated: decision-makers in key informant interviews, front-line clinicians in focus groups and other stakeholders through a survey. The analysis was conducted within site and then across sites. A total of 22 semi-structured interviews, three focus groups and 27 questionnaires (52% response rate) were conducted. Participants recognized a strong need to evaluate different areas of CMHC in Latin America, including access, types and quality of services, human resources and outcomes related to mental disorders, including addiction. A priority was to evaluate collaboration within the health system, including the referral system. Issues of feasibility, including the weaknesses of information systems, were also identified. Local stakeholders strongly supported the development of a comprehensive evaluation framework for CMHC in Latin America and cited several dimensions and contextual factors critical for inclusion. Implementation must allow flexibility and adaptation to the local context. © 2015 John Wiley & Sons Ltd.

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

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.

Participatory Research for Chronic Disease Prevention in Inuit Communities

ERIC Educational Resources Information Center

Gittelsohn, Joel; Roache, Cindy; Kratzmann, Meredith; Reid, Rhonda; Ogina, Julia; Sharma, Sangita

2010-01-01

Objective: To develop a community-based chronic disease prevention program for Inuit in Nunavut, Canada. Methods: Stakeholders contributed to intervention development through formative research [in-depth interviews (n = 45), dietary recalls (n = 42)], community workshops, group feedback and implementation training. Results: Key cultural themes…

Sustainable Procurement: Integrating Classroom Learning with University Sustainability Programs

ERIC Educational Resources Information Center

Goldschmidt, Kyle; Harrison, Terry; Holtry, Matthew; Reeh, Jeremy

2013-01-01

Organizations are facing increased pressure from various stakeholders to address issues of sustainability, resulting in a growing demand for sustainability education and training. Procurement groups remain the key drivers of many sustainability-related strategies, placing pressure on universities to integrate sustainability concepts into the…

Identifying Key Issues and Potential Solutions for Integrated Arrival, Departure, Surface Operations by Surveying Stakeholder Preferences

NASA Technical Reports Server (NTRS)

Aponso, Bimal; Coppenbarger, Richard A.; Jung, Yoon; Quon, Leighton; Lohr, Gary; O’Connor, Neil; Engelland, Shawn

2015-01-01

NASA's Aeronautics Research Mission Directorate (ARMD) collaborates with the FAA and industry to provide concepts and technologies that enhance the transition to the next-generation air-traffic management system (NextGen). To facilitate this collaboration, ARMD has a series of Airspace Technology Demonstration (ATD) sub-projects that develop, demonstrate, and transitions NASA technologies and concepts for implementation in the National Airspace System (NAS). The second of these sub-projects, ATD-2, is focused on the potential benefits to NAS stakeholders of integrated arrival, departure, surface (IADS) operations. To determine the project objectives and assess the benefits of a potential solution, NASA surveyed NAS stakeholders to understand the existing issues in arrival, departure, and surface operations, and the perceived benefits of better integrating these operations. NASA surveyed a broad cross-section of stakeholders representing the airlines, airports, air-navigation service providers, and industry providers of NAS tools. The survey indicated that improving the predictability of flight times (schedules) could improve efficiency in arrival, departure, and surface operations. Stakeholders also mentioned the need for better strategic and tactical information on traffic constraints as well as better information sharing and a coupled collaborative planning process that allows stakeholders to coordinate IADS operations. To assess the impact of a potential solution, NASA sketched an initial departure scheduling concept and assessed its viability by surveying a select group of stakeholders for a second time. The objective of the departure scheduler was to enable flights to move continuously from gate to cruise with minimal interruption in a busy metroplex airspace environment using strategic and tactical scheduling enhanced by collaborative planning between airlines and service providers. The stakeholders agreed that this departure concept could improve schedule predictability and suggested several key attributes that were necessary to make the concept successful. The goals and objectives of the planned ATD-2 sub-project will incorporate the results of this stakeholder feedback.

An end-users oriented methodology for enhancing the integration of knowledge on soil-water-sediment systems in River Basin Management: an illustration from the AquaTerra project.

PubMed

Merly, Corinne; Chapman, Antony; Mouvet, Christophe

2012-01-01

Research results in environmental and socio-economic sciences are often under-used by stakeholders involved in the management of natural resources. To minimise this gap, the FP6 EU interdisciplinary project AquaTerra (AT) developed an end-users' integration methodology in order to ensure that the data, knowledge and tools related to the soil-water-sediment system that were generated by the project were delivered in a meaningful way for end-users, thus improving their uptake. The methodology and examples of its application are presented in this paper. From the 408 project deliverables, 96 key findings were identified, 53 related to data and knowledge, and 43 describing advanced tools. River Basin Management (RBM) stakeholders workshops identified 8 main RBM issues and 25 specific stakeholders' questions related to RBM which were classified into seven groups of cross-cutting issues, namely scale, climate change, non-climatic change, the need for systemic approaches, communication and participation, international and inter-basin coordination and collaboration, and the implementation of the Water Framework Directive. The integration methodology enabled an assessment of how AT key findings meet stakeholders' demands, and for each main RBM issue and for each specific question, described the added-value of the AT project in terms of knowledge and tools generated, key parameters to consider, and recommendations that can be made to stakeholders and the wider scientific community. Added value and limitations of the integration methodology and its outcomes are discussed and recommendations are provided to further improve integration methodology and bridge the gaps between scientific research data and their potential uptake by end-users.

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 science of stakeholder engagement in research: classification, implementation, and evaluation.

PubMed

Goodman, Melody S; Sanders Thompson, Vetta L

2017-09-01

In this commentary, we discuss the science of stakeholder engagement in research. We propose a classification system with definitions to determine where projects lie on the stakeholder engagement continuum. We discuss the key elements of implementation and evaluation of stakeholder engagement in research posing key questions to consider when doing this work. We commend and critique the work of Hamilton et al. in their multilevel stakeholder engagement in a VA implementation trial of evidence-based quality improvement in women's health primary care. We also discuss the need for more work in this area to enhance the science of stakeholder engagement in research.

Strengthening community participation in reducing GHG emission from forest and peatland fire

NASA Astrophysics Data System (ADS)

Thoha, A. S.; Saharjo, B. H.; Boer, R.; Ardiansyah, M.

2018-02-01

Strengthening community participation is needed to find solutions to encourage community more participate in reducing Green House Gas (GHG) from forest and peatland fire. This research aimed to identify stakeholders that have the role in forest and peatland fire control and to formulate strengthening model of community participation through community-based early warning fire. Stakeholder mapping and action research were used to determine stakeholders that had potential influence and interest and to formulate strengthening model of community participation in reducing GHG from forest and peatland fire. There was found that position of key players in the mapping of stakeholders came from the government institution. The existence of community-based fire control group can strengthen government institution through collaborating with stakeholders having strong interest and influence. Moreover, it was found several local knowledge in Kapuas District about how communities predict drought that have potential value for developing the community-based early warning fire system. Formulated institutional model in this research also can be further developed as a model institution in the preservation of natural resources based on local knowledge. In conclusion, local knowledge and community-based fire groups can be integrated within strengthening model of community participation in reducing GHG from forest and peatland fire.

The role of evidence and the expert in contemporary processes of governance: the case of opioid substitution treatment policy in England.

PubMed

Duke, Karen; Thom, Betsy

2014-09-01

This paper is based on research examining stakeholder involvement in substitution treatment policy which was undertaken as part of the EU funded FP7 ALICE-RAP (Addictions and Lifestyles in Contemporary Europe - Reframing Addictions Project). In England, the research coincided with a policy shift towards a recovery orientated drug treatment framework and a heated debate surrounding the role of substitute prescribing. The study aimed to explore the various influences on the development of the new 'recovery' policy from the perspectives of the key stakeholders involved. The paper is based on documentary analyses and key informant interviews with a range of stakeholders, including representatives of user organisations, treatment providers, civil servants, and members of expert committees. Drawing on the theoretical insights offered by Backstrand's 'civic science' framework, the changing role of evidence and the position of experts in the processes of drugs policy governance are explored. 'Evidence' was used to problematise the issue of substitution treatment and employed to legitimise, justify and construct arguments around the possible directions of policy and practice. Conflicting beliefs about drug treatment and about motivation for policy change emerge in the argumentation, illustrating tensions in the governance of drug treatment and the power differentials separating different groups of stakeholders. Their role in the production of evidence also illustrates issues of power regarding the definition and development of 'usable knowledge'. There were various attempts at greater representation of different forms of evidence and participation by a wider group of stakeholders in the debates surrounding substitution treatment. However, key national and international experts and the appointment of specialist committees continued to play dominant roles in building consensus and translating scientific evidence into policy discourse. Substitution treatment policy has witnessed a challenge to the dominance of 'scientific evidence' within policy decision making, but in the absence of alternative evidence with an acceptable credibility and legitimacy base, traditional notions of what constitutes evidence based policy persist and there is a continuing lack of recognition of 'civic science'. Copyright © 2014 Elsevier B.V. All rights reserved.

Information infrastructure for consumer health: a health information exchange stakeholder study.

PubMed

Thornewill, Judah; Dowling, Alan F; Cox, Barbara A; Esterhay, Robert J

2011-05-01

An enabling infrastructure for population-wide health information capture and transfer is beginning to emerge in the U.S. However, the essential infrastructure component that is still missing is effective health information exchange (HIE). Health record banks (HRBs) are one of several possible approaches to achieving HIE. Is the approach viable? If so, what requirements must be satisfied in order for it to succeed? The research, conducted in 2007-2008, explored HRB-related interests, concerns, benefits, payment preferences, design requirements, value propositions, and challenges for 12 healthcare stakeholder groups and the consumers they serve in a U.S. metropolitan area of 1.3 million people. A mixed-methods design was developed in a community action research context. Data were gathered and analyzed through 23 focus groups, 13 web surveys, a consumer phone survey (nonstratified random sample) and follow-up meetings. Recruiting goals for leaders representing targeted groups were achieved using a multi-channel communications strategy. Key themes were identified through data triangulation. Then, requirements, value propositions and challenges were developed through iterative processes of interaction with community members. Results include key themes, design requirements, value propositions, and challenges for 12 stakeholder groups and consumers. The research provides a framework for developing a consumer permission-driven, financially sustainable, community HRB model. However, for such a model to flourish, it will need to be part of a nationwide network of HIEs with compatible HRB approaches able to overcome a number of challenges. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Insights from an international stakeholder consultation to identify informational needs related to seafood safety

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

Tediosi, Alice, E-mail: alice.tediosi@aeiforia.eu; Fait, Gabriella; Jacobs, Silke

Food safety assessment and communication have a strong importance in reducing human health risks related to food consumption. The research carried out within the ECsafeSEAFOOD project aims to assess seafood safety issues, mainly related to non-regulated priority environmental contaminants, and to evaluate their impact on public health. In order to make the research results accessible and exploitable, and to respond to actual stakeholders' demands, a consultation with international stakeholders was performed by means of a survey. The focus was on policy and decision makers, food producers and processors, and agencies (i.e. EU and National or Regional agencies related to Foodmore » Safety or Public Health) and consumer organisations. The survey considered questions related to: seafood safety assessment and mitigation strategies, availability of data, such as the level of information on different contaminants, and communication among different stakeholder groups. Furthermore, stakeholders were asked to give their opinion on how they believe consumers perceive risks associated with environmental contaminants. The survey was distributed to 531 key stakeholders and 91 responses were received from stakeholders from 30 EU and non-EU countries. The main results show that communication between different groups of stakeholders needs to be improved and that there is a deficit of information and data in the field of seafood safety. This pertains mainly to the transfer of contaminants between the environment and seafood, and to the diversity of environmental contaminants such as plastic additives, algal toxins and hormones. On-line tools were perceived to be the most useful communication channel. - Highlights: • We consulted stakeholders to identify their needs about seafood safety. • An on-line survey was prepared and sent to gather stakeholders' opinions. • Communication among stakeholders needs to be improved. • There is a deficit of information and data in the field of seafood safety. • On-line tools are perceived to be the most useful communication channel.« less

Policy content and stakeholder network analysis for infant and young child feeding in Nepal.

PubMed

Karn, Sumit; Devkota, Madhu Dixit; Uddin, Shahadat; Thow, Anne Marie

2017-06-13

Despite concerted effort from government and partners, Nepal continues to have a high burden of under nutrition among children. Identifying opportunities to strengthen policy support for infant and young child feeding (IYCF) is a key component to improve child survival, growth and development. This study aims to explore policy support for IYCF and to identify the influential stakeholders for IYCF for effective future policy development and programmatic action. Policies relevant to IYCF were identified through web searches and direct approaches to relevant government ministries. Policy content was analysed based on four key domains focussed on mothers, using a qualitative synthesis approach. Three group interviews were conducted using the participatory tool "Net-Map", to identify the influential stakeholders in IYCF policy and programming processes. Twenty-six relevant policy documents were analysed for content relating to IYCF. General support for IYCF was found in most of the development plans and high-level health sector policies. Most implementation level documents included support for provision of correct information to mothers. Capacity building of frontline workers for IYCN and system strengthening were well supported through sectoral plans and policies. However, gaps were identified regarding maternity protection, support for monitoring and evaluation, and translation of high-level policy directives into implementation level guidelines, resulting in a lack of clarity over roles and responsibilities. Both government and non-governmental stakeholders, particularly donors, emerged as influential drivers of IYCF policy decisions in Nepal, through technical assistance and funding. The Nutrition Technical Committee under the Ministry of Health, UNICEF, Suaahara, USAID and WHO were identified as key actors providing technical assistance. Key funding agencies were identified as UNICEF and USAID. This study reveals strong policy support for key dimensions of IYCF, supported by a highly networked stakeholder environment. Opportunities to further strengthen IYCF policy in Nepal include: further support for training of frontline workers and complementary feeding interventions; extending maternity leave provisions; and clarifying roles and responsibilities of actors, particularly non-governmental actors. Engaging technical and funding agencies and developing partnerships with other relevant actors will be crucial for ensuring effective policy translates into effective practice.

CONTRIBUTION OF STAKEHOLDER ENGAGEMENT TO THE IMPACT OF A HEALTH TECHNOLOGY ASSESSMENT: AN IRISH CASE STUDY.

PubMed

Ryan, Máirín; Moran, Patrick S; Harrington, Patricia; Murphy, Linda; O'Neill, Michelle; Whelan, Marty; Teljeur, Conor

2017-01-01

The aim of this study was to illustrate the contribution of stakeholder engagement to the impact of health technology assessment (HTA) using an Irish HTA of a national public access defibrillation (PAD) program. In response to draft legislation that proposed a PAD program, the Minister for Health requested that Health Information and Quality Authority undertake an HTA to inform the design and implementation of a national PAD program and the necessary underpinning legislation. The draft legislation outlined a program requiring widespread installation and maintenance of automatic external defibrillators in specified premises. Stakeholder engagement to optimize the impact of the HTA included one-to-one interviews with politicians, engagement with an Expert Advisory Group, public and targeted consultation, and positive media management. The HTA quantified the clinical benefits of the proposed PAD program as modest, identified that substantial costs would fall on small/medium businesses at a time of economic recession, and that none of the programs modeled were cost-effective. The Senator who proposed the Bill actively publicized the HTA process and its findings and encouraged participation in the public consultation. Participation of key stakeholders was important for the quality and acceptability of the HTA findings and advice. Media management promoted public engagement and understanding. The Bill did not progress. The HTA informed the decision not to progress with legislation for a national PAD program. Engagement was tailored to ensure that key stakeholders including politicians and the public were informed of the HTA process, the findings, and the advice, thereby maximizing acceptance. Appropriate stakeholder engagement optimizes the impact of HTA.

Protocol for developing, disseminating and implementing a core outcome set for endometriosis.

PubMed

Hirsch, Martin; Duffy, James M N; Barker, Claire; Hummelshoj, Lone; Johnson, Neil P; Mol, Ben; Khan, Khalid S; Farquhar, Cindy

2016-12-21

Endometriosis is a common gynaecological disease characterised by pain and subfertility. Randomised controlled trials evaluating treatments for endometriosis have reported many different outcomes and outcome measures. This variation restricts effective data synthesis limiting the usefulness of research to inform clinical practice. To address these methodological concerns, we aim to develop, disseminate and implement a core outcome set for endometriosis engaging with key stakeholders, including healthcare professionals, researchers and women with endometriosis. An international steering group has been established, including healthcare professionals, researchers and patient representatives. Potential outcomes identified from a systematic review of the literature will be entered into a modified Delphi method. Key stakeholders will be invited to participate including healthcare professionals, researchers and women with endometriosis. Participants will be invited to score individual outcomes on a nine-point Likert scale anchored between 1 (not important) and 9 (critical). Repeated reflection and rescoring should promote whole and individual stakeholder group converge towards consensus, 'core', outcomes. High-quality outcome measures will be associated with core outcomes. The implementation of a core outcome set for endometriosis within future clinical trials, systematic reviews and clinical guidelines will enhance the availability of comparable data to facilitate evidence-based patient care. This study was prospectively registered with Core Outcome Measures in Effectiveness Trials Initiative; number: 691. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

78 FR 66698 - Pesticides; Repellency Awareness Graphic; Notice of Availability

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-06

... information you consider to be Confidential Business Information (CBI) or other information whose disclosure... products for quick and easy identification by the consumer. Prototypes of this graphic were presented to... from several key stakeholder groups. Starting in May 2012, EPA presented the concept, draft guidance...

Participatory planning of a primary care service for people with severe mental disorders in rural Ethiopia

PubMed Central

Mayston, Rosie; Alem, Atalay; Habtamu, Alehegn; Shibre, Teshome; Fekadu, Abebaw; Hanlon, Charlotte

2016-01-01

Little is understood about the feasibility and acceptability of primary care-based models of task-sharing care for people with severe mental disorders (SMDs) in low- and middle-income countries (LMICs). A participatory planning approach was adopted in preparation for the transition from hospital-delivered psychiatric care for SMD to a primary care-based, task-sharing model in a rural Ethiopian community. In this article, we present findings from community consultation meetings (n = 4), focus group discussions (n = 7) and in-depth interviews (n = 11) with key stakeholders (healthcare administrators and providers, caregivers, service-users and community leaders) which were carried out over a 2-year period in the context of ongoing dialogue with the community. The principle of local delivery of mental health services was agreed upon by all stakeholder groups. Key reasons for supporting local delivery were increased access for the majority due to proximity, reduced cost and reduced stress related to transportation. However, acceptance of the new service was qualified by concerns about the competence of staff to deliver a comprehensive and dependable service of equal quality to that currently provided at the hospital. Adequate training and support, as well as ensuring consistency of medication supply were identified as key components to ensure success. Encouragingly, our results suggest that there is significant support for the service change and an interest for the mobilization of community resources to support this. One of the study strengths was that we were able to present the different perspectives of multiple stakeholder groups. By nesting the study in an ongoing community-based cohort of people with SMD we were able to interview a more representative and empowered group of caregivers and service users than is often available in LMICs. Despite this, the extent to which service-users are able to express their opinions is likely limited by their marginalized role in rural Ethiopian society. PMID:26282860

Stakeholders’ Perceptions of Agronomic Iodine Biofortification: A SWOT-AHP Analysis in Northern Uganda

PubMed Central

Olum, Solomon; Gellynck, Xavier; Okello, Collins; Webale, Dominic; Odongo, Walter; Ongeng, Duncan

2018-01-01

Agronomic biofortification (i.e., the application of fertilizer to elevate micronutrient concentrations in staple crops) is a recent strategy recommended for controlling Iodine Deficiency Disorders (IDDs). However, its success inevitably depends on stakeholders’ appreciation and acceptance of it. By taking Northern Uganda as a case, this study aimed to capture and compare the perceptions of seven key stakeholder groups with respect to agronomic iodine biofortification. Therefore, we employed a SWOT (Strength, Weaknesses, Opportunities & Threats) analysis in combination with an Analytical Hierarchy Process (AHP). Findings show that stakeholders (n = 56) are generally positive about agronomic iodine biofortification in Uganda, as its strengths and opportunities outweighed weaknesses and threats. Cultural acceptance and effectiveness are considered the most important strengths while the high IDD prevalence rate and the availability of iodine deficient soils are key opportunities for further developing agronomic iodine biofortification. Environmental concerns about synthetic fertilizers as well as the time needed to supply iodine were considered crucial weaknesses. The limited use of fertilizer in Uganda was the main threat. While this study provides insight into important issues and priorities for iodine biofortification technology in Uganda, including differences in stakeholder views, the application of the SWOT-AHP method will guide future researchers and health planners conducting stakeholder analysis in similar domains. PMID:29587370

PRISMA-Children (C) and PRISMA-Protocol for Children (P-C) Extensions: a study protocol for the development of guidelines for the conduct and reporting of systematic reviews and meta-analyses of newborn and child health research.

PubMed

Kapadia, Mufiza Z; Askie, Lisa; Hartling, Lisa; Contopoulos-Ioannidis, Despina; Bhutta, Zulfiqar A; Soll, Roger; Moher, David; Offringa, Martin

2016-04-18

Paediatric systematic reviews differ from adult systematic reviews in several key aspects such as considerations of child tailored interventions, justifiable comparators, valid outcomes and child sensitive search strategies. Available guidelines, including PRISMA-P (2015) and PRISMA (2009), do not cover all the complexities associated with reporting systematic reviews in the paediatric population. Using a collaborative, multidisciplinary structure, we aim to develop evidence-based and consensus-based PRISMA-P-C (Protocol for Children) and PRISMA-C (Children) Extensions to guide paediatric systematic review protocol and completed review reporting. This project's methodology follows published recommendations for developing reporting guidelines and involves the following six phases; (1) establishment of a steering committee representing key stakeholder groups; (2) a scoping review to identify potential Extension items; (3) three types of consensus activities including meetings of the steering committee to achieve high-level decisions on the content and methodology of the Extensions, a survey of key stakeholders to generate a list of possible items to include in the Extensions and a formal consensus meeting to select the reporting items to add to, or modify for, the Extension; (4) the preliminary checklist items generated in phase III will be evaluated against the existing evidence and reporting practices in paediatric systematic reviews; (5) extension statements and explanation and elaboration documents will provide detailed advice for each item and examples of good reporting; (6) development and implementation of effective knowledge translation of the extension checklist, and an evaluation of the Extensions by key stakeholders. This protocol was considered a quality improvement project by the Hospital for Sick Children's Ethics Committee and did not require ethical review. The resultant checklists, jointly developed with all relevant stakeholders, will be disseminated through peer-reviewed journals as well as national and international conference presentations. Endorsement of the checklist will be sought simultaneously in multiple journals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Integrated community case management of malaria, pneumonia and diarrhoea across three African countries: A qualitative study exploring lessons learnt and implications for further scale up

PubMed Central

Strachan, Clare; Wharton–Smith, Alexandra; Sinyangwe, Chomba; Mubiru, Denis; Ssekitooleko, James; Meier, Joslyn; Gbanya, Miatta; Tibenderana, James K.; Counihan, Helen

2014-01-01

Numerous studies highlight the effectiveness of an integrated approach for the management of malaria, pneumonia and diarrhoea at the community level. There has however been little study on lessons learnt from implementation in practice and stakeholder experiences which could inform future programmatic planning and evaluation frameworks. A participatory, qualitative evaluation was conducted in the three varied settings of South Sudan, Uganda and Zambia, which have seen the scale up of integrated community case management (iCCM) over the last five years. All key in–country stakeholders were consulted on study design, with a particular focus on scope and methodology. Data collection methods included stakeholder consultations (key informant interviews, focus group discussions), and a review of project and Ministry of Health documentation. Data analysis followed the Framework Approach. Results suggest that iCCM implementation generally followed national pre–agreed guidelines. Overarching key programmatic recommendations included: collaboration with implementing partners in planning stages to positively impact on community acceptance and ownership; adoption of participatory training methods adapted to low literacy populations; development of alternative support supervision methods such as peer support groups; full integration of community level data into the health management information system and emphasizing data analysis, use and feedback at all levels; strengthened supply chains through improved quantification and procurement of commodities in conjunction with the national distribution network; community engagement to establish a support system for community health workers to increase their motivation; enhanced sensitisation and behaviour change communication to raise awareness and usage of appropriate health services; and advocacy at the national level for funding and logistical support for the continuation and integration of iCCM. This qualitative study is a valuable contribution in understanding the ‘hows’ of iCCM implementation with key insights for improved feasibility and acceptability. Main findings show how community support to iCCM and community health workers is necessary for sustained health benefits coupled with a focus on strengthening and ‘enabling’ the public health system. The participatory study design and methodologies used enabled the scope of the research enquiry to effectively capture various stakeholder perspectives. PMID:25520794

Beyond the "general public": implications of audience characteristics for promoting species conservation in the Western Ghats hotspot, India.

PubMed

Kanagavel, Arun; Raghavan, Rajeev; Veríssimo, Diogo

2014-03-01

Understanding how different audience groups perceive wildlife is crucial for the promotion of biodiversity conservation, especially given the key role of flagship species in conservation campaigns. Although the heterogeneity in preferences reinforces the need for campaigns tailored to specific target audiences, many conservation education and awareness campaigns still claim to target the "general public". Audiences can be segmented according to social, economic, and cultural criteria across which species perceptions are known to vary. Different studies have investigated the preferences of different groups towards certain wildlife species, but these are largely confined to a single conservation stakeholder group, such as tourists, local communities, or potential donors in western countries. In this study, we seek to determine from a multi-stakeholder perspective, audience characteristics that influence perceptions towards wildlife at Valparai, a fragmented plateau in the Western Ghats region of the Western Ghats-Sri Lanka Hotspot. We found that stakeholder group membership was the most important characteristic followed by gender. While some characteristics had a wide-scale effect others were restricted to a few species. Our results emphasize the need to design conservation campaigns with specific audiences in mind, instead of the very often referred to "general public".

A qualitative study of health care providers' perceptions and experiences of working together to care for children with medical complexity (CMC).

PubMed

Altman, Lisa; Zurynski, Yvonne; Breen, Christie; Hoffmann, Tim; Woolfenden, Susan

2018-01-31

Children with medical complexity (CMC) have a wide range of long term health problems and disabilities that have an adverse impact on their quality of life. They have high levels of family identified health care needs and health care utilisation. There is no Australian literature on the experiences of health care providers working in the Australian tertiary, secondary and primary health care system, whilst managing CMC. This information is essential to inform the design of integrated health care systems for these children. We address this knowledge gap by exploring the perceptions and experiences of health care providers on the provision of health care for CMC aged 0 to 18 years. A qualitative research study was undertaken. Stakeholder forums, group and individual in depth interviews were undertaken using a semi-structured interview guide. The stakeholder forums were audio recorded and transcribed verbatim. Field notes of the stakeholder forums, group and individual interviews were taken. Inductive thematic analysis was undertaken to identify key themes. One hundred and three providers took part in the stakeholder forums and interviews across 3 local health districts, a tertiary paediatric hospital network, and primary health care organisations. Providers expressed concern regarding family capacity to negotiate the system, which was impacted by the medical complexity of the children and psychosocial complexity of their families. Lack of health care provider capacity in terms of their skills, time and availability to manage CMC was also a key problem. These issues occurred within a health system that had impaired capacity in terms of fragmentation of care and limited communication among health care providers. When designing integrated care models for CMC, it is essential to understand and address the challenges experienced by their health care providers. This requires adequate training of providers, additional resources and time for coordination of care, improved systems of communication among services, with timely access to key information for parents and providers.

[Quality development within interdisciplinary transgender healthcare : Results and implications of a participatory research project].

PubMed

Nieder, Timo O; Köhler, Andreas; Eyssel, Jana; Briken, Peer

2017-09-01

Both internationally and nationally, the objective has been set to offer specialized, coordinated, and interdisciplinary treatment to individuals with rare clinical needs, such as trans individuals (e. g., transsexual, transgender). The Interdisciplinary Transgender Health Care Center Hamburg (ITHCCH) is the first and only center in Germany to integrate all disciplines relevant to trans healthcare (THC).The research project seeks to generate valid information to support quality development and assure high-quality treatment at the ITHCCH. This was done by (a) investigating needs and concerns of trans individuals regarding interdisciplinary THC, and (b) analyzing attitudes and interests of key stakeholders.Using a participatory approach involving a work group (representatives of trans support groups and local THC professionals), researchers developed an online survey focusing on trans individuals' needs and concerns. Data from N = 415 trans-identified participants were analyzed using quantitative and qualitative methods. In addition, a short survey was used to record key stakeholders' attitudes and interests towards the ITHCCH.Healthcare offers accessed by trans individuals as part of transition related treatment vary in focus and number. For example, take-up numbers of genital surgery differ between binary and non-binary trans individuals. Crucial aspects impacting on THC quality are structural characteristics, communication/social aspects, individuality, and professionalism/quality.To ensure successful, high-quality interdisciplinary THC, feedback from (potential) patients and stakeholders is crucial. In addition, both structural development and optimizing individuality and flexibility throughout the treatment process are key. This poses a considerable challenge to the sector of THC provision.

Stakeholder views on pharmacogenomic testing.

PubMed

Patel, Haridarshan N; Ursan, Iulia D; Zueger, Patrick M; Cavallari, Larisa H; Pickard, A Simon

2014-02-01

Pharmacogenomics has an important role in the evolution of personalized medicine, and its widespread uptake may ultimately depend on the interests and perspectives of key players in health care. Our aim was to summarize studies on stakeholder perspectives and attitudes toward pharmacogenomic testing. Thus, we conducted a review of original research studies that reported stakeholder views on pharmacogenomic testing using a structured approach in PubMed, International Pharmaceutical Abstracts, Cumulative Index to Nursing and Allied Health Literature, and EMBASE. A standardized data abstraction form was developed that included stakeholder group of interest-patients, general public, providers, and payers. Stakeholder views regarding barriers to pharmacogenetic implementation were organized into the following themes: ancillary information-related, clinical, economic, educational, ethical or legal, medical mistrust, and practicality. Of 34 studies that met our inclusion criteria, 37 perspectives were reported (15 on providers, 9 on the general public, 9 on patients, and 4 on payers). The most common topics that arose in studies of providers related to clinical usefulness of genetic data (n=11) and educational needs (n=11). Among the general public, the most common concerns were medical mistrust (n=5), insufficient education (n=5), and practicality (n=5). The most prevalent issues from the patient perspective were ethical or legal (n=6) and economic (n=5) issues. Among payers, leading issues were practicality (n=4) and clinical usefulness (n=3). There was overlap in the topics and concerns across stakeholder perspectives, including lack of knowledge about pharmacogenomic testing. Views on issues related to privacy, cost, and test result dissemination varied by stakeholder perspective. Limited research had been conducted in underrepresented groups. Efforts to address the issues raised by stakeholders may facilitate the implementation of pharmacogenomic testing into clinical practice. © 2013 American College of Clinical Pharmacy.

Input from Key Stakeholders in the National Security Technology Incubator

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

None

This report documents the input from key stakeholders of the National Security Technology Incubator (NSTI) in developing a new technology incubator and related programs for southern New Mexico. The technology incubator is being developed as part of the National Security Preparedness Project (NSPP), funded by a Department of Energy (DOE)/National Nuclear Security Administration (NNSA) grant. This report includes identification of key stakeholders as well as a description and analysis of their input for the development of an incubator.

A Typology of International Student Community Engagement

ERIC Educational Resources Information Center

Fleischman, David; Raciti, Maria; Lawley, Meredith

2014-01-01

This paper presents an empirical study undertaken to develop a typology of international student community engagement activities that incorporates the perceptions of three key stakeholder groups--the international students, the community and the university. Framed by the notion of value co-creation, our exploratory study was undertaken at a…

Multimodal Information Sharing Team (MIST) - Port of Baltimore Industry and Public Sector Cooperation for Information Sharing

DTIC Science & Technology

2012-11-01

engage key stakeholders. For example, it was identified that the liquid bulk, private terminal operators, rail and trucking groups are not...implementation of their counterterrorism and public safety missions. 30 Maryland Natural Resources Police/Department of Natural Resources ( MNRP ) http

A Quality Framework for Personalised Residential Supports for Adults with Developmental Disabilities

ERIC Educational Resources Information Center

Cocks, E.; Boaden, R.

2011-01-01

Background: The Personalised Residential Supports (PRS) Project provided detailed information about the nature, purposes and outcomes of PRS from the perspectives of key stakeholder groups including people with developmental disabilities, family members and service providers. Although these forms of support have developed over the past two…

Dilemmas Concerning the Employment of University Graduates in China

ERIC Educational Resources Information Center

Ren, Shuang; Zhu, Ying; Warner, Malcolm

2017-01-01

This article draws on a "within-subject" design of employment of university graduates in China over two different periods, namely 2008 and 2014. This research was conducted based on semi-structured interviews and secondary data analysis with four groups of key stakeholders including universities, government agencies, labor-market…

Market Demand for Sustainability in Management Education

ERIC Educational Resources Information Center

Gitsham, Matthew; Clark, Timothy S.

2014-01-01

Purpose: This paper aims to contribute to the ongoing debate about the relevance of sustainability in management education through exploration of the needs and expectations of a key group of business schools' stakeholders--senior executives of leading corporations. Design/methodology/approach: The paper presents findings from a survey regarding…

Stakeholders' Perceptions About a Newly Established Dental School with a Problem-Based, Student-Led, Patient-Centered Curriculum: A Qualitative Study.

PubMed

Ali, Kamran; Tredwin, Christopher; Kay, Elizabeth; Slade, Anita

2016-03-01

The aim of this study was to explore the perceptions of stakeholders regarding a newly established dental school with a problem-based, student-led, patient-centered curriculum in a community setting. Qualitative methods using 16 semistructured interviews and two focus groups were used to engage a range of stakeholders from students to faculty members to practitioners. Purposive sampling was employed with participants contacted through professional channels. Interview and focus group transcripts were transcribed verbatim. The data were analyzed thematically using an inductive approach. Themes related to preparedness of dental graduates were identified during data analyses. Early clinical exposure with patients in the first year of the course, holistic care using a patient-centered approach, and the acquisition of communication skills, professionalism, team-working skills, reflective practice, and evidence-informed clinical practice were perceived to be key strengths of the curriculum. The participants also expressed the need to strengthen teaching of life sciences and provide additional clinical experience in simulated general dental practice clinics. This study provides insight into the perceptions of a wide range of stakeholders and provides a deeper understanding of the merits and challenges of an innovative undergraduate dental curriculum.

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.

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.

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

Culture and Process Change as a Priority for Patient Engagement in Medicines Development

PubMed Central

Dewulf, Lode; Hoos, Anton; Geissler, Jan; Todaro, Veronica; Schneider, Roslyn F.; Garzya, Vincenzo; Garvey, Andrew; Robinson, Paul; Saffer, Tonya; Krug, Sarah; Sargeant, Ify

2016-01-01

Patient Focused Medicines Development (PFMD) is a not-for-profit independent multinational coalition of patients, patient stakeholders, and the pharmaceutical industry with interests across diverse disease areas and conditions. PFMD aims to facilitate an integrated approach to medicines development with all stakeholders involved early in the development process. A key strength of the coalition that differentiates it from other groups that involve patients or patient groups is that PFMD has patient organizations as founding members, ensuring that the patient perspective is the starting point when identifying priorities and developing solutions to meet patients’ needs. In addition, PFMD has from inception been formed as an equal collaboration among patient groups, patients, and pharmaceutical industry and has adopted a unique trans-Atlantic setup and scope that reflects its global intent. This parity extends to its governance model, which ensures at least equal or greater share of voice for patient group members. PFMD is actively inviting additional members and aims to expand the collaboration to include stakeholders from other sectors. The establishment of PFMD is particularly timely as patient engagement (PE) has become a priority for many health stakeholders and has led to a surge of mostly disconnected activities to deliver this. Given the current plethora of PE initiatives, an essential first step has been to determine, based on a comprehensive mapping, those strategic areas of most need requiring a focused initial effort from the perspective of all stakeholders. PFMD has identified four priority areas that will need to be addressed to facilitate implementation of PE. These are (1) culture and process change, (2) development of a global meta-framework for PE, (3) information exchange, and (4) training. This article discusses these priority themes and ongoing or planned PFMD activities within each. PMID:28232876

Bringing voice in policy building.

PubMed

Lotrecchiano, Gaetano R; Kane, Mary; Zocchi, Mark S; Gosa, Jessica; Lazar, Danielle; Pines, Jesse M

2017-07-03

Purpose The purpose of this paper is to describe the use of group concept mapping (GCM) as a tool for developing a conceptual model of an episode of acute, unscheduled care from illness or injury to outcomes such as recovery, death and chronic illness. Design/methodology/approach After generating a literature review drafting an initial conceptual model, GCM software (CS Global MAX TM ) is used to organize and identify strengths and directionality between concepts generated through feedback about the model from several stakeholder groups: acute care and non-acute care providers, patients, payers and policymakers. Through online and in-person population-specific focus groups, the GCM approach seeks feedback, assigned relationships and articulated priorities from participants to produce an output map that described overarching concepts and relationships within and across subsamples. Findings A clustered concept map made up of relational data points that produced a taxonomy of feedback was used to update the model for use in soliciting additional feedback from two technical expert panels (TEPs), and finally, a public comment exercise was performed. The results were a stakeholder-informed improved model for an acute care episode, identified factors that influence process and outcomes, and policy recommendations, which were delivered to the Department of Health and Human Services's (DHHS) Assistant Secretary for Preparedness and Response. Practical implications This study provides an example of the value of cross-population multi-stakeholder input to increase voice in shared problem health stakeholder groups. Originality/value This paper provides GCM results and a visual analysis of the relational characteristics both within and across sub-populations involved in the study. It also provides an assessment of observational key factors supporting how different stakeholder voices can be integrated to inform model development and policy recommendations.

Culture and Process Change as a Priority for Patient Engagement in Medicines Development.

PubMed

Boutin, Marc; Dewulf, Lode; Hoos, Anton; Geissler, Jan; Todaro, Veronica; Schneider, Roslyn F; Garzya, Vincenzo; Garvey, Andrew; Robinson, Paul; Saffer, Tonya; Krug, Sarah; Sargeant, Ify

2017-01-01

Patient Focused Medicines Development (PFMD) is a not-for-profit independent multinational coalition of patients, patient stakeholders, and the pharmaceutical industry with interests across diverse disease areas and conditions. PFMD aims to facilitate an integrated approach to medicines development with all stakeholders involved early in the development process. A key strength of the coalition that differentiates it from other groups that involve patients or patient groups is that PFMD has patient organizations as founding members, ensuring that the patient perspective is the starting point when identifying priorities and developing solutions to meet patients' needs. In addition, PFMD has from inception been formed as an equal collaboration among patient groups, patients, and pharmaceutical industry and has adopted a unique trans-Atlantic setup and scope that reflects its global intent. This parity extends to its governance model, which ensures at least equal or greater share of voice for patient group members. PFMD is actively inviting additional members and aims to expand the collaboration to include stakeholders from other sectors. The establishment of PFMD is particularly timely as patient engagement (PE) has become a priority for many health stakeholders and has led to a surge of mostly disconnected activities to deliver this. Given the current plethora of PE initiatives, an essential first step has been to determine, based on a comprehensive mapping, those strategic areas of most need requiring a focused initial effort from the perspective of all stakeholders. PFMD has identified four priority areas that will need to be addressed to facilitate implementation of PE. These are (1) culture and process change, (2) development of a global meta-framework for PE, (3) information exchange, and (4) training. This article discusses these priority themes and ongoing or planned PFMD activities within each.

Enabling multi-faceted measures of success for protected area management in Trinidad and Tobago.

PubMed

Granderson, Ainka A

2011-08-01

A key challenge has been to define and measure "success" in managing protected areas. A case study was conducted of efforts to evaluate the new protected area management system in Trinidad and Tobago using a participatory approach. The aim of the case study was to (1) examine whether stakeholder involvement better captures the multi-faceted nature of success and (2) identify the role and influence of various stakeholder groups in this process. An holistic and systematic framework was developed with stakeholder input that facilitated the integration of expert and lay knowledge, a broad emphasis on ecological, socio-economic, and institutional aspects, and the use of both quantitative and qualitative data allowing the evaluation to capture the multi-faceted nature and impacts of protected area management. Input from primary stakeholders, such as local communities, was critical as they have a high stake in protected area outcomes. Secondary and external stakeholders, including government agencies, non-governmental organizations, academia and the private sector, were also important in providing valuable technical assistance and serving as mediators. However, a lack of consensus over priorities, politics, and limited stakeholder capacity and data access pose significant barriers to engaging stakeholders to effectively measure the management success of protected areas. Copyright © 2011 Elsevier Ltd. All rights reserved.

A Value Analysis of Lean Processes in Target Value Design and Integrated Project Delivery.

PubMed

Nanda, Upali; K Rybkowski, Zofia; Pati, Sipra; Nejati, Adeleh

2017-04-01

To investigate what key stakeholders consider to be the advantages and the opportunities for improvement in using lean thinking and tools in the integrated project delivery (IPD) process. A detailed literature review was followed by case study of a Lean-IPD project. Interviews with members of the project leadership team, focus groups with the integrated team as well as the design team, and an online survey of all stakeholders were conducted. Statistical analysis and thematic content analysis were used to analyze the data, followed by a plus-delta analysis. (1) Learning is a large, implicit benefit of Lean-IPD that is not currently captured by any success metric; (2) the cardboard mock-up was the most successful lean strategy; (3) although a collaborative project, the level of influence of different stakeholder groups was perceived to be different by different stakeholders; (4) overall, Lean-IPD was rated as better than traditional design-bid-build methods; and (5) opportunities for improvement reported were increase in accurate cost estimating, more efficient use of time, perception of imbalance of control/influence, and need for facilitation (which represents different points of view). While lean tools and an IPD method are preferred to traditional design-bid-build methods, the perception of different stakeholders varies and more work needs to be done to allow a truly shared decision-making model. Learning was identified as one of the biggest advantages.

Recommendations for patient engagement in guideline development panels: A qualitative focus group study of guideline-naïve patients.

PubMed

Armstrong, Melissa J; Mullins, C Daniel; Gronseth, Gary S; Gagliardi, Anna R

2017-01-01

Patient and consumer engagement in clinical practice guideline development is internationally advocated, but limited research explores mechanisms for successful engagement. To investigate the perspectives of potential patient/consumer guideline representatives on topics pertaining to engagement including guideline development group composition and barriers to and facilitators of engagement. Participants were guideline-naïve volunteers for programs designed to link community members to academic research with diverse ages, gender, race, and degrees of experience interacting with health care professionals. Three focus groups and one key informant interview were conducted and analyzed using a qualitative descriptive approach. Participants recommended small, diverse guideline development groups engaging multiple patient/consumer stakeholders with no prior relationships with each other or professional panel members. No consensus was achieved on the ideal balance of patient/consumer and professional stakeholders. Pre-meeting reading/training and an identified contact person were described as keys to successful early engagement; skilled facilitators, understandable speech and language, and established mechanisms for soliciting patient opinions were suggested to enhance engagement at meetings. Most suggestions for effective patient/consumer engagement in guidelines require forethought and planning but little additional expense, making these strategies easily accessible to guideline developers desiring to achieve more meaningful patient and consumer engagement.

Patient Engagement Practices in Clinical Research among Patient Groups, Industry, and Academia in the United States: A Survey

PubMed Central

Smith, Sophia K.; Selig, Wendy; Harker, Matthew; Roberts, Jamie N.; Hesterlee, Sharon; Leventhal, David; Klein, Richard; Patrick-Lake, Bray; Abernethy, Amy P.

2015-01-01

Objective Patient-centered clinical trial design and execution is becoming increasingly important. No best practice guidelines exist despite a key stakeholder declaration to create more effective engagement models. This study aims to gain a better understanding of attitudes and practices for engaging patient groups so that actionable recommendations may be developed. Methods Individuals from industry, academic institutions, and patient groups were identified through Clinical Trials Transformation Initiative and Drug Information Association rosters and mailing lists. Objectives, practices, and perceived barriers related to engaging patient groups in the planning, conduct, and interpretation of clinical trials were reported in an online survey. Descriptive and inferential statistical analysis of survey data followed a literature review to inform survey questions. Results Survey respondents (n = 179) valued the importance of involving patient groups in research; however, patient group respondents valued their contributions to research protocol development, funding acquisition, and interpretation of study results more highly than those contributions were valued by industry and academic respondents (all p < .001). Patient group respondents placed higher value in open communications, clear expectations, and detailed contract execution than did non–patient group respondents (all p < .05). Industry and academic respondents more often cited internal bureaucratic processes and reluctance to share information as engagement barriers than did patient group respondents (all p < .01). Patient groups reported that a lack of transparency and understanding of the benefits of collaboration on the part of industry and academia were greater barriers than did non–patient group respondents (all p< .01). Conclusions Despite reported similarities among approaches to engagement by the three stakeholder groups, key differences exist in perceived barriers and benefits to partnering with patient groups among the sectors studied. This recognition could inform the development of best practices for patient-centered clinical trial design and execution. Additional research is needed to define and optimize key success factors. PMID:26465328

Patient Engagement Practices in Clinical Research among Patient Groups, Industry, and Academia in the United States: A Survey.

PubMed

Smith, Sophia K; Selig, Wendy; Harker, Matthew; Roberts, Jamie N; Hesterlee, Sharon; Leventhal, David; Klein, Richard; Patrick-Lake, Bray; Abernethy, Amy P

2015-01-01

Patient-centered clinical trial design and execution is becoming increasingly important. No best practice guidelines exist despite a key stakeholder declaration to create more effective engagement models. This study aims to gain a better understanding of attitudes and practices for engaging patient groups so that actionable recommendations may be developed. Individuals from industry, academic institutions, and patient groups were identified through Clinical Trials Transformation Initiative and Drug Information Association rosters and mailing lists. Objectives, practices, and perceived barriers related to engaging patient groups in the planning, conduct, and interpretation of clinical trials were reported in an online survey. Descriptive and inferential statistical analysis of survey data followed a literature review to inform survey questions. Survey respondents (n = 179) valued the importance of involving patient groups in research; however, patient group respondents valued their contributions to research protocol development, funding acquisition, and interpretation of study results more highly than those contributions were valued by industry and academic respondents (all p < .001). Patient group respondents placed higher value in open communications, clear expectations, and detailed contract execution than did non-patient group respondents (all p < .05). Industry and academic respondents more often cited internal bureaucratic processes and reluctance to share information as engagement barriers than did patient group respondents (all p < .01). Patient groups reported that a lack of transparency and understanding of the benefits of collaboration on the part of industry and academia were greater barriers than did non-patient group respondents (all p< .01). Despite reported similarities among approaches to engagement by the three stakeholder groups, key differences exist in perceived barriers and benefits to partnering with patient groups among the sectors studied. This recognition could inform the development of best practices for patient-centered clinical trial design and execution. Additional research is needed to define and optimize key success factors.

Development of a community-based oral healthcare model for Thai dependent older people.

PubMed

Prayoonwong, Tipruthai; Wiwatkhunupakan, Tidawan; Lasuka, Duangruedee; Srisilapanan, Patcharawan

2016-12-01

The objective of this study was to develop a community-based oral healthcare model for Thai dependent older people in Tambon Tha Pla Duk, Amphur Mae Tha, Lamphun Province, in the north of Thailand. Participatory action research was conducted, taking an interdisciplinary approach. Data were collected through focus group discussions with key stakeholders in health care of older people in Amphur Mae Tha. Supplementary data were also collected with the stakeholders through a triangulation of in-depth interviews, a self-administered questionnaire, participant observations with field notes and a literature review. The model was subsequently refined and checked by the stakeholders. The data from all processes were coded, grouped, interpreted and thematically analysed for emerging themes and patterns, independently by the researcher (TP). This model consists of two key components: (i) primary care and (ii) other related factors. Primary care: This model provides a strong linkage between home, community and healthcare services to foster strong collaborations with dependent older people. This is the central focus of the model. Other related factors consist of the following: (i) Thai social norms and culture, (ii) the need for equity, (iii) the need for effectiveness, (iv) the need for efficiency and (v) the need for quality (that is, holistic, integrated and continuous). Finally, interdisciplinary collaboration was a strategy used to achieve improved quality of oral health care. A community-based care model to enhance oral health of dependent older people was developed for potential implementation and submitted to the stakeholders at the location of the study. © 2015 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

Perceptions of Quality Life in Hamilton's Neighbourhood Hubs: A Qualitative Analysis

ERIC Educational Resources Information Center

Eby, Jeanette; Kitchen, Peter; Williams, Allison

2012-01-01

This paper examines perceptions of quality of life in Hamilton, Ontario, Canada from the perspective of residents and key community stakeholders. A series of eight focus groups were conducted. Six sessions were held with residents of neighbourhood "hubs", areas characterized by high levels of poverty. The following themes were…

Learning Mathematics: Perspectives of Australian Aboriginal Children and Their Teachers

ERIC Educational Resources Information Center

Howard, Peter; Perry, Bob

2005-01-01

Two key stakeholders in enhancing and building Aboriginal children's capacity to learn mathematics are teachers and the Aboriginal children themselves. In Australian schools it is often the case that the two groups come from different cultural backgrounds with very differing life experiences. This paper reports on an ethnographic study and focuses…

Mining Aboriginal Labour: Examining Capital Reconversion Strategies Occurring on the Risk Management Field

ERIC Educational Resources Information Center

Hodgkins, Andrew P.

2016-01-01

This article examines a vocational education and training partnership occurring in the Canadian oil sands mining industry. The case study involves a corporate-sponsored pre-apprenticeship training programme designed to procure aboriginal labour in the province of Alberta. Interviews with members of key partner groups and stakeholders occurred…

A sustainable dietetics bridging program: development and implementation in Atlantic Canada.

PubMed

Lordly, Daphne; Guy, Jennifer; Barry, Paula; Garus, Jennifer

2014-01-01

A provincial focus on immigration and improved foreign credential recognition has led to an investigation of best practices and subsequent recommendations for the development and implementation of a sustainable university-based bridging program for internationally educated dietitians in Atlantic Canada. Data were collected from various sources and used to inform program decisions and direction. An advisory framework was established through a core group representing dietetics education and regulation and internationalization. Subsequently, a key stakeholder group was formed. As a result of this collaboration and research, a dietetics bridging framework was developed and a program pilot tested. Lessons learned may inform similar endeavours and highlight the importance of collaborative leadership and collaboration among multiple stakeholders, and of creatively addressing program sustainability issues while keeping learners (internationally educated dietitians) at the centre.

Tennessee Valley and Eastern Kentucky Wind Working Group

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

Katie Stokes

2012-05-03

In December 2009, the Southern Alliance for Clean Energy (SACE), through a partnership with the Appalachian Regional Commission, EKPC, Kentucky's Department for Energy Development and Independence, SACE, Tennessee's Department of Environment and Conservation, and TVA, and through a contract with the Department of Energy, established the Tennessee Valley and Eastern Kentucky Wind Working Group (TVEKWWG). TVEKWWG consists of a strong network of people and organizations. Working together, they provide information to various organizations and stakeholders regarding the responsible development of wind power in the state. Members include representatives from utility interests, state and federal agencies, economic development organizations, non-government organizations,more » local decision makers, educational institutions, and wind industry representatives. The working group is facilitated by the Southern Alliance for Clean Energy. TVEKWWG supports the Department of Energy by helping educate and inform key stakeholders about wind energy in the state of Tennessee.« less

An organizational analysis of road traffic crash prevention to explain the difficulties of a national program in a low income country.

PubMed

Vogel, Tania; Reinharz, Daniel; Gripenberg, Marissa; Barennes, Hubert

2015-09-28

Road traffic crashes (RTC), that daily kill 3400 people and leave 15,000 with a permanent disability could be prevented through the implementation of safety programs developed in partnership with governments and institutions. The relationship between key stakeholders can be a crucial determinant to the effectiveness of road safety programs. This issue has rarely been addressed. We conducted a detailed organizational analysis of the stakeholders involved in road safety programs in Lao People's Democratic Republic (Lao PDR). A case study was performed. The framework used was a snowball effect in which the characterization of all key stakeholders and the links between them, as well as the factors that led to these links, were determined. The effect of the relations between key stakeholders on the prevention of RTC was assessed through an analysis of the transactional, intangible and controlling factors that influence these relationships. The design and implementation of road safety programs in Lao PDR suffer from weak relationships between stakeholders and a poorly functional bicephal leadership between the Ministry of Public Works and Transport and the non-governmental organisation called Handicap International. This poor coordination between key stakeholders is evident, particularly in the area of collective action and is reinforced by a lack of interest from several different stakeholders. Most agencies do not prioritize road safety. Uneven distribution of funding is another contributing factor. Strengthening the leadership is crucial to the success of the program. Some organisations have skills, power the decision making and the allocation of resources in regards to road safety programs. Encouraging participation of these organizations through a more prominent position would thus result in a better collaboration. Non-monetary rewards would further help to strengthen collaborative work. The bicephal nature of the leadership of road safety programs proves detrimental, is associated with a weak coalition between stakeholders, and contributes to the declaimed poor effectiveness of the existing programs. The study has identified non-monetary and realistic means of strengthening the collaboration between key stakeholders. Stakeholders need to revise their interpretive schemes, in order to actively support the reinforcement of government leadership of road safety policies.

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

Perspectives on the role of stakeholders in knowledge translation in health policy development in Uganda.

PubMed

Nabyonga Orem, Juliet; Marchal, Bruno; Mafigiri, DavidKaawa; Ssengooba, Freddie; Macq, Jean; Da Silveira, Valeria Campos; Criel, Bart

2013-08-19

Stakeholder roles in the application of evidence are influenced by context, the nature of the evidence, the policy development process, and stakeholder interactions. Past research has highlighted the role of stakeholders in knowledge translation (KT) without paying adequate attention to the peculiarities of low-income countries. Here we identify the roles, relations, and interactions among the key stakeholders involved in KT in Uganda and the challenges that they face. This study employed qualitative approaches to examine the roles of and links among various stakeholders in KT. In-depth interviews were conducted with 21 key informants and focused on the key actors in KT, their perceived roles, and challenges. Major stakeholders included civil society organizations with perceived roles of advocacy, community mobilization, and implementation. These stakeholders may ignore unconvincing evidence. The community's role was perceived as advocacy and participation in setting research priorities. The key role of the media was perceived as knowledge dissemination, but respondents noted that the media may misrepresent evidence if it is received in a poorly packaged form. The perceived roles of policy makers were evidence uptake, establishing platforms for KT and stewardship; negative roles included ignoring or even misrepresenting evidence that is not in their favor. The roles of parliamentarians were perceived as advocacy and community mobilization, but they were noted to pursue objectives that may not be supported by the evidence. The researchers' main role was defined as evidence generation, but focusing disproportionately on academic interests was cited as a concern. The donors' main role was defined as funding research and KT, but respondents were concerned about the local relevance of donor-supported research. Respondents reported that links among stakeholders were weak due to the absence of institutionalized, inclusive platforms. Challenges facing the stakeholders in the process of KT were identified. Our investigation revealed the need to consider the roles that various stakeholders are best placed to play. Links and necessary platforms must be put in place to achieve synergy in KT. Relevant capacities need to be built to overcome the challenges faced by the various stakeholders.

Workplace health promotion and stakeholder positions: a Finnish case study.

PubMed

Auvinen, Ari-Matti; Kohtamäki, Kari; Ilvesmäki Msc, Antti

2012-01-01

Modern workplace health promotion (WHP) requires collaboration, partnerships, and alliances with both internal and external stakeholders. However, the identification of the key stakeholders as well as the systematic mapping of their views has barely been covered in the existing research literature. This article describes the stakeholders and stakeholder positions in WHP in Finland. In this study, the stakeholders were classified as internal, interface, and external stakeholders. Furthermore, based on the authors' research, stakeholders and their positions were represented on a stakeholder map as well as by the power-interest matrix of the stakeholders. The governmental authorities play a key role in driving the strategic change toward WHP by preparing the required legislation and regulatory measures. However, both active employers and active employees can through their own work accelerate the development of new WHP services. Close collaboration between employers and employees is required at the individual workplaces. Some stakeholders, such as pension funds and occupational health services (OHS) providers, can act as important driving forces and support the strategic implementation of WHP in the workplaces. However, alone they have only limited opportunities to organize the WHP activities. Understanding the various stakeholders and the systematic mapping of their positions is essential for the successful planning and implementation of WHP activities.

