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

NASA Astrophysics Data System (ADS)

Lopes, Rita; Videira, Nuno

2016-08-01

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

How Rural America Sees Its Future. The Main Street Economist: Commentary on the Rural Economy.

ERIC Educational Resources Information Center

Barkema, Alan D.; Drabenstott, Mark

To gain a perspective on rural America's future, seven roundtables consisting of seven rural stakeholder groups were convened. Four groups of challenges facing rural areas emerged. The rural business environment was considered the source of greatest challenge. Agriculture concerns included low profits and access to world markets. The effects of…

Towards a New Definition of Return-to-Work Outcomes in Common Mental Disorders from a Multi-Stakeholder Perspective

PubMed Central

Hees, Hiske L.; Nieuwenhuijsen, Karen; Koeter, Maarten W. J.; Bültmann, Ute; Schene, Aart H.

2012-01-01

Objectives To examine the perspectives of key stakeholders involved in the return-to-work (RTW) process regarding the definition of successful RTW outcome after sickness absence related to common mental disorders (CMD’s). Methods A mixed-method design was used: First, we used qualitative methods (focus groups, interviews) to identify a broad range of criteria important for the definition of successful RTW (N = 57). Criteria were grouped into content-related clusters. Second, we used a quantitative approach (online questionnaire) to identify, among a larger stakeholder sample (N = 178), the clusters and criteria most important for successful RTW. Results A total of 11 clusters, consisting of 52 unique criteria, were identified. In defining successful RTW, supervisors and occupational physicians regarded “Sustainability” and “At-work functioning” most important, while employees regarded “Sustainability,” “Job satisfaction,” “Work-home balance,” and “Mental Functioning” most important. Despite agreement on the importance of certain criteria, considerable differences among stakeholders were observed. Conclusions Key stakeholders vary in the aspects and criteria they regard as important when defining successful RTW after CMD-related sickness absence. Current definitions of RTW outcomes used in scientific research may not accurately reflect these key stakeholder perspectives. Future studies should be more aware of the perspective from which they aim to evaluate the effectiveness of a RTW intervention, and define their RTW outcomes accordingly. PMID:22768180

ENVIRONMENTAL TECHNOLOGY REPORT - LEAD DUST WIPE MEASUREMENT TECHNOLOGY MONITORING TECHNOLOGIES INTERNATIONAL, PDV 5000 TRACE ELEMENT ANALYZER

EPA Science Inventory

ETV works in partnership with recognized standards and testing organizations and stakeholder groups consisting of regulators, buyers, and vendor organizations, with the full participation of individual technology developers. The program evaluates the performance of innovative

ENVIRONMENTAL TECHNOLOGY VERIFICATION REPORT - LEAD IN DUST WIPE MEASUREMENT TECHNOLOGY, PALINTEST, SCANNING ANALYZER , SA-5000 SYSTEM

EPA Science Inventory

ETV works in partnership with recognized standards and testing organizations and stakeholder groups consisting of regulators, buyers, and vendor organizations, with the full participation of individual technology developers. The program evaluates the performance of innovative

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.

ENVIRONMENTAL TECHNOLOGY VERIFICATION REPORT - LEAD IN DUST WIPE MEASUREMENT TECHNOLOGY, KEYMASTER TECHNOLOGIES, X-RAY FLUORESCENCE INSTRUMENT PB-TEST

EPA Science Inventory

ETV works in partnership with recognized standards and testing organizations and stakeholder groups consisting of regulators, buyers, and vendor organizations, with the full participation of individual technology developers. The program evaluates the performance of innovative

ENVIRONMENTAL TECHNOLOGY VERIFICATION REPORT - LEAD IN DUST WIPE MEASUREMENT TECHNOLOGY, NITON CORPORATION, X-RAY FLURESCENCE SPECTRUM ANALYZER, XL-700

EPA Science Inventory

ETV works in partnership with recognized standards and testing organizations and stakeholder groups consisting of regulators, buyers, and vendor organizations, with the full participation of individual technology developers. The program evaluates the performance of innovative

Exploring the boundary of a specialist service for adults with intellectual disabilities using a Delphi study: a quantification of stakeholder participation.

PubMed

Hempe, Eva-Maria; Morrison, Cecily; Holland, Anthony

2015-10-01

There are arguments that a specialist service for adults with intellectual disabilities is needed to address the health inequalities that this group experiences. The boundary of such a specialist service however is unclear, and definition is difficult, given the varying experiences of the multiple stakeholder groups. The study reported here quantitatively investigates divergence in stakeholders' views of what constitutes a good specialist service for people with intellectual disabilities. It is the first step of a larger project that aims to investigate the purpose, function and design of such a specialist service. The results are intended to support policy and service development. A Delphi study was carried out to elicit the requirements of this new specialist service from stakeholder groups. It consisted of three panels (carers, frontline health professionals, researchers and policymakers) and had three rounds. The quantification of stakeholder participation covers the number of unique ideas per panel, the value of these ideas as determined by the other panels and the level of agreement within and between panels. There is some overlap of ideas about of what should constitute this specialist service, but both carers and frontline health professionals contributed unique ideas. Many of these were valued by the researchers and policymakers. Interestingly, carers generated more ideas regarding how to deliver services than what services to deliver. Regarding whether ideas are considered appropriate, the variation both within and between groups is small. On the other hand, the feasibility of solutions is much more contested, with large variations among carers. This study provides a quantified representation of the diversity of ideas among stakeholder groups regarding where the boundary of a specialist service for adults with learning disabilities should sit. The results can be used as a starting point for the design process. The study also offers one way to measure the impact of participation for those interested in participation as a mechanism for service improvement. © 2013 The Authors Health Expectations Published by John Wiley & Sons Ltd.

ENVIRONMENTAL TECHNOLOGY VERIFICATION REPORT - LEAD IN DUST WIPE MEASUREMENT TECHNOLOGY, NITON CORPORATION, X-RAY FLUORESCENCE SPECTRUM ANALYSER, XL-300 SERIES

EPA Science Inventory

ETV works in partnership with recognized standards and testing organizations and stakeholder groups consisting of regulators, buyers, and vendor organizations, with the full participation of individual technology developers. The program evaluates the performance of innovative

Advancing Care for Family Caregivers of persons with dementia through caregiver and community partnerships.

PubMed

White, Carole L; Overbaugh, Kristen J; Pickering, Carolyn E Z; Piernik-Yoder, Bridgett; James, Debbie; Patel, Darpan I; Puga, Frank; Ford, Lark; Cleveland, James

2018-01-01

There are currently 15 million Americans who provide over 80% of the care required by their family members with Alzheimer's disease and other dementias. Yet care for caregivers continues to be fragmented and few evidence-based interventions have been translated into routine clinical care and therefore remain inaccessible to most family caregivers. To address this gap, the Caring for the Caregiver program is being developed at UT Health San Antonio, School of Nursing to improve support services and health outcomes for family caregivers. Our purpose is to describe the engagement process undertaken to assess caregiver and community needs and how findings are informing program development. We are using a model of public engagement that consists of communication of information, collection of information from stakeholders, and collaboration where stakeholders are partners in an exchange of information to guide program activities. An assessment of the community was undertaken to identify resources/services for family caregivers. Subsequently, stakeholders were invited to a community-academic forum to discuss strategies to build on existing strengths for family caregiving and to identify gaps in care. Detailed notes were taken and all discussions were recorded and transcribed for analysis. Data were analyzed using thematic content analysis. We conducted site visits with 15 community agencies, interviewed 13 family caregivers, and attended community events including support groups and health and senior fairs. Fifty-three diverse stakeholders attended the community-academic forum. Participants identified existing assets within our community to support family caregivers. Consistent among groups was the need to increase awareness in our community about family caregivers. Themes identified from the discussion were: making the invisible visible, you don't know what you don't know, learning too late, and anticipating and preparing for the future. Incorporating caregiver and community stakeholders was critical to ensure that the priorities of our community are addressed in a culturally responsive accessible program for family caregivers. The forum served as important mechanism to partner with the community and will be an annual event where we can continue to work with our stakeholders around needs for practice, education, and research.

Improving health through neighbourhood environmental change: are we speaking the same language? A qualitative study of views of different stakeholders.

PubMed

Trayers, Tanya; Deem, Rosemary; Fox, Kenneth R; Riddoch, Chris J; Ness, Andy R; Lawlor, Debbie A

2006-03-01

To explore the perspectives of four groups of stakeholders to proposed improvements to the built environment-a neighbourhood renewal consisting of a home zone development and an extension of the National Cycle Network (NCN). Design Qualitative focus group study. Setting A deprived neighbourhood. Sample Four focus groups were conducted with 10 residents from the neighbourhood undergoing change, nine pupils from a local primary school, 10 students and tutors from a local further education college and three local authority planners overseeing the developments. We identified four main themes relating to the impact of environmental change. These were safety, space, antisocial behaviour and physical activity and health, the latter being the least important to all groups. A mismatch regarding environmental change emerged in perspectives between different stakeholders. The residents were most concerned about home and car (parking) safety and in particular felt that the new cycle/walk way would reduce their safety, whereas the planners felt that the environmental change would provide a safer and healthier environment for the residents. The assumption that planned provision of supportive environments will improve levels of physical activity, health and lifestyle may not be true if the developments do not take account of community concerns regarding personal safety.

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

If We Build It, Will They Come? A Qualitative Study of Key Stakeholder Opinions on the Implementation of a Videogame Intervention for Risk Reduction in Adolescents.

PubMed

Pendergrass, Tyra M; Hieftje, Kimberly; Crusto, Cindy A; Montanaro, Erika; Fiellin, Lynn E

2016-08-01

Serious games are emerging as important tools that offer an innovative approach to teach adolescents behavioral skills to avoid risky situations. PlayForward: Elm City Stories, an interactive videogame targeting risk reduction, is currently undergoing evaluation. Collecting stakeholder data on its acceptability and real-life implementation strategies is critical for successful dissemination. We collected interview data from four stakeholder groups regarding incorporating PlayForward into settings with adolescents. Transcripts were coded, creating a comprehensive code structure for each stakeholder group. We conducted 40 semi-structured interviews that included 14 adolescents (aged 12-15 years; 10 boys), eight parents/guardians (all women), 12 after-school/school coordinators (nine women), and 14 community partners (13 women). We identified four themes that reflected stakeholders' perceptions about how the videogame might be implemented in real-world settings. (1) Stakeholder groups expressed that the topics of sex, alcohol, and drugs were not being taught in an educational setting. (2) Stakeholder groups saw a videogame as a viable option to teach about sex, alcohol, and drugs. (3) Stakeholder groups thought that the videogame would fit well into other settings, such as after-school programs or community organizations. (4) Some stakeholder groups highlighted additional tools that could help with implementation, such as manuals, homework assignments, and group discussion questions. Stakeholder groups supported the game as a delivery vehicle for targeted content, indicating high acceptability but highlighting additional tools that would aid in implementation.

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.

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.

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.

The environmental management problem of Pohorje, Slovenia: A new group approach within ANP - SWOT framework.

PubMed

Grošelj, Petra; Zadnik Stirn, Lidija

2015-09-15

Environmental management problems can be dealt with by combining participatory methods, which make it possible to include various stakeholders in a decision-making process, and multi-criteria methods, which offer a formal model for structuring and solving a problem. This paper proposes a three-phase decision making approach based on the analytic network process and SWOT (strengths, weaknesses, opportunities and threats) analysis. The approach enables inclusion of various stakeholders or groups of stakeholders in particular stages of decision making. The structure of the proposed approach is composed of a network consisting of an objective cluster, a cluster of strategic goals, a cluster of SWOT factors and a cluster of alternatives. The application of the suggested approach is applied to a management problem of Pohorje, a mountainous area in Slovenia. Stakeholders from sectors that are important for Pohorje (forestry, agriculture, tourism and nature protection agencies) who can offer a wide range of expert knowledge were included in the decision-making process. The results identify the alternative of "sustainable development" as the most appropriate for development of Pohorje. The application in the paper offers an example of employing the new approach to an environmental management problem. This can also be applied to decision-making problems in various other fields. Copyright © 2015 Elsevier Ltd. All rights reserved.

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.

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

PubMed

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

2017-05-11

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

Factors affecting the implementation of green specifications in construction.

PubMed

Lam, Patrick T I; Chan, Edwin H W; Poon, C S; Chau, C K; Chun, K P

2010-01-01

Green specifications constitute one of the important elements in green construction. New sustainability requirements and changing priorities in construction management have spurred the emerging green specifications to a faster pace of development. A cross-sectional survey has been conducted in Hong Kong in 2007 to identify principal factors leading to the success of preparing green specifications. Based on extensive construction management literature, 20 variables concerning sustainable construction were summarized. Using the Mann-Whitney U-test, the subtle differences between stakeholders in specifying construction work have been detected even with the high consistency of the responses among the groups. Moreover, five independent factors for successful specification of green construction have been categorized by factor analysis. They are related to (1) green technology and techniques, (2) reliability and quality of specification, (3) leadership and responsibility, (4) stakeholder involvement, and (5) guide and benchmarking systems. Whilst the first and fourth factors are generally more important, different stakeholder groups have different emphases. The results of the survey have been validated against established principles. 2009 Elsevier Ltd. All rights reserved.

If We Build It, Will They Come? A Qualitative Study of Key Stakeholder Opinions on the Implementation of a Videogame Intervention for Risk Reduction in Adolescents

PubMed Central

Hieftje, Kimberly; Crusto, Cindy A.; Montanaro, Erika; Fiellin, Lynn E.

2016-01-01

Abstract Objective: Serious games are emerging as important tools that offer an innovative approach to teach adolescents behavioral skills to avoid risky situations. PlayForward: Elm City Stories, an interactive videogame targeting risk reduction, is currently undergoing evaluation. Collecting stakeholder data on its acceptability and real-life implementation strategies is critical for successful dissemination. Materials and Methods: We collected interview data from four stakeholder groups regarding incorporating PlayForward into settings with adolescents. Transcripts were coded, creating a comprehensive code structure for each stakeholder group. Results: We conducted 40 semi-structured interviews that included 14 adolescents (aged 12–15 years; 10 boys), eight parents/guardians (all women), 12 after-school/school coordinators (nine women), and 14 community partners (13 women). We identified four themes that reflected stakeholders' perceptions about how the videogame might be implemented in real-world settings. (1) Stakeholder groups expressed that the topics of sex, alcohol, and drugs were not being taught in an educational setting. (2) Stakeholder groups saw a videogame as a viable option to teach about sex, alcohol, and drugs. (3) Stakeholder groups thought that the videogame would fit well into other settings, such as after-school programs or community organizations. (4) Some stakeholder groups highlighted additional tools that could help with implementation, such as manuals, homework assignments, and group discussion questions. Conclusion: Stakeholder groups supported the game as a delivery vehicle for targeted content, indicating high acceptability but highlighting additional tools that would aid in implementation. PMID:27336205

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.

Distinguishing values from science in decision making: Setting harvest quotas for mountain lions in Montana

USGS Publications Warehouse

Mitchell, Michael S.; Cooley, Hilary; Gude, Justin A.; Kolbe, Jay; Nowak, J. Joshua; Proffitt, Kelly M.; Sells, Sarah N.; Thompson, Mike

2018-01-01

The relative roles of science and human values can be difficult to distinguish when informal processes are used to make complex and contentious decisions in wildlife management. Structured Decision Making (SDM) offers a formal process for making such decisions, where scientific results and concepts can be disentangled from the values of differing stakeholders. We used SDM to formally integrate science and human values for a citizen working group of ungulate hunting advocates, lion hunting advocates, and outfitters convened to address the contentious allocation of harvest quotas for mountain lions (Puma concolor) in west‐central Montana, USA, during 2014. A science team consisting of mountain lion biologists and population ecologists convened to support the working group. The science team used integrated population models that incorporated 4 estimates of mountain lion density to estimate population trajectories for 5 alternative harvest quotas developed by the working group. Results of the modeling predicted that effects of each harvest quota were consistent across the 4 density estimates; harvest quotas affected predicted population trajectories for 5 years after implementation but differences were not strong. Based on these results, the focus of the working group changed to differences in values among stakeholders that were the true impediment to allocating harvest quotas. By distinguishing roles of science and human values in this process, the working group was able to collaboratively recommend a compromise solution. This solution differed little from the status quo that had been the focus of debate, but the SDM process produced understanding and buy‐in among stakeholders involved, reducing disagreements, misunderstanding, and unproductive arguments founded on informal application of scientific data and concepts. Whereas investments involved in conducting SDM may be unnecessary for many decisions in wildlife management, the investment may be beneficial for complex, contentious, and multiobjective decisions that integrate science and human values.

AHRQ series paper 3: identifying, selecting, and refining topics for comparative effectiveness systematic reviews: AHRQ and the effective health-care program.

PubMed

Whitlock, Evelyn P; Lopez, Sarah A; Chang, Stephanie; Helfand, Mark; Eder, Michelle; Floyd, Nicole

2010-05-01

This article discusses the identification, selection, and refinement of topics for comparative effectiveness systematic reviews within the Agency for Healthcare Research and Quality's Effective Health Care (EHC) program. The EHC program seeks to align its research topic selection with the overall goals of the program, impartially and consistently apply predefined criteria to potential topics, involve stakeholders to identify high-priority topics, be transparent and accountable, and continually evaluate and improve processes. A topic prioritization group representing stakeholder and scientific perspectives evaluates topic nominations that fit within the EHC program (are "appropriate") to determine how "important" topics are as considered against seven criteria. The group then judges whether a new comparative effectiveness systematic review would be a duplication of existing research syntheses, and if not duplicative, if there is adequate type and volume of research to conduct a new systematic review. Finally, the group considers the "potential value and impact" of a comparative effectiveness systematic review. As the EHC program develops, ongoing challenges include ensuring the program addresses truly unmet needs for synthesized research because national and international efforts in this arena are uncoordinated, as well as engaging a range of stakeholders in program decisions while also achieving efficiency and timeliness.

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.

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.

75 FR 67992 - Notice of Proposed Information Collection: Comment Request; HUD Stakeholder Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-04

... Information Collection: Comment Request; HUD Stakeholder Survey AGENCY: Office of the Chief Information... responses. This Notice also lists the following information: Title of Proposal: HUD Stakeholder Survey. OMB... to educate stakeholders about HUD initiatives and policies. This data collection consists of a brief...

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.

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

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.

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' 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.

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.

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.

Understanding ecosystem service preferences across residential classifications near Mt. Baker Snoqualmie National Forest, Washington (USA).

Treesearch

Katherine Williams; Kelly Biedenweg; Lee Cerveny

2017-01-01

Ecosystem services consistently group together both spatially and cognitively into “bundles”. Understanding socio-economic predictors of these bundles is essential to informing a management approach that emphasizes equitable distribution of ecosystem services. We received 1796 completed surveys from stakeholders of the Mt. Baker-Snoqualmie National Forest (WA, USA)...

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…

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.

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.

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

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

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.

Exploring methods the for selection and integration of stakeholder views in the development of core outcome sets: a case study in reconstructive breast surgery.

PubMed

Potter, Shelley; Brookes, Sara T; Holcombe, Christopher; Ward, Joseph A; Blazeby, Jane M

2016-09-23

The development and use of core outcome sets (COSs) in trials may improve data synthesis and reduce outcome reporting bias. The selection of outcomes in COSs is informed by views of key stakeholders, yet little is known about the role and influence of different stakeholders' views during COS development. We report an exploratory case study examining how stakeholder selection and incorporation of stakeholders' views may influence the selection of outcomes for a COS in reconstructive breast surgery (RBS). We also make recommendations for future considerations. Key stakeholder groups and subgroups were identified from the literature and expert opinion by the COS management group. They included health care professionals, subdivided by profession (breast and plastic surgeons, specialist nurses and psychologists) and patients, subdivided according to type of surgery received, timing of reconstruction, time since surgery and patient age. All participated in a survey in which they were asked to prioritise outcomes. Outcomes were prioritised using a 9-point scale from 1 (not important) to 9 (extremely important). The proportion of (1) all participants, ignoring stakeholder group (single heterogeneous panel analysis), (2) 'professional' and 'patient' groups separately (two heterogeneous panels), ignoring prespecified subgroups and (3) each participant subgroup separately (multiple homogeneous panel analysis) rating each item 'extremely important' was summarised and compared to explore how selection and integration of stakeholder views may influence outcome prioritisation. There were many overlaps between items rated as most important by all groups. Specific stakeholders, however, prioritised specific concerns and a broader range of outcomes were prioritised when the subgroups were considered separately. For example, two additional outcomes were prioritised when patient and professional groups were considered separately and eight additional outcomes were identified when the views of the individual subgroups were explored. In general, patient subgroups preferentially valued additional clinical outcomes, including unplanned surgery, whereas professional subgroups prioritised additional psychosocial issues including body image. Stakeholder groups value different outcomes. Selection of groups, therefore, is important. Our recommendations for robust and transparent stakeholder selection and integration of stakeholder views may aid future COS developers in the design and conduct of their studies and improve the validity and value of future COS.

Implementation challenges and successes of a population-based colorectal cancer screening program: a qualitative study of stakeholder perspectives.

PubMed

Liles, Elizabeth G; Schneider, Jennifer L; Feldstein, Adrianne C; Mosen, David M; Perrin, Nancy; Rosales, Ana Gabriela; Smith, David H

2015-03-29

Few studies describe system-level challenges or facilitators to implementing population-based colorectal cancer (CRC) screening outreach programs. Our qualitative study explored viewpoints of multilevel stakeholders before, during, and after implementation of a centralized outreach program. Program implementation was part of a broader quality-improvement initiative. During 2008-2010, we conducted semi-structured, open-ended individual interviews and focus groups at Kaiser Permanente Northwest (KPNW), a not-for-profit group model health maintenance organization using the practical robust implementation and sustainability model to explore external and internal barriers to CRC screening. We interviewed 55 stakeholders: 8 health plan leaders, 20 primary care providers, 4 program managers, and 23 endoscopy specialists (15 gastroenterologists, 8 general surgeons), and analyzed interview transcripts to identify common as well as divergent opinions expressed by stakeholders. The majority of stakeholders at various levels consistently reported that an automated telephone-reminder system to contact patients and coordinate mailing fecal tests alleviated organizational constraints on staff's time and resources. Changing to a single-sample fecal immunochemical test (FIT) lessened patient and provider concerns about feasibility and accuracy of fecal testing. The centralized telephonic outreach program did, however, result in some screening duplication and overuse. Higher rates of FIT completion and a higher proportion of positive results with FIT required more colonoscopies. Addressing barriers at multiple levels of a health system by changing the delivery system design to add a centralized outreach program, switching to a more accurate and easier-to-use fecal test, and providing educational and electronic support had both benefits and problematic consequences. Other health care organizations can use our results to understand the complexities of implementing centralized screening programs.

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.

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.

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.

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.

Stakeholder Perceptions of Cyberbullying Cases: Application of the Uniform Definition of Bullying.