Ethical issues in the export, storage and reuse of human biological samples in biomedical research: perspectives of key stakeholders in Ghana and Kenya.

PubMed

Tindana, Paulina; Molyneux, Catherine S; Bull, Susan; Parker, Michael

2014-10-18

For many decades, access to human biological samples, such as cells, tissues, organs, blood, and sub-cellular materials such as DNA, for use in biomedical research, has been central in understanding the nature and transmission of diseases across the globe. However, the limitations of current ethical and regulatory frameworks in sub-Saharan Africa to govern the collection, export, storage and reuse of these samples have resulted in inconsistencies in practice and a number of ethical concerns for sample donors, researchers and research ethics committees. This paper examines stakeholders' perspectives of and responses to the ethical issues arising from these research practices. We employed a qualitative strategy of inquiry for this research including in-depth interviews and focus group discussions with key research stakeholders in Kenya (Nairobi and Kilifi), and Ghana (Accra and Navrongo). The stakeholders interviewed emphasised the compelling scientific importance of sample export, storage and reuse, and acknowledged the existence of some structures governing these research practices, but they also highlighted the pressing need for a number of practical ethical concerns to be addressed in order to ensure high standards of practice and to maintain public confidence in international research collaborations. These concerns relate to obtaining culturally appropriate consent for sample export and reuse, understanding cultural sensitivities around the use of blood samples, facilitating a degree of local control of samples and sustainable scientific capacity building. Drawing on these findings and existing literature, we argue that the ethical issues arising in practice need to be understood in the context of the interactions between host research institutions and local communities and between collaborating institutions. We propose a set of 'key points-to-consider' for research institutions, ethics committees and funding agencies to address these issues.

Addressing overuse of health services in health systems: a critical interpretive synthesis.

PubMed

Ellen, Moriah E; Wilson, Michael G; Vélez, Marcela; Shach, Ruth; Lavis, John N; Grimshaw, Jeremy M; Moat, Kaelan A

2018-06-15

Health systems are increasingly focusing on the issue of 'overuse' of health services and how to address it. We developed a framework focused on (1) the rationale and context for health systems prioritising addressing overuse, (2) elements of a comprehensive process and approach to reduce overuse and (3) implementation considerations for addressing overuse. We conducted a critical interpretive synthesis informed by a stakeholder-engagement process. The synthesis identified relevant empirical and non-empirical articles about system-level overuse. Two reviewers independently screened records, assessed for inclusion and conceptually mapped included articles. From these, we selected a purposive sample, created structured summaries of key findings and thematically synthesised the results. Our search identified 3545 references, from which we included 251. Most articles (76%; n = 192) were published within 5 years of conducting the review and addressed processes for addressing overuse (63%; n = 158) or political and health system context (60%; n = 151). Besides negative outcomes at the patient, system and global level, there were various contextual factors to addressing service overuse that seem to be key issue drivers. Processes for addressing overuse can be grouped into three elements comprising a comprehensive approach, including (1) approaches to identify overused health services, (2) stakeholder- or patient-led approaches and (3) government-led initiatives. Key implementation considerations include the need to develop 'buy in' from stakeholders and citizens. Health systems want to ensure the use of high-value services to keep citizens healthy and avoid harm. Our synthesis can be used by policy-makers, stakeholders and researchers to understand how the issue has been prioritised, what approaches have been used to address it and implementation considerations. PROSPERO CRD42014013204 .

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.

Social Networking in an Agricultural Research Center: Using Data to Enhance Outcomes.

PubMed

Cramer, Mary E; Araz, Ozgur M; Wendl, Mary J

2017-01-01

The purpose of this article is to present a case study of one midwestern Agricultural Center (Ag Center) that used social network analysis (SNA) to (1) evaluate its collaborations with extramural stakeholders and (2) strategically plan for extending outreach for goal achievement. An evaluation team developed a data collection instrument based on SNA principles. It was administered to the Ag Center's intramural stakeholders (N = 9), who were asked to identify the key extramural stakeholders with whom they had collaborated within the previous 12 months. Additional questions about each extramural stakeholder helped to categorize them according to SNA network measures for degree of centrality, betweenness centrality, and closeness centrality. Findings showed the Ag Center had N = 305 extramural stakeholders. Most of these were other researchers and did not represent the diverse group of stakeholders that the Ag Center had targeted for engagement. Only a few of the intramural stakeholders had national or international connections. Findings were used to improve and diversify connections in order to leverage the Ag Center's expertise and ability to translate research into new best practices and policies. The SNA case study has implications for other evaluators and project directors looking for methodologies that can monitor networks in large science consortia and help leaders plan for translating research into practice and policies by networking with those who can influence such change.

Time for a Western Australian "Group of Three"?: A Speculative Essay

ERIC Educational Resources Information Center

Turner, Michael; Brown, Alistair

2015-01-01

This study analyses the theoretical cost-savings that might flow from a merger of three of Western Australia's five universities. The results of the study show that an amalgamation would not only reduce costs of operation, but also improve non-current asset use and accountability. Combination reporting also allows the key stakeholders to appraise…

Critical Success Factors: How One Multinational Company Develops Global E-Learning

ERIC Educational Resources Information Center

Nathan, Edward Pavel

2011-01-01

This research study examined how a multinational company determined what the critical success factors (CSFs) were for developing global e-learning. The study analyzed how these CSFs were grouped together to make their management more efficient. There were 21 participants in the study who were key stakeholders from the United States, Europe, Latin…

Perceptions of Quality in Higher Education: A Comparative Study of Turkish and Australian Business Academics

ERIC Educational Resources Information Center

Kalayci, Nurdan; Watty, Kim; Hayirsever, Fahriye

2012-01-01

Finding a common definition of "quality" in studies of quality and quality improvement in higher education institutions is very important. This study identifies the views of a key stakeholder group, academics, with reference to their beliefs (what is currently occurring) and their attitudes (what ought to be occurring) in relation to…

Critical Success Factors: How One Multinational Company Develops Global E-Learning

ERIC Educational Resources Information Center

Nathan, Edward Pavel

2009-01-01

This research study examined how a multinational company determined what the critical success factors (CSFs) were for developing global e-learning. The study analyzed how these CSFs were grouped together in order to make their management more efficient. There were 21 participants in the study who were key stakeholders and came from one of four…

From Classroom to Workplace: An Exploration of How Teachers and Employers of Accounting Graduates Define and Assess Critical Thinking in Action

ERIC Educational Resources Information Center

Jagannathan, Christine

2017-01-01

Purpose: The purpose of this study was to explore how 2 important stakeholder groups of Southern California business education, regional faculty and employers of accounting graduates, defined and assessed critical thinking skills. Methods: A literature review identified 2 key variables--conceptualization and operational assessment of critical…

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.

Economic evaluation of occupational health and safety programmes in health care.

PubMed

Guzman, J; Tompa, E; Koehoorn, M; de Boer, H; Macdonald, S; Alamgir, H

2015-10-01

Evidence-based resource allocation in the public health care sector requires reliable economic evaluations that are different from those needed in the commercial sector. To describe a framework for conducting economic evaluations of occupational health and safety (OHS) programmes in health care developed with sector stakeholders. To define key resources and outcomes to be considered in economic evaluations of OHS programmes and to integrate these into a comprehensive framework. Participatory action research supported by mixed qualitative and quantitative methods, including a multi-stakeholder working group, 25 key informant interviews, a 41-member Delphi panel and structured nominal group discussions. We found three resources had top priority: OHS staff time, training the workers and programme planning, promotion and evaluation. Similarly, five outcomes had top priority: number of injuries, safety climate, job satisfaction, quality of care and work days lost. The resulting framework was built around seven principles of good practice that stakeholders can use to assist them in conducting economic evaluations of OHS programmes. Use of a framework resulting from this participatory action research approach may increase the quality of economic evaluations of OHS programmes and facilitate programme comparisons for evidence-based resource allocation decisions. The principles may be applicable to other service sectors funded from general taxes and more broadly to economic evaluations of OHS programmes in general. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

'The ones that turn up are the ones that are responsible': Key stakeholders perspectives on liquor accords.

PubMed

Curtis, Ashlee; Miller, Peter; Droste, Nicolas; McFarlane, Emma; Martino, Florentine; Palmer, Darren

2016-05-01

Liquor accords were introduced as an intervention to reduce alcohol-related harm in and around licensed venues. There have been very few evaluations of the accords, made all the more difficult given the multitude of measures that are often implemented under their banner. This study provides perspectives on the effectiveness of the liquor accords from key stakeholders who were involved in the strategy. In-depth interviews were conducted with 97 key stakeholders as part of a larger study, of which 46 spoke about the effectiveness of liquor accords. Responses were analysed using thematic analysis. Stakeholders reported the greatest benefit of liquor accords to be their ability to improve communication. Many stakeholders recognised the need for mandatory attendance and discussed whether the accords are a waste of time of resources. Stakeholders did not generally view liquor accords as effective means of reducing alcohol-related harm. There was a lack of positive feedback about liquor accords provided by stakeholders, indicating a clear need to better understand the role of liquor accords, and what they aim to achieve. Responsive regulation theory suggests that the dual roles of communication and intervention are confused, leading to some of the inherent problems with accords. The role and aims of liquor accords need to be clearly defined. The findings suggest that separating the communication and regulatory functions from accords will lead to a clearer role for accords, and interventions and regulation might be better placed in the hands of regulators and enforcement. [Curtis A, Miller P, Droste N, McFarlane E, Martino F, Palmer D. 'The ones that turn up are the ones that are responsible': Key stakeholders perspectives on liquor accords. Drug Alcohol Rev 2016;35:273-279]. © 2016 Australasian Professional Society on Alcohol and other Drugs.

Improving Population Health Through an Innovative Collaborative: The Be There San Diego Data for Quality Group.

PubMed

Fremont, Allen; Kranz, Ashley M; Phillips, Jessica; Garber, Chandra

2017-06-01

In 2012, leaders from disparate health care organizations established a data group aligned around a regional goal of preventing heart attacks and strokes in San Diego. The group---now named the Be There San Diego Data for Quality (DFQ) Group---is a safe venue for medical directors and other quality-improvement leaders to share performance data on quality-of-care measures for diabetes, hypertension, and cardiovascular disease, as well as insights, lessons learned, and challenges faced by each organization in treating these conditions. The DFQ Group has focused its efforts on improving the quality of services provided by each participating health care organization, and has placed a strong emphasis on analyzing trends in combined quality data to better understand the health of the entire San Diego population. By fostering collaboration among organizations that collectively serve a large portion of the local population and other key community stakeholders, the DFQ Group has helped form the foundation of a unique, multifaceted, multi-stakeholder, regional effort that is gaining national attention and funding for its community-driven approach.

Stakeholders' Engagement Methods for the Mining Social Responsibility Practice: Determination of Local Issues and Concerns Related to the Mines Operations in Northwest of the US.

NASA Astrophysics Data System (ADS)

Masaitis, A.

2014-12-01

Every year, all around the world, global environmental change affects the human habitat. This is effect enhanced by the mining operation, and creates new challenges in relationship between the mining and local community. The purpose of this project are developed the Stakeholders engagement evaluation plan which is currently developed in University of Nevada, Reno for the Emigrant mining project, located in the central Nevada, USA, and belong to the Newmont Mining Corporation, one of the gold production leader worldwide. The needs for this project is to create the open dialog between Newmont mining company and all interested parties which have social or environmental impacts from the Emigrant mine. Identification of the stakeholders list is first and one of the most difficult steps in the developing of mine social responsibility. Stakeholders' engagement evaluation plan must be based on the timing and available resources of the mining company, understanding the goals for the engagement, and on analyzes of the possible risks from engagement. In conclusion, the Stakeholders engagement evaluation plan includes: first, determinations of the stakeholders list, which must include any interested or effected by the mine projects groups, for example: state and local government representatives, people from local communities, business partners, environmental NGOs, indigenous people, and academic groups. The contacts and availability for communication is critical for Stakeholders engagement. Next, is to analyze characteristics of all these parties and determinate the level of interest and level of their influence on the project. The next step includes the Stakeholders matrix and mapping development, where all these information will be put together.After that, must be chosen the methods for stakeholders' engagement. The methods usually depends from the goals of engagement (create the dialog lines, collect the data, determinations of the local issues and concerns, or establish the negotiation process) and available resources as a time, people, budget. Is it very important here to recognize the possible risks from the engagement and establish the key massage for stakeholders. Finally, the engagement plan should be evaluated and can be implementing for the new social responsibility practice development.

Investigating stakeholders' perceptions of the link between high STD rates and the current Baltimore City Public Schools' sex education curriculum

NASA Astrophysics Data System (ADS)

Bolden, Shenell L. T.

The purpose of this exploratory study was to examine key stakeholders' perceptions of the current Baltimore City Public Schools' (BCPS) sex education curriculum and to gain insight into how they believe the curriculum could be modified to be more effective. A mixed methods approach using qualitative and quantitative data collection consisting of a survey, focus group interview, and individual interviews was conducted to gather information on stakeholders' perceptions. The stakeholders included: (1) former students who received their sex education courses in the Baltimore City Public School system (BCPS); (2) teachers in BCPS who were affiliated with the sex education curriculum; (3) health care professionals who screened and/or treated East Baltimore City residents for a sexually transmitted disease (STD) and; (4) one policy maker who was responsible for creating sex education curriculum at the national level. Analysis of the quantitative data from former Baltimore City Public School students revealed a general satisfaction with the current sex education curriculum. However, qualitative data from the same group of stakeholders revealed several changes they thought should be implemented into the program in an effort to improve the current curriculum. Findings from the other groups after qualitative analysis of the interviews suggest three major themes in support of curriculum change: (1) a blended curriculum that integrates both the cognitive and affective learning domains; (2) knowledge of prevention of STD's and pregnancy; and (3) authentic teaching and learning. Results from this study strongly suggest that the Baltimore City Public School system is apathetic to the sexual health needs of students and, therefore, is inadvertently contributing to the high rate of sexually transmitted diseases among young people. Keywords: Abstinence, Affective domain, Indoctrination, Behavior Modification, Cognitive domain, Sex education curriculum, Sexually Transmitted Diseases.

Kullback-Leibler information in resolving natural resource conflicts when definitive data exist

USGS Publications Warehouse

Anderson, D.R.; Burnham, K.P.; White, Gary C.

2001-01-01

Conflicts often arise in the management of natural resources. Often they result from differing perceptions, varying interpretations of the law, and self-interests among stakeholder groups (for example, the values and perceptions about spotted owls and forest management differ markedly among environmental groups, government regulatory agencies, and timber industries). We extend the conceptual approach to conflict resolution of Anderson et al. (1999) by using information-theoretic methods to provide quantitative evidence for differing stakeholder positions. Importantly, we assume that relevant empirical data exist that are central to the potential resolution of the conflict. We present a hypothetical example involving an experiment to assess potential effects of a chemical on monthly survival probabilities of the hen clam (Spisula solidissima). The conflict centers on 3 stakeholder positions: 1) no effect, 2) an acute effect, and 3) an acute and chronic effect of the chemical treatment. Such data were given to 18 analytical teams to make independent analyses and provide the relative evidence for each of 3 stakeholder positions in the conflict. The empirical evidence strongly supports only one of the 3 positions in the conflict: the application of the chemical causes acute and chronic effects on monthly survival, following treatment. Formal inference from all the stakeholder positions is provided for the 2 key parameters underlying the hen clam controversy. The estimates of these parameters were essentially unbiased (the relative bias for the control and treatment group's survival probability was -0.857% and 1.400%, respectively) and precise (coefficients of variation were 0.576% and 2.761%, respectively). The advantages of making formal inference from all the models, rather than drawing conclusions from only the estimated best model, is illustrated. Finally, we contrast information-theoretic and Bayesian approaches in terms of how positions in the controversy enter the formal analysis.

Developing a spinal cord injury research strategy using a structured process of evidence review and stakeholder dialogue. Part II: Background to a research strategy.

PubMed

Bragge, P; Piccenna, L; Middleton, J; Williams, S; Creasey, G; Dunlop, S; Brown, D; Gruen, R

2015-10-01

Literature review/semi-structured interviews. To develop a spinal cord injury (SCI) research strategy for Australia and New Zealand. Australia. The National Trauma Research Institute Forum approach of structured evidence review and stakeholder consultation was employed. This involved gathering from published literature and stakeholder consultation the information necessary to properly consider the challenge, and synthesising this into a briefing document. A research strategy 'roadmap' was developed to define the major steps and key planning questions to consider; next, evidence from published SCI research strategy initiatives was synthesised with information from four one-on-one semi-structured interviews with key SCI research stakeholders to create a research strategy framework, articulating six key themes and associated activities for consideration. These resources, combined with a review of SCI prioritisation literature, were used to generate a list of draft principles for discussion in a structured stakeholder dialogue meeting. The research strategy roadmap and framework informed discussion at a structured stakeholder dialogue meeting of 23 participants representing key SCI research constituencies, results of which are published in a companion paper. These resources could also be of value in other research strategy or planning exercises. This project was funded by the Victorian Transport Accident Commission and the Australian and New Zealand Spinal Cord Injury Network.

Implementing clinical guidelines in stroke: a qualitative study of perceived facilitators and barriers.

PubMed

Donnellan, Claire; Sweetman, S; Shelley, E

2013-08-01

Clinical guidelines are frequently used as a mechanism for implementing evidence-based practice. However research indicates that health professionals vary in the extent to which they adhere to these guidelines. This study aimed to study the perceptions of stakeholders and health professionals on the facilitators and barriers to implementing national stroke guidelines in Ireland. Qualitative interviews using focus groups were conducted with stakeholders (n=3) and multidisciplinary team members from hospitals involved in stroke care (n=7). All focus group interviews were semi-structured, using open-ended questions. Data was managed and analysed using NVivo 9 software. The main themes to emerge from the focus groups with stakeholders and hospital multidisciplinary teams were very similar in terms of topics discussed. These were resources, national stroke guidelines as a tool for change, characteristics of national stroke guidelines, advocacy at local level and community stroke care challenges. Facilitators perceived by stakeholders and health professionals included having dedicated resources, user-friendly guidelines relevant at local level and having supportive advocates on the ground. Barriers were inadequate resources, poor guideline characteristics and insufficient training and education. This study highlights health professionals' perspectives regarding many key concepts which may affect the implementation of stroke care guidelines. The introduction of stroke clinical guidelines at a national level is not sufficient to improve health care quality as they should be incorporated in a quality assurance cycle with education programmes and feedback from surveys of clinical practice. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Fear of (re)injury and return to work following compensable injury: qualitative insights from key stakeholders in Victoria, Australia.

PubMed

Bunzli, Samantha; Singh, Nabita; Mazza, Danielle; Collie, Alex; Kosny, Agnieszka; Ruseckaite, Rasa; Brijnath, Bianca

2017-04-11

Return to work (RTW) is important for recovery post-injury. Fear of (re)injury is a strong predictor of delayed RTW, and therefore much attention has been given to addressing injured workers' fear beliefs. However, RTW is a socially-negotiated process and it may be important to consider the wider social context of the injured worker, including the beliefs of the key people involved in their RTW journey. This paper involves data collected as part of a wider study in which semi-structured interviews explored RTW from the perspectives of 93 key stakeholders: injured workers, GPs, employers and insurance case managers in Victoria, Australia. Inductive analysis of interview transcripts identified fear of (re)injury as a salient theme across all stakeholder groups. This presented an opportunity to analyse how the wider social context of the injured worker may influence fear and avoidance behaviour. Two co-authors performed inductive analysis of the theme 'fear of (re)injury'. Codes identified in the data were grouped into five categories. Between and within category analysis revealed three themes describing the contextual factors that may influence fear avoidance and RTW behaviour. Theme one described how injured workers engaged in a process of weighing up the risk of (re)injury in the workplace against the perceived benefits of RTW. Theme two described how workplace factors could influence an injured workers' perception of the risk of (re)injury in the workplace, including confidence that the source of the injury had been addressed, the availability and suitability of alternative duties. Theme three described other stakeholders' reluctance to accept injured workers back at work because of the fear that they might reinjure themselves. Our findings illustrate the need for a contextualised perspective of fear avoidance and RTW behaviour that includes the beliefs of other important people surrounding the injured worker (e.g. employers, family members, GPs). Existing models of health behaviour such as The Health Beliefs Model may provide useful frameworks for interventions targeting the affective, cognitive, social, organisational and policy factors that can influence fear avoidance or facilitate RTW following injury.

Ecosystem Services Flows: Why Stakeholders' Power Relationships Matter.

PubMed

Felipe-Lucia, María R; Martín-López, Berta; Lavorel, Sandra; Berraquero-Díaz, Luis; Escalera-Reyes, Javier; Comín, Francisco A

2015-01-01

The ecosystem services framework has enabled the broader public to acknowledge the benefits nature provides to different stakeholders. However, not all stakeholders benefit equally from these services. Rather, power relationships are a key factor influencing the access of individuals or groups to ecosystem services. In this paper, we propose an adaptation of the "cascade" framework for ecosystem services to integrate the analysis of ecological interactions among ecosystem services and stakeholders' interactions, reflecting power relationships that mediate ecosystem services flows. We illustrate its application using the floodplain of the River Piedra (Spain) as a case study. First, we used structural equation modelling (SEM) to model the dependence relationships among ecosystem services. Second, we performed semi-structured interviews to identify formal power relationships among stakeholders. Third, we depicted ecosystem services according to stakeholders' ability to use, manage or impair ecosystem services in order to expose how power relationships mediate access to ecosystem services. Our results revealed that the strongest power was held by those stakeholders who managed (although did not use) those keystone ecosystem properties and services that determine the provision of other services (i.e., intermediate regulating and final services). In contrast, non-empowered stakeholders were only able to access the remaining non-excludable and non-rival ecosystem services (i.e., some of the cultural services, freshwater supply, water quality, and biological control). In addition, land stewardship, access rights, and governance appeared as critical factors determining the status of ecosystem services. Finally, we stress the need to analyse the role of stakeholders and their relationships to foster equal access to ecosystem services.

Recommendations for patient engagement in guideline development panels: A qualitative focus group study of guideline-naïve patients

PubMed Central

Mullins, C. Daniel; Gronseth, Gary S.; Gagliardi, Anna R.

2017-01-01

Background Patient and consumer engagement in clinical practice guideline development is internationally advocated, but limited research explores mechanisms for successful engagement. Objective To investigate the perspectives of potential patient/consumer guideline representatives on topics pertaining to engagement including guideline development group composition and barriers to and facilitators of engagement. Setting and participants Participants were guideline-naïve volunteers for programs designed to link community members to academic research with diverse ages, gender, race, and degrees of experience interacting with health care professionals. Methods Three focus groups and one key informant interview were conducted and analyzed using a qualitative descriptive approach. Results Participants recommended small, diverse guideline development groups engaging multiple patient/consumer stakeholders with no prior relationships with each other or professional panel members. No consensus was achieved on the ideal balance of patient/consumer and professional stakeholders. Pre-meeting reading/training and an identified contact person were described as keys to successful early engagement; skilled facilitators, understandable speech and language, and established mechanisms for soliciting patient opinions were suggested to enhance engagement at meetings. Conclusions Most suggestions for effective patient/consumer engagement in guidelines require forethought and planning but little additional expense, making these strategies easily accessible to guideline developers desiring to achieve more meaningful patient and consumer engagement. PMID:28319201

Integrating: A managerial practice that enables implementation in fragmented health care environments.

PubMed

Kerrissey, Michaela; Satterstrom, Patricia; Leydon, Nicholas; Schiff, Gordon; Singer, Sara

How some organizations improve while others remain stagnant is a key question in health care research. Studies identifying how organizations can implement improvement despite barriers are needed, particularly in primary care. This inductive qualitative study examines primary care clinics implementing improvement efforts in order to identify mechanisms that enable implementation despite common barriers, such as lack of time and fragmentation across stakeholder groups. Using an embedded multiple case study design, we leverage a longitudinal data set of field notes, meeting minutes, and interviews from 16 primary care clinics implementing improvement over 15 months. We segment clinics into those that implemented more versus those that implemented less, comparing similarities and differences. We identify interpersonal mechanisms promoting implementation, develop a conceptual model of our key findings, and test the relationship with performance using patient surveys conducted pre-/post-implementation. Nine clinics implemented more successfully over the study period, whereas seven implemented less. Successfully implementing clinics exhibited the managerial practice of integrating, which we define as achieving unity of effort among stakeholder groups in the pursuit of a shared and mutually developed goal. We theorize that integrating is critical in improvement implementation because of the fragmentation observed in health care settings, and we extend theory about clinic managers' role in implementation. We identify four integrating mechanisms that clinic managers enacted: engaging groups, bridging communication, sensemaking, and negotiating. The mean patient survey results for integrating clinics improved by 0.07 units over time, whereas the other clinics' survey scores declined by 0.08 units on a scale of 5 (p = .02). Our research explores an understudied element of how clinics can implement improvement despite barriers: integrating stakeholders within and outside the clinic into the process. It provides clinic managers with an actionable path for implementing improvement.

Well-Child Care Practice Redesign for Low-Income Children: The Perspectives of Health Plans, Medical Groups, and State Agencies

PubMed Central

Coker, Tumaini R.; DuPlessis, Helen M.; Davoudpour, Ramona; Moreno, Candice; Rodriguez, Michael A.; Chung, Paul J.

2015-01-01

Objective The aim of this study was to examine the views of key stakeholders in health care payer organizations on the use of practice redesign strategies to improve the delivery of well-child care (WCC) to low-income children aged 0 to 3 years. Methods We conducted semistructured interviews with 18 key stakeholders (eg, chief medical officers, medical directors) in 11 California health plans and 2 medical group organizations serving low-income children, as well as the 2 state agencies that administer the 2 largest low-income insurance programs for California children. Discussions were recorded, transcribed, and analyzed using the constant comparative method of qualitative analysis. Results Participants reported that nonphysicians were underutilized as WCC providers, and group visits and Internet services were likely a more effective way to provide anticipatory guidance and behavioral/developmental services. Participants described barriers to redesign, including the start-up costs required to implement redesign as well as a lack of financial incentives to support innovation in WCC delivery. Participants suggested solutions to these barriers, including using pay-for-performance programs to reward practices that expanded WCC services, and providing practices with start-up grants to implement pilot redesign projects that would eventually become self-sustaining. State-level barriers included poor Medicaid reimbursement rates and disincentives to innovation created by current Healthcare Effectiveness Data and Information Set measures. Conclusions All stakeholders will ultimately be needed to support WCC redesign; however, California payers may need to provide logistic, design, and financial support to practices, whereas state agencies may need to reshape the incentives to reward innovation around child preventive health and developmental services. PMID:22075467

Acute care patient portals: a qualitative study of stakeholder perspectives on current practices.

PubMed

Collins, Sarah A; Rozenblum, Ronen; Leung, Wai Yin; Morrison, Constance Rc; Stade, Diana L; McNally, Kelly; Bourie, Patricia Q; Massaro, Anthony; Bokser, Seth; Dwyer, Cindy; Greysen, Ryan S; Agarwal, Priyanka; Thornton, Kevin; Dalal, Anuj K

2017-04-01

To describe current practices and stakeholder perspectives of patient portals in the acute care setting. We aimed to: (1) identify key features, (2) recognize challenges, (3) understand current practices for design, configuration, and use, and (4) propose new directions for investigation and innovation. Mixed methods including surveys, interviews, focus groups, and site visits with stakeholders at leading academic medical centers. Thematic analyses to inform development of an explanatory model and recommendations. Site surveys were administered to 5 institutions. Thirty interviews/focus groups were conducted at 4 site visits that included a total of 84 participants. Ten themes regarding content and functionality, engagement and culture, and access and security were identified, from which an explanatory model of current practices was developed. Key features included clinical data, messaging, glossary, patient education, patient personalization and family engagement tools, and tiered displays. Four actionable recommendations were identified by group consensus. Design, development, and implementation of acute care patient portals should consider: (1) providing a single integrated experience across care settings, (2) humanizing the patient-clinician relationship via personalization tools, (3) providing equitable access, and (4) creating a clear organizational mission and strategy to achieve outcomes of interest. Portals should provide a single integrated experience across the inpatient and ambulatory settings. Core functionality includes tools that facilitate communication, personalize the patient, and deliver education to advance safe, coordinated, and dignified patient-centered care. Our findings can be used to inform a "road map" for future work related to acute care patient portals. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Patient's access to healthcare and treatment in rheumatoid arthritis: the views of stakeholders in Portugal.

PubMed

Laires, Pedro A; Mesquita, Rui; Veloso, Luís; Martins, Ana Paula; Cernadas, Rui; Fonseca, João Eurico

2013-09-25

The access to healthcare and treatment by rheumatoid arthritis (RA) patients, particularly to biologics, differs significantly among European countries.We aimed to explore the views and experiences of Portuguese healthcare stakeholders on key barriers which limit the access to treatment, and ultimately to biologics, by RA patients and to find potential solutions (leverage points) to overcome the identified barriers. This was a qualitative research consisting of semi-structured face-to-face interviews with key stakeholders in RA framework. Thirty four individuals from eight groups of stakeholders were interviewed: rural and urban general practitioners (GPs), rheumatologists, hospital managers, hospital pharmacists, budget holders, representatives from the Portuguese Rheumatology Society and the RA Patient Association. Interviews were conducted between May and June 2011. Conventional content analysis with research triangulation was used. The key barriers identified were related to the accessibility to primary healthcare services, difficulties in RA diagnosis among GPs, inefficient referral to secondary healthcare and controlled process of biologics prescription in public hospitals. The leverage points identified included the improvement of epidemiological and clinical knowledge about RA in Portugal, a better understanding of the disease among patients and GPs, the clarification of biologics benefits among budget holders and a raised awareness of the current treatment guidelines. In order to further address the leverage points, the following key initiatives were proposed: optimization of RA national registry; dissemination of information on rheumatic symptoms in primary care facilities and among the general public; increase interaction between rheumatologists and GPs through clinical discussions of successfully treated patients or workshops; broader utilization of disease diagnosis and monitoring tools, such as DAS28, and implementation of hospital-based research to collect real-world data. Most of the key barriers limiting the access to treatment, including biologics, in RA in Portugal are upstream of rheumatology practice. Our findings suggest that future actions should be focused on the primary care level to improve referral to rheumatologists. In addition, the collection of real-world data seems essential to characterise the RA population, to improve disease management and to increase compliance with current treatment guidelines.

Climate scenarios for the Truckee-Carson River system

USGS Publications Warehouse

Dettinger, Michael; Sterle, Kelley; Simpson, Karen; Singletary, Loretta; Fitzgerald, Kelsey; McCarthy, Maureen

2017-01-01

In this study, the scenarios ultimately take the form of gridded, daily (maximum and minimum) temperatures and precipitation totals spanning the entire Truckee-Carson River System, from which meteorological inputs to various hydrologic, water-balance and watermanagement models can be extracted by other parts of the Water for the Seasons project and by other studies and stakeholders. Climate scenarios are constructed using: 1) survey data from interviews with 66 Truckee-Carson River System water-management and water-interest organizations to identify plausible drought and high-flow events that could stress the system irreparably; 2) input from the Stakeholder Affiliate Group and other modelers on the Water for the Seasons team to gain additional key stakeholder input with regard to organizational survey results and to identify the most pressing water-management issues being faced in the system; and 3) historical climate datasets used to simulate possible future conditions.

Identifying Opportunities for Decision Support Systems in Support of Regional Resource Use Planning: An Approach Through Soft Systems Methodology.

PubMed

Zhu; Dale

2000-10-01

/ Regional resource use planning relies on key regional stakeholder groups using and having equitable access to appropriate social, economic, and environmental information and assessment tools. Decision support systems (DSS) can improve stakeholder access to such information and analysis tools. Regional resource use planning, however, is a complex process involving multiple issues, multiple assessment criteria, multiple stakeholders, and multiple values. There is a need for an approach to DSS development that can assist in understanding and modeling complex problem situations in regional resource use so that areas where DSSs could provide effective support can be identified, and the user requirements can be well established. This paper presents an approach based on the soft systems methodology for identifying DSS opportunities for regional resource use planning, taking the Central Highlands Region of Queensland, Australia, as a case study.

Stakeholder Engagement in Sustainability Reporting in Higher Education: An Analysis of Key Internal Stakeholders' Expectations

ERIC Educational Resources Information Center

Ferrero-Ferrero, Idoya; Fernández-Izquierdo, María Ángeles; Muñoz-Torres, María Jesús; Bellés-Colomer, Lucía

2018-01-01

Purpose: The purpose of this study is to improve the understanding of stakeholder engagement in the context of sustainability reporting (SR) for higher education institutions (HEIs), together with the materiality principle and stakeholder expectations. Design/methodology/approach: This research uses an exploratory approach based on content…

Improving access to medicines via the Health Impact Fund in India: a stakeholder analysis.

PubMed

McMullan, Patrick; Ajay, Vamadevan S; Srinivas, Ravi; Bhalla, Sandeep; Prabhakaran, Dorairaj; Banerjee, Amitava

2018-01-01

In India, 50-65% of the population face difficulties in accessing medicines. The Health Impact Fund (HIF) is a novel proposal whereby pharmaceutical companies would be paid based on the measured global health impact of their drugs. We conducted a key stakeholder analysis to explore access to medicines in India, acceptability of the HIF and potential barriers and facilitators at policy level. To conduct a stakeholder analysis of the HIF in India: to determine key stakeholder views regarding access to medicines in India; to evaluate acceptability of the HIF; and to assess potential barriers and facilitators to the HIF as a policy. In New Delhi, we conducted semi-structured interviews. There was purposive recruitment of participants with snowball sampling. Transcribed data were analysed using stakeholder analysis frameworks and directed content analysis. Participation rate was 29% (14/49). 14 semi-structured interviews were conducted among stakeholders in New Delhi. All participants highlighted access to medicines as a problem in India. There were mixed views about the HIF in terms of relevance and scaleability. Stakeholders felt it should focus on diseases with limited or no market and potentially incorporate direct investment in research. First, access to medicines is perceived to be a major problem in India by all stakeholders, but affordability is just one factor. Second, stakeholders despite considerable support for the idea of the HIF, there are major concerns about scaleability, generalisability and impact on access to medicines. Third, the HIF and other novel drug-related health policies can afford to be more radical, e.g. working outside the existing intellectual property rights regime, targeting generic as well as branded drugs, or extending to research and development. Further innovations in access to medicines must involve country-specific key stakeholders in order to increase the likelihood of their success.

Stakeholder Perceptions of Welfare Issues and Indicators for Extensively Managed Sheep in Australia

PubMed Central

Doughty, Amanda K.; Coleman, Grahame J.; Hinch, Geoff N.; Doyle, Rebecca E.

2017-01-01

Simple Summary This survey was designed as the first step in the development of a welfare assessment framework with the aim of identifying potential causes of welfare compromise and useful indicators for sheep in extensive Australian production systems. We asked the general public, sheep producers, service providers and sheep industry related scientists to provide their thoughts on the importance of a range of sheep welfare issues and possible key indicators. All respondents thought sheep welfare was adequate but that improvement was desired. Issues perceived to cause the most risk to sheep related to factors influenced by the environment (i.e., nutrition and food supply), heat stress and lameness while key indicators useful to assess welfare were nutrition and food availability, mortality/management issues, pain and fear related indicators, and numbers of illness/injuries. Women and the general public perceived all issues and indicators to be more important than other groups of respondents. These results highlight the need to consult a wide range of stakeholders in order to develop a broadly acceptable assessment system. Abstract An online survey was designed to form the basis of a framework for the welfare assessment of extensively managed sheep in Australia. The survey focused on welfare compromise and useful welfare indicators. A total of 952 people completed the survey in its entirety, representing four stakeholder groups: Public (53.6%), Producer (27.4%), Scientist (9.9%), and Service provider (9.1%). Animal welfare was considered to be important by all participating groups in this survey (average score of 3.78/4). Respondents felt the welfare of grazing sheep was generally adequate but improvement was desired (2.98/5), with female members of the public rating sheep welfare significantly worse than other respondents (p < 0.05). Environmental issues were considered to pose the greatest risk to welfare (3.87/5), followed by heat stress (3.79), lameness (3.57) and husbandry practices (3.37). Key indicators recognised by all respondents were those associated with pain and fear (3.98/5), nutrition (4.23), mortality/management (4.27), food on offer (4.41) and number of illness/injures in a flock (4.33). There were gender and stakeholder differences in the perceived importance of both welfare issues and indicators with women and the public consistently rating issues (all p < 0.01) and indicators (all p < 0.05) to be of greater significance than other respondents. These results highlight the importance of including all stakeholders and an even balance of genders when developing a welfare framework that can address both practical and societal concerns. PMID:28333110

Qualitative exploration of stakeholders' perspectives of involuntary admission under the Mental Health Act 2001 in Ireland.

PubMed

Smyth, Siobhán; Casey, Dympna; Cooney, Adeline; Higgins, Agnes; McGuinness, David; Bainbridge, Emma; Keys, Mary; Georgieva, Irina; Brosnan, Liz; Beecher, Claire; Hallahan, Brian; McDonald, Colm; Murphy, Kathy

2017-12-01

There is international interest in, and continued concern about, the potential long-term impact of involuntary admission to psychiatric institutions, and the effect this coercive action has on a person's well-being and human rights. Involuntary detention in hospital remains a controversial process that involves stakeholders with competing concerns and who often describe negative experiences of the process, which can have long-lasting effects on the therapeutic relationship with service users. The aim of the present study was to explore the perspectives of key stakeholders involved in the involuntary admission and detention of people under the Mental Health Act 2001 in Ireland. Focus groups were used to collect data. Stakeholders interviewed were service users, relatives, general practitioners, psychiatrists, mental health nurses, solicitors, tribunal members, and police. Data were analysed using a general inductive approach. Three key categories emerged: (i) getting help; (ii) detention under the Act; and (iii) experiences of the tribunal process. This research highlights gaps in information and uncertainty about the involuntary admission process for stakeholders, but particularly for service users who are most affected by inadequate processes and supports. Mental health law has traditionally focussed on narrower areas of detention and treatment, but human rights law requires a greater refocussing on supporting service users to ensure a truly voluntary approach to care. The recent human rights treaty, the UN Convention on the Rights of Persons with Disabilities, is to guarantee a broad range of fundamental rights, such as liberty and integrity, which can be affected by coercive processes of involuntary admission and treatment. © 2016 Australian College of Mental Health Nurses Inc.

Older people's views on what they need to successfully adjust to life with a hearing aid.

PubMed

Kelly, Timothy B; Tolson, Debbie; Day, Tracy; McColgan, Gillian; Kroll, Thilo; Maclaren, William

2013-05-01

This article reports a study exploring what older people believe would enable them to adjust to and gain maximum benefit from wearing a hearing aid. A mixed methods approach was employed during 2006 involving interviews with key stakeholders, a survey across three Scottish health board areas and focus groups. Nine key stakeholders from six national and local organisations were interviewed about the needs of older people being fitted with hearing aids. In total, 240 older people belonging to three different types of hearing impaired older people were surveyed: long-term users of hearing aids, new hearing aid users, and those on a waiting list from urban and rural areas (response rate = 24%). A series of eight follow-up focus groups with 31 audiology patients was held. Health professionals appeared to neglect appropriate provision of information and overly rely on technological interventions. Of 154 older people already fitted with hearing aids, only 52% of hearing aid users reported receiving enough practical help post fitting and only 41% reported receiving enough support. Approximately 40% reported not feeling confident in the use of their aids or their controls. Older people wanted more information than they received both before and after hearing aid fitting. Information provision and attention to the psychosocial aspects of care are key to enabling older people to adjust and optimise hearing aid benefit. © 2013 Blackwell Publishing Ltd.

Washington State Birth to 3 Plan: Building on Existing Efforts to Improve Services and Achieve Measurable Outcomes for Children and Families

ERIC Educational Resources Information Center

Washington State Department of Early Learning, 2010

2010-01-01

Washington State Department of Early Learning (DEL) contracted with Thrive by Five Washington to facilitate and write this report. A collaborative group of key stakeholders helped develop this plan, which consists of actionable policy recommendations in seven high-level focus areas. Within each area are specific "next steps" that build…

Revising the 2001 Revised Recommendation Concerning Technical and Vocational Education. Report of the UNESCO-UNEVOC Special Virtual Conference, 1-14 April 2014

ERIC Educational Resources Information Center

UNESCO-UNEVOC International Centre for Technical and Vocational Education and Training, 2014

2014-01-01

This virtual conference is part of a larger consultation process through which UNESCO will consult with practitioners and researchers; representatives of key stakeholder groupings such as employers' federations, trade unions and youth organizations; other international agencies and Member States in order to draft a new Revised Recommendation that…

Disinvestment policy and the public funding of assisted reproductive technologies: outcomes of deliberative engagements with three key stakeholder groups.

PubMed

Hodgetts, Katherine; Hiller, Janet E; Street, Jackie M; Carter, Drew; Braunack-Mayer, Annette J; Watt, Amber M; Moss, John R; Elshaug, Adam G

2014-05-05

Measures to improve the quality and sustainability of healthcare practice and provision have become a policy concern. In addition, the involvement of stakeholders in health policy decision-making has been advocated, as complex questions arise around the structure of funding arrangements in a context of limited resources. Using a case study of assisted reproductive technologies (ART), deliberative engagements with a range of stakeholder groups were held on the topic of how best to structure the distribution of Australian public funding in this domain. Deliberative engagements were carried out with groups of ART consumers, clinicians and community members. The forums were informed by a systematic review of ART treatment safety and effectiveness (focusing, in particular, on maternal age and number of treatment cycles), as well as by international policy comparisons, and ethical and cost analyses. Forum discussions were transcribed and subject to thematic analysis. Each forum demonstrated stakeholders' capacity to understand concepts of choice under resource scarcity and disinvestment, and to countenance options for ART funding not always aligned with their interests. Deliberations in each engagement identified concerns around 'equity' and 'patient responsibility', culminating in a broad preference for (potential) ART subsidy restrictions to be based upon individual factors rather than maternal age or number of treatment cycles. Community participants were open to restrictions based upon measures of body mass index (BMI) and smoking status, while consumers and clinicians saw support to improve these factors as part of an ART treatment program, as distinct from a funding criterion. All groups advocated continued patient co-payments, with measures in place to provide treatment access to those unable to pay (namely, equity of access). Deliberations yielded qualitative, socially-negotiated evidence required to inform ethical, accountable policy decisions in the specific area of ART and health care more broadly. Notably, reductionist, deterministic characterizations of stakeholder 'self-interest' proved unfounded as each group sought to prioritise universal values (in particular, 'equity' and 'responsibility') over specific, within-group concerns. Our results--from an emotive case study in ART--highlight that evidence-informed disinvestment decision-making is feasible, and potentially less controversial than often presumed.

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.

Healthcare service quality: towards a broad definition.

PubMed

Mosadeghrad, Ali Mohammad

2013-01-01

The main purpose of this study is to define healthcare quality to encompass healthcare stakeholder needs and expectations because healthcare quality has varying definitions for clients, professionals, managers, policy makers and payers. This study represents an exploratory effort to understand healthcare quality in an Iranian context. In-depth individual and focus group interviews were conducted with key healthcare stakeholders. Quality healthcare is defined as "consistently delighting the patient by providing efficacious, effective and efficient healthcare services according to the latest clinical guidelines and standards, which meet the patient's needs and satisfies providers". Healthcare quality definitions common to all stakeholders involve offering effective care that contributes to the patient well-being and satisfaction. This study helps us to understand quality healthcare, highlighting its complex nature, which has direct implications for healthcare providers who are encouraged to regularly monitor healthcare quality using the attributes identified in this study. Accordingly, they can initiate continuous quality improvement programmes to maintain high patient-satisfaction levels. This is the first time a comprehensive healthcare quality definition has been developed using various healthcare stakeholder perceptions and expectations.

Stakeholders perspectives on the key components of community-based interventions coordinating care in dementia: a qualitative systematic review.

PubMed

Backhouse, Amy; Richards, David A; McCabe, Rose; Watkins, Ross; Dickens, Chris

2017-11-22

Interventions aiming to coordinate services for the community-based dementia population vary in components, organisation and implementation. In this review we aimed to investigate the views of stakeholders on the key components of community-based interventions coordinating care in dementia. We searched four databases from inception to June 2015; Medline, The Cochrane Library, EMBASE and PsycINFO, this was aided by a search of four grey literature databases, and backward and forward citation tracking of included papers. Title and abstract screening was followed by a full text screen by two independent reviewers, and quality was assessed using the CASP appraisal tool. We then conducted thematic synthesis on extracted data. A total of seven papers from five independent studies were included in the review, and encompassed the views of over 100 participants from three countries. Through thematic synthesis we identified 32 initial codes that were grouped into 5 second-order themes: (1) case manager had four associated codes and described preferences for the case manager personal and professional attributes, including a sound knowledge in dementia and availability of local services; (2) communication had five associated codes and emphasized the importance stakeholders placed on multichannel communication with service users, as well as between multidisciplinary teams and across organisations; (3) intervention had 11 associated codes which focused primarily on the practicalities of implementation such as the contact type and frequency between case managers and service users, and the importance of case manager training and service evaluation; (4) resources had five associated codes which outlined stakeholder views on the required resources for coordinating interventions and potential overlap with existing resources, as well as arising issues when available resources do not meet those required for successful implementation; and (5) support had seven associated codes that reflect the importance that was placed on the support network around the case manager and the investment of professionals involved directly in care as well as the wider professional network. The synthesis of relevant qualitative studies has shown how various stakeholder groups considered dementia care coordination interventions to be acceptable, useful and appropriate for dementia care, and have clear preferences for components, implementation methods and settings of these interventions. By incorporating stakeholders' perspectives and preferences when planning and developing coordinating interventions we may increase the likelihood of successful implementation and patient benefits.

Societal-Equity-Enhancing Criteria and Facility-Host Incentives Supporting Five Key Elements in the January 2012 Blue Ribbon Commission Report - 13015

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

Eriksson, Leif G.; Dials, George E.; George, Critz H.

2013-07-01

In February 2009, the Obama Administration announced it would abandon USA's only candidate SNF/HLW-disposal facility since 1987. In 2010, all related activities were stopped and the Blue Ribbon Commission on America's Nuclear Future was established 'to recommend a new strategy for managing the back end of the nuclear fuel cycle', which it did in January 2012, emphasizing eight key elements. However, Key Element 1, 'A new, consent-based approach to siting future nuclear facilities', is qualitative/indeterminate rather than quantitative/measurable. It is thus highly-susceptible to semantic permutations that could extend rather than, as intended, expedite the siting of future nuclear facilities unlessmore » it also defines: a) Whose consent is needed?; and b) What constitutes consent? The following 'generic', radiation-risk- and societal-equity-based criteria address these questions: 1. Identify areas affected by projected radiation and other health risks from: a. The proposed nuclear facility (facility stakeholders); and b. The related nuclear-materials-transportation routes (transportation stakeholders); then 2. Surround each stakeholder area with a buffer zone and use this enlarged foot print to identify: a. Stakeholder hosts; and b. Areas not hosting any stakeholder category (interested parties). 3. Define 'consent-based' as being at least 60 percent of the 'population' in the respective stakeholder category and apply this yardstick to both 'in favor' and 'against' votes. Although criteria 1 and 2 also need facility-based definitions to make Key Element 1 measurable, the described siting approach, augmented by related facility-host incentives, would expedite the schedule and reduce the cost for achieving Key Elements 4-6 and 8, politics permitting. (authors)« less

Understanding perceptions of stakeholder groups about Forestry Best Management Practices in Georgia.

PubMed

Tumpach, Chantal; Dwivedi, Puneet; Izlar, Robert; Cook, Chase

2018-05-01

Forestry Best Management Practices (BMPs) are critical in ensuring sustainable forest management in the United States because of their effectiveness in protecting water quality, reducing soil erosion, maintaining riparian habitat, and sustaining site productivity. The success of forestry BMPs depends heavily on coordination among primary stakeholder groups. It is important to understand perceptions of such groups for a successful forest policy formulation. We used the SWOT-AHP (Strengths, Weaknesses, Opportunities, and Threats analysis with the Analytical Hierarchy Process) framework to assess perceptions of three stakeholder groups (loggers, landowners, agency foresters) about forestry BMPs in Georgia, the largest roundwood producing state in the United States. The agency and logger stakeholder groups gave the highest priority to improved reputation under the strength category, whereas the landowner stakeholder group perceived sustainable forestry as the highest priority under the same category. Lack of landowner education was the highest priority under the weakness category for landowner and agency stakeholder groups, whereas the logger stakeholder group selected lack of trained personnel as the highest priority under the same category. Agency and landowner stakeholder groups gave the highest priority to training and education while loggers indicated maintenance of forest-based environmental benefits as their highest priority under the opportunity category. Finally, landowners and agency stakeholder groups perceived more regulations and restrictions as most significant in the threat category whereas the logger stakeholder group was most concerned about the insufficient accounting of cost sharing under the same category. Overall, selected stakeholder groups recognize the importance of forestry BMPs and had positive perceptions about them. A collaborative approach based on continuous feedback can streamline expectations of stakeholder groups about forestry BMPs in Georgia and several other states that are interested in maintaining high compliance rate of forestry BMPs for ensuring sustainable forest management. Copyright © 2018 Elsevier Ltd. All rights reserved.

Key stakeholders' perceptions of the acceptability and usefulness of a tablet-based tool to improve communication and shared decision making in ICUs.

PubMed

Ernecoff, Natalie C; Witteman, Holly O; Chon, Kristen; Chen, Yanquan Iris; Buddadhumaruk, Praewpannarai; Chiarchiaro, Jared; Shotsberger, Kaitlin J; Shields, Anne-Marie; Myers, Brad A; Hough, Catherine L; Carson, Shannon S; Lo, Bernard; Matthay, Michael A; Anderson, Wendy G; Peterson, Michael W; Steingrub, Jay S; Arnold, Robert M; White, Douglas B

2016-06-01

Although barriers to shared decision making in intensive care units are well documented, there are currently no easily scaled interventions to overcome these problems. We sought to assess stakeholders' perceptions of the acceptability, usefulness, and design suggestions for a tablet-based tool to support communication and shared decision making in ICUs. We conducted in-depth semi-structured interviews with 58 key stakeholders (30 surrogates and 28 ICU care providers). Interviews explored stakeholders' perceptions about the acceptability of a tablet-based tool to support communication and shared decision making, including the usefulness of modules focused on orienting families to the ICU, educating them about the surrogate's role, completing a question prompt list, eliciting patient values, educating about treatment options, eliciting perceptions about prognosis, and providing psychosocial support resources. The interviewer also elicited stakeholders' design suggestions for such a tool. We used constant comparative methods to identify key themes that arose during the interviews. Overall, 95% (55/58) of participants perceived the proposed tool to be acceptable, with 98% (57/58) of interviewees finding six or more of the seven content domains acceptable. Stakeholders identified several potential benefits of the tool including that it would help families prepare for the surrogate role and for family meetings as well as give surrogates time and a framework to think about the patient's values and treatment options. Key design suggestions included: conceptualize the tool as a supplement to rather than a substitute for surrogate-clinician communication; make the tool flexible with respect to how, where, and when surrogates can access the tool; incorporate interactive exercises; use video and narration to minimize the cognitive load of the intervention; and build an extremely simple user interface to maximize usefulness for individuals with low computer literacy. There is broad support among stakeholders for the use of a tablet-based tool to improve communication and shared decision making in ICUs. Eliciting the perspectives of key stakeholders early in the design process yielded important insights to create a tool tailored to the needs of surrogates and care providers in ICUs. Copyright © 2016 Elsevier Inc. All rights reserved.

Stakeholder Perspectives on Optimizing Communication in a School-Centered Asthma Program

ERIC Educational Resources Information Center

Snieder, Hylke M.; Nickels, Sarah; Gleason, Melanie; McFarlane, Arthur; Szefler, Stanley J.; Allison, Mandy A.

2017-01-01

Background: School-centered asthma programs (SAPs) can be an effective intervention to improve asthma control for underserved populations but little is known about how key stakeholders communicate within these programs. Therefore, our aim was to identify key components of effective communication in a SAP. Methods: Primary care providers (PCPs),…

Stakeholders Influence in Maltese Tourism Higher Education Curriculum Development

ERIC Educational Resources Information Center

Caruana, Simon; Lau, Lydia

2014-01-01

Tourism sector is a key element of the Maltese economy. Therefore, having an appropriately trained workforce becomes a critical factor in ensuring that tourism continues to flourish. In order to avoid skills mismatch and similar problems, it is extremely important to identify the key stakeholders and encourage them to participate in the process of…

Preferences on policy options for ensuring the financial sustainability of health care services in the future: results of a stakeholder survey.

PubMed

Tordrup, David; Angelis, Aris; Kanavos, Panos

2013-12-01

Universal access to health care in most western European countries has been a given for many decades; however, macroeconomic developments and increased pressure on health care budgets could mean the status quo cannot be maintained. As populations age, a declining proportion of economically active citizens are being required to support a larger burden of health and social care, while increasing availability of novel technologies for extending and improving life continues to push health care costs upwards. With health expenditure continuing to rise as a proportion of national income, concerns are raised about the current and future financial sustainability of Organisation for Economic Co-Operation and Development (OECD) health care systems. Against this backdrop, a discussion about options to fund health care in the future, including whether to raise additional health care finance (and the ways to do so), reallocate resources and/or ration services becomes very pertinent. This study elicits preferences among a group of key stakeholders (payers, providers, government, academia and health-related industry) on the issue of health care financial sustainability and the future funding of health care services, with a view to understanding the different degrees of acceptability between policy interventions and future funding options as well as their feasibility. We invited 842 individuals from academia, other research organisations (eg. think tanks), national health services, providers, health insurance organisations, government representatives and health-related industry and related advisory stakeholders to participate in an online survey collecting preferences on a variety of revenue-generating mechanisms and cost/demand reducing policies. Respondents represented the 28 EU member states as well as Norway, Iceland, Switzerland, Australia, Russian Federation, Canada and New Zealand. We received 494 responses to our survey from all stakeholder groups. Across all groups, the highest preference was for policies to modify lifestyle and implement more extensive screening within risk groups for high burden illnesses. There was a broad consensus not to reallocate resources from social security/education. Between stakeholders, there were differences of opinion between industry/advisory and a range of other groups, with industry being generally more in favour of market-based interventions and an increased role for the private sector in health care financing/delivery. Conversely, stakeholders from academia, government, national health services and insurance were relatively more in favour of more restrictive purchasing of new and expensive technologies, and (to varying extent) of higher income/corporate taxes. Taxes on cigarettes/alcohol were by far considered the most politically feasible option. According to this study, policy options that are broadly acceptable across stakeholder groups with different inherent interests exist but are limited to lifestyle modification, screening interventions and excise taxes on harmful products. Representatives from the private sector tend to view solutions rooted in the private sector as both effective and politically feasible options, while stakeholders from academia and the public sector seem to place more emphasis on solutions that do not disproportionately impact certain population groups.

Making Patient Engagement a Reality.

PubMed

Pushparajah, Daphnee S

2018-02-01

Patients are increasingly recognised as the true customers of healthcare. By providing insights and perspectives, patients can help the wider healthcare community better understand their needs and ultimately enhance the value of healthcare solutions being developed. In the development of new medicines, for example, meaningful patient engagement can enable the pharmaceutical industry, healthcare providers and other stakeholders to achieve more meaningful health outcomes. While both the pharmaceutical industry and regulators have achieved some progress in incorporating patient perspectives into their activities, the lack of standardised best practices and metrics has made it challenging to achieve consistency and measure success in patient engagement. Practical guidance for patient engagement can facilitate better interactions between patients or patient groups and other collaborators, e.g. industry, regulators and other healthcare stakeholders. Accordingly, UCB has developed an internal model for Patient Group Engagement incorporating four key principles, based on shared ambition, transparency, accountability and respect, essential for effective collaborations.

Wheelchair transportation safety on school buses: stakeholder recommendations for priority issues and actions.

PubMed

Buning, Mary Ellen; Karg, Patricia E

2011-01-01

This paper presents results from and provides discussion of a state-of-the-science workshop in which highly informed stakeholders in wheelchair transportation safety for students on school buses were participants. The Nominal Group Technique was used to create a process in which the main issues preventing safe transportation of wheelchair-seated students and key strategies to overcome these issues were identified and ranked. These results, along with a synthesis of group discussion and recommendations for action, are presented along with consideration of current policies, regulations, and political realities. Critical safety shortcomings exist in this highly specialized enterprise that varies from state to state. Recommended strategies include implementing wheelchair requirements in federal transportation safety standards, creation of a clearinghouse for wheelchair transportation best practices and education, creation of national standards for training, practices, and monitoring, and increased "buy-in" to voluntary wheelchair standards by wheelchair manufacturers.

Shared decision-making in medication management: development of a training intervention

PubMed Central

Stead, Ute; Morant, Nicola; Ramon, Shulamit

2017-01-01

Shared decision-making is a collaborative process in which clinicians and patients make treatment decisions together. Although it is considered essential to patient-centred care, the adoption of shared decision-making into routine clinical practice has been slow, and there is a need to increase implementation. This paper describes the development and delivery of a training intervention to promote shared decision-making in medication management in mental health as part of the Shared Involvement in Medication Management Education (ShIMME) project. Three stakeholder groups (service users, care coordinators and psychiatrists) received training in shared decision-making, and their feedback was evaluated. The programme was mostly well received, with all groups rating interaction with peers as the best aspect of the training. This small-scale pilot shows that it is feasible to deliver training in shared decision-making to several key stakeholders. Larger studies will be required to assess the effectiveness of such training. PMID:28811918

Shared decision-making in medication management: development of a training intervention.

PubMed

Stead, Ute; Morant, Nicola; Ramon, Shulamit

2017-08-01

Shared decision-making is a collaborative process in which clinicians and patients make treatment decisions together. Although it is considered essential to patient-centred care, the adoption of shared decision-making into routine clinical practice has been slow, and there is a need to increase implementation. This paper describes the development and delivery of a training intervention to promote shared decision-making in medication management in mental health as part of the Shared Involvement in Medication Management Education (ShIMME) project. Three stakeholder groups (service users, care coordinators and psychiatrists) received training in shared decision-making, and their feedback was evaluated. The programme was mostly well received, with all groups rating interaction with peers as the best aspect of the training. This small-scale pilot shows that it is feasible to deliver training in shared decision-making to several key stakeholders. Larger studies will be required to assess the effectiveness of such training.

Ambivalence about supervised injection facilities among community stakeholders.

PubMed

Strike, Carol; Watson, Tara Marie; Kolla, Gillian; Penn, Rebecca; Bayoumi, Ahmed M

2015-08-21

Community stakeholders express a range of opinions about supervised injection facilities (SIFs). We sought to identify reasons for ambivalence about SIFs amongst community stakeholders in two Canadian cities. We used purposive sampling methods to recruit various stakeholder representatives (n = 141) for key informant interviews or focus group discussions. Data were analyzed using a thematic process. We identified seven reasons for ambivalence about SIFs: lack of personal knowledge of evidence about SIFs; concern that SIF goals are too narrow and the need for a comprehensive response to drug use; uncertainty that the community drug problem is large enough to warrant a SIF(s); the need to know more about the "right" places to locate a SIF(s) to avoid damaging communities or businesses; worry that a SIF(s) will renew problems that existed prior to gentrification; concern that resources for drug use prevention and treatment efforts will be diverted to pay for a SIF(s); and concern that SIF implementation must include evaluation, community consultation, and an explicit commitment to discontinue a SIF(s) in the event of adverse outcomes. Stakeholders desire evidence about potential SIF impacts relevant to local contexts and that addresses perceived potential harms. Stakeholders would also like to see SIFs situated within a comprehensive response to drug use. Future research should determine the relative importance of these concerns and optimal approaches to address them to help guide decision-making about SIFs.

Designing systematic conservation assessments that promote effective implementation: best practice from South Africa.

PubMed

Knight, Andrew T; Driver, Amanda; Cowling, Richard M; Maze, Kristal; Desmet, Philip G; Lombard, Amanda T; Rouget, Mathieu; Botha, Mark A; Boshoff, Andre F; Castley, J Guy; Goodman, Peter S; Mackinnon, Kathy; Pierce, Shirley M; Sims-Castley, Rebecca; Stewart, Warrick I; von Hase, Amrei

2006-06-01

Systematic conservation assessment and conservation planning are two distinct fields of conservation science often confused as one and the same. Systematic conservation assessment is the technical, often computer-based, identification of priority areas for conservation. Conservation planning is composed of a systematic conservation assessment coupled with processes for development of an implementation strategy and stakeholder collaboration. The peer-reviewed conservation biology literature abounds with studies analyzing the performance of assessments (e.g., area-selection techniques). This information alone, however can never deliver effective conservation action; it informs conservation planning. Examples of how to translate systematic assessment outputs into knowledge and then use them for "doing" conservation are rare. South Africa has received generous international and domestic funding for regional conservation planning since the mid-1990s. We reviewed eight South African conservation planning processes and identified key ingredients of best practice for undertaking systematic conservation assessments in a way that facilitates implementing conservation action. These key ingredients include the design of conservation planning processes, skills for conservation assessment teams, collaboration with stakeholders, and interpretation and mainstreaming of products (e.g., maps) for stakeholders. Social learning institutions are critical to the successful operationalization of assessments within broader conservation planning processes and should include not only conservation planners but also diverse interest groups, including rural landowners, politicians, and government employees.

Key outcomes from stakeholder workshops at a symposium to inform the development of an Australian national plan for rare diseases.

PubMed

Molster, Caron; Youngs, Leanne; Hammond, Emma; Dawkins, Hugh

2012-08-10

Calls have been made for governments to adopt a cohesive approach to rare diseases through the development of national plans. At present, Australia does not have a national plan for rare diseases. To progress such a plan an inaugural Australian Rare Diseases Symposium was held in Western Australia in April 2011. This paper describes the key issues identified by symposium attendees for the development of a national plan, compares these to the content of EUROPLAN and national plans elsewhere and discusses how the outcomes might be integrated for national planning. The symposium was comprised of a series of plenary sessions followed by workshops. The topics covered were; 1) Development of national plans for rare diseases; 2) Patient empowerment; 3) Patient care, support and management; 4) Research and translation; 5) Networks, partnerships and collaboration. All stakeholders within the rare diseases community were invited to participate, including: people affected by rare diseases such as patients, carers, and families; clinicians and allied health practitioners; social and disability services; researchers; patient support groups; industry (e.g. pharmaceutical, biotechnology and medical device companies); regulators and policy-makers. All of these stakeholder groups were represented at the symposium. Workshop participants indicated the need for a national plan, a national peak body, a standard definition of 'rare diseases', education campaigns, lobbying of government, research infrastructure, streamlined whole-of-lifetime service provision, case co-ordination, early diagnosis, support for health professionals and dedicated funding. These findings are consistent with frameworks and initiatives being undertaken internationally (such as EUROPLAN), and with national plans in other countries. This implies that the development of an Australian national plan could plausibly draw on frameworks for plan development that have been proposed for use in other jurisdictions. The translation of the symposium outcomes to government policy (i.e. a national plan) requires the consideration of several factors such as the under-representation of some stakeholder groups (e.g. clinicians) and the current lack of evidence required to translate some of the symposium outcomes to policy options. The acquisition of evidence provides a necessary first step in a comprehensive planning approach.

Scaling green rubber cultivation in Southwest China-An integrative analysis of stakeholder perspectives.

PubMed

Wigboldus, Seerp; Hammond, Jim; Xu, Jianchu; Yi, Zhuang-Fang; He, Jun; Klerkx, Laurens; Leeuwis, Cees

2017-02-15

The rubber boom across much of Southeast Asia has led to environmental destruction, and the resultant crash in the price of rubber has destabilised livelihoods. We investigated the necessary factors required to enable a transition towards a more sustainable model for rubber cultivation in Southwest China (i.e. the 'greening' of rubber cultivation), using a framework for the integrative study of multiple aspects in complex land use issues. We present findings from stakeholder interviews and a stakeholder workshop, and discuss their relevance within and beyond Southwest China. The current focus of researchers and development practitioners tends to be on finding technical solutions to address unsustainable rubber cultivation practices. However, stakeholder consultations revealed that the key barriers were more social: low levels of trust and knowledge exchange between stakeholder groups and fragmented visions about the future of the landscape. It is very important to continue the economic prosperity initially brought by rubber, but, without improved communication between government and researchers and smallholder farmers, this will be very difficult to achieve. A wider landscape perspective is needed to address issues in rubber cultivation to avoid repeating the same problems of cash crop boom and bust experienced with other crops, most notably bananas. We conclude that more effort should be put into developing mechanisms that integrate technical knowledge, enhance social relationships, and present a forum for reconciling - or at least acknowledging - the differing needs, knowledge, and objectives of different groups, and transcending the power dynamics between smallholder farmers and government and researchers. Copyright © 2016 The Author(s). Published by Elsevier B.V. All rights reserved.

Stakeholders' views on maternity care shortcomings in rural Ghana: An ethnographic study among women, providers, public, and quasiprivate policy sector actors.

PubMed

Ayanore, Martin Amogre; Pavlova, Milena; Biesma, Regien; Groot, Wim

2018-01-01

Access to skilled provider and emergency obstetric care is not universal across all districts in Ghana. The lived experiences of 3 stakeholder groups on maternity care shortcomings in 3 rural Ghanaian districts are examined in this study. We applied an ethnographic study approach where field data were collected between March to May 2015 in 3 rural districts of northern Ghana. Data were collected among women with recent births experiences (n = 90), health care providers (n = 16), and policy actors (n = 6). Transcripts were read through to identify similar and divergent stakeholders' views. Significant expressions and experiences of stakeholders on maternity care shortcomings were extracted and evaluated to define key themes. Four themes emerged: social/community factors, payments for health care, facility level factors, and policy level factors. The results show that traditional women's roles divest time for maternity care. Poor transport arrangements, insufficient health workforce, health funding gaps, insurance reimbursements delays, and catastrophic health expenditures on travel and drugs are attested as major barriers across all stakeholder groups in all districts studied. The discussion of the study findings suggests it is important to ascertain the scale of informal payments and their impacts on health access. Investments in health workforce and reliable ambulatory service systems could help address poor referral difficulties in rural areas of the country. Social support for community initiatives that pool funds could provide extra resources and relieve cost access-related challenges for using maternity care in rural settings in Ghana. Copyright © 2017 John Wiley & Sons, Ltd.

Participatory research towards co-management: lessons from artisanal fisheries in coastal Uruguay.

PubMed

Trimble, Micaela; Berkes, Fikret

2013-10-15

Participatory research has become increasingly common in natural resources management. Even though participatory research is considered a strategy to facilitate co-management, there is little empirical evidence supporting this. The objective of the present paper is to analyze the contributions of participatory research to help encourage the emergence of co-management, based on a case study in Piriápolis artisanal fishery in coastal Uruguay (where management has been top-down). We argue that participatory research involving artisanal fishers, government, and other stakeholders (university scientists and NGOs) can be a key stimulus towards co-management. We build this argument by considering "seven faces" by which co-management can be analyzed: (1) as power sharing; (2) as institution building; (3) as trust building; (4) as process; (5) as learning and knowledge co-production; (6) as problem solving; and (7) as governance. Our findings show that participatory research had an impact on these various faces: (1) power was shared when making research decisions; (2) a multi-stakeholder group (POPA), with a common vision and goals, was created; (3) trust among participants increased; (4) the process of group formation was valued by participants; (5) stakeholders learned skills for participation; (6) two problem-solving exercises were conducted; and (7) a diversity of stakeholders of the initial problem identified by fishers (sea lions' impact on long-line fishery) participated in the process. The case shows that participatory research functions as a platform which enhances learning and knowledge co-production among stakeholders, paving the way towards future co-management. Copyright © 2013 Elsevier Ltd. All rights reserved.

Moral dimensions of human-wildlife conflict.

PubMed

Lute, Michelle L; Navarrete, Carlos David; Nelson, Michael Paul; Gore, Meredith L

2016-12-01

Despite increasing support for conservation globally, controversy over specific conservation policies persists among diverse stakeholders. Investigating the links between morals in relation to conservation can help increase understanding about why humans support or oppose policy, especially related to human-wildlife conflict or human conflict over wildlife. Yet the moral dimension of human-wildlife conflict has mostly gone unconsidered and unmeasured; thus, policy and programmatic efforts to reduce controversy may be missing a key part of the equation. We conducted a web-based survey (n = 1239 respondents) in Michigan (U.S.A.) to investigate cognitive and emotional influences on the value-behavior relationship. Respondents were identified by their interest and involvement in Michigan wolf management. The survey consisted of questions about values, emotions, cognitions, and behaviors relative to wolves in Michigan. We used path analysis to explore whether emotions and cognitions mediated the relationship between value and behavior. Most respondents attributed intrinsic value to wolves (n = 734) and all life (n = 773) and engaged in behaviors that benefited wolf populations and ecosystems regardless of stakeholder group (e.g., environmentalist, farmer). Attributing intrinsic value to wolves was positively related to favorable emotions toward wolves and cognitive assessments that hunting and trapping of wolves is unacceptable. Despite similarities in attribution of intrinsic value, groups differed in emotions and cognitions about wolf hunting. These differences provide a useful way to predict stakeholder behavior. Our findings may inform interventions aimed at increasing support for wolf management policies and positive interactions among stakeholders and wildlife. Leveraging agreement over intrinsic value may foster cooperation among stakeholders and garner support for controversial conservation policy. © 2016 Society for Conservation Biology.

Using Concept Mapping to Develop a Conceptual Framework for Creating Virtual Communities of Practice to Translate Cancer Research into Practice

PubMed Central

2014-01-01

Introduction Translating government-funded cancer research into clinical practice can be accomplished via virtual communities of practice that include key players in the process: researchers, health care practitioners, and intermediaries. This study, conducted from November 2012 through January 2013, examined issues that key stakeholders believed should be addressed to create and sustain government-sponsored virtual communities of practice to integrate cancer control research, practice, and policy and demonstrates how concept mapping can be used to present relevant issues. Methods Key stakeholders brainstormed statements describing what is needed to create and sustain virtual communities of practice for moving cancer control research into practice. Participants rated them on importance and feasibility, selected most relevant statements, and sorted them into clusters. I used concept mapping to examine the issues identified and multidimensional scaling analyses to create a 2-dimensional conceptual map of the statement clusters. Results Participants selected 70 statements and sorted them into 9 major clusters related to creating and sustaining virtual communities of practice: 1) standardization of best practices, 2) external validity, 3) funding and resources, 4) social learning and collaboration, 5) cooperation, 6) partnerships, 7) inclusiveness, 8) social determinants and cultural competency, and 9) preparing the environment. Researchers, health care practitioners, and intermediaries were in relative agreement regarding issues of importance for creating these communities. Conclusion Virtual communities of practice can be created to address the needs of researchers, health care practitioners, and intermediaries by using input from these key stakeholders. Increasing linkages between these subgroups can improve the translation of research into practice. Similarities and differences between groups can provide valuable information to assist the government in developing virtual communities of practice. PMID:24762532

Using concept mapping to develop a conceptual framework for creating virtual communities of practice to translate cancer research into practice.

PubMed

Vinson, Cynthia A

2014-04-24

Translating government-funded cancer research into clinical practice can be accomplished via virtual communities of practice that include key players in the process: researchers, health care practitioners, and intermediaries. This study, conducted from November 2012 through January 2013, examined issues that key stakeholders believed should be addressed to create and sustain government-sponsored virtual communities of practice to integrate cancer control research, practice, and policy and demonstrates how concept mapping can be used to present relevant issues. Key stakeholders brainstormed statements describing what is needed to create and sustain virtual communities of practice for moving cancer control research into practice. Participants rated them on importance and feasibility, selected most relevant statements, and sorted them into clusters. I used concept mapping to examine the issues identified and multidimensional scaling analyses to create a 2-dimensional conceptual map of the statement clusters. Participants selected 70 statements and sorted them into 9 major clusters related to creating and sustaining virtual communities of practice: 1) standardization of best practices, 2) external validity, 3) funding and resources, 4) social learning and collaboration, 5) cooperation, 6) partnerships, 7) inclusiveness, 8) social determinants and cultural competency, and 9) preparing the environment. Researchers, health care practitioners, and intermediaries were in relative agreement regarding issues of importance for creating these communities. Virtual communities of practice can be created to address the needs of researchers, health care practitioners, and intermediaries by using input from these key stakeholders. Increasing linkages between these subgroups can improve the translation of research into practice. Similarities and differences between groups can provide valuable information to assist the government in developing virtual communities of practice.

Developing, implementing and disseminating a core outcome set for neonatal medicine.

PubMed

Webbe, James; Brunton, Ginny; Ali, Shohaib; Duffy, James Mn; Modi, Neena; Gale, Chris

2017-01-01

In high resource settings, 1 in 10 newborn babies require admission to a neonatal unit. Research evaluating neonatal care involves recording and reporting many different outcomes and outcome measures. Such variation limits the usefulness of research as studies cannot be compared or combined. To address these limitations, we aim to develop, disseminate and implement a core outcome set for neonatal medicine. A steering group that includes parents and former patients, healthcare professionals and researchers has been formed to guide the development of the core outcome set. We will review neonatal trials systematically to identify previously reported outcomes. Additionally, we will specifically identify outcomes of importance to parents, former patients and healthcare professionals through a systematic review of qualitative studies. Outcomes identified will be entered into an international, multi-perspective eDelphi survey. All key stakeholders will be invited to participate. The Delphi method will encourage individual and group stakeholder consensus to identify a core outcome set. The core outcome set will be mapped to existing, routinely recorded data where these exist. Use of a core set will ensure outcomes of importance to key stakeholders, including former patients and parents, are recorded and reported in a standard fashion in future research. Embedding the core outcome set within future clinical studies will extend the usefulness of research to inform practice, enhance patient care and ultimately improve outcomes. Using routinely recorded electronic data will facilitate implementation with minimal addition burden. Core Outcome Measures in Effectiveness Trials (COMET) database: 842 (www.comet-initiative.org/studies/details/842).

Ergonomics and nursing in hospital environments.

PubMed

Rogers, Bonnie; Buckheit, Kathleen; Ostendorf, Judith

2013-10-01

This study describes workplace conditions, the environment, and activities that may contribute to musculoskeletal injuries among nurses, as well as identifies solutions to decrease these risks and improve work-related conditions. The study used a mixed-methods design. Participants included nurses and stakeholders from five hospitals. Several focus groups were held with nurses, walk-throughs of clinical units were conducted, and stakeholder interviews with key occupational health and safety personnel were conducted in each of the five hospitals, as well as with representatives from the American Nurses Association, Veterans Health Administration hospital, and National Institute for Occupational Safety and Health. Several key contributing factors, including the physical environment (e.g., layout and organization of work stations), work organization and culture (e.g., heavy workload, inadequate staffing, lack of education), and work activities (e.g., manual lifting of patients, lack of assistive devices), were identified. Recommendations included the need for a multifaceted and comprehensive approach to developing a sound ergonomics program. Copyright 2013, SLACK Incorporated.

Stakeholders' views on the strengths and weaknesses of maternal care financing and its reform in Georgia.

PubMed

Shengelia, Lela; Pavlova, Milena; Groot, Wim

2017-08-08

The improvement of maternal health has been one of the aims of the health financing reforms in Georgia. Public-private relationships are the most notable part of the reform. This study aimed to assess the strengths and weakness of the maternal care financing in Georgia in terms of adequacy and effects. A qualitative design was used to explore the opinions of key stakeholders about the adequacy of maternal care financing and financial protection of pregnant women in Georgia. Women who had used maternal care during the past 4 years along with health care providers, policy makers, and representatives of international partner organizations and national professional body were the respondents in this study. Six focus group discussions to collect data from women and 15 face-to-face in-depth interviews to collect data from the other stakeholders were conducted. Each focus group discussion consisted of 7-8 women. Two focus group discussions were carried out at each of the target settings (i.e. Tbilisi, Imereti and Adjara). Women were selected in each location through the hospital registry and snowballing method. The evidence shows that there is a consensus among maternal care stakeholder groups on the influence of the healthcare financing reforms on maternal health. Specifically, the privatization of the maternal care services has had positive effects because it significantly improved the environment and technical capacity of the maternity houses. Also, in contrast to other former-soviet republics, there are no informal payments anymore for maternal care in Georgia. However the privatization, which was done without strict regulation, negatively influenced the reform process and provided the possibility to private providers to manipulate the formal user fees in maternal care. Stakeholders also indicated that the UHC programs implemented at the last stage of the healthcare financing reform as well as other state maternal health programs protect women from catastrophic health care expenditure. The results suggest a consensus among stakeholders on the influence of the healthcare financing reform on maternal healthcare. The total privatization of the maternal care services has had positive effects because it significantly improved the environment and the technical capacity of the maternity house. However, the aim to improve maternal health and to reduce maternal mortality was not fully achieved. Financial protection of mothers should be further studied to identify vulnerable groups who should be targeted in future programs.

Animal Study Registries: Results from a Stakeholder Analysis on Potential Strengths, Weaknesses, Facilitators, and Barriers.

PubMed

Wieschowski, Susanne; Silva, Diego S; Strech, Daniel

2016-11-01

Publication bias in animal research, its extent, its predictors, and its potential countermeasures are increasingly discussed. Recent reports and conferences highlight the potential strengths of animal study registries (ASRs) in this regard. Others have warned that prospective registration of animal studies could diminish creativity, add administrative burdens, and complicate intellectual property issues in translational research. A literature review and 21 international key-informant interviews were conducted and thematically analyzed to develop a comprehensive matrix of main- and subcategories for potential ASR-related strengths, weaknesses, facilitators, and barriers (SWFBs). We identified 130 potential SWFBs. All stakeholder groups agreed that ASRs could in various ways improve the quality and refinement of animal studies while allowing their number to be reduced, as well as supporting meta-research on animal studies. However, all stakeholder groups also highlighted the potential for theft of ideas, higher administrative burdens, and reduced creativity and serendipity in animal studies. Much more detailed reasoning was captured in the interviews than is currently found in the literature, providing a comprehensive account of the issues and arguments around ASRs. All stakeholder groups highlighted compelling potential strengths of ASRs. Although substantial weaknesses and implementation barriers were highlighted as well, different governance measures might help to minimize or even eliminate their impact. Such measures might include confidentiality time frames for accessing prospectively registered protocols, harmonized reporting requirements across ASRs, ethics reviews, lab notebooks, and journal submissions. The comprehensive information gathered in this study could help to guide a more evidence-based debate and to design pilot tests for ASRs.

Improving informed consent: Stakeholder views

PubMed Central

Anderson, Emily E.; Newman, Susan B.; Matthews, Alicia K.

2017-01-01

Purpose Innovation will be required to improve the informed consent process in research. We aimed to obtain input from key stakeholders—research participants and those responsible for obtaining informed consent—to inform potential development of a multimedia informed consent “app.” Methods This descriptive study used a mixed-methods approach. Five 90-minute focus groups were conducted with volunteer samples of former research participants and researchers/research staff responsible for obtaining informed consent. Participants also completed a brief survey that measured background information and knowledge and attitudes regarding research and the use of technology. Established qualitative methods were used to conduct the focus groups and data analysis. Results We conducted five focus groups with 41 total participants: three groups with former research participants (total n = 22), and two groups with researchers and research coordinators (total n = 19). Overall, individuals who had previously participated in research had positive views regarding their experiences. However, further discussion elicited that the informed consent process often did not meet its intended objectives. Findings from both groups are presented according to three primary themes: content of consent forms, experience of the informed consent process, and the potential of technology to improve the informed consent process. A fourth theme, need for lay input on informed consent, emerged from the researcher groups. Conclusions Our findings add to previous research that suggests that the use of interactive technology has the potential to improve the process of informed consent. However, our focus-group findings provide additional insight that technology cannot replace the human connection that is central to the informed consent process. More research that incorporates the views of key stakeholders is needed to ensure that multimedia consent processes do not repeat the mistakes of paper-based consent forms. PMID:28949896

Does the operations of the National Health Insurance Scheme (NHIS) in Ghana align with the goals of Primary Health Care? Perspectives of key stakeholders in northern Ghana.

PubMed

Awoonor-Williams, John Koku; Tindana, Paulina; Dalinjong, Philip Ayizem; Nartey, Harry; Akazili, James

2016-08-30

In 2005, the World Health Assembly (WHA) of the World Health Organization (WHO) urged member states to aim at achieving affordable universal coverage and access to key promotive, preventive, curative, rehabilitative and palliative health interventions for all their citizens on the basis of equity and solidarity. Since then, some African countries, including Ghana, have taken steps to introduce national health insurance reforms as one of the key strategies towards achieving universal health coverage (UHC). The aim of this study was to get a better understanding of how Ghana's health insurance institutions interact with stakeholders and other health sector programmes in promoting primary health care (PHC). Specifically, the study identified the key areas of misalignment between the operations of the NHIS and that of PHC. Using qualitative and survey methods, this study involved interviews with various stakeholders in six selected districts in the Upper East region of Ghana. The key stakeholders included the National Health Insurance Authority (NHIA), district coordinators of the National Health Insurance Schemes (NHIS), the Ghana Health Service (GHS) and District Health Management Teams (DHMTs) who supervise the district hospitals, health centers/clinics and the Community-based Health and Planning Services (CHPS) compounds as well as other public and private PHC providers. A stakeholders' workshop was organized to validate the preliminary results which provided a platform for stakeholders to deliberate on the key areas of misalignment especially, and to elicit additional information, ideas and responses, comments and recommendations from participants for the achievement of the goals of UHC and PHC. The key areas of misalignments identified during this pilot study included: delays in reimbursements of claims for services provided by health care providers, which serves as a disincentive for service providers to support the NHIS, inadequate coordination among stakeholders in PHC delivery; and inadequate funding for PHC, particularly on preventive and promotive services. Other areas are: the bypassing of PHC facilities due to lack of basic services at the PHC level such as laboratory services, as well as proximity to the district hospitals; and finally the lack of clear understanding of the national policy on PHC. This study suggests that despite the progress that has been made since the establishment of the NHIS in Ghana, there are still huge gaps that need urgent attention to ensure that the goals of UHC and PHC are met. The key areas of misalignment identified in this study, particularly on the delays in reimbursements need to be taken seriously. It is also important for more dialogue between the NHIA and service providers to address key concerns in the implementation of the NHIS which is key to achieving UHC.

Does the operations of the National Health Insurance Scheme (NHIS) in Ghana align with the goals of Primary Health Care? Perspectives of key stakeholders in northern Ghana.

PubMed

Awoonor-Williams, John Koku; Tindana, Paulina; Dalinjong, Philip Ayizem; Nartey, Harry; Akazili, James

2016-09-05

In 2005, the World Health Assembly (WHA) of the World Health Organization (WHO) urged member states to aim at achieving affordable universal coverage and access to key promotive, preventive, curative, rehabilitative and palliative health interventions for all their citizens on the basis of equity and solidarity. Since then, some African countries, including Ghana, have taken steps to introduce national health insurance reforms as one of the key strategies towards achieving universal health coverage (UHC). The aim of this study was to get a better understanding of how Ghana's health insurance institutions interact with stakeholders and other health sector programmes in promoting primary health care (PHC). Specifically, the study identified the key areas of misalignment between the operations of the NHIS and that of PHC. Using qualitative and survey methods, this study involved interviews with various stakeholders in six selected districts in the Upper East region of Ghana. The key stakeholders included the National Health Insurance Authority (NHIA), district coordinators of the National Health Insurance Schemes (NHIS), the Ghana Health Service (GHS) and District Health Management Teams (DHMTs) who supervise the district hospitals, health centers/clinics and the Community-based Health and Planning Services (CHPS) compounds as well as other public and private PHC providers. A stakeholders' workshop was organized to validate the preliminary results which provided a platform for stakeholders to deliberate on the key areas of misalignment especially, and to elicit additional information, ideas and responses, comments and recommendations from respondents for the achievement of the goals of UHC and PHC. The key areas of misalignments identified during this pilot study included: delays in reimbursements of claims for services provided by health care providers, which serves as a disincentive for service providers to support the NHIS; inadequate coordination among stakeholders in PHC delivery; and inadequate funding for PHC, particularly on preventive and promotive services. Other areas are: the bypassing of PHC facilities due to lack of basic services at the PHC level such as laboratory services, as well as proximity to the district hospitals; and finally the lack of clear understanding of the national policy on PHC. This study suggests that despite the progress that has been made since the establishment of the NHIS in Ghana, there are still huge gaps that need urgent attention to ensure that the goals of UHC and PHC are met. The key areas of misalignment identified in this study, particularly on the delays in reimbursements need to be taken seriously. It is also important for more dialogue between the NHIA and service providers to address key concerns in the implementation of the NHIS which is key to achieving UHC.

'Hot particles' in the cold light of day: principles for a stakeholder and public engagement architecture relating to historic liabilities in the marine environment.

PubMed

Wylie, Rick

2007-09-01

This paper discusses issues in stakeholder relations, focusing on the challenges of liabilities management associated with small fragments of irradiated nuclear fuel hereafter termed particles (and sometimes termed 'hot particles' in the public domain, from which this paper gets its title), produced over a number of decades from now ceased operations at Dounreay. It describes key problems confronting the nuclear industry in developing a stakeholder-relations strategy. Drawing upon examples of the stakeholder activity at Dounreay, and using an ecological metaphor, an innovative architecture for stakeholder engagement relating to nuclear issues is outlined. This is based upon the view that the solution of the stakeholder issue must reflect the complexity and connectivity of influences and interests within the stakeholder environment. It is argued that the lay public should be visualised as the stakeholder if an effective stakeholder-relations strategy is to be achieved. The importance of creating trust in a context of scientific uncertainty is highlighted. This will, it is argued, become an increasingly salient issue in the thrust for openness and transparency, two key drivers of nuclear industry public and stakeholder relations, which could make the limits of scientific knowledge and control more widely appreciated, and bring to the fore the role of lay conceptions of perceived risk.

Policy, Research and Residents' Perspectives on Built Environments Implicated in Heart Disease: A Concept Mapping Approach.

PubMed

Stankov, Ivana; Howard, Natasha J; Daniel, Mark; Cargo, Margaret

2017-02-09

An underrepresentation of stakeholder perspectives within urban health research arguably limits our understanding of what is a multi-dimensional and complex relationship between the built environment and health. By engaging a wide range of stakeholders using a participatory concept mapping approach, this study aimed to achieve a more holistic and nuanced understanding of the built environments shaping disease risk, specifically cardiometabolic risk (CMR). Moreover, this study aimed to ascertain the importance and changeability of identified environments through government action. Through the concept mapping process, community members, researchers, government and non-government stakeholders collectively identified eleven clusters encompassing 102 built environmental domains related to CMR, a number of which are underrepresented within the literature. Among the identified built environments, open space, public transportation and pedestrian environments were highlighted as key targets for policy intervention. Whilst there was substantive convergence in stakeholder groups' perspectives concerning the built environment and CMR, there were disparities in the level of importance government stakeholders and community members respectively assigned to pedestrian environments and street connectivity. These findings support the role of participatory methods in strengthening how urban health issues are understood and in affording novel insights into points of action for public health and policy intervention.

National Environmental Change Information System Case Study

NASA Technical Reports Server (NTRS)

Goodman, S. J.; Ritschard, R.; Estes, M. G., Jr.; Hatch, U.

2001-01-01

The Global Hydrology and Climate Center and NASA's Marshall Space Flight Center conducted a fact-finding case study for the Data Management Working Group (DMWG), now referred to as the Data and Information Working Group (DIWG), of the U.S. Global Change Research Program (USGCRP) to determine the feasibility of an interagency National Environmental Change Information System (NECIS). In order to better understand the data and information needs of policy and decision makers at the national, state, and local level, the DIWG asked the case study team to choose a regional water resources issue in the southeastern United States that had an impact on a diverse group of stakeholders. The southeastern United States was also of interest because the region experiences interannual climatic variations and impacts due to El Nino and La Nina. Jointly, with input from the DIWG, a focus on future water resources planning in the Apalachicola-Chattahoochee-Flint (ACF) River basins of Alabama, Georgia, and Florida was selected. A tristate compact and water allocation formula is currently being negotiated between the states and U.S. Army Corps of Engineers (COE) that will affect the availability of water among competing uses within the ACF River basin. All major reservoirs on the ACF are federally owned and operated by the U.S. Army COE. A similar two-state negotiation is ongoing that addresses the water allocations in the adjacent Alabama-Coosa-Tallapoosa (ACT) River basin, which extends from northwest Georgia to Mobile Bay. The ACF and ACT basins are the subject of a comprehensive river basin study involving many stakeholders. The key objectives of this case study were to identify specific data and information needs of key stakeholders in the ACF region, determine what capabilities are needed to provide the most practical response to these user requests, and to identify any limitations in the use of federal data and information. The NECIS case study followed the terms of reference developed by the interagency DIWG. The case study "lessons learned" and "key findings" offer guidelines and considerations to the DMWG for the development and implementation of a NECIS that would support the data and information needs of policy and decision makers at the national, state, and local level.

Outcomes-Based Funding and Stakeholder Engagement. Lumina Issue Papers

ERIC Educational Resources Information Center

Kadlec, Alison; Shelton, Susan

2015-01-01

This paper examines the key aspects of stakeholder engagement that can strengthen the design, implementation and sustainability of outcomes-based funding policies. We seek to help policymakers understand the prevailing starting-point attitudes of institutional stakeholders, primarily college and university administrators, faculty and staff, and…

Detecting and Treating Depression in People with Mild Intellectual Disability: The Views of Key Stakeholders

ERIC Educational Resources Information Center

McGillivray, Jane A.; McCabe, Marita P.

2010-01-01

There is a pressing need for the development of programs for the early identification and treatment of depression in individuals with mild intellectual disability. The aim of this study was to ascertain the perspective of 64 key stakeholders (people with intellectual disability, healthcare professionals, family/caregivers & support workers)…

Key Stakeholdersí Attitudes towards Teacher Education Programs in TEFL: A Case Study of Farhangian University in Iran

ERIC Educational Resources Information Center

Gholami, Javad; Qurbanzada, Isa

2016-01-01

Recently, teacher training courses have attracted the researchers' special attention, while teacher education programs have not received as much attention. The present study investigated the attitudes key stakeholders in a teacher education program (i.e., student teachers, in-service teachers, and teacher educators) hold toward the appropriateness…

Social Media as a Practical Approach in Engaging Key Stakeholders in School Crisis Communication Plans: A Qualitative Analysis

ERIC Educational Resources Information Center

Agozzino, Alisa; Kaiser, Candace

2014-01-01

The current study examined how public relations specialists within school systems are developing, implementing, and revising their communication crisis plans in an effort to fully engage all key stakeholders. Four research questions and two hypotheses were posed. Members from a state public relations association for schools were asked to…

Understanding Key Stakeholder Belief Systems or Institutional Logics Related to Nontenure-Track Faculty and the Changing Professoriate

ERIC Educational Resources Information Center

Teachers College Record, 2014

2014-01-01

Background/context: Over the past 40 years, the composition of the professoriate has changed substantially across all institutional types. Once predominantly tenure track, now nontenure-track faculty (NTTF) constitute more than 70% of the faculty. While these major changes have occurred, we know little about key stakeholders' views…

Non-medical prescribing of chemotherapy: engaging stakeholders to maximise success?

PubMed

Lennan, Elaine

2014-01-01

This study report examines the views and experiences of professional stakeholders about non-medical prescribing (NMP) of chemotherapy. The introduction of open formulary NMP has created opportunities to radically change health-care delivery. For chemotherapy services, the most recent advice from the National Chemotherapy Advisory Group [Department of Health (2009) Chemotherapy Services in England, ensuring quality and safety: a report from the National Chemotherapy Advisory Group, London Her Majesty's Stationary Office] clearly endorses the development of nurse- or pharmacist-led chemotherapy clinics. This is very much welcomed but is based on very limited evidence as to their effectiveness. A fourth-generation evaluation study. A purposeful sample of 23 stakeholders connected with the chemotherapy service was used. A serial data collection technique with individual interviews followed by uni-professional focus groups was adopted. Finally, a multi-professional focus group was held to determine the strategic way forward. Data were collected in 2009-2010. The study illuminated the key features necessary to maximise success of NMP in chemotherapy clinics and captures the importance of good working relationships. Whilst different practice models will emerge, fundamental and core to services is the need for good team working, established and effective communication strategies, and most importantly avoiding isolation in practice. This study additionally reinforced any evaluation takes place within preexisting political contexts and in particular medical dominance. Not all medical colleagues agreed with or wanted NMP for their patients, highlighting difficulties of developing new models of working within a resisting culture. No objections to NMP of chemotherapy were found, but, clearly, the context of practice needs to be agreed and supportedby all professional stakeholders. What is already known about this topicOpen formulary non-medical prescribing has been rapidly introduced over the past decade.Little research has been conducted in acute care and none in the chemotherapy setting.Cancer policy recommends the introduction of nurse-led chemotherapy clinics.What this paper addsNon-medical prescribing (NMP) in chemotherapy is appropriate with the right model of practice.Well-established professional relationships are a key to success.NMP is not appropriate in isolation of the multidisciplinary team (MDT).Implications for practice and/or policyNurses need to demonstrate the value of non-medical prescribing in chemotherapy using available metrics.Models of practice need to ensure good communication channels, MDT working, and transparency of prescribing.

Improving Awareness of Cancer Clinical Trials Among Hispanic Patients and Families: Audience Segmentation Decisions for a Media Intervention

PubMed Central

QUINN, GWENDOLYN P.; McINTYRE, JESSICA; GONZALEZ, LUIS E.; ANTONIA, TERESITA MUÑOZ; ANTOLINO, PRADO; WELLS, KRISTEN J.

2016-01-01

Clinical trials hold great promise for cancer treatment; yet, Hispanic cancer patients have low rates of clinical trial participation. Lack of awareness and knowledge of clinical trials and language barriers may account for low participation rates. Patient education through audiovisual materials can improve knowledge of and attitudes toward clinical trials among Hispanic populations. In this study, 36 Hispanic cancer patients/survivors and caregivers in Florida and Puerto Rico participated in focus groups to aid in developing a Spanish-language DVD and booklet intervention designed to increase knowledge about clinical trials. Focus group results showed (a) low levels of knowledge about clinical trials, (b) uncertainty about why a physician would expect a patient to make a choice about treatment, and (c) desire for family participation in decision making. Respondents expressed various preferences for aspects of the DVD such as showing extended family in the DVD and physician explanations about key terms. On the basis of these preferences, the authors developed a creative brief for a DVD. The content of the DVD was reviewed by Hispanic community leaders and key stakeholders. A final DVD was created, in Spanish, using Hispanic patients and physicians, which contained the information deemed important from the focus groups and stakeholder interviews. The DVD is complete with companion booklet and currently undergoing a randomized control trial. PMID:23639101

Community Member and Stakeholder Perspectives on a Healthy Environment Initiative in North Carolina.

PubMed

Carter-Edwards, Lori; Lowe-Wilson, Abby; Mouw, Mary Sherwyn; Jeon, Janet Yewon; Baber, Ceola Ross; Vu, Maihan B; Bethell, Monique

2015-08-13

The North Carolina Community Transformation Grant Project (NC-CTG) aimed to implement policy, system, and environmental strategies to promote healthy eating, active living, tobacco-free living, and clinical and community preventive services to advance health equity and reduce health disparities for the state's most vulnerable communities. This article presents findings from the Health Equity Collaborative Evaluation and Implementation Project, which assessed community and stakeholder perceptions of health equity for 3 NC-CTG strategies: farmers markets, shared use, and smoke-free multiunit housing. In a triangulated qualitative evaluation, 6 photo elicitation (PE) sessions among 45 community members in 1 urban and 3 rural counties and key informant interviews among 22 stakeholders were conducted. Nine participants from the PE sessions and key informant interviews in the urban county subsequently participated in a stakeholder power analysis and mapping session (SPA) to discuss and identify people and organizations in their community perceived to be influential in addressing health equity-related issues. Evaluations of the PE sessions and key informant interviews indicated that access (convenience, cost, safety, and awareness of products and services) and community fit (community-defined quality, safety, values, and norms) were important constructs across the strategies. The SPA identified specific community- and faith-based organizations, health care organizations, and local government agencies as key stakeholders for future efforts. Both community fit and access are essential constructs for promoting health equity. Findings demonstrate the feasibility of and need for formative research that engages community members and local stakeholders to shape context-specific, culturally relevant health promotion strategies.

Community Member and Stakeholder Perspectives on a Healthy Environment Initiative in North Carolina

PubMed Central

Lowe-Wilson, Abby; Mouw, Mary Sherwyn; Jeon, Janet Yewon; Baber, Ceola Ross; Vu, Maihan B.; Bethell, Monique

2015-01-01

Introduction The North Carolina Community Transformation Grant Project (NC-CTG) aimed to implement policy, system, and environmental strategies to promote healthy eating, active living, tobacco-free living, and clinical and community preventive services to advance health equity and reduce health disparities for the state’s most vulnerable communities. This article presents findings from the Health Equity Collaborative Evaluation and Implementation Project, which assessed community and stakeholder perceptions of health equity for 3 NC-CTG strategies: farmers markets, shared use, and smoke-free multiunit housing. Methods In a triangulated qualitative evaluation, 6 photo elicitation (PE) sessions among 45 community members in 1 urban and 3 rural counties and key informant interviews among 22 stakeholders were conducted. Nine participants from the PE sessions and key informant interviews in the urban county subsequently participated in a stakeholder power analysis and mapping session (SPA) to discuss and identify people and organizations in their community perceived to be influential in addressing health equity–related issues. Results Evaluations of the PE sessions and key informant interviews indicated that access (convenience, cost, safety, and awareness of products and services) and community fit (community-defined quality, safety, values, and norms) were important constructs across the strategies. The SPA identified specific community- and faith-based organizations, health care organizations, and local government agencies as key stakeholders for future efforts. Conclusions Both community fit and access are essential constructs for promoting health equity. Findings demonstrate the feasibility of and need for formative research that engages community members and local stakeholders to shape context-specific, culturally relevant health promotion strategies. PMID:26270741

A national collaboration process: Finnish engineering education for the benefit of people and environment.

PubMed

Takala, A; Korhonen-Yrjänheikki, K

2013-12-01

The key stakeholders of the Finnish engineering education collaborated during 2006-09 to reform the system of education, to face the challenges of the changing business environment and to create a national strategy for the Finnish engineering education. The work process was carried out using participatory work methods. Impacts of sustainable development (SD) on engineering education were analysed in one of the subprojects. In addition to participatory workshops, the core part of the work on SD consisted of a research with more than 60 interviews and an extensive literature survey. This paper discusses the results of the research and the work process of the Collaboration Group in the subproject of SD. It is suggested that enhancing systematic dialogue among key stakeholders using participatory work methods is crucial in increasing motivation and commitment in incorporating SD in engineering education. Development of the context of learning is essential for improving skills of engineering graduates in some of the key abilities related to SD: systemic- and life-cycle thinking, ethical understanding, collaborative learning and critical reflection skills. This requires changing of the educational paradigm from teacher-centred to learner-centred applying problem- and project-oriented active learning methods.

Improving access to medicines via the Health Impact Fund in India: a stakeholder analysis

PubMed Central

McMullan, Patrick; Ajay, Vamadevan S.; Srinivas, Ravi; Bhalla, Sandeep; Prabhakaran, Dorairaj; Banerjee, Amitava

2018-01-01

ABSTRACT Background: In India, 50–65% of the population face difficulties in accessing medicines. The Health Impact Fund (HIF) is a novel proposal whereby pharmaceutical companies would be paid based on the measured global health impact of their drugs. We conducted a key stakeholder analysis to explore access to medicines in India, acceptability of the HIF and potential barriers and facilitators at policy level. Objectives: To conduct a stakeholder analysis of the HIF in India: to determine key stakeholder views regarding access to medicines in India; to evaluate acceptability of the HIF; and to assess potential barriers and facilitators to the HIF as a policy. Methods: In New Delhi, we conducted semi-structured interviews. There was purposive recruitment of participants with snowball sampling. Transcribed data were analysed using stakeholder analysis frameworks and directed content analysis. Results: Participation rate was 29% (14/49). 14 semi-structured interviews were conducted among stakeholders in New Delhi. All participants highlighted access to medicines as a problem in India. There were mixed views about the HIF in terms of relevance and scaleability. Stakeholders felt it should focus on diseases with limited or no market and potentially incorporate direct investment in research. Conclusions: First, access to medicines is perceived to be a major problem in India by all stakeholders, but affordability is just one factor. Second, stakeholders despite considerable support for the idea of the HIF, there are major concerns about scaleability, generalisability and impact on access to medicines. Third, the HIF and other novel drug-related health policies can afford to be more radical, e.g. working outside the existing intellectual property rights regime, targeting generic as well as branded drugs, or extending to research and development. Further innovations in access to medicines must involve country-specific key stakeholders in order to increase the likelihood of their success. PMID:29495950

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.

New Superintendents: Trust, Networking, and Social Capital

ERIC Educational Resources Information Center

Ripley, Joan; Mitchell, Roxanne M.; Richman, John A.

2013-01-01

This instrumental case study explored how five newly appointed superintendents identified key stakeholders and built trust and social capital with stakeholders in their districts. Stakeholder, trust, and social capital theory were the lenses that guided this study. We utilized a pragmatic research design and thematic data analysis to interpret our…

Attracting and retaining GPs: a stakeholder survey of priorities.

PubMed

Lorant, Vincent; Geerts, Charlotte; Duchesnes, Christiane; Goedhuys, Jo; Ryssaert, Lynn; Remmen, Roy; D'hoore, William

2011-07-01

Despite being a key player in the healthcare system, training and practising general practice has become less attractive in many countries and is in need of reform. To identify political priorities for improving GPs' attraction to the profession and their retention within it. Stakeholder face-to-face survey in Belgium, 2008. A total of 102 key stakeholders were recruited from policymakers, professional groups, academia, GP leaders, and the media. All interviewees were asked to score 23 policies on four criteria: effectiveness in attracting and retaining GPs, cost to society, acceptance by other health professionals, and accessibility of care. An overall performance score was computed (from -3 to +3) for each type of policy - training, financing, work-life balance, practice organisation, and governance - and for innovative versus conservative policies. Practice organisation policies and training policies received the highest scores (mean score ≥ 1.11). Financing policies, governance, and work-life balance policies scored poorly (mean score ≤ 0.65) because they had negative effects, particularly in relation to cost, acceptance, and accessibility of care. Stakeholders were keen on moving GPs towards team work, improving their role as care coordinator, and helping them to offload administrative tasks (score ≥ 1.4). They also favoured moves to increase the early and integrated exposure of all medical students to general practice. Overall, conservative policies were better scored than innovative ones (beta = -0.16, 95% confidence interval = -0.28 to -0.03). The reforming of general practice is made difficult by the small-step approach, as well as the importance of decision criteria related to cost, acceptance, and access.

The development of Tobacco Harm Prevention Law in Vietnam: stakeholder tensions over tobacco control legislation in a state owned industry

PubMed Central

2011-01-01

Background Building on its National Tobacco Control Policy initiated in 2000, Vietnam is currently considering introducing a comprehensive law to strengthen the implementation of tobacco control policy. This study analyses the positions of key stakeholders in the development of tobacco control legislation in the context of a largely state-owned industry, and discusses their implications for the policy process. Methods Several qualitative methods were employed for the study including: literature review and documentary analysis; key informant interview; focus groups discussion; and key stakeholders survey. Findings The Ministry of Health, Ministry of Trade and Industry, and Ministry of Finance are key players in the tobacco control policy and legislation, representing competing bureaucratic interests over health, macro-economy and revenue. High-ranking officials, including the Communist Party and National Assembly members, take a rather relaxed position reflecting the low political stakes placed on tobacco issues. The state-owned tobacco industry is regarded as an important contributor to the government revenue and gross domestic product, and the relative weight on health and socioeconomic issues placed by stakeholders determine their positions on tobacco control. Overall, short-term economic interests have more immediate influence in setting policy directions, with the consequences of health gains perceived as relegated to a distant future. This was reflected in the position of tobacco control advocates, including MOH, that presented with reluctance in insisting on some tobacco control strategies revealing a mixture attitude of concessions to the socioeconomic uncertainties and a sense of bargaining to win the strategies that are more likely to be accepted. Conclusion The state-ownership of tobacco industry poses a major paradox within the government that benefits from manufacturing of tobacco products and is also responsible for controlling tobacco consumption. The perceptions of negative implications on government revenue and the macro-economy, coupled with the reluctance to challenge these issues from health perspective too directly, means that tobacco control has yet to secure itself a place on the priority policy agenda. The overall policy environment will shift in favour of tobacco control only if the economic framing can be challenged. PMID:21923945

PRISMA-Children (C) and PRISMA-Protocol for Children (P-C) Extensions: a study protocol for the development of guidelines for the conduct and reporting of systematic reviews and meta-analyses of newborn and child health research

PubMed Central

Kapadia, Mufiza Z; Askie, Lisa; Hartling, Lisa; Contopoulos-Ioannidis, Despina; Bhutta, Zulfiqar A; Soll, Roger; Moher, David; Offringa, Martin

2016-01-01

Introduction Paediatric systematic reviews differ from adult systematic reviews in several key aspects such as considerations of child tailored interventions, justifiable comparators, valid outcomes and child sensitive search strategies. Available guidelines, including PRISMA-P (2015) and PRISMA (2009), do not cover all the complexities associated with reporting systematic reviews in the paediatric population. Using a collaborative, multidisciplinary structure, we aim to develop evidence-based and consensus-based PRISMA-P-C (Protocol for Children) and PRISMA-C (Children) Extensions to guide paediatric systematic review protocol and completed review reporting. Methods and analysis This project's methodology follows published recommendations for developing reporting guidelines and involves the following six phases; (1) establishment of a steering committee representing key stakeholder groups; (2) a scoping review to identify potential Extension items; (3) three types of consensus activities including meetings of the steering committee to achieve high-level decisions on the content and methodology of the Extensions, a survey of key stakeholders to generate a list of possible items to include in the Extensions and a formal consensus meeting to select the reporting items to add to, or modify for, the Extension; (4) the preliminary checklist items generated in phase III will be evaluated against the existing evidence and reporting practices in paediatric systematic reviews; (5) extension statements and explanation and elaboration documents will provide detailed advice for each item and examples of good reporting; (6) development and implementation of effective knowledge translation of the extension checklist, and an evaluation of the Extensions by key stakeholders. Ethics and Dissemination This protocol was considered a quality improvement project by the Hospital for Sick Children's Ethics Committee and did not require ethical review. The resultant checklists, jointly developed with all relevant stakeholders, will be disseminated through peer-reviewed journals as well as national and international conference presentations. Endorsement of the checklist will be sought simultaneously in multiple journals. PMID:27091820

The development of Tobacco Harm Prevention Law in Vietnam: stakeholder tensions over tobacco control legislation in a state owned industry.

PubMed

Higashi, Hideki; Khuong, Tuan A; Ngo, Anh D; Hill, Peter S

2011-09-18

Building on its National Tobacco Control Policy initiated in 2000, Vietnam is currently considering introducing a comprehensive law to strengthen the implementation of tobacco control policy. This study analyses the positions of key stakeholders in the development of tobacco control legislation in the context of a largely state-owned industry, and discusses their implications for the policy process. Several qualitative methods were employed for the study including: literature review and documentary analysis; key informant interview; focus groups discussion; and key stakeholders survey. The Ministry of Health, Ministry of Trade and Industry, and Ministry of Finance are key players in the tobacco control policy and legislation, representing competing bureaucratic interests over health, macro-economy and revenue. High-ranking officials, including the Communist Party and National Assembly members, take a rather relaxed position reflecting the low political stakes placed on tobacco issues. The state-owned tobacco industry is regarded as an important contributor to the government revenue and gross domestic product, and the relative weight on health and socioeconomic issues placed by stakeholders determine their positions on tobacco control. Overall, short-term economic interests have more immediate influence in setting policy directions, with the consequences of health gains perceived as relegated to a distant future. This was reflected in the position of tobacco control advocates, including MOH, that presented with reluctance in insisting on some tobacco control strategies revealing a mixture attitude of concessions to the socioeconomic uncertainties and a sense of bargaining to win the strategies that are more likely to be accepted. The state-ownership of tobacco industry poses a major paradox within the government that benefits from manufacturing of tobacco products and is also responsible for controlling tobacco consumption. The perceptions of negative implications on government revenue and the macro-economy, coupled with the reluctance to challenge these issues from health perspective too directly, means that tobacco control has yet to secure itself a place on the priority policy agenda. The overall policy environment will shift in favour of tobacco control only if the economic framing can be challenged.

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.

Appetite for health-related food taxes: New Zealand stakeholder views.

PubMed

Signal, Louise N; Watts, Carolyn; Murphy, Celia; Eyles, Helen; Ni Mhurchu, Cliona

2017-05-05

There is increasing discussion globally of the value of health-related food taxes and subsidies to address obesity and noncommunicable diseases. In order for such policies to be successful it is important to understand the positions of key stakeholders. This research investigated New Zealand (NZ) stakeholders' views on the feasibility and acceptability of selected health-related food taxes and subsidies over the next 5 to 10 years. Twenty semi-structured interviews were undertaken by telephone from November 2014 to May 2015. The purposive sample of key stakeholders included politicians, bureaucrats, public health experts, food industry leaders and consumer representatives. Prior to interviews participants were sent summary information on the estimated impacts of a range of health-related food taxes and subsidies on dietary intake and mortality. According to key stakeholders there appears to be little appetite for taxes on foods high in saturated fat or salt in NZ. Stakeholders largely agreed that a tax on sugar-sweetened beverages (SSBs) and a subsidy on fruit and vegetables were both feasible and likely acceptable. There was strong support for starting with a SSBs tax, possibly framed around protecting children and dental health. Addressing obesity and noncommunicable diseases is a multidimensional challenge. A tax on SSBs and a subsidy on fruit and vegetables, possibly in tandem, could be part of the solution in NZ. There is growing interest in, and evidence for, health-related taxes and subsidies internationally. Given the critical role of stakeholder support for such policies similar research on stakeholders' views may assist the implementation of health-related food taxes and subsidies in other jurisdictions. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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.

Supporting Police Community Support Officers to Become Effective School Link Officers: Key Stakeholder Perceptions of a Pilot Professional Development Programme

ERIC Educational Resources Information Center

Thomas, Lorraine; Trotman, Dave

2017-01-01

This article presents the findings of a pilot professional development programme designed to support police community support officers (PCSOs) to become effective school link officers (SLOs) within urban secondary schools in the English West Midlands. Findings are presented via perceptions of key stakeholders: SLOs themselves; school-based mentors…

A Stakeholder Analysis of One Institution's Assuring Learning Experience--Is the Promise and the Practice Worth the Price?

ERIC Educational Resources Information Center

French, Erica; Casali, Gian Luca

2014-01-01

Universities around the world are rushing to implement assurance of learning policies and practices with varying degrees of success. One School investigated its own policy and practice development through the eyes of its key stakeholders to identify whether the practice was worth the price. Findings indicate that although the key stakeholders…

Gauging state-level and user group views of oyster reef restoration activities in the northern Gulf of Mexico

USGS Publications Warehouse

LaPeyre, Megan K.; Nix, Ashby; Laborde, Luke; Piazza, Bryan P.