PubMed

Moreno, Megan A; Suthamjariya, Nina; Selkie, Ellen

2018-04-01

The Uniform Definition of Bullying was developed to address bullying and cyberbullying, and to promote consistency in measurement and policy. The purpose of this study was to understand community stakeholder perceptions of typical cyberbullying cases, and to evaluate how these case descriptions align with the Uniform Definition. In this qualitative case analysis we recruited stakeholders commonly involved in cyberbullying. We used purposeful sampling to identify and recruit adolescents and young adults, parents, and professionals representing education and health care. Participants were asked to write a typical case of cyberbullying and descriptors in the context of a group discussion. We applied content analysis to case excerpts using inductive and deductive approaches, and chi-squared tests for mixed methods analyses. A total of 68 participants contributed; participants included 73% adults and 27% adolescents and young adults. A total of 650 excerpts were coded from participants' example cases and 362 (55.6%) were consistent with components of the Uniform Definition. The most frequently mentioned component of the Uniform Definition was Aggressive Behavior (n = 218 excerpts), whereas Repeated was mentioned infrequently (n = 19). Most participants included two to three components of the Uniform Definition within an example case; none of the example cases included all components of the Uniform Definition. We found that most participants described cyberbullying cases using few components of the Uniform Definition. Findings can be applied toward considering refinement of the Uniform Definition to ensure stakeholders find it applicable to cyberbullying. Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Strengthening Indonesia's health workforce through partnerships.

PubMed

Kurniati, A; Rosskam, E; Afzal, M M; Suryowinoto, T B; Mukti, A G

2015-09-01

Indonesia faces critical challenges pertaining to human resources for health (HRH). These relate to HRH policy, planning, mismatch between production and demand, quality, renumeration, and mal-distribution. This paper provides a state of the art review of the existing conditions in Indonesia, innovations to tackle the problems, results of the innovations to date, and a picture of the on-going challenges that have yet to be met. Reversing this crisis level shortage of HRH requires an inclusive approach to address the underlying challenges. In 2010 the government initiated multi-stakeholder coordination for HRH, using the Country Coordination and Facilitation approach. The process requires committed engagement and coordination of relevant stakeholders to address priority health needs. This manuscript is a formative evaluation of the program using documentary study and analysis. Consistent with Indonesia's decentralized health system, since 2011 local governments also started establishing provincial multi-stakeholder committees and working groups for HRH development. Through this multi-stakeholder approach with high level government support and leadership, Indonesia was able to carry out HRH planning by engaging 164 stakeholders. Multi-stakeholder coordination has produced positive results in Indonesia by bringing about a number of innovations in HRH development to achieve UHC, fostered partnerships, attracted international attention, and galvanized multi-stakeholder support in improving the HRH situation. This approach also has facilitated mobilizing technical and financial support from domestic and international partners for HRH development. Applying the multi-stakeholder engagement and coordination process in Indonesia has proved instrumental in advancing the country's work to achieve Universal Health Coverage and the Millennium Development Goals by 2015. Indonesia continues to face an HRH crisis but the collaborative process provides an opportunity to achieve results. Indonesia's experience indicates that irrespective of geographical or economic status, countries can benefit from multi-stakeholder coordination and engagement to increase access to health workers, strengthen health systems, as well as achieve and sustain UHC. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

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

Consonance in Information System Projects: A Relationship Marketing Perspective

ERIC Educational Resources Information Center

Lin, Pei-Ying

2010-01-01

Different stakeholders in the information system project usually have different perceptions and expectations of the projects. There is seldom consistency in the stakeholders' evaluations of the project outcome. Thus the outcomes of information system projects are usually disappointing to one or more stakeholders. Consonance is a process that can…

Canadian 24-hour movement guidelines for the early years (0-4 years): exploring the perceptions of stakeholders and end users regarding their acceptability, barriers to uptake, and dissemination.

PubMed

Riazi, Negin; Ramanathan, Subha; O'Neill, Meghan; Tremblay, Mark S; Faulkner, Guy

2017-11-20

It is important to engage stakeholders and end users in the development of guidelines for knowledge translation purposes. The aim of this study was to examine stakeholders' (experts in pediatric and family medicine, physical activity knowledge translation, and research) and end users' (parents and early childhood educators) perceptions of the Canadian 24-Hour Movement Guidelines for the Early Years (0-4 years). Stakeholders (n = 10) engaged in telephone interviews and end users (n = 92) participated in focus groups (n = 14) to discuss perceived clarity and need for the guidelines, potential barriers to implementation, identification of credible messengers, and methods for dissemination of the guidelines. A thematic analysis was conducted. The proposed guidelines were very well received by both stakeholders and end users. A clear need for such guidelines was identified, and most believed the guidelines were achievable. Stakeholders and end users identified several potential barriers to uptake, including low awareness of current guidelines; 'daily challenges' such as allure of screen time, lack of time, and competing priorities; and challenges in the context of shifting social norms. A range of methods and messengers of dissemination were identified. Medical and child care settings were the most frequently cited places for dissemination, and physicians and early childhood educators were the most common suggestions for messengers. There was consistent support for the Canadian 24-Hour Movement Guidelines for the Early Years (0-4 years) from both stakeholders and end users. Moving forward, it is important to dedicate appropriate support and funding toward dissemination efforts in order to reach end users, particularly parents and early childhood educators.

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.

7 CFR 3418.2 - Scope and Purpose.

Code of Federal Regulations, 2010 CFR

2010-01-01

... SERVICE, DEPARTMENT OF AGRICULTURE STAKEHOLDER INPUT REQUIREMENTS FOR RECIPIENTS OF AGRICULTURAL RESEARCH... stakeholders concerning the use of formula funds. This regulation implements this requirement consistently for...

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

PubMed Central

2011-01-01

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

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

PubMed

Green, Amy E; Aarons, Gregory A

2011-09-07

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

Identifying priority medicines policy issues for New Zealand: a general inductive study

PubMed Central

Babar, Zaheer-Ud-Din; Francis, Susan

2014-01-01

Objectives To identify priority medicines policy issues for New Zealand. Setting Stakeholders from a broad range of healthcare and policy institutions including primary, secondary and tertiary care. Participants Exploratory, semistructured interviews were conducted with 20 stakeholders throughout New Zealand. Primary and secondary outcome measures The interviews were digitally recorded, transcribed and coded into INVIVO 10, then compared and grouped for similarity of theme. Perceptions, experiences and opinions regarding New Zealand's medicines policy issues were recorded. Results A large proportion of stakeholders appeared to be unaware of New Zealand's (NZ) medicines policy. In general, the policy was considered to offer consistency to guide decision-making. In the context of Pharmaceutical Management Agency's (PHARMAC's) fixed budget for procuring and subsidising medicines, there was reasonable satisfaction with the range of medicines available—rare disorder medicines being the clear exception. Concerns raised were by whom and how decisions are made and whether desired health outcomes are being measured. Other concerns included inconsistencies in evidence and across health technologies. Despite attempts to improve the situation, lower socioeconomic groups (including rural residents) Māori and Pacific ethnicities and people with rare disorders face challenges with regards to accessing medicines. Other barriers include, convenience to and affordability of prescribers and the increase of prescription fees from NZ$3 to NZ$5. Concerns related to the PHARMAC of New Zealand included: a constraining budget; non-transparency of in-house analysis; lack of consistency in recommendations between the Pharmacology and Therapeutics Advisory Committee. Constraints and inefficiencies also exist in the submission process to access high-cost medicines. Conclusions The results suggest reasonable satisfaction with the availability of subsidised medicines. However, some of the major challenges include access to medicines in vulnerable groups, increasing costs and demand for new medicines, access to prescribers, budgetary constraints, cultural and health literacy, patient affordability and evidence requirement for gaining subsidy for medicines. PMID:24871535

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…

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.

Exploring the architectural trade space of NASAs Space Communication and Navigation Program

NASA Astrophysics Data System (ADS)

Sanchez, M.; Selva, D.; Cameron, B.; Crawley, E.; Seas, A.; Seery, B.

NASAs Space Communication and Navigation (SCaN) Program is responsible for providing communication and navigation services to space missions and other users in and beyond low Earth orbit. The current SCaN architecture consists of three independent networks: the Space Network (SN), which contains the TDRS relay satellites in GEO; the Near Earth Network (NEN), which consists of several NASA owned and commercially operated ground stations; and the Deep Space Network (DSN), with three ground stations in Goldstone, Madrid, and Canberra. The first task of this study is the stakeholder analysis. The goal of the stakeholder analysis is to identify the main stakeholders of the SCaN system and their needs. Twenty-one main groups of stakeholders have been identified and put on a stakeholder map. Their needs are currently being elicited by means of interviews and an extensive literature review. The data will then be analyzed by applying Cameron and Crawley's stakeholder analysis theory, with a view to highlighting dominant needs and conflicting needs. The second task of this study is the architectural tradespace exploration of the next generation TDRSS. The space of possible architectures for SCaN is represented by a set of architectural decisions, each of which has a discrete set of options. A computational tool is used to automatically synthesize a very large number of possible architectures by enumerating different combinations of decisions and options. The same tool contains models to evaluate the architectures in terms of performance and cost. The performance model uses the stakeholder needs and requirements identified in the previous steps as inputs, and it is based in the VASSAR methodology presented in a companion paper. This paper summarizes the current status of the MIT SCaN architecture study. It starts by motivating the need to perform tradespace exploration studies in the context of relay data systems through a description of the history NASA's space communicati- n networks. It then presents the generalities of possible architectures for future space communication and navigation networks. Finally, it describes the tools and methods being developed, clearly indicating the architectural decisions that have been taken into account as well as the systematic approach followed to model them. The purpose of this study is to explore the SCaN architectural tradespace by means of a computational tool. This paper describes the tool, while the tradespace exploration is underway.

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.

Stakeholder Alignment and Changing Geospatial Information Capabilities

NASA Astrophysics Data System (ADS)

Winter, S.; Cutcher-Gershenfeld, J.; King, J. L.

2015-12-01

Changing geospatial information capabilities can have major economic and social effects on activities such as drought monitoring, weather forecasts, agricultural productivity projections, water and air quality assessments, the effects of forestry practices and so on. Whose interests are served by such changes? Two common mistakes are assuming stability in the community of stakeholders and consistency in stakeholder behavior. Stakeholder communities can reconfigure dramatically as some leave the discussion, others enter, and circumstances shift — all resulting in dynamic points of alignment and misalignment . New stakeholders can bring new interests, and existing stakeholders can change their positions. Stakeholders and their interests need to be be considered as geospatial information capabilities change, but this is easier said than done. New ways of thinking about stakeholder alignment in light of changes in capability are presented.

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.

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...

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.

Stakeholder analysis for the development of a community pharmacy service aimed at preventing cardiovascular disease.

PubMed

Franco-Trigo, L; Hossain, L N; Durks, D; Fam, D; Inglis, S C; Benrimoj, S I; Sabater-Hernández, D

Participatory approaches involving stakeholders across the health care system can help enhance the development, implementation and evaluation of health services. These approaches may be particularly useful in planning community pharmacy services and so overcome challenges in their implementation into practice. Conducting a stakeholder analysis is a key first step since it allows relevant stakeholders to be identified, as well as providing planners a better understanding of the complexity of the health care system. The main aim of this study was to conduct a stakeholder analysis to identify those individuals and organizations that could be part of a leading planning group for the development of a community pharmacy service (CPS) to prevent cardiovascular disease (CVD) in Australia. An experienced facilitator conducted a workshop with 8 key informants of the Australian health care system. Two structured activities were undertaken. The first explored current needs and gaps in cardiovascular care and the role of community pharmacists. The second was a stakeholder analysis, using both ex-ante and ad-hoc approaches. Identified stakeholders were then classified into three groups according to their relative influence on the development of the pharmacy service. The information gathered was analyzed using qualitative content analysis. The key informants identified 46 stakeholders, including (1) patient/consumers and their representative organizations, (2) health care providers and their professional organizations and (3) institutions and organizations that do not directly interact with patients but organize and manage the health care system, develop and implement health policies, pay for health care, influence funding for health service research or promote new health initiatives. From the 46 stakeholders, a core group of 12 stakeholders was defined. These were considered crucial to the service's development because they held positions that could drive or inhibit progress. Secondary results of the workshop included: a list of needs and gaps in cardiovascular care (n = 6), a list of roles for community pharmacists in cardiovascular prevention (n = 12) and a list of potential factors (n = 7) that can hinder the integration of community pharmacy services into practice. This stakeholder analysis provided a detailed picture of the wide range of stakeholders across the entire health care system that have a stake in the development of a community pharmacy service aimed at preventing CVD. Of these, a core group of key stakeholders, with complementary roles, can then be approached for further planning of the service. The results of this analysis highlight the relevance of establishing multilevel stakeholder groups for CPS planning. Copyright © 2016 Elsevier Inc. All rights reserved.

Multi-Stakeholder Decision Aid for Improved Prioritization of the Public Health Impact of Climate Sensitive Infectious Diseases

PubMed Central

Hongoh, Valerie; Michel, Pascal; Gosselin, Pierre; Samoura, Karim; Ravel, André; Campagna, Céline; Cissé, Hassane Djibrilla; Waaub, Jean-Philippe

2016-01-01

The effects of climate change on infectious diseases are an important global health concern and necessitate decisions for allocation of resources. Economic tools have been used previously; however, how prioritization results might differ when done using broader considerations identified by local stakeholders has yet to be assessed. A multicriteria decision analysis (MCDA) approach was used to assess multi-stakeholder expressed concerns around disease prioritization via focus groups held in Quebec and Burkina Faso. Stakeholders weighted criteria and comparisons were made across study sites. A pilot disease prioritization was done to examine effects on disease rankings. A majority of identified criteria were common to both sites. The effect of context specific criteria and weights resulted in similar yet distinct prioritizations of diseases. The presence of consistent criteria between sites suggests that common concerns exist for prioritization; however, context-specific adjustments reveal much regarding resource availability, capacity and concerns that should be considered as this impacts disease ranking. Participatory decision aid approaches facilitate rich knowledge exchange and problem structuring. Furthermore, given multiple actors in low- and middle-income countries settings, multi-actor collaborations across non-governmental organizations, local government and community are important. Formal mechanisms such as MCDA provide means to foster consensus, shared awareness and collaboration. PMID:27077875

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.

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.

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

VET [Vocational Education and Training] Research: Influencing Policy & Practice. Proceedings of the National Conference of the Australian Vocational Education and Training Research Association (AVETRA) (1st, Sydney, Australia, February 16-17, 1998).

ERIC Educational Resources Information Center

McIntyre, John, Ed.; Barrett, Mary, Ed.

These proceedings consist of 46 papers on the influence of vocational education and training (VET) research on policy and practice. These papers are grouped into these categories: impact of research; equity in participation; partnerships and stakeholders; practice and practitioners; research and policy; learning, work, and organizations; and VET,…

Exploration of Experiences and Perceptions of Three Botswana Basic Education Stakeholders on Employment and Unemployment of Graduates of Basic Education

ERIC Educational Resources Information Center

Tidimane, Christopher

2012-01-01

This study used a phenomenological approach to explore the lived experiences of three groups of stakeholders of the Botswana basic education program related to the employment and unemployment of graduates of basic education. Semi-structured interviews were conducted with 21 participants from three groups of stakeholders, graduates of basic…

Report On Stakeholders Analysis Fast-Trac Phase Iii Deliverables, #5 One Set Of Stakeholder Readings, #6. Final Version Of The Stakeholders? Questionnaire, #7. Stakeholders? Analysis Report

DOT National Transportation Integrated Search

1996-12-10

THIS STUDY WAS UNDERTAKEN TO IDENTIFY AND EVALUATE CRITERIA BY WHICH THE PUBLIC, AND CERTAIN STAKEHOLDER GROUPS WITHIN THE PUBLIC, WILL JUDGE THE MERITS OF THE FAST-TRAC SYSTEM. OVER A PERIOD OF TWO YEARS, THREE SURVEYS WERE CONDUCTED TO OBTAIN SPECI...

Contingency plan implementation.

PubMed

Neurath, D; Cober, N; Owens, W; Giulivi, A

2012-06-01

Although the National blood system in Canada reduces the risk of inventory shortages the possibility of a blood supply shortage still exists. The Ontario Ministry of Health and Long-Term Care developed a provincial plan to manage blood transfusion needs and inventory in the event of a National blood shortage. The Ontario plan was developed to align with the National plan as well as other provincial plans in order to ensure consistency in blood management strategies across the country. The Ontario plan was released in 2008, along with a toolkit to aid hospitals in developing their facility specific plans. In the Champlain region of Ontario, a group of 16 hospitals worked collaboratively to develop a regional blood shortage plan. A provincial blood shortage simulation exercise was held in 2010 to test out these plans. The Director of Transfusion Medicine of the largest facility in the group of 16 hospitals (The Ottawa Hospital) took the lead in the development of the regional blood shortage management plan. Working groups from all 16 sites contributed to the plan development. The proposed plan was presented to the Medical Advisory Committee for approval. The plan consists of activities relating to the severity of the supply shortage as defined by Amber, Red, Recovery and Green phases. The plan includes a communication plan for notifying stakeholders including patients whose treatment may be affected. Inventory management and triage guidelines are provided to reduce the demand for blood and to conserve inventory for those patients whose need is prioritized as highest. The regional blood shortage management plan was tested successfully during the provincial simulation exercise. Where regional hospitals work together to provide healthcare, it is beneficial to develop a standardized plan to provide guidance to hospital personnel in response to a blood supply shortage. A consistent plan will ensure patient care is provided in a consistent manner across a health region. Mock or simulation exercises can aid in testing plans and raising the awareness of stakeholders. Copyright © 2012 Elsevier Ltd. All rights reserved.

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.

Using concept mapping in the knowledge-to-action process to compare stakeholder opinions on barriers to use of cancer screening among South Asians.

PubMed

Lobb, Rebecca; Pinto, Andrew D; Lofters, Aisha

2013-03-23

Using the knowledge-to-action (KTA) process, this study examined barriers to use of evidence-based interventions to improve early detection of cancer among South Asians from the perspective of multiple stakeholders. In 2011, we used concept mapping with South Asian residents, and representatives from health service and community service organizations in the region of Peel Ontario. As part of concept mapping procedures, brainstorming sessions were conducted with stakeholders (n = 53) to identify barriers to cancer screening among South Asians. Participants (n = 46) sorted barriers into groups, and rated barriers from lowest (1) to highest (6) in terms of importance for use of mammograms, Pap tests and fecal occult blood tests, and how feasible it would be to address them. Multi-dimensional scaling, cluster analysis, and descriptive statistics were used to analyze the data. A total of 45 unique barriers to use of mammograms, Pap tests, and fecal occult blood tests among South Asians were classified into seven clusters using concept mapping procedures: patient's beliefs, fears, lack of social support; health system; limited knowledge among residents; limited knowledge among physicians; health education programs; ethno-cultural discordance with the health system; and cost. Overall, the top three ranked clusters of barriers were 'limited knowledge among residents,' 'ethno-cultural discordance,' and 'health education programs' across surveys. Only residents ranked 'cost' second in importance for fecal occult blood testing, and stakeholders from health service organizations ranked 'limited knowledge among physicians' third for the feasibility survey. Stakeholders from health services organizations ranked 'limited knowledge among physicians' fourth for all other surveys, but this cluster consistently ranked lowest among residents. The limited reach of cancer control programs to racial and ethnic minority groups is a critical implementation issue that requires attention. Opinions of community service and health service organizations on why this deficit in implementation occurs are fundamental to understanding the solutions because these are the settings in which evidence-based interventions are implemented. Using concept mapping within a KTA process can facilitate the engagement of multiple stakeholders in the utilization of study results and in identifying next steps for action.

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.

Supporting multi-stakeholder environmental decisions.

PubMed

Hajkowicz, Stefan A

2008-09-01

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

Balancing Competing Rights: A Stakeholder Model for Democratic Schools

ERIC Educational Resources Information Center

Shariff, Shaheen

2006-01-01

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

Theory-Based Stakeholder Evaluation

ERIC Educational Resources Information Center

Hansen, Morten Balle; Vedung, Evert

2010-01-01

This article introduces a new approach to program theory evaluation called theory-based stakeholder evaluation or the TSE model for short. Most theory-based approaches are program theory driven and some are stakeholder oriented as well. Practically, all of the latter fuse the program perceptions of the various stakeholder groups into one unitary…

Collaborative learning framework for online stakeholder engagement.

PubMed

Khodyakov, Dmitry; Savitsky, Terrance D; Dalal, Siddhartha

2016-08-01

Public and stakeholder engagement can improve the quality of both research and policy decision making. However, such engagement poses significant methodological challenges in terms of collecting and analysing input from large, diverse groups. To explain how online approaches can facilitate iterative stakeholder engagement, to describe how input from large and diverse stakeholder groups can be analysed and to propose a collaborative learning framework (CLF) to interpret stakeholder engagement results. We use 'A National Conversation on Reducing the Burden of Suicide in the United States' as a case study of online stakeholder engagement and employ a Bayesian data modelling approach to develop a CLF. Our data modelling results identified six distinct stakeholder clusters that varied in the degree of individual articulation and group agreement and exhibited one of the three learning styles: learning towards consensus, learning by contrast and groupthink. Learning by contrast was the most common, or dominant, learning style in this study. Study results were used to develop a CLF, which helps explore multitude of stakeholder perspectives; identifies clusters of participants with similar shifts in beliefs; offers an empirically derived indicator of engagement quality; and helps determine the dominant learning style. The ability to detect learning by contrast helps illustrate differences in stakeholder perspectives, which may help policymakers, including Patient-Centered Outcomes Research Institute, make better decisions by soliciting and incorporating input from patients, caregivers, health-care providers and researchers. Study results have important implications for soliciting and incorporating input from stakeholders with different interests and perspectives. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

[Building local citizen participation among older adults : A participatory project].

PubMed

Douma, Linden; Bouwman, Ruben; Hutter, Inge; Meijering, Louise

2017-02-01

Dutch municipalities are looking for ways to promote citizen participation, among which older adults. This paper discusses older adults' experiences regarding favoring and inhibiting factors for lasting and independent citizen participation around the themes of housing, wellbeing and health care. The participatory research project lasted from April 2014 to March 2016. The organizational structure consisted of a working group, a group of 21 participants (aged 65+) and the research team. Interviews and focus-group discussions were used. The project did not result in lasting and independent citizen participation of older adults, as was intended beforehand. When we examined the experiences of the participants, we found that their participation was favored and inhibited by the factors Can do, Like to, Enabled to, Asked to, and Responded to. In order for citizen participation to be successful, all five identified factors should be met by the stakeholders involved. To achieve this we recommend to fine-tune the mutual expectations of the stakeholders, using the CLEAR model. The empirically grounded knowledge, generated throughout the project, strengthens the existing evidence-base about participation of older adults and helps to shape local participation programs.

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.

Enhancing School Asthma Action Plans: Qualitative Results from Southeast Minnesota Beacon Stakeholder Groups

ERIC Educational Resources Information Center

Egginton, Jason S.; Textor, Lauren; Knoebel, Erin; McWilliams, Deborah; Aleman, Marty; Yawn, Barbara

2013-01-01

Background: This study explores ways southeast Minnesota schools currently address asthma problems, identifies areas for improvement, and assesses the potential value of asthma action plans (AAPs) in schools. Methods: Focus groups were used to query stakeholder groups on asthma care in schools. Groups were held separately for elementary school…

Conventional and New Ways of Governing Forest Threats: A Study of Stakeholder Coherence in Sweden.