2012-01-01

Successful oyster reef restoration, like many conservation challenges, requires not only biological understanding of the resource, but also stakeholder cooperation and political support. To measure perceptions of oyster reef restoration activities and priorities for future restoration along the northern Gulf of Mexico coast, a survey of 1500 individuals representing 4 user groups (oyster harvesters, shrimpers, environmental organization members, professionals), across 5 states (Texas, Louisiana, Mississippi, Alabama, Florida) was conducted in 2011. All respondents highly supported reef restoration efforts, but there was a dichotomy in preferred restoration goals with commercial fishermen more likely to support oyster reef restoration for stock enhancement, while professionals and environmental organization members were more likely to support oyster reef restoration to enhance ecosystem services. All user groups identified enforcement, funding, and appropriate site selection as basic requirements for successful reef restoration. For management of restored oyster reefs, oyster harvesters and shrimpers were less likely to support options that restricted the use of reefs, including gear restrictions and permanent closures, but did support rotating annual reef closures, while other stakeholders were willing to consider all options, including annual reef closures and sanctuary reefs. Overall, there were clear differences in management and communication preferences across user groups, but few differences across states. Understanding these key differences in stakeholder support for, and willingness to accept specific management actions is critical in moving management and restoration forward while minimizing conflict.

Stakeholder views on criteria and processes for priority setting in Norway: a qualitative study.

PubMed

Aidem, Jeremy M

2017-06-01

Since 2013, Norway has engaged in political processes to revise criteria for priority setting. These processes have yielded key efficiency and equity criteria, but excluded potentially relevant social values. This study describes the views of 27 stakeholders in Norway's health system regarding a wider set of priority-setting criteria and procedural characteristics. Between January and February 2016, semi-structured interviews and focus groups were conducted with a purposive sample of policymakers, hospital administrators, practitioners, university students and seniors. Improving health among low-socioeconomic-status groups was considered an important policy objective: some favored giving more priority to diseases affecting socioeconomically disadvantaged groups, and some believed inequalities in health could be more effectively addressed outside the health sector. Age was not widely accepted as an independent criterion, but deemed relevant as an indicator of capacity to benefit, cost-effectiveness and health loss. Cost-effectiveness, severity and health-loss measures were judged relevant to policymaking, but cost-effectiveness and health loss were considered less influential to clinical decision-making. Public engagement was seen as essential yet complicated by media and stakeholder pressures. This study highlights how views on the relevance and implementation of criteria can vary significantly according to the health system level being evaluated. Further, the findings suggest that giving priority to socioeconomically disadvantaged groups and reducing inequalities in health may be relevant preferences not captured in recent policy proposals. Copyright © 2017 Elsevier B.V. All rights reserved.

Engaging Key Stakeholders to Assess and Improve the Professional Preparation of MPH Health Educators

PubMed Central

Steckler, Allan; Maman, Suzanne; Ellenson, Meg; French, Elizabeth; Blanchard, Lynn; Bowling, Mike; Yamanis, Nina; Succop, Stacey; Davenport, Amy; Moracco, Beth

2010-01-01

Objectives. We described the process of engaging key stakeholders in a systematic review of requirements for a master of public health (MPH) degree within the Department of Health Behavior and Health Education, University of North Carolina Gillings School of Global Public Health, and summarized resulting changes. Methods. A benchmarking study of 11 peer institutions was completed. Key stakeholders (i.e., current students, alumni, faculty, staff, employers, and practicum preceptors) received online or print surveys. A faculty retreat was convened to process results and reach consensus on program revisions. Results. MPH program changes included (1) improved advising and mentoring program, (2) elimination of research and practice track options, (3) increased elective and decreased required credit hours, (4) replacement of master's paper requirement with “deliverables” (written products such as reports, documents, and forms) produced as part of the required “Capstone” course, (5) extended community field experience to 2 semesters and moved it to year 2 of the program, and (6) allowed practica of either 200, 300, or 400 hours. Conclusions. Engaging key stakeholders in the program review process yielded important changes to the MPH degree program requirements. Others may consider this approach when undertaking curriculum reviews. PMID:20395575

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.

Measuring value for low-acuity care across settings.

PubMed

Morgan, Sofie Rahman; Smith, Meaghan A; Pitts, Stephen R; Shesser, Robert; Uscher-Pines, Lori; Ward, Michael J; Pines, Jesse M

2012-09-01

Increasing healthcare costs have created an emphasis on improving value, defined as how invested time, money, and resources improve health. The role of emergency departments (EDs) within value-driven health systems is still undetermined. Often questioned is the value of an ED visit for conditions that could be reasonably treated elsewhere such as office-based, urgent, and retail clinics. This paper presents a conceptual approach to assess the value of these low-acuity visits. It adapts an existing analytic model to highlight specific factors that impact key stakeholders' (patients, insurers, and society) assessments of the value of ED-based care compared with care in alternative settings. These factors are presented in 3 equations, 1 for each stakeholder, emphasizing how tangible and intangible benefits of care weigh against direct and indirect costs and how each perspective influences value. Aligning value among groups could allow stakeholders to influence each other and could guide rational change in the delivery of acute medical care for low-acuity conditions.

Conflict resolution efforts through stakeholder mapping in Labanan Research Forest, Berau, East Kalimantan, Indonesia

NASA Astrophysics Data System (ADS)

Wiati, C. B.; Indriyanti, S. Y.; Maharani, R.; Subarudi

2018-04-01

Conflict resolution in Labanan Research Forest (LRF) by the Dipterocarps Forest Ecosystem Research and Development Center (Balai Besar Penelitian dan Pengembangan Ekosistem Hutan Dipterokarpa – B2P2EHD) needs support from other parties that are also interested in such forest management. This paper aimed to presented conflict resolution in LRF through stakeholder mapping for its engagement. This research was conducted for seven months (June to December 2015) with interviews and literature study as its data collection. Collected data were analysed by a stakeholder analysis and matrix based on their interest and power levels. Two important findings were: (1) There are 19 parties having interests in the existence of LRF should be engaged; (2) Conflict resolution of LRF can be achieved: (a) ensuring key stakeholders which have high interest and high power level has same perception in existence and management of LRF, (b) establishing a partnership with primary stakeholders which have high interest and high power levels; (c) building partnerships between primary stakeholders which have high interest but low power levels, (d) building partnerships between key and secondary stakeholders which have low interest but high power levels and (e) gaining support from primary and secondary stakeholders which have low interest and low power levels. Stakeholder mapping is an important tool for tenure conflict resolution through mapping the power and interest of the conflicted parties and finding the proper parties to be approached.

Development of a core outcome set for studies involving patients undergoing major lower limb amputation for peripheral arterial disease: study protocol for a systematic review and identification of a core outcome set using a Delphi survey.

PubMed

Ambler, Graeme K; Bosanquet, David C; Brookes-Howell, Lucy; Thomas-Jones, Emma; Waldron, Cherry-Ann; Edwards, Adrian G K; Twine, Christopher P

2017-12-28

The development of a standardised reporting set is important to ensure that research is directed towards the most important outcomes and that data is comparable. To ensure validity, the set must be agreed by a consensus of stakeholders including patients, healthcare professionals and lay representatives. There is currently no agreed core outcome set for patients undergoing major lower limb amputation for peripheral arterial disease (PAD) for either short- or medium-term research outcomes. By developing these sets we aim to rationalise future trial outcomes, facilitate meta-analysis and improve the quality and applicability of amputation research. We will undertake a comprehensive systematic review of studies of patients undergoing major lower limb amputation for PAD. Data regarding all primary and secondary outcomes reported in relevant studies will be extracted and summarised as outcome domains. We will then undertake focus groups with key stakeholders (patients, carers, health and social care workers) to collect qualitative data to identify the main short- and medium-term research outcomes for patients undergoing major lower limb amputation. Results of the systematic review and focus groups will be combined to create a comprehensive list of potential key outcomes. Stakeholders (patients, researchers and health and social care workers) will then be polled to determine which of the outcomes are considered to be important in a general context using a three-phase Delphi process. After preliminary analysis, results will be presented at a face-to-face meeting of key stakeholders for discussion and voting on the final set of core outcomes. This project is being run in parallel with a feasibility trial assessing perineural catheters in patients undergoing lower limb amputation (the PLACEMENT trial). Full ethical approval has been granted for the study (Wales REC 3 reference number 16/WA/0353). Core outcome sets will be developed for short- and medium-term outcomes of research involving patients undergoing major lower limb amputation for PAD. This will help with the design of future trials and facilitate meta-analyses of trial data. PROSPERO: CRD42017059329 . Registered on 30 March 2017. 975 . Registered on 5 April 2017.

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

Dental Public Health In Action: Putting Oral Health on the Local Public Health Agenda.

PubMed

Walker, I F; Eapen-Simon, S; Gibson, S

2018-04-18

Oral health is a key public health issue across England. In Wakefield in the north of England, local data suggested the oral health of local children was significantly worse than the national average. This paper describes the work undertaken by Wakefield Council to strategically address this issue. A structured process was adopted. Key lessons include; having senior ownership from the Director of Public Health, partnership working across all key stakeholders, utilising dental public health expertise from Public Health England and the use of extensive engagement with stakeholders. Through this work, oral health is now identified with greater importance in Wakefield as a public health issue. Actions are now strategically co-ordinated across stakeholders to improve oral health in local children. Copyright© 2018 Dennis Barber Ltd.

Not the last word: dissemination strategies for patient-centred research in nursing.

PubMed

Hagan, Teresa L; Schmidt, Karen; Ackison, Guyanna R; Murphy, Megan; Jones, Jennifer R

2017-08-01

Research results hold value for many stakeholders including researchers, patient populations, advocacy organizations, and community groups. The aim of this study is to describe our research team's systematic process to designing a dissemination strategy for a completed research study. We organized a dissemination event to feed the results of our study to participants and stakeholders and collect feedback regarding our study. We applied the Agency for Healthcare Research and Quality's dissemination framework to guide the development of the event and collected participant feedback during the event. We describe our dissemination strategy along with attendees' feedback and suggestions for our research as an example of a way to design a patient- and community-focused dissemination. We explain the details of our dissemination strategy including (a) our process of reporting a large research study into a stakeholder event, (b) stakeholder feedback collected at the event, and (c) the translation of feedback into our research team's research. We also describe challenges encountered during the dissemination process and ways to handle issues such as logistics, funding, and staff. This analysis provides key insights and practical advice for researchers looking for innovative ways to disseminate their findings within the lay and scientific communities.

Business, Management and Administration: A Subject-Based Aspect Report by Education Scotland on Behalf of the Scottish Funding Council on Provision in Scotland's Colleges. Transforming Lives through Learning

ERIC Educational Resources Information Center

Education Scotland, 2014

2014-01-01

In preparing this report, reviewers visited a sample of four colleges, detailed in Appendix 1. They also drew on the findings of published Education Scotland external reviews of colleges, and examined other relevant publications and reports. They consulted and held focus groups with key stakeholders, including the Scottish Qualifications Authority…

Campus Solidarity Campaign: Developing a Program to Promote an Environment of Solidarity and Support on College Campuses for Students with Mental Illness

ERIC Educational Resources Information Center

Kosyluk, Kristin A.; Corrigan, Patrick W.; Jones, Nev; James, Drexler; Abelson, Sara; Malmon, Alison

2016-01-01

Purpose: The aim of this work was to develop a campaign to promote an environment of solidarity and support on college campuses for students with mental illnesses. Method: Data were gathered from 24 members of a Chicago university campus who were selected as representatives of key campus stakeholder groups including students, administrative staff,…

Transforming a municipal school sports programme through a critical communicative methodology: The role of the of advisory committee.

PubMed

Jiménez-Herranz, Borja; Manrique-Arribas, Juan C; López-Pastor, Víctor M; García-Bengoechea, Enrique

2016-10-01

This research applies a communicative methodology (CM) to the transformation and improvement of the Municipal Comprehensive School Sports Programme in Segovia, Spain (MCSSP), using egalitarian dialogue, based on validity rather than power claims to achieve intersubjectivity and arrive at consensus between all of the Programme's stakeholders through the intervention of an advisory committee (AC). The AC is a body comprising representatives of all stakeholder groups involved in the programme. During the 2013-2014 academic year the programme's AC met four times, operating as a communicative focus group (CFG). The meetings focused on: (1) excluding dimensions (barriers preventing transformation) and transforming dimensions (ways of overcoming barriers), (2) the programme's strengths, (3) the programme's weaknesses and specific actions to remedy them, and (4) the resulting conclusions which were then incorporated into the subsequent programme contract signed between the University and the Segovia Local Authority for 2014-2018. The key conclusions were: (1) the recommendations of the AC widen the range of perspectives and help the research team to make key decisions and (2) the use of CM to fully evaluate the programme and to reach a consensus on how to improve it proved very valuable. Copyright © 2016 Elsevier Ltd. All rights reserved.

Stakeholder analysis for a maternal and newborn health project in Eastern Uganda.

PubMed

Namazzi, Gertrude; N, Kiwanuka Suzanne; Peter, Waiswa; John, Bua; Olico, Okui; A, Allen Katharine; A, Hyder Adnan; Elizabeth, Ekirapa Kiracho

2013-03-04

Based on the realization that Uganda is not on track to achieving Millennium Development Goals 4 and 5, Makerere University School of Public Health in collaboration with other partners proposed to conduct two community based maternal/newborn care interventions aimed at increasing access to health facility care through transport vouchers and use of community health workers to promote ideal family care practices. Prior to the implementation, a stakeholder analysis was undertaken to assess and map stakeholders' interests, influence/power and position in relation to the interventions; their views regarding the success and sustainability; and how this research can influence policy formulation in the country. A stakeholder analysis was carried out in March 2011 at national level and in four districts of Eastern Uganda where the proposed interventions would be conducted. At the national level, four key informant interviews were conducted with the ministry of health representative, Member of Parliament, and development partners. District health team members were interviewed and also engaged in a workshop; and at community level, twelve focus group discussions were conducted among women, men and motorcycle transporters. This analysis revealed that district and community level stakeholders were high level supporters of the proposed interventions but not drivers. At community level the mothers, their spouses and transporters were of low influence due to the limited funds they possessed. National level and district stakeholders believed that the intervention is costly and cannot be affordably scaled up. They advised the study team to mobilize and sensitize the communities to contribute financially from the start in order to enhance sustainability beyond the study period. Stakeholders believed that the proposed interventions will influence policy through modeling on how to improve the quality of maternal/newborn health services, male involvement, and improved accessibility of services. Most of the stakeholders interviewed were supporters of the proposed maternal and newborn care intervention because of the positive benefits of the intervention. The analysis highlighted stakeholder concerns that will be included in the final project design and that could also be useful in countries of similar setting that are planning to set up programmes geared at increasing access to maternal and new born interventions. Key among these concerns was the need to use both human and financial resources that are locally available in the community, to address supply side barriers that influence access to maternal and child healthcare. Research to policy translation, therefore, will require mutual trust, continued dialogue and engagement of the researchers, implementers and policy makers to enable scale up.

Collaboration, negotiation, and coalescence for interagency-collaborative teams to scale-up evidence-based practice.

PubMed

Aarons, Gregory A; Fettes, Danielle L; Hurlburt, Michael S; Palinkas, Lawrence A; Gunderson, Lara; Willging, Cathleen E; Chaffin, Mark J

2014-01-01

Implementation and scale-up of evidence-based practices (EBPs) is often portrayed as involving multiple stakeholders collaborating harmoniously in the service of a shared vision. In practice, however, collaboration is a more complex process that may involve shared and competing interests and agendas, and negotiation. The present study examined the scale-up of an EBP across an entire service system using the Interagency Collaborative Team approach. Participants were key stakeholders in a large-scale county-wide implementation of an EBP to reduce child neglect, SafeCare. Semistructured interviews and/or focus groups were conducted with 54 individuals representing diverse constituents in the service system, followed by an iterative approach to coding and analysis of transcripts. The study was conceptualized using the Exploration, Preparation, Implementation, and Sustainment framework. Although community stakeholders eventually coalesced around implementation of SafeCare, several challenges affected the implementation process. These challenges included differing organizational cultures, strategies, and approaches to collaboration; competing priorities across levels of leadership; power struggles; and role ambiguity. Each of the factors identified influenced how stakeholders approached the EBP implementation process. System-wide scale-up of EBPs involves multiple stakeholders operating in a nexus of differing agendas, priorities, leadership styles, and negotiation strategies. The term collaboration may oversimplify the multifaceted nature of the scale-up process. Implementation efforts should openly acknowledge and consider this nexus when individual stakeholders and organizations enter into EBP implementation through collaborative processes.

Collaboration, Negotiation, and Coalescence for Interagency-Collaborative Teams to Scale-up Evidence-Based Practice

PubMed Central

Aarons, Gregory A.; Fettes, Danielle; Hurlburt, Michael; Palinkas, Lawrence; Gunderson, Lara; Willging, Cathleen; Chaffin, Mark

2014-01-01

Objective Implementation and scale-up of evidence-based practices (EBPs) is often portrayed as involving multiple stakeholders collaborating harmoniously in the service of a shared vision. In practice, however, collaboration is a more complex process that may involve shared and competing interests and agendas, and negotiation. The present study examined the scale-up of an EBP across an entire service system using the Interagency Collaborative Team (ICT) approach. Methods Participants were key stakeholders in a large-scale county-wide implementation of an EBP to reduce child neglect, SafeCare®. Semi-structured interviews and/or focus groups were conducted with 54 individuals representing diverse constituents in the service system, followed by an iterative approach to coding and analysis of transcripts. The study was conceptualized using the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework. Results Although community stakeholders eventually coalesced around implementation of SafeCare, several challenges affected the implementation process. These challenges included differing organizational cultures, strategies, and approaches to collaboration, competing priorities across levels of leadership, power struggles, and role ambiguity. Each of the factors identified influenced how stakeholders approached the EBP implementation process. Conclusions System wide scale-up of EBPs involves multiple stakeholders operating in a nexus of differing agendas, priorities, leadership styles, and negotiation strategies. The term collaboration may oversimplify the multifaceted nature of the scale-up process. Implementation efforts should openly acknowledge and consider this nexus when individual stakeholders and organizations enter into EBP implementation through collaborative processes. PMID:24611580

Gaps and gains from engaging districts stakeholders for community-based health professions education in Uganda: a qualitative study.

PubMed

Okello, Elialilia S; Nankumbi, Joyce; Ruzaaza, Gad Ndaruhutse; Bakengesa, Evelyn; Gumikiriza, Joy; Arubaku, Wilfred; Acio, Christine; Samantha, Mary; Matte, Michael

2015-12-01

Community-based education research and service (COBERS) is a brand of community-based education that has been adopted by the Medical Education and Service for All Ugandans consortium. The COBERS programme is aimed at equipping students in health professional education with the knowledge, attitudes and skills required to provide appropriate health care services. For sustainability purposes, the health professional training institutions have made efforts to involve various stakeholders in the implementation of the programme. However, the actual engagement process and outcome of such efforts have not been documented. This paper documents gaps and gains made in engaging district stakeholders for community-based education. Key informant interviews, focus group discussions and document review were used to collect data. Atlas.ti, computer software for qualitative data was used to aid analysis. The analysis revealed that the adopted engagement model has registered some gains including increased awareness among district leaders about potential opportunities offered by COBERS such as boosting of human resources at health facilities, opportunities for professional development for health care workers at health facilities, and establishment of linkages between prospective employees and employers. However, the engagement model left some gaps in terms of knowledge, awareness and ownership of the programme among some sections of stakeholders. The apparent information gap about the programme among district stakeholders, especially the political leadership, may hinder concerted partnership. The findings highlight the need for health professional education institutions to broaden the scope of actively engaged stakeholders with the district level.

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…

The Future of Australian Apprenticeships: Report of the Stakeholder Forum. Summary Report

ERIC Educational Resources Information Center

Couldrey, Margo; Loveder, Phil

2017-01-01

"The future of Australian Apprenticeships" stakeholder forum was hosted by the National Centre for Vocational Education Research (NCVER) in conjunction with the Australian Government Department of Education and Training in Canberra on 25 October, 2016. The forum was attended by over 60 key stakeholders from across the vocational…

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…

An evaluation framework for participatory modelling

NASA Astrophysics Data System (ADS)

Krueger, T.; Inman, A.; Chilvers, J.

2012-04-01

Strong arguments for participatory modelling in hydrology can be made on substantive, instrumental and normative grounds. These arguments have led to increasingly diverse groups of stakeholders (here anyone affecting or affected by an issue) getting involved in hydrological research and the management of water resources. In fact, participation has become a requirement of many research grants, programs, plans and policies. However, evidence of beneficial outcomes of participation as suggested by the arguments is difficult to generate and therefore rare. This is because outcomes are diverse, distributed, often tacit, and take time to emerge. In this paper we develop an evaluation framework for participatory modelling focussed on learning outcomes. Learning encompasses many of the potential benefits of participation, such as better models through diversity of knowledge and scrutiny, stakeholder empowerment, greater trust in models and ownership of subsequent decisions, individual moral development, reflexivity, relationships, social capital, institutional change, resilience and sustainability. Based on the theories of experiential, transformative and social learning, complemented by practitioner experience our framework examines if, when and how learning has occurred. Special emphasis is placed on the role of models as learning catalysts. We map the distribution of learning between stakeholders, scientists (as a subgroup of stakeholders) and models. And we analyse what type of learning has occurred: instrumental learning (broadly cognitive enhancement) and/or communicative learning (change in interpreting meanings, intentions and values associated with actions and activities; group dynamics). We demonstrate how our framework can be translated into a questionnaire-based survey conducted with stakeholders and scientists at key stages of the participatory process, and show preliminary insights from applying the framework within a rural pollution management situation in the UK.

Stakeholder engagement in diabetes self-management: patient preference for peer support and other insights.

PubMed

Kwan, Bethany M; Jortberg, Bonnie; Warman, Meredith K; Kane, Ilima; Wearner, Robyn; Koren, Romona; Carrigan, Thomas; Martinez, Vincent; Nease, Donald E

2017-06-01

Self-management support (SMS) for patients with diabetes can improve adherence to treatment, mitigate disease-related distress, and improve health outcomes. Translating this evidence into real-world practice is needed, as it is not clear which SMS models are acceptable to patients, and feasible and sustainable for primary care practices. To use the Boot Camp Translation (BCT) method to engage patient, practice, community resource and research stakeholders in translation of evidence about SMS and diabetes distress into mutually acceptable care models and to inform patient-centred outcomes research (PCOR). Twenty-seven diabetes care stakeholders, including patients and providers from a local network of federally qualified health centres participated. Stakeholders met in-person and by conference call over the course of 8 months. Subject matter experts provided education on the diabetes SMS evidence. Facilitators engaged the group in discussions about barriers to self-management and opportunities for improving delivery of SMS. BCT participants identified lack of social support, personal resources, trust, knowledge and confidence as barriers to diabetes self-management. Intervention opportunities emphasized peer support, use of multidisciplinary care teams and centralized systems for sharing information about community and practice resources. BCT informed new services and a PCOR study proposal. Patients and family engaged in diabetes care research value peer support, group visits, and multidisciplinary care teams as key features of SMS models. SMS should be tailored to an individual patient's health literacy. BCT can be used to engage multiple stakeholders in translation of evidence into practice and to inform PCOR. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Mind the Gap. A systematic review to identify usability and safety challenges and practices during electronic health record implementation.

PubMed

Ratwani, Raj; Fairbanks, Terry; Savage, Erica; Adams, Katie; Wittie, Michael; Boone, Edna; Hayden, Andrew; Barnes, Janey; Hettinger, Zach; Gettinger, Andrew

2016-11-16

Decisions made during electronic health record (EHR) implementations profoundly affect usability and safety. This study aims to identify gaps between the current literature and key stakeholders' perceptions of usability and safety practices and the challenges encountered during the implementation of EHRs. Two approaches were used: a literature review and interviews with key stakeholders. We performed a systematic review of the literature to identify usability and safety challenges and best practices during implementation. A total of 55 articles were reviewed through searches of PubMed, Web of Science and Scopus. We used a qualitative approach to identify key stakeholders' perceptions; semi-structured interviews were conducted with a diverse set of health IT stakeholders to understand their current practices and challenges related to usability during implementation. We used a grounded theory approach: data were coded, sorted, and emerging themes were identified. Conclusions from both sources of data were compared to identify areas of misalignment. We identified six emerging themes from the literature and stakeholder interviews: cost and resources, risk assessment, governance and consensus building, customization, clinical workflow and usability testing, and training. Across these themes, there were misalignments between the literature and stakeholder perspectives, indicating major gaps. Major gaps identified from each of six emerging themes are discussed as critical areas for future research, opportunities for new stakeholder initiatives, and opportunities to better disseminate resources to improve the implementation of EHRs. Our analysis identified practices and challenges across six different emerging themes, illustrated important gaps, and results suggest critical areas for future research and dissemination to improve EHR implementation.

Using the International Classification of Functioning, Disability, and Health to identify outcome domains for a core outcome set for aphasia: a comparison of stakeholder perspectives.

PubMed

Wallace, Sarah J; Worrall, Linda; Rose, Tanya; Le Dorze, Guylaine

2017-11-12

This study synthesised the findings of three separate consensus processes exploring the perspectives of key stakeholder groups about important aphasia treatment outcomes. This process was conducted to generate recommendations for outcome domains to be included in a core outcome set for aphasia treatment trials. International Classification of Functioning, Disability, and Health codes were examined to identify where the groups of: (1) people with aphasia, (2) family members, (3) aphasia researchers, and (4) aphasia clinicians/managers, demonstrated congruence in their perspectives regarding important treatment outcomes. Codes were contextualized using qualitative data. Congruence across three or more stakeholder groups was evident for ICF chapters: Mental functions; Communication; and Services, systems, and policies. Quality of life was explicitly identified by clinicians/managers and researchers, while people with aphasia and their families identified outcomes known to be determinants of quality of life. Core aphasia outcomes include: language, emotional wellbeing, communication, patient-reported satisfaction with treatment and impact of treatment, and quality of life. International Classification of Functioning, Disability, and Health coding can be used to compare stakeholder perspectives and identify domains for core outcome sets. Pairing coding with qualitative data may ensure important nuances of meaning are retained. Implications for rehabilitation The outcomes measured in treatment research should be relevant to stakeholders and support health care decision making. Core outcome sets (agreed, minimum set of outcomes, and outcome measures) are increasingly being used to ensure the relevancy and consistency of the outcomes measured in treatment studies. Important aphasia treatment outcomes span all components of the International Classification of Functioning, Disability, and Health. Stakeholders demonstrated congruence in the identification of important outcomes which related Mental functions; Communication; Services, systems, and policies; and Quality of life. A core outcome set for aphasia treatment research should include measures relating to: language, emotional wellbeing, communication, patient-reported satisfaction with treatment and impact of treatment, and quality of life. Coding using the International Classification of Functioning, Disability, and Health, presents a novel methodology for the comparison of stakeholder perspectives to inform recommendations for outcome constructs to be included in a core outcome set. Coding can be paired with qualitative data to ensure nuances of meaning are retained.

Providing long-acting reversible contraception services in Seattle school-based health centers: key themes for facilitating implementation.

PubMed

Gilmore, Kelly; Hoopes, Andrea J; Cady, Janet; Amies Oelschlager, Anne-Marie; Prager, Sarah; Vander Stoep, Ann

2015-06-01

The purpose of this study was to describe the implementation of a program that provides long-acting reversible contraception (LARC) services within school-based health centers (SBHCs) and to identify barriers and facilitators to implementation as reported by SBHC clinicians and administrators, public health officials, and community partners. We conducted 14 semistructured interviews with key informants involved in the implementation of LARC services. Key informants included SBHC clinicians and administrators, public health officials, and community partners. We used a content analysis approach to analyze interview transcripts for themes. We explored barriers to and facilitators of LARC service delivery across and within key informant groups. The most cited barriers across key informant groups were as follows: perceived lack of provider procedural skills and bias and negative attitudes about LARC methods. The most common facilitators identified across groups were as follows: clear communication strategies, contraceptive counseling practice changes, provider trainings, and stakeholder engagement. Two additional barriers emerged in specific key informant groups. Technical and logistical barriers to LARC service delivery were cited heavily by SBHC administrative staff, community partners, and public health officials. Expense and billing was a major barrier to SBHC administrative staff. LARC counseling and procedural services can be implemented in an SBHC setting to promote access to effective contraceptive options for adolescent women. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Key principles for a national clinical decision support knowledge sharing framework: synthesis of insights from leading subject matter experts.

PubMed

Kawamoto, Kensaku; Hongsermeier, Tonya; Wright, Adam; Lewis, Janet; Bell, Douglas S; Middleton, Blackford

2013-01-01

To identify key principles for establishing a national clinical decision support (CDS) knowledge sharing framework. As part of an initiative by the US Office of the National Coordinator for Health IT (ONC) to establish a framework for national CDS knowledge sharing, key stakeholders were identified. Stakeholders' viewpoints were obtained through surveys and in-depth interviews, and findings and relevant insights were summarized. Based on these insights, key principles were formulated for establishing a national CDS knowledge sharing framework. Nineteen key stakeholders were recruited, including six executives from electronic health record system vendors, seven executives from knowledge content producers, three executives from healthcare provider organizations, and three additional experts in clinical informatics. Based on these stakeholders' insights, five key principles were identified for effectively sharing CDS knowledge nationally. These principles are (1) prioritize and support the creation and maintenance of a national CDS knowledge sharing framework; (2) facilitate the development of high-value content and tooling, preferably in an open-source manner; (3) accelerate the development or licensing of required, pragmatic standards; (4) acknowledge and address medicolegal liability concerns; and (5) establish a self-sustaining business model. Based on the principles identified, a roadmap for national CDS knowledge sharing was developed through the ONC's Advancing CDS initiative. The study findings may serve as a useful guide for ongoing activities by the ONC and others to establish a national framework for sharing CDS knowledge and improving clinical care.

Digital health now and in the future: Findings from a participatory design stakeholder workshop

PubMed Central

2017-01-01

Objectives While digital health technologies hold potential for improving healthcare and the generation and dissemination of health information, there are many issues to be resolved in facilitating their provision and efficacy and ensuring ethical management of personal health data. In the face of high-stakes digital health initiatives, debates and controversies, eliciting the views and experiences of the diverse constituents in the digital health ecosystem is important. Methods A digital health stakeholder workshop was held in Canberra, Australia, to address two key questions: 1) What is currently working and not working in digital health? and 2) Where should digital health go in the future? As part of a living lab approach, the 25 workshop participants from research, industry, patient and other healthcare consumer groups and government, engaged in participatory design activities directed at stimulating ideas and discussion. The design artefacts and videos generated during the workshop were thematically analysed. Results Digital health technologies offer valuable ways for healthcare consumers, providers, community groups and health industries to create and share information about health, medicine and healthcare. However, members of some social groups are currently excluded from full participation in the digital health ecosystem. Mechanisms for facilitating further consultation between the various stakeholders involved in digital health, including patients and carers, need to be established. The rights and responsibilities of the different stakeholders involved in connected digital health also need to be better identified and highlighted. At the same time, personal data privacy and security need protection. Conclusion Establishing the effective and responsible delivery of digital health technologies and collection, protection and sharing of health data is highly complex. Infrastructure, ethical and social issues need to be considered. PMID:29942616

Building partnerships: a pilot study of stakeholders' attitudes on technology disruption in behavioral health delivery and research.

PubMed

Sucala, Madalina; Nilsen, Wendy; Muench, Frederick

2017-12-01

Collaborations between scientists, care providers, and technology industry professionals are becoming more relevant for developing, testing, and implementing behavioral health technologies. As the need for such partnerships increases, it is important to understand stakeholders' attitudes about their role in partnering for developing such technologies and how much do they expect technology to impact behavioral research and care. The aim of this study was to investigate how much technology disruption do stakeholders expect in healthcare, as well as their perceived contribution in partnering for developing behavioral health technologies. Stakeholders (N = 74) responded to an online convenience sampling survey. Over 89% of participants reported expecting that technology will bring at least a moderate amount of disruption in the current models of behavioral healthcare, with respondents with the most experience in digital health expecting the most disruption. As for their perception of each other's role in partnering for developing behavioral health technologies, one group's weakness was considered to be complemented by another group's strength. Academics were perceived as having more theoretical and research expertise but being less technology-savvy, while industry professionals were considered to excel at technological and marketing activities. Providers were considered to have the most clinical and real-world healthcare industry expertise. Our results indicate that technology is expected to disrupt current healthcare models, while also highlighting the need for collaboration, as no single group was considered to have sufficient expertise and resources to develop successful, effective behavioral health technologies on its own. These results may contribute to a better understanding of how technology disruption is affecting behavioral healthcare from the standpoint of its key players, which may lead to better collaborative models of research and care delivery.

Improving integration and coordination of funding, technical assistance, and reporting/data collection: recommendations from CDC and USAPI stakeholders.

PubMed

Ka'opua, Lana Sue I; White, Susan F; Rochester, Phyllis F; Holden, Debra J

2010-09-01

Current US Federal funding mechanisms may foster program silos that disable sharing of resources and information across programs within a larger system of public health services. Such silos present challenges to USAPI communities where human resources, health infrastructure, and health financing are limited. Integrative and coordinated approaches have been recommended. The CDC Pacific Islands Integration and Coordination project was initiated by the Division of Cancer Prevention and Control (DCPC). Its project aim was to identify ways for the CDC to collaborate with the USAPI in improving CDC activities and processes related to chronic disease. This article focuses on recommendations for improving coordination and integration in three core areas of health services programming: funding, program reporting/data collection and analysis, and technical assistance. Preliminary information on challenges and issues relevant to the core areas was gathered through site visits, focus groups, key informant interviews, and other sources. This information was used by stakeholder groups from the CDC and the USAPI to develop recommendations in the core programming areas. Recommendations generated at the CDC and USAPI stakeholder meetings were prepared into a single set of recommendations and stakeholders reviewed the document for accuracy prior to its dissemination to CDC's National Center for Chronic Disease Prevention and Health Promotion programs management and staff. Key recommendations, include: (1) consideration of resource s and other challenges unique to the USAPI when reviewing funding applications, (2) consideration of ways to increase flexibility in USAPI use of program funds, (3) dedicate funding and human resources for technical assistance, (4) provide opportunities for capacity-building across programs and jurisdictions, (5) consider ways to more directly link program reporting with technical assistance. This project provided a unique opportunity for CDC and USAPI stakeholders to share diverse perspectives on challenges to public health programs in the USAPI. Despite diverse experiences, the final set of recommendations reflected a high level of concordance between USAPI and CDC stakeholders on ways to improve coordination and integration of CDC processes and activities in the three core areas. Recommendations have informed some actions already initiated by the DCPC, including the dedication of funds for leadership institutes aimed at enhancing USAPI capacity for sustainable, integrated regional and jurisdictional cancer control infrastructure. Such efforts are an important beginning, but more remains to be done. Indicated is the need for continuous dialogue and collaboration. While this project focused on the USAPI, our results may be relevant to those interested in inter-organizational collaborations, medically underserved areas, public health services programs, and community-based participatory approaches.

Improving integration and coordination of funding, technical assistance, and reporting/data collection: recommendations from CDC and USAPI stakeholders.

PubMed

Ka'opua, Lana Sue I; White, Susan F; Rochester, Phyllis F; Holden, Debra J

2011-03-01

Current US Federal funding mechanisms may foster program silos that disable sharing of resources and information across programs within a larger system of public health services. Such silos present challenges to USAPI communities where human resources, health infrastructure, and health financing are limited. Integrative and coordinated approaches have been recommended. The CDC Pacific Islands Integration and Coordination project was initiated by the CDC Division of Cancer Prevention and Control (DCPC). The project aim was to identify ways for the CDC to collaborate with the USAPI in improving CDC activities and processes related to chronic disease. This article focuses on recommendations for improving coordination and integration in three core areas of health services programming: funding, program reporting/data collection and analysis, and technical assistance. Preliminary information on challenges and issues relevant to the core areas was gathered through site visits, focus groups, key informant interviews, and other sources. This information was used by stakeholder groups from the CDC and the USAPI to develop recommendations in the core programming areas. Recommendations generated at the CDC and USAPI stakeholder meetings were prepared into a single set of recommendations and stakeholders reviewed the document for accuracy prior to its dissemination to CDC's National Center for Chronic Disease Prevention and Health Promotion programs management and staff. Key recommendations, include: (1) consideration of resources and other challenges unique to the USAPI when reviewing funding applications, (2) consideration of ways to increase flexibility in USAPI use of program funds, (3) dedication of funding and human resources for technical assistance, (4) provision of opportunities for capacity-building across programs and jurisdictions, (5) consideration of ways to more directly link program reporting with technical assistance. This project provided a unique opportunity for CDC and USAPI stakeholders to share diverse perspectives on challenges to public health programs in the USAPI. Despite diverse experiences, the final set of recommendations reflected a high level of concordance between USAPI and CDC stakeholders. Recommendations have informed or reinforced actions initiated by the DCPC, including the dedication of funds for leadership institutes aimed at enhancing USAPI capacity for sustainable, integrated regional and jurisdictional cancer control infrastructure. Such efforts are an important beginning, but more remains to be done. Indicated is the need for continuous dialogue and collaboration. While this project focused on the USAPI, our results may be relevant to those interested in inter-organizational collaborations, medically underserved areas, public health services programs, and community-based participatory approaches.

Global trade, public health, and health services: stakeholders' constructions of the key issues.

PubMed

Waitzkin, Howard; Jasso-Aguilar, Rebeca; Landwehr, Angela; Mountain, Carolyn

2005-09-01

Focusing mainly on the United States and Latin America, we aimed to identify the constructions of social reality held by the major stakeholders participating in policy debates about global trade, public health, and health services. In a multi-method, qualitative design, we used three sources of data: research and archival literature, 1980-2004; interviews with key informants who represented major organizations participating in these debates, 2002-2004; and organizational reports, 1980-2004. We targeted several types of organizations: government agencies, international financial institutions (IFIs) and trade organizations, international health organizations, multinational corporations, and advocacy groups. Many governments in Latin America define health as a right and health services as a public good. Thus, the government bears responsibility for that right. In contrast, the US government's philosophy of free trade and promoting a market economy assumes that by expanding the private sector, improved economic conditions will improve overall health with a minimum government provision of health care. US government agencies also view promotion of global health as a means to serve US interests. IFIs have emphasized reforms that include reduction and privatization of public sector services. International health organizations have tended to adopt the policy perspectives of IFIs and trade organizations. Advocacy groups have emphasized the deleterious effects of international trade agreements on public health and health services. Organizational stakeholders hold widely divergent constructions of reality regarding trade, public health, and health services. Social constructions concerning trade and health reflect broad ideologies concerning the impacts of market processes. Such constructions manifest features of "creed," regarding the role of the market in advancing human purposes and meeting human needs. Differences in constructions of trade and health constrain policies to address the profound changes generated by global trade.

Primary Prevention Efforts: How Do We Implement and Monitor the Tier 1 Component of Our Comprehensive, Integrated, Three-Tiered (CI3T) Model?

ERIC Educational Resources Information Center

Lane, Kathleen Lynne; Oakes, Wendy Peia; Magill, Lauren

2014-01-01

In this article, the authors clarify the role of the leadership team, providing a rationale for one integrated team to examine academic, social, and behavioral programming, with careful attention to including all key stakeholders. Next, the authors discuss the procedures for teaching all key stakeholders the comprehensive, integrated, three-tiered…

Community Context of Sober Living Houses

PubMed Central

Henderson, Diane; Trocki, Karen; Evans, Kristy; Wittman, Fried

2012-01-01

The success or failure of programs designed to address alcohol and drug problems can be profoundly influenced by the communities where they are located. Support from the community is vital for long term stability and conflict with the community can harm a program’s reputation or even result in closure. This study examined the community context of sober living houses (SLHs) in one Northern California community by interviewing key stakeholder groups. SLHs are alcohol and drug free living environments for individuals attempting to abstain from substance use. Previous research on residents of SLHs showed they make long-term improvements on measures of substance use, psychiatric symptoms, arrests, and employment. Interviews were completed with house managers, neighbors, and key informants from local government and community organizations. Overall, stakeholders felt SLHs were necessary and had a positive impact on the community. It was emphasized that SLHs needed to practice a “good neighbor” policy that prohibited substance use and encouraged community service. Size and density of SLHs appeared to influence neighbor perceptions. For small (six residents or less), sparsely populated houses, a strategy of blending in with the neighborhood seemed to work. However, it was clear that larger, densely populated houses need to actively manage relationships with community stakeholders. Strategies for improving relationships with immediate neighbors, decreasing stigma, and broadening the leadership structure are discussed. Implications for a broad array of community based programs are discussed. PMID:24478615

Hospital decentralisation in Romania: stakeholders' perspectives in the newsprint media.

PubMed

Popa, Adela Elena

2014-01-01

In the summer of 2010, Romania undertook a process of hospital decentralisation as part of the reform in the healthcare sector. The national newsprint media covered the process thoroughly. This paper is a study of how key stakeholders' views, attitudes, beliefs and attitudes towards decentralisation are represented in print media. 106 articles, published between June and September 2010, retrieved from the online databases of six leading national dailies were analysed. A mixed methodology was used in the data analysis stage. The qualitative data exploration identified five voices belonging to stakeholders involved directly or indirectly in the process: the representatives of central government, the local authorities (district and local councils, municipal mayors), health professionals (managers and physicians in hospitals), the media (journalists, analysts) and finally voices from civil society, professional associations and advocacy groups. These were the main actors negotiating the subjective meanings of the decentralisation process. An imbalance between these key actors were observed in the frequency, content and tone of the messages delivered in media during the four months. Central government and the local authorities were the most active voices, but the respective discourses differed significantly. An analysis of the accounts identified three main themes: the financial problem (hospitals liabilities and future spending), human resource in hospitals (the impact of decentralisation upon it) and the political character of the decentralisation. Copyright © 2013 John Wiley & Sons, Ltd.

Interactive Learning Program (ILP)- a concept for life long learning and Capacity Building of Stakeholders in Integrated Flood Management (IFM)

NASA Astrophysics Data System (ADS)

Pasche, E.; Manojlovic, N.; Basener, S.; Behzadnia, N.

2009-04-01

In the paradigm shift in flood management from traditional to more integrated approach the key to initialising this transition stage is capacity building of stakeholders. It supports the effective participation of stakeholders within their role by giving the individuals/professionals and institutions required knowledge and skills. Such a process of empowering targeted stakeholder groups should be based on the interactive learning rather than mere delivering of flood related information. It can be achieved by initiating the learning process and developing life-long learning programs in form of blended learning that combines both, supervised online and face-to-face approaches. The learning concept based on the didactic principle of Kolb/Fry, has been used as a basis for development of the Interactive Learning Program (ILP) presented in this paper. Kolb/Fry define learning as a cyclic process dividing it into four steps: concrete experience, reflection & observation, forming abstract concepts, testing of acquainted knowledge in new situations. As the knowledge to understand the complexity of IFM is extensive and required level usually cannot be achieved within the face-to-face phase, additional autodidactic learning module tailored to the individual skills should be included in the learning program. ILP combines both, the face-to-face sessions following the Kolb?s learning cycle including theoretical and practical aspects and autodidactic phase by means of the e-learning platform based on the web dissemination strategy for IFM- Kalypso Inform (Pasche/Kraus/Manojlovic). According to this strategy, the access to the flood related information is enabled through three different modules Tutorial, Knowledge Base and Virtual Trainer enabling interaction with the system. This ILP is generic and can be tailored to requirements of different stakeholder groups depending on their role and level of integration in IFM. The first results, obtained for both public and private stakeholders, are encouraging indicating that such concepts should become a substantial part of the IFM.

A systematic review of stakeholder views of selection methods for medical schools admission.

PubMed

Kelly, M E; Patterson, F; O'Flynn, S; Mulligan, J; Murphy, A W

2018-06-15

The purpose of this paper is to systematically review the literature with respect to stakeholder views of selection methods for medical school admissions. An electronic search of nine databases was conducted between January 2000-July 2014. Two reviewers independently assessed all titles (n = 1017) and retained abstracts (n = 233) for relevance. Methodological quality of quantitative papers was assessed using the MERSQI instrument. The overall quality of evidence in this field was low. Evidence was synthesised in a narrative review. Applicants support interviews, and multiple mini interviews (MMIs). There is emerging evidence that situational judgement tests (SJTs) and selection centres (SCs) are also well regarded, but aptitude tests less so. Selectors endorse the use of interviews in general and in particular MMIs judging them to be fair, relevant and appropriate, with emerging evidence of similarly positive reactions to SCs. Aptitude tests and academic records were valued in decisions of whom to call to interview. Medical students prefer interviews based selection to cognitive aptitude tests. They are unconvinced about the transparency and veracity of written applications. Perceptions of organisational justice, which describe views of fairness in organisational processes, appear to be highly influential on stakeholders' views of the acceptability of selection methods. In particular procedural justice (perceived fairness of selection tools in terms of job relevance and characteristics of the test) and distributive justice (perceived fairness of selection outcomes in terms of equal opportunity and equity), appear to be important considerations when deciding on acceptability of selection methods. There were significant gaps with respect to both key stakeholder groups and the range of selection tools assessed. Notwithstanding the observed limitations in the quality of research in this field, there appears to be broad concordance of views on the various selection methods, across the diverse stakeholders groups. This review highlights the need for better standards, more appropriate methodologies and for broadening the scope of stakeholder research.

Communicating River Level Data and Information to Stakeholders with Different Interests

NASA Astrophysics Data System (ADS)

Macleod, K.; Sripada, S.; Ioris, A.; Arts, K.; van der Wal, R.

2012-12-01

There is a need to increase the effectiveness of how river level data are communicated to a range of stakeholders with an interest in river level information to increase the use of data collected by regulatory agencies. Currently, river level data is provided to members of the public through a web site without any formal engagement with river users having taken place. In our research project called wikiRivers, we are working with the suppliers of river level data as well as the users of this data to explore and improve from the user perspective how river level data and information is made available online. We are focusing on the application of natural language generation technology to create textual summaries of river level data tailored for specific interest groups. These tailored textual summaries will be presented among other modes of information presentation (e.g. maps and visualizations) with the aim to increase communication effectiveness. Natural language generation involves developing computational models that use non-linguistic input data to produce natural language as their output. Acquiring accurate correct system knowledge for natural language generation is a key step in developing such an effective computer software system. In this paper we set out the needs for this project based on discussions with the stakeholder who supplies the river level data and current cyberinfrastructure and report on what we have learned from those individuals and groups who use river level data. Stages in the wikiRivers stakeholder identification, engagement and cyberinfrastructure development. S1- interviews with collectors and suppliers of river level data. S2- river level data stakeholder analysis, including analysis of their interests in individual river networks in Scotland and what they require from the cyberinfrastructure. S3-5 Iterative development and testing of cyberinfrastructure and modelling of river level data with domain and stakeholder knowledge.

Internal stakeholder group participation in hospital strategic decision-making: making structure fit the moment.

PubMed

McDaniel, R R; Ashmos, D P

1996-01-01

This study examines the participation of six internal stakeholder groups in hospital strategic decision-making. Results show that internal stakeholder group participation is affected by strategic decision content and by the nature of the hospital's strategy. Results show that the participation of internal stakeholdergroups is associated with lower cost per full-time employee (fte). In particular, when the low participation stakeholder groups do participate, hospitals experience lower cost per fte.

Perceptions of climate change across the Canadian forest sector: The key factors of institutional and geographical environment.

PubMed

Ameztegui, Aitor; Solarik, Kevin A; Parkins, John R; Houle, Daniel; Messier, Christian; Gravel, Dominique

2018-01-01

Assessing the perception of key stakeholders within the forest sector is critical to evaluating their readiness to engage in adapting to climate change. Here, we report the results of the most comprehensive survey carried out in the Canadian forestry sector to date regarding perceptions of climate change. A total of 1158 individuals, representing a wide range of stakeholders across the five most important forestry provinces in Canada, were asked about climate change, its impact on forest ecosystems, and the suitability of current forest management for addressing future impacts. Overall, we found that respondents were more concerned about climate change than the general population. More than 90% of respondents agreed with the anthropogenic origins of climate change, and > 50% considered it a direct threat to their welfare. Political view was the main driver of general beliefs about the causes of climate change and its future consequences, while the province of origin proved to be the best predictor of perceived current impacts on forest ecosystems and its associated risks; and type of stakeholder was the main driver of perceived need for adaptation. Industrial stakeholders were the most skeptical about the anthropogenic cause(s) of climate change (18% disagreed with this statement, compared to an average of 8% in the other stakeholders), its impacts on forest ecosystems (28% for industry vs. 10% for other respondents), and the need for new management practices (18% vs. 7%). Although the degree of awareness and the willingness to implement adaptive practices were high even for the most skeptical groups, our study identified priority sectors or areas for action when designing awareness campaigns. We suggest that the design of a strategic framework for implementing climate adaptation within the Canadian forest sector should focus on the relationship between climate change and changes in disturbance regimes, and above all on the economic consequences of these changes, but it should also take into account the positions shown by each of the actors in each province.

Perceptions of climate change across the Canadian forest sector: The key factors of institutional and geographical environment

PubMed Central

Parkins, John R.; Houle, Daniel; Messier, Christian; Gravel, Dominique

2018-01-01

Assessing the perception of key stakeholders within the forest sector is critical to evaluating their readiness to engage in adapting to climate change. Here, we report the results of the most comprehensive survey carried out in the Canadian forestry sector to date regarding perceptions of climate change. A total of 1158 individuals, representing a wide range of stakeholders across the five most important forestry provinces in Canada, were asked about climate change, its impact on forest ecosystems, and the suitability of current forest management for addressing future impacts. Overall, we found that respondents were more concerned about climate change than the general population. More than 90% of respondents agreed with the anthropogenic origins of climate change, and > 50% considered it a direct threat to their welfare. Political view was the main driver of general beliefs about the causes of climate change and its future consequences, while the province of origin proved to be the best predictor of perceived current impacts on forest ecosystems and its associated risks; and type of stakeholder was the main driver of perceived need for adaptation. Industrial stakeholders were the most skeptical about the anthropogenic cause(s) of climate change (18% disagreed with this statement, compared to an average of 8% in the other stakeholders), its impacts on forest ecosystems (28% for industry vs. 10% for other respondents), and the need for new management practices (18% vs. 7%). Although the degree of awareness and the willingness to implement adaptive practices were high even for the most skeptical groups, our study identified priority sectors or areas for action when designing awareness campaigns. We suggest that the design of a strategic framework for implementing climate adaptation within the Canadian forest sector should focus on the relationship between climate change and changes in disturbance regimes, and above all on the economic consequences of these changes, but it should also take into account the positions shown by each of the actors in each province. PMID:29897977

Workplace exposure to engineered nanomaterials: the Italian path for the definition of occupational health and safety policies.

PubMed

Mirabile, Marco; Boccuni, Fabio; Gagliardi, Diana; Rondinone, Bruna Maria; Iavicoli, Sergio

2014-07-01

This study explores the way the publication of a National White Book on health and safety risks that affect workers in jobs involving Nanotechnologies and Nanomaterials influenced the key Italian stakeholders attitude toward this issue and identifies the standpoints and priorities shared among researchers and stakeholders to develop a policy framework to address this issue. The study not only highlights some important assumptions (i.e. the acknowledgment by the key stakeholders of the need for actions and the identification of objectives which can gain a wide consensus) for the establishment of a policy community that sustains the development of a policymaking process on the issue but, through the interaction between stakeholders and OSH researchers, it also identifies some in nuce proposals that represent the starting point for policy interventions aimed at meeting the needs of both stakeholders and scientific community. Results obtained in terms of clarification of interests at stake, identification of potential areas of consensus and level of key national actors' engagement achieved, show the potentialities of adopting a knowledge based and inclusive approach to policy-making to address the issue of prevention and management of health and safety risks related to technological innovation within a framework of scientific uncertainty. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

"We were treated like adults"--development of a pre-medicine summer school for 16 year olds from deprived socioeconomic backgrounds: action research study.

PubMed

Greenhalgh, Trisha; Russell, Jill; Boynton, Petra; Lefford, Frances; Chopra, Nikhil; Dunkley, Lisa

2006-04-01

To develop a one week widening access summer school for 16 year old pupils from non-traditional backgrounds who are considering applying to medical school, and to identify its short term impact and key success factors. Action research with partnership schools in deprived inner city areas in five overlapping phases: schools liaison, recruitment of pupils and assessment of needs, programme design, programme delivery, and evaluation. The design phase incorporated findings from one to one interviews with every pupil, and workshops and focus groups for pupils, parents, teachers, medical student assistants, NHS staff, and other stakeholders. An in-depth process evaluation of the summer school was undertaken from the perspective of multiple stakeholders using questionnaires, interviews, focus groups, and observation. 40 pupils aged 16 years from socioeconomically deprived and under-represented ethnic minority groups. The summer school was popular with pupils, parents, teachers, and staff. It substantially raised pupils' confidence and motivation to apply to medical school. Critical success factors were identified as an atmosphere of "respect"; a focus on hands-on work in small groups; the input of medical students as role models; and vision and leadership from senior staff. A particularly popular and effective aspect of the course was a grand round held on the last day, in which pupils gave group presentations of real cases. An action research format allowed us to draw the different stakeholders into a collaborative endeavour characterised by enthusiasm, interpersonal support, and mutual respect. The input from pupils to the programme design ensured high engagement and low dropout rates. Hands-on activities in small groups and social drama of preparing and giving a grand round presentation were particularly important.

Perceptions and Use of Technology to Support Older Adults with Multimorbidity.

PubMed

Murphy, Emma; Doyle, Julie; Hannigan, Caoimhe; Smith, Suzanne; Kuiper, Janneke; Jacobs, An; Hoogerwerf, Evert-Jan; Desideri, Lorenzo; Fiordelmondo, Valentina; Maluccelli, Lorenza; Brady, Anne-Marie; Dinsmore, John

2017-01-01

Digital technologies hold great potential to improve and advance home based integrated care for older people living with multiple chronic health conditions. In this paper, we present the results of a user requirement study for a planned digital integrated care system, based on the experiences and needs of key stakeholders. We present rich, multi-stakeholder, qualitative data on the perceptions and use of technology among older people with multiple chronic health conditions and their key support actors. We have outlined our future work for the design of the system, which will involve continuous stakeholder engagement through a user-centred co-design method.

Substitution treatment in the era of "recovery": An analysis of stakeholder roles and policy windows in Britain.

PubMed

Duke, Karen; Herring, Rachel; Thickett, Anthony; Thom, Betsy

2013-08-01

Based on documentary analyses and interviews with twenty key informants in 2012, this paper analyses the shift in British drugs policy towards "recovery" from the perspectives of major stakeholders. The processes involved in reopening the debate surrounding the role of substitution treatment and its re-emergence on to the policy agenda are examined. Drawing on Kingdon's work on agenda-setting, the ways in which methadone maintenance was challenged and defended by key stakeholders in the initial phase of policy development and the negotiation of a "recovery" focus as the organizing concept for British drugs policy are explored. Study limitations are noted.

Collective Leadership: Principals' Decision Influence and the Supportive or Inhibiting Decision Influence of Other Stakeholders

ERIC Educational Resources Information Center

Ni, Yongmei; Yan, Rui; Pounder, Diana

2018-01-01

Purpose: Using the collective leadership framework, this study examines (a) how principals perceive their own influence and that of other key stakeholders in various school decisions and (b) how principals' perceived influences of other stakeholders are associated with their own influence. Research Method/Approach: This study uses the nationally…

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…

Smart Mobility Stakeholders - Curating Urban Data & Models

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

Sperling, Joshua

This presentation provides an overview of the curation of urban data and models through engaging SMART mobility stakeholders. SMART Mobility Urban Science Efforts are helping to expose key data sets, models, and roles for the U.S. Department of Energy in engaging across stakeholders to ensure useful insights. This will help to support other Urban Science and broader SMART initiatives.

Is It Time for a Sudden Infant Death Syndrome (SIDS) Awareness Campaign? Community Stakeholders' Perceptions of SIDS

ERIC Educational Resources Information Center

Gollenberg, Audra; Fendley, Kim

2018-01-01

Sudden infant death syndrome (SIDS) remains a leading cause of infant death in the United States, and in Virginia. We sought to gauge the perceptions among community-identified stakeholders regarding community resource needs to reduce SIDS. Snowball sampling identified important community stakeholders to be interviewed as key informants. A…

Creating a Partnering Community Aimed to Foster Climate Literacy in the Southeastern United States

NASA Astrophysics Data System (ADS)

Rutherford, D.; McNeal, K. S.; Smith, R.; Hare, D.; Nair, U. S.