PubMed

Eriksson, Louise

2018-01-01

Based on a framework for analyzing stakeholder coherence horizontally and vertically, the present study examined the governance of forest threats in Sweden. Opinions of forest risk governance in stakeholder groups with and without a connection to private forestry were compared (n = 2496) and the opinions were analyzed in relation to current governance practices. More specifically, forest threat appraisals, trust in the Swedish Forest Agency (SFA), and the acceptability of forest risk policy measures directed at private forest owners were assessed. Results revealed an overall coherence between different stakeholders in this context. However, the groups differed in, for example, the acceptability of the hypothetical regulative measure aiming to reduce damages threatening the forest long-term (e.g., climate change). Furthermore, an extensive use of advice for a fee may challenge particularly the internal, but also the external, legitimacy of forest risk governance. The forest owner stakeholder group showed lower threat appraisals when evaluating threat to one's own forest rather than to the Swedish forest, except regarding browsing by animals. Regulations were not disapproved of in any of the stakeholder groups, although the forest owner group generally displayed higher acceptability of encouraging measures compared to the general public. Trust in the SFA was furthermore confirmed as an important driver of policy acceptability, and higher threat appraisals of novel threats, such as climate change and fire, resulted in a higher acceptability of measures less central or new in this context. The value of analyzing stakeholder coherence for natural resource management and governance is discussed.

Conventional and New Ways of Governing Forest Threats: A Study of Stakeholder Coherence in Sweden

NASA Astrophysics Data System (ADS)

Eriksson, Louise

2018-01-01

Based on a framework for analyzing stakeholder coherence horizontally and vertically, the present study examined the governance of forest threats in Sweden. Opinions of forest risk governance in stakeholder groups with and without a connection to private forestry were compared ( n = 2496) and the opinions were analyzed in relation to current governance practices. More specifically, forest threat appraisals, trust in the Swedish Forest Agency (SFA), and the acceptability of forest risk policy measures directed at private forest owners were assessed. Results revealed an overall coherence between different stakeholders in this context. However, the groups differed in, for example, the acceptability of the hypothetical regulative measure aiming to reduce damages threatening the forest long-term (e.g., climate change). Furthermore, an extensive use of advice for a fee may challenge particularly the internal, but also the external, legitimacy of forest risk governance. The forest owner stakeholder group showed lower threat appraisals when evaluating threat to one's own forest rather than to the Swedish forest, except regarding browsing by animals. Regulations were not disapproved of in any of the stakeholder groups, although the forest owner group generally displayed higher acceptability of encouraging measures compared to the general public. Trust in the SFA was furthermore confirmed as an important driver of policy acceptability, and higher threat appraisals of novel threats, such as climate change and fire, resulted in a higher acceptability of measures less central or new in this context. The value of analyzing stakeholder coherence for natural resource management and governance is discussed.

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

PubMed Central

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

2016-01-01

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

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.

Evaluation of stormwater harvesting sites using multi criteria decision methodology

NASA Astrophysics Data System (ADS)

Inamdar, P. M.; Sharma, A. K.; Cook, Stephen; Perera, B. J. C.

2018-07-01

Selection of suitable urban stormwater harvesting sites and associated project planning are often complex due to spatial, temporal, economic, environmental and social factors, and related various other variables. This paper is aimed at developing a comprehensive methodology framework for evaluating of stormwater harvesting sites in urban areas using Multi Criteria Decision Analysis (MCDA). At the first phase, framework selects potential stormwater harvesting (SWH) sites using spatial characteristics in a GIS environment. In second phase, MCDA methodology is used for evaluating and ranking of SWH sites in multi-objective and multi-stakeholder environment. The paper briefly describes first phase of framework and focuses chiefly on the second phase of framework. The application of the methodology is also demonstrated over a case study comprising of the local government area, City of Melbourne (CoM), Australia for the benefit of wider water professionals engaged in this area. Nine performance measures (PMs) were identified to characterise the objectives and system performance related to the eight alternative SWH sites for the demonstration of the application of developed methodology. To reflect the stakeholder interests in the current study, four stakeholder participant groups were identified, namely, water authorities (WA), academics (AC), consultants (CS), and councils (CL). The decision analysis methodology broadly consisted of deriving PROMETHEE II rankings of eight alternative SWH sites in the CoM case study, under two distinct group decision making scenarios. The major innovation of this work is the development and application of comprehensive methodology framework that assists in the selection of potential sites for SWH, and facilitates the ranking in multi-objective and multi-stakeholder environment. It is expected that the proposed methodology will assist the water professionals and managers with better knowledge that will reduce the subjectivity in the selection and evaluation of SWH sites.

Financial Conflicts of Interest Checklist 2010 for clinical research studies.

PubMed

Rochon, Paula A; Hoey, John; Chan, An-Wen; Ferris, Lorraine E; Lexchin, Joel; Kalkar, Sunila R; Sekeres, Melanie; Wu, Wei; Van Laethem, Marleen; Gruneir, Andrea; Maskalyk, James; Streiner, David L; Gold, Jennifer; Taback, Nathan; Moher, David

2010-01-01

A conflict of interest is defined as "a set of conditions in which professional judgment concerning a primary interest (such as a patient's welfare or the validity of research) tends to be unduly influenced by a secondary interest (such as financial gain)" [Thompson DF. Understanding financial conflicts of interest. N Engl J Med 1993;329(8):573-576]. Because financial conflict of interest (fCOI) can occur at different stages of a study, and because it can be difficult for investigators to detect their own bias, particularly retrospectively, we sought to provide funders, journal editors and other stakeholders with a standardized tool that initiates detailed reporting of different aspects of fCOI when the study begins and continues that reporting throughout the study process to publication. We developed a checklist using a 3-phase process of pre-meeting item generation, a stakeholder meeting and post-meeting consolidation. External experts (n = 18), research team members (n = 12) and research staff members (n = 4) rated or reviewed items for some or all of the 7 major iterations. The resulting Financial Conflicts of Interest Checklist 2010 consists of 4 sections covering administrative, study, personal financial, and authorship information, which are divided into 6 modules and contain a total of 15 items and their related sub-items; it also includes a glossary of terms. The modules are designed to be completed by all investigators at different points over the course of the study, and updated information can be appended to the checklist when it is submitted to stakeholder groups for review. We invite comments and suggestions for improvement at http://www.openmedicine.ca/fcoichecklist and ask stakeholder groups to endorse the use of the checklist.

Influencing Organizations to Promote Health: Applying Stakeholder Theory

ERIC Educational Resources Information Center

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

2015-01-01

Stakeholder theory may help health promoters to make changes at the organizational and policy level to promote health. A stakeholder is any individual, group, or organization that can influence an organization. The organization that is the focus for influence attempts is called the focal organization. The more salient a stakeholder is and the more…

Factors that Facilitate and Impede Effective Knowledge Translation in Population Health Promotion: Results from a Consultation Workshop in Iran.

PubMed

Shooshtari, Shahin

2012-01-01

The workshop that this paper reports, held in Iran in May of 2011, at the 1st Inter-national and 4th National Congress on Health Education and Promotion, had three main objec-tives: 1) to introduce participants to the knowledge translation (KT) concept, along with its mod-els and methods; 2) to enhance participants' knowledge of how KT could apply to public health education and promotion ; and 3) to learn from different participating stakeholder groups about the factors that facilitate or impede effective KT in public health education and promotion in Iran. The workshop consisted of three components: introducing the KT concept, assessing the KT capacity of participants, and facilitating a discussion of the important contextual factors that promote and impede effective KT. Of the 26 individuals from across the country participat-ing in the workshop, 17 took part in a KT capacity assessment activity. They classified them-selves into one of the following three stakeholder groups: administrators and policymakers (n=6), practitioners (n=2), and researchers (n=9). There were different capacities for KT across the three stakeholder groups. The re-ported challenges for effective KT include "lack of resources and funding"; "lack of time"; "poor quality of relationships and lack of trust between health policymakers, administrators, re-searchers, and clinicians"; "inadequate skills possessed by healthcare professionals and adminis-trators for assessment and adaptation of research findings"; and "poor involvement of commu-nity partners in the research process." There is a great need to develop effective strategies to overcome the reported barri-ers for effective KT.

Ethics and incentives: an evaluation and development of stakeholder theory in the health care industry.

PubMed

Elms, Heather; Berman, Shawn; Wicks, Andrew C

2002-10-01

This paper utilizes a qualitative case study of the health care industry and a recent legal case to demonstrate that stakeholder theory's focus on ethics, without recognition of the effects of incentives, severely limits the theory's ability to provide managerial direction and explain managerial behavior. While ethics provide a basis for stakeholder prioritization, incentives influence whether managerial action is consistent with that prioritization. Our health care examples highlight this and other limitations of stakeholder theory and demonstrate the explanatory and directive power added by the inclusion of the interactive effects of ethics and incentives in stakeholder ordering.

A Study of Crisis Management Based on Stakeholders Analysis Model

NASA Astrophysics Data System (ADS)

Qingchun, Yue

2017-11-01

From the view of stakeholder theory, not only the enterprises should provide services to shareholders, but also take care of the demands of stakeholders. Stakeholders for the enterprise crisis are the organizations and individuals, which cause crisis, respond to the crisis and affected by the enterprise crisis. In this paper, first of all, to comb the development of stakeholder theory systematically; secondly, with the help of the enterprise crisis stakeholder analysis model, analyze the concept of stakeholders for the enterprise crisis and membership, and with the example of Shuanghui Group for further analysis; finally, we put forward relevant proposals for the enterprise crisis from the view of stakeholders.

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

PubMed

Hwabamungu, Boroto; Brown, Irwin; Williams, Quentin

2018-01-01

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

A framework to expand public services to children with biomedical healthcare needs related to HIV in the Free State, South Africa.

PubMed

Reid, Marianne; Botma, Yvonne

2012-06-01

The study undertook the development of a framework for expanding the public services available to children with biomedical healthcare needs related to HIV in South Africa. The study consisted of various component projects which were depicted as phases. The first phase was a descriptive quantitative analysis of healthcare services for children exposed to or infected by HIV, as rendered by the public health sector in the Free State Province. The second stage was informed by health policy research: a nominal group technique with stakeholders was used to identify strategies for expanding the healthcare services available to these children. The third phase consisted of workshops with stakeholders in order to devise and validate a framework for the expansion. The theory of change logic model served as the theoretical underpinning of the draft framework. Triangulated data from the literature and the preceding two phases of the study provided the empirical foundation. The problem identified was that of fragmented care delivered to children exposed to or infected with HIV, due to the 'over-verticalization' of programmes. A workshop was held during which the desired results, the possible factors that could influence the results, as well as the suggested strategies to expand and integrate the public services available to HIV-affected children were confirmed. Thus the framework was finalised during the validation workshop by the researchers in collaboration with the stakeholders.

A watershed-based adaptive knowledge system for developing ecosystem stakeholder partnerships

NASA Astrophysics Data System (ADS)

Lin, Hebin; Thornton, Jeffrey A.; Shadrin, Nickolai

2015-11-01

This study proposes a Watershed-based Adaptive Knowledge System (WAKES) to consistently coordinate multiple stakeholders in developing sustainable partnerships for ecosystem management. WAKES is extended from the institutional mechanism of Payments for Improving Ecosystem Services at the Watershed-scale (PIES-W). PIES-W is designed relating to the governance of ecosystem services fl ows focused on a lake as a resource stock connecting its infl owing and outfl owing rivers within its watershed. It explicitly realizes the values of conservation services provided by private land managers and incorporates their activities into the public organizing framework for ecosystem management. It implicitly extends the "upstream-to-downstream" organizing perspective to a broader vision of viewing the ecosystems as comprised of both "watershed landscapes" and "marine landscapes". Extended from PIES-W, WAKES specifies two corresponding feedback: Framework I and II. Framework I is a relationship matrix comprised of three input-output structures of primary governance factors intersecting three subsystems of a watershed with regard to ecosystem services and human stakeholders. Framework II is the Stakeholder-and-Information structure channeling five types of information among four stakeholder groups in order to enable the feedbacks mechanism of Framework I. WAKES identifies the rationales behind three fundamental information transformations, illustrated with the Transboundary Diagnostic Analysis and the Strategic Action Program of the Bermejo River Binational Basin. These include (1) translating scientific knowledge into public information within the Function-and-Service structure corresponding to the ecological subsystem, (2) incorporating public perceptions into political will within the Service- and- Value structure corresponding to the economic subsystem, and (3) integrating scientific knowledge, public perceptions and political will into management options within the Value-and-Stakeholder structure corresponding to the social subsystem. This study seeks to share a vision of social adaptation for a global sustainable future through developing a network to adopt contributions from and forming partnerships among all ecosystem stakeholders.

Who's in and why? A typology of stakeholder analysis methods for natural resource management.

PubMed

Reed, Mark S; Graves, Anil; Dandy, Norman; Posthumus, Helena; Hubacek, Klaus; Morris, Joe; Prell, Christina; Quinn, Claire H; Stringer, Lindsay C

2009-04-01

Stakeholder analysis means many things to different people. Various methods and approaches have been developed in different fields for different purposes, leading to confusion over the concept and practice of stakeholder analysis. This paper asks how and why stakeholder analysis should be conducted for participatory natural resource management research. This is achieved by reviewing the development of stakeholder analysis in business management, development and natural resource management. The normative and instrumental theoretical basis for stakeholder analysis is discussed, and a stakeholder analysis typology is proposed. This consists of methods for: i) identifying stakeholders; ii) differentiating between and categorising stakeholders; and iii) investigating relationships between stakeholders. The range of methods that can be used to carry out each type of analysis is reviewed. These methods and approaches are then illustrated through a series of case studies funded through the Rural Economy and Land Use (RELU) programme. These case studies show the wide range of participatory and non-participatory methods that can be used, and discuss some of the challenges and limitations of existing methods for stakeholder analysis. The case studies also propose new tools and combinations of methods that can more effectively identify and categorise stakeholders and help understand their inter-relationships.

Effectiveness of additional self-care acupressure for women with menstrual pain compared to usual care alone: using stakeholder engagement to design a pragmatic randomized trial and study protocol.

PubMed

Blödt, Susanne; Schützler, Lena; Huang, Wenjing; Pach, Daniel; Brinkhaus, Benno; Hummelsberger, Josef; Kirschbaum, Barbara; Kuhlmann, Kirsten; Lao, Lixing; Liang, Fanrong; Mietzner, Anna; Mittring, Nadine; Müller, Sabine; Paul, Anna; Pimpao-Niederle, Carolina; Roll, Stephanie; Wu, Huangan; Zhu, Jiang; Witt, Claudia M

2013-04-11

Self-care acupressure might be successful in treating menstrual pain, which is common among young women. There is a need for comparative effectiveness research with stakeholder engagement in all phases seeking to address the needs of decision-makers. Our aim was to design a study on the effectiveness of additional self-care acupressure for menstrual pain comparing usual care alone using different methods of stakeholder engagement. The study was designed using multiple mixed methods for stakeholder engagement. Based on the results of a survey and focus group discussion, a stakeholder advisory group developed the study design. Stakeholder engagement resulted in a two-arm pragmatic randomized trial. Two hundred and twenty women aged 18 to 25 years with menstrual pain will be included in the study. Outcome measurement will be done using electronic questionnaires provided by a study specific mobile application (App). Primary outcome will be the mean pain intensity at the days of pain during the third menstruation after therapy start. Stakeholder engagement helped to develop a study design that better serves the needs of decision makers, including an App as a modern tool for both intervention and data collection in a young target group. Clinicaltrials.gov identifier http://NCT01582724.

Building a picture: Prioritisation of exotic diseases for the pig industry in Australia using multi-criteria decision analysis.

PubMed

Brookes, V J; Hernández-Jover, M; Cowled, B; Holyoake, P K; Ward, M P

2014-01-01

Diseases that are exotic to the pig industry in Australia were prioritised using a multi-criteria decision analysis framework that incorporated weights of importance for a range of criteria important to industry stakeholders. Measurements were collected for each disease for nine criteria that described potential disease impacts. A total score was calculated for each disease using a weighted sum value function that aggregated the nine disease criterion measurements and weights of importance for the criteria that were previously elicited from two groups of industry stakeholders. One stakeholder group placed most value on the impacts of disease on livestock, and one group placed more value on the zoonotic impacts of diseases. Prioritisation lists ordered by disease score were produced for both of these groups. Vesicular diseases were found to have the highest priority for the group valuing disease impacts on livestock, followed by acute forms of African and classical swine fever, then highly pathogenic porcine reproductive and respiratory syndrome. The group who valued zoonotic disease impacts prioritised rabies, followed by Japanese encephalitis, Eastern equine encephalitis and Nipah virus, interspersed with vesicular diseases. The multi-criteria framework used in this study systematically prioritised diseases using a multi-attribute theory based technique that provided transparency and repeatability in the process. Flexibility of the framework was demonstrated by aggregating the criterion weights from more than one stakeholder group with the disease measurements for the criteria. This technique allowed industry stakeholders to be active in resource allocation for their industry without the need to be disease experts. We believe it is the first prioritisation of livestock diseases using values provided by industry stakeholders. The prioritisation lists will be used by industry stakeholders to identify diseases for further risk analysis and disease spread modelling to understand biosecurity risks to this industry. Copyright © 2013 Elsevier B.V. All rights reserved.

Transition Follow-Up System Development for Youth with Disabilities: Stakeholders' Perspectives

ERIC Educational Resources Information Center

Park, Youn-Young

2014-01-01

In this study I examined in depth the perspectives of stakeholders in Manitoba on the development and implementation of a transition follow-up system (TFS) for youth with disabilities. I conducted focus groups and individual interviews with a total of 76 stakeholders and obtained qualitative data. The stakeholders who participated in this study…

76 FR 5393 - Notice of Submission of Proposed Information Collection to OMB; HUD Stakeholder Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-31

... Proposed Information Collection to OMB; HUD Stakeholder Survey AGENCY: Office of the Chief Information... will allow HUD to collect feedback from a wide range of stakeholder groups using a brief, optional survey to be completed in person at the end of each stakeholder event. The events range in size from...

Stakeholder identification of advanced technology opportunities at international ports of entry

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

Parker, S.K.; Icerman, L.

As part of the Advanced Technologies for International and Intermodal Ports of Entry (ATIPE) Project, a diverse group of stakeholders was engaged to help identify problems experienced at inland international border crossings, particularly those at the US-Mexican border. The fundamental issue at international ports of entry is reducing transit time through the required documentation and inspection processes. Examples of other issues or problems, typically manifested as time delays at border crossings, repeatedly mentioned by stakeholders include: (1) lack of document standardization; (2) failure to standardize inspection processes; (3) inadequate information and communications systems; (4) manual fee and tariff collection; (5)more » inconsistency of processes and procedures; and (6) suboptimal cooperation among governmental agencies. Most of these issues can be addressed to some extent by the development of advanced technologies with the objective of allowing ports of entry to become more efficient while being more effective. Three categories of technologies were unambiguously of high priority to port of entry stakeholders: (1) automated documentation; (2) systems integration; and (3) vehicle and cargo tracking. Together, these technologies represent many of the technical components necessary for pre-clearance of freight approaching international ports of entry. Integration of vehicle and cargo tracking systems with port of entry information and communications systems, as well as existing industry legacy systems, should further enable border crossings to be accomplished consistently with optimal processing times.« less

Report from the Panama Canal Stakeholder Working Group.

DOT National Transportation Integrated Search

2013-03-01

This project assists the Texas Department of Transportation (TxDOT) in assessing the potential impacts of the Panama Canal expansion on Texas ports and the landside transportation system. TxDOT formed a Panama Canal Stakeholder Working Group (PCSWG) ...

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

PubMed Central

2014-01-01

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

Using Cartoons to Transfer Knowledge Concerning the Principles of Work Disability Prevention Among Stakeholders.

PubMed

Labrecque, Marie-Elise; Coutu, Marie-France; Durand, Marie-José; Fassier, Jean-Baptiste; Loisel, Patrick

2016-06-01

Purpose This study assesses how well two cartoons transfer knowledge of principles of work disability prevention among stakeholders, according to their level of experience. We also document stakeholders' perceptions of the usefulness of the cartoons. Method We performed a descriptive study. Two groups of stakeholders were recruited: (1) experienced (working for more than 2 years in work disability), (2) non-experienced (in training). A self-administered questionnaire with open-ended questions documented stakeholders' understanding of each cartoon box and their perception of the possible usefulness of the cartoons. We transformed qualitative responses into quantitative responses for descriptive purposes. We performed independent t tests to compare the groups' level of understanding, and content analysis for the perception of usefulness. Results Overall, 149 stakeholders (50 experienced and 99 non-experienced) participated and identified 79.4 and 61.4 % of all principles presented in each of the two cartoons respectively. Experienced stakeholders identified more principles compared to non-experienced stakeholders (p = 0.007). Both cartoons were perceived to be useful for knowledge transfer. Conclusions Principles were generally well identified in the cartoons by all participants. Cartoons can be used as an effective tool among stakeholders to achieve a common understanding in order to coordinate their actions.

Implementing an organised cervical screening programme in the Republic of Moldova-Stakeholder identification and engagement.

PubMed

Davies, Philip; Valuta, Diana; Cojohari, Natalia; Sancho-Garnier, Helene

2017-10-01

Successfully implementing cervical screening programmes requires them to be adapted to the local context and have broad stakeholder support. This can be achieved by actively engaging local stakeholders in planning as well as implementing the programmes. The Moldovan government started implementing an organised cervical screening programme in 2010 with the first step being stakeholder identification and engagement. This process started by contacting easily identified stakeholders with each asked to recommend others and the process continued until no new ones were identified. Stakeholders were then involved in a series of individual and group meetings over a 2-year period to build confidence and encourage progressively greater engagement. In total, 87 individuals from 46 organisations were identified. Over the 2-year process, the individual and group meetings facilitated a change in stakeholder attitudes from disinterest, to acceptance and finally to active cooperation in designing the screening programme and preparing an implementation plan that were both well adapted to the Moldovan context. Developing the broad support needed to implement cervical screening programmes required ongoing interaction with stakeholders over an extended period. This interaction allowed stakeholder concerns to be identified and addressed, progress to be demonstrated, and stakeholders to be educated about organised screening programmes so they had the knowledge to progressively take greater responsibility and ownership. Copyright © 2017 Elsevier Ltd. All rights reserved.

Frontiers in Outreach and Education: The Florida Red Tide Experience.

PubMed

Nierenberg, Kate; Hollenbeck, Julie; Fleming, Lora E; Stephan, Wendy; Reich, Andrew; Backer, Lorraine C; Currier, Robert; Kirkpatrick, Barbara

2011-05-01

To enhance information sharing and garner increased support from the public for scientific research, funding agencies now typically require that research groups receiving support convey their work to stakeholders. The National Institute of Environmental Health Sciences-(NIEHS) funded Aerosolized Florida Red Tide P01 research group (Florida Red Tide Research Group) has employed a variety of outreach strategies to meet this requirement. Messages developed from this project began a decade ago and have evolved from basic print material (fliers and posters) to an interactive website, to the use of video and social networking technologies, such as Facebook and Twitter. The group was able to track dissemination of these information products; however, evaluation of their effectiveness presented much larger challenges. The primary lesson learned by the Florida Red Tide Research Group is that the best ways to reach specific stakeholders is to develop unique products or services to address specific stakeholders needs, such as the Beach Conditions Reporting System. Based on the experience of the Group, the most productive messaging products result when scientific community engages potential stakeholders and outreach experts during the very initial phases of a project.

Stakeholder opinions on the use of the added value approach in siting radioactive waste management facilities

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

Kojo, Matti; Richardson, Phil

In some countries nuclear waste facility siting programs include social and economic benefits, compensation, local empowerment and motivation measures and other incentives for the potential host community. This can generally be referred to as an 'added value approach'. Demonstration of the safety of a repository is seen as a precondition of an added value approach. Recently much focus has been placed on studying and developing public participation approaches but less on the use of such incentive and community benefit packages, although they are becoming a more common element in many site selection strategies for nuclear waste management facilities. The primarymore » objective of this paper is to report on an ongoing study of stakeholders' opinions of the use of an added value approach in siting a radioactive waste facility in the Czech Republic, Poland and Slovenia. The paper argues that an added value approach should adapt to the interests and needs of stakeholders during different stages of a siting process. The main question posed in the study is as follows: What are the measures which should be included in 'added value approach' according to the stakeholders? The research data consists of stakeholders' responses to a survey focusing on the use of added value (community benefits) and incentives in siting nuclear waste management facilities. The survey involved use of a questionnaire developed as part of the EU-funded IPPA* project in three countries: the Czech Republic, Poland and Slovenia. (* Implementing Public Participation Approaches in Radioactive Waste Disposal, FP7 Contract Number: 269849). The target audiences for the questionnaires were the stakeholders represented in the national stakeholder groups established to discuss site selection for a nuclear waste repository in their country. A total of 105 questionnaires were sent to the stakeholders between November 2011 and January 2012. 44 questionnaires were returned, resulting in a total response rate of 41% (10/29 in the Czech Republic, 11/14 in Poland and in 23/64 in Slovenia). (authors)« less

Stakeholder engagement for promoting the Comprehensive Nuclear-Test-Ban Treaty (CTBT): Malaysia’s experience

NASA Astrophysics Data System (ADS)

Rashid, F. I. A.; Zolkaffly, M. Z.; Jamal, N.

2018-01-01

In order to keep abreast on issues related to CTBT in Malaysia, Malaysian Nuclear Agency (Nuklear Malaysia), as the CTBT National Authority in Malaysia, has collaborated with local partners to implement various stakeholder engagement programme. This paper aims at highlighting Malaysia’s approach in promoting CTBT through stakeholder engagement programme targeted at multilevel stakeholders, both national and international. Such programmes includes participation in the international forums, inter-agency meetings, awareness seminars, training courses, technical visits to IMS station, promoting civil and scientific application of International Monitoring System (IMS) data and International Data Centre (IDC) products using Virtual Data Exploitation Center (vDEC), inviting youth groups to participate in the CTBTO Youth Group, and publications of CTBT-related topics. This approach has successfully fortify Malaysia’s commitments at the international level, enhanced national awareness of global multilateral framework, increased stakeholders awareness and their roles related to CTBT, as well as building domestic capacity on CTBT matters. In conclusion, stakeholder engagement is crucial in promoting and enhancing stakeholders understanding on CTBT. Continuous engagement with relevant stakeholders will enable effective dissemination and smooth implementation of CTBT related matters that will eventually support global universalization of CTBT.

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

PubMed

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

2013-11-01

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

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.

Using Operational Analysis to Improve Access to Pulmonary Function Testing.

PubMed

Ip, Ada; Asamoah-Barnieh, Raymond; Bischak, Diane P; Davidson, Warren J; Flemons, W Ward; Pendharkar, Sachin R

2016-01-01

Background. Timely pulmonary function testing is crucial to improving diagnosis and treatment of pulmonary diseases. Perceptions of poor access at an academic pulmonary function laboratory prompted analysis of system demand and capacity to identify factors contributing to poor access. Methods. Surveys and interviews identified stakeholder perspectives on operational processes and access challenges. Retrospective data on testing demand and resource capacity was analyzed to understand utilization of testing resources. Results. Qualitative analysis demonstrated that stakeholder groups had discrepant views on access and capacity in the laboratory. Mean daily resource utilization was 0.64 (SD 0.15), with monthly average utilization consistently less than 0.75. Reserved testing slots for subspecialty clinics were poorly utilized, leaving many testing slots unfilled. When subspecialty demand exceeded number of reserved slots, there was sufficient capacity in the pulmonary function schedule to accommodate added demand. Findings were shared with stakeholders and influenced scheduling process improvements. Conclusion. This study highlights the importance of operational data to identify causes of poor access, guide system decision-making, and determine effects of improvement initiatives in a variety of healthcare settings. Importantly, simple operational analysis can help to improve efficiency of health systems with little or no added financial investment.

A Good Idea May Not Be Good Enough: Stakeholder Buy In to QuitConnect, a National Smokers' Registry.

PubMed

Macauda, Mark M; Thrasher, James F; Saul, Jessie E; Celestino, Paula; Cummings, K Michael; Strayer, Scott M

2017-01-01

To examine interest and concerns among those who fund and operate state-run smoking cessation helplines (quitlines) about the concept of creating a centralized smokers' registry that could be used to reengage smokers after they receive initial quitline support services. We conducted 3, hour-long focus groups with stakeholders, covering the perceived benefits and barriers to creating a smokers' registry. The focus groups were conducted via telephone. Three groups participated: quitline service providers (n = 14), quitline funders (n = 9), and national quitline partners (n = 8). Data collection: Focus groups were recorded, transcribed, and coded for major relevant themes. Analysis Strategies: We used a grounded theory approach. Stakeholders were generally positive about the concept of a centralized smokers' registry (ie, QuitConnect), especially with its potential to link relapsed smokers to ongoing research studies designed to help smokers achieve abstinence from tobacco. However, stakeholders expressed concern about QuitConnect duplicating services already offered by state quitlines. Despite a common goal, many state quitline stakeholders had strong reservations about the creation of a centralized smokers' registry unless they could see clear evidence that the registry added value and was not duplicative of their existing services.

A Decision Support Framework For Science-Based, Multi-Stakeholder Deliberation: A Coral Reef Example

EPA Science Inventory

We present a decision support framework for science-based assessment and multi-stakeholder deliberation. The framework consists of two parts: a DPSIR (Drivers-Pressures-States-Impacts-Responses) analysis to identify the important causal relationships among anthropogenic environ...

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 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.

Innovation management based on proactive engagement of customers: A case study on LEGO Group. Part I: Innovation Management at Lego Group

NASA Astrophysics Data System (ADS)

Rusu, G.; Avasilcăi, S.

2015-11-01

Customers' proactive engagement in the innovation process represents a business priority for companies which adopt the open innovation business model. In such a context, it is of outmost importance for companies to use the online environment and social media, in order to create an interactive and open dialogue with customers and other important external stakeholders, achieving to gather creative solutions and innovative ideas by involving them in the process of co-creating value. Thus, the current paper is based on a case study approach, which aims to highlight the open innovation business model of the LEGO Group, one of the most successful and active company in engaging customers in submitting ideas and creative solutions for developing new products and new technologies, through online platforms. The study then proceeds to analyze the innovation management at LEGO Group, emphasizing the most important elements regarding the management team, the success and failures, the evolution of the LEGO products focusing on the innovation efforts of the company, its mission, vision, and values, emphasizing the innovation terms which guide the actions and objectives of the LEGO Group. Also, the research based on the case study approach, outlines the most important policies and strategies of the company, the organizational structure consisting of flat structures which facilitate the orientation of the team management on the innovation process and the proactive involvement of consumers and other external stakeholders in product development, highlighting also the most important activities developed by the management team in exploring the new opportunities which may occur on the market, involving customers in sharing their ideas at festivals, participating to discussions of adult fans on web-based platforms and establishing partnerships with the external stakeholders in order to create value. Moreover, the paper is focused on identifying the company's concerns regarding the competitive strategies, new technologies developed for sustainable development and innovation, emphasizing also the concerns of the LEGO Group for a long-term orientation strategy which implies developing innovative products, made by ecological materials, reducing the negative impact on the environment. In addition, the company aims to foster innovation maintaining a clear vision, multiple contacts with the internal and external environment, and the flat structures which enable the communication between innovative management teams and top management team. Consequently, the study provides the insights regarding the innovation management of the LEGO Group, emphasizing the role of engaging customers and other external stakeholders in the co-creation of value.

Stakeholder analysis: a useful tool for biobank planning.

PubMed

Bjugn, Roger; Casati, Bettina

2012-06-01

Stakeholders are individuals, groups, or organizations that are affected by or can affect a particular action undertaken by others. Biobanks relate to a number of donors, researchers, research institutions, regulatory bodies, funders, and others. These stakeholders can potentially have a strong influence upon the organization and operation of a biobank. A sound strategy for stakeholder engagement is considered essential in project management and organization theory. In this article, we review relevant stakeholder theory and demonstrate how a stakeholder analysis was undertaken in the early stage of a planned research biobank at a public hospital in Norway.

A Tale of Two Trails: Exploring Different Paths to Success

PubMed Central

Walker, Jennifer G.; Evenson, Kelly R.; Davis, William J.; Bors, Philip; Rodríguez, Daniel A.

2016-01-01

Background This comparative case study investigates 2 successful community trail initiatives, using the Active Living By Design (ALBD) Community Action Model as an analytical framework. The model includes 5 strategies: preparation, promotion, programs, policy, and physical projects. Methods Key stakeholders at 2 sites participated in in-depth interviews (N = 14). Data were analyzed for content using Atlas Ti and grouped according to the 5 strategies. Results Preparation Securing trail resources was challenging, but shared responsibilities facilitated trail development. Promotions The initiatives demonstrated minimal physical activity encouragement strategies. Programs Community stakeholders did not coordinate programmatic opportunities for routine physical activity. Policy Trails’ inclusion in regional greenway master plans contributed to trail funding and development. Policies that were formally institutionalized and enforced led to more consistent trail construction and safer conditions for users. Physical Projects Consistent standards for way finding signage and design safety features enhanced trail usability and safety. Conclusions Communities with different levels of government support contributed unique lessons to inform best practices of trail initiatives. This study revealed a disparity between trail development and use-encouragement strategies, which may limit trails’ impact on physical activity. The ALBD Community Action Model provided a viable framework to structure cross-disciplinary community trail initiatives. PMID:21597125

Comparing two sampling methods to engage hard-to-reach communities in research priority setting.

PubMed

Valerio, Melissa A; Rodriguez, Natalia; Winkler, Paula; Lopez, Jaime; Dennison, Meagen; Liang, Yuanyuan; Turner, Barbara J

2016-10-28

Effective community-partnered and patient-centered outcomes research needs to address community priorities. However, optimal sampling methods to engage stakeholders from hard-to-reach, vulnerable communities to generate research priorities have not been identified. In two similar rural, largely Hispanic communities, a community advisory board guided recruitment of stakeholders affected by chronic pain using a different method in each community: 1) snowball sampling, a chain- referral method or 2) purposive sampling to recruit diverse stakeholders. In both communities, three groups of stakeholders attended a series of three facilitated meetings to orient, brainstorm, and prioritize ideas (9 meetings/community). Using mixed methods analysis, we compared stakeholder recruitment and retention as well as priorities from both communities' stakeholders on mean ratings of their ideas based on importance and feasibility for implementation in their community. Of 65 eligible stakeholders in one community recruited by snowball sampling, 55 (85 %) consented, 52 (95 %) attended the first meeting, and 36 (65 %) attended all 3 meetings. In the second community, the purposive sampling method was supplemented by convenience sampling to increase recruitment. Of 69 stakeholders recruited by this combined strategy, 62 (90 %) consented, 36 (58 %) attended the first meeting, and 26 (42 %) attended all 3 meetings. Snowball sampling recruited more Hispanics and disabled persons (all P < 0.05). Despite differing recruitment strategies, stakeholders from the two communities identified largely similar ideas for research, focusing on non-pharmacologic interventions for management of chronic pain. Ratings on importance and feasibility for community implementation differed only on the importance of massage services (P = 0.045) which was higher for the purposive/convenience sampling group and for city improvements/transportation services (P = 0.004) which was higher for the snowball sampling group. In each of the two similar hard-to-reach communities, a community advisory board partnered with researchers to implement a different sampling method to recruit stakeholders. The snowball sampling method achieved greater participation with more Hispanics but also more individuals with disabilities than a purposive-convenience sampling method. However, priorities for research on chronic pain from both stakeholder groups were similar. Although utilizing a snowball sampling method appears to be superior, further research is needed on implementation costs and resources.

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.

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

PubMed

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

2016-09-01

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

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

PubMed

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

2016-09-01

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

Stakeholder opinion of functional communication activities following traumatic brain injury.

PubMed

Larkins, B M; Worrall, L E; Hickson, L M

2004-07-01

To establish a process whereby assessment of functional communication reflects the authentic communication of the target population. The major functional communication assessments available from the USA may not be as relevant to those who reside elsewhere, nor assessments developed primarily for persons who have had a stroke as relevant for traumatic brain injury rehabilitation. The investigation used the Nominal Group Technique to elicit free opinion and support individuals who have compromised communication ability. A survey mailed out sampled a larger number of stakeholders to test out differences among groups. Five stakeholder groups generated items and the survey determined relative 'importance'. The stakeholder groups in both studies comprised individuals with traumatic brain injury and their families, health professionals, third-party payers, employers, and Maori, the indigenous population of New Zealand. There was no statistically significant difference found between groups for 19 of the 31 items. Only half of the items explicitly appear on a well-known USA functional communication assessment. The present study has implications for whether functional communication assessments are valid across cultures and the type of impairment.

Competitive forces in the medical group industry: a stakeholder perspective.

PubMed

Blair, J D; Buesseler, J A

1998-01-01

Applying Porter's model of competitive forces to health care, stakeholder concepts are integrated to analyze the future of medical groups. Using both quantitative survey and qualitative observational data, competitors, physician suppliers, integrated systems new entrants, patient and managed care buyers, and hospitals substitutes are examined.

Design and efficacy of an Ecohealth competency-based course on the prevention and control of vector diseases in Latin America.

PubMed

Magaña-Valladares, Laura; Rodríguez, Mario Henry; Betanzos-Reyes, Ángel Francisco; Riojas-Rodríguez, Horacio; Quezada-Jiménez, María Laura; Suárez-Conejero, Juana Elvira; Lamadrid-Figueroa, Héctor

2018-01-01

To design and analyze the efficacy of an Ecohealth competency-based course on the prevention and control of vector-borne-diseases for specific stakeholders. Multiple stakeholders and sectors of the region were consulted to identify Ecohealth group-specific competencies using an adjusted analysis matrix. Eight courses based on the competencies were implemented to train EA tutors. The effectiveness of the course was evaluated through the use of paired- t-tests by intervention group. Strategic, tactical, academia and community stakeholder groups and their competencies were identified. An overall gain of 43 percentage points (p<0.001) was observed in terms of competencies score in trained tutors, which further trained 1 033 people. The identification of the stakeholders and their competencies proved to be useful to guide training courses to significantly improve the initial competencies and create a critical mass to further advance the EA in the region.

What Is eHealth (6): Perspectives on the Evolution of eHealth Research

PubMed Central

Kreslake, Jennifer M; Phalen, Judith M

2006-01-01

Background The field of eHealth holds promise for supporting and enabling health behavior change and the prevention and management of chronic disease. Objective In order to establish areas of congruence and controversy among contributors to the early development, evaluation, and dissemination of eHealth applications, as well as the desire to inform an evaluation research funding agenda, 38 semistructured, qualitative interviews were conducted among stakeholders in eHealth between May 2002 and September 2003. Methods Participants were asked about their perspectives on the credibility, value, and future potential of information technology for health behavior change and chronic disease management. Interviews were coded and analyzed for emergent themes using qualitative methods. Results Consistent themes were identified across stakeholder groups, with slight differences in emphasis. These topics included the following: (1) consensus and standardization—most stakeholders expressed a strong desire for a more coordinated, rigorous effort to define and integrate the field; (2) evaluation methods and challenges—demonstrating outcomes is required to establish eHealth quality and efficacy, but stakeholders were not satisfied with the sensitivity, validity, and reliability of existing outcome measures; (3) quality, value, and future potential—the intersection between eHealth’s potential cost-effectiveness, efficiency, and improved clinical status among users generated a high degree of interest; and (4) health disparities—many stakeholders contended that traditionally underserved populations will particularly benefit from eHealth applications, although others argued that the underserved are also disadvantaged in terms of access to technology. Conclusions Recommendations included the need for improvement and formalization of development and evaluation standards across private and public sectors, additional research on the technology needs and preferences of traditionally underserved populations, and long-term epidemiologic studies of the impact of eHealth on outcomes and cost-effectiveness. PMID:16585029

Frontiers in Outreach and Education: The Florida Red Tide Experience

PubMed Central

Nierenberg, Kate; Hollenbeck, Julie; Fleming, Lora E.; Stephan, Wendy; Reich, Andrew; Backer, Lorraine C.; Currier, Robert; Kirkpatrick, Barbara

2011-01-01

To enhance information sharing and garner increased support from the public for scientific research, funding agencies now typically require that research groups receiving support convey their work to stakeholders. The National Institute of Environmental Health Sciences-(NIEHS) funded Aerosolized Florida Red Tide P01 research group (Florida Red Tide Research Group) has employed a variety of outreach strategies to meet this requirement. Messages developed from this project began a decade ago and have evolved from basic print material (fliers and posters) to an interactive website, to the use of video and social networking technologies, such as Facebook and Twitter. The group was able to track dissemination of these information products; however, evaluation of their effectiveness presented much larger challenges. The primary lesson learned by the Florida Red Tide Research Group is that the best ways to reach specific stakeholders is to develop unique products or services to address specific stakeholders needs, such as the Beach Conditions Reporting System. Based on the experience of the Group, the most productive messaging products result when scientific community engages potential stakeholders and outreach experts during the very initial phases of a project. PMID:21532966

Collaborative Stakeholder Engagement. Special Report

ERIC Educational Resources Information Center

Jordan, Matt; Chrislip, David; Workman, Emily

2016-01-01

Stakeholder engagement and collaboration are essential to the development of an effective state plan. Engaging a diverse group of stakeholders tasked with working together to create education policies that will have a positive, lasting impact on students is not as easy as it sounds. Experts in the field argue that the traditional stakeholder…

Stakeholders' Perceptions of School Counselling in Singapore

ERIC Educational Resources Information Center

Low, Poi Kee

2015-01-01

This article reports on a qualitative study that set out to understand stakeholders' perception of the school counselling service in Singapore. Using semi-structured interviews, this study explored the perceptions of three main stakeholder groups, namely teachers and counsellors working within the schools and those working in the communities.…

Does Research Information Meet the Needs of Stakeholders? Exploring Evidence Selection in the Global Management of Invasive Species

ERIC Educational Resources Information Center

Bayliss, Helen R.; Wilcox, Andrew; Stewart, Gavin B.; Randall, Nicola P.

2012-01-01

This study explored factors affecting information selection by international stakeholders working with invasive species. Despite differences in information requirements between groups, all stakeholders demonstrated a clear preference for free, easily accessible online information, and predominantly used internet search engines and specialist…

Influencing organizations to promote health: applying stakeholder theory.

PubMed

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

2015-04-01

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

Community Engagement in the CTSA Program: Stakeholder Responses from a National Delphi Process

PubMed Central

Seifer, Sarena D.; Stupak, Matthew; Martinez, Linda Sprague

2014-01-01

Abstract In response to the Institute of Medicine (IOM) Committee's December 2012 public request for stakeholder input on the Clinical and Translational Science Award (CTSA) program, two nonprofit organizations, the Center for Community Health Education Research and Service, Inc. (CCHERS) and Community‐Campus Partnerships for Health (CCPH), solicited feedback from CTSA stakeholders using the Delphi method. Academic and community stakeholders were invited to participate in the Delphi, which is an exploratory method used for group consensus building. Six questions posed by the IOM Committee to an invited panel on community engagement were electronically sent to stakeholders. In Round 1 stakeholder responses were coded thematically and then tallied. Round 2 asked stakeholders to state their level of agreement with each of the themes using a Likert scale. Finally, in Round 3 the group was asked to rank the Round 2 based on potential impact for the CTSA program and implementation feasibility. The benefits of community engagement in clinical and translational research as well as the need to integrate community engagement across all components of the CTSA program were common themes. Respondents expressed skepticism as to the feasibility of strengthening CTSA community engagement. PMID:24841362

Community engagement in the CTSA program: stakeholder responses from a national Delphi process.

PubMed

Freeman, Elmer; Seifer, Sarena D; Stupak, Matthew; Martinez, Linda Sprague

2014-06-01

In response to the Institute of Medicine (IOM) Committee's December 2012 public request for stakeholder input on the Clinical and Translational Science Award (CTSA) program, two nonprofit organizations, the Center for Community Health Education Research and Service, Inc. (CCHERS) and Community-Campus Partnerships for Health (CCPH), solicited feedback from CTSA stakeholders using the Delphi method. Academic and community stakeholders were invited to participate in the Delphi, which is an exploratory method used for group consensus building. Six questions posed by the IOM Committee to an invited panel on community engagement were electronically sent to stakeholders. In Round 1 stakeholder responses were coded thematically and then tallied. Round 2 asked stakeholders to state their level of agreement with each of the themes using a Likert scale. Finally, in Round 3 the group was asked to rank the Round 2 based on potential impact for the CTSA program and implementation feasibility. The benefits of community engagement in clinical and translational research as well as the need to integrate community engagement across all components of the CTSA program were common themes. Respondents expressed skepticism as to the feasibility of strengthening CTSA community engagement. © 2014 Wiley Periodicals, Inc.

Stakeholder analysis: theAndalusian Agency For Healthcare Quality case.

PubMed

Reyes-Alcázar, Víctor; Casas-Delgado, Marta; Herrera-Usagre, Manuel; Torres-Olivera, Antonio

2012-01-01

The aim of this study was to identify the different groups that can affect or be affected by an agency charged with the promoting and guaranteeing of health care quality in Andalusian region (Spain) and to provide a framework with the stakeholders included in different categories. The study adopted a cross-sectional research design. A case study with structured interviews among Andalusian Agency for Healthcare Quality Steering Committee members was carried out in 2010 to define stakeholders' categories and map the interest groups using 5 attributes: influence, importance, legitimacy, power, and urgency. After identification and categorization, stakeholders were weighted qualitatively according to the attributes of importance and influence using 4 possible levels. A matrix was made with the collected data relating both attributes. Furthermore, 8 different types of stakeholders were identified according to attributes power, legitimacy, and urgency. The study concludes that identifying and classifying stakeholders are fundamental to ensuring the success of an organization that must respond to needs and expectations, especially those of its clients. Moreover, knowing stakeholder linkages can contribute to increase organizational worth. This is essential for organizations basically directed to the provision of services in the scope of health care.

Performance Measures for Evaluating Public Participation Activities in the Office of Environmental Management (DOE)

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

Carnes, S.A.