2011-12-01

The Climate Literacy Partnership in the Southeast (CLiPSE) is a part of the Climate Change Education Program supported by the National Science Foundation (http://CLiPSE-project.org). The established CLiPSE partnership is dedicated to improving climate literacy in the southeast through crafting a shared vision and strategic plan among stakeholders that promotes scientific formal and informal educational resources, materials and programs; a diverse network of key partnering organizations throughout the Southeastern United States (SE US); and effective public dialogues that address diverse learners and audiences and supports learning of climate, climate change, and its relevance upon human and environmental systems. The CLiPSE project has been successful in creating partnerships with more than fifty key stakeholders that stem from a few key publics such as agriculture, education, leisure, religious organizations, and culturally diverse communities. These key publics in the SE US frequently consist of individuals that place great trust in local, private efforts, and CLiPSE has realized the importance of the role of the partnering organizations in providing information through a trusted source. A second unique characteristic of the SE US is the predominately conservative and Protestant citizenry in the region. Working with and through these communities enhances climate change education outreach to this citizenry. The CLiPSE project rests on solid climate science and learning science research in order to formulate an effective plan with desired learning outcomes of critical thinking and civil conversation through effective communication strategies. This paper will present the CLiPSE model in reaching the key publics that traditionally hold ideologies that are traditionally perceived as incompatible with climate change science. We will present the strategies utilized to bring together experts and researchers in climate science, learning science, and social science with practitioners and leaders of key stakeholder groups to formulate a shared climate change education plan in the SE US that is uniquely formatted for each target audience. We will also share what we have learned from interacting with the leaders of our partnering organizations in crafting effective messages for their audiences and addressing learners' affective and cognitive domains.

Forms of benefit sharing in global health research undertaken in resource poor settings: a qualitative study of stakeholders' views in Kenya.

PubMed

Lairumbi, Geoffrey M; Parker, Michael; Fitzpatrick, Raymond; English, Michael C

2012-01-17

Increase in global health research undertaken in resource poor settings in the last decade though a positive development has raised ethical concerns relating to potential for exploitation. Some of the suggested strategies to address these concerns include calls for providing universal standards of care, reasonable availability of proven interventions and more recently, promoting the overall social value of research especially in clinical research. Promoting the social value of research has been closely associated with providing fair benefits to various stakeholders involved in research. The debate over what constitutes fair benefits; whether those that addresses micro level issues of justice or those focusing on the key determinants of health at the macro level has continued. This debate has however not benefited from empirical work on what stakeholders consider fair benefits. This study explores practical experiences of stakeholders involved in global health research in Kenya, over what benefits are fair within a developing world context. We conducted in-depth interviews with key informants drawn from within the broader health research system in Kenya including researchers from the mainstream health research institutions, networks and universities, teaching hospitals, policy makers, institutional review boards, civil society organisations and community representative groups.The range of benefits articulated by stakeholders addresses both micro and macro level concerns for justice by for instance, seeking to engage with interests of those facilitating research, and the broader systemic issues that make resource poor settings vulnerable to exploitation. We interpret these views to suggest a need for global health research to engage with current crises that face people in these settings as well as the broader systemic issues that produce them. Global health research should provide benefits that address both the micro and macro level issues of justice in order to forestall exploitation. Embracing the two is however challenging in terms of how the various competing interests/needs should be balanced ethically, especially in the absence of structures to guide the process. This challenge should point to the need for greater dialogue to facilitate value clarification among stakeholders.

Integration of Water, Sanitation, and Hygiene for the Prevention and Control of Neglected Tropical Diseases: A Rationale for Inter-Sectoral Collaboration

PubMed Central

Jacobson, Julie; Abbott, Daniel; Addiss, David G.; Amnie, Asrat G.; Beckwith, Colin; Cairncross, Sandy; Callejas, Rafael; Colford, Jack M.; Emerson, Paul M.; Fenwick, Alan; Fishman, Rebecca; Gallo, Kerry; Grimes, Jack; Karapetyan, Gagik; Keene, Brooks; Lammie, Patrick J.; MacArthur, Chad; Lochery, Peter; Petach, Helen; Platt, Jennifer; Prabasi, Sarina; Rosenboom, Jan Willem; Roy, Sharon; Saywell, Darren; Schechtman, Lisa; Tantri, Anupama; Velleman, Yael; Utzinger, Jürg

2013-01-01

Improvements of water, sanitation, and hygiene (WASH) infrastructure and appropriate health-seeking behavior are necessary for achieving sustained control, elimination, or eradication of many neglected tropical diseases (NTDs). Indeed, the global strategies to fight NTDs include provision of WASH, but few programs have specific WASH targets and approaches. Collaboration between disease control programs and stakeholders in WASH is a critical next step. A group of stakeholders from the NTD control, child health, and WASH sectors convened in late 2012 to discuss opportunities for, and barriers to, collaboration. The group agreed on a common vision, namely “Disease-free communities that have adequate and equitable access to water and sanitation, and that practice good hygiene.” Four key areas of collaboration were identified, including (i) advocacy, policy, and communication; (ii) capacity building and training; (iii) mapping, data collection, and monitoring; and (iv) research. We discuss strategic opportunities and ways forward for enhanced collaboration between the WASH and the NTD sectors. PMID:24086781

Integration of water, sanitation, and hygiene for the prevention and control of neglected tropical diseases: a rationale for inter-sectoral collaboration.

PubMed

Freeman, Matthew C; Ogden, Stephanie; Jacobson, Julie; Abbott, Daniel; Addiss, David G; Amnie, Asrat G; Beckwith, Colin; Cairncross, Sandy; Callejas, Rafael; Colford, Jack M; Emerson, Paul M; Fenwick, Alan; Fishman, Rebecca; Gallo, Kerry; Grimes, Jack; Karapetyan, Gagik; Keene, Brooks; Lammie, Patrick J; Macarthur, Chad; Lochery, Peter; Petach, Helen; Platt, Jennifer; Prabasi, Sarina; Rosenboom, Jan Willem; Roy, Sharon; Saywell, Darren; Schechtman, Lisa; Tantri, Anupama; Velleman, Yael; Utzinger, Jürg

2013-01-01

Improvements of water, sanitation, and hygiene (WASH) infrastructure and appropriate health-seeking behavior are necessary for achieving sustained control, elimination, or eradication of many neglected tropical diseases (NTDs). Indeed, the global strategies to fight NTDs include provision of WASH, but few programs have specific WASH targets and approaches. Collaboration between disease control programs and stakeholders in WASH is a critical next step. A group of stakeholders from the NTD control, child health, and WASH sectors convened in late 2012 to discuss opportunities for, and barriers to, collaboration. The group agreed on a common vision, namely "Disease-free communities that have adequate and equitable access to water and sanitation, and that practice good hygiene." Four key areas of collaboration were identified, including (i) advocacy, policy, and communication; (ii) capacity building and training; (iii) mapping, data collection, and monitoring; and (iv) research. We discuss strategic opportunities and ways forward for enhanced collaboration between the WASH and the NTD sectors.

Implementing guidelines and training initiatives to improve cross-cultural communication in primary care consultations: a qualitative participatory European study.

PubMed

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

2017-02-10

Cross-cultural communication in primary care is often difficult, leading to unsatisfactory, substandard care. Supportive evidence-based guidelines and training initiatives (G/TIs) exist to enhance cross cultural communication but their use in practice is sporadic. The objective of this paper is to elucidate how migrants and other stakeholders can adapt, introduce and evaluate such G/TIs in daily clinical practice. We undertook linked qualitative case studies to implement G/TIs focused on enhancing cross cultural communication in primary care, in five European countries. We combined Normalisation Process Theory (NPT) as an analytical framework, with Participatory Learning and Action (PLA) as the research method to engage migrants, primary healthcare providers and other stakeholders. Across all five sites, 66 stakeholders participated in 62 PLA-style focus groups over a 19 month period, and took part in activities to adapt, introduce, and evaluate the G/TIs. Data, including transcripts of group meetings and researchers' fieldwork reports, were coded and thematically analysed by each team using NPT. In all settings, engaging migrants and other stakeholders was challenging but feasible. Stakeholders made significant adaptations to the G/TIs to fit their local context, for example, changing the focus of a G/TI from palliative care to mental health; or altering the target audience from General Practitioners (GPs) to the wider multidisciplinary team. They also progressed plans to deliver them in routine practice, for example liaising with GP practices regarding timing and location of training sessions and to evaluate their impact. All stakeholders reported benefits of the implemented G/TIs in daily practice. Training primary care teams (clinicians and administrators) resulted in a more tolerant attitude and more effective communication, with better focus on migrants' needs. Implementation of interpreter services was difficult mainly because of financial and other resource constraints. However, when used, migrants were more likely to trust the GP's diagnoses and GPs reported a clearer understanding of migrants' symptoms. Migrants, primary care providers and other key stakeholders can work effectively together to adapt and implement G/TIs to improve communication in cross-cultural consultations, and enhance understanding and trust between GPs and migrant patients.

One Health stakeholder and institutional analysis in Kenya

PubMed Central

Kimani, Tabitha; Ngigi, Margaret; Schelling, Esther; Randolph, Tom

2016-01-01

Introduction One Health (OH) can be considered a complex emerging policy to resolve health issues at the animal–human and environmental interface. It is expected to drive system changes in terms of new formal and informal institutional and organisational arrangements. This study, using Rift Valley fever (RVF) as a zoonotic problem requiring an OH approach, sought to understand the institutionalisation process at national and subnational levels in an early adopting country, Kenya. Materials and methods Social network analysis methodologies were used. Stakeholder roles and relational data were collected at national and subnational levels in 2012. Key informants from stakeholder organisations were interviewed, guided by a checklist. Public sector animal and public health organisations were interviewed first to identify other stakeholders with whom they had financial, information sharing and joint cooperation relationships. Visualisation of the OH social network and relationships were shown in sociograms and mathematical (degree and centrality) characteristics of the network summarised. Results and discussion Thirty-two and 20 stakeholders relevant to OH were identified at national and subnational levels, respectively. Their roles spanned wildlife, livestock, and public health sectors as well as weather prediction. About 50% of national-level stakeholders had made significant progress on OH institutionalisation to an extent that formal coordination structures (zoonoses disease unit and a technical working group) had been created. However, the process had not trickled down to subnational levels although cross-sectoral and sectoral collaborations were identified. The overall binary social network density for the stakeholders showed that 35 and 21% of the possible ties between the RVF and OH stakeholders existed at national and subnational levels, respectively, while public health actors’ collaborations were identified at community/grassroots level. We recommend extending the OH network to include the other 50% stakeholders and fostering of the process at subnational-level building on available cross-sectoral platforms. PMID:27330042

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.

Developing core outcome sets for clinical trials: issues to consider

PubMed Central

2012-01-01

The selection of appropriate outcomes or domains is crucial when designing clinical trials in order to compare directly the effects of different interventions in ways that minimize bias. If the findings are to influence policy and practice then the chosen outcomes need to be relevant and important to key stakeholders including patients and the public, health care professionals and others making decisions about health care. There is a growing recognition that insufficient attention has been paid to the outcomes measured in clinical trials. These issues could be addressed through the development and use of an agreed standardized collection of outcomes, known as a core outcome set, which should be measured and reported, as a minimum, in all trials for a specific clinical area. Accumulating work in this area has identified the need for general guidance on the development of core outcome sets. Key issues to consider in the development of a core outcome set include its scope, the stakeholder groups to involve, choice of consensus method and the achievement of a consensus. PMID:22867278

Clinical Research Informatics: Challenges, Opportunities and Definition for an Emerging Domain

PubMed Central

Embi, Peter J.; Payne, Philip R.O.

2009-01-01

Objectives Clinical Research Informatics, an emerging sub-domain of Biomedical Informatics, is currently not well defined. A formal description of CRI including major challenges and opportunities is needed to direct progress in the field. Design Given the early stage of CRI knowledge and activity, we engaged in a series of qualitative studies with key stakeholders and opinion leaders to determine the range of challenges and opportunities facing CRI. These phases employed complimentary methods to triangulate upon our findings. Measurements Study phases included: 1) a group interview with key stakeholders, 2) an email follow-up survey with a larger group of self-identified CRI professionals, and 3) validation of our results via electronic peer-debriefing and member-checking with a group of CRI-related opinion leaders. Data were collected, transcribed, and organized for formal, independent content analyses by experienced qualitative investigators, followed by an iterative process to identify emergent categorizations and thematic descriptions of the data. Results We identified a range of challenges and opportunities facing the CRI domain. These included 13 distinct themes spanning academic, practical, and organizational aspects of CRI. These findings also informed the development of a formal definition of CRI and supported further representations that illustrate areas of emphasis critical to advancing the domain. Conclusions CRI has emerged as a distinct discipline that faces multiple challenges and opportunities. The findings presented summarize those challenges and opportunities and provide a framework that should help inform next steps to advance this important new discipline. PMID:19261934

Attracting and retaining GPs: a stakeholder survey of priorities

PubMed Central

Lorant, Vincent; Geerts, Charlotte; Duchesnes, Christiane; Goedhuys, Jo; Ryssaert, Lynn; Remmen, Roy; D'hoore, William

2011-01-01

Background Despite being a key player in the healthcare system, training and practising general practice has become less attractive in many countries and is in need of reform. Aim To identify political priorities for improving GPs' attraction to the profession and their retention within it. Design and setting Stakeholder face-to-face survey in Belgium, 2008. Method A total of 102 key stakeholders were recruited from policymakers, professional groups, academia, GP leaders, and the media. All interviewees were asked to score 23 policies on four criteria: effectiveness in attracting and retaining GPs, cost to society, acceptance by other health professionals, and accessibility of care. An overall performance score was computed (from –3 to +3) for each type of policy — training, financing, work–life balance, practice organisation, and governance — and for innovative versus conservative policies. Results Practice organisation policies and training policies received the highest scores (mean score ≥1.11). Financing policies, governance, and work–life balance policies scored poorly (mean score ≤0.65) because they had negative effects, particularly in relation to cost, acceptance, and accessibility of care. Stakeholders were keen on moving GPs towards team work, improving their role as care coordinator, and helping them to offload administrative tasks (score ≥1.4). They also favoured moves to increase the early and integrated exposure of all medical students to general practice. Overall, conservative policies were better scored than innovative ones (beta = –0.16, 95% confidence interval = –0.28 to –0.03). Conclusion The reforming of general practice is made difficult by the small-step approach, as well as the importance of decision criteria related to cost, acceptance, and access. PMID:21722449

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.

Basis for the development of sustainable optimisation indicators for activated sludge wastewater treatment plants in the Republic of Ireland.

PubMed

Gordon, G T; McCann, B P

2015-01-01

This paper describes the basis of a stakeholder-based sustainable optimisation indicator (SOI) system to be developed for small-to-medium sized activated sludge (AS) wastewater treatment plants (WwTPs) in the Republic of Ireland (ROI). Key technical publications relating to best practice plant operation, performance audits and optimisation, and indicator and benchmarking systems for wastewater services are identified. Optimisation studies were developed at a number of Irish AS WwTPs and key findings are presented. A national AS WwTP manager/operator survey was carried out to verify the applied operational findings and identify the key operator stakeholder requirements for this proposed SOI system. It was found that most plants require more consistent operational data-based decision-making, monitoring and communication structures to facilitate optimised, sustainable and continuous performance improvement. The applied optimisation and stakeholder consultation phases form the basis of the proposed stakeholder-based SOI system. This system will allow for continuous monitoring and rating of plant performance, facilitate optimised operation and encourage the prioritisation of performance improvement through tracking key operational metrics. Plant optimisation has become a major focus due to the transfer of all ROI water services to a national water utility from individual local authorities and the implementation of the EU Water Framework Directive.

Attitudes and perceptions of stakeholders on decentralization of health services in Uganda: the case of Lira and Apac districts.

PubMed

Anokbonggo, W W; Ogwal-Okeng, J W; Ross-Degnan, D; Aupont, O

2004-02-01

In Uganda, the decentralization of administrative functions, management, and responsibility for health care to districts, which began in 1994, resulted in fundamental changes in health care delivery. Since the introduction of the policy in Uganda, little information has been available on stakeholders' perceptions about the benefits of the policy and how decentralization affected health care delivery. To identify the perceptions and beliefs of key stakeholders on the impact and process of decentralization and on the operations of health services in two districts in Uganda, and to report their suggestions to improve future implementation of similar policies. We used qualitative research methods that included focus group discussions with 90 stakeholders from both study districts. The sample population comprised of 12 health workers from the two hospitals, 11 district health administrators, and 67 Local Council Leaders. Perceptions and concerns of stakeholders on the impact of decentralization on district health services. There was a general consensus that decentralization empowered local administrative and political decision-making. Among stakeholders, the policy was perceived to have created a sense of ownership and responsibility. Major problems that were said to be associated with decentralization included political harassment of civil servants, increased nepotism, inadequate financial resources, and mismanagement of resources. This study elicited perceptions about critical factors upon which successful implementation of the decentralization policy depended. These included: appreciation of the role of all stakeholders by district politicians; adequate availability and efficient utilization of resources; reasonably developed infrastructure prior to the policy change; appropriate sensitisation and training of those implementing policies; and the good will and active involvement of the local community. In the absence of these factors, implementation of decentralization of services to districts may not immediately make economic and administrative sense.

The views of stakeholders on controlled access schemes for high-cost antirheumatic biological medicines in Australia

PubMed Central

Lu, Christine Y; Ritchie, Jan; Williams, Ken; Day, Ric

2007-01-01

Background In Australia, government-subsidised access to high-cost medicines is "targeted" to particular sub-sets of patients under the Pharmaceutical Benefits Scheme to achieve cost-effective use. In order to determine how this access system could be improved, the opinions of key stakeholders on access to biological agents for rheumatoid arthritis were explored. Methods Thirty-six semi-structured interviews were conducted with persons from relevant stakeholder groups. These were transcribed verbatim, and analysed thematically. Results Controlled access to expensive medicines was considered to be equitable and practical; however, there was disagreement as to the method of defining the target patient populations. Other concerns included timeliness of access, excessive bureaucracy, and the need for additional resources to facilitate the scheme. Collaboration between stakeholders was deemed important because it allows more equitable distribution of limited resources. The majority considered that stakeholder consultation should have been broader. Most wanted increased transparency of the decision-making process, ongoing and timely review of access criteria, and an increased provision of information for patients. More structured communication between stakeholders was proposed. Conclusion The Pharmaceutical Benefit Scheme is adapting to meet the changing needs of patients. Provision of subsidised access to high-cost medicines in a manner that is affordable for individuals and society, and that is equitable and efficiently managed is challenging. The views of stakeholders on targeted access to anti-rheumatic biological medicines in Australia acknowledged this challenge and provided a number of suggestions for modifications. These could serve as a basis to inform the debate on how to change the processes and policies so as to improve the scheme. PMID:18096055

'We all want to succeed, but we've also got to be realistic about what is happening': an ethnographic study of relationships in trial oversight and their impact.

PubMed

Daykin, Anne; Selman, Lucy E; Cramer, Helen; McCann, Sharon; Shorter, Gillian W; Sydes, Matthew R; Gamble, Carrol; Macefield, Rhiannon; Lane, J Athene; Shaw, Alison

2017-12-22

The oversight and conduct of a randomised controlled trial involves several stakeholders, including a Trial Steering Committee (TSC), Trial Management Group (TMG), Data Monitoring Committee (DMC), funder and sponsor. We aimed to examine how the relationships between these stakeholders affect the trial oversight process and its rigour, to inform future revision of Good Clinical Practice guidelines. Using an ethnographic study design, we observed the oversight processes of eight trials and conducted semi-structured interviews with members of the trials' TSCs and TMGs, plus other relevant informants, including sponsors and funders of trials. Data were analysed thematically, and findings triangulated and integrated to give a multi-perspective account of current oversight practices in the UK. Eight TSC and six TMG meetings from eight trials were observed and audio-recorded, and 66 semi-structured interviews conducted with 52 purposively sampled key informants. Five themes are presented: (1) Collaboration within the TMG and role of the CTU; (2) Collaboration and conflict between oversight committees; (3) Priorities; (4) Communication between trial oversight groups and (5) Power and accountability. There was evidence of collaborative relationships, based on mutual respect, between CTUs, TMGs and TSCs, but also evidence of conflict. Relationships between trial oversight committees were influenced by stakeholders' priorities, both organisational and individual. Good communication following specific, recognised routes played a central role in ensuring that relationships were productive and trial oversight efficient. Participants described the possession of power over trials as a shifting political landscape, and there was lack of clarity regarding the roles and accountability of each committee, the sponsor and funder. Stakeholders' perceptions of their own power over a trial, and the power of others, influenced relationships between those involved in trial oversight. Recent developments in trial design and conduct have been accompanied by changes in roles and relationships between trial oversight groups. Recognising and respecting the value of differing priorities among those involved in running trials is key to successful relationships between committees, funders and sponsors. Clarity regarding appropriate lines of communication, roles and accountability is needed. We present 10 evidence-based recommendations to inform updates to international trial guidance, particularly the Medical Research Council guidelines.

Understanding and Modeling Freight Stakeholder Behavior

DOT National Transportation Integrated Search

2012-04-01

This project developed a conceptual model of private-sector freight stakeholder decisions and interactions for : forecasting freight demands in response to key policy variables. Using East Central Wisconsin as a study area, empirical : models were de...

A qualitative study exploring the views, attitudes and beliefs of patients and health professionals towards exercise intervention for people who are surgically treated for lung cancer.

PubMed

Crandall, K; Maguire, R; Campbell, A; Kearney, N

2018-03-01

Surgical removal remains the best curative option for patients diagnosed with early-stage lung cancer. However, it is also associated with significant morbidity and reduced quality of life. Interventions to improve patient outcomes are required. This study aimed to explore the views, attitudes and beliefs of key stakeholders on exercise intervention for people who are surgically treated for lung cancer to inform the development of future interventions. Focus groups and individual interviews were carried out at two Scottish sites. The study was guided by the Health Action Process Approach behaviour change model. A total of 23 (12 patients and 11 health professionals) participated in the study. The data analysis resulted in three main themes: attitudes and beliefs, external factors and intervention design. The results highlighted certain key elements that should be included in an exercise intervention, such as the need for supervised sessions, an element of individualisation and the perceived social benefits of exercising with others. This study emphasises the importance of including key stakeholders in the development of complex interventions such as exercise and provides important information for the development of future exercise intervention trials for people who are surgically treated for lung cancer. © 2018 John Wiley & Sons Ltd.

Interprofessional enhanced skills training in periodontology: a qualitative study of one London pilot.

PubMed

Radcliffe, Eloise; Ghotane, Swapnil G; Harrison, Victoria; Gallagher, Jennifer E

2017-01-01

Health Education England (HEE) London developed an innovative 2-year pilot educational and training initiative for enhancing skills in periodontology for dentists and dental hygienists/therapists in 2011. This study explores the perceptions and experiences of those involved in initiating, designing, delivering and participating in this interprofessional approach to training. Semi-structured qualitative interviews were conducted with a purposive sample of key stakeholders including course participants (dentists and dental hygienists and/or therapists), education and training commissioners, and providers towards the end of the 2-year programme. Interviews, based on a topic guide informed by health services and policy literature, were audio-recorded and transcribed verbatim. Data were analysed based on framework methodology, using QSR NVivo 9 software to manage the data. Twenty-two people were interviewed. Although certain challenges were identified in designing, and teaching, a course bringing together different professional backgrounds and level of skills, the experiences of all key stakeholders were overwhelmingly positive relating to the concept. There was evidence of 'creative interprofessional learning', which led to 'enhancing team working', 'enabling role recognition' and 'equipping participants for delivery of new models of care'. Recommendations emerged with regard to future training and wider health policy, and systems that will enable participants on future enhanced skills courses in periodontology to apply these skills in clinical practice. The interprofessional approach to enhanced skills training in periodontology represents an important creative innovation to build capacity within the oral health workforce. This qualitative study has provided a useful insight into the benefits and tensions of an interprofessional model of training from the perspectives of different groups of key stakeholders and suggests its application to other areas of dentistry.

Interprofessional enhanced skills training in periodontology: a qualitative study of one London pilot

PubMed Central

Radcliffe, Eloise; Ghotane, Swapnil G; Harrison, Victoria; Gallagher, Jennifer E

2017-01-01

OBJECTIVES/AIMS: Health Education England (HEE) London developed an innovative 2-year pilot educational and training initiative for enhancing skills in periodontology for dentists and dental hygienists/therapists in 2011. This study explores the perceptions and experiences of those involved in initiating, designing, delivering and participating in this interprofessional approach to training. MATERIALS AND METHODS: Semi-structured qualitative interviews were conducted with a purposive sample of key stakeholders including course participants (dentists and dental hygienists and/or therapists), education and training commissioners, and providers towards the end of the 2-year programme. Interviews, based on a topic guide informed by health services and policy literature, were audio-recorded and transcribed verbatim. Data were analysed based on framework methodology, using QSR NVivo 9 software to manage the data. RESULTS: Twenty-two people were interviewed. Although certain challenges were identified in designing, and teaching, a course bringing together different professional backgrounds and level of skills, the experiences of all key stakeholders were overwhelmingly positive relating to the concept. There was evidence of ‘creative interprofessional learning’, which led to ‘enhancing team working’, ‘enabling role recognition’ and ‘equipping participants for delivery of new models of care’. Recommendations emerged with regard to future training and wider health policy, and systems that will enable participants on future enhanced skills courses in periodontology to apply these skills in clinical practice. CONCLUSION: The interprofessional approach to enhanced skills training in periodontology represents an important creative innovation to build capacity within the oral health workforce. This qualitative study has provided a useful insight into the benefits and tensions of an interprofessional model of training from the perspectives of different groups of key stakeholders and suggests its application to other areas of dentistry. PMID:29607074

Partnerships for Policy Development: A Case Study From Uganda’s Costed Implementation Plan for Family Planning

PubMed Central

Lipsky, Alyson B; Gribble, James N; Cahaelen, Linda; Sharma, Suneeta

2016-01-01

ABSTRACT In global health, partnerships between practitioners and policy makers facilitate stakeholders in jointly addressing those issues that require multiple perspectives for developing, implementing, and evaluating plans, strategies, and programs. For family planning, costed implementation plans (CIPs) are developed through a strategic government-led consultative process that results in a detailed plan for program activities and an estimate of the funding required to achieve an established set of goals. Since 2009, many countries have developed CIPs. Conventionally, the CIP approach has not been defined with partnerships as a focal point; nevertheless, cooperation between key stakeholders is vital to CIP development and execution. Uganda launched a CIP in November 2014, thus providing an opportunity to examine the process through a partnership lens. This article describes Uganda’s CIP development process in detail, grounded in a framework for assessing partnerships, and provides the findings from 22 key informant interviews. Findings reveal strengths in Uganda’s CIP development process, such as willingness to adapt and strong senior management support. However, the evaluation also highlighted challenges, including district health officers (DHOs), who are a key group of implementers, feeling excluded from the development process. There was also a lack of planning around long-term partnership practices that could help address anticipated execution challenges. The authors recommend that future CIP development efforts use a long-term partnership strategy that fosters accountability by encompassing both the short-term goal of developing the CIP and the longer-term goal of achieving the CIP objectives. Although this study focused on Uganda’s CIP for family planning, its lessons have implications for any policy or strategy development efforts that require multiple stakeholders to ensure successful execution. PMID:27353621

Key principles for a national clinical decision support knowledge sharing framework: synthesis of insights from leading subject matter experts

PubMed Central

Hongsermeier, Tonya; Wright, Adam; Lewis, Janet; Bell, Douglas S; Middleton, Blackford

2013-01-01

Objective To identify key principles for establishing a national clinical decision support (CDS) knowledge sharing framework. Materials and methods As part of an initiative by the US Office of the National Coordinator for Health IT (ONC) to establish a framework for national CDS knowledge sharing, key stakeholders were identified. Stakeholders' viewpoints were obtained through surveys and in-depth interviews, and findings and relevant insights were summarized. Based on these insights, key principles were formulated for establishing a national CDS knowledge sharing framework. Results Nineteen key stakeholders were recruited, including six executives from electronic health record system vendors, seven executives from knowledge content producers, three executives from healthcare provider organizations, and three additional experts in clinical informatics. Based on these stakeholders' insights, five key principles were identified for effectively sharing CDS knowledge nationally. These principles are (1) prioritize and support the creation and maintenance of a national CDS knowledge sharing framework; (2) facilitate the development of high-value content and tooling, preferably in an open-source manner; (3) accelerate the development or licensing of required, pragmatic standards; (4) acknowledge and address medicolegal liability concerns; and (5) establish a self-sustaining business model. Discussion Based on the principles identified, a roadmap for national CDS knowledge sharing was developed through the ONC's Advancing CDS initiative. Conclusion The study findings may serve as a useful guide for ongoing activities by the ONC and others to establish a national framework for sharing CDS knowledge and improving clinical care. PMID:22865671

On the front lines: Stakeholder threat cues determine how identified employees cope with scandal.

PubMed

Grandey, Alicia A; Krannitz, Morgan A; Slezak, Tyler

2015-07-01

When organizational identity is threatened as a result of scandal, highly identified members who represent the threatened organization to stakeholders have a particularly challenging and overlooked experience. Addressing a theoretical paradox, we propose that organizational identification interacts with the threat cues from stakeholders to determine employee responses. We conducted a multimethod, in vivo test of these ideas with university fundraising employees after events threatened the university's moral identity. Interview and archival data demonstrated that stakeholders expressed identity threat to fundraisers, who experienced their own identity-related distress and engaged in both group-dissociative and group-affirming responses. Surveys of professional and student university fundraisers demonstrated that more identified employees were more distressed (e,g., felt anxious, grief, betrayed) regardless of stakeholder threat cues. Yet, when employees perceived weak threat cues from stakeholders, more identified members were less likely to dissociate from the group and more likely to affirm the group's positive identity with stakeholders. These benefits of identification were not present when the stakeholder threat cues were strong. We discuss future research and practical implications of front-line employee identification and stakeholder cues during scandal. (c) 2015 APA, all rights reserved).

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

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.

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 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

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.

Stakeholder analysis for a maternal and newborn health project in Eastern Uganda

PubMed Central

2013-01-01

Background Based on the realization that Uganda is not on track to achieving Millennium Development Goals 4 and 5, Makerere University School of Public Health in collaboration with other partners proposed to conduct two community based maternal/newborn care interventions aimed at increasing access to health facility care through transport vouchers and use of community health workers to promote ideal family care practices. Prior to the implementation, a stakeholder analysis was undertaken to assess and map stakeholders’ interests, influence/power and position in relation to the interventions; their views regarding the success and sustainability; and how this research can influence policy formulation in the country. Methods A stakeholder analysis was carried out in March 2011 at national level and in four districts of Eastern Uganda where the proposed interventions would be conducted. At the national level, four key informant interviews were conducted with the ministry of health representative, Member of Parliament, and development partners. District health team members were interviewed and also engaged in a workshop; and at community level, twelve focus group discussions were conducted among women, men and motorcycle transporters. Results This analysis revealed that district and community level stakeholders were high level supporters of the proposed interventions but not drivers. At community level the mothers, their spouses and transporters were of low influence due to the limited funds they possessed. National level and district stakeholders believed that the intervention is costly and cannot be affordably scaled up. They advised the study team to mobilize and sensitize the communities to contribute financially from the start in order to enhance sustainability beyond the study period. Stakeholders believed that the proposed interventions will influence policy through modeling on how to improve the quality of maternal/newborn health services, male involvement, and improved accessibility of services. Conclusion Most of the stakeholders interviewed were supporters of the proposed maternal and newborn care intervention because of the positive benefits of the intervention. The analysis highlighted stakeholder concerns that will be included in the final project design and that could also be useful in countries of similar setting that are planning to set up programmes geared at increasing access to maternal and new born interventions. Key among these concerns was the need to use both human and financial resources that are locally available in the community, to address supply side barriers that influence access to maternal and child healthcare. Research to policy translation, therefore, will require mutual trust, continued dialogue and engagement of the researchers, implementers and policy makers to enable scale up. PMID:23497057

Preference weights for cost-outcome analyses of schizophrenia treatments: comparison of four stakeholder groups.

PubMed

Shumway, Martha

2003-01-01

This study quantified preferences for schizophrenia outcomes in four stakeholder groups, tested the hypotheses that outcomes differ in importance and stakeholder groups have different preferences, and produced preference weights for seven outcomes for cost-outcome analysis. Fifty patients with schizophrenia, 50 clinicians, 41 family members of patients, and 50 members of the general public rated 16 schizophrenia-related health states, yielding preference weights for seven outcomes: positive symptoms, negative symptoms, extrapyramidal symptoms, tardive dyskinesia, social function, independent living, and vocational function. Outcomes differed in importance (F = 23.4, p < 0.01). All stakeholders rated positive symptoms and social functioning as more important than negative and extrapyramidal symptoms. Stakeholder groups had different preferences (F = 1.9, p = 0.01). Patients rated extrapyramidal symptoms as more important than did other groups (p < 0.01); clinicians rated social functioning as more important than did patients or family members (p < 0.05); and clinicians and family members rated vocational functioning as more important than did patients and the general public (p < 0.05). Results show that schizophrenia outcomes are not equally important and that stakeholder groups value outcomes differently, demonstrating the importance of incorporating stakeholder preferences in cost-outcome analyses and other treatment comparisons.

Stakeholders apply the GRADE evidence-to-decision framework to facilitate coverage decisions.

PubMed

Dahm, Philipp; Oxman, Andrew D; Djulbegovic, Benjamin; Guyatt, Gordon H; Murad, M Hassan; Amato, Laura; Parmelli, Elena; Davoli, Marina; Morgan, Rebecca L; Mustafa, Reem A; Sultan, Shahnaz; Falck-Ytter, Yngve; Akl, Elie A; Schünemann, Holger J

2017-06-01

Coverage decisions are complex and require the consideration of many factors. A well-defined, transparent process could improve decision-making and facilitate decision-maker accountability. We surveyed key US-based stakeholders regarding their current approaches for coverage decisions. Then, we held a workshop to test an evidence-to-decision (EtD) framework for coverage based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. A total of 42 individuals (including 19 US stakeholders as well as international health policymakers and GRADE working group members) attended the workshop. Of the 19 stakeholders, 14 (74%) completed the survey before the workshop. Almost all of their organizations (13 of 14; 93%) used systematic reviews for coverage decision-making; few (2 of 14; 14%) developed their own evidence synthesis; a majority (9 of 14; 64%) rated the certainty of evidence (using various systems); almost all (13 of 14; 93%) denied formal consideration of resource use; and half (7 of 14; 50%) reported explicit criteria for decision-making. At the workshop, stakeholders successfully applied the EtD framework to four case studies and provided narrative feedback, which centered on contextual factors affecting coverage decisions in the United States, the need for reliable data on subgroups of patients, and the challenge of decision-making without formal consideration of resource use. Stakeholders successfully applied the EtD framework to four case studies and highlighted contextual factors affecting coverage decisions and affirmed its value. Their input informed the further development of a revised EtD framework, now publicly available (http://gradepro.org/). Published by Elsevier Inc.

Distribution of Economic Benefits from Ecotourism: A Case Study of Wolong Nature Reserve for Giant Pandas in China

NASA Astrophysics Data System (ADS)

He, Guangming; Chen, Xiaodong; Liu, Wei; Bearer, Scott; Zhou, Shiqiang; Cheng, Lily Yeqing; Zhang, Hemin; Ouyang, Zhiyun; Liu, Jianguo

2008-12-01

Ecotourism is widely promoted as a conservation tool and actively practiced in protected areas worldwide. Theoretically, support for conservation from the various types of stakeholder inside and outside protected areas is maximized if stakeholders benefit proportionally to the opportunity costs they bear. The disproportional benefit distribution among stakeholders can erode their support for or lead to the failure of ecotourism and conservation. Using Wolong Nature Reserve for Giant Pandas (China) as an example, we demonstrate two types of uneven distribution of economic benefits among four major groups of stakeholders. First, a significant inequality exists between the local rural residents and the other types of stakeholder. The rural residents are the primary bearers of the cost of conservation, but the majority of economic benefits (investment, employment, and goods) in three key ecotourism sectors (infrastructural construction, hotels/restaurants, and souvenir sales) go to other stakeholders. Second, results show that the distribution of economic benefits is unequal among the rural residents inside the reserve. Most rural households that benefit from ecotourism are located near the main road and potentially have less impact on panda habitat than households far from the road and closer to panda habitats. This distribution gap is likely to discourage conservation support from the latter households, whose activities are the main forces degrading panda habitats. We suggest that the unequal distribution of the benefits from ecotourism can be lessened by enhancing local participation, increasing the use of local goods, and encouraging relocation of rural households closer to ecotourism facilities.

Distribution of economic benefits from ecotourism: a case study of Wolong Nature Reserve For Giant Pandas in China.

PubMed

He, Guangming; Chen, Xiaodong; Liu, Wei; Bearer, Scott; Zhou, Shiqiang; Cheng, Lily Yeqing; Zhang, Hemin; Ouyang, Zhiyun; Liu, Jianguo

2008-12-01

Ecotourism is widely promoted as a conservation tool and actively practiced in protected areas worldwide. Theoretically, support for conservation from the various types of stakeholder inside and outside protected areas is maximized if stakeholders benefit proportionally to the opportunity costs they bear. The disproportional benefit distribution among stakeholders can erode their support for or lead to the failure of ecotourism and conservation. Using Wolong Nature Reserve for Giant Pandas (China) as an example, we demonstrate two types of uneven distribution of economic benefits among four major groups of stakeholders. First, a significant inequality exists between the local rural residents and the other types of stakeholder. The rural residents are the primary bearers of the cost of conservation, but the majority of economic benefits (investment, employment, and goods) in three key ecotourism sectors (infrastructural construction, hotels/restaurants, and souvenir sales) go to other stakeholders. Second, results show that the distribution of economic benefits is unequal among the rural residents inside the reserve. Most rural households that benefit from ecotourism are located near the main road and potentially have less impact on panda habitat than households far from the road and closer to panda habitats. This distribution gap is likely to discourage conservation support from the latter households, whose activities are the main forces degrading panda habitats. We suggest that the unequal distribution of the benefits from ecotourism can be lessened by enhancing local participation, increasing the use of local goods, and encouraging relocation of rural households closer to ecotourism facilities.

Ecosystem Services Flows: Why Stakeholders’ Power Relationships Matter

PubMed Central

Felipe-Lucia, María R.; Martín-López, Berta; Lavorel, Sandra; Berraquero-Díaz, Luis; Escalera-Reyes, Javier; Comín, Francisco A.

2015-01-01

The ecosystem services framework has enabled the broader public to acknowledge the benefits nature provides to different stakeholders. However, not all stakeholders benefit equally from these services. Rather, power relationships are a key factor influencing the access of individuals or groups to ecosystem services. In this paper, we propose an adaptation of the “cascade” framework for ecosystem services to integrate the analysis of ecological interactions among ecosystem services and stakeholders’ interactions, reflecting power relationships that mediate ecosystem services flows. We illustrate its application using the floodplain of the River Piedra (Spain) as a case study. First, we used structural equation modelling (SEM) to model the dependence relationships among ecosystem services. Second, we performed semi-structured interviews to identify formal power relationships among stakeholders. Third, we depicted ecosystem services according to stakeholders’ ability to use, manage or impair ecosystem services in order to expose how power relationships mediate access to ecosystem services. Our results revealed that the strongest power was held by those stakeholders who managed (although did not use) those keystone ecosystem properties and services that determine the provision of other services (i.e., intermediate regulating and final services). In contrast, non-empowered stakeholders were only able to access the remaining non-excludable and non-rival ecosystem services (i.e., some of the cultural services, freshwater supply, water quality, and biological control). In addition, land stewardship, access rights, and governance appeared as critical factors determining the status of ecosystem services. Finally, we stress the need to analyse the role of stakeholders and their relationships to foster equal access to ecosystem services. PMID:26201000

Separating 'emotion' from 'the science': Exploring the perceived value of information for parents and families of children with autistic spectrum disorder.

PubMed

O'Reilly, Michelle; Karim, Khalid; Lester, Jessica Nina

2015-07-01

Autistic spectrum disorder (ASD) is a life-long condition. In recent years, there has been a rise in the number of children diagnosed with ASD and a greater recognition that parents need clear, accessible information communicated through different modalities. The objective of this research was to explore the views of stakeholders regarding their information needs, current information modalities and the perceived barriers and complexities of information. Three focus groups with the same stakeholders were conducted with a range of individuals from a variety of backgrounds, all of whom had a personal and/or professional interest in ASD. The same stakeholders were included in all three groups to promote depth of analysis and to facilitate rapport. All focus groups were audio-recorded, transcribed and analysed using thematic analysis. Three main issues were identified, including (1) the value of particular information sources; (2) the vulnerability of families and (3) the need for validated evidence. It was concluded, therefore, that information should be available through a multitude of modalities, accounting for the educational ability and economic status of families. The information should also be communicated in an accessible style, should be presented as trustworthy and clinical professionals may play a key role in translating information. Such information also needs to account for practical problems inherent to having a child with ASD, including time constraints and fatigue. © The Author(s) 2014.

Quantifying economic benefits for rail infrastructure projects.

DOT National Transportation Integrated Search

2014-10-01

This project identifies metrics for measuring the benefit of rail infrastructure projects for key : stakeholders. It is important that stakeholders with an interest in community economic development play an active : role in the development of the rai...

USDOT guidance summary for connected vehicle deployments : participant training and stakeholder education.

DOT National Transportation Integrated Search

2016-07-01

This document provides guidance material in regards to the Participant Training and Stakeholder Education Plan forthe CV Pilots Deployment Concept Development Phase. The guidance provides key requirements and references indeveloping the training plan...

Final Technical Report: "Achieving Regional Energy Efficiency Potential in the Southeast”

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

Mahoney, Mandy

The overall objective of this award was to facilitate sharing of DOE resources and best practices as well as provide technical assistance to key stakeholders to support greater compliance with energy efficiency standards and increased energy savings. The outcomes of this award include greater awareness among key stakeholders on energy efficiency topics, increased deployment and utilization of DOE resources, and effective policies and programs to support energy efficiency in the Southeast.

Stakeholders' contributions to tailored implementation programs: an observational study of group interview methods.

PubMed

Huntink, Elke; van Lieshout, Jan; Aakhus, Eivind; Baker, Richard; Flottorp, Signe; Godycki-Cwirko, Maciek; Jäger, Cornelia; Kowalczyk, Anna; Szecsenyi, Joachim; Wensing, Michel

2014-12-06

Tailored strategies to implement evidence-based practice can be generated in several ways. In this study, we explored the usefulness of group interviews for generating these strategies, focused on improving healthcare for patients with chronic diseases. Participants included at least four categories of stakeholders (researchers, quality officers, health professionals, and external stakeholders) in five countries. Interviews comprised brainstorming followed by a structured interview and focused on different chronic conditions in each country. We compared the numbers and types of strategies between stakeholder categories and between interview phases. We also determined which strategies were actually used in tailored intervention programs. In total, 127 individuals participated in 25 group interviews across five countries. Brainstorming generated 8 to 120 strategies per group; structured interviews added 0 to 55 strategies. Healthcare professionals and researchers provided the largest numbers of strategies. The type of strategies for improving healthcare practice did not differ systematically between stakeholder groups in four of the five countries. In three out of five countries, all components of the chosen intervention programs were mentioned by the group of researchers. Group interviews with different stakeholder categories produced many strategies for tailored implementation of evidence-based practice, of which the content was largely similar across stakeholder categories.

Stakeholder Perceptions of Welfare Issues and Indicators for Extensively Managed Sheep in Australia.

PubMed

Doughty, Amanda K; Coleman, Grahame J; Hinch, Geoff N; Doyle, Rebecca E

2017-03-23

An online survey was designed to form the basis of a framework for the welfare assessment of extensively managed sheep in Australia. The survey focused on welfare compromise and useful welfare indicators. A total of 952 people completed the survey in its entirety, representing four stakeholder groups: Public (53.6%), Producer (27.4%), Scientist (9.9%), and Service provider (9.1%). Animal welfare was considered to be important by all participating groups in this survey (average score of 3.78/4). Respondents felt the welfare of grazing sheep was generally adequate but improvement was desired (2.98/5), with female members of the public rating sheep welfare significantly worse than other respondents ( p < 0.05). Environmental issues were considered to pose the greatest risk to welfare (3.87/5), followed by heat stress (3.79), lameness (3.57) and husbandry practices (3.37). Key indicators recognised by all respondents were those associated with pain and fear (3.98/5), nutrition (4.23), mortality/management (4.27), food on offer (4.41) and number of illness/injures in a flock (4.33). There were gender and stakeholder differences in the perceived importance of both welfare issues and indicators with women and the public consistently rating issues (all p < 0.01) and indicators (all p < 0.05) to be of greater significance than other respondents. These results highlight the importance of including all stakeholders and an even balance of genders when developing a welfare framework that can address both practical and societal concerns.

Improving Group Work Practices in Teaching Life Sciences: Trialogical Learning

NASA Astrophysics Data System (ADS)

Tammeorg, Priit; Mykkänen, Anna; Rantamäki, Tomi; Lakkala, Minna; Muukkonen, Hanni

2017-08-01

Trialogical learning, a collaborative and iterative knowledge creation process using real-life artefacts or problems, familiarizes students with working life environments and aims to teach skills required in the professional world. We target one of the major limitation factors for optimal trialogical learning in university settings, inefficient group work. We propose a course design combining effective group working practices with trialogical learning principles in life sciences. We assess the usability of our design in (a) a case study on crop science education and (b) a questionnaire for university teachers in life science fields. Our approach was considered useful and supportive of the learning process by all the participants in the case study: the students, the stakeholders and the facilitator. Correspondingly, a group of university teachers expressed that the trialogical approach and the involvement of stakeholders could promote efficient learning. In our case in life sciences, we identified the key issues in facilitating effective group work to be the design of meaningful tasks and the allowance of sufficient time to take action based on formative feedback. Even though trialogical courses can be time consuming, the experience of applying knowledge in real-life cases justifies using the approach, particularly for students just about to enter their professional careers.

Not the last word: dissemination strategies for patient-centred research in nursing

PubMed Central

Hagan, Teresa L.; Schmidt, Karen; Ackison, Guyanna R.; Murphy, Megan; Jones, Jennifer R.

2017-01-01

Introduction Research results hold value for many stakeholders including researchers, patient populations, advocacy organizations, and community groups. The aim of this study is to describe our research team’s systematic process to designing a dissemination strategy for a completed research study. Methodology We organized a dissemination event to feed the results of our study to participants and stakeholders and collect feedback regarding our study. We applied the Agency for Healthcare Research and Quality’s dissemination framework to guide the development of the event and collected participant feedback during the event. Results We describe our dissemination strategy along with attendees’ feedback and suggestions for our research as an example of a way to design a patient- and community-focused dissemination. We explain the details of our dissemination strategy including (a) our process of reporting a large research study into a stakeholder event, (b) stakeholder feedback collected at the event, and (c) the translation of feedback into our research team’s research. We also describe challenges encountered during the dissemination process and ways to handle issues such as logistics, funding, and staff. Conclusions This analysis provides key insights and practical advice for researchers looking for innovative ways to disseminate their findings within the lay and scientific communities. PMID:29081824

Explaining differences in stakeholder take up of disease management programmes: A comparative analysis of policy implementation in Austria and Germany.

PubMed

Schang, Laura; Thomson, Sarah; Czypionka, Thomas

2016-03-01

Understanding why policies to improve care for people with chronic conditions fail to be implemented is a pressing issue in health system reform. We explore reasons for the relatively high uptake of disease management programmes (DMPs) in Germany, in contrast to low uptake in Austria. We focus on the motivation, information and power of key stakeholder groups (payers, physician associations, individual physicians and patients). We conducted a comparative stakeholder analysis using qualitative data from interviews (n=15 in Austria and n=26 in Germany), legal documents and media reports. Stakeholders in Germany appeared to have systematically stronger motivation, exposure to more positive information about DMPs and better ability to implement DMPs than their counterparts in Austria. Policy in Austria focused on financial incentives to physicians only. In Germany, limited evidence about the quality improvement and cost savings potential of DMPs was mitigated by strong financial incentives to sickness funds but proved a fundamental obstacle in Austria. Efforts to promote DMPs should seek to ensure the cooperation of payers and patients, not just physicians, using a mix of financial and non-financial instruments suited to the context. A singular focus on financially incentivising providers is unlikely to stimulate uptake of DMPs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Stakeholders' Cooperation in the Study Programme Quality Assurance: Theory and Practice in Lithuania

ERIC Educational Resources Information Center

Pileicikiene, Nora

2011-01-01

The cooperation of various stakeholders' groups is a prerequisite to develop and realise high-quality study programmes, i.e. during studies to develop skills that are relevant to the labour market and social life. In order to achieve effective stakeholders' cooperation, it is necessary to identify stakeholder's groups relevant to a study programme…

Stakeholder Definition for Indonesian Integrated Agriculture Information System (IAIS)

NASA Astrophysics Data System (ADS)

Budi Santoso, Halim; Delima, Rosa

2017-03-01

Stakeholders plays an important roles to determine the system requirements. Stakeholders are people or organizations that has an interest to the enterprise. Timely and effective consultation of relevant stakeholders is a paramount importance in the requirements engineering process. From the research and analysis of system stakeholder finds that there are four stakeholder groups in IAIS. Stakeholder analysis is being implemented by identifying stakeholder, stakeholder category, and analysis interaction between stakeholders.

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.

The use of a policy dialogue to facilitate evidence-informed policy development for improved access to care: the case of the Winnipeg Central Intake Service (WCIS).

PubMed

Damani, Zaheed; MacKean, Gail; Bohm, Eric; DeMone, Brie; Wright, Brock; Noseworthy, Tom; Holroyd-Leduc, Jayna; Marshall, Deborah A

2016-10-18

Policy dialogues are critical for developing responsive, effective, sustainable, evidence-informed policy. Our multidisciplinary team, including researchers, physicians and senior decision-makers, comprehensively evaluated The Winnipeg Central Intake Service, a single-entry model in Winnipeg, Manitoba, to improve patient access to hip/knee replacement surgery. We used the evaluation findings to develop five evidence-informed policy directions to help improve access to scheduled clinical services across Manitoba. Using guiding principles of public participation processes, we hosted a policy roundtable meeting to engage stakeholders and use their input to refine the policy directions. Here, we report on the use and input of a policy roundtable meeting and its role in contributing to the development of evidence-informed policy. Our evidence-informed policy directions focused on formal measurement/monitoring of quality, central intake as a preferred model for service delivery, provincial scope, transparent processes/performance indicators, and patient choice of provider. We held a policy roundtable meeting and used outcomes of facilitated discussions to refine these directions. Individuals from our team and six stakeholder groups across Manitoba participated (n = 44), including patients, family physicians, orthopaedic surgeons, surgical office assistants, Winnipeg Central Intake team, and administrators/managers. We developed evaluation forms to assess the meeting process, and collected decision-maker partners' perspectives on the value of the policy roundtable meeting and use of policy directions to improve access to scheduled clinical services after the meeting, and again 15 months later. We analyzed roundtable and evaluation data using thematic analysis to identify key themes. Four key findings emerged. First, participants supported all policy directions, with revisions and key implementation considerations identified. Second, participants felt the policy roundtable meeting achieved its purpose (to engage stakeholders, elicit feedback, refine policy directions). Third, our decision-maker partners' expectations of the policy roundtable meeting were exceeded; they re-affirmed its value and described the refined policy directions as foundational to establishing the vocabulary, vision and framework for improving access to scheduled clinical services in Manitoba. Finally, our adaptation of key design elements was conducive to discussion of issues surrounding access to care. Our policy roundtable process was an effective tool for acquiring broad input from stakeholders, refining policy directions and forming the necessary consensus starting points to move towards evidence-informed policy.

Meeting the Tobacco Cessation Coverage Requirement of the Patient Protection and Affordable Care Act: State Smoking Cessation Quitlines and Cost Sharing.

PubMed

Lemaire, Robin H; Bailey, Linda; Leischow, Scott J

2015-11-01

We explored whether various key stakeholders considered cost sharing with state telephone-based tobacco cessation quitlines, because including tobacco cessation services as part of the required essential health benefits is a new requirement of the Patient Protection and Affordable Care Act (ACA). We analyzed qualitative data collected from interviews conducted in April and May of 2014 with representatives of state health departments, quitline service providers, health plans, and insurance brokers in 4 US states. State health departments varied in the strategies they considered the role their state quitline would play in meeting the ACA requirements. Health plans and insurance brokers referred to state quitlines because they were perceived as effective and free, but in 3 of the 4 states, the private stakeholder groups did not consider cost sharing. If state health departments are going to initiate cost-sharing agreements with private insurance providers, then they will need to engage a broad array of stakeholders and will need to overcome the perception that state quitline services are free.

Meeting the Tobacco Cessation Coverage Requirement of the Patient Protection and Affordable Care Act: State Smoking Cessation Quitlines and Cost Sharing

PubMed Central

Bailey, Linda; Leischow, Scott J.

2015-01-01

Objectives. We explored whether various key stakeholders considered cost sharing with state telephone-based tobacco cessation quitlines, because including tobacco cessation services as part of the required essential health benefits is a new requirement of the Patient Protection and Affordable Care Act (ACA). Methods. We analyzed qualitative data collected from interviews conducted in April and May of 2014 with representatives of state health departments, quitline service providers, health plans, and insurance brokers in 4 US states. Results. State health departments varied in the strategies they considered the role their state quitline would play in meeting the ACA requirements. Health plans and insurance brokers referred to state quitlines because they were perceived as effective and free, but in 3 of the 4 states, the private stakeholder groups did not consider cost sharing. Conclusions. If state health departments are going to initiate cost-sharing agreements with private insurance providers, then they will need to engage a broad array of stakeholders and will need to overcome the perception that state quitline services are free. PMID:26447918

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.

Communication Challenges During the Development and Introduction of a New Meningococcal Vaccine in Africa.

PubMed

Berlier, Monique; Barry, Rodrigue; Shadid, John; Sirica, Coimbra; Brunier, Alison; Hasan, Hayatee; Bouma, Enricke

2015-11-15

A new group A meningococcal conjugate vaccine was developed to eliminate deadly meningitis epidemics in sub-Saharan Africa. From the outset of the project, advocacy and communication strategies were developed and adjusted as the project evolved in Europe, Africa, India, and the United States. Communications efforts were evidence-based, and involved partnerships with the media and various stakeholders including African ministries of health, the World Health Organization, UNICEF, Gavi, the Centers for Disease Control and Prevention, and Médecins Sans Frontières. The implementation of an integrated communication strategy ensured the active cooperation of stakeholders while providing an organized and defined format for the dissemination of project-related developmental activities and the successful introduction of the vaccine. Early in the project, a communications strategy that engaged stakeholders and potential supporters was developed. The strategy was implemented and adapted as the project matured. Linked communication proved to be key to the successful wide-scale introduction of the PsA-TT (MenAfriVac) vaccine in Africa. © 2015 World Health Organization; licensee Oxford Journals.

Communication Challenges During the Development and Introduction of a New Meningococcal Vaccine in Africa

PubMed Central

Berlier, Monique; Barry, Rodrigue; Shadid, John; Sirica, Coimbra; Brunier, Alison; Hasan, Hayatee; Bouma, Enricke

2015-01-01

Background. A new group A meningococcal conjugate vaccine was developed to eliminate deadly meningitis epidemics in sub-Saharan Africa. Methods. From the outset of the project, advocacy and communication strategies were developed and adjusted as the project evolved in Europe, Africa, India, and the United States. Communications efforts were evidence-based, and involved partnerships with the media and various stakeholders including African ministries of health, the World Health Organization, UNICEF, Gavi, the Centers for Disease Control and Prevention, and Médecins Sans Frontières. Results. The implementation of an integrated communication strategy ensured the active cooperation of stakeholders while providing an organized and defined format for the dissemination of project-related developmental activities and the successful introduction of the vaccine. Conclusions. Early in the project, a communications strategy that engaged stakeholders and potential supporters was developed. The strategy was implemented and adapted as the project matured. Linked communication proved to be key to the successful wide-scale introduction of the PsA-TT (MenAfriVac) vaccine in Africa. PMID:26553674

Stakeholder Meetings on Black Carbon from Diesel Sources in the Russian Arctic

EPA Pesticide Factsheets

From January 28-February 1, 2013, EPA and its partners held meetings in Murmansk and Moscow with key Russian stakeholders to gather input into the project’s emissions inventory methodologies and potential pilot project ideas.

Developing Health-Related Indicators of Climate Change: Australian Stakeholder Perspectives.

PubMed

Navi, Maryam; Hansen, Alana; Nitschke, Monika; Hanson-Easey, Scott; Pisaniello, Dino

2017-05-22

Climate-related health indicators are potentially useful for tracking and predicting the adverse public health effects of climate change, identifying vulnerable populations, and monitoring interventions. However, there is a need to understand stakeholders' perspectives on the identification, development, and utility of such indicators. A qualitative approach was used, comprising semi-structured interviews with key informants and service providers from government and non-government stakeholder organizations in South Australia. Stakeholders saw a need for indicators that could enable the monitoring of health impacts and time trends, vulnerability to climate change, and those which could also be used as communication tools. Four key criteria for utility were identified, namely robust and credible indicators, specificity, data availability, and being able to be spatially represented. The variability of risk factors in different regions, lack of resources, and data and methodological issues were identified as the main barriers to indicator development. This study demonstrates a high level of stakeholder awareness of the health impacts of climate change, and the need for indicators that can inform policy makers regarding interventions.

Stakeholder attitudes and needs regarding cell-free fetal DNA testing.

PubMed

Hill, Melissa; Lewis, Celine; Chitty, Lyn S

2016-04-01

To explore stakeholder views on cell-free DNA testing and highlight findings important for successful implementation and the provision of best practice in counseling. Noninvasive tests based on the analysis of cell-free fetal DNA are now widely available in clinical practice and applications are expanding rapidly. It is essential that stakeholder views are considered in order to identify and address any ethical and social issues. We provide an overview of stakeholder viewpoints and then focus on the key issues of informed decision making, test uptake, service delivery and information sources. Stakeholders are positive about the introduction of cell-free fetal DNA testing into clinical practice. They describe both practical and psychological benefits arising from tests that are safe and can potentially be performed earlier in pregnancy. Key concerns, which include the potential for these tests to have a negative impact on informed decision making and increased societal pressure to have testing, can be addressed through careful parent-directed counseling. As applications for these tests expand it is increasingly important to develop innovative approaches to facilitate good understanding for parents who are offered noninvasive prenatal testing.

Survey of the perceptions of key stakeholders on the attributes of the South African Notifiable Diseases Surveillance System.

PubMed

Benson, F G; Musekiwa, A; Blumberg, L; Rispel, L C

2016-10-25

An effective and efficient notifiable diseases surveillance system (NDSS) is essential for a rapid response to disease outbreaks, and the identification of priority diseases that may cause national, regional or public health emergencies of international concern (PHEICs). Regular assessments of country-based surveillance system are needed to enable countries to respond to outbreaks before they become PHEICs. As part of a broader evaluation of the NDSS in South Africa, the aim of the study was to determine the perceptions of key stakeholders on the national NDSS attributes of acceptability, flexibility, simplicity, timeliness and usefulness. During 2015, we conducted a nationally representative cross-sectional survey of communicable diseases coordinators and surveillance officers, as well as members of NDSS committees. Individuals with less than 1 year experience of the NDSS were excluded. Consenting participants completed a self-administered questionnaire. The questionnaire elicited information on demographic information and perceptions of the NDSS attributes. Data were analysed using descriptive statistics and the unconditional logistic regression model. Most stakeholders interviewed (53 %, 60/114) were involved in disease control and response. The median number of years of experience with the NDSS was 11 years (inter-quartile range (IQR): 5 to 20 years). Regarding the NDSS attributes, 25 % of the stakeholders perceived the system to be acceptable, 51 % to be flexible, 45 % to be timely, 61 % to be useful, and 74 % to be simple. Health management stakeholders perceived the system to be more useful and timely compared to the other stakeholders. Those with more years of experience were less likely to perceive the NDSS system as acceptable (OR 0.91, 95 % CI: 0.84-1.00, p = 0.041); those in disease detection were less likely to perceive it as timely (OR 0.10, 95 % CI: 0.01-0.96, p = 0.046) and those participating in National Outbreak Response Team were less likely to perceive it as useful (OR 0.38, 95 % CI: 0.16-0.93, p = 0.034). The overall poor perceptions of key stakeholder on the system attributes are a cause for concern. The study findings should inform the revitalisation and reform of the NDSS in South Africa, done in consultation and partnership with the key stakeholders.

Fulfilling the social contract between medical schools and the public.

PubMed

McCurdy, L; Goode, L D; Inui, T S; Daugherty, R M; Wilson, D E; Wallace, A G; Weinstein, B M; Copeland, E M

1997-12-01

To gain a better understanding of the effects of medical schools related to transformations in medical practice, science, and public expectations, the Association of American Medical Colleges (AAMC) established the Advisory Panel on the Mission and Organization of Medical Schools (APMOMS) in 1994. Recognizing the privileges academic medicine enjoys as well as the power of and the strain on its special relationship with the American public, APMOMS formed the Working Group on Fulfilling the Social Contract. That group focused on the question: What are the roles and responsibilities involved in the social contract between medical schools and various interested communities and constituencies? This article reports the working group's findings. The group describes the historical and philosophical reasons supporting the concept of a social contract and asserts that medical schools have individual and collective social contracts with various subsets of the public, referred to as "stakeholders." Obligations derive implicitly from the generous public funding and other benefits medical school receive. Schools' primary obligation is to improve the nation's health. This obligation is carried out most directly by educating the next generation of physicians and biomedical scientists in a manner that instills appropriate professional attitudes, values, and skills. Group members identified 27 core stakeholders (e.g., government, patients, local residents, etc.) and outlined the expectations those stakeholders have of medical schools and the expectations medical schools have of those stakeholders. The group conducted a survey to test how leaders at medical schools responded to the notion of a social contract, to gather data on school leaders' perceptions of what groups they considered their schools' most important stakeholders, and to determine how likely it was that the schools' and the stakeholders expectations of each other were being met. Responses from 69 deans suggested that the survey provoked thinking about the broad issue of the social contract and stakeholders. Leaders on the same campuses disagreed about what groups were the most important stakeholders. Similarly, the responses revealed a lack of national consensus about the most important stakeholders, although certain groups were consistently included in the responses. The group concludes that medical school leaders should examine their assumptions and perspectives about their institutions' stakeholders and consider the interests of the stakeholders in activities such as strategic planning, policymaking, and program development.

The Fisheries and Marine Renewable Energy Working Group: creating an agenda for improved co-existence.

NASA Astrophysics Data System (ADS)

Campbell, M. S.; De Groot, J.; Ashley, M.; Rodwell, L.

2014-12-01

As an emerging industry, Marine Renewable Energy (MRE) is expected to play a major contributory role if the UK is to successfully reach its desired target of renewable energy production by 2020. However, due to the competing objectives and priorities of MRE and other industries, for example fisheries, and in the delivering of conservation measures, the demand for space within our marine landscape is increasing, and interactions are inevitable. In order to promote better understanding of the challenges in resolving interactions between these industries, a Fisheries and Marine Renewable Energy Working Group was set up under the Natural Environment Research Council Marine Renewable Energy Knowledge Exchange Programme (NERC MREKEP). The Working Group carried out an initial scoping survey in order to summarise recent and current research activities and identify key issues and topics in the fields of fisheries and MRE interactions. Mixed stakeholder groups discussed four primary topics: priority issues; barriers to progress; problem mitigation; and thoughts on the consultation process. Points of discussion were categorized into themes to aid analysis and protocol development. These themes were: culture, community and economy; legislation and rights; data and information; and collaboration and communication. Subsequent invited stakeholder and expert panel workshops were held to facilitate knowledge exchange between fisheries and development of MRE in order to identify priority research issues, knowledge gaps and collaboration needs. Four group sessions identified: practical steps to aid interaction between industries; barriers, opportunities and solutions; an agenda for action, timescales and partners; and action points carried forward by each stakeholder group. This Working Group, guided under the MREKEP banner, is the first of its kind in the UK, bringing together individuals from a nationally diverse group of academics, regulators, policy makers and representatives from fisheries, MRE sectors and conservation bodies. Therefore, it has the potential, for the first time, to develop effective guidelines and protocols for both mitigation and assessment of displacement of fishing effort, for the entire life cycle of MRE projects.

How Do Stakeholder Groups' Views Vary on Technology in Language Learning?

ERIC Educational Resources Information Center

Trace, Jonathan; Brown, James Dean; Rodriguez, Julio

2018-01-01

This study examines how technology is perceived by different stakeholder groups in The Language Flagship programs. We administered questionnaires to three stakeholder groups: 14 directors, 34 instructors, and 100 learners at a variety of institutions with three goals: (a) to investigate what technologies the directors, instructors, and learners…

Issues for interpreting external stakeholder feedback on restructuring NCIC's research programs.

PubMed

Ashbury, F D; Iverson, D C; Shephard, P J

1995-03-01

The National Cancer Institute of Canada surveyed members of its stakeholder groups on a number of issues pertaining to restructuring research programs. While it was hoped that the survey would ensure input from its primary stakeholder groups and thereby facilitate decision-making on critical issues like distribution of funds and research awards, there is reason to believe this may not have occurred. Some of the stakeholder groups seemed to be over-represented in the respondent population and the effect of this on the results was therefore examined. Analysis revealed several important issues: 1) a clear definition of who constitutes a "stakeholder" needs to be developed when stakeholder input-gathering is being contemplated; 2) multi-faceted strategies need to be developed to gain input from stakeholders; 3) potential sources of bias can emerge from the various techniques used to gather feedback from stakeholders; and 4) a clear outline of how the feedback is to be used in the decision-making process needs to be determined.

Development of Enriched Core Competencies for Health Services and Policy Research: Training for Stronger Career Readiness and Greater Impact.

PubMed

Bornstein, Stephen; Heritage, Melissa; Chudak, Amanda; Tamblyn, Robyn; McMahon, Meghan; Brown, Adalsteinn

2018-03-11

To develop an enriched set of core competencies for health services and policy research (HSPR) doctoral training that will help graduates maximize their impact across a range of academic and nonacademic work environments and roles. Data were obtained from multiple sources, including literature reviews, key informant interviews, stakeholder consultations, and Expert Working Group (EWG) meetings between January 2015 and March 2016. The study setting is Canada. The study used qualitative methods and an iterative development process with significant stakeholder engagement throughout. The literature reviews, key informant interviews, existing data on graduate career trajectories, and EWG deliberations informed the identification of career profiles for HSPR graduates and the competencies required to succeed in these roles. Stakeholder consultations were held to vet, refine, and validate the competencies. The EWG reached consensus on six sectors and eight primary roles in which HSPR doctoral graduates can bring value to employers and the health system. Additionally, 10 core competencies were identified that should be included or further emphasized in the training of HSPR doctoral students to increase their preparedness and potential for impact in a variety of roles within and outside of traditional academic workplaces. The results offer an expanded view of potential career paths for HSPR doctoral graduates and provide recommendations for an expanded set of core competencies that will better equip graduates to maximize their impact on the health system. © Health Research and Educational Trust.

Advancing palliative care in the Uganda health system: an evidence-based policy brief.

PubMed

Nabudere, Harriet; Obuku, Ekwaro; Lamorde, Mohammed

2014-12-01

This paper describes the development and findings for a policy brief on "Advancing the Integration of Palliative Care into the National Health System" and the subsequent use of this report. Key stakeholders involved with palliative care helped identify the problem and potential policy solutions to scale up these services within the health system. A working group of national stakeholder representatives and external reviewers commented on and contributed to successive drafts of the report. Research describing the problem, policy options and implementation considerations was identified by reviewing government documents, routinely collected data, electronic literature searches, contact with key informants, and reviewing the reference lists of relevant documents that were retrieved. The palliative burden is not only high but increasing due to the rise in population and life expectancy. A few options for holistic, supportive care include: Home-based care increases chances of a peaceful death for the terminally ill surrounded by their loved ones; supporting informal caregivers improves their quality of life and discharge planning reduces unscheduled admissions and has the potential to free up capacity for acute care services. A combination of strategies is needed to effectively implement the proposed options as discussed further in this article. The policy brief report was used as a background document for two stakeholder dialogues whose main outcome was that a comprehensive national palliative care policy should be instituted to include all the options, which need to be integrated within the public health system. A draft policy is now in process.

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

Key Points to Facilitate the Adoption of Computer-Based Assessments.

PubMed

Burr, S A; Chatterjee, A; Gibson, S; Coombes, L; Wilkinson, S

2016-01-01

There are strong pedagogical arguments in favor of adopting computer-based assessment. The risks of technical failure can be managed and are offset by improvements in cost-effectiveness and quality assurance capability. Academic, administrative, and technical leads at an appropriately senior level within an institution need to be identified, so that they can act as effective advocates. All stakeholder groups need to be represented in undertaking a detailed appraisal of requirements and shortlisting software based on core functionality, summative assessment life cycle needs, external compatibility, security, and usability. Any software that is a candidate for adoption should be trialed under simulated summative conditions, with all stakeholders having a voice in agreeing the optimum solution. Transfer to a new system should be carefully planned and communicated, with a programme of training established to maximize the success of adoption.

Key Points to Facilitate the Adoption of Computer-Based Assessments

PubMed Central

Burr, S.A.; Chatterjee, A.; Gibson, S.; Coombes, L.; Wilkinson, S.

2016-01-01

There are strong pedagogical arguments in favor of adopting computer-based assessment. The risks of technical failure can be managed and are offset by improvements in cost-effectiveness and quality assurance capability. Academic, administrative, and technical leads at an appropriately senior level within an institution need to be identified, so that they can act as effective advocates. All stakeholder groups need to be represented in undertaking a detailed appraisal of requirements and shortlisting software based on core functionality, summative assessment life cycle needs, external compatibility, security, and usability. Any software that is a candidate for adoption should be trialed under simulated summative conditions, with all stakeholders having a voice in agreeing the optimum solution. Transfer to a new system should be carefully planned and communicated, with a programme of training established to maximize the success of adoption. PMID:29349322

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

Decision aids for randomised controlled trials: a qualitative exploration of stakeholders’ views

PubMed Central

Gillies, Katie; Skea, Zoë C; Campbell, Marion K

2014-01-01

Objectives To explore stakeholders’ perceptions of decision aids designed to support the informed consent decision-making process for randomised controlled trials. Design Qualitative semistructured interviews. Participants were provided with prototype trial decision aids in advance to stimulate discussion. Interviews were analysed using an established interpretive approach. Participants 23 stakeholders: Trial Managers (n=5); Research Nurses (n=5); Ethics Committee Chairs (n=5); patients (n=4) and Clinical Principal Investigators (n=4). Setting Embedded within two ongoing randomised controlled trials. All interviews conducted with UK-based participants. Results Certain key aspects (eg, values clarification exercises, presentation of probabilities, experiences of others and balance of options) in the prototype decision aids were perceived by all stakeholders as having a significant advantage (over existing patient information leaflets) in terms of supporting well informed appropriate decisions. However, there were some important differences between the stakeholder groups on specific content (eg, language used in the section on positive and negative features of taking part in a trial and the overall length of the trial decision aids). Generally the stakeholders believed trial decision aids have the potential to better engage potential participants in the decision-making process and allow them to make more personally relevant decisions about their participation. Conclusions Compared to existing patient information leaflets, stakeholders perceived decision aids for trial participation to have the potential to promote a more ‘informed’ decision-making process. Further efforts to develop, refine and formally evaluate trial decision aids should be explored. PMID:25138811

Stakeholder perceptions of a total market approach to family planning in Nicaragua.

PubMed

Drake, Jennifer Kidwell; Espinoza, Henry; Suraratdecha, Chutima; Lacayo, Yann; Keith, Bonnie M; Vail, Janet G

2011-05-01

To assess private-sector stakeholders' and donors' perceptions of a total market approach (TMA) to family planning in Nicaragua in the context of decreased funding; to build evidence for potential strategies and mechanisms for TMA implementation (including public-private partnerships (PPPs)); and to identify information gaps and future priorities for related research and advocacy. A descriptive exploratory study was conducted in various locations in Nicaragua from March to April 2010. A total of 24 key private-sector stakeholders and donors were interviewed and their responses analyzed using two questionnaires and a stakeholder analysis tool (PolicyMakerTM software). All survey participants supported a TMA, and public-private collaboration, in family planning in Nicaragua. Based on the survey responses, opportunities for further developing PPPs for family planning include building on and expanding existing governmental frameworks, such as Nicaragua's current coordination mechanism for contraceptive security. Obstacles include the lack of ongoing government engagement with the commercial (for-profit) sector and confusion about regulations for its involvement in family planning. Strategies for strengthening existing PPPs include establishing a coordination mechanism specifically for the commercial sector and collecting and disseminating evidence supporting public-private collaboration in family planning. There was no formal or absolute opposition to a TMA or PPPs in family planning in Nicaragua among a group of diverse nongovernmental stakeholders and donors. This type of study can help identify strategies to mobilize existing and potential advocates in achieving articulated policy goals, including diversification of funding sources for family planning to achieve contraceptive security.

Framing Extreme Event Attribution from the Bottom up - an Enquiry into the Social Representations of key stakeholders, of the Press and of Climate Scientists.

NASA Astrophysics Data System (ADS)

Vanderlinden, J. P.; Fellmer, M.; Capellini, N.; Meinke, I.; Remvikos, Y.; Bray, D.; Pacteau, C.; Von Storch, H.

2014-12-01

Attribution of extreme weather events has recently generated a lot of interest simultaneously within the general public, the scientific community, and stakeholders affected by meteorological extremes. This interest calls for the need to explore the potential convergence of the current atttribution science with the desire and needs of stakeholders. Such an euiry contributes to the development of climate services aiming at quantifying the human responsibility for particular events. Through interviews with climate scientists, through the analysis of the press coverage of extreme meteorological events, and through stakeholder (private sector, covernment services and local and regional government) focus groups, we analyze how social representations of the concepts associated with extreme event attribution are theorized. From the corpuses generated in the course of this enquiry, we build up a grounded, bottom-up, theorization of extreme weather event attribution. This bottom-up theorization allows for a framing of the potential climate services in a way that is attuned to the needs and expectations of the stakeholders. From apparently simple formulations: "what is an extreme event?", "what makes it extreme?", "what is meant by attribution of extreme weather events?", "what do we want to attribute?", "what is a climate service?", we demonstrate the polysemy of these terms and propose ways to address the challenges associated with the juxtaposition of four highly loaded concepts: extreme - event - attribution - climate services.

How ownership rights over microorganisms affect infectious disease control and innovation: A root-cause analysis of barriers to data sharing as experienced by key stakeholders.

PubMed

Ribeiro, Carolina Dos S; van Roode, Martine Y; Haringhuizen, George B; Koopmans, Marion P; Claassen, Eric; van de Burgwal, Linda H M

2018-01-01

Genetic information of pathogens is an essential input for infectious disease control, public health and for research. Efficiency in preventing and responding to global outbreaks relies on timely access to such information. Still, ownership barriers stand in the way of timely sharing of genetic data from pathogens, frustrating efficient public health responses and ultimately the potential use of such resources in innovations. Under a One Health approach, stakeholders, their interests and ownership issues are manifold and need to be investigated. We interviewed key actors from governmental and non-governmental bodies to identify overlapping and conflicting interests, and the overall challenges for sharing pathogen data, to provide essential inputs to the further development of political and practical strategies for improved data sharing practices. To identify and prioritize barriers, 52 Key Opinion Leaders were interviewed. A root-cause analysis was performed to identify causal relations between barriers. Finally, barriers were mapped to the innovation cycle reflecting how they affect the range of surveillance, innovation, and sharing activities. Four main barrier categories were found: compliance to regulations, negative consequences, self-interest, and insufficient incentives for compliance. When grouped in sectors (research institutes, public health organizations, supra-national organizations and industry) stakeholders appear to have similar interests, more than when grouped in domains (human, veterinary and food). Considering the innovation process, most of barriers could be mapped to the initial stages of the innovation cycle as sampling and sequencing phases. These are stages of primary importance to outbreak control and public health response. A minority of barriers applied to later stages in the innovation cycle, which are of more importance to product development. Overall, barriers are complex and entangled, due to the diversity of causal factors and their crosscutting features. Therefore, barriers must be addressed in a comprehensive and integrated manner. Stakeholders have different interests highlighting the diversity in motivations for sharing pathogen data: prioritization of public health, basic research, economic welfare and/or innovative capacity. Broad inter-sectorial discussions should start with the alignment of these interests within sectors. The improved sharing of pathogen data, especially in upstream phases of the innovation process, will generate substantial public health benefits through increased availability of data to inform surveillance systems, as well as to allow the (re-)use of data for the development of medical countermeasures to control infectious diseases.

How ownership rights over microorganisms affect infectious disease control and innovation: A root-cause analysis of barriers to data sharing as experienced by key stakeholders

PubMed Central

Haringhuizen, George B.; Koopmans, Marion P.; Claassen, Eric; van de Burgwal, Linda H. M.

2018-01-01

Background Genetic information of pathogens is an essential input for infectious disease control, public health and for research. Efficiency in preventing and responding to global outbreaks relies on timely access to such information. Still, ownership barriers stand in the way of timely sharing of genetic data from pathogens, frustrating efficient public health responses and ultimately the potential use of such resources in innovations. Under a One Health approach, stakeholders, their interests and ownership issues are manifold and need to be investigated. We interviewed key actors from governmental and non-governmental bodies to identify overlapping and conflicting interests, and the overall challenges for sharing pathogen data, to provide essential inputs to the further development of political and practical strategies for improved data sharing practices. Methods & findings To identify and prioritize barriers, 52 Key Opinion Leaders were interviewed. A root-cause analysis was performed to identify causal relations between barriers. Finally, barriers were mapped to the innovation cycle reflecting how they affect the range of surveillance, innovation, and sharing activities. Four main barrier categories were found: compliance to regulations, negative consequences, self-interest, and insufficient incentives for compliance. When grouped in sectors (research institutes, public health organizations, supra-national organizations and industry) stakeholders appear to have similar interests, more than when grouped in domains (human, veterinary and food). Considering the innovation process, most of barriers could be mapped to the initial stages of the innovation cycle as sampling and sequencing phases. These are stages of primary importance to outbreak control and public health response. A minority of barriers applied to later stages in the innovation cycle, which are of more importance to product development. Conclusion Overall, barriers are complex and entangled, due to the diversity of causal factors and their crosscutting features. Therefore, barriers must be addressed in a comprehensive and integrated manner. Stakeholders have different interests highlighting the diversity in motivations for sharing pathogen data: prioritization of public health, basic research, economic welfare and/or innovative capacity. Broad inter-sectorial discussions should start with the alignment of these interests within sectors. The improved sharing of pathogen data, especially in upstream phases of the innovation process, will generate substantial public health benefits through increased availability of data to inform surveillance systems, as well as to allow the (re-)use of data for the development of medical countermeasures to control infectious diseases. PMID:29718947

University students as recipients of and contributors to information on climate change: insights from South Africa and implications for well-being.

PubMed

El Zoghbi, Mona Betour; El Ansari, Walid

2014-06-01

This study aimed to enhance the in-depth understanding of the contextual dimensions that shape the relationships between climate change communication approach and youth well-being. The study focused on university students who constitute the key stakeholders and future decision-makers and leaders for managing the long-term climate risks. A total of 10 focus group interviews were conducted with 117 undergraduate and graduate South African university students from over 12 universities located in different provinces of South Africa. In addition, another 16 interviews were also undertaken with university students, 10 interviews with key experts, and 3 youth national events were attended as participant-observation. As recipients of information on climate change, students' well-being was negatively affected by the media's pessimism of communicating risks and the inadequate or restricted networking of communicating solutions and strategies. As contributors to information on climate change, students faced key barriers to their efficacy and agency that entailed socio-cultural inequalities (e.g. race and language) and a lack of formal forums for community recognition, policy consultation and collaboration. In addition, for some students (e.g. journalism students), the lack of sufficient knowledge and skills on climate change and sustainability issues limited their ability to effectively communicate these issues to their audience. Platforms for interactive and reflective discussions, access to innovative technologies and social media, and opportunities for multi-stakeholder partnerships are keys to the success of youth-targeted and youth-initiated communication on climate change.

Summary for Stakeholder Meetings on Black Carbon from Diesel Sources in the Russian Arctic

EPA Pesticide Factsheets

From January 28-February 1, 2013, EPA and its partners held meetings in Murmansk and Moscow with key Russian stakeholders to gather input into the project’s emissions inventory methodologies and potential pilot project ideas.

Capacity building efforts and perceptions for wildlife surveillance to detect zoonotic pathogens: comparing stakeholder perspectives.

PubMed

Schwind, Jessica S; Goldstein, Tracey; Thomas, Kate; Mazet, Jonna A K; Smith, Woutrina A

2014-07-04

The capacity to conduct zoonotic pathogen surveillance in wildlife is critical for the recognition and identification of emerging health threats. The PREDICT project, a component of United States Agency for International Development's Emerging Pandemic Threats program, has introduced capacity building efforts to increase zoonotic pathogen surveillance in wildlife in global 'hot spot' regions where zoonotic disease emergence is likely to occur. Understanding priorities, challenges, and opportunities from the perspectives of the stakeholders is a key component of any successful capacity building program. A survey was administered to wildlife officials and to PREDICT-implementing in-country project scientists in 16 participating countries in order to identify similarities and differences in perspectives between the groups regarding capacity needs for zoonotic pathogen surveillance in wildlife. Both stakeholder groups identified some human-animal interfaces (i.e. areas of high contact between wildlife and humans with the potential risk for disease transmission), such as hunting and markets, as important for ongoing targeting of wildlife surveillance. Similarly, findings regarding challenges across stakeholder groups showed some agreement in that a lack of sustainable funding across regions was the greatest challenge for conducting wildlife surveillance for zoonotic pathogens (wildlife officials: 96% and project scientists: 81%). However, the opportunity for improving zoonotic pathogen surveillance capacity identified most frequently by wildlife officials as important was increasing communication or coordination among agencies, sectors, or regions (100% of wildlife officials), whereas the most frequent opportunities identified as important by project scientists were increasing human capacity, increasing laboratory capacity, and the growing interest or awareness regarding wildlife disease or surveillance programs (all identified by 69% of project scientists). A One Health approach to capacity building applied at local and global scales will have the greatest impact on improving zoonotic pathogen surveillance in wildlife. This approach will involve increasing communication and cooperation across ministries and sectors so that experts and stakeholders work together to identify and mitigate surveillance gaps. Over time, this transdisciplinary approach to capacity building will help overcome existing challenges and promote efficient targeting of high risk interfaces for zoonotic pathogen transmission.

Crisis resolution and home treatment: stakeholders' views on critical ingredients and implementation in England.

PubMed

Morant, Nicola; Lloyd-Evans, Brynmor; Lamb, Danielle; Fullarton, Kate; Brown, Eleanor; Paterson, Beth; Istead, Hannah; Kelly, Kathleen; Hindle, David; Fahmy, Sarah; Henderson, Claire; Mason, Oliver; Johnson, Sonia

2017-07-17

Crisis resolution teams (CRTs) can provide effective home-based treatment for acute mental health crises, although critical ingredients of the model have not been clearly identified, and implementation has been inconsistent. In order to inform development of a more highly specified CRT model that meets service users' needs, this study used qualitative methods to investigate stakeholders' experiences and views of CRTs, and what is important in good quality home-based crisis care. Semi-structured interviews and focus groups were conducted with service users (n = 41), carers (n = 20) and practitioners (CRT staff, managers and referrers; n = 147, 26 focus groups, 9 interviews) in 10 mental health catchment areas in England, and with international CRT developers (n = 11). Data were analysed using thematic analysis. Three domains salient to views about optimal care were identified. 1. The organisation of CRT care: Providing a rapid initial responses, and frequent home visits from the same staff were seen as central to good care, particularly by service users and carers. Being accessible, reliable, and having some flexibility were also valued. Negative experiences of some referral pathways, and particularly lack of staff continuity were identified as problematic. 2. The content of CRT work: Emotional support was at the centre of service users' experiences. All stakeholder groups thought CRTs should involve the whole family, and offer a range of interventions. However, carers often feel excluded, and medication is often prioritised over other forms of support. 3. The role of CRTs within the care system: Gate-keeping admissions is seen as a key role for CRTs within the acute care system. Service users and carers report that recovery is quicker compared to in-patient care. Lack of knowledge and misunderstandings about CRTs among referrers are common. Overall, levels of stakeholder agreement about the critical ingredients of good crisis care were high, although aspects of this were not always seen as achievable. Stakeholders' views about optimal CRT care suggest that staff continuity, carer involvement, and emotional and practical support should be prioritised in service improvements and more clearly specified CRT models.

Development of a comprehensive model for stakeholder management in mental healthcare.

PubMed

Bierbooms, Joyce; Van Oers, Hans; Rijkers, Jeroen; Bongers, Inge

2016-06-20

Purpose - Stakeholder management is not yet incorporated into the standard practice of most healthcare providers. The purpose of this paper is to assess the applicability of a comprehensive model for stakeholder management in mental healthcare organization for more evidence-based (stakeholder) management. Design/methodology/approach - The assessment was performed in two research parts: the steps described in the model were executed in a single case study at a mental healthcare organization in the Netherlands; and a process and effect evaluation was done to find the supporting and impeding factors with regard to the applicability of the model. Interviews were held with managers and directors to evaluate the effectiveness of the model with a view to stakeholder management. Findings - The stakeholder analysis resulted in the identification of eight stakeholder groups. Different expectations were identified for each of these groups. The analysis on performance gaps revealed that stakeholders generally find the collaboration with a mental healthcare provider "sufficient." Finally a prioritization showed that five stakeholder groups were seen as "definite" stakeholders by the organization. Practical implications - The assessment of the model showed that it generated useful knowledge for more evidence-based (stakeholder) management. Adaptation of the model is needed to increase its feasibility in practice. Originality/value - Provided that the model is properly adapted for the specific field, the analysis can provide more knowledge on stakeholders and can help integrate stakeholder management as a comprehensive process in policy planning.

Sustaining visceral leishmaniasis elimination in Bangladesh – Could a policy brief help?

PubMed Central

Ahmed, Be-Nazir; Olliaro, Piero

2017-01-01

Bangladesh has made significant progress towards elimination of visceral leishmaniasis, and is on track to achieve its target of less than one case per 10,000 inhabitants in each subdistrict in 2017. As the incidence of disease falls, it is likely that the political capital and financial resources dedicated towards the elimination of visceral leishmaniasis may decrease, raising the prospect of disease resurgence. Policy memos may play a crucial role during the transition of the elimination plan from the ‘attack’ to the ‘consolidation’ and ‘maintenance’ phases, highlighting key stakeholders and areas where ongoing investment is crucial. An example of a policy brief is outlined in this paper. The background to the current elimination efforts is highlighted, with emphasis on remaining uncertainties including the impact of disease reservoirs and sustainable surveillance strategies. A stakeholder map is provided outlining the current and projected future activities of key bodies. Identification of key stakeholders subsequently frames the discussion of three key policy recommendations in the Bangladeshi context for the transition to the consolidation and maintenance phases of the elimination program. Recommendations include determining optimal vector control and surveillance strategies, shifting the emphasis towards horizontal integration of disease programs, and prioritising remaining research questions with a focus on operational and technical capacity. Achieving elimination is as much a political as a scientific question. Integrating the discussion of key stakeholders with policy priorities and the research agenda provides a novel insight into potential pathways forwards in the elimination of visceral leishmaniasis in Bangladesh and in the rest of the Indian subcontinent. PMID:29232385

Sustaining visceral leishmaniasis elimination in Bangladesh - Could a policy brief help?

PubMed

Fitzpatrick, Alyssa; Al-Kobaisi, Noor Saad M S; Beitman Maya, Jessica; Ren Chung, Yu; Duhan, Satyender; Elbegdorj, Erdene; Jain, Sushant; Kuhn, Edward; Nastase, Alexandra; Ahmed, Be-Nazir; Olliaro, Piero

2017-12-01

Bangladesh has made significant progress towards elimination of visceral leishmaniasis, and is on track to achieve its target of less than one case per 10,000 inhabitants in each subdistrict in 2017. As the incidence of disease falls, it is likely that the political capital and financial resources dedicated towards the elimination of visceral leishmaniasis may decrease, raising the prospect of disease resurgence. Policy memos may play a crucial role during the transition of the elimination plan from the 'attack' to the 'consolidation' and 'maintenance' phases, highlighting key stakeholders and areas where ongoing investment is crucial. An example of a policy brief is outlined in this paper. The background to the current elimination efforts is highlighted, with emphasis on remaining uncertainties including the impact of disease reservoirs and sustainable surveillance strategies. A stakeholder map is provided outlining the current and projected future activities of key bodies. Identification of key stakeholders subsequently frames the discussion of three key policy recommendations in the Bangladeshi context for the transition to the consolidation and maintenance phases of the elimination program. Recommendations include determining optimal vector control and surveillance strategies, shifting the emphasis towards horizontal integration of disease programs, and prioritising remaining research questions with a focus on operational and technical capacity. Achieving elimination is as much a political as a scientific question. Integrating the discussion of key stakeholders with policy priorities and the research agenda provides a novel insight into potential pathways forwards in the elimination of visceral leishmaniasis in Bangladesh and in the rest of the Indian subcontinent.

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.

Impacts of the Interim Federal Health Program reforms: A stakeholder analysis of barriers to health care access and provision for refugees.

PubMed

Antonipillai, Valentina; Baumann, Andrea; Hunter, Andrea; Wahoush, Olive; O'Shea, Timothy

2017-11-09

Changes to the Interim Federal Health Program (IFHP) in 2012 reduced health care access for refugees and refugee claimants, generating concerns among key stakeholders. In 2014, a new IFHP temporarily reinstated access to some health services; however, little is known about these changes, and more information is needed to map the IFHP's impact. This study explores barriers occurring during the time period of the IFHP reforms to health care access and provision for refugees. A stakeholder analysis, using 23 semi-structured interviews, was conducted to obtain insight into stakeholder perceptions of the 2014 reforms, as well as stakeholders' position and their influence to assess the acceptability of the IFHP changes. The majority of stakeholders expressed concerns about the 2014 IFHP changes as a result of the continuing barriers posed by the 2012 retrenchments and the emergence of new barriers to health care access and provision for refugees. Key barriers identified included lack of communication and awareness, lack of continuity and comprehensive care, negative political discourse and increased costs. A few stakeholders supported the reforms as they represented some, but limited, access to health care. Overall, the reforms to the IFHP in 2014 generated barriers to health care access and provision that contributed to confusion among stakeholders, the transfer of refugee health responsibility to provincial authorities and the likelihood of increased health outcome disparities, as refugees and refugee claimants chose to delay seeking health care. The study recommends that policy-makers engage with refugee health stakeholders to formulate a policy that improves health care provision and access for refugee populations.

US EPA REGION 10 EJ INITIATIVE: NEEDS ASSESSMENT/SUMMIT

EPA Science Inventory

Milestones for Phase 1 (Needs Assessment) of the Initiative. Within 6 months, Region 10 will complete a written report that

1. identifies the key stakeholders,
2. identifies the issues and causes of conflict from the perspectives of those stakeholders ...

3. Stakeholders' expectations and perceived effects of the pharmacy ownership liberalization reform in Sweden: a qualitative interview study.

   PubMed

   Wisell, Kristin; Winblad, Ulrika; Sporrong, Sofia Kälvemark

   2016-08-12

   Reforms in the health-care sector, including the pharmacy sector, can have different rationales. The Swedish pharmacies were prior to 2009 organized in a state-owned monopoly. In 2009, a liberalization of the ownership took place, in which a majority of the pharmacies were sold to private owners. The rationales for this liberalization changed profoundly during the preparatory work, making it probable that other rationales than the ones first expressed existed. The aim of this study was to explore the underlying rationales (not stated in official documents) for the liberalization in the Swedish pharmacy sector, and also to compare the expectations with the perceived outcomes. Semi-structured interviews were conducted with representatives from key stakeholder organizations; i.e., political, patient, and professional organizations. The analysis was performed in steps, and themes were developed in an inductive manner. One expectation among the political organization participants was that the ownership liberalization would create opportunities for ideas. The competition introduced in the market was supposed to lead to a more diversified pharmacy sector. After the liberalization, the participants in favor of the liberalization were surprised that the pharmacies were so similar. Among the professional organization participants, one important rationale for the liberalization was to get better use of the pharmacists' knowledge. However, all the professional, and some of the patient organization participants, thought that the counseling in the pharmacies had deteriorated after the liberalization. As expected in the interviews, the post-liberalization pharmacy sector consists of more pharmacies. However, an unexpected perceived effect of the liberalization was, among participants from all the stakeholder groups, less access to prescription medicines in the pharmacies. This study showed that the political organization participants had an ideological basis for their opinion. The political stakeholders did not have a clear view about what the liberalization should lead to, apart from abolishing the monopoly. The perceived effects are quite similar in the different stakeholder groups, and not as positive as were expected.

4. Self-Management and Self-Management Support Outcomes: A Systematic Review and Mixed Research Synthesis of Stakeholder Views.

   PubMed

   Boger, Emma; Ellis, Jaimie; Latter, Sue; Foster, Claire; Kennedy, Anne; Jones, Fiona; Fenerty, Vicky; Kellar, Ian; Demain, Sara

   2015-01-01

   Self-management has received growing attention as an effective approach for long-term condition management. Little is known about which outcomes of supported self-management are valued by patients, their families, health professionals and those who commission self-management services. This study systematically reviewed published empirical evidence in accordance with PRISMA guidelines to determine the outcomes of self-management valued by these key stakeholder groups, using three prominent exemplar conditions: colorectal cancer, diabetes and stroke. To systematically review the literature to identify which generic outcomes of self-management have been targeted and are considered important using three exemplar conditions (colorectal cancer, diabetes and stroke), which collectively have a range of features that are likely to be representative of generic self-management issues. Systematic searching of nine electronic databases was conducted in addition to hand searches of review articles. Abstracts were identified against inclusion criteria and appraised independently by two reviewers, using a critical appraisal tool. Synthesis of findings was conducted using mixed research synthesis. Over 20,536 abstracts were screened. 41 studies which met the review criteria were fully retrieved and appraised. The majority of evidence related to diabetes. Few studies directly focussed on stakeholders' views concerning desired self-management outcomes; the majority of evidence was derived from studies focusing upon the experience of self-management. The views of health care commissioners were absent from the literature. We identified that self-management outcomes embrace a range of indicators, from knowledge, skills, and bio-psychosocial markers of health through to positive social networks. Patients', families', health professionals' and commissioners' views regarding which outcomes of self-management are important have not been clearly elicited. The extent to which bio-psychosocial indicators relate to successful self-management from the perspectives of all groups of stakeholders is unknown. Further investigation regarding which self-management outcomes are considered important by all stakeholders is necessary to guide the commissioning and design of future self-management services.

5. Increasing business resilience to flood risk: Developing an effective e-learning tool to bridge the knowledge gap between policy, practice and business owners

   NASA Astrophysics Data System (ADS)

   Wragg, Amanda; McEwen, Lindsey; Harries, Tim

   2015-04-01

   The focus of this paper is on the use of an innovative co-production process that engages small and medium sized enterprises (SMEs) and other stakeholders in the development of an e-learning tool that has appeal for business owners as well as being a resource for agents working directly with businesses. It outlines t priorities identified by businesses in relation to the support, advice, and, usefulness of sharing experiences which will be reflected in the 'tool'. The researchers suggest that business adaptation to flood risk is a neglected area and that an information 'hub' for businesses will enable sign-posting to advisory sources, 'science communication', and support for those suffering the trauma of damage to their premises and livelihoods. The flooding of communities is becoming a repeated, widespread issue within the UK, and elsewhere. Significant impacts of extreme floods in 2007 were: loss of life, 48,000 houses and 7,000 businesses flooded, community disruption, and, monetary loss to local economies. The winter floods of 2013/2014 also had devastating impacts. This paper reports on research from a three year multi-disciplinary project funded by the UK Engineering and Physical Sciences Research Council (EPSRC). In early 2014, SMEs accounted for 99.3% of all private sector businesses in the UK and 47.8% of private sector employment (FSB, 2014), thus they are a crucial part of the UK economy. Whilst some research focuses on 'community resilience', less is focused on the resilience of SMEs. Although SMEs may be vulnerable to fluctuations in turnover and housed in vulnerable premises, they often have the ability to make quick decisions and be innovative in the face of adversity owing to smaller, less complex systems. One key research aim has been to determine attitudes of business owners towards flood resilience and business continuity and barriers and motivators relating to adaptation. The resources SMEs draw on, their understanding of flood risk, and, the part that their knowledges and learning play in decision-making have been explored. The co-production process engages regional/national stakeholders who form a Stakeholder Competency Group (from policy and practice), and, a Business Research Partnership Group comprising local business participants. The two groups have opportunities to liaise and network in discussing the prototype for the learning tool. Whatmore et al (2008) and McEwen et al (2014) show that stakeholder views, experience and expertise can strengthen research outputs. The approach reflects current ethics and practices of stakeholder participation in that alongside an academic approach to the research, other equally valid forms of knowledge are recognised: 'a lot can be learned from exploring parallels, controversies and frictions between different forms of competency and knowledge (McEwen et al, 2014), for example, scientific, local, tacit and embedded. This paper presents concerns identified by businesses and wider stakeholders in relation to how the tool is framed and its key design premises. The tool is planned as a living resource that can support a community of learning practice among SMEs to increase flood resilience in the face of increased risk. References Federation of Small Businesses (2014) http://www.fsb.org.uk/stats Whatmore, Lane and Ward et al (2007-2010) Understanding Environmental Knowledge Controversies ESRC/NERC funded interdisciplinary research project (2007-2010) McEwen et al (2014) https://floodmemories.wordpress.com/2011/04/06/advice-from-competent-stakeholders/.

6. A strategy for human factors/ergonomics: developing the discipline and profession.

   PubMed

   Dul, Jan; Bruder, Ralph; Buckle, Peter; Carayon, Pascale; Falzon, Pierre; Marras, William S; Wilson, John R; van der Doelen, Bas

   2012-01-01

   Human factors/ergonomics (HFE) has great potential to contribute to the design of all kinds of systems with people (work systems, product/service systems), but faces challenges in the readiness of its market and in the supply of high-quality applications. HFE has a unique combination of three fundamental characteristics: (1) it takes a systems approach (2) it is design driven and (3) it focuses on two closely related outcomes: performance and well-being. In order to contribute to future system design, HFE must demonstrate its value more successfully to the main stakeholders of system design. HFE already has a strong value proposition (mainly well-being) and interactivity with the stakeholder group of 'system actors' (employees and product/service users). However, the value proposition (mainly performance) and relationships with the stakeholder groups of 'system experts' (experts fromtechnical and social sciences involved in system design), and 'system decision makers' (managers and other decision makers involved in system design, purchase, implementation and use), who have a strong power to influence system design, need to be developed. Therefore, the first main strategic direction is to strengthen the demand for high-quality HFE by increasing awareness among powerful stakeholders of the value of high-quality HFE by communicating with stakeholders, by building partnerships and by educating stakeholders. The second main strategic direction is to strengthen the application of high-quality HFE by promoting the education of HFE specialists, by ensuring high-quality standards of HFE applications and HFE specialists, and by promoting HFE research excellence at universities and other organisations. This strategy requires cooperation between the HFE community at large, consisting of the International Ergonomics Association (IEA), local (national and regional) HFE societies, and HFE specialists. We propose a joint world-wide HFE development plan, in which the IEA takes a leadership role. Human factors/ergonomics (HFE) has much to offer by addressing major business and societal challenges regarding work and product/service systems. HFE potential, however, is underexploited. This paper presents a strategy for the HFE community to strengthen demand and application of high-quality HFE, emphasising its key elements: systems approach, design driven, and performance and well-being goals.

7. Assessing the feasibility of introducing health insurance in Afghanistan: a qualitative stakeholder analysis.

   PubMed

   Zeng, Wu; Kim, Christine; Archer, Lauren; Sayedi, Omarzaman; Jabarkhil, Mohammad Yousuf; Sears, Kathleen

   2017-02-22

   In the last decade, the health status of Afghans has improved drastically. However, the health financing system in Afghanistan remains fragile due to high out-of-pocket spending and reliance on donor funding. To address the country's health financing challenges, the Ministry of Public Health investigated health insurance as a mechanism to mobilize resources for health. This paper presents stakeholders' opinions on seven preconditions of implementing this approach, as their understanding and buy-in to such an approach will determine its success. Key informant interviews and focus group discussions were conducted with stakeholders. The interviews focused on perceptions of the seven preconditions of introducing health insurance, and adapting a framework developed by the International Labor Organization. Content analysis was conducted after interviews and discussions were transcribed and coded. Almost all of the stakeholders from government agencies, the private sector, and development partners are interested in introducing health insurance in Afghanistan, and they were aware of the challenges of the country's health financing system. Stakeholders acknowledged that health insurance could be an instrument to address these challenges. However, stakeholders differed in their beliefs about how and when to initiate a health insurance scheme. In addition to increasing insecurity in the country, they saw a lack of clear legal guidance, low quality of healthcare services, poor awareness among the population, limited technical capacity, and challenges to willingness to pay as the major barriers to establishing a successful nationwide health insurance scheme. The identified barriers prevent Afghanistan from establishing health insurance in the short term. Afghanistan must progressively address these major impediments in order to build a health insurance system.

8. 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.

9. Lessons Learned by Community Stakeholders in the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) Project, 2013–2014

   PubMed Central

   Ganter, Claudia; Aftosmes-Tobio, Alyssa; Chuang, Emmeline; Kwass, Jo-Ann; Land, Thomas

   2017-01-01

   Introduction Childhood obesity is a multifaceted disease that requires sustainable, multidimensional approaches that support change at the individual, community, and systems levels. The Massachusetts Childhood Obesity Research Demonstration project addressed this need by using clinical and public health evidence-based methods to prevent childhood obesity. To date, little information is known about successes and lessons learned from implementing such large-scale interventions. To address this gap, we examined perspectives of community stakeholders from various sectors on successes achieved and lessons learned during the implementation process. Methods We conducted 39 semistructured interviews with key stakeholders from 6 community sectors in 2 low-income communities from November 2013 through April 2014, during project implementation. Interviews were audio-recorded, transcribed, and analyzed by using the constant comparative method. Data were analyzed by using QSR NVivo 10. Results Successes included increased parental involvement in children’s health and education, increased connections within participating organizations and within the broader community, changes in organizational policies and environments to better support healthy living, and improvements in health behaviors in children, parents, and stakeholders. Lessons learned included the importance of obtaining administrative and leadership support, involving key stakeholders early in the program planning process, creating buffers that allow for unexpected changes, and establishing opportunities for regular communication within and across sectors. Conclusion Study findings indicate that multidisciplinary approaches support health behavior change and provide insight into key issues to consider in developing and implementing such approaches in low-income communities. PMID:28125400

10. Ethical perspectives on emerging assistive technologies: insights from focus groups with stakeholders in long-term care facilities.

    PubMed

    Dorsten, Aimee-Marie; Sifford, K Susan; Bharucha, Ashok; Mecca, Laurel Person; Wactlar, Howard

    2009-03-01

    ASSISTIVE TECHNOLOGIES ARE RELATIVELY novel tools for research and daily care in long-term care (LTC) facilities that are faced with the burgeoning of the older adult population and dwindling staffing resources. The degree to which stakeholders in LTC facilities are receptive to the use of these technologies is poorly understood. Eighteen semi-structured focus groups and one interview were conducted with relevant groups of stakeholders at seven LTC facilities in southwestern Pennsylvania. Common themes identified across all focus groups centered on concerns for privacy, autonomy, cost, and safety associated with implementation of novel technologies. The relative importance of each theme varied by stakeholder group as well as the perceived severity of cognitive and/or physical disability. Our findings suggest that ethical issues are critical to acceptance of novel technologies by their end users, and that stakeholder groups are interdependent and require shared communication about the acceptance of these emerging technologies.

11. Barriers to and facilitators of implementing complex workplace dietary interventions: process evaluation results of a cluster controlled trial.

    PubMed

    Fitzgerald, Sarah; Geaney, Fiona; Kelly, Clare; McHugh, Sheena; Perry, Ivan J

    2016-04-21

    Ambiguity exists regarding the effectiveness of workplace dietary interventions. Rigorous process evaluation is vital to understand this uncertainty. This study was conducted as part of the Food Choice at Work trial which assessed the comparative effectiveness of a workplace environmental dietary modification intervention and an educational intervention both alone and in combination versus a control workplace. Effectiveness was assessed in terms of employees' dietary intakes, nutrition knowledge and health status in four large manufacturing workplaces. The study aimed to examine barriers to and facilitators of implementing complex workplace interventions, from the perspectives of key workplace stakeholders and researchers involved in implementation. A detailed process evaluation monitored and evaluated intervention implementation. Interviews were conducted at baseline (27 interviews) and at 7-9 month follow-up (27 interviews) with a purposive sample of workplace stakeholders (managers and participating employees). Topic guides explored factors which facilitated or impeded implementation. Researchers involved in recruitment and data collection participated in focus groups at baseline and at 7-9 month follow-up to explore their perceptions of intervention implementation. Data were imported into NVivo software and analysed using a thematic framework approach. Four major themes emerged; perceived benefits of participation, negotiation and flexibility of the implementation team, viability and intensity of interventions and workplace structures and cultures. The latter three themes either positively or negatively affected implementation, depending on context. The implementation team included managers involved in coordinating and delivering the interventions and the researchers who collected data and delivered intervention elements. Stakeholders' perceptions of the benefits of participating, which facilitated implementation, included managers' desire to improve company image and employees seeking health improvements. Other facilitators included stakeholder buy-in, organisational support and stakeholder cohesiveness with regards to the level of support provided to the intervention. Anticipation of employee resistance towards menu changes, workplace restructuring and target-driven workplace cultures impeded intervention implementation. Contextual factors such as workplace structures and cultures need to be considered in the implementation of future workplace dietary interventions. Negotiation and flexibility of key workplace stakeholders plays an integral role in overcoming the barriers of workplace cultures, structures and resistance to change. Current Controlled Trials: ISRCTN35108237. Date of registration: 02/07/2013.

12. Do different stakeholder groups share mental health research priorities? A four-arm Delphi study.

    PubMed

    Owens, Christabel; Ley, Ann; Aitken, Peter

    2008-12-01

    Despite considerable investment in research priority setting within diverse fields of healthcare, little is known about the extent to which different stakeholder groups share research priorities. Conflicting priorities may jeopardize stakeholder engagement in research. To identify the research priorities of different stakeholder groups within mental health care and examine the extent and nature of agreement between them. Using a Delphi technique, we conducted parallel consultation processes within four different stakeholder groups. Each group process consisted of three rounds. The study was carried out within a mental health and learning disabilities trust in southern England. Participants were recruited from the following groups: mental health service users (34), informal carers (26), mental health practitioners (35) and service managers (23). There were striking differences between the four groups in respect of their ability and willingness to make priority decisions. These differences notwithstanding, there was considerable overlap in respect of their research interests. All groups identified and attached high importance to issues relating to the promotion of independence, self-esteem and recovery. The quality of in-patient care, the place of psychological therapies and the relationship between physical and mental health also emerged across the board. The confluence of four different stakeholder groups around a number of clear themes is highly encouraging, providing a framework within which to construct a research agenda and suggesting that mental health research can be built on solid partnerships.

2012 Stakeholder Workshop on Natural Gas in the Inventory of U.S. Greenhouse Gas Emissions and Sinks

EPA Pesticide Factsheets

This page describes EPA's September 2012 stakeholder workshop on key aspects of the estimates of greenhouse gas emissions from the natural gas sector in the Inventory of U.S. Greenhouse Gas Emissions and Sinks.

Defining disaster resilience: comparisons from key stakeholders involved in emergency management in Victoria, Australia.

PubMed

Goode, Natassia; Salmon, Paul M; Spencer, Caroline; McArdle, Dudley; Archer, Frank

2017-01-01

Three years after the introduction of the National Strategy for Disaster Resilience there remains no unanimously adopted definition of disaster resilience within Australia's emergency management sector. The aim of this study is to determine what the concept means to key stakeholders in the emergency management sector in the Australian State of Victoria, and how these conceptualisations overlap and diverge. Via an online survey, 113 people were asked how they define disaster resilience in their work in the emergency management sector. A data mining software tool, Leximancer, was employed to uncover the relationships between the definitions provided. The findings show that stakeholders see resilience as an 'ability' that encompasses emergency management activities and personal responsibility. However, the findings also highlight some possible points of conflict between stakeholders. In addition, the paper outlines and discusses a number of potential consequences for the implementation and the success of the resilience-based approach in Australia. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

Optimising diagnosis of viraemic hepatitis C infection: the development of a target product profile.

PubMed

Ivanova Reipold, Elena; Easterbrook, Philippa; Trianni, Alessandra; Panneer, Nivedha; Krakower, Douglas; Ongarello, Stefano; Roberts, Teri; Miller, Veronica; Denkinger, Claudia

2017-11-01

The current low access to virological testing to confirm chronic viraemic HCV infection in low- and middle-income countries (LMIC) is limiting the rollout of hepatitis C (HCV) care. Existing tests are complex, costly and require sophisticated laboratory infrastructure. Diagnostic manufacturers need guidance on the optimal characteristics a virological test needs to have to ensure the greatest impact on HCV diagnosis and treatment in LMIC. Our objective was to develop a target product profile (TPP) for diagnosis of HCV viraemia using a global stakeholder consensus-based approach. Based on the standardised process established to develop consensus-based TPPs, we followed five key steps. (i) Identifying key potential global stakeholders for consultation and input into the TPP development process. (ii) Informal priority-setting exercise with key experts to identify the needs that should be the highest priority for the TPP development; (iii) Defining the key TPP domains (scope, performance and operational characteristics and price). (iv) Delphi-like process with larger group of key stakeholder to facilitate feedback on the key TPP criteria and consensus building based on pre-defined consensus criteria. (v) A final consensus-gathering meeting for discussions around disputed criteria. A complementary values and preferences survey helped to assess trade-offs between different key characteristics. The following key attributes for the TPP for a test to confirm HCV viraemic infection were identified: The scope defined is for both HCV detection as well as confirmation of cure. The timeline of development for tests envisioned in the TPP is 5 years. The test should be developed for use by health-care workers or laboratory technicians with limited training in countries with a medium to high prevalence of HCV (1.5-3.5% and >3.5%) and in high-risk populations in low prevalence settings (<1.5%). A clinical sensitivity at a minimum of 90% is considered sufficient (analytical sensitivity of the equivalent of 3000 IU/ml), particularly if the test increases access to testing through an affordable price, increase ease-of-use and feasibility on capillary blood. Polyvalency would be optimal (i.e. ability to test for HIV and others). The only characteristic that full agreement could not be achieved on was the price for a virological test. Discussants felt that to reach the optimal target price substantial trade-offs had to be made (e.g. in regards to sensitivity and integration). The TPP and V&P survey results define the need for an easy-to-use, low cost test to increase access to diagnosis and linkage to care in LMIC.

Stakeholder engagement and public policy evaluation: factors contributing to the development and implementation of a regional network for geriatric care.