2001-02-15

Public participation in Office of Environmental Management (EM) activities throughout the DOE complex is a critical component of the overall success of remediation and waste management efforts. The challenges facing EM and its stakeholders over the next decade or more are daunting (Nuclear Waste News 1996). Achieving a mission composed of such challenges will require innovation, dedication, and a significant degree of good will among all stakeholders. EM's efforts to date, including obtaining and using inputs offered by EM stakeholders, have been notable. Public participation specialists have accepted and met challenges and have consistently tried to improve their performance. Theymore » have reported their experiences both formally and informally (e.g., at professional conferences and EM Public Participation Network Workshops, other internal meetings of DOE and contractor public participation specialists, and one-on-one consultations) in order to advance the state of their practice. Our research, and our field research in particular (including our interactions with many representatives of numerous stakeholder groups at nine DOE sites with diverse EM problems), have shown that it, is possible to develop coherent results even in a problem domain as complex as that of EM. We conclude that performance-based evaluations of public participation appear possible, and we have recommended an approach, based on combined and integrated multi-stakeholder views on the attributes of successful public participation and associated performance indicators, that seems workable and should be acceptable to diverse stakeholders. Of course, as an untested recommendation, our approach needs the validation that can only be achieved by application (perhaps at a few DOE sites with ongoing EM activities). Such an application would serve to refine the proposed approach in terms of its clarity, its workability, and its potential for full-scale use by EM and, potentially, other government agencies and private sector concerns.« less

Collaborative development of an educational resource on rehabilitation for people living with HIV.

PubMed

Solomon, Patricia; Salbach, Nancy M; O'Brien, Kelly K; Nixon, Stephanie; Worthington, Catherine; Baxter, Larry; Tattle, Stephen; Gervais, Nicole

2017-07-12

The objective of this study is to describe the collaborative development of a rehabilitation guide for people living with human immunodeficiency virus (HIV) which was adapted from an online resource for clinicians. We adapted a comprehensive evidence-informed online clinical resource for people living with HIV using a three-phase participatory process. In Phase 1, we interviewed 26 clinicians and 16 people living with HIV to gather recommendations on how to adapt and format the content to benefit people living with HIV. In Phase 2, we adapted the patient education resource using the recommendations that emerged from Phase 1. Phase 3 consisted of comprehensive stakeholder review of the revised resource on the adaptability, usability, communicability, and relevance of the information. Stakeholders participated in an interview to obtain in-depth information on their perspectives. Transcribed interviews underwent qualitative content analysis. Stakeholders indicated that the e-guide had utility for people living with HIV, community HIV service organizations, and care providers. Engaging people living with HIV resulted in a more relevant and meaningful resource that incorporated patients' values, needs, and preferences. Involving multiple stakeholders and user groups in the adaptation and evaluation of online patient education resources can assist in meeting patients' needs through increasing the relevance, organization and presentation of the content, and incorporating patients' values and needs. Implications for Rehabilitation Online patient education resources should be adapted in order to maximize relevance and meaningfulness to patients. Involving multiple stakeholders in the adaptation and evaluation of online patient education resources can assist in meeting patients' needs. Involving multiple stakeholders increases the relevance, organization and presentation of the content and allows the incorporation of patient values and needs. This collaborative approach with an emphasis on meaningful participation of patients and community may be of interest to others interested in promoting knowledge translation.

Childhood pneumonia diagnostics: community health workers' and national stakeholders' differing perspectives of new and existing aids.

PubMed

Spence, Hollie; Baker, Kevin; Wharton-Smith, Alexandra; Mucunguzi, Akasiima; Matata, Lena; Habte, Tedila; Nanyumba, Diana; Sebsibe, Anteneh; Thany, Thol; Källander, Karin

2017-01-01

Pneumonia heavily contributes to global under-five mortality. Many countries use community case management to detect and treat childhood pneumonia. Community health workers (CHWs) have limited tools to help them assess signs of pneumonia. New respiratory rate (RR) counting devices and pulse oximeters are being considered for this purpose. To explore perspectives of CHWs and national stakeholders regarding the potential usability and scalability of seven devices to aid community assessment of pneumonia signs. Pile sorting was conducted to rate the usability and scalability of 7 different RR counting aids and pulse oximeters amongst 16 groups of participants. Following each pile-sorting session, a focus group discussion (FGD) explored participants' sorting rationale. Purposive sampling was used to select CHWs and national stakeholders with experience in childhood pneumonia and integrated community case management (iCCM) in Cambodia, Ethiopia, Uganda and South Sudan. Pile-sorting data were aggregated for countries and participant groups. FGDs were audio recorded and transcribed verbatim. Translated FGDs transcripts were coded in NVivo 10 and analysed using thematic content analysis. Comparative analysis was performed between countries and groups to identify thematic patterns. CHWs and national stakeholders across the four countries perceived the acute respiratory infection (ARI) timer and fingertip pulse oximeter as highly scalable and easy for CHWs to use. National stakeholders were less receptive to new technologies. CHWs placed greater priority on device acceptability to caregivers and children. Both groups felt that heavy reliance on electricity reduced potential scalability and usability in rural areas. Device simplicity, affordability and sustainability were universally valued. CHWs and national stakeholders prioritise different device characteristics according to their specific focus of work. The views of all relevant stakeholders, including health workers, policy makers, children and parents, should be considered in future policy decisions, research and development regarding suitable pneumonia diagnostic aids for community use.

Putting people into water quality modelling.

NASA Astrophysics Data System (ADS)

Strickert, G. E.; Hassanzadeh, E.; Noble, B.; Baulch, H. M.; Morales-Marin, L. A.; Lindenschmidt, K. E.

2017-12-01

Water quality in the Qu'Appelle River Basin, Saskatchewan is under pressure due to nutrient pollution entering the river system from major cities, industrial zones and agricultural areas. Among these stressors, agricultural activities are basin-wide; therefore, they are the largest non-point source of water pollution in this region. The dynamics of agricultural impacts on water quality are complex and stem from decisions and activities of two distinct stakeholder groups, namely grain farmers and cattle producers, which have different business plans, values, and attitudes towards water quality. As a result, improving water quality in this basin requires engaging with stakeholders to: (1) understand their perspectives regarding a range of agricultural Beneficial Management Practices (BMPs) that can improve water quality in the region, (2) show them the potential consequences of their selected BMPs, and (3) work with stakeholders to better understand the barriers and incentives to implement the effective BMPs. In this line, we held a series of workshops in the Qu'Appelle River Basin with both groups of stakeholders to understand stakeholders' viewpoints about alternative agricultural BMPs and their impact on water quality. Workshop participants were involved in the statement sorting activity (Q-sorts), group discussions, as well as mapping activity. The workshop outcomes show that stakeholder had four distinct viewpoints about the BMPs that can improve water quality, i.e., flow and erosion control, fertilizer management, cattle site management, as well as mixed cattle and wetland management. Accordingly, to simulate the consequences of stakeholder selected BMPs, a conceptual water quality model was developed using System Dynamics (SD). The model estimates potential changes in water quality at the farm, tributary and regional scale in the Qu'Appelle River Basin under each and/or combination of stakeholder selected BMPs. The SD model was then used for real-time engagement of stakeholders in simulations to demostrate the potential effects of BMPs on water quality. This exercise helped us to better understand the stakeholders' viewpoints to propose effective BMPs and policies that are in-line with stakeholders' values and preferences.

Development of a Web-Based Intervention for Addressing Distress in Caregivers of Patients Receiving Stem Cell Transplants: Formative Evaluation With Qualitative Interviews and Focus Groups

PubMed

Pensak, Nicole Amoyal; Joshi, Tanisha; Simoneau, Teresa; Kilbourn, Kristin; Carr, Alaina; Kutner, Jean; Laudenslager, Mark L

2017-06-22

Caregivers of cancer patients experience significant burden and distress including depression and anxiety. We previously demonstrated the efficacy of an eight session, in-person, one-on-one stress management intervention to reduce distress in caregivers of patients receiving allogeneic hematopoietic stem cell transplants (allo-HSCT). The objective of this study was to adapt and enhance the in-person caregiver stress management intervention to a mobilized website (eg, tablet, smartphone, or computer-based) for self-delivery in order to enhance dissemination to caregiver populations most in need. We used an established approach for development of a mhealth intervention, completing the first two research and evaluation steps: Step One: Formative Research (eg, expert and stakeholder review from patients, caregivers, and palliative care experts) and Step Two: Pretesting (eg, Focus Groups and Individual Interviews with caregivers of patients with autologous HSCT (auto-HSCT). Step one included feedback elicited for a mock-up version of Pep-Pal session one from caregiver, patients and clinician stakeholders from a multidisciplinary palliative care team (N=9 caregivers and patient stakeholders and N=20 palliative care experts). Step two included two focus groups (N=6 caregivers) and individual interviews (N=9 caregivers) regarding Pep-Pal's look and feel, content, acceptability, and potential usability/feasibility. Focus groups and individual interviews were audio-recorded. In addition, individual interviews were transcribed, and applied thematic analysis was conducted in order to gain an in-depth understanding to inform the development and refinement of the mobilized caregiver stress management intervention, Pep-Pal (PsychoEducation and skills for Patient caregivers). Overall, results were favorable. Pep-Pal was deemed acceptable for caregivers of patients receiving an auto-HSCT. The refined Pep-Pal program consisted of 9 sessions (Introduction to Stress, Stress and the Mind Body Connection, How Thoughts Can Lead to Stress, Coping with Stress, Strategies for Maintaining Energy and Stamina, Coping with Uncertainty, Managing Changing Relationships and Communicating Needs, Getting the Support You Need, and Improving Intimacy) delivered via video instruction through a mobilized website. Feedback from stakeholder groups, focus groups, and individual interviews provided valuable feedback in key areas that was integrated into the development of Pep-Pal with the goal of enhancing dissemination, engagement, acceptability, and usability. ©Nicole Amoyal Pensak, Tanisha Joshi, Teresa Simoneau, Kristin Kilbourn, Alaina Carr, Jean Kutner, Mark L. Laudenslager. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 22.06.2017.

78 FR 18624 - U.S. Extractive Industries Transparency Initiative Multi-Stakeholder Group (USEITI MSG) Advisory...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-27

... DEPARTMENT OF THE INTERIOR Office of the Secretary [Docket No. ONRR-2012-0003] U.S. Extractive Industries Transparency Initiative Multi- Stakeholder Group (USEITI MSG) Advisory Committee AGENCY: Policy..., teleconference and the May 1-2, 2013, meeting of the United States Extractive Industries Transparency Initiative...

Empirically Supported Interventions for Sexual and Gender Minority Youth.

PubMed

Austin, Ashley; Craig, Shelley L

2015-01-01

When empirically supported treatments (ESTs) are effectively adapted for use with minority populations, they may be more efficacious. As such, there is a need to adapt existing ESTs for use with diverse sexual and gender minority youth (SGMY). The unique bias-based challenges faced by SGMY require the integration of affirmative practices into ESTs to effectively address the specific needs of this underserved group of youth. The primary purpose of the authors in this article is to present a clearly articulated stakeholder driven model for developing an affirmative adapted version of cognitive behavioral therapy (CBT) for use with diverse SGMY. The authors' approach to adaptation follows the "adapt and evaluate" framework for enhancing cultural congruence of interventions for minority groups. A community based participatory research approach, consistent with a stakeholder driven process, is utilized to develop the intervention from the ground up through the voices of the target community. Researchers conducted 3 focus groups with culturally diverse SGMY to explore salient aspects of youths' cultural and SGM identities in order to inform the intervention and ensure its applicability to a wide range of SGMY. Focus group data is analyzed and integrated into an existing group-based CBT intervention. The following themes emerge as critical to affirmative work with diverse SGMY: (1) the interplay between cultural norms, gender norms, sexual orientation, and gender identity; (2) the complex role of religious community within the lives of SGMY; and (3) consideration of extended family and cultural community as youth navigate their SGM identities.

How stakeholders frame dam removal: The role of current and anticipated future ecosystem service use

NASA Astrophysics Data System (ADS)

Reilly, Kate; Adamowski, Jan

2016-04-01

Many river restoration projects, including dam removal, are controversial and can trigger conflicts between stakeholders who are for and against the proposed project. The study of environmental conflicts suggests that differences in how stakeholders 'frame', or make sense of a situation based on their prior knowledge and experiences, can perpetuate conflicts. Understanding different stakeholders' frames, particularly how they converge, can form the basis of successful conflict resolution. In the case of dam removals, it is often assumed that emphasising increased provision of ecosystem services can be a point of convergence between those advocating for ecological restoration and those opposed to removal because of negative human impacts. However, how exactly stakeholders frame a contentious proposed dam removal and how those frames relate to ecosystem services has been little studied. Here we used the case of a potential dam removal in New Brunswick to investigate how people frame the issue and how that relates to their current and anticipated future use of ecosystem services. Based on in-depth interviews with 30 stakeholders in the area, including both people for and against dam removal, we found that both groups currently used ecosystem services and were in favour of ecosystem protection. However, they differed in how they framed the issue of the potential dam removal. The group against dam removal framed the issue as one of loss and risk - they thought that any potential benefits to the ecosystem would be outweighed by the high risk of negative social impacts caused by a loss of access to ecosystem services, such as recreation and aesthetic enjoyment. By contrast, the group in favour of the dam framed the issue as one of opportunity and justice. They thought that following a short transition period, all stakeholders would benefit from the restored river, particularly from a restored salmon fishery, improved aesthetic appeal and the long-term sustainability of an undammed river. Ultimately, we argue that increased provision of ecosystem services does not always represent a point of convergence between stakeholder groups, because both groups support ecosystem protection but differ in how they expect the benefits they derive from ecosystem services to change. Conflict resolution strategies may be better addressed by measures to mitigate the perceived loss of ecosystem services in the group against dam removal.

Education Stakeholders' Translation and Sense-Making of Accountability Policies

ERIC Educational Resources Information Center

Werts, Amanda B.; Della Sala, Matt; Lindle, Jane; Horace, Jennifer M.; Brewer, Curtis; Knoeppel, Robert

2013-01-01

Scholars of education policy have consistently found that the capacity, beliefs, and values of local actors affect the relative success or failure of policy implementation. This article examines stakeholders' perceptions of education policy in South Carolina to consider the relationship between interpretations of education policy and attitudes of…

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.

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

Training tomorrow's clinicians today--managed care essentials: a process for curriculum development.

PubMed

Colenda, C C; Wadland, W; Hayes, O; Anderson, W; Priester, F; Pearson, R; Keefe, C; Fleck, L

2000-05-01

To develop a managed care curriculum for primary care residents. This article outlines a 4-stage curriculum development process focusing on concepts of managed care organization and finance. The stages consist of: (1) identifying the curriculum development work group and framing the scope of the curriculum, (2) identifying stakeholder buy-in and expectations, (3) choosing curricular topics and delivery mechanisms, and (4) outlining the evaluation process. Key elements of building a curriculum development team, content objectives of the curriculum, the rationale for using problem-based learning, and finally, lessons learned from the partnership among the stakeholders are reviewed. The curriculum was delivered to an entering group of postgraduate-year 1 primary care residents. Attitudes among residents toward managed care remained relatively negative and stable over the yearlong curriculum, especially over issues relating to finance, quality of care, control and autonomy of practitioners, time spent with patients, and managed care's impact on the doctor-patient relationship. Residents' baseline knowledge of core concepts about managed care organization and finance improved during the year that the curriculum was delivered. Satisfaction with a problem-based learning approach was high. Problem-based learning, using real-life clinical examples, is a successful approach to resident instruction about managed care.

Stakeholders' Voices: Defining Needs of Students with Emotional and Behavioral Disorders Transitioning between School Settings.

PubMed

Buchanan, Rohanna; Nese, Rhonda N T; Clark, Miriam

2016-05-01

Students with emotional and behavioral disorders (EBD) too often do not receive adequate services or care in their school settings, particularly during transitions in educational placements. In addition, school support teams often struggle with creating transition plans that honor the needs of students with input from key stakeholders responsible for supporting student success. This article presents findings from the information-gathering phase of an iterative project that aims to develop a support program for students with EBD transitioning from day-treatment schools to district schools. We conducted 5 semistructured, qualitative focus groups with parents and teachers to explore needs during students' transitions between school settings. Five themes emerged from the focus groups: (a) consistent, behavior-specific feedback and positive reinforcement are vital to sustaining learned prosocial skills; (b) students benefit from regular opportunities to learn and practice social skills; (c) transition programming should emphasize communication between school and home; (d) routines at home and school should be coordinated; and (e) parents need support at school meetings. We will use findings from this study to develop a multifaceted intervention that aims to support students, their caregivers, and their teachers during transitions between the aforementioned types of schools.

When Stakeholders Rebel: Lessons from a Safe Schools Program

ERIC Educational Resources Information Center

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

2008-01-01

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

Advancing Sustainable Bioenergy: Evolving Stakeholder Interests and the Relevance of Research

NASA Astrophysics Data System (ADS)

Johnson, Timothy Lawrence; Bielicki, Jeffrey M.; Dodder, Rebecca S.; Hilliard, Michael R.; Ozge Kaplan, P.; Andrew Miller, C.

2013-02-01

The sustainability of future bioenergy production rests on more than continual improvements in its environmental, economic, and social impacts. The emergence of new biomass feedstocks, an expanding array of conversion pathways, and expected increases in overall bioenergy production are connecting diverse technical, social, and policy communities. These stakeholder groups have different—and potentially conflicting—values and cultures, and therefore different goals and decision making processes. Our aim is to discuss the implications of this diversity for bioenergy researchers. The paper begins with a discussion of bioenergy stakeholder groups and their varied interests, and illustrates how this diversity complicates efforts to define and promote "sustainable" bioenergy production. We then discuss what this diversity means for research practice. Researchers, we note, should be aware of stakeholder values, information needs, and the factors affecting stakeholder decision making if the knowledge they generate is to reach its widest potential use. We point out how stakeholder participation in research can increase the relevance of its products, and argue that stakeholder values should inform research questions and the choice of analytical assumptions. Finally, we make the case that additional natural science and technical research alone will not advance sustainable bioenergy production, and that important research gaps relate to understanding stakeholder decision making and the need, from a broader social science perspective, to develop processes to identify and accommodate different value systems. While sustainability requires more than improved scientific and technical understanding, the need to understand stakeholder values and manage diversity presents important research opportunities.

Advancing sustainable bioenergy: evolving stakeholder interests and the relevance of research.

PubMed

Johnson, Timothy Lawrence; Bielicki, Jeffrey M; Dodder, Rebecca S; Hilliard, Michael R; Kaplan, P Ozge; Miller, C Andrew

2013-02-01

The sustainability of future bioenergy production rests on more than continual improvements in its environmental, economic, and social impacts. The emergence of new biomass feedstocks, an expanding array of conversion pathways, and expected increases in overall bioenergy production are connecting diverse technical, social, and policy communities. These stakeholder groups have different-and potentially conflicting-values and cultures, and therefore different goals and decision making processes. Our aim is to discuss the implications of this diversity for bioenergy researchers. The paper begins with a discussion of bioenergy stakeholder groups and their varied interests, and illustrates how this diversity complicates efforts to define and promote "sustainable" bioenergy production. We then discuss what this diversity means for research practice. Researchers, we note, should be aware of stakeholder values, information needs, and the factors affecting stakeholder decision making if the knowledge they generate is to reach its widest potential use. We point out how stakeholder participation in research can increase the relevance of its products, and argue that stakeholder values should inform research questions and the choice of analytical assumptions. Finally, we make the case that additional natural science and technical research alone will not advance sustainable bioenergy production, and that important research gaps relate to understanding stakeholder decision making and the need, from a broader social science perspective, to develop processes to identify and accommodate different value systems. While sustainability requires more than improved scientific and technical understanding, the need to understand stakeholder values and manage diversity presents important research opportunities.

Environmental attitudes of stakeholders and their perceptions regarding protected area-community conflicts: a case study in China.

PubMed

Liu, Jing; Ouyang, Zhiyun; Miao, Hong

2010-11-01

Large numbers of people living in and around protected areas are highly dependent on the natural resources. However, simply excluding them from the area management has always inevitably resulted in conflicts. We conducted a case study of the Protected Area of Jinyun Mountain (PJM) in China to evaluate social context variables, environmental attitudes, and perceptions regarding protected area-community conflicts. Data were collected through questionnaire surveys administered to four stakeholder groups (i.e. local farmers, government staff, business persons, and tourists). A total of 112 questionnaires were completed in December 2008, after the Sichuan Earthquake. The questionnaire consisted of three parts, social context (gender, race, age, income, and education level), protected area-community conflicts, and environmental attitudes. The New Ecological Paradigm (NEP) scores, which were employed to evaluate environmental attitudes, differed significantly among the stakeholder groups (P<0.01). Specifically, government staff reported the highest and business persons did the lowest. Among the five items evaluated, anti-exemptionalism received the lowest score, while nature's balance did the highest. Evaluation of the protected area-community relationship indicated that harmony and conflict both exist in the PJM, but have different forms among different stakeholders, and seem to be opposite between government staff and local farmers. Among the indexes, tourism primarily contributed to the harmonious aspect, while collection of NTFPs did to the conflicting one. Conflict scores were positively related to age and negatively related to education level. Respondents with higher NEP scores were more partial to the park management. Besides, the respondents with higher annual incomes tended to support the policy of harmonizing the relationship and lessening the harm of local communities to the area. To promote proenvironmental attitudes and alleviate the protected area-community conflicts, we recommend improving environmental education, establishing community co-management, and launching substitute sources of cash for traditional cultivation. Copyright 2010 Elsevier Ltd. All rights reserved.

Engaging Stakeholders through Participatory Mapping and Spatial Analysis in a Scenarios Process for Alaska's North Slope

NASA Astrophysics Data System (ADS)

Fradkin, B.; Vargas, J. C.; Lee, O. A.; Emperador, S.

2016-12-01

A scenarios process was conducted for Alaska's North Slope to consider the wide range of drivers of change and uncertainties that could contribute to shifts in research and monitoring needs over the next 25 years. The project team, consisting of specialists in participatory scenarios and academic researchers, developed an interactive approach that helped facilitate the exploration of a range of plausible changes in the region. Over two years, the team designed and executed a series of workshops to capitalize on the collective expertise of researchers, resource managers, industry representatives, and traditional and local knowledge holders on the North Slope. The goal of this process was to evaluate three energy and resource development scenarios, which incorporated biophysical and socioeconomic drivers, to assess the implications of development on high-priority biophysical resources and the subsistence lifestyle and well-being of its Inupiat residents. Due to the diversity of the stakeholders engaged in the process, the workshop materials and activities had to be carefully designed and executed, in order to provide an adequate platform for discussion of each scenario component, as well as generating products that would provide management-relevant information to the NSSI and its member entities. Each workshop implemented a participatory mapping component, which relied on the best available geospatial datasets to generate informational maps that enabled participants to effectively consider a wide range of variables and outcomes for each of the selected scenarios. In addition, the map sketches produced in each workshop were digitized and incorporated into a spatial analysis that evaluated the level of agreement between stakeholder groups, as well as evaluating the geographic overlap of development features and anticipated implications with terrestrial and marine habitats, subsistence hunting zones, and sensitive landscape elements such as permafrost. This presentation will focus on how participatory mapping and analysis aided in eliciting stakeholder input and working towards consensus through a process that engaged a diverse group of parties concerned with the region's future research and monitoring needs.

78 FR 64525 - U.S. Extractive Industries Transparency Initiative Multi-Stakeholder Group (USEITI MSG) Advisory...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-29

... DEPARTMENT OF THE INTERIOR Office of the Secretary [Docket No. ONRR-2012-0003; DS63600000 DR2PS0000.PX8000 134D0102R2] U.S. Extractive Industries Transparency Initiative Multi- Stakeholder Group...: This notice announces the rescheduling of the U.S. Extractive Industries Transparency Initiative...

Formative research and stakeholder participation in intervention development.