PubMed

Glover, Catherine; Hillier, Loretta M; Gutmanis, Iris

2007-01-01

The development and implementation of a regional network that provides universally accessible and consistent services to the frail elderly living in Southwestern Ontario is described. Through continuous stakeholder engagement, clear network goals were identified and operationalized. Stakeholder commitment to the integration of expertise and specialized services, to evidence-based public policy and to iterative evaluation cycles were key to network success.

Stakeholder management in a hyperturbulent health care environment.

PubMed

Rotarius, T; Liberman, A

2000-12-01

The fast-paced change in today's health care environment presents an unsettling organizational climate within which managers must make important decisions that affect key stakeholders. This ambiguousness has resulted in the proliferation of health care organizations that are bundling together to find a sense of environmental stability in which they can achieve common goals. This means that health care managers need to view stakeholders as parts of larger bundles rather than only as individual organizations.

Organization for rare diseases India (ORDI) - addressing the challenges and opportunities for the Indian rare diseases' community.

PubMed

Rajasimha, Harsha Karur; Shirol, Prasannakumar Basayya; Ramamoorthy, Preveen; Hegde, Madhuri; Barde, Sangeeta; Chandru, Vijay; Ravinandan, M E; Ramchandran, Ramani; Haldar, Kasturi; Lin, Jimmy C; Babar, Imran A; Girisha, Katta M; Srinivasan, Sudha; Navaneetham, Duraiswamy; Battu, Rajani; Devarakonda, Rajashree; Kini, Usha; Vijayachandra, Kinnimulki; Verma, Ishwar C

2014-08-13

In order to address the unmet needs and create opportunities that benefit patients with rare disease in India, a group of volunteers created a not-for-profit organization named Organization for Rare Diseases India (ORDI; www.ordindia.org). ORDI plans to represent the collective voice and advocate the needs of patients with rare diseases and other stakeholders in India. The ORDI team members come from diverse backgrounds such as genetics, molecular diagnostics, drug development, bioinformatics, communications, information technology, patient advocacy and public service. ORDI builds on the lessons learned from numerous similar organizations in the USA, European Union and disease-specific rare disease foundations in India. In this review, we provide a background on the landscape of rare diseases and the organizations that are active in this area globally and in India. We discuss the unique challenges in tackling rare diseases in India, and highlight the unmet needs of the key stakeholders of rare diseases. Finally, we define the vision, mission, goals and objectives of ORDI, identify the key developments in the health care context in India and welcome community feedback and comments on our approach.

Development of a clinical pharmacy model within an Australian home nursing service using co-creation and participatory action research: the Visiting Pharmacist (ViP) study

PubMed Central

Lee, Cik Yin; Beanland, Christine; Goeman, Dianne P; Petrie, Neil; Petrie, Barbara; Vise, Felicity; Gray, June

2017-01-01

Objective To develop a collaborative, person-centred model of clinical pharmacy support for community nurses and their medication management clients. Design Co-creation and participatory action research, based on reflection, data collection, interaction and feedback from participants and other stakeholders. Setting A large, non-profit home nursing service in Melbourne, Australia. Participants Older people referred to the home nursing service for medication management, their carers, community nurses, general practitioners (GPs) and pharmacists, a multidisciplinary stakeholder reference group (including consumer representation) and the project team. Data collection and analysis Feedback and reflections from minutes, notes and transcripts from: project team meetings, clinical pharmacists’ reflective diaries and interviews, meetings with community nurses, reference group meetings and interviews and focus groups with 27 older people, 18 carers, 53 nurses, 15 GPs and seven community pharmacists. Results The model was based on best practice medication management standards and designed to address key medication management issues raised by stakeholders. Pharmacist roles included direct client care and indirect care. Direct care included home visits, medication reconciliation, medication review, medication regimen simplification, preparation of medication lists for clients and nurses, liaison and information sharing with prescribers and pharmacies and patient/carer education. Indirect care included providing medicines information and education for nurses and assisting with review and implementation of organisational medication policies and procedures. The model allowed nurses to refer directly to the pharmacist, enabling timely resolution of medication issues. Direct care was provided to 84 older people over a 15-month implementation period. Ongoing feedback and consultation, in line with participatory action research principles, informed the development and refinement of the model and identification of enablers and challenges. Conclusions A collaborative, person-centred clinical pharmacy model that addressed the needs of clients, carers, nurses and other stakeholders was successfully developed. The model is likely to have applicability to home nursing services nationally and internationally. PMID:29102998

Trade and health in Samoa: views from the insiders.

PubMed

Fa'alili-Fidow, Jacinta; McCool, Judith; Percival, Teuila

2014-04-04

The purpose of this paper is to portray the views of key stakeholders on the potential impacts of Samoa's free trade negotiations and agreements, on health and wellbeing in Samoa. A series of key informant interviews were undertaken with identified stakeholders during June and July, 2011. Interviews were conducted using a semi-structured interview protocol. They were conducted in-person, in New Zealand and in Samoa. Despite potential health and wellbeing gains arising from trade activities (employment, increase in income, health innovations and empowerment of women), key stakeholders expressed a growing concern about the effect of trade on the population's health, nutrition and the rates of non-communicable diseases. Unease about compromising the national policies due to international regulations was also conveyed. Business and trade representatives however, believed that trade benefits outweighed any health and wellbeing risks to the population of Samoa. Further investigation, using new methodologies are required to determine both the opportunities and threats for trade as a mechanism to improve the health of Samoa's population.

Stakeholders’ Views on Barriers to Research on Controversial Controlled Substances

PubMed Central

Rhodes; Andreae; Bourgiose; Indyk; Rhodes; Sacks

2017-01-01

Many diseases and disease symptoms still lack effective treatment. At the same time, certain controversial Schedule I drugs, such as heroin and cannabis, have been reputed to have considerable therapeutic potential for addressing significant medical problems. Yet, there is a paucity of U.S. clinical studies on the therapeutic uses of controlled drugs. For example, people living with HIV/AIDS experience a variety of disease- and medication-related symptoms. Their chronic pain is intense, frequent, and difficult to treat. Nevertheless, clinical trials of compassionate management for their chronic symptoms that should be a research priority, is stymied. We employed qualitative methods to develop an understanding of the barriers to research on potential therapeutic uses of Schedule I drugs so that they might be addressed. We elicited the perspectives of key stakeholder groups that would be involved in such studies: people living with HIV/AIDS, clinicians, and Institutional Review Board members. As we identified obstacles to research, we found all stakeholder groups to arrive at the same conclusion, that clinical research on the therapeutic potential of these drugs is ethically required. PMID:28001138

Value-Driven Population Health: An Emerging Focus for Improving Stakeholder Role Performance.

PubMed

Allen, Harris; Burton, Wayne N; Fabius, Raymond

2017-12-01

Health and health care in the United States are being jeopardized by top-end spending whose share of the gross domestic product continues to increase even as aggregate health outcomes remain mediocre. This paper focuses on a new approach for improving stakeholder role performance in the marketplace, value-driven population health (VDPH SM ). Devoted to maximizing the value of every dollar spent on population health, VDPH holds much promise for ameliorating this dilemma and exerting a constructive influence on the reshaping of the Affordable Care Act. This paper introduces VDPH and differentiates the science underlying it from the management that serves to make good on its potential. To highlight what VDPH brings to the table, comparisons are made with 3 like-minded approaches to health reform. Next, 2 areas are highlighted, workplace wellness and the quality and cost of health care, where without necessarily being recognized as such, VDPH has gained real traction among 2 groups: leading employers and, more recently, leading providers. Key findings with respect to workplace wellness are assessed in terms of psychometric performance to evaluate workplace wellness and to point out how VDPH can help direct future employer initiatives toward firmer scientific footing. Then, insights gleaned from the employer experience are applied to illustrate how VDPH can help guide future provider efforts to build on the model developed. This paper concludes with a framework for the use of VDPH by each of 5 stakeholder groups. The discussion centers on how VDPH transcends and differentiates these groups. Implications for health reform in the recently altered political landscape are explored.

Feasibility and acceptability of interventions to delay gun access in VA mental health settings.

PubMed

Walters, Heather; Kulkarni, Madhur; Forman, Jane; Roeder, Kathryn; Travis, Jamie; Valenstein, Marcia

2012-01-01

The majority of VA patient suicides are completed with firearms. Interventions that delay patients' gun access during high-risk periods may reduce suicide, but may not be acceptable to VA stakeholders or may be challenging to implement. Using qualitative methods, stakeholders' perceptions about gun safety and interventions to delay gun access during high-risk periods were explored. Ten focus groups and four individual interviews were conducted with key stakeholders, including VA mental health patients, mental health clinicians, family members and VA facility leaders (N=60). Transcripts were consensus-coded by two independent coders, and structured summaries were developed and reviewed using a consensus process. All stakeholder groups indicated that VA health system providers had a role in increasing patient safety and emphasized the need for providers to address gun access with their at-risk patients. However, VA mental health patients and clinicians reported limited discussion regarding gun access in VA mental health settings during routine care. Most, although not all, patients and clinicians indicated that routine screening for gun access was acceptable, with several noting that it was more acceptable for mental health patients. Most participants suggested that family and friends be involved in reducing gun access, but expressed concerns about potential family member safety. Participants generally found distribution of trigger locks acceptable, but were skeptical about its effectiveness. Involving Veteran Service Organizations or other individuals in temporarily holding guns during high-risk periods was acceptable to many participants but only with numerous caveats. Patients, clinicians and family members consider the VA health system to have a legitimate role in addressing gun safety. Several measures to delay gun access during high-risk periods for suicide were seen as acceptable and feasible if implemented thoughtfully. Published by Elsevier Inc.

Transgender women in Malaysia, in the context of HIV and Islam: a qualitative study of stakeholders' perceptions.

PubMed

Barmania, Sima; Aljunid, Syed Mohamed

2017-10-18

Globally, one of the key groups considered to be at high risk of acquiring HIV are transgender women, often a marginalised group. In the Malaysian context there has been a scarcity of published research relating to transgender women, a sensitive issue in a Muslim majority country, where Islam plays an influential role in society. Furthermore, there has been a paucity of research relating to how such issues relate to HIV prevention in transgender women in Malaysia. Thus, the aim of this study is to explore the attitudes of stakeholders involved in HIV prevention policy in Malaysia towards transgender women, given the Islamic context. In-depth interviews were undertaken with stakeholders involved in HIV prevention, Ministry of Health, Religious Leaders and People Living with HIV, including transgender women. Thirty five participants were recruited using purposive sampling from June to December 2013 within Kuala Lumpur and surrounding vicinities. Interviews were in person, audiotaped, transcribed verbatim and used a framework analysis. Five central themes emerged from the qualitative data; Perceptions of Transgender women and their place in Society; Reaching out to Transgender Women; Islamic doctrine; 'Cure', 'Correction' and finally, Stigma and Discrimination. Islamic rulings about transgenderism were often the justification given by participants chastising transgender women, whilst there were also more progressive attitudes and room for debate. Pervasive negative attitudes and stigma and discrimination created a climate where transgender women often felt more comfortable with non-governmental organisations. The situation of transgender women in Malaysia and HIV prevention is a highly sensitive and challenging environment for all stakeholders, given the Muslim context and current legal system. Despite this apparent impasse, there are practically achievable areas that can be improved upon to optimise HIV prevention services and the environment for transgender women in Malaysia.

Risk perceptions of public health and food safety hazards in poultry husbandry by citizens, poultry farmers and poultry veterinarians.

PubMed

van Asselt, M; Poortvliet, P M; Ekkel, E D; Kemp, B; Stassen, E N

2018-02-01

Differences in risk perceptions of public health and food safety hazards in various poultry husbandry systems by various stakeholder groups, may affect the acceptability of those husbandry systems. Therefore, the objective was to gain insight into risk perceptions of citizens, poultry farmers, and poultry veterinarians regarding food safety and public health hazards in poultry husbandry systems, and into factors explaining these risk perceptions. We surveyed risk perceptions of Campylobacter contamination of broiler meat, avian influenza introduction in laying hens, and altered dioxin levels in eggs for the most commonly used broiler and laying hen husbandry systems in Dutch citizens (n = 2,259), poultry farmers (n = 100), and poultry veterinarians (n = 41). Citizens perceived the risks of the three hazards in the indoor systems higher and in the outdoor systems lower than did the professionals. Citizens reported higher concerns regarding aspects reflecting underlying psychological factors of risk perception compared to professionals. Professionals indicated a relatively low level of personal control, which might imply risk denial. Of the socio-demographic characteristics, gender and childhood residence were associated with risk perceptions. The influence of other factors of risks perception are discussed. It is suggested that risk perceptions of all stakeholder groups are influenced by affect, stigma, and underlying values. To adapt current or new husbandry systems that can count on societal support, views of key stakeholders and multiple aspects such as animal welfare, public health, food safety, and underlying values should be considered integrally. When trade-offs, such as between animal welfare and public health have to be made, insight into underlying values might help to find consensus among stakeholders. © The Author 2017. Published by Oxford University Press on behalf of Poultry Science Association.

Risk perceptions of public health and food safety hazards in poultry husbandry by citizens, poultry farmers and poultry veterinarians

PubMed Central

Poortvliet, P M; Ekkel, E D; Kemp, B; Stassen, E N

2018-01-01

Abstract Differences in risk perceptions of public health and food safety hazards in various poultry husbandry systems by various stakeholder groups, may affect the acceptability of those husbandry systems. Therefore, the objective was to gain insight into risk perceptions of citizens, poultry farmers, and poultry veterinarians regarding food safety and public health hazards in poultry husbandry systems, and into factors explaining these risk perceptions. We surveyed risk perceptions of Campylobacter contamination of broiler meat, avian influenza introduction in laying hens, and altered dioxin levels in eggs for the most commonly used broiler and laying hen husbandry systems in Dutch citizens (n = 2,259), poultry farmers (n = 100), and poultry veterinarians (n = 41). Citizens perceived the risks of the three hazards in the indoor systems higher and in the outdoor systems lower than did the professionals. Citizens reported higher concerns regarding aspects reflecting underlying psychological factors of risk perception compared to professionals. Professionals indicated a relatively low level of personal control, which might imply risk denial. Of the socio-demographic characteristics, gender and childhood residence were associated with risk perceptions. The influence of other factors of risks perception are discussed. It is suggested that risk perceptions of all stakeholder groups are influenced by affect, stigma, and underlying values. To adapt current or new husbandry systems that can count on societal support, views of key stakeholders and multiple aspects such as animal welfare, public health, food safety, and underlying values should be considered integrally. When trade-offs, such as between animal welfare and public health have to be made, insight into underlying values might help to find consensus among stakeholders. PMID:29161444

Is there a need for a universal benefit-risk assessment framework for medicines? Regulatory and industry perspectives.

PubMed

Leong, James; McAuslane, Neil; Walker, Stuart; Salek, Sam

2013-09-01

To explore the current status and need for a universal benefit-risk framework for medicines in regulatory agencies and pharmaceutical companies. A questionnaire was developed and sent to 14 mature regulatory agencies and 24 major companies. The data were analysed using descriptive statistics, for a minority of questions preceded by manual grouping of the responses. Overall response rate was 82%, and study participants included key decision makers from agencies and companies. None used a fully quantitative system, most companies preferring a qualitative method. The major reasons for this group not using semi-quantitative or quantitative systems were lack of a universal and scientifically validated framework. The main advantages of a benefit-risk framework were that it provided a systematic standardised approach to decision-making and that it acted as a tool to enhance quality of communication. It was also reported that a framework should be of value to both agencies and companies throughout the life cycle of a product. They believed that it is possible to develop an overarching benefit-risk framework that should involve relevant stakeholders in the development, validation and application of a universal framework. The entire cohort indicated common barriers to implementing a framework were resource limitations, a lack of knowledge and a scientifically validated and acceptable framework. Stakeholders prefer a semi-quantitative, overarching framework that incorporates a toolbox of different methodologies. A coordinating committee of relevant stakeholders should be formed to guide its development and implementation. Through engaging the stakeholders, these outcomes confirm sentiments and need for developing a universal benefit-risk assessment framework. Copyright © 2013 John Wiley & Sons, Ltd.

Twin-Twin Transfusion Syndrome: study protocol for developing, disseminating, and implementing a core outcome set.

PubMed

Khalil, Asma; Perry, Helen; Duffy, James; Reed, Keith; Baschat, Ahmet; Deprest, Jan; Hecher, Kurt; Lewi, Liesbeth; Lopriore, Enrico; Oepkes, Dick

2017-07-14

Twin-Twin Transfusion Syndrome (TTTS) is associated with an increased risk of perinatal mortality and morbidity. Several treatment interventions have been described for TTTS, including fetoscopic laser surgery, amnioreduction, septostomy, expectant management, and pregnancy termination. Over the last decade, fetoscopic laser surgery has become the primary treatment. The literature to date reports on many different outcomes, making it difficult to compare results or combine data from individual studies, limiting the value of research to guide clinical practice. With the advent and ongoing development of new therapeutic techniques, this is more important than ever. The development and use of a core outcome set has been proposed to address these issues, prioritising outcomes important to the key stakeholders, including patients. We aim to produce, disseminate, and implement a core outcome set for TTTS. An international steering group has been established to oversee the development of this core outcome set. This group includes healthcare professionals, researchers and patients. A systematic review is planned to identify previously reported outcomes following treatment for TTTS. Following completion, the identified outcomes will be evaluated by stakeholders using an international, multi-perspective online modified Delphi method to build consensus on core outcomes. This method encourages the participants towards consensus 'core' outcomes. All key stakeholders will be invited to participate. The steering group will then hold a consensus meeting to discuss results and form a core outcome set to be introduced and measured. Once core outcomes have been agreed, the next step will be to determine how they should be measured, disseminated, and implemented within an international context. The development, dissemination, and implementation of a core outcome set in TTTS will enable its use in future clinical trials, systematic reviews and clinical practice guidelines. This is likely to advance the quality of research studies and their effective use in order to guide clinical practice and improve patient care, maternal, short-term perinatal outcomes and long-term neurodevelopmental outcomes. Core Outcome Measures in Effectiveness Trials (COMET), 921 Registered on July 2016. International Prospective Register of Systematic Reviews (PROSPERO), CRD42016043999 . Registered on 2 August 2016.

Opportunities, challenges and systems requirements for developing post-abortion family planning services: Perceptions of service stakeholders in China

PubMed Central

Richards, Esther; Zhang, Weihong; Hu, Lina; Wu, Shangchun; Tolhurst, Rachel

2017-01-01

Post-abortion family planning (PAFP) has been proposed as a key strategy to decrease unintended pregnancy and repeat induced abortions. However, the accessibility and quality of PAFP services remain a challenge in many countries including China where more than 10 million unintended pregnancies occur each year. Most of these unwanted pregnancies end in repeated induced abortions. This paper aims to explore service providers’ perceptions of the current situation regarding family planning and abortion service needs, provision, utilization, and the feasibility and acceptability of high quality PAFP in the future. Qualitative methods, including in-depth interviews and focus group discussions, were used with family planning policy makers, health managers, and service providers. Three provinces—Zhejiang, Hubei and Yunnan—were purposively selected, representing high, medium and relatively undeveloped areas of China. A total of fifty-three in-depth interviews and ten focus-group discussions were conducted and analysed thematically. Increased numbers of abortions among young, unmarried women were perceived as a major reason for high numbers of abortions. Participants attributed this to increasing socio-cultural acceptability of premarital sex, and simultaneously, lack of understanding or awareness of contraception among young people. The majority of service stakeholders acknowledged that free family planning services were neither targeted at, nor accessible to unmarried people. The extent of PAFP provision is variable and limited. However, service providers expressed willingness and enthusiasm towards providing PAFP services in the future. Three main considerations were expressed regarding the feasibility of developing and implementing PAFP services: policy support, human resources, and financial resources. The study indicated that key service stakeholders show demand for and perceive considerable opportunities to develop PAFP in China. However, changes are needed to enable the systematic development of high quality PAFP, including actively targeting young and unmarried people in service provision, obtaining policy support and increasing the investment of human and financial resources. PMID:29045434

Allied health research positions: a qualitative evaluation of their impact.

PubMed

Wenke, Rachel J; Ward, Elizabeth C; Hickman, Ingrid; Hulcombe, Julie; Phillips, Rachel; Mickan, Sharon

2017-02-06

Research positions embedded within healthcare settings have been identified as an enabler to allied health professional (AHP) research capacity; however, there is currently limited research formally evaluating their impact. In 2008, a Health Practitioner industrial agreement funded a research capacity building initiative within Queensland Health, Australia, which included 15 new allied health research positions. The present project used a qualitative and realist approach to explore the impact of these research positions, as well as the mechanisms which facilitated or hindered their success within their respective organisations. Forty-four AHP employees from six governmental health services in Queensland, Australia, participated in the study. Individual interviews were undertaken, with individuals in research positions (n = 8) and their reporting line managers (n = 8). Four stakeholder focus groups were also conducted with clinicians, team leaders and professional heads who had engaged with the research positions. Nine key outcomes of the research positions were identified across individual, team/service and organisational/community levels. These outcomes included clinician skill development, increased research activity, clinical and service changes, increased research outputs and collaborations, enhanced research and workplace culture, improved profile of allied health, development of research infrastructure, and professional development of individuals in the research positions. Different mechanisms that influenced these outcomes were identified. These mechanisms were grouped by those related to the (1) research position itself, (2) organisational factors and (3) implementation factors. The present findings highlight the potential value of the research positions for individuals, teams and clinical services across different governmental healthcare services, and demonstrate the impact of the roles on building the internal and external profile of allied health. Results build upon the emerging evidence base for allied health research positions and have important implications for a number of stakeholders (i.e. individuals in the research positions, AHPs and their managers, university partners and state-wide executives). Key recommendations are provided for all stakeholders to enhance the ongoing impact of these roles and the potential advocacy for additional positions and resources to support them.

Using paradox theory to understand responses to tensions between service and training in general surgery.

PubMed

Cleland, Jennifer; Roberts, Ruby; Kitto, Simon; Strand, Pia; Johnston, Peter

2018-03-01

The tension between service and training in pressured health care environments can have a detrimental impact on training quality and job satisfaction. Yet the management literature proposes that competing demands are inherent in organisational settings: it is not the demands as such that lead to negative outcomes but how people and organisations react to opposing tensions. We explored how key stakeholders responded to competing service-training demands in a surgical setting that had recently gone through a highly-publicised organisational crisis. This was an explanatory case study of a general surgery unit. Public documents informed the research questions and the data were triangulated with semi-structured interviews (n = 14) with key stakeholders. Data coding and analysis were initially inductive but, after the themes emerged, we used a paradox lens to group themes into four contextual dimensions: performing, organising, belonging and learning. Tensions were apparent in the data, with managers, surgeons and trainees or residents in conflict with each other because of different goals or priorities and divergent perspectives on the same issue of balancing service and training (performing). This adversely impacted on relationships across and within groups (belonging, learning) and led to individuals prioritising their own goals rather than working for the 'greater good' (performing, belonging). Yet although relationships and communication improved, the approach to getting a better balance maintained the 'compartmentalisation' of training (organising) rather than acknowledging that training and service cannot be separated. Stakeholder responses to the tensions provided temporary relief but were unlikely to lead to real change if the tension between service and training was considered to be an interdependent and persistent paradox. Reframing the service-training paradox in this way may encourage adjusting responses to create effective working partnerships. Our findings add to the body of knowledge on this topic, and will resonate with all those engaged in surgical and other postgraduate training. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Opportunities, challenges and systems requirements for developing post-abortion family planning services: Perceptions of service stakeholders in China.

PubMed

Jiang, Hong; Xu, Jieshuang; Richards, Esther; Qian, Xu; Zhang, Weihong; Hu, Lina; Wu, Shangchun; Tolhurst, Rachel

2017-01-01

Post-abortion family planning (PAFP) has been proposed as a key strategy to decrease unintended pregnancy and repeat induced abortions. However, the accessibility and quality of PAFP services remain a challenge in many countries including China where more than 10 million unintended pregnancies occur each year. Most of these unwanted pregnancies end in repeated induced abortions. This paper aims to explore service providers' perceptions of the current situation regarding family planning and abortion service needs, provision, utilization, and the feasibility and acceptability of high quality PAFP in the future. Qualitative methods, including in-depth interviews and focus group discussions, were used with family planning policy makers, health managers, and service providers. Three provinces-Zhejiang, Hubei and Yunnan-were purposively selected, representing high, medium and relatively undeveloped areas of China. A total of fifty-three in-depth interviews and ten focus-group discussions were conducted and analysed thematically. Increased numbers of abortions among young, unmarried women were perceived as a major reason for high numbers of abortions. Participants attributed this to increasing socio-cultural acceptability of premarital sex, and simultaneously, lack of understanding or awareness of contraception among young people. The majority of service stakeholders acknowledged that free family planning services were neither targeted at, nor accessible to unmarried people. The extent of PAFP provision is variable and limited. However, service providers expressed willingness and enthusiasm towards providing PAFP services in the future. Three main considerations were expressed regarding the feasibility of developing and implementing PAFP services: policy support, human resources, and financial resources. The study indicated that key service stakeholders show demand for and perceive considerable opportunities to develop PAFP in China. However, changes are needed to enable the systematic development of high quality PAFP, including actively targeting young and unmarried people in service provision, obtaining policy support and increasing the investment of human and financial resources.

Occupational psychosocial health policies in Hong Kong schools: a review and exploration of key stakeholder perceptions.

PubMed

Tang, Jessica Janice; Leka, Stavroula; Hunt, Nigel; MacLennan, Sara

2011-12-01

It is widely acknowledged that teachers are suffering from work-related health problems. However, the implementation of relevant occupational safety and health (OSH) policies is complex and under-studied. This study reviews key legislation of relevance to psychosocial health and explores stakeholders' perceptions on their implementation in Hong Kong (HK) schools. The content of OSH legislation applicable to psychosocial health was systematically reviewed by the modified WHO checklist on legislation. Semi-structured interviews were then conducted with 38 key stakeholders. These were transcribed and subjected to Framework Analysis. The review showed that there were several ambiguities in the legislation and the interviews found that awareness and understanding in relation to OSH issues and policies differed on the basis of the level of implementation bodies. The importance of management, trust, communication and interpersonal relationships was emphasised. On the basis of the study it is concluded that implementation of psychosocial health policies in HK schools is poor and there appears to be a gap among stakeholder communication. Also, the content of these policies needs to be clarified so that it can be more conducive to implementation in practice. The improvement of OSH climate and social capital could foster a more effective implementation of OSH policies. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

78 FR 32255 - HHS-Operated Risk Adjustment Data Validation Stakeholder Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-29

...-Operated Risk Adjustment Data Validation Stakeholder Meeting AGENCY: Centers for Medicare & Medicaid... Act HHS-operated risk adjustment data validation process. The purpose of this public meeting is to... interested parties about key HHS policy considerations pertaining to the HHS-operated risk adjustment data...

Responsible gambling: general principles and minimal requirements.

PubMed

Blaszczynski, Alex; Collins, Peter; Fong, Davis; Ladouceur, Robert; Nower, Lia; Shaffer, Howard J; Tavares, Hermano; Venisse, Jean-Luc

2011-12-01

Many international jurisdictions have introduced responsible gambling programs. These programs intend to minimize negative consequences of excessive gambling, but vary considerably in their aims, focus, and content. Many responsible gambling programs lack a conceptual framework and, in the absence of empirical data, their components are based only on general considerations and impressions. This paper outlines the consensus viewpoint of an international group of researchers suggesting fundamental responsible gambling principles, roles of key stakeholders, and minimal requirements that stakeholders can use to frame and inform responsible gambling programs across jurisdictions. Such a framework does not purport to offer value statements regarding the legal status of gambling or its expansion. Rather, it proposes gambling-related initiatives aimed at government, industry, and individuals to promote responsible gambling and consumer protection. This paper argues that there is a set of basic principles and minimal requirements that should form the basis for every responsible gambling program.

Accelerating to Zero: Strategies to Eliminate Malaria in the Peruvian Amazon

PubMed Central

Quispe, Antonio M.; Llanos-Cuentas, Alejandro; Rodriguez, Hugo; Clendenes, Martin; Cabezas, Cesar; Leon, Luis M.; Chuquiyauri, Raul; Moreno, Marta; Kaslow, David C.; Grogl, Max; Herrera, Sócrates; Magill, Alan J.; Kosek, Margaret; Vinetz, Joseph M.; Lescano, Andres G.; Gotuzzo, Eduardo

2016-01-01

In February 2014, the Malaria Elimination Working Group, in partnership with the Peruvian Ministry of Health (MoH), hosted its first international conference on malaria elimination in Iquitos, Peru. The 2-day meeting gathered 85 malaria experts, including 18 international panelists, 23 stakeholders from different malaria-endemic regions of Peru, and 11 MoH authorities. The main outcome was consensus that implementing a malaria elimination project in the Amazon region is achievable, but would require: 1) a comprehensive strategic plan, 2) the altering of current programmatic guidelines from control toward elimination by including symptomatic as well as asymptomatic individuals for antimalarial therapy and transmission-blocking interventions, and 3) the prioritization of community-based active case detection with proper rapid diagnostic tests to interrupt transmission. Elimination efforts must involve key stakeholders and experts at every level of government and include integrated research activities to evaluate, implement, and tailor sustainable interventions appropriate to the region.

Dealing with pollution from conflict: Analysis of discourses around the 2006 Lebanon oil spill.

PubMed

Takshe, Aseel A; Huby, Meg; Frantzi, Sofia; Lovett, Jon C

2010-01-01

In July 2006 a war between Lebanon and Israel resulted in severe environmental damage in Lebanon from Israeli bombing raids. An attack on the Lebanese Jiyyeh Power Plant released 15,000 tons of heavy fuel oil into the Mediterranean Sea. Remarkably, a clean-up operation was effected despite a continued state of war and lack of capacity in the Lebanese government. Civil society environmentalists played a key role in dealing with the pollution and complying with pollution-control legislation. In this study we use Q-methodology to analyse discourses on the effectiveness of pollution legislation during times of conflict using the Jiyyeh oil spill as an example. We interviewed 35 people from eight different stakeholder groups involved in environmental issues. Five distinct discourses were generated covering compensation schemes, need for new legislation, role of stakeholders during wartime and strengthening government ministries. Copyright 2009 Elsevier Ltd. All rights reserved.

Whose Community are You Working for? A Change Agent Case Study.

PubMed

Silva, Janelle M

2017-12-01

This article explores the role and responsibility of the community psychologist in creating change that could potentially harm the group they are meant to be in solidarity with. Drawing upon a 2-year project with a Latinx Student Union at a public middle school in the Pacific Northwest, I examine the ethical dilemmas that arose when powerful stakeholders (school administration) changed the goals and intention of the research project without the consent of the low-power stakeholders (the students). This narrative seeks to shed light on the dilemmas that come with being an ethical community psychologist (Balcazar, Garate-Serafini, & Keys, 2004; Nelson, Prilleltensky, & MacGillivary, 2001; O'Neill, 1989), how these ethics can be compromised by one's identity, and what it means to work for/with/against one's community when deciding whether to stay with or leave a project. © Society for Community Research and Action 2017.

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

Strategic planning to reduce conflicts for offshore wind development in Taiwan: A social marketing perspective.

PubMed

Chen, Jyun-Long; Liu, Hsiang-Hsi; Chuang, Ching-Ta

2015-10-15

This study aims to improve the current inefficiency and ineffectiveness of communications among stakeholders when planning and constructing offshore wind farms (OWFs). An analysis using a social marketing approach with segmentation techniques is used to identify the target market based on stakeholders' perceptions. The empirical results identify three stakeholder segments: (1) impact-attend group; (2) comprehensive group; and (3) benefit-attend group. The results suggest that communication should be implemented to alter stakeholders' attitudes toward the construction of OWFs. Furthermore, based on the results of segmentation, target markets are identified to plan the communication strategies for reducing the conflicts among stakeholders of OWF construction. The results also indicated that in the planning phase of construction for OWFs, effective stakeholder participation and policy communication can enhance the perception of benefits to reduce conflict with local communities and ocean users. Copyright © 2015 Elsevier Ltd. All rights reserved.

A framework for stakeholder identification in concept mapping and health research: a novel process and its application to older adult mobility and the built environment.

PubMed

Schiller, Claire; Winters, Meghan; Hanson, Heather M; Ashe, Maureen C

2013-05-02

Stakeholders, as originally defined in theory, are groups or individual who can affect or are affected by an issue. Stakeholders are an important source of information in health research, providing critical perspectives and new insights on the complex determinants of health. The intersection of built and social environments with older adult mobility is an area of research that is fundamentally interdisciplinary and would benefit from a better understanding of stakeholder perspectives. Although a rich body of literature surrounds stakeholder theory, a systematic process for identifying health stakeholders in practice does not exist. This paper presents a framework of stakeholders related to older adult mobility and the built environment, and further outlines a process for systematically identifying stakeholders that can be applied in other health contexts, with a particular emphasis on concept mapping research. Informed by gaps in the relevant literature we developed a framework for identifying and categorizing health stakeholders. The framework was created through a novel iterative process of stakeholder identification and categorization. The development entailed a literature search to identify stakeholder categories, representation of identified stakeholders in a visual chart, and correspondence with expert informants to obtain practice-based insight. The three-step, iterative creation process progressed from identifying stakeholder categories, to identifying specific stakeholder groups and soliciting feedback from expert informants. The result was a stakeholder framework comprised of seven categories with detailed sub-groups. The main categories of stakeholders were, (1) the Public, (2) Policy makers and governments, (3) Research community, (4) Practitioners and professionals, (5) Health and social service providers, (6) Civil society organizations, and (7) Private business. Stakeholders related to older adult mobility and the built environment span many disciplines and realms of practice. Researchers studying this issue may use the detailed stakeholder framework process we present to identify participants for future projects. Health researchers pursuing stakeholder-based projects in other contexts are encouraged to incorporate this process of stakeholder identification and categorization to ensure systematic consideration of relevant perspectives in their work.

A framework for stakeholder identification in concept mapping and health research: a novel process and its application to older adult mobility and the built environment

PubMed Central

2013-01-01

Background Stakeholders, as originally defined in theory, are groups or individual who can affect or are affected by an issue. Stakeholders are an important source of information in health research, providing critical perspectives and new insights on the complex determinants of health. The intersection of built and social environments with older adult mobility is an area of research that is fundamentally interdisciplinary and would benefit from a better understanding of stakeholder perspectives. Although a rich body of literature surrounds stakeholder theory, a systematic process for identifying health stakeholders in practice does not exist. This paper presents a framework of stakeholders related to older adult mobility and the built environment, and further outlines a process for systematically identifying stakeholders that can be applied in other health contexts, with a particular emphasis on concept mapping research. Methods Informed by gaps in the relevant literature we developed a framework for identifying and categorizing health stakeholders. The framework was created through a novel iterative process of stakeholder identification and categorization. The development entailed a literature search to identify stakeholder categories, representation of identified stakeholders in a visual chart, and correspondence with expert informants to obtain practice-based insight. Results The three-step, iterative creation process progressed from identifying stakeholder categories, to identifying specific stakeholder groups and soliciting feedback from expert informants. The result was a stakeholder framework comprised of seven categories with detailed sub-groups. The main categories of stakeholders were, (1) the Public, (2) Policy makers and governments, (3) Research community, (4) Practitioners and professionals, (5) Health and social service providers, (6) Civil society organizations, and (7) Private business. Conclusions Stakeholders related to older adult mobility and the built environment span many disciplines and realms of practice. Researchers studying this issue may use the detailed stakeholder framework process we present to identify participants for future projects. Health researchers pursuing stakeholder-based projects in other contexts are encouraged to incorporate this process of stakeholder identification and categorization to ensure systematic consideration of relevant perspectives in their work. PMID:23639179

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.

Extending stakeholder theory to promote resource management initiatives to key stakeholders: a case study of water transfers in Alberta, Canada.

PubMed

Lafreniere, Katherine C; Deshpande, Sameer; Bjornlund, Henning; Hunter, M Gordon

2013-11-15

Many attempts to implement resource management initiatives in Canadian and international communities have been resisted by stakeholders despite inclusion of their representatives in the decision-making process. Managers' failure to understand stakeholders' perspectives when proposing initiatives is a potential cause of this resistance. Our study uses marketing thought to enhance stakeholder theory by bringing in an audience-centric perspective. We attempt to understand how stakeholders perceive their interests in an organization and consequently decide how to influence that organization. By doing so, we investigate whether a disconnect exists between the perceptions of managers and those of stakeholders. Natural resource managers can utilize this knowledge to garner stakeholder support for the organization and its activities. We support this claim with findings from a water transfer plebiscite held in the Canadian province of Alberta. Sixteen personal interviews employing narrative inquiry were conducted to document voters' (i.e., irrigators') interpretations. Copyright © 2013 Elsevier Ltd. All rights reserved.

Disinvestment policy and the public funding of assisted reproductive technologies: outcomes of deliberative engagements with three key stakeholder groups

PubMed Central

2014-01-01

Background Measures to improve the quality and sustainability of healthcare practice and provision have become a policy concern. In addition, the involvement of stakeholders in health policy decision-making has been advocated, as complex questions arise around the structure of funding arrangements in a context of limited resources. Using a case study of assisted reproductive technologies (ART), deliberative engagements with a range of stakeholder groups were held on the topic of how best to structure the distribution of Australian public funding in this domain. Methods Deliberative engagements were carried out with groups of ART consumers, clinicians and community members. The forums were informed by a systematic review of ART treatment safety and effectiveness (focusing, in particular, on maternal age and number of treatment cycles), as well as by international policy comparisons, and ethical and cost analyses. Forum discussions were transcribed and subject to thematic analysis. Results Each forum demonstrated stakeholders’ capacity to understand concepts of choice under resource scarcity and disinvestment, and to countenance options for ART funding not always aligned with their interests. Deliberations in each engagement identified concerns around ‘equity’ and ‘patient responsibility’, culminating in a broad preference for (potential) ART subsidy restrictions to be based upon individual factors rather than maternal age or number of treatment cycles. Community participants were open to restrictions based upon measures of body mass index (BMI) and smoking status, while consumers and clinicians saw support to improve these factors as part of an ART treatment program, as distinct from a funding criterion. All groups advocated continued patient co-payments, with measures in place to provide treatment access to those unable to pay (namely, equity of access). Conclusions Deliberations yielded qualitative, socially-negotiated evidence required to inform ethical, accountable policy decisions in the specific area of ART and health care more broadly. Notably, reductionist, deterministic characterizations of stakeholder ‘self-interest’ proved unfounded as each group sought to prioritise universal values (in particular, ‘equity’ and ‘responsibility’) over specific, within-group concerns. Our results - from an emotive case study in ART - highlight that evidence-informed disinvestment decision-making is feasible, and potentially less controversial than often presumed. PMID:24885716

Attitudes toward evaluation: An exploratory study of students' and stakeholders' social representations.

PubMed

Schultes, Marie-Therese; Kollmayer, Marlene; Mejeh, Mathias; Spiel, Christiane

2018-06-15

Positive attitudes toward evaluation among stakeholders are an important precondition for successful evaluation processes. However, empirical studies focusing on stakeholders' attitudes toward evaluation are scarce. The present paper explores the approach of assessing social representations as indicators of people's attitudes toward evaluation. In an exploratory study, two groups were surveyed: University students (n = 60) with rather theoretical knowledge of evaluation and stakeholders (n = 61) who had shortly before taken part in participatory evaluation studies. Both groups were asked to name their free associations with the term "evaluation", which were subsequently analyzed lexicographically. The results indicate different social representations of evaluation in the two groups. The student group primarily saw evaluation as an "appraisal", whereas the stakeholders emphasized the "improvement" resulting from evaluation. Implications for further evaluation research and practice are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

How do the public and policy makers communicate their perceptions of environmental risk to academics?

NASA Astrophysics Data System (ADS)

Holden, Jennifer

2010-05-01

This paper investigates the ways that the public and policy makers talk about environmental risk to academics. The case study is heavy-metal contamination of food in Zambia, Southern Africa. In several localities in Zambia, urban agriculture is practised using heavy-metal contamination wastewater for irrigation. This leads to contaminated food crops that are subsequently consumed. One case study site where this occurs is Chunga, situated in the northwest of the Zambian capital: Lusaka. For members of the public, six focus groups were carried out at the Chunga, Zambia study site, involving a total of 48 participants. The participants were those involved in urban agriculture through cultivation, selling and consumption of food crops. Urban agriculturalist focus group participants were recruited through key field informants. Focus group discussion starter questions involved pollution awareness, health impacts of pollution in the area and who is responsible for communicating environmental contamination risks to the general population. For policy stakeholders, 39 semi-structured interviews were conducted with individuals from various organisations including government ministries, non-governmental organisations, community based organisations and international institutions. Semi-structured interviews investigated the perceived major health issues in Zambia, food safety, environmental contamination and specifically heavy-metal contamination. Policy stakeholders were identified through policy mapping and organisations mentioned in focus group discussions and other interviews. The results at the Chunga study site show that members of the public perceive: (i) heavy metal pollution is not an issue in Lusaka and for their irrigation practices, (ii) dirty food can cause illness, (iii) heavy metals in foods can cause illness but they are not present at the Chunga site. Amongst urban agriculturalists the quantity of food available is the greatest issue, with some saying that they do not have the luxury of thinking about the quality of food. Only two policy makers in the semi-structured interviews perceived there to be a possible health problems due to heavy metal contaminated food in Zambia. However, this was from personal experience and not a corporate view. Policy makers did not think that food safety was an issue in Zambia, with several interviewees stating that food security was more of a priority, reflecting the urban agriculture cultivators' views that quantity is the more important issue than quality of food. Risks due to environmental contamination are not high in the public and policy makers' priorities, even when asked directly about the issue. Both urban agriculturalists and policy stakeholders believe that academics have a key role to play in communicating the possible and actual risks to the affected populations and institutional stakeholders.

Applying Critical Race Theory to Group Model Building Methods to Address Community Violence.

PubMed

Frerichs, Leah; Lich, Kristen Hassmiller; Funchess, Melanie; Burrell, Marcus; Cerulli, Catherine; Bedell, Precious; White, Ann Marie

2016-01-01

Group model building (GMB) is an approach to building qualitative and quantitative models with stakeholders to learn about the interrelationships among multilevel factors causing complex public health problems over time. Scant literature exists on adapting this method to address public health issues that involve racial dynamics. This study's objectives are to (1) introduce GMB methods, (2) present a framework for adapting GMB to enhance cultural responsiveness, and (3) describe outcomes of adapting GMB to incorporate differences in racial socialization during a community project seeking to understand key determinants of community violence transmission. An academic-community partnership planned a 1-day session with diverse stakeholders to explore the issue of violence using GMB. We documented key questions inspired by critical race theory (CRT) and adaptations to established GMB "scripts" (i.e., published facilitation instructions). The theory's emphasis on experiential knowledge led to a narrative-based facilitation guide from which participants created causal loop diagrams. These early diagrams depict how violence is transmitted and how communities respond, based on participants' lived experiences and mental models of causation that grew to include factors associated with race. Participants found these methods useful for advancing difficult discussion. The resulting diagrams can be tested and expanded in future research, and will form the foundation for collaborative identification of solutions to build community resilience. GMB is a promising strategy that community partnerships should consider when addressing complex health issues; our experience adapting methods based on CRT is promising in its acceptability and early system insights.

The Use of Telemental Health to Meet the Mental Health Needs of Women Using Department of Veterans Affairs Services.

PubMed

Moreau, Jessica L; Cordasco, Kristina M; Young, Alexander S; Oishi, Sabine M; Rose, Danielle E; Canelo, Ismelda; Yano, Elizabeth M; Haskell, Sally G; Hamilton, Alison B

Women veterans are a growing segment of Department of Veterans Affairs (VA) users with distinct mental health needs and well-documented barriers to care. Telemental health holds much promise for reducing barriers to mental health care. We assessed VA stakeholders' perceptions of telemental health's appropriateness and potential to address the mental health needs of women veteran VA users. We conducted semistructured qualitative interviews with 40 key leadership and clinical stakeholders at VA medical centers and associated outpatient clinics. Transcripts were summarized in a template of key domains developed based on the interview guide, and coded for topics relevant to women's mental health needs and telehealth services. Telemental health was perceived to increase access to mental health care, including same-gender care and access to providers with specialized training, especially for rural women and those with other limiting circumstances. Respondents saw women veterans as being particularly poised to benefit from telemental health, owing to responsibilities associated with childcare, spousal care, and elder caregiving. Interviewees expressed enthusiasm for telemental health's potential and were eager to expand services, including women-only mental health groups. Implementation challenges were also noted. Overall, our stakeholders saw telemental health as a good fit for helping to address the perceived needs of women veterans, especially in addressing the geographical barriers experienced by rural women and those with a limited ability to travel. These findings can help to inform gender-tailored expansion of telemental health within and outside of the VA. Published by Elsevier Inc.

Primary health care nurses implement and evaluate a community outreach approach to health care in the South African agricultural sector.

PubMed

Dick, J; Clarke, M; van Zyl, H; Daniels, K

2007-12-01

Early detection and effective case management of tuberculosis (TB) among a high-risk group of materially poor farm workers in an area of the Cape Winelands, South Africa, presents special challenges to the health community, where resource constraints lead to service reduction. In order to address this problem, local nurses established a collaborative partnership between permanent farm workers and their families, their employers, selected non-governmental organizations and the public health sector. In consultation with stakeholders, they developed an intervention primarily focusing on having peer selected trained lay health workers (LHWs) on farms, mentored and managed by nurses. To describe the complex process of implementation and evaluation of the LHW project, and provide a summary of a number of discrete studies evaluating the effectiveness, cost implications, and the perceptions and experiences of key stakeholders of the intervention. Quantitative and qualitative research methods conducted within the context of a pragmatic unblinded community cluster randomized control trial were used. Emphasis was placed on an iterative participatory interaction between the researchers and key stakeholders. The intervention contributed to significantly better successful treatment completion rates among adult new smear-positive TB cases. The process implemented proved cost-effective and was pivotal in initiating a community-based social development programme. The use of peer-selected LHWs within a wider programme of integrated care designed to merge technical biomedical approaches to disease management with more holistic social development activities, appears essential to meet the complex health needs in conjunction with public health of the rural poor.

Beyond the Continent: Creating an Independent Scientific Assessment Process for the Hawai`i and U.S. Affiliated Pacific Islands Region

NASA Astrophysics Data System (ADS)

Grecni, Z. N.; Keener, V. W.

2017-12-01

An external evaluation found that the inclusion of users of climate information and diverse regional experts in developing the 2012 Pacific Islands Regional Climate Assessment was a key factor in the report's perceived credibility and usefulness (Moser 2013). The 2012 assessment is seen as a foundational summary for Hawai`i and the U.S.-Affiliated Pacific Islands and is still used in vulnerability assessments and to support decisions by public- and private-sector actors. Recently, lessons learned from the 2012 assessment process were applied in engaging technical experts and potential future users in developing a chapter for the U.S. National Climate Assessment, as a regional update that builds on previous assessment activities. In the absence of downscaled climate projection scenarios and products available to the contiguous U.S., the Pacific Islands chapter continued to draw on projections from regional climate models and extensive user engagement. Through surveys, webinars, technical sectoral workshops, and peer review networks, the regional author team received input from a range of stakeholders. In particular, engagement aimed to identify key risks in sectors of importance to the Hawai`i and U.S.-Affiliated Pacific Islands region and cases in which stakeholder groups are already implementing measures toward resilience and adaptation. Data collection began during the chapter development process and will continue at the release of the 4th National Climate Assessment in 2018, with the aim of evaluating how stakeholder engagement affects the assessment's usefulness in assisting island communities to understand risks and vulnerabilities and review potential adaptation strategies.

Universal Free School Breakfast: A Qualitative Model for Breakfast Behaviors

PubMed Central

Harvey-Golding, Louise; Donkin, Lynn Margaret; Blackledge, John; Defeyter, Margaret Anne

2015-01-01

In recent years, the provision of school breakfast has increased significantly in the UK. However, research examining the effectiveness of school breakfast is still within relative stages of infancy, and findings to date have been rather mixed. Moreover, previous evaluations of school breakfast schemes have been predominantly quantitative in their methodologies. Currently, there are few qualitative studies examining the subjective perceptions and experiences of stakeholders, and thereby an absence of knowledge regarding the sociocultural impacts of school breakfast. The purpose of this study was to investigate the beliefs, views and attitudes, and breakfast consumption behaviors, among key stakeholders, served by a council-wide universal free school breakfast initiative, within the North West of England, UK. A sample of children, parents, and school staff were recruited from three primary schools, participating in the universal free school breakfast scheme, to partake in semi-structured interviews and small focus groups. A Grounded Theory analysis of the data collected identified a theoretical model of breakfast behaviors, underpinned by the subjective perceptions and experiences of these key stakeholders. The model comprises of three domains relating to breakfast behaviors, and the internal and external factors that are perceived to influence breakfast behaviors, among children, parents, and school staff. Findings were validated using triangulation methods, member checks, and inter-rater reliability measures. In presenting this theoretically grounded model for breakfast behaviors, this paper provides a unique qualitative insight into the breakfast consumption behaviors and barriers to breakfast consumption, within a socioeconomically deprived community, participating in a universal free school breakfast intervention program. PMID:26125017

Designing a workplace return-to-work program for occupational low back pain: an intervention mapping approach.

PubMed

Ammendolia, Carlo; Cassidy, David; Steensta, Ivan; Soklaridis, Sophie; Boyle, Eleanor; Eng, Stephanie; Howard, Hamer; Bhupinder, Bains; Côté, Pierre

2009-06-09

Despite over 2 decades of research, the ability to prevent work-related low back pain (LBP) and disability remains elusive. Recent research suggests that interventions that are focused at the workplace and incorporate the principals of participatory ergonomics and return-to-work (RTW) coordination can improve RTW and reduce disability following a work-related back injury. Workplace interventions or programs to improve RTW are difficult to design and implement given the various individuals and environments involved, each with their own unique circumstances. Intervention mapping provides a framework for designing and implementing complex interventions or programs. The objective of this study is to design a best evidence RTW program for occupational LBP tailored to the Ontario setting using an intervention mapping approach. We used a qualitative synthesis based on the intervention mapping methodology. Best evidence from systematic reviews, practice guidelines and key articles on the prognosis and management of LBP and improving RTW was combined with theoretical models for managing LBP and changing behaviour. This was then systematically operationalized into a RTW program using consensus among experts and stakeholders. The RTW Program was further refined following feedback from nine focus groups with various stakeholders. A detailed five step RTW program was developed. The key features of the program include; having trained personnel coordinate the RTW process, identifying and ranking barriers and solutions to RTW from the perspective of all important stakeholders, mediating practical solutions at the workplace and, empowering the injured worker in RTW decision-making. Intervention mapping provided a useful framework to develop a comprehensive RTW program tailored to the Ontario setting.

Chapter 3: choosing the important outcomes for a systematic review of a medical test.

PubMed

Segal, Jodi B

2012-06-01

In this chapter of the Evidence-based Practice Centers Methods Guide for Medical Tests, we describe how the decision to use a medical test generates a broad range of outcomes and that each of these outcomes should be considered for inclusion in a systematic review. Awareness of these varied outcomes affects how a decision maker balances the benefits and risks of the test; therefore, a systematic review should present the evidence on these diverse outcomes. The key outcome categories include clinical management outcomes and direct health effects; emotional, social, cognitive, and behavioral responses to testing; legal and ethical outcomes, and costs. We describe the challenges of incorporating these outcomes in a systematic review, suggest a framework for generating potential outcomes for inclusion, and describe the role of stakeholders in choosing the outcomes for study. Finally, we give examples of systematic reviews that either included a range of outcomes or that might have done so. The following are the key messages in this chapter: Consider both the outcomes that are relevant to the process of testing and those that are relevant to the results of the test. Consider inclusion of outcomes in all five domains: clinical management effects, direct test effects; emotional, social, cognitive and behavioral effects; legal and ethical effects, and costs. Consider to which group the outcomes of testing are most relevant. Given resource limitations, prioritize which outcomes to include. This decision depends on the needs of the stakeholder(s), who should be assisted in prioritizing the outcomes for inclusion.

A Multiyear Investigation of Combating Bullying in Middle School: Stakeholder Perspectives

ERIC Educational Resources Information Center

Shriberg, David; Burns, Mallory; Desai, Poonam; Grunewald, Stephanie; Pitt, Rachel

2015-01-01

Working collaboratively to address bullying among middle school students is an ongoing challenge. This study used participatory action research to collaborate with key stakeholders within a middle school to identify needs and implement more effective practices. Extensive qualitative and quantitative data are presented, along with process…

What works for wellbeing in culture and sport? Report of a DELPHI process to support coproduction and establish principles and parameters of an evidence review.

PubMed

Daykin, Norma; Mansfield, Louise; Payne, Annette; Kay, Tess; Meads, Catherine; D'Innocenzo, Giorgia; Burnett, Adele; Dolan, Paul; Julier, Guy; Longworth, Louise; Tomlinson, Alan; Testoni, Stefano; Victor, Christina

2017-09-01

There is a growing recognition of the ways in which culture and sport can contribute to wellbeing. A strong evidence base is needed to support innovative service development and a 3-year research programme is being undertaken to capture best evidence of wellbeing impacts and outcomes of cultural and sporting activities in order to inform UK policy and practice. This article provides an overview of methods and findings from an initial coproduction process with key stakeholders that sought to explore and agree principles and parameters of the evidence review for culture, sport and wellbeing (CSW). A two-stage DELPHI process was conducted with a purposeful sample of 57 stakeholders between August and December 2015. Participants were drawn from a range of culture and sport organisations and included commissioners and managers, policy makers, representatives of service delivery organisations (SDOs) and scholars. The DELPHI 1 questionnaire was developed from extensive consultation in July and August 2015. It explored definitions of wellbeing, the role of evidence, quality assessment, and the culture and sport populations, settings and interventions that are most likely to deliver wellbeing outcomes. Following further consultation, the results, presented as a series of ranked statements, were sent back to participants (DELPHI 2), which allowed them to reflect on and, if they wished, express agreement or disagreement with the emerging consensus. A total of 40 stakeholders (70.02%) responded to the DELPHI questionnaires. DELPHI 1 mapped areas of agreement and disagreement, confirmed in DELPHI 2. The exercise drew together the key priorities for the CSW evidence review. The DELPHI process, in combination with face-to-face deliberation, enabled stakeholders to engage in complex discussion and express nuanced priorities while also allowing the group to come to an overall consensus and agree outcomes. The results will inform the CSW evidence review programme until its completion in March 2018.