PubMed

Vastine, Amy; Gittelsohn, Joel; Ethelbah, Becky; Anliker, Jean; Caballero, Benjamin

2005-01-01

To present a model for using formative research and stakeholder participation to develop a community-based dietary intervention targeting American Indians. Formative research included interviews, assessment of food- purchasing frequency and preparation methods, and dietary recalls. Stakeholders contributed to intervention development through formative research, a program planning workshop, group feedback, and implementation training. Foods high in fat and sugar are commonly consumed. Barriers to healthy eating include low availability, perceived high cost, and poor flavor. Stakeholder participation contributed to the development of a culturally appropriate intervention. This approach resulted in project acceptance, stakeholder collaboration, and a culturally appropriate program.

CHALLENGES OF DSD: DIVERSE PERCEPTIONS ACROSS STAKEHOLDERS

PubMed Central

Kogan, Barry A.; Gardner, Melissa; Alpern, Adrianne N.; Cohen, Laura M.; Grimley, Mary Beth; Quittner, Alexandra L.; Sandberg, David E.

2012-01-01

Background/Aims Disorders of Sex Development (DSD) are congenital conditions in which chromosomal, gonadal, or anatomic sex development is atypical. Optimal management is patient- and family-centered and delivered by interdisciplinary teams. The present pilot study elicits concerns held by important stakeholders on issues affecting young patients with DSD and their families. Methods Content from focus groups with expert clinicians (pediatric urologists [n=7], pediatric endocrinologists [n=10], mental health professionals [n=4]), DSD patient advocates (n=4), and interviews with parents of DSD-affected children (newborn to 6 yrs; n=11) was coded and content-analyzed to identify health-related quality of life issues. Results Key stressors varied across stakeholder groups. In general, family-centered issues were noted more than child-centered. In the child-centered domain, providers worried more about physical functioning; family and advocates emphasized gender concerns and body image. In the family-centered domain, parental concerns about medication management outweighed those of providers. Advocates reported more stressors regarding communication/information than other stakeholders. Conclusion Variability exists across stakeholder groups in the key concerns affecting young children/families with DSD. Interdisciplinary DSD healthcare team development should account for varying perspectives when counseling families and planning treatment. PMID:22832323

Integrating interdisciplinary pain management into primary care: development and implementation of a novel clinical program.

PubMed

Dorflinger, Lindsey M; Ruser, Christopher; Sellinger, John; Edens, Ellen L; Kerns, Robert D; Becker, William C

2014-12-01

The aims of this study were to develop and implement an interdisciplinary pain program integrated in primary care to address stakeholder-identified gaps. Program development and evaluation project utilizing a Plan-Do-Study-Act (PDSA) approach to address the identified problem of insufficient pain management resources within primary care. A large Healthcare System within the Veterans Health Administration, consisting of two academically affiliated medical centers and six community-based outpatients clinics. An interprofessional group of stakeholders participated in a Rapid Process Improvement Workshop (RPIW), a consensus-building process to identify systems-level gaps and feasible solutions and obtain buy-in. Changes were implemented in 2012, and in a 1-year follow-up, we examined indicators of engagement in specialty and multimodal pain care services as well as patient and provider satisfaction. In response to identified barriers, RPIW participants proposed and outlined two readily implementable, interdisciplinary clinics embedded within primary care: 1) the Integrated Pain Clinic, providing in-depth assessment and triage to targeted resources; and 2) the Opioid Reassessment Clinic, providing assessment and structured monitoring of patients with evidence of safety, efficacy, or misuse problems with opioids. Implementation of these programs led to higher rates of engagement in specialty and multimodal pain care services; patients and providers reported satisfaction with these services. Our PDSA cycle engaged an interprofessional group of stakeholders that recommended introduction of new systems-based interventions to better integrate pain resources into primary care to address reported barriers. Early data suggest improved outcomes; examination of additional outcomes is planned. Wiley Periodicals, Inc.

[Materiality Analysis of Health Plans Based on Stakeholder Engagement and the Issues Included at ISO 26000:2010].

PubMed

Moyano Santiago, Miguel Angel; Rivera Lirio, Juana María

2017-01-18

Health plans of the Spanish autonomous communities can incorporate sustainable development criteria in its development. There have been no analysis or proposals about development and indicators. The goal is to add a contribution to help build better health plans aimed at sustainable development and help to manage economic, social and environmental impacts of health systems criteria. We used a variation of the RAND/UCLA or modified Delphi technique method. The process consisted of a bibliographical and context matters and issues related to health and social responsibility analysis based on ISO 26000: 2010. A survey by deliberately to a selection of 70 expert members of the identified stakeholders was carried out and a discussion group was held to determine the consensus on the issues addressed in the survey sample. The research was conducted in 2015. From the literature review 33 health issues included in ISO 26000:2010 were obtained. 7 survey proved relevant high consensus, 8 relevance and average consensus and 18 with less relevance and high level of dissent. The expert group excluded 4 of the 18 subjects with less consensus. 29 issues included 33 at work, divided into 7 subjects contained in the guide ISO 26000 of social responsibility, were relevant stakeholders regarding possible inclusion in health plans. Considering the direct relationship published by ISO (International Organization for Standardization) among the issues ISO 26000 and the economic, social and environmental indicators in GRI (Global Reporting Initiative) in its G4 version, a panel with monitoring indicators related to relevant issues were elaborated.

A Multivariate Model of Stakeholder Preference for Lethal Cat Management

PubMed Central

Wald, Dara M.; Jacobson, Susan K.

2014-01-01

Identifying stakeholder beliefs and attitudes is critical for resolving management conflicts. Debate over outdoor cat management is often described as a conflict between two groups, environmental advocates and animal welfare advocates, but little is known about the variables predicting differences among these critical stakeholder groups. We administered a mail survey to randomly selected stakeholders representing both of these groups (n = 1,596) in Florida, where contention over the management of outdoor cats has been widespread. We used a structural equation model to evaluate stakeholder intention to support non-lethal management. The cognitive hierarchy model predicted that values influenced beliefs, which predicted general and specific attitudes, which in turn, influenced behavioral intentions. We posited that specific attitudes would mediate the effect of general attitudes, beliefs, and values on management support. Model fit statistics suggested that the final model fit the data well (CFI = 0.94, RMSEA = 0.062). The final model explained 74% of the variance in management support, and positive attitudes toward lethal management (humaneness) had the largest direct effect on management support. Specific attitudes toward lethal management and general attitudes toward outdoor cats mediated the relationship between positive (p<0.05) and negative cat-related impact beliefs (p<0.05) and support for management. These results supported the specificity hypothesis and the use of the cognitive hierarchy to assess stakeholder intention to support non-lethal cat management. Our findings suggest that stakeholders can simultaneously perceive both positive and negative beliefs about outdoor cats, which influence attitudes toward and support for non-lethal management. PMID:24736744

A multivariate model of stakeholder preference for lethal cat management.

PubMed

Wald, Dara M; Jacobson, Susan K

2014-01-01

Identifying stakeholder beliefs and attitudes is critical for resolving management conflicts. Debate over outdoor cat management is often described as a conflict between two groups, environmental advocates and animal welfare advocates, but little is known about the variables predicting differences among these critical stakeholder groups. We administered a mail survey to randomly selected stakeholders representing both of these groups (n=1,596) in Florida, where contention over the management of outdoor cats has been widespread. We used a structural equation model to evaluate stakeholder intention to support non-lethal management. The cognitive hierarchy model predicted that values influenced beliefs, which predicted general and specific attitudes, which in turn, influenced behavioral intentions. We posited that specific attitudes would mediate the effect of general attitudes, beliefs, and values on management support. Model fit statistics suggested that the final model fit the data well (CFI=0.94, RMSEA=0.062). The final model explained 74% of the variance in management support, and positive attitudes toward lethal management (humaneness) had the largest direct effect on management support. Specific attitudes toward lethal management and general attitudes toward outdoor cats mediated the relationship between positive (p<0.05) and negative cat-related impact beliefs (p<0.05) and support for management. These results supported the specificity hypothesis and the use of the cognitive hierarchy to assess stakeholder intention to support non-lethal cat management. Our findings suggest that stakeholders can simultaneously perceive both positive and negative beliefs about outdoor cats, which influence attitudes toward and support for non-lethal management.

The Life Science Exchange: a case study of a sectoral and sub-sectoral knowledge exchange programme.

PubMed

Perkins, Brian Lee; Garlick, Rob; Wren, Jodie; Smart, Jon; Kennedy, Julie; Stephens, Phil; Tudor, Gwyn; Bisson, Jonathan; Ford, David V

2016-04-27

Local and national governments have implemented sector-specific policies to support economic development through innovation, entrepreneurship and knowledge exchange. Supported by the Welsh Government through the European Regional Development Fund, The Life Science Exchange® project was created with the aim to increase interaction between stakeholders, to develop more effective knowledge exchange mechanisms, and to stimulate the formation and maintenance of long-term collaborative relationships within the Welsh life sciences ecosystem. The Life Science Exchange allowed participants to interact with other stakeholder communities (clinical, academic, business, governmental), exchange perspectives and discover new opportunities. Six sub-sector focus groups comprising over 200 senior stakeholders from academia, industry, the Welsh Government and National Health Service were established. Over 18 months, each focus group provided input to inform healthcare innovation policy and knowledge mapping exercises of their respective sub-sectors. Collaborative projects identified during the focus groups and stakeholder engagement were further developed through sandpit events and bespoke support. Each sub-sector focus group produced a report outlining the significant strengths and opportunities in their respective areas of focus, made recommendations to overcome any 'system failures', and identified the stakeholder groups which needed to take action. A second outcome was a stakeholder-driven knowledge mapping exercise for each area of focus. Finally, the sandpit events and bespoke support resulted in participants generating more than £1.66 million in grant funding and inward investment. This article outlines four separate outcomes from the Life Science Exchange programme. The Life Science Exchange process has resulted in a multitude of collaborations, projects, inward investment opportunities and special interest group formations, in addition to securing over ten times its own costs in funding for Wales. The Life Science Exchange model is a simple and straightforward mechanism for a regional or national government to adapt and implement in order to improve innovation, skills, networks and knowledge exchange.

Hygiene and sanitation promotion strategies among ethnic minority communities in northern Vietnam: a stakeholder analysis.

PubMed

Rheinländer, Thilde; Xuan, Le Thi Thanh; Hoat, Luu Ngoc; Dalsgaard, Anders; Konradsen, Flemming

2012-10-01

Effective rural hygiene and sanitation promotion (RHSP) is a major challenge for many low-income countries. This paper investigates strategies and stakeholders' roles and responsibilities in RHSP implementation in a multi-ethnic area of northern Vietnam, in order to identify lessons learned for future RHSP. A stakeholder analysis was performed, based on 49 semi-structured individual interviews and one group interview with stakeholders in RHSP in a northern province of Vietnam. Participants came from three sectors (agriculture, health and education), unions supported by the Vietnamese government and from four administrative levels (village, commune, district and province). The study villages represented four ethnic minority groups including lowland and highland communities. Stakeholders' roles, responsibilities and promotion methods were outlined, and implementation constraints and opportunities were identified and analysed using thematic content analysis. Effective RHSP in Vietnam is severely constrained despite supporting policies and a multi-sectorial and multi-level framework. Four main barriers for effective implementation of RHSP were identified: (1) weak inter-sectorial collaborations; (2) constraints faced by frontline promoters; (3) almost exclusive information-based and passive promotion methods applied; and (4) context unadjusted promotion strategies across ethnic groups, including a limited focus on socio-economic differences, language barriers and gender roles in the target groups. Highland communities were identified as least targeted and clearly in need of more intensive and effective RHSP. It is recommended that the Vietnamese government gives priority to increasing capacities of and collaboration among stakeholders implementing RHSP activities. This should focus on frontline promoters to perform effective behaviour change communication. It is also recommended to support more participatory and community-based initiatives, which can address the complex socio-economic and cultural determinants of health in multi-ethnic population groups. These lessons learned can improve future RHSP in Vietnam and are also of relevance for health promotion in other minority population groups in the region and globally.

Developing a spinal cord injury research strategy using a structured process of evidence review and stakeholder dialogue. Part III: outcomes.

PubMed

Middleton, J W; Piccenna, L; Lindsay Gruen, R; Williams, S; Creasey, G; Dunlop, S; Brown, D; Batchelor, P E; Berlowitz, D J; Coates, S; Dunn, J A; Furness, J B; Galea, M P; Geraghty, T; Kwon, B K; Urquhart, S; Yates, D; Bragge, P

2015-10-01

Focus Group. To develop a unified, regional spinal cord injury (SCI) research strategy for Australia and New Zealand. Australia. A 1-day structured stakeholder dialogue was convened in 2013 in Melbourne, Australia, by the National Trauma Research Institute in collaboration with the SCI Network of Australia and New Zealand. Twenty-three experts participated, representing local and international research, clinical, consumer, advocacy, government policy and funding perspectives. Preparatory work synthesised evidence and articulated draft principles and options as a starting point for discussion. A regional SCI research strategy was proposed, whose objectives can be summarised under four themes. (1) Collaborative networks and strategic partnerships to increase efficiency, reduce duplication, build capacity and optimise research funding. (2) Research priority setting and coordination to manage competing studies. (3) Mechanisms for greater consumer engagement in research. (4) Resources and infrastructure to further develop SCI data registries, evaluate research translation and assess alignment of research strategy with stakeholder interests. These are consistent with contemporary international SCI research strategy development activities. This first step in a regional SCI research strategy has articulated objectives for further development by the wider SCI research community. The initiative has also reinforced the importance of coordinated, collective action in optimising outcomes following SCI.

Stakeholder perceptions: Biological control of Russian olive (Elaeagnus angustifolia)

Treesearch

Sharlene E. Sing; Kevin J. Delaney

2016-01-01

An online survey was distributed through email lists provided by various stakeholder groups on behalf of the International Consortium for Biological Control of Russian Olive in spring of 2012. A total of 392 respondents replied from 24 U.S. states and 1 Canadian province. Questions posed in the survey were designed to identify and categorize 1) stakeholders by...

Mismatched Perceptions and Expectations: An Exploration of Stakeholders' Views of Key and Technical Skills in Vocational Education and Training

ERIC Educational Resources Information Center

Saunders, Mark N. K.; Skinner, Denise; Beresford, Richard

2005-01-01

Purpose: To explore potential mismatches between stakeholders' perceptions and expectations of key and technical skills needed for an advanced modern apprentice within the UK. Design/methodology/approach: Using data collected from the automotive sector, the template process is used to establish lecturer, student and employee stakeholder group's…

Patient-centred outcomes research: perspectives of patient stakeholders.

PubMed

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

2017-11-01

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

Stakeholder analysis in the management of irrigation in Kampili area

NASA Astrophysics Data System (ADS)

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

2018-05-01

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

A Study of Consistency in Design Selection and the Rank Ordering of Alternatives Using a Value Driven Design Approach

NASA Astrophysics Data System (ADS)

Subramanian, Tenkasi R.

In the current day, with the rapid advancement in technology, engineering design is growing in complexity. Nowadays, engineers have to deal with design problems that are large, complex and involving multi-level decision analyses. With the increase in complexity and size of systems, the production and development cost tend to overshoot the allocated budget and resources. This often results in project delays and project cancellation. This is particularly true for aerospace systems. Value Driven Design proves to be means to strengthen the design process and help counter such trends. Value Driven is a novel framework for optimization which puts stakeholder preferences at the forefront of the design process to capture their true preferences to present system alternatives that are consistent the stakeholder's expectations. Traditional systems engineering techniques promote communication of stakeholder preferences in the form of requirements which confines the design space by imposing additional constraints on it. This results in a design that does not capture the true preferences of the stakeholder. Value Driven Design provides an alternate approach to design wherein a value function is created that corresponds to the true preferences of the stakeholder. The applicability of VDD broad, but it is imperative to first explore its feasibility to ensure the development of an efficient, robust and elegant system design. The key to understanding the usability of VDD is to investigate the formation, propagation and use of a value function. This research investigates the use of rank correlation metrics to ensure consistent rank ordering of design alternatives, while investigating the fidelity of the value function. The impact of design uncertainties on rank ordering. A satellite design system consisting of a satellite, ground station and launch vehicle is used to demonstrate the use of the metrics to aid in decision support during the design process.

The Core Competencies for General Orthopaedic Surgeons.

PubMed

Kellam, James F; Archibald, Douglas; Barber, James W; Christian, Eugene P; D'Ascoli, Richard J; Haynes, Richard J; Hecht, Suzanne S; Hurwitz, Shepard R; Kellam, James F; McLaren, Alexander C; Peabody, Terrance D; Southworth, Stephen R; Strauss, Robert W; Wadey, Veronica M R

2017-01-18

With the changing delivery of orthopaedic surgical care, there is a need to define the knowledge and competencies that are expected of an orthopaedist providing general and/or acute orthopaedic care. This article provides a proposal for the knowledge and competencies needed for an orthopaedist to practice general and/or acute care orthopaedic surgery. Using the modified Delphi method, the General Orthopaedic Competency Task Force consisting of stakeholders associated with general orthopaedic practice has proposed the core knowledge and competencies that should be maintained by orthopaedists who practice emergency and general orthopaedic surgery. For relevancy to clinical practice, 2 basic sets of competencies were established. The assessment competencies pertain to the general knowledge needed to evaluate, investigate, and determine an overall management plan. The management competencies are generally procedural in nature and are divided into 2 groups. For the Management 1 group, the orthopaedist should be competent to provide definitive care including assessment, investigation, initial or emergency care, operative or nonoperative care, and follow-up. For the Management 2 group, the orthopaedist should be competent to assess, investigate, and commence timely non-emergency or emergency care and then either transfer the patient to the appropriate subspecialist's care or provide definitive care based on the urgency of care, exceptional practice circumstance, or individual's higher training. This may include some higher-level procedures usually performed by a subspecialist, but are consistent with one's practice based on experience, practice environment, and/or specialty interest. These competencies are the first step in defining the practice of general orthopaedic surgery including acute orthopaedic care. Further validation and discussion among educators, general orthopaedic surgeons, and subspecialists will ensure that these are relevant to clinical practice. These competencies provide many stakeholders, including orthopaedic educators and orthopaedists, with what may be the minimum knowledge and competencies necessary to deliver acute and general orthopaedic care. This document is the first step in defining a practice-based standard for training programs and certification groups.

Differentiating the effect of social enterprise activities on health.

PubMed

Macaulay, Bobby; Mazzei, Micaela; Roy, Michael J; Teasdale, Simon; Donaldson, Cam

2018-03-01

An emerging stream of literature has focused on the ways in which social enterprises might act on the social determinants of health. However, this previous work has not taken a sufficiently broad account of the wide range of stakeholders involved in social enterprises and has also tended to reduce and simplify a complex and heterogeneous set of organisations to a relatively homogenous social enterprise concept. In an attempt to address these gaps, we conducted an empirical investigation between August 2014 and October 2015 consisting of qualitative case studies involving in-depth semi-structured interviews and a focus group with a wide variety of stakeholders from three social enterprises in different regions of Scotland. We found that different forms of social enterprise impact on different dimensions of health in different ways, including through: engendering a feeling of ownership and control; improving environmental conditions (both physical and social); and providing or facilitating meaningful employment. In conclusion, we highlight areas for future research. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Recreation-related perceptions of natural resource managers in the Saranac Lakes wild forest area

Treesearch

Diane Kuehn; Mark Mink; Rudy Schuster

2007-01-01

Public forest managers often work with diverse stakeholder groups as they implement forest management policies. Within the Saranac Lakes Wild Forest area of New York State's Adirondack Park, stakeholder groups such as visitors, business owners, and landowners often have conflicting perceptions about issues related to water-based recreation in the region's...

78 FR 50437 - U.S. Extractive Industries Transparency Initiative Multi-Stakeholder Group (USEITI MSG) Advisory...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-19

... DEPARTMENT OF THE INTERIOR Office of the Secretary [Docket No. ONRR-2012-0003; DS63600000 DR2PS0000.PX8000 134D0102R2] U.S. Extractive Industries Transparency Initiative Multi- Stakeholder Group...: This notice announces the next three meetings of the United States Extractive Industries Transparency...

78 FR 60304 - U.S. Extractive Industries Transparency Initiative Multi-Stakeholder Group (USEITI MSG) Advisory...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-01

... DEPARTMENT OF THE INTERIOR Office of the Secretary [Docket No. ONRR-2012-0003; DS63600000 DR2PS0000.PX8000 134D0102R2] U.S. Extractive Industries Transparency Initiative Multi- Stakeholder Group...: This notice announces the meeting date change of the United States Extractive Industries Transparency...

Copper Corrosion in Nuclear Waste Disposal: A Swedish Case Study on Stakeholder Insight

ERIC Educational Resources Information Center

Andersson, Kjell

2013-01-01

The article describes the founding principles, work program, and accomplishments of a Reference Group with both expert and layperson stakeholders for the corrosion of copper canisters in a proposed deep repository in Sweden for spent nuclear fuel. The article sets the Reference Group as a participatory effort within a broader context of…

Lessons learned from facilitating the state and tribal government working group

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

Kurstedt, H.A. Jr.

1994-12-31

Thirteen lessons learned from my experience in facilitating the State and Tribal Government Working Group for the U.S. Department of Energy have been identified. The conceptual base for supporting the veracity of each lesson has been developed and the lessons are believed to be transferable to any stakeholder group. The crux of stakeholder group success if the two-directional, two-mode empowerment required in this case. Most of the lessons learned deal with the scope of that empowerment. A few of the lessons learned deal with the operations of the group.

Advancing sustainable bioenergy: Evolving stakeholder interests and the relevance of research

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

Johnson, Timothy L; Bielicki, Dr Jeffrey M; Dodder, Rebecca

2013-01-01

The sustainability of future bioenergy production rests on more than continual improvements in its environmental, economic, and social impacts. The emergence of new biomass feedstocks, an expanding array of conversion pathways, and expected increases in overall bioenergy production are connecting diverse technical, social, and policy communities. These stakeholder groups have different and potentially conflicting values and cultures, and therefore different goals and decision making processes. Our aim is to discuss the implications of this diversity for bioenergy researchers. The paper begins with a discussion of bioenergy stakeholder groups and their varied interests, and illustrates how this diversity complicates efforts tomore » define and promote sustainable bioenergy production. We then discuss what this diversity means for research practice. Researchers, we note, should be aware of stakeholder values, information needs, and the factors affecting stakeholder decision making if the knowledge they generate is to reach its widest potential use. We point out how stakeholder participation in research can increase the relevance of its products, and argue that stakeholder values should inform research questions and the choice of analytical assumptions. Finally, we make the case that additional natural science and technical research alone will not advance sustainable bioenergy production, and that important research gaps relate to understanding stakeholder decision making and the need, from a broader social science perspective, to develop processes to identify and accommodate different value systems. While sustainability requires more than improved scientific and technical understanding, the need to understand stakeholder values and manage diversity presents important research opportunities.« less

Effectiveness and implementation of a community-based prevention programme targeting anabolic androgenic steroid use in gyms: study protocol of a quasi-experimental control group study.

PubMed

Molero, Yasmina; Gripenberg, Johanna; Bakshi, Ann-Sofie

2016-01-01

During the past decades, concerns about increased anabolic androgenic steroid (AAS) use among recreational sportspeople have been raised, yet there is a paucity of AAS prevention efforts targeting this group. Accordingly, doping prevention efforts aimed at gyms have been recommended. The overall objective of the present project is to examine a prevention programme named 100% Pure Hard Training (100% PHT), which targets AAS use among recreational sportspeople training in gyms. Specifically, the project aims to: 1) assess the prevalence of AAS, and its associations with alcohol, illicit drugs, and nutritional supplements use; 2) examine whether 100% PHT can decrease AAS use in gyms, and 3) provide insights into which factors facilitate and/or impede implementation of the programme. The intervention group consists of 27 gyms, and 27 gyms serve as controls. Intervention gyms take part in 100% PHT, a community-based programme involving several components: (a) training of key stakeholders (i.e., gym staff, gym owners, local police, and municipal prevention coordinators) regarding AAS use; (b) developing an action plan for AAS prevention for each gym; (c) certification of gyms that follow 100% PHT; (d) cooperative relationship between stakeholders; (e) annual follow-up of gyms. The project consists of two studies: Study A will examine the prevalence of AAS use and the effectiveness of 100% PHT (aims 1 and 2), and data for Study A will be collected using questionnaires distributed to gym attendees at two assessment points: baseline (pre-intervention) and follow-up (post-intervention). Study B will evaluate the implementation of 100% PHT (aim 3), and semi-structured interviews with participating stakeholders will be carried out post-intervention. Knowledge gained from the present project can be used to develop community-based doping prevention efforts aimed at recreational sportspeople training in gyms. Furthermore, it can provide insights into which factors are important for successful implementation of AAS prevention programmes that target gyms. Results are also expected to yield information on the prevalence of AAS use as well as associations between the use of AAS and other licit and illicit substances, including nutritional supplements, among recreational sportspeople. The study was registered retrospectively at isrctn.com (Identifier: ISRCTN11655041; Registration date: 3 November 2016;).

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.

Partitioning Stakeholders for the Economic Valuation of Ecosystem Services: Examples of a Mangrove System

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

Micheletti, Tatiane, E-mail: micheletti@forst.tu-dresden.de; Jost, François; Berger, Uta

Although the importance of ecosystem services provided by natural forests, especially mangroves, is well known, the destruction of these environments is still ubiquitous and therefore protection measures are urgently needed. The present study compares the current approach of economic valuation of ecosystem services to a proposed one, using a study case of a mangrove system as an example. We suggest that a cost-benefit analysis for economically valuing environmental services should be performed with three additional modifications consisting of (i) a categorization of local stakeholders as demanders of particular ecosystem services, (ii) acknowledgement of the government as one of these demandermore » groups, and (iii) the inclusion of opportunity costs in the valuation. The application of this approach to the mangrove area in the east portion of Great Abaco Island, the Bahamas, reveals that not only the ecosystem services received differ between demander groups, but the monetary benefits and costs are also specific to each of these groups. We show that the economic valuation of the ecosystem should be differentiated for each category, instead of being calculated as a net ‘societal value’ as it is currently. Applying this categorization of demanders enables a better understanding of the cost and benefit structure of the protection of a natural area. The present paper aims to facilitate discussions regarding benefit and cost sharing related to the protection of natural areas.« less

Quantifying Stakeholder Values of VET Provision in the Netherlands

ERIC Educational Resources Information Center

van der Sluis, Margriet E.; Reezigt, Gerry J.; Borghans, Lex

2014-01-01

It is well-known that the quality of vocational education and training (VET) depends on how well a given programme aligns with the values and interests of its stakeholders, but it is less well-known what these values and interests are and to what extent they are shared across different groups of stakeholders. We use vignettes to quantify the…

Evolving the US Army Research Laboratory (ARL) Technical Communication Strategy

DTIC Science & Technology

2016-10-01

of added value and enhanced tech transfer, and strengthened relationships with academic and industry collaborators. In support of increasing ARL’s...communication skills; and Prong 3: Promote a Stakeholder Database to implement a stakeholder database (including names and preferences) and use a...Group, strategic planning, communications strategy, stakeholder database , workforce improvement, science and technology, S&T 16. SECURITY

Perspectives of key stakeholders and smokers on a very low nicotine content cigarette-only policy: qualitative study.

PubMed

Fraser, Trish; Kira, Anette

2017-06-02

To investigate views of New Zealand key stakeholders (stakeholders) and smokers on very low nicotine content (VLNC) cigarettes, and a policy mandating that only VLNC cigarettes are available for sale. Using a semi-structured interview schedule, we interviewed 17 stakeholders and held focus groups with 21 smokers. Questions were asked about VLNC cigarettes and a VLNC cigarette-only policy. Smokers were given approximately 15 VLNC cigarettes to take home and smoke. One week after the focus groups, 17 smokers were interviewed. Data were analysed using a general inductive approach. Stakeholders and smokers were largely unconvinced of the value of a mandated reduction in nicotine in cigarettes. After smoking VLNC cigarettes, smokers had less interest in them but would support them being sold alongside high nicotine content (HNC) cigarettes at a much cheaper price. The government is not likely to mandate nicotine reduction in cigarettes if there is a perceived lack of support from stakeholders or smokers. However, they could make VLNC cigarettes available as an option for smokers utilising a differential tax favouring VLNC cigarettes. If this were combined with better access to nicotine containing e-cigarettes, smokers may shift away from HNC cigarettes.

Stakeholders' Perception on National Heatwave Plans and Their Local Implementation in Belgium and The Netherlands.

PubMed

van Loenhout, Joris Adriaan Frank; Rodriguez-Llanes, Jose Manuel; Guha-Sapir, Debarati

2016-11-10

National heatwave plans are aimed at reducing the avoidable human health consequences due to heatwaves, by providing warnings as well as improving communication between relevant stakeholders. The objective of this study was to assess the perceptions of key stakeholders within plans in Belgium and The Netherlands on their responsibilities, the partnerships, and the effectiveness of the local implementation in Brussels and Amsterdam. Key informant interviews were held with stakeholders that had an important role in development of the heatwave plan in these countries, or its implementation in Brussels or Amsterdam. Care organisations, including hospitals and elderly care organisations, had a lack of familiarity with the national heatwave plan in both cities, and prioritised heat the lowest. Some groups of individuals, specifically socially isolated individuals, are not sufficiently addressed by the current national heatwave plans and most local plans. Stakeholders reported that responsibilities were not clearly described and that the national plan does not describe tasks on a local level. We recommend to urgently increase awareness on the impact of heat on health among care organisations. More emphasis needs to be given to the variety of heat-risk groups. Stakeholders should be involved in the development of updates of the plans.

Community engagement: outcomes for occupational therapy students, faculty and clients.

PubMed

Schindler, Victoria P

2014-06-01

Students in health care professions, including occupational therapy, are required to develop knowledge, skills and attitudes in mental health and research. Persons diagnosed with a mental illness, a learning disability or an autism-spectrum disorder desire to achieve goals in higher education and employment. Faculty in health care programmes strives to meet professional goals and accreditation and institution requirements for teaching, service and scholarship. The Bridge Program, a programme based on principles of community engagement, was developed to meet the needs of these three stakeholders. The objective of this paper is to provide programme description and outcomes of the effectiveness of the Bridge Program for all three stakeholders. This uses mixed methods research design including descriptive and quantitative and qualitative one-group pre-test-post-test designs. Instruments consisted of the Occupational Therapy Student and Mental Health Population Scale and the Canadian Occupational Performance Measure. Quantitative results support that graduate occupational therapy students gained research and clinical skills (n = 100; p = .000); clients increased performance and satisfaction toward goals (n = 113; p = .000) and faculty (n = 1) achieved goals related to teaching, service and scholarship. Programmes based on principles of community engagement can address the needs of the community, can provide outcomes that advance knowledge about community practice and can result in benefits for all stakeholders. This paper is limited to generalization and instrumentation and recommends an ongoing evaluation of other community engagement programmes involving all stakeholders in the future research. Copyright © 2014 John Wiley & Sons, Ltd.

Measuring Stakeholder Participation in Evaluation: An Empirical Validation of the Participatory Evaluation Measurement Instrument (PEMI)

ERIC Educational Resources Information Center

Daigneault, Pierre-Marc; Jacob, Steve; Tremblay, Joel

2012-01-01

Background: Stakeholder participation is an important trend in the field of program evaluation. Although a few measurement instruments have been proposed, they either have not been empirically validated or do not cover the full content of the concept. Objectives: This study consists of a first empirical validation of a measurement instrument that…

Prioritizing comparative effectiveness research for cancer diagnostics using a regional stakeholder approach.

PubMed

Klein, Gregory; Gold, Laura S; Sullivan, Sean D; Buist, Diana S M; Ramsey, Scott; Kreizenbeck, Karma; Snell, Kyle; Loggers, Elizabeth Trice; Gifford, Joseph; Watkins, John B; Kessler, Larry

2012-05-01

This paper describes our process to engage regional stakeholders for prioritizing comparative effectiveness research (CER) in cancer diagnostics. We also describe a novel methodology for incorporating stakeholder data and input to inform the objectives of selected CER studies. As an integrated component to establishing the infrastructure for community-based CER on diagnostic technologies, we have assembled a regional stakeholder group composed of local payers, clinicians and state healthcare representatives to not only identify and prioritize CER topics most important to the western Washington State region, but also to inform the study design of selected research areas. A landscape analysis process combining literature searches, expert consultations and stakeholder discussions was used to identify possible CER topics in cancer diagnostics. Stakeholders prioritized the top topics using a modified Delphi/group-nominal method and a standardized evaluation criteria framework to determine a final selected CER study area. Implementation of the selected study was immediate due to a unique American Recovery and Reinvestment Act funding structure involving the same researchers and stakeholders in both the prioritization and execution phases of the project. Stakeholder engagement was enhanced after study selection via a rapid analysis of a subset of payers' internal claims, coordinated by the research team, to obtain summary data of imaging patterns of use. Results of this preliminary analysis, which we termed an 'internal analysis,' were used to determine with the stakeholders the most important and feasible study objectives. Stakeholders identified PET and MRI in cancers including breast, lung, lymphoma and colorectal as top priorities. In an internal analysis of breast cancer imaging, summary data from three payers demonstrated utilization rates of advanced imaging increased between 2002 and 2009 in the study population, with a great deal of variability in use between different health plans. Assessing whether breast MRI affects treatment decisions was the top breast cancer study objective selected by the stakeholders. There were other high-priority research areas including whether MRI use improved survival that were not deemed feasible with the length of follow-up time following MRI adoption. Continuous stakeholder engagement greatly enhanced their enthusiasm for the project. We believe CER implementation will be more successful when undertaken by regional stakeholders.

Setting Priorities in Global Child Health Research Investments: Addressing Values of Stakeholders

PubMed Central

Kapiriri, Lydia; Tomlinson, Mark; Gibson, Jennifer; Chopra, Mickey; El Arifeen, Shams; Black, Robert E.; Rudan, Igor

2007-01-01

Aim To identify main groups of stakeholders in the process of health research priority setting and propose strategies for addressing their systems of values. Methods In three separate exercises that took place between March and June 2006 we interviewed three different groups of stakeholders: 1) members of the global research priority setting network; 2) a diverse group of national-level stakeholders from South Africa; and 3) participants at the conference related to international child health held in Washington, DC, USA. Each of the groups was administered different version of the questionnaire in which they were asked to set weights to criteria (and also minimum required thresholds, where applicable) that were a priori defined as relevant to health research priority setting by the consultants of the Child Health and Nutrition Research initiative (CHNRI). Results At the global level, the wide and diverse group of respondents placed the greatest importance (weight) to the criterion of maximum potential for disease burden reduction, while the most stringent threshold was placed on the criterion of answerability in an ethical way. Among the stakeholders’ representatives attending the international conference, the criterion of deliverability, answerability, and sustainability of health research results was proposed as the most important one. At the national level in South Africa, the greatest weight was placed on the criterion addressing the predicted impact on equity of the proposed health research. Conclusions Involving a large group of stakeholders when setting priorities in health research investments is important because the criteria of relevance to scientists and technical experts, whose knowledge and technical expertise is usually central to the process, may not be appropriate to specific contexts and in accordance with the views and values of those who invest in health research, those who benefit from it, or wider society as a whole. PMID:17948948

Stakeholder opinions on the assessment of MPA effectiveness and their interests to participate at Pacific Rim National Park Reserve, Canada.

PubMed

Heck, Nadine; Dearden, Philip; McDonald, Adrian; Carver, Steve

2011-04-01

As the number of marine protected areas (MPAs) is globally increasing, information is needed on the effectiveness of existing sites. Many protected area agencies however have limited resources and are unable to evaluate MPA effectiveness. An evaluation conducted entirely by the managing agency may also lack credibility. Long-term monitoring and evaluation programs should ideally offer opportunities for participation of diverse groups in the selection of evaluation indicators and their assessment. A participatory approach has the potential to enhance evaluation capacity, to increase credibility and acceptance of results, to strengthen relationships between managers and local stakeholders, and to address more locally relevant information. Using a case study approach, this paper investigates diverse stakeholder groups' opinions on the design of an evaluation and their interest to participate in an assessment. Respondents were most interested in the assessment of MPA achievements and outcome indicators. Most groups identified a range of government agencies and stakeholders that should participate in an assessment but only half of all respondents were interested to participate in monitoring activities. Most frequently mentioned limitations for more participation were a lack of time and money, but also governance shortcomings such as limited participation possibilities and not paying enough credit to stakeholders' input. Participation interest was also influenced by occupation, place of residency, and familiarity with the marine environment. Differences exist among stakeholders about suitable evaluators and preferred monitoring partners, which could affect the credibility of evaluation results and affect monitoring activities.

Engaging Patients in Setting a Patient-Centered Outcomes Research Agenda in Hematopoietic Cell Transplantation

PubMed Central

Burns, Linda J; Abbetti, Beatrice; Arnold, Stacie D; Bender, Jeffrey; Doughtie, Susan; El-Jawahiri, Areej; Gee, Gloria; Hahn, Theresa; Horowitz, Mary M; Johnson, Shirley; Juckett, Mark; Krishnamurit, Lakshmanan; Kullberg, Susan; LeMaistre, C. Fred; Loren, Alison; Majhail, Navneet S; Murphy, Elizabeth A; Rizzo, Doug; Roche-Green, Alva; Saber, Wael; Schatz, Barry A; Schmit-Pokorny, Kim; Shaw, Bronwen E; Syrjala, Karen L; Tierney, D. Kathryn; Ullrich, Christina; Vanness, David J; Wood, William A; Denzen, Ellen M

2018-01-01

The goal of patient-centered outcomes research (PCOR) is to help patients and those who care for them make informed decisions about healthcare. However, the clinical research enterprise has not involved patients, caregivers, and other non-providers routinely in the process of prioritizing, designing and conducting research in hematopoietic cell transplantation (HCT). To address this need, the National Marrow Donor Program (NMDP)/Be The Match® engaged patients, caregivers, researchers and other key stakeholders in a two-year project with the goal of setting a PCOR agenda for the HCT community. Through a collaborative process, we identified six major areas of interest: 1) Patient, Caregiver and Family Education and Support; 2) Emotional, Cognitive and Social Health; 3) Physical Health and Fatigue; 4) Sexual Health and Relationships; 5) Financial Burden; and 6) Models of Survivorship Care Delivery. We then organized into multi-stakeholder Working Groups to identify gaps in knowledge and make priority recommendations for critical research to fill those gaps. Gaps varied by Working Group, but all noted that a historical lack of consistency in measures utilized and patient populations made it difficult to compare outcomes across studies and urged investigators to incorporate uniform measures and homogenous patient groups in future research. Some groups advised that additional pre-emptory work is needed before conducting prospective interventional trials, whereas others felt ready to proceed with comparative clinical effectiveness research studies. This report presents the results of this major initiative, and makes recommendations by Working Group on priority questions for PCOR in HCT. PMID:29408289

Development of a Draft Core Set of Domains for Measuring Shared Decision Making in Osteoarthritis: An OMERACT Working Group on Shared Decision Making

PubMed Central

Toupin April, Karine; Barton, Jennifer; Fraenkel, Liana; Li, Linda; Grandpierre, Viviane; Guillemin, Francis; Rader, Tamara; Stacey, Dawn; Légaré, France; Jull, Janet; Petkovic, Jennifer; Scholte Voshaar, Marieke; Welch, Vivian; Lyddiatt, Anne; Hofstetter, Cathie; De Wit, Maarten; March, Lyn; Meade, Tanya; Christensen, Robin; Gaujoux-Viala, Cécile; Suarez-Almazor, Maria E.; Boonen, Annelies; Pohl, Christoph; Martin, Richard; Tugwell, Peter

2015-01-01

Objective Despite the importance of shared decision making for delivering patient-centred care in rheumatology, there is no consensus on how to measure its process and outcomes. The aim of this OMERACT working group is to determine the core set of domains for measuring shared decision making in intervention studies in adults with osteoarthritis (OA), from the perspective of patients, health professionals and researchers. Methods We followed the OMERACT Filter 2.0 to develop a draft core domain set, which consisted of: (i) forming an OMERACT working group; (ii) conducting a review of domains of shared decision making; and (iii) obtaining the opinions of stakeholders using a modified nominal group process held at a session activity at the OMERACT 2014 meeting. Results 26 stakeholders from Europe, North America and Australia, including 5 patient research partners, participated in the session activity. Participants identified the following domains for measuring shared decision making to be included as part of the Draft Core Set: 1) Identifying the decision; 2) Exchanging Information; 3) Clarifying views; 4) Deliberating; 5) Making the decision; 6) Putting the decision into practice; and 7) Assessing the impact of the decision. Contextual factors were also suggested. Conclusion We propose a Draft Core Set of shared decision making domains for OA intervention research studies. Next steps include a workshop at OMERACT 2016 to reach consensus on these proposed domains in the wider OMERACT group, as well as detail sub-domains and assess instruments to develop a Core Outcome Measurement Set. PMID:25877502

Persuading, protesting and exchanging favours: strategies used by Indian sex workers to win local support for their HIV prevention programmes.

PubMed

Cornish, Flora; Shukla, Anuprita; Banerji, Riddhi

2010-01-01

Given that the communities which are most vulnerable to HIV often have little control over their own lives and their health-related behaviour, HIV prevention policies increasingly recommend that HIV prevention projects work to build relationships with powerful external groups (i.e., build "bridging social capital"). To aid conceptualisation of how community organisations may build such social capital, this paper outlines a typology of strategies for influencing local stakeholders. We present a study of two successful Indian sex workers' organisations, VAMP and DMSC, focusing on how the organisations have influenced three groups of stakeholders, namely police, politicians and local social organisations. Interviews with project employees (45), with representatives of the three groups of stakeholders (12) and fieldwork diaries recording 6 months of observation in each site provide the data. Three approaches emerged. "Persuading" refers to the practice of holding information-giving meetings with stakeholders and requesting their support. It appears to build "weak social ties". "Protesting" entails a collective confrontation with stakeholders, and appears to be useful when the stakeholder has a public image to protect that would be tarnished by protest, and when the protestors can stake a legitimate claim that their rights are being denied. In "exchanging favours", the sex workers' organisations find creative ways to position themselves as offering valued resources to their stakeholders (such as useful information on criminal activities for the police, a stage and audience for politicians or a celebration for local social organisations) as incentives for their support. In conclusion, we discuss the strengths and weaknesses of each approach, the implications for social capital theorising and implications for community HIV prevention.

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.

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

The Development of Best Practice Recommendations to Support the Hiring, Recruitment, and Advancement of Women Physicians in Emergency Medicine.

PubMed

Choo, Esther K; Kass, Dara; Westergaard, Mary; Watts, Susan H; Berwald, Nicole; Regan, Linda; Promes, Susan B; Clem, Kathleen J; Schneider, Sandra M; Kuhn, Gloria J; Abbuhl, Stephanie; Nobay, Flavia

2016-11-01

Women in medicine continue to experience disparities in earnings, promotion, and leadership roles. There are few guidelines in place defining organization-level factors that promote a supportive workplace environment beneficial to women in emergency medicine (EM). We assembled a working group with the goal of developing specific and feasible recommendations to support women's professional development in both community and academic EM settings. We formed a working group from the leadership of two EM women's organizations, the Academy of Women in Academic Emergency Medicine (AWAEM) and the American Association of Women Emergency Physicians (AAWEP). Through a literature search and discussion, working group members identified four domains where organizational policies and practices supportive of women were needed: 1) global approaches to supporting the recruitment, retention, and advancement of women in EM; 2) recruitment, hiring, and compensation of women emergency physicians; 3) supporting development and advancement of women in EM; and 4) physician health and wellness (in the context of pregnancy, childbirth, and maternity leave). Within each of these domains, the working group created an initial set of specific recommendations. The working group then recruited a stakeholder group of EM physician leaders across the country, selecting for diversity in practice setting, geographic location, age, race, and gender. Stakeholders were asked to score and provide feedback on each of the recommendations. Specific recommendations were retained by the working group if they achieved high rates of approval from the stakeholder group for importance and perceived feasibility. Those with >80% agreement on importance and >50% agreement on feasibility were retained. Finally, recommendations were posted in an open online forum (blog) and invited public commentary. An initial set of 29 potential recommendations was created by the working group. After stakeholder voting and feedback, 16 final recommendations were retained. Recommendations were refined through qualitative comments from stakeholders and blog respondents. Using a consensus building process that included male and female stakeholders from both academic and community EM settings, we developed recommendations for organizations to implement to create a workplace environment supportive of women in EM that were perceived as acceptable and feasible. This process may serve as a model for other medical specialties to establish clear, discrete organization-level practices aimed at supporting women physicians. © 2016 by the Society for Academic Emergency Medicine.

The complex relationships involved in global health: a qualitative description

PubMed Central

2013-01-01

Background Growing numbers of medical trainees now participate in global health experiences (GHEs) during their training. To enhance these experiences we sought to explore expectations inherent in the relationships between GHE stakeholder groups. Methods 20 open-ended, semi-structured interviews probed participant perceptions and assumptions embedded in GHEs. A fundamental qualitative descriptive approach was applied, with conventional content analysis and constant comparison methods, to identify and refine emerging themes. Thematic structure was finalized when saturation was achieved. Participants all had experience as global health participants (10 trainees, 10 professionals) from an urban, academic, Canadian medical centre. Results We identified three stakeholder groups: participants (trainees and professionals), host communities, and sponsoring institutions. During interviews, four major themes emerged: (i) cultural challenges, (ii) expectations and perceptions, (iii) relationships and communication, and (iv) discordant objectives. Within each theme, participants recurrently described tensions existing between the three stakeholder groups. Conclusions GHE participants frequently face substantial tensions with host communities and sponsoring agencies. Trainees are particularly vulnerable as they lack experience to navigate these tensions. In the design of GHEs, the needs of each group must be considered to ensure that benefits outweigh potential harms. We propose a conceptual model for developing educational objectives that acknowledge all three GHE stakeholder groups. PMID:24090069

Standardised outcomes in nephrology - Haemodialysis (SONG-HD): study protocol for establishing a core outcome set in haemodialysis.