What works for wellbeing in culture and sport? Report of a DELPHI process to support coproduction and establish principles and parameters of an evidence review

PubMed Central

Daykin, Norma; Mansfield, Louise; Payne, Annette; Kay, Tess; Meads, Catherine; D’Innocenzo, Giorgia; Burnett, Adele; Dolan, Paul; Julier, Guy; Longworth, Louise; Tomlinson, Alan; Testoni, Stefano; Victor, Christina

2016-01-01

Aims: There is a growing recognition of the ways in which culture and sport can contribute to wellbeing. A strong evidence base is needed to support innovative service development and a 3-year research programme is being undertaken to capture best evidence of wellbeing impacts and outcomes of cultural and sporting activities in order to inform UK policy and practice. This article provides an overview of methods and findings from an initial coproduction process with key stakeholders that sought to explore and agree principles and parameters of the evidence review for culture, sport and wellbeing (CSW). Methods: A two-stage DELPHI process was conducted with a purposeful sample of 57 stakeholders between August and December 2015. Participants were drawn from a range of culture and sport organisations and included commissioners and managers, policy makers, representatives of service delivery organisations (SDOs) and scholars. The DELPHI 1 questionnaire was developed from extensive consultation in July and August 2015. It explored definitions of wellbeing, the role of evidence, quality assessment, and the culture and sport populations, settings and interventions that are most likely to deliver wellbeing outcomes. Following further consultation, the results, presented as a series of ranked statements, were sent back to participants (DELPHI 2), which allowed them to reflect on and, if they wished, express agreement or disagreement with the emerging consensus. Results: A total of 40 stakeholders (70.02%) responded to the DELPHI questionnaires. DELPHI 1 mapped areas of agreement and disagreement, confirmed in DELPHI 2. The exercise drew together the key priorities for the CSW evidence review. Conclusion: The DELPHI process, in combination with face-to-face deliberation, enabled stakeholders to engage in complex discussion and express nuanced priorities while also allowing the group to come to an overall consensus and agree outcomes. The results will inform the CSW evidence review programme until its completion in March 2018. PMID:27789779

Lessons in Commercial PACE Leadership: The Path from Legislation to Launch

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

Leventis, G; Schwartz, LC; Kramer, C

Nonresidential buildings are responsible for over a quarter of primary energy consumption in the United States. Efficiency improvements in these buildings could result in significant energy and utility bill savings. To unlock those potential savings, a number of market barriers to energy efficiency must be addressed. Commercial Property Assessed Clean Energy (C-PACE) financing programs can help overcome several of these barriers with minimal investment from state and local governments. With programs established or under development in 22 states, and at least $521 million in investments so far, other state and local governments are interested in bringing the benefits of C-PACEmore » to their jurisdictions. Lessons in Commercial PACE Leadership: The Path from Legislation to Launch, aims to fast track the set-up of C-PACE programs for state and local governments by capturing the lessons learned from leaders. The report examines the list of potential program design options and important decision points in setting up a C-PACE program, tradeoffs for available options, and experiences of stakeholders that have gone through (or are going through) the process. C-PACE uses a voluntary special property assessment to facilitate energy and other improvements in commercial buildings. For example: - Long financing terms under C-PACE can produce cash flow-positive -- projects to help overcome a focus on short paybacks. - Payment obligations can transfer to subsequent owners, mitigating concern about investing in improvements for a building that may be sold before the return on the investment is fully realized. - 100% of both hard and soft costs can be financed. To capture the benefits of C-PACE financing, state and local governments must navigate numerous decision points and engage with stakeholders to set-up or join a program. Researchers interviewed experts (including state and local sponsors, program administrators, capital providers and industry experts) on their lessons learned and arrived at the following key takeaways for state and local leaders: Enabling legislation: Carefully developed enabling legislation (which includes certain key provisions) and early stakeholder input can greatly improve the chances of program success. Options for program administrative structure: At least four program administrative structures are in use; certain administrative structures inherently result in more standardized product offerings and, potentially, economies of scale. Approaches to program and project capitalization: Two approaches to capitalization have been used. Bonding (project capital is raised through a bond sale) and direct funding (capital providers fund projects directly); programs can rely on one capital provider (a closed market) or allow multiple capital providers to participate (an open market). What and who qualifies for the program: Some programs require a minimum project savings-to-investment ratio; other programs encourage it or are indifferent. Estimating and documenting project energy cost saving: Estimating and documenting energy and cost savings can add costs to projects but also demonstrate C-PACE program value. Stakeholder engagement: Key stakeholder groups to engage include community leaders, local governments, building owners, contractors, utilities, capital providers and mortgage holders; stakeholder engagement should be tailored to each particular group. Start-up and ongoing costs: Understanding set-up and ongoing costs can help program sponsors plan for funding C-PACE programs and projects. The U.S. Department of Energy's Office of Weatherization and Intergovernmental Programs funded the report.« less

Insurer and employer views on pediatric obesity treatment: a qualitative study.

PubMed

Hampl, S E; Davis, A M; Sampilo, M L; Stephens, K L; Dean, K

2013-04-01

The effectiveness of group-based comprehensive, multidisciplinary (stage 3) pediatric weight management programs is backed by a growing body of literature, yet insurance coverage of these programs is scarce to nonexistent, limiting their reach and long-term survival. The objective of this study was to better understand the perspectives of insurers and large employers on the issue of group-based treatment coverage. The authors performed a qualitative study utilizing structured interviews with these stakeholders, following accepted techniques. Six major themes emerged: cost, program effectiveness, corporate social responsibility, secondary parental (employee) benefits, coverage options and new benefit determination. Future efforts to secure payment for group-based pediatric weight management programs should address these key themes. Copyright © 2012 The Obesity Society.

Privatizing the English National Health Service: an irregular verb?

PubMed

Powell, Martin; Miller, Robin

2013-10-01

This article explores different stakeholder perspectives of "privatization" in the English National Health Service (NHS). Much of the academic literature makes empirical claims about privatization on the basis of absent or shaky definitions of the term, resulting in much of the debate on this issue largely being a "non-debate," where opponents talk past rather than to each other. We aim to throw light on privatization by applying the lens of the "three-dimensional" approach (ownership, finance, and regulation) of the mixed economy of welfare to the views of key voices within these debates. These stakeholder perspectives are political (parliamentary debates), public (opinion polls), clinical provider (British Medical Association and Royal College of Nursing), and campaigning groups. We argue that in terms of grammar, "privatize" seems to be an irregular verb: I want more private-sector involvement; you wish to privatize the NHS. The term privatization is multidimensional, and definitions and operationalizations of the term are often implicit, unclear, and conflicting, resulting in differing accounts of the occurrence, chronology, and degree of privatization in the NHS. Stakeholders have divergent interests, and they use "privatization" as a way to express them, resulting in a Tower of Babel.

Stakeholders Participation In The European Water Framework Directive

NASA Astrophysics Data System (ADS)

van Ast, J. A.; Boot, S. P.

In the new framework directive, public information and consultation are main ele- ments in the procedure towards River Basin Management Plans. In general decision making in integrated water management should not be limited to the application of models and desk study. All important decisions need interaction with societal actors. These stakeholders have visions, ideas, patterns of behaviour and solutions for per- ceived problems. For example, farmer organisations, environmental groups and house- owners associations all have different ideas about measures that change the physical, chemical or biological characteristics of a river basin. Well- organised interaction has two main advantages: 1. The quality of the decision will be higher because specific knowledge of involved people and their different views are being taken into consider- ation. 2. The interaction enables exchange of information which can lead to a better understanding of the ins and outs of the specific situation and in this way contribute to public support. There are different ways for operationalisation of public informa- tion and consultation, like interactive workshops, internet assessment and interview rounds with key players. In this paper some of the different methods of interaction with stakeholders are elaborated. The aim is to improve the quality of integrated water management in river basins.

Stakeholder Perspectives on a Culture of Health: Key Findings.

PubMed

Acosta, Joie D; Whitley, Margaret D; May, Linnea Warren; Dubowitz, Tamara; Williams, Malcolm V; Chandra, Anita

2017-06-01

Since 2013, the Robert Wood Johnson Foundation (RWJF) has embarked on a pioneering effort to advance a Culture of Health. The Culture of Health action framework is founded on a vision in which "everyone in our diverse society leads healthier lives now and for generations to come." To put the Culture of Health vision into action, RWJF asked RAND Health to support the development of an action framework and measurement strategy. This article summarizes the stakeholder engagement efforts that RAND used to inform this work. It draws on a series of interviews and focus groups that RAND researchers conducted with stakeholders both within and outside the United States. It should be of interest to RWJF, as well as to those individuals and organizations interested in advancing the Culture of Health action framework. Given that RWJF is focused on using the Culture of Health action framework and measures to catalyze national dialogue about content and investments to improve population health and well-being, the study should be beneficial to a range of national, state, and local leaders across a variety of sectors that contribute to health as described by the Culture of Health action framework.

Minutes of the Stakeholder Meetings on the Report of the Jsa Shrimp Virus Work Group (1997)

EPA Science Inventory

Minutes of the Stakeholder Meetings on the Report of the JSA Shrimp Virus Work Group - Availability September 1997 (EPA/600/R-97/136)

This document is comprised of five pieces as follows:

Minutes of the Stakeholder Meetings on the Report o...

Using Online Learning To Meet Workforce Demand: A Case Study of Stakeholder Influence.

ERIC Educational Resources Information Center

Benson, Angela D.

2002-01-01

Investigated how stakeholder interests influenced one state's efforts to provide online undergraduate degree programs to meet workforce needs. Describes the use of an embedded qualitative case study design; discusses findings that showed that the interests of some stakeholder groups prevailed at the expense of other groups; and suggests further…

Exploring the influence of service user involvement on health and social care services for cancer.

PubMed

Attree, Pamela; Morris, Sara; Payne, Sheila; Vaughan, Suzanne; Hinder, Susan

2011-03-01

Service user involvement in health and social care is a key policy driver in the UK. In cancer care it is central to developing services which are effective, responsive and accessible to patients. Cancer network partnership groups are set up to enable joint working between service users and health care professionals and to drive service improvements. The aim of this study was to explore the influence of the cancer network partnership groups' service user involvement activities on cancer care. This was a qualitative study involving documentary analysis and in-depth case studies of a sample of partnership groups. Five partnership groups were purposively selected as case studies from Macmillan regions across the UK; documents were collated from a further five groups. Forty people, including core group members and key stakeholders in cancer services, were interviewed. The evidence from this study suggests that cancer network partnership groups are at their most influential at 'grass roots' level - contributing to patient information resources, enhancing access to services, and improving care environments. While such improvements are undoubtedly important to patients, the groups' aim is to influence strategic changes, for example in cancer care commissioning or macro-level policy decision-making. The evolution of open, participatory relationships between service users and professionals, and recognition of the value of experiential knowledge are seen as key factors in influencing cancer care. The provision of dedicated resources to strengthen service user involvement activities is also vital. © 2010 Blackwell Publishing Ltd.

Issues and approaches for ensuring effective communication on acceptable daily exposure (ADE) values applied to pharmaceutical cleaning.

PubMed

Olson, Michael J; Faria, Ellen C; Hayes, Eileen P; Jolly, Robert A; Barle, Ester Lovsin; Molnar, Lance R; Naumann, Bruce D; Pecquet, Alison M; Shipp, Bryan K; Sussman, Robert G; Weideman, Patricia A

2016-08-01

This manuscript centers on communication with key stakeholders of the concepts and program goals involved in the application of health-based pharmaceutical cleaning limits. Implementation of health-based cleaning limits, as distinct from other standards such as 1/1000th of the lowest clinical dose, is a concept recently introduced into regulatory domains. While there is a great deal of technical detail in the written framework underpinning the use of Acceptable Daily Exposures (ADEs) in cleaning (for example ISPE, 2010; Sargent et al., 2013), little is available to explain how to practically create a program which meets regulatory needs while also fulfilling good manufacturing practice (GMP) and other expectations. The lack of a harmonized approach for program implementation and communication across stakeholders can ultimately foster inappropriate application of these concepts. Thus, this period in time (2014-2017) could be considered transitional with respect to influencing best practice related to establishing health-based cleaning limits. Suggestions offered in this manuscript are intended to encourage full and accurate communication regarding both scientific and administrative elements of health-based ADE values used in pharmaceutical cleaning practice. This is a large and complex effort that requires: 1) clearly explaining key terms and definitions, 2) identification of stakeholders, 3) assessment of stakeholders' subject matter knowledge, 4) formulation of key messages fit to stakeholder needs, 5) identification of effective and timely means for communication, and 6) allocation of time, energy, and motivation for initiating and carrying through with communications. Copyright © 2016 Elsevier Inc. All rights reserved.

A framework for m-health service development and success evaluation.

PubMed

Sadegh, S Saeedeh; Khakshour Saadat, Parisa; Sepehri, Mohammad Mehdi; Assadi, Vahid

2018-04-01

The emergence of mobile technology has influenced many service industries including health care. Mobile health (m-Health) applications have been used widely, and many services have been developed that have changed delivery systems and have improved effectiveness of health care services. Stakeholders of m-Health services have various resources and rights that lends to a complexity in service delivery. In addition, abundance of different m-Health services makes it difficult to choose an appropriate service for these stakeholders that include customers, patients, users or even providers. Moreover, a comprehensive framework is not yet provided in the literature that would help manage and evaluate m-health services, considering various stakeholder's benefits. In this paper, a comprehensive literature review has been done on famous frameworks and models in the field of Information Technology and electronic health with the aim of finding different aspects of developing and managing m-health services. Using the results of literature review and conducting a stakeholder analysis, we have proposed an m-health evaluation framework which evaluates the success of a given m-health service through a three-stage life cycle: (1) Service Requirement Analysis, (2) Service Development, and (3) Service Delivery. Key factors of m-health evaluation in each step are introduced in the proposed framework considering m-health key stakeholder's benefits. The proposed framework is validated via expert interviews, and key factors in each evaluation step is validated using PLS model. Results show that path coefficients are higher than their threshold which supports the validity of proposed framework. Copyright © 2018 Elsevier B.V. All rights reserved.

Mind the Gap

PubMed Central

Fairbanks, Terry; Savage, Erica; Adams, Katie; Wittie, Michael; Boone, Edna; Hayden, Andrew; Barnes, Janey; Hettinger, Zach; Gettinger, Andrew

2016-01-01

Summary Objective Decisions made during electronic health record (EHR) implementations profoundly affect usability and safety. This study aims to identify gaps between the current literature and key stakeholders’ perceptions of usability and safety practices and the challenges encountered during the implementation of EHRs. Materials and Methods Two approaches were used: a literature review and interviews with key stakeholders. We performed a systematic review of the literature to identify usability and safety challenges and best practices during implementation. A total of 55 articles were reviewed through searches of PubMed, Web of Science and Scopus. We used a qualitative approach to identify key stakeholders’ perceptions; semi-structured interviews were conducted with a diverse set of health IT stakeholders to understand their current practices and challenges related to usability during implementation. We used a grounded theory approach: data were coded, sorted, and emerging themes were identified. Conclusions from both sources of data were compared to identify areas of misalignment. Results We identified six emerging themes from the literature and stakeholder interviews: cost and resources, risk assessment, governance and consensus building, customization, clinical work-flow and usability testing, and training. Across these themes, there were misalignments between the literature and stakeholder perspectives, indicating major gaps. Discussion Major gaps identified from each of six emerging themes are discussed as critical areas for future research, opportunities for new stakeholder initiatives, and opportunities to better disseminate resources to improve the implementation of EHRs. Conclusion Our analysis identified practices and challenges across six different emerging themes, illustrated important gaps, and results suggest critical areas for future research and dissemination to improve EHR implementation. PMID:27847961

Building on what you know.

PubMed

Patry, Leslie Anne

2006-02-01

The author undertook a project to support nurses participating in study groups as part of their strategy to prepare for the Canadian Nurses Association certification exams. Feedback was obtained from CNA certified nurses, study group participants and facilitators and other key stakeholders to develop a study group resource manual. CNA certification is a voluntary national nursing specialty credential that offers Canadian nurses the opportunity to demonstrate their knowledge and skills by meeting eligibility criteria and successfully writing an examination. Initially, development of a study group manual was the principal aim of the project; however, nurses' insights into their study group experiences became the focal point. Nurses recognized that being part of a study group was an effective learning strategy and a valuable networking experience. The author highlights nurses' study group experiences, describes the use of a nursing leadership conceptual model to frame the project and discusses the concept of continuing competence.

UK podiatrists' experiences of podiatry services for people living with arthritis: a qualitative investigation.

PubMed

McCulloch, Louise; Borthwick, Alan; Redmond, Anthony; Edwards, Katherine; Pinedo-Villanueva, Rafael; Prieto-Alhambra, Daniel; Judge, Andrew; Arden, Nigel K; Bowen, Catherine J

2018-01-01

Provision of podiatry services, like other therapies in the UK, is an area that lacks guidance by the National Institute for Health and Care Excellence. Many individuals living with arthritis in the UK are not eligible to access NHS podiatry services. The primary aim of this investigation was to understand the views of podiatry clinicians on their experiences of referral, access, provision and treatment for foot problems for patients who have arthritis. Focus groups were undertaken to explore, in-depth, individual views of podiatrists working in the UK to gain feedback on experiences of barriers and facilitators to referral, access, provision and treatment for foot problems for individuals living with arthritis. A purposive sampling strategy was adopted and two, semi-structured, focus group interviews conducted, involving 12 podiatrists from both NHS and independent sectors. To account for geographical variations one focus group took place in each of 2 predetermined 'zones' of the UK; Yorkshire and Hampshire. Thematic analysis was employed to identify key meanings and report patterns within the data. The key themes derived from the podiatry clinician focus groups suggest a variety of factors influencing demand for, and burden of, foot pain within the UK. Participants expressed frustration on having a service that accepts and treats patients according to their condition, rather than their complaint. Additionally, concern was conveyed over variations in the understanding of stakeholders' views of what podiatry is and what podiatrists aim to achieve for patients. Podiatrists interviewed believed that many individuals living with arthritis in the UK are not eligible to access NHS podiatry services and that this may be, in part, due to confusion over what is known about podiatry and access criteria. Essentially, podiatrists interviewed called for a timely renaissance of current systems, to newer models of care that meet the foot care needs of individual patients' circumstances and incorporate national multi-disciplinary guidance. Through this project, we have formulated key recommendations that are directed towards improving what other stakeholders (including GPs, commissioners and users of podiatry services) know about the effectiveness of podiatry and also to futureproof the profession of podiatry.

The demonstration of a theory-based approach to the design of localized patient safety interventions

PubMed Central

2013-01-01

Background There is evidence of unsafe care in healthcare systems globally. Interventions to implement recommended practice often have modest and variable effects. Ideally, selecting and adapting interventions according to local contexts should enhance effects. However, the means by which this can happen is seldom systematic, based on theory, or made transparent. This work aimed to demonstrate the applicability, feasibility, and acceptability of a theoretical domains framework implementation (TDFI) approach for co-designing patient safety interventions. Methods We worked with three hospitals to support the implementation of evidence-based guidance to reduce the risk of feeding into misplaced nasogastric feeding tubes. Our stepped process, informed by the TDF and key principles from implementation literature, entailed: involving stakeholders; identifying target behaviors; identifying local factors (barriers and levers) affecting behavior change using a TDF-based questionnaire; working with stakeholders to generate specific local strategies to address key barriers; and supporting stakeholders to implement strategies. Exit interviews and audit data collection were undertaken to assess the feasibility and acceptability of this approach. Results Following audit and discussion, implementation teams for each Trust identified the process of checking the positioning of nasogastric tubes prior to feeding as the key behavior to target. Questionnaire results indicated differences in key barriers between organizations. Focus groups generated innovative, generalizable, and adaptable strategies for overcoming barriers, such as awareness events, screensavers, equipment modifications, and interactive learning resources. Exit interviews identified themes relating to the benefits, challenges, and sustainability of this approach. Time trend audit data were collected for 301 patients over an 18-month period for one Trust, suggesting clinically significant improved use of pH and documentation of practice following the intervention. Conclusions The TDF is a feasible and acceptable framework to guide the implementation of patient safety interventions. The stepped TDFI approach engages healthcare professionals and facilitates contextualization in identifying the target behavior, eliciting local barriers, and selecting strategies to address those barriers. This approach may be of use to implementation teams and policy makers, although our promising findings confirm the need for a more rigorous evaluation; a balanced block evaluation is currently underway. PMID:24131864

Environmental Influences on Physical Activity among Rural Adults in Montana, United States: Views from Built Environment Audits, Resident Focus Groups, and Key Informant Interviews.

PubMed

Lo, Brian K; Morgan, Emily H; Folta, Sara C; Graham, Meredith L; Paul, Lynn C; Nelson, Miriam E; Jew, Nicolette V; Moffat, Laurel F; Seguin, Rebecca A

2017-10-04

Rural populations in the United States have lower physical activity levels and are at a higher risk of being overweight and suffering from obesity than their urban counterparts. This paper aimed to understand the environmental factors that influence physical activity among rural adults in Montana. Eight built environment audits, 15 resident focus groups, and 24 key informant interviews were conducted between August and December 2014. Themes were triangulated and summarized into five categories of environmental factors: built, social, organizational, policy, and natural environments. Although the existence of active living features was documented by environmental audits, residents and key informants agreed that additional indoor recreation facilities and more well-maintained and conveniently located options were needed. Residents and key informants also agreed on the importance of age-specific, well-promoted, and structured physical activity programs, offered in socially supportive environments, as facilitators to physical activity. Key informants, however, noted that funding constraints and limited political will were barriers to developing these opportunities. Since building new recreational facilities and structures to support active transportation pose resource challenges, especially for rural communities, our results suggest that enhancing existing features, making small improvements, and involving stakeholders in the city planning process would be more fruitful to build momentum towards larger changes.

Knowledge management in dementia care networks: a qualitative analysis of successful information and support strategies for people with dementia living at home and their family caregivers.

PubMed

Heinrich, S; Laporte Uribe, F; Roes, M; Hoffmann, W; Thyrian, J R; Wolf-Ostermann, K; Holle, B

2016-02-01

Stakeholders involved in community dementia support services often work on their own and without coordination with other services. These circumstances can result in a lack of information and support for people with dementia and their family caregivers at home. To increase the coordination between existing support services, so-called 'Dementia Care Networks' (DCNs) have been established. Most of the tasks that are performed in DCNs are based on communication strategies. Therefore, knowledge management (KM) is a key process in these networks. However, few studies have focused on this topic. This study attempted to evaluate KM strategies in DCNs across Germany as part of the DemNet-D study. A qualitative interview study design was used. Qualitative data were collected during single and group interviews with key persons associated with thirteen DCNs. Interviews were audiotaped and transcribed, and a structured content analysis was conducted. The framework for the analysis was derived from a KM model. Information dissemination strategies for people with dementia and their informal caregivers based on actively established contacts appear to be more successful than passive strategies. General practitioners often play a key role as external gatekeepers in initiating contact between a network and a person affected by dementia. In this context, case managers can help integrate external stakeholders, such as general practitioners or pharmacists, into DCNs using different KM strategies. The systematic development of common objectives under an agency-neutral leadership seems to be an important aspect of successful KM within DCNs. The findings reported here can help DCNs optimize their KM strategies for generating tailored information and support services for people with dementia living at home and their family caregivers. In particular, the identified potential knowledge distribution barriers and facilitators will be of practical use to DCN stakeholders. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

AMCP Partnership Forum: Improving Quality, Value, and Outcomes with Patient-Reported Outcomes.

PubMed

2018-03-01

Patient-reported outcomes (PROs), which provide a direct measure of a patient's health status or treatment preferences, represent a key component of the shift toward patient-centered health care. PROs can measure the state of a patient's disease-specific and overall health throughout the care continuum, enabling them to have a variety of uses for key health care stakeholders. Currently, PROs are used in drug development, aligning patient and clinician goals in care, quality-of-care measures, and coverage and reimbursement decisions. While there have been significant strides by key health care stakeholders to further the development and use of PROs, there are a number of challenges limiting more widespread use. In light of these current challenges and the potential for PROs to improve health care quality and value, on October 19, 2017, the Academy of Managed Care Pharmacy convened a forum of key stakeholders representing patients, payers, providers, government, and pharmaceutical companies to discuss and identify solutions to the current challenges and barriers to further use of PROs. These discussions informed the development of participants' ideal future state in which PROs maximize the goals of all health care stakeholders and the actionable steps required to make the future state a reality. While stakeholders shared unique perspectives throughout the forum, they had consensus on 2 overarching issues: the importance of PROs in defining value, improving patient care, and implementing value-based payment models and the need for strong organizational and operational systems to achieve optimal adoption and use. Participants identified several key challenges in PRO use and adoption: achieving a representative patient population, inclusion of PRO data in medication labels, the necessity for both standardized and customizable PROs, and operational and organizational barriers to collecting and analyzing PROs. To overcome these challenges, participants recommended that manufacturers should engage key stakeholders early and throughout the drug development process to ensure the most valid and representative PROs and patient populations will be included. To streamline the PRO collection process, participants suggested engaging pharmacists and other providers who may have more frequent interaction with patients. Participants also recommended that PRO collection and analysis should use common technology platforms, streamline components of clinician care to reduce workflow, and be integrated with claims data to provider payers a better understanding of patient health in real time. Finally, additional work should be done to develop patient-reported outcome measures that contain relevant measures for all healthcare stakeholders. While significant challenges remain in PRO development and adoption, participants agreed that greater use can only be achieved through collaboration and patient-centered care. The AMCP Partnership Forum titled "Improving Quality, Value, and Outcomes with Patient-Reported Outcomes" and the development of this proceedings report were supported by Amgen, Boehringer Ingelheim Pharmaceuticals, Genentech, GlaxoSmithKline, Novartis Pharmaceuticals, Novo Nordisk, Precision for Value, Premier, Sanofi, Takeda Pharmaceuticals USA, and Xcenda.

Implementing effective and sustainable multidisciplinary clinical thoracic oncology programs

PubMed Central

Freeman, Richard K.; Krasna, Mark J.

2015-01-01

Three models of care are described, including two models of multidisciplinary care for thoracic malignancies. The pros and cons of each model are discussed, the evidence supporting each is reviewed, and the need for more (and better) research into care delivery models is highlighted. Key stakeholders in thoracic oncology care delivery outcomes are identified, and the need to consider stakeholder perspectives in designing, validating and implementing multidisciplinary programs as a vehicle for quality improvement in thoracic oncology is emphasized. The importance of reconciling stakeholder perspectives, and identify meaningful stakeholder-relevant benchmarks is also emphasized. Metrics for measuring program implementation and overall success are proposed. PMID:26380186

Implementing effective and sustainable multidisciplinary clinical thoracic oncology programs.

PubMed

Osarogiagbon, Raymond U; Freeman, Richard K; Krasna, Mark J

2015-08-01

Three models of care are described, including two models of multidisciplinary care for thoracic malignancies. The pros and cons of each model are discussed, the evidence supporting each is reviewed, and the need for more (and better) research into care delivery models is highlighted. Key stakeholders in thoracic oncology care delivery outcomes are identified, and the need to consider stakeholder perspectives in designing, validating and implementing multidisciplinary programs as a vehicle for quality improvement in thoracic oncology is emphasized. The importance of reconciling stakeholder perspectives, and identify meaningful stakeholder-relevant benchmarks is also emphasized. Metrics for measuring program implementation and overall success are proposed.

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.

An official American Thoracic Society research statement: comparative effectiveness research in pulmonary, critical care, and sleep medicine.

PubMed

Carson, Shannon S; Goss, Christopher H; Patel, Sanjay R; Anzueto, Antonio; Au, David H; Elborn, Stuart; Gerald, Joe K; Gerald, Lynn B; Kahn, Jeremy M; Malhotra, Atul; Mularski, Richard A; Riekert, Kristin A; Rubenfeld, Gordon D; Weaver, Terri E; Krishnan, Jerry A

2013-11-15

Comparative effectiveness research (CER) is intended to inform decision making in clinical practice, and is central to patient-centered outcomes research (PCOR). To summarize key aspects of CER definitions and provide examples highlighting the complementary nature of efficacy and CER studies in pulmonary, critical care, and sleep medicine. An ad hoc working group of the American Thoracic Society with experience in clinical trials, health services research, quality improvement, and behavioral sciences in pulmonary, critical care, and sleep medicine was convened. The group used an iterative consensus process, including a review by American Thoracic Society committees and assemblies. The traditional efficacy paradigm relies on clinical trials with high internal validity to evaluate interventions in narrowly defined populations and in research settings. Efficacy studies address the question, "Can it work in optimal conditions?" The CER paradigm employs a wide range of study designs to understand the effects of interventions in clinical settings. CER studies address the question, "Does it work in practice?" The results of efficacy and CER studies may or may not agree. CER incorporates many attributes of outcomes research and health services research, while placing greater emphasis on meeting the expressed needs of nonresearcher stakeholders (e.g., patients, clinicians, and others). CER complements traditional efficacy research by placing greater emphasis on the effects of interventions in practice, and developing evidence to address the needs of the many stakeholders involved in health care decisions. Stakeholder engagement is an important component of CER.

Identifying management and disease priorities of Canadian dairy industry stakeholders.

PubMed

Bauman, C A; Barkema, H W; Dubuc, J; Keefe, G P; Kelton, D F

2016-12-01

The objective of this study was to identify the key management and disease issues affecting the Canadian dairy industry. An online questionnaire (FluidSurveys, http://fluidsurveys.com/) was conducted between March 1 and May 31, 2014. A total of 1,025 responses were received from across Canada of which 68% (n=698) of respondents were dairy producers, and the remaining respondents represented veterinarians, university researchers, government personnel, and other allied industries. Participants were asked to identify their top 3 management and disease priorities from 2 lists offered. Topics were subsequently ranked from highest to lowest using 3 different ranking methods based on points: 5-3-1 (5 points for first priority, 3 for second, and 1 for first), 3-2-1, and 1-1-1 (equal ranking). The 5-3-1 point system was selected because it minimized the number of duplicate point scores. Stakeholder groups showed general agreement with the top management issue identified as animal welfare and the number one health concern as lameness. Other areas identified as priorities were reproductive health, antibiotic use, bovine viral diarrhea, and Staphylococcus aureus mastitis with these rankings influenced by region, herd size, and stakeholder group. This is the first national comprehensive assessment of priorities undertaken in the Canadian dairy industry and will assist researchers, policymakers, program developers, and funding agencies make future decisions based on direct industry feedback. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Final Report. An Integrated Partnership to Create and Lead the Solar Codes and Standards Working Group

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

Rosenthal, Andrew

The DOE grant, “An Integrated Partnership to Create and Lead the Solar Codes and Standards Working Group,” to New Mexico State University created the Solar America Board for Codes and Standards (Solar ABCs). From 2007 – 2013 with funding from this grant, Solar ABCs identified current issues, established a dialogue among key stakeholders, and catalyzed appropriate activities to support the development of codes and standards that facilitated the installation of high quality, safe photovoltaic systems. Solar ABCs brought the following resources to the PV stakeholder community; Formal coordination in the planning or revision of interrelated codes and standards removing “stovemore » pipes” that have only roofing experts working on roofing codes, PV experts on PV codes, fire enforcement experts working on fire codes, etc.; A conduit through which all interested stakeholders were able to see the steps being taken in the development or modification of codes and standards and participate directly in the processes; A central clearing house for new documents, standards, proposed standards, analytical studies, and recommendations of best practices available to the PV community; A forum of experts that invites and welcomes all interested parties into the process of performing studies, evaluating results, and building consensus on standards and code-related topics that affect all aspects of the market; and A biennial gap analysis to formally survey the PV community to identify needs that are unmet and inhibiting the market and necessary technical developments.« less

Stakeholder perspectives on transitions of nursing home residents to hospital emergency departments and back in two Canadian provinces.

PubMed

Robinson, C A; Bottorff, J L; Lilly, M B; Reid, C; Abel, S; Lo, M; Cummings, G G

2012-12-01

Major gaps exist in our understanding of transitions in care for older persons living in nursing homes. The purpose of the study was to identify key elements, from multiple stakeholder perspectives, that influence the success of transitions experienced by nursing home residents when they required transfer to a hospital emergency department. This interpretive descriptive study was conducted in two cities in the Canadian provinces of British Columbia and Alberta. Data were collected from 71 participants via focus groups and individual interviews with nursing home residents, family members, and professional healthcare providers working in nursing homes, emergency departments, and emergency medical services. Transcripts were analyzed using constant comparison. The elements contributing to the success of transitions reflected a patient- and family-centered approach to care. Transitions were influenced by the complex interplay of multiple elements that included: knowing the resident; critical geriatric knowledge and skilled assessment; positive relationships; effective communication; and timeliness. When one or more of the elements was absent or compromised, the success of the transition was also compromised. There was consistency about the importance of all the identified elements across all stakeholder groups whether they are residents, family members, or health professionals in nursing homes, emergency departments or emergency medical services. Aspects of many of these elements are modifiable and suggest viable targets for interventions aimed at improving the success of transitions for this vulnerable population. Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.

Prison health service directors' views on research priorities and organizational issues in conducting research in prison: outcomes of a national deliberative roundtable.

PubMed

Simpson, Paul Leslie; Guthrie, Jill; Butler, Tony

2017-06-12

Purpose Given that prisoners have significant health needs across most areas, the paucity of prisoner health research, and the difficulties involved in the conduct of research in this setting, there is a need to develop research priorities that align with key stakeholder groups. One such group are those responsible for health service provision in prisons - prison health service directors. The paper aims to discuss these issues. Design/methodology/approach Prison health service directors in each Australian state and territory were invited to participate in a national (deliberative) roundtable where the consensus building nominal group technique was utilized. This involved the identification of research priorities and organizational issues in conducting research with prisoners, and ranking research priorities. A thematic analysis was conducted on organizational issues. Findings In total, 13 participants attended the roundtable. Participants identified 28 research priorities and 12 organizational issues. Top ranked research priorities were mental health, cognitive and intellectual disability, post-release health maintenance, ageing prisoners, chronic health conditions and Aboriginal and Torres Strait Islander health. Themes identified from the organizational issues included prisoner access to research participation, health and research literacy of custodial staff, and institutional protectionism in response to research that may discover negative information about the custodial setting. Research limitations/implications These findings should inform future efforts to improve research infrastructures to undertake research to improve the health of people in Australian prisons, and help to align researchers' efforts with those of a key organizational stakeholder. Originality/value This is the first paper to determine the research priorities and organizational issues in conducting research in prisons of prison health service directors.

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.

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....

7 CFR 3418.4 - Reporting requirement.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., AND EXTENSION SERVICE, DEPARTMENT OF AGRICULTURE STAKEHOLDER INPUT REQUIREMENTS FOR RECIPIENTS OF... information related to stakeholder input and recommendations: (a) Actions taken to seek stakeholder input that... identify individuals and groups who are stakeholders and to collect input from them; and (c) A statement of...

The perceptions of key stakeholders of the roles of specialist and advanced nursing and midwifery practitioners.

PubMed

Casey, Mary; O'Connor, Laserina; Nicholson, Emma; Smith, Rita; O'Brien, Denise; O'Leary, Denise; Fealy, Gerard M; Mcnamara, Martin S; Stokes, Diarmuid; Egan, Claire

2017-12-01

To explore the perceptions of key stakeholders of the roles of specialist and advanced nursing and midwifery practitioners. There is evidence that the contribution of these roles to patient care is poorly understood. This research took place over 2 months in 2015 and is part of a larger study involving a rapid review to inform policy development on the specialist and advanced nursing and midwifery practice in Ireland. As an added value, a qualitative element involving thematic analysis was undertaken with key stakeholders. A phenomenological qualitative study was conducted incorporating semi-structured interviews with key stakeholders (n = 15). Purposive sampling with maximum diversity was used to recruit a wide range of perspectives. Participant's perspectives led to seven themes: Impact of these roles; role preparation, experience and organizational support; specialist and advanced practice roles in an interdisciplinary context; different folks but not such different roles; impact of specialist and advanced practice roles on patient outcomes; barriers and facilitators to enacting specialist and advanced practice roles; future development of these roles. There is acknowledgement of the positive impact of specialist and advanced practitioners; however, the evidence is currently not conclusive. Preparation for these roles needs to reflect changes in the calibre of today's professional applicants, and organizational support is paramount to their successful execution. The contribution of their activity to patient outcome needs to be made visible to enhance these roles and to justify the development of new roles across a variety of healthcare areas. © 2017 John Wiley & Sons Ltd.

What do stakeholders expect from patient engagement: Are these expectations being met?

PubMed

Boudes, Mathieu; Robinson, Paul; Bertelsen, Neil; Brooke, Nicholas; Hoos, Anton; Boutin, Marc; Geissler, Jan; Sargeant, Ify

2018-06-01

Meaningful patient engagement (PE) in medicines development and during the life cycle of a product requires all stakeholders have a clear understanding of respective expectations. A qualitative survey was undertaken to understand stakeholder expectations. The survey explored 4 themes from the perspective of each stakeholder group: meaning, views, expectations and priorities for PE. Participants were grouped into 7 categories: policymakers/regulators; health-care professionals (HCPs); research funders; payers/purchasers/HTA; patients/patient representatives; pharmaceutical/life sciences industry; and academic researchers. Fifty-nine interviews were conducted across a range of geographies, PE experience and job seniority/role. There was consensus across stakeholders on meaning of PE; importance of promoting PE to a higher level than currently; need for a more structured process and guidance. There was little consensus on stakeholder expectations and roles. Policymakers/regulators were expected by others to drive PE, create a framework and facilitate PE, provide guidelines of good practice and connect stakeholders, but this expectation was not shared by the policymakers/regulators group. HCPs were seen as the link between patients and other stakeholders, but HCPs did not necessarily share this view. Despite broad stakeholder categories, clear themes emerged: there is no "leader"; no stakeholder has a clear view on how to meaningfully engage with patients; there are educational gaps; and a structure and guidance for PE is urgently required. Given the diversity of stakeholders, there needs to be multistakeholder collaborative leadership. Effective collaboration requires consensus on roles, responsibilities and expectations to synergize efforts to deliver meaningful PE in medicines life cycle. © 2018 The Authors. Health Expectations published by John Wiley & Sons Ltd.

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.

Facilitating Evaluations of Innovative, Competence-Based Assessments: Creating Understanding and Involving Multiple Stakeholders

ERIC Educational Resources Information Center

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

2010-01-01

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…

Knowledge Management in Sustainability Research Projects: Concepts, Effective Models, and Examples in a Multi-Stakeholder Environment

ERIC Educational Resources Information Center

Kaiser, David Brian; Köhler, Thomas; Weith, Thomas

2016-01-01

This article aims to sketch a conceptual design for an information and knowledge management system in sustainability research projects. The suitable frameworks to implement knowledge transfer models constitute social communities, because the mutual exchange and learning processes among all stakeholders promote key sustainable developments through…

A Futures Study of Internationalization of the Carlson School of Management: Diverse Perspectives of Key Stakeholders

ERIC Educational Resources Information Center

D'Angelo, Anne Marie

2010-01-01

Internationalization is a multi-faceted, multi-dimensional and complex concept described most notably as a higher educational process that integrates an international perspective into its organizational leadership, vision, and curricular goals. Success is dependent upon ongoing engagement of a multitude of internal and external stakeholders with…

Multi-Stakeholder Aid to Education: Power in the Context of Partnership

ERIC Educational Resources Information Center

Menashy, Francine

2018-01-01

This study examines power asymmetries within the largest multi-stakeholder agency in the education sector: the Global Partnership for Education (GPE). Drawing from data collected through key informant interviews and document analyses, this research asks if the establishment of the GPE has altered power arrangements in educational aid. The study…

Winning the Skills Race.

ERIC Educational Resources Information Center

Council on Competitiveness, Washington, DC.

This document reports on how key stakeholders in work force preparedness nationwide are responding to pressures of the skills race. Part 1 presents an overview of the skills challenge and the economic and social consequences of failing to meet the challenge. Part 2 examines the impact of the skills shortage on major stakeholders and explains how…

Corporate Social Responsibility in NCAA Athletics: Institutional Practices and Decision Makers

ERIC Educational Resources Information Center

Brown, Lauren Elizabeth

2012-01-01

Tactical corporate social responsibility (CSR) can play a central role in an organization's strategic management (Hamil & Morrow, 2011) by enhancing the relationship between an organization and its key stakeholders (Babiak & Wolfe, 2009). In the context of sport, these stakeholders can include fans, the media, team employees, and the…

Challenges Faced by Key Stakeholders Using Educational Online Technologies in Blended Tertiary Environments

ERIC Educational Resources Information Center

Tuapawa, Kimberley

2016-01-01

Traditional learning spaces have evolved into dynamic blended tertiary environments (BTEs), providing a modern means through which tertiary education institutes (TEIs) can augment delivery to meet stakeholder needs. Despite the significant demand for web-enabled learning, there are obstacles concerning the use of EOTs, which challenge the…

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.

Fuzzy cognitive mapping in support of integrated ecosystem assessments: Developing a shared conceptual model among stakeholders.

PubMed

Vasslides, James M; Jensen, Olaf P

2016-01-15

Ecosystem-based approaches, including integrated ecosystem assessments, are a popular methodology being used to holistically address management issues in social-ecological systems worldwide. In this study we utilized fuzzy logic cognitive mapping to develop conceptual models of a complex estuarine system among four stakeholder groups. The average number of categories in an individual map was not significantly different among groups, and there were no significant differences between the groups in the average complexity or density indices of the individual maps. When ordered by their complexity scores, eight categories contributed to the top four rankings of the stakeholder groups, with six of the categories shared by at least half of the groups. While non-metric multidimensional scaling (nMDS) analysis displayed a high degree of overlap between the individual models across groups, there was also diversity within each stakeholder group. These findings suggest that while all of the stakeholders interviewed perceive the subject ecosystem as a complex series of social and ecological interconnections, there are a core set of components that are present in most of the groups' models that are crucial in managing the system towards some desired outcome. However, the variability in the connections between these core components and the rest of the categories influences the exact nature of these outcomes. Understanding the reasons behind these differences will be critical to developing a shared conceptual model that will be acceptable to all stakeholder groups and can serve as the basis for an integrated ecosystem assessment. Copyright © 2015 Elsevier Ltd. All rights reserved.

Divergent stakeholder views of corporate social responsibility in the Australian forest plantation sector.

PubMed

Gordon, Melissa; Lockwood, Michael; Vanclay, Frank; Hanson, Dallas; Schirmer, Jacki

2012-12-30

Although the Australian forest plantation industry acknowledges that there is a role for corporate social responsibility (CSR) in forest management, there is confusion as to what this constitutes in practice. This paper describes the conflicts between internal and external stakeholder views on CSR in plantation forestry. We conducted in-depth interviews with key informants across three plantation management regions in Australia: Tasmania, the Green Triangle and south-west Western Australia. We interviewed a range of stakeholders including forest company employees, local councils, Indigenous representatives, and environmental non-government organisations. CSR-related initiatives that stakeholders believed were important for plantation management included the need for community engagement, accountability towards stakeholders, and contribution to community development and well-being. Although there was wide support for these initiatives, some stakeholders were not satisfied that forest companies were actively implementing them. Due to the perception that forest companies are not committed to CSR initiatives such as community engagement, some stakeholder expectations are not being satisfied. Copyright © 2012 Elsevier Ltd. All rights reserved.

A Reporting System to Protect the Human Rights of People Living with HIV and Key Populations.

PubMed

Williamson, R Taylor; Fiscian, Vivian; Olson, Ryan Ubuntu; Poku, Fred Nana; Whittal, Joseph

2017-12-01

People living with HIV and key populations face human rights violations that affect their access to health services, relationships in their communities, housing options, and employment. To address these violations, government and civil society organizations in Ghana developed a discrimination reporting system managed by the Commission on Human Rights and Administrative Justice that links people living with HIV and key populations to legal services. This article presents findings on how Ghanaian stakeholders built this reporting system and discusses preliminary data on its impact. To organize our analysis, we used a conceptual framework that outlines the legal frameworks that protect human rights, the institutions that promote access to justice, and the mechanisms that link people living with HIV and key populations to legal services. Using in-depth interviews, we show that targeted technical assistance increased stakeholders' knowledge of issues that affect people living with HIV and key populations, strengthened these stakeholders' commitment to address discrimination, streamlined case management systems, and improved relationships between civil society and the government. Through case review, we find that most discrimination happens when accessing government services, inside communities and families, and in the workplace. Finally, we describe implications for other human rights commissions that are considering using a reporting system to protect human rights, including using legal frameworks, developing case management systems, and working with civil society.

Trade and health in Samoa: views from the insiders

PubMed Central

2014-01-01

Background The purpose of this paper is to portray the views of key stakeholders on the potential impacts of Samoa’s free trade negotiations and agreements, on health and wellbeing in Samoa. Methods A series of key informant interviews were undertaken with identified stakeholders during June and July, 2011. Interviews were conducted using a semi-structured interview protocol. They were conducted in–person, in New Zealand and in Samoa. Results Despite potential health and wellbeing gains arising from trade activities (employment, increase in income, health innovations and empowerment of women), key stakeholders expressed a growing concern about the effect of trade on the population’s health, nutrition and the rates of non-communicable diseases. Unease about compromising the national policies due to international regulations was also conveyed. Business and trade representatives however, believed that trade benefits outweighed any health and wellbeing risks to the population of Samoa. Conclusion Further investigation, using new methodologies are required to determine both the opportunities and threats for trade as a mechanism to improve the health of Samoa’s population. PMID:24708596

Requirements' Role in Mobilizing and Enabling Design Conversation

NASA Astrophysics Data System (ADS)

Bergman, Mark

Requirements play a critical role in a design conversation of systems and products. Product and system design exists at the crossroads of problems, solutions and requirements. Requirements contextualize problems and solutions, pointing the way to feasible outcomes. These are captured with models and detailed specifications. Still, stakeholders need to be able to understand one-another using shared design representations in order to mobilize bias and transform knowledge towards legitimized, desired results. Many modern modeling languages, including UML, as well as detailed, logic-based specifications are beyond the comprehension of key stakeholders. Hence, they inhibit, rather than promote design conversation. Improved design boundary objects (DBO), especially design requirements boundary objects (DRBO), need to be created and refined to improve the communications between principals. Four key features of design boundary objects that improve and promote design conversation are discussed in detail. A systems analysis and design case study is presented which demonstrates these features in action. It describes how a small team of analysts worked with key stakeholders to mobilize and guide a complex system design discussion towards an unexpected, yet desired outcome within a short time frame.

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.

Maternal and perinatal health research priorities beyond 2015: an international survey and prioritization exercise.

PubMed

Souza, Joao Paulo; Widmer, Mariana; Gülmezoglu, Ahmet Metin; Lawrie, Theresa Anne; Adejuyigbe, Ebunoluwa Aderonke; Carroli, Guillermo; Crowther, Caroline; Currie, Sheena M; Dowswell, Therese; Hofmeyr, Justus; Lavender, Tina; Lawn, Joy; Mader, Silke; Martinez, Francisco Eulógio; Mugerwa, Kidza; Qureshi, Zahida; Silvestre, Maria Asuncion; Soltani, Hora; Torloni, Maria Regina; Tsigas, Eleni Z; Vowles, Zoe; Ouedraogo, Léopold; Serruya, Suzanne; Al-Raiby, Jamela; Awin, Narimah; Obara, Hiromi; Mathai, Matthews; Bahl, Rajiv; Martines, José; Ganatra, Bela; Phillips, Sharon Jelena; Johnson, Brooke Ronald; Vogel, Joshua P; Oladapo, Olufemi T; Temmerman, Marleen

2014-08-07

Maternal mortality has declined by nearly half since 1990, but over a quarter million women still die every year of causes related to pregnancy and childbirth. Maternal-health related targets are falling short of the 2015 Millennium Development Goals and a post-2015 Development Agenda is emerging. In connection with this, setting global research priorities for the next decade is now required. We adapted the methods of the Child Health and Nutrition Research Initiative (CHNRI) to identify and set global research priorities for maternal and perinatal health for the period 2015 to 2025. Priority research questions were received from various international stakeholders constituting a large reference group, and consolidated into a final list of research questions by a technical working group. Questions on this list were then scored by the reference working group according to five independent and equally weighted criteria. Normalized research priority scores (NRPS) were calculated, and research priority questions were ranked accordingly. A list of 190 priority research questions for improving maternal and perinatal health was scored by 140 stakeholders. Most priority research questions (89%) were concerned with the evaluation of implementation and delivery of existing interventions, with research subthemes frequently concerned with training and/or awareness interventions (11%), and access to interventions and/or services (14%). Twenty-one questions (11%) involved the discovery of new interventions or technologies. Key research priorities in maternal and perinatal health were identified. The resulting ranked list of research questions provides a valuable resource for health research investors, researchers and other stakeholders. We are hopeful that this exercise will inform the post-2015 Development Agenda and assist donors, research-policy decision makers and researchers to invest in research that will ultimately make the most significant difference in the lives of mothers and babies.

OA26 How inclusive partnership working influences local policy and practice: the case of the end of life partnership.

PubMed

Zammit, Rachel

2015-04-01

: Ageing, death, dying and loss are universal issues that have a range of health, wellbeing, financial and socio-economic costs for society. The End of Life Partnership (EoLP) is a charitable collaborative in Cheshire, which aims to transform end of life experience and care, by working with a wide range partners from the public, private and third sectors and by engaging individuals, families and communities. Launched in April 2014, the EoLP merged three existing programmes focussing on public health, education and service development and added an additional research focus. There are now four dedicated departments: Public Health and Wellbeing; Research, Evaluation and Technology; Service Development; Education and Practice Development. In October 2014 a Dementia work stream was added. The work of The EoLP is shaped, overseen and monitored by a Strategic Partnership Executive, with representation from key local stakeholders and a board of trustees. The EoLP meets national objectives and delivers on local priorities agreed with stakeholders, including patients and the public. This is strengthened through a dedicated Cheshire Living Well, Dying Well Partnership to enable community voices to be heard. Significant milestones have already been realised as a partnership collaborative. For example, response to the national review of the Liverpool Care Pathway incorporated development of a local care plan with stakeholders, educational strategy to ensure effective roll-out, public consultation and work to measure impact. The EoLP works to influence and shape policy and practice at a local, regional, national and international level. © 2015, 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.

Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence (DECIDE): protocol and preliminary results.

PubMed

Treweek, Shaun; Oxman, Andrew D; Alderson, Philip; Bossuyt, Patrick M; Brandt, Linn; Brożek, Jan; Davoli, Marina; Flottorp, Signe; Harbour, Robin; Hill, Suzanne; Liberati, Alessandro; Liira, Helena; Schünemann, Holger J; Rosenbaum, Sarah; Thornton, Judith; Vandvik, Per Olav; Alonso-Coello, Pablo

2013-01-09

Healthcare decision makers face challenges when using guidelines, including understanding the quality of the evidence or the values and preferences upon which recommendations are made, which are often not clear. GRADE is a systematic approach towards assessing the quality of evidence and the strength of recommendations in healthcare. GRADE also gives advice on how to go from evidence to decisions. It has been developed to address the weaknesses of other grading systems and is now widely used internationally. The Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence (DECIDE) consortium (http://www.decide-collaboration.eu/), which includes members of the GRADE Working Group and other partners, will explore methods to ensure effective communication of evidence-based recommendations targeted at key stakeholders: healthcare professionals, policymakers, and managers, as well as patients and the general public. Surveys and interviews with guideline producers and other stakeholders will explore how presentation of the evidence could be improved to better meet their information needs. We will collect further stakeholder input from advisory groups, via consultations and user testing; this will be done across a wide range of healthcare systems in Europe, North America, and other countries. Targeted communication strategies will be developed, evaluated in randomized trials, refined, and assessed during the development of real guidelines. Results of the DECIDE project will improve the communication of evidence-based healthcare recommendations. Building on the work of the GRADE Working Group, DECIDE will develop and evaluate methods that address communication needs of guideline users. The project will produce strategies for communicating recommendations that have been rigorously evaluated in diverse settings, and it will support the transfer of research into practice in healthcare systems globally.

Impact of laws aimed at healthcare-associated infection reduction: a qualitative study.

PubMed

Stone, Patricia W; Pogorzelska-Maziarz, Monika; Reagan, Julie; Merrill, Jacqueline A; Sperber, Brad; Cairns, Catherine; Penn, Matthew; Ramanathan, Tara; Mothershed, Elizabeth; Skillen, Elizabeth

2015-10-01

Healthcare-associated infections (HAIs) are preventable. Globally, laws aimed at reducing HAIs have been implemented. In the USA, these laws are at the federal and state levels. It is not known whether the state interventions are more effective than the federal incentives alone. The aims of this study were to explore the impact federal and state HAI laws have on state departments of health and hospital stakeholders in the USA and to explore similarities and differences in perceptions across states. A qualitative study was conducted. In 2012, we conducted semistructured interviews with key stakeholders from states with and without state-level laws to gain multiple perspectives. Interviews were transcribed and open coding was conducted. Data were analysed using content analysis and collected until theoretical saturation was achieved. Ninety interviews were conducted with stakeholders from 12 states (6 states with laws and 6 states without laws). We found an increase in state-level collaboration. The publicly reported data helped hospitals benchmark and focus leaders on HAI prevention. There were concerns about the publicly reported data (eg, lack of validation and timeliness). Resource needs were also identified. No major differences were expressed by interviewees from states with and without laws. While we could not tease out the impact of specific interventions, increased collaboration between departments of health and their partners is occurring. Harmonisation of HAI definitions and reporting between state and federal laws would minimise reporting burden. Continued monitoring of the progress of HAI prevention is needed. 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.

Engaging Gatekeeper-Stakeholders in Development of a Mobile Health Intervention to Improve Medication Adherence Among African American and Pacific Islander Elderly Patients With Hypertension

PubMed Central

Bazargan, Mohsen; Jones, Loretta; Vawer, May; Seto, Todd B; Farooq, Summer; Taira, Deborah A

2016-01-01

Background Approximately 70 million people in the United States have hypertension. Although antihypertensive therapy can reduce the morbidity and mortality associated with hypertension, often patients do not take their medication as prescribed. Objective The goal of this study was to better understand issues affecting the acceptability and usability of mobile health technology (mHealth) to improve medication adherence for elderly African American and Native Hawaiian and Pacific Islander patients with hypertension. Methods In-depth interviews were conducted with 20 gatekeeper-stakeholders using targeted open-ended questions. Interviews were deidentified, transcribed, organized, and coded manually by two independent coders. Analysis of patient interviews used largely a deductive approach because the targeted open-ended interview questions were designed to explore issues specific to the design and acceptability of a mHealth intervention for seniors. Results A number of similar themes regarding elements of a successful intervention emerged from our two groups of African American and Native Hawaiian and Pacific Islander gatekeeper-stakeholders. First was the need to teach participants both about the importance of adherence to antihypertensive medications. Second, was the use of mobile phones for messaging and patients need to be able to access ongoing technical support. Third, messaging needs to be short and simple, but personalized, and to come from someone the participant trusts and with whom they have a connection. There were some differences between groups. For instance, there was a strong sentiment among the African American group that the church be involved and that the intervention begin with group workshops, whereas the Native Hawaiian and Pacific Islander group seemed to believe that the teaching could occur on a one-to-one basis with the health care provider. Conclusions Information from our gatekeeper-stakeholder (key informant) interviews suggests that the design of a mHealth intervention to improve adherence to antihypertensives among the elderly could be very similar for African Americans and Native Hawaiian and Pacific Islanders. The main difference might be in the way in which the program is initiated (possibly through church-based workshops for African Americans and by individual providers for Native Hawaiian and Pacific Islanders). Another difference might be who sends the messages with African Americans wanting someone outside the health care system, but Native Hawaiian and Pacific Islanders preferring a provider. PMID:27784651

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.

Stakeholder Analysis Worksheet

EPA Pesticide Factsheets

Stakeholder Analysis WorksheetA worksheet that can be used to document potential stakeholder groups, the information or expertise they hold, the role that they can play, their interests or concerns about the HIA

A conceptual model for the development process of confirmatory adaptive clinical trials within an emergency research network.

PubMed

Mawocha, Samkeliso C; Fetters, Michael D; Legocki, Laurie J; Guetterman, Timothy C; Frederiksen, Shirley; Barsan, William G; Lewis, Roger J; Berry, Donald A; Meurer, William J

2017-06-01

Adaptive clinical trials use accumulating data from enrolled subjects to alter trial conduct in pre-specified ways based on quantitative decision rules. In this research, we sought to characterize the perspectives of key stakeholders during the development process of confirmatory-phase adaptive clinical trials within an emergency clinical trials network and to build a model to guide future development of adaptive clinical trials. We used an ethnographic, qualitative approach to evaluate key stakeholders' views about the adaptive clinical trial development process. Stakeholders participated in a series of multidisciplinary meetings during the development of five adaptive clinical trials and completed a Strengths-Weaknesses-Opportunities-Threats questionnaire. In the analysis, we elucidated overarching themes across the stakeholders' responses to develop a conceptual model. Four major overarching themes emerged during the analysis of stakeholders' responses to questioning: the perceived statistical complexity of adaptive clinical trials and the roles of collaboration, communication, and time during the development process. Frequent and open communication and collaboration were viewed by stakeholders as critical during the development process, as were the careful management of time and logistical issues related to the complexity of planning adaptive clinical trials. The Adaptive Design Development Model illustrates how statistical complexity, time, communication, and collaboration are moderating factors in the adaptive design development process. The intensity and iterative nature of this process underscores the need for funding mechanisms for the development of novel trial proposals in academic settings.