PubMed

Tong, Allison; Manns, Braden; Hemmelgarn, Brenda; Wheeler, David C; Tugwell, Peter; Winkelmayer, Wolfgang C; van Biesen, Wim; Crowe, Sally; Kerr, Peter G; Polkinghorne, Kevan R; Howard, Kirsten; Pollock, Carol; Hawley, Carmel M; Johnson, David W; McDonald, Stephen P; Gallagher, Martin P; Urquhart-Secord, Rachel; Craig, Jonathan C

2015-08-19

Chronic kidney disease is a significant contributor to mortality and morbidity worldwide, and the number of people who require dialysis or transplantation continues to increase. People on dialysis are 15 times more likely to die than the general population. Dialysis is also costly, intrusive, and time-consuming and imposes an enormous burden on patients and their families. This escalating problem has spurred a proliferation of trials in dialysis, yet health and quality of life remain poor. The reasons for this are complex and varied but are attributable in part to problems in the design and reporting of studies, particularly outcome selection. Problems related to outcomes include use of unvalidated surrogates, outcomes of little or no relevance to patients, highly variable outcome selection limiting comparability across studies, and bias in reporting outcomes. The aim of the Standardised Outcomes in Nephrology-Haemodialysis (SONG-HD) study is to establish a core outcome set for haemodialysis trials, to improve the quality of reporting, and the relevance of trials conducted in people on haemodialysis. SONG-HD is a five-phase project that includes the following: a systematic review to identify outcomes that have been reported in haemodialysis systematic reviews and trials; nominal group technique with patients and caregivers to identify, rank, and describe reasons for their choices; qualitative stakeholder interviews with patients, caregivers, clinicians, researchers, and policy makers to elicit individual values and perspectives on outcomes for haemodialysis trials; a three-round Delphi survey with stakeholder groups to distil and generate a prioritised list of core outcomes; and a consensus workshop to establish a core outcome set for haemodialysis trials. Establishing a core outcome set to be consistently measured and reported in haemodialysis trials will improve the integrity, transparency, usability, and contribution of research relevant to patients requiring haemodialysis; ensure that outcomes of relevance to all stakeholders are consistently reported across trials; and mitigate against outcome reporting bias. Ultimately, patients will be more protected from potential harm, patients and clinicians will be better able to make informed decisions about treatment, and researchers and policy makers will be more able to maximise the value of research to the public.

Analysis of Stakeholder's Behaviours for an Improved Management of an Agricultural Coastal Region in Oman

NASA Astrophysics Data System (ADS)

Khatri, Ayisha Al; Jens, Grundmann; der Weth Rüdiger, van; Niels, Schütze

2015-04-01

Al Batinah coastal area is the main agricultural region in Oman. Agriculture is concentrated in Al Batinah, because of more fertile soils and easier access to water in the form of groundwater compared to other administrative areas in the country. The region now is facing a problem as a result of over abstraction of fresh groundwater for irrigation from the main aquifer along the coast. This enforces the inflow of sea water into the coastal aquifer and causes salinization of the groundwater. As a consequence the groundwater becomes no longer suitable for irrigation which impacts the social and economical situation of farmers as well as the environment. Therefore, the existing situation generates conflicts between different stakeholders regarding water availability, sustainable aquifer management, and profitable agricultural production in Al Batinah region. Several management measures to maintain the groundwater aquifer in the region, were implemented by the government. However, these solutions showed only limited successes for the existing problem. The aim of this study now is to evaluate the implementation potential of several management interventions and their combinations by analysing opinions and responses of all relevant stakeholders in the region. This is done in order to identify potential conflicts among stakeholders to a participatory process within the frame of an integrated water resources management and to support decision makers in taking more informed decisions. Questionnaires were designed for collecting data from different groups of stakeholders e.g. water professionals, farmers from the study area and decision makers of different organizations and ministries. These data were analysed statistically for each group separately as well as regarding relations amongst groups by using the SPSS (Statistical Package for Social Science) software package. Results show, that the need to improve the situation is supported by all groups. However, significant differences exist between groups on how to achieve this improvement, since farmers prefer management interventions operating more on the water resources side while decision makers support measures for a better management on the water demand side. Furthermore, the opinions within single groups are sometimes contradicting for several management interventions. The use of more advanced statistical methods like discriminant analysis or Bayesian network allow for identifying factors and drivers to explain these differences. Both approaches, will help to understand stakeholder's behaviours and to evaluate the implementation potential of several management interventions. Keywords IWRM, Stakeholder participation, field survey, statistical analysis, Oman

Trust Formation When Youth and Adults Partner to Lead School Reform: A Case Study of Supportive Structures and Challenges

ERIC Educational Resources Information Center

Biddle, Catharine

2017-01-01

Schools that build and support high levels of trust between stakeholder groups have been shown to support greater collaboration amongst those groups, including parents, teachers, administrators, and students (Tschannen-Moran, 2001). When stakeholders in schools feel the sense of psychological safety that accompanies trust, they are more willing or…

A multi-criteria assessment of fishing gear impacts in demersal fisheries.

PubMed

Innes, James P; Pascoe, Sean

2010-01-01

Fishing gears have multiple impacts on the marine environment, and policies to reduce these impacts through modifying fishing gears are becoming common place. Different modifications result in different changes in the set of environmental impacts, and imply different sets of costs and benefits for different stakeholder groups. In this study, the analytic hierarchy process (AHP) is used to quantify the relative importance of the environmental impacts of fishing to different stakeholder groups. Forty eight individuals representing six different stakeholder groups (ecologists, biologists, economists, gear technologists, fishers and fisheries managers) were surveyed. As expected, fishers and gear technologists placed substantially greater importance on reducing discarding of commercial fish species than on habitat damage. Priorities of other stakeholder groups varied, but all placed greater priority on habitats than the commercial sector. The results suggest that management aimed at reducing environmental impacts of fishing broader than just discarding is appropriate, but such moves are likely to be opposed by the fishing industry. The derived weights also have a direct application to fisheries management, as they allow otherwise non-commensurate impacts to be aggregated into an overall impact to compare environmental benefits from alternative modifications of fishing gear. Copyright 2009 Elsevier Ltd. All rights reserved.

Representing inequities in the distribution of socio-economic benefits and environmental risk.

PubMed

Louis, Garric E; Magpili, Luna M

2002-10-01

There is currently no standard method for analyzing claims of environmental inequity. Neither is there a database of statistics on the extent of relationship between regional indicators of environmental quality, likely sources of pollution, and the demographic characteristics of affected populations. The resolution of environmental disputes is often hampered by inadequate communication between stakeholder groups about their perceptions and prioritization of the issues in dispute and by differential access to information about the issues by each stakeholder group. This paper describes a web-based tool, ICEP, that uses multi-layered GIS maps to establish a standard method for analyzing claims of environmental inequity and establish a database of correlation coefficients between environmental indicators, industry type by SIC code, and demographic characteristics of the population in proximity to noxious facilities. The maps are generated from stakeholder reports of environmental quality and are designed to be accessible via the Internet. This provides stakeholders with direct access to graphical displays of the perceptions of their co-stakeholders and provides all groups with links to relevant information sources about the issues in dispute. ICEP enhances existing community environmental websites like Scorecard and Envirofacts by providing displays of median household income as a measure of the distribution of benefits accrued within an area.

Patient-centric Care and Chronic Disease Management: A Stakeholder Perspective.

PubMed

Stroetmann, Karl A

2015-01-01

By taking a stakeholder perspective, the paper explores reasons why the political commitment to patient-centric integrated care, facilitated by eHealth applications, is so difficult to meet. In spite of hundreds of pilots, still today there is a dearth of evidence on how to indeed successfully organise such services. Outcomes from a variety of implementation projects supported by the European Union were analysed, focusing on benefits and costs for the diverse stakeholder groups involved or impacted. The re-engineering of the services may result in a considerable shift in these variables between groups. Rendering both positive clinical impacts and a positive (overall) socio-economic return is not sufficient to assure wide acceptance and long-term sustainability. However motivated stakeholders may be, few will operate against their economic interests. Successfully establishing modern eHealth facilitated services is not so much a technical, but a social, organisational, and business innovation. We need to better understand in detail the benefits and costs, or the new 'business models' that go with integrated care for each involved stakeholder group, and the likely impacts for each of them, with a focus on how to best assure a win-win situation for all. Health policy has to respond to this, and a promising approach would be to promote organisational integration with shared budgets and outcome targets.

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

Project Icarus: Stakeholder Scenarios for an Interstellar Exploration Program

NASA Astrophysics Data System (ADS)

Hein, A. M.; Tziolas, A. C.; Osborne, R.

The Project Icarus Study Group's objective is to design a mainly fusion-propelled interstellar probe. The starting point are the results of the Daedalus study, which was conducted by the British Interplanetary Society during the 1970's. As the Daedalus study already indicated, interstellar probes will be the result of a large scale, decade-long development program. To sustain a program over such long periods, the commitment of key stakeholders is vital. Although previous publications identified political and societal preconditions to an interstellar exploration program, there is a lack of more specific scientific and political stakeholder scenarios. This paper develops stakeholder scenarios which allow for a more detailed sustainability assessment of future programs. For this purpose, key stakeholder groups and their needs are identified and scientific and political scenarios derived. Political scenarios are based on patterns of past space programs but unprecedented scenarios are considered as well. Although it is very difficult to sustain an interstellar exploration program, there are scenarios in which this seems to be possible, e.g. the discovery of life within the solar system and on an exoplanet, a global technology development program, and dual-use of technologies for defence and security purposes. This is a submission of the Project Icarus Study Group.

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

Systems and context modeling approach to requirements analysis

NASA Astrophysics Data System (ADS)

Ahuja, Amrit; Muralikrishna, G.; Patwari, Puneet; Subhrojyoti, C.; Swaminathan, N.; Vin, Harrick

2014-08-01

Ensuring completeness and correctness of the requirements for a complex system such as the SKA is challenging. Current system engineering practice includes developing a stakeholder needs definition, a concept of operations, and defining system requirements in terms of use cases and requirements statements. We present a method that enhances this current practice into a collection of system models with mutual consistency relationships. These include stakeholder goals, needs definition and system-of-interest models, together with a context model that participates in the consistency relationships among these models. We illustrate this approach by using it to analyze the SKA system requirements.

What do stakeholders need to implement shared decision making in routine cancer care? A qualitative needs assessment.

PubMed

Müller, Evamaria; Hahlweg, Pola; Scholl, Isabelle

2016-12-01

Shared decision making (SDM) is particularly relevant in oncology, where complex treatment options with varying side effects may lead to meaningful changes in the patient's quality of life. For several years, health policies have called for the implementation of SDM, but SDM remains poorly implemented in routine clinical practice. Implementation science has highlighted the importance of assessing stakeholders' needs to inform the development of implementation programs. Thus, the aim of the present study was to assess different stakeholders' needs regarding the implementation of SDM in routine care. A qualitative study using focus groups and interviews was conducted. Focus groups were carried out with junior physicians, senior physicians, nurses and other healthcare providers (HPCs) (e.g. psycho-oncologists, physiotherapists), patients and family members. Head physicians as well as other HPCs in management positions were interviewed. Audiotapes of focus groups and interviews were transcribed verbatim and analyzed using content analysis. Six focus groups with a total of n = 42 stakeholders as well as n = 17 interviews were conducted. Focus groups and interviews revealed five main categories of needs to be fulfilled in order to achieve a better implementation of SDM in routine cancer care: 1) changes in communication, 2) involvement of other parties, 3) a trustful patient-physician relationship, 4) culture change and 5) structural changes. Stakeholders discussed four clusters of intervention strategies that could foster the implementation of SDM in routine cancer care: 1) clinician-mediated interventions, 2) patient-mediated interventions, 3) provision of patient information material and 4) the establishment of a patient advocate. Study results show that stakeholders voiced a diversity of needs to foster implementation of SDM in routine cancer care, of which some can be directly addressed by intervention strategies. Present results can be used to develop an implementation program to foster SDM in routine cancer care.

In the eye of the stakeholder: The challenges of governing social forest values.

PubMed

Sténs, Anna; Bjärstig, Therese; Nordström, Eva-Maria; Sandström, Camilla; Fries, Clas; Johansson, Johanna

2016-02-01

This study examines which kinds of social benefits derived from forests are emphasised by Swedish stakeholders and what governance modes and management tools they accept. Our study shows that there exists a great variety among stakeholders' perceptions of forests' social values, where tourism and recreation is the most common reference. There are also differences in preferred governance modes and management where biomass and bioenergy sectors advocate business as usual (i.e. framework regulations and voluntarism) and other stakeholders demand rigid tools (i.e. coercion and targeting) and improved landscape planning. This divide will have implications for future policy orientations and require deliberative policy processes and improved dialogue among stakeholders and authorities. We suggest that there is a potential for these improvements, since actors from almost all stakeholder groups support local influence on governance and management, acknowledged and maintained either by the authorities, i.e. targeting, or by the stakeholders themselves, i.e. voluntarism.

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

PubMed

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

2015-04-01

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

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

PubMed Central

Jenkins, Melissa M.; Haine-Schlagel, Rachel

2012-01-01

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

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

PubMed

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

2016-12-01

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

Stakeholder Education for Community-Wide Health Initiatives: A Focus on Teen Pregnancy Prevention.

PubMed

Finley, Cara; Suellentrop, Katherine; Griesse, Rebecca; House, Lawrence Duane; Brittain, Anna

2018-01-01

Teen pregnancies and births continue to decline due in part to implementation of evidence-based interventions and clinical strategies. While local stakeholder education is also thought to be critical to this success, little is known about what types of strategies work best to engage stakeholders. With the goal of identifying and describing evidence-based or best practice strategies for stakeholder education in community-based public health initiatives, we conducted a systematic literature review of strategies used for effective stakeholder education. Over 400 articles were initially retrieved; 59 articles met inclusion criteria. Strategies were grouped into four steps that communities can use to support stakeholder education efforts: identify stakeholder needs and resources, develop a plan, develop tailored and compelling messaging, and use implementation strategies. These strategies lay a framework for high-quality stakeholder education. In future research, it is important to prioritize evaluating specific activities taken to raise awareness, educate, and engage a community in community-wide public health efforts.

Skyping Class: Using Videoconferencing in Organizational Communication Classes

ERIC Educational Resources Information Center

Garner, Johny T.; Buckner, Marjorie M.

2013-01-01

Organizations use this technology to connect employees and stakeholders because of reduced cost and greater participation among global stakeholders (Hertel, Geister, & Konradt, 2005). Scholars have examined videoconferencing in groups (Zornoza, Prieto, Marti, & Piero, 1993),…

Consideration of stakeholder interests in the planning of sustainable waste management programmes.

PubMed

López-Toro, Alberto A; Rubio-Romero, Juan Carlos; Suárez-Cebador, Manuel; Arjona-Jiménez, Rafael

2016-10-01

Those responsible for developing sustainable solid waste management programmes must consider the impacts of programme elements on everyone involved. This paper focuses on identifying the effects of waste management activities and assessing their overall impact on stakeholders. Collaborating with four focus groups and 36 experts, 19 effects were identified and nine questionnaires were designed to evaluate them, one for each stakeholder group. All told, 1805 people took part in the survey. The results show that the effects most important to the survey participants are: (a) recycling solid urban waste, (b) pollution and (c) corporate social responsibility. © The Author(s) 2016.

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.

Engaging stakeholders and target groups in prioritising a public health intervention: the Creating Active School Environments (CASE) online Delphi study.

PubMed

Morton, Katie L; Atkin, Andrew J; Corder, Kirsten; Suhrcke, Marc; Turner, David; van Sluijs, Esther M F

2017-01-13

Stakeholder engagement and public involvement are considered as integral to developing effective public health interventions and is encouraged across all phases of the research cycle. However, limited guidelines and appropriate tools exist to facilitate stakeholder engagement-especially during the intervention prioritisation phase. We present the findings of an online 'Delphi' study that engaged stakeholders (including young people) in the process of prioritising secondary school environment-focused interventions that aim to increase physical activity. Web-based data collection using an online Delphi tool enabling participation of geographically diverse stakeholders. 37 stakeholders participated, including young people (age 13-16 years), parents, teachers, public health practitioners, academics and commissioners; 33 participants completed both rounds. Participants were asked to prioritise a (short-listed) selection of school environment-focused interventions (eg, standing desks, outdoor design changes) based on the criteria of 'reach', 'equality', 'acceptability', 'feasibility', 'effectiveness' and 'cost'. Participants were also asked to rank the criteria and the effectiveness outcomes (eg, physical activity, academic achievement, school enjoyment) from most to least important. Following feedback along with any new information provided, participants completed round 2 4 weeks later. The intervention prioritisation process was feasible to conduct and comments from participants indicated satisfaction with the process. Consensus regarding intervention strategies was achieved among the varied groups of stakeholders, with 'active lessons' being the favoured approach. Participants ranked 'mental health and well-being' as the most important outcome followed by 'enjoyment of school'. The most important criteria was 'effectiveness', followed by 'feasibility'. This novel approach to engaging a wide variety of stakeholders in the research process was feasible to conduct and acceptable to participants. It also provided insightful information relating to how stakeholders prioritise interventions. The approach could be extended beyond the specific project to be a useful tool for researchers and practitioners. 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/.

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.

State and Local Government Partnership

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

Barton, Alexander; Rinebold, Joel; Aresta, Paul

The State and Local Government Partnership project has built relationships between the Department of Energy (DOE), regional states, and municipalities. CCAT implemented this project using a structure that included leadership by the DOE. Outreach was undertaken through collaborative meetings, workshops, and briefings; the development of technical models and local energy plans; support for state stakeholder groups; and implementation of strategies to facilitate the deployment of hydrogen and fuel cell technologies. The final guidance documents provided to stakeholders consisted of individual strategic state “Roadmaps” to serve as development plans. These “Roadmaps” confirm economic impacts, identify deployment targets, and compare policies andmore » incentives for facility development in each of the regional states. The partnerships developed through this project have improved the exchange of knowledge between state and local government stakeholders and is expected to increase the deployment of hydrogen and fuel cell technologies in early market applications, consistent with the DOE’s market transformation efforts. Technically accurate and objective information was, and continues to be, provided to improve public and stakeholder perceptions regarding the use of hydrogen and fuel cell technologies. Based on the “Roadmaps” and studies conducted for this project, there is the potential to generate approximately 10.75 million megawatt hours (MWh) of electricity annually from hydrogen and fuel cell technologies at potential host sites in the Northeast regional states, through the development of 1,364 to 1,818 megawatts (MW) of fuel cell electric generation capacity. Currently, the region has approximately 1,180 companies that are part of the growing hydrogen and fuel cell industry supply chain in the region. These companies are estimated to have over $1 billion in annual revenue and investment, contribute more than $51 million in annual state and local tax revenue, and provide approximately $650 million in annual gross state product from their participation in this regional energy cluster. Twenty-five (25) of these companies are original equipment manufacturers (OEMs) of hydrogen and/or fuel cell systems that provided 2,228 direct jobs and $433.15 million in direct revenue and investment in 2010.« less

Stakeholders' Perception on Teachers' Assessment Effectiveness in Secondary Schools in Port Harcourt Metropolis in Rivers State

ERIC Educational Resources Information Center

Ogidi, Reuben C.; Udechukwu, Jonathan O.

2017-01-01

The study sought to investigate the perception of stakeholders on teachers' assessment effectiveness in secondary schools in Port Harcourt Metropolis in Rivers State. Three research questions and one hypothesis were formulated to guide the study. The study adopted survey research design. The sample of the study consisted of 20 principles, 30 vice…

The Impact of Stakeholders' Roles within the Livestock Industry on Their Attitudes to Livestock Welfare in Southeast and East Asia.

PubMed

Sinclair, Michelle; Zito, Sarah; Phillips, Clive J C

2017-01-25

Stakeholders in the livestock industry are in a position to make critical choices that directly impact on animal welfare during slaughter and transport. Understanding the attitudes of stakeholders in livestock-importing countries, including factors that motivate the stakeholders to improve animal welfare, can lead to improved trade relations with exporting developed countries and improved animal welfare initiatives in the importing countries. Improving stakeholder attitudes to livestock welfare may help to facilitate the better welfare that is increasingly demanded by the public for livestock. Knowledge of the existing attitudes towards the welfare of livestock during transport and slaughter provides a starting point that may help to target efforts. This study aimed to investigate the animal welfare attitudes of livestock stakeholders (farmers, team leaders, veterinarians, business owners, business managers, and those working directly with animals) in selected countries in E and SE Asia (China, Thailand, Viet Nam, and Malaysia). The factors that motivated them to improve animal welfare (in particular their religion, knowledge levels, monetary gain, the availability of tools and resources, more pressing community issues, and the approval of their supervisor and peers) were assessed for their relationships to stakeholder role and ranked according to their importance. Stakeholder roles influenced attitudes to animal welfare during livestock transport and slaughter. Farmers were more motivated by their peers compared to other stakeholders. Business owners reported higher levels of motivation from monetary gain, while business managers were mainly motivated by what was prescribed by the company for which they worked. Veterinarians reported the highest levels of perceived approval for improving animal welfare, and all stakeholder groups were least likely to be encouraged to change by a 'western' international organization. This study demonstrates the differences in attitudes of the major livestock stakeholders towards their animals' welfare during transport and slaughter, which advocacy organisations can use to tailor strategies more effectively to improve animal welfare. The results suggest that animal welfare initiatives are more likely to engage their target audience when tailored to specific stakeholder groups.

Collaborative environmental planning in river management: An application of multicriteria decision analysis in the White River Watershed in Vermont

USGS Publications Warehouse

Hermans, C.; Erickson, J.; Noordewier, T.; Sheldon, A.; Kline, M.

2007-01-01

Multicriteria decision analysis (MCDA) provides a well-established family of decision tools to aid stakeholder groups in arriving at collective decisions. MCDA can also function as a framework for the social learning process, serving as an educational aid in decision problems characterized by a high level of public participation. In this paper, the framework and results of a structured decision process using the outranking MCDA methodology preference ranking organization method of enrichment evaluation (PROMETHEE) are presented. PROMETHEE is used to frame multi-stakeholder discussions of river management alternatives for the Upper White River of Central Vermont, in the northeastern United States. Stakeholders met over 10 months to create a shared vision of an ideal river and its services to communities, develop a list of criteria by which to evaluate river management alternatives, and elicit preferences to rank and compare individual and group preferences. The MCDA procedure helped to frame a group process that made stakeholder preferences explicit and substantive discussions about long-term river management possible. ?? 2006 Elsevier Ltd. All rights reserved.

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.

Collaborative environmental planning in river management: an application of multicriteria decision analysis in the White River Watershed in Vermont.

PubMed

Hermans, Caroline; Erickson, Jon; Noordewier, Tom; Sheldon, Amy; Kline, Mike

2007-09-01

Multicriteria decision analysis (MCDA) provides a well-established family of decision tools to aid stakeholder groups in arriving at collective decisions. MCDA can also function as a framework for the social learning process, serving as an educational aid in decision problems characterized by a high level of public participation. In this paper, the framework and results of a structured decision process using the outranking MCDA methodology preference ranking organization method of enrichment evaluation (PROMETHEE) are presented. PROMETHEE is used to frame multi-stakeholder discussions of river management alternatives for the Upper White River of Central Vermont, in the northeastern United States. Stakeholders met over 10 months to create a shared vision of an ideal river and its services to communities, develop a list of criteria by which to evaluate river management alternatives, and elicit preferences to rank and compare individual and group preferences. The MCDA procedure helped to frame a group process that made stakeholder preferences explicit and substantive discussions about long-term river management possible.

Barriers, Facilitators and Priorities for Implementation of WHO Maternal and Perinatal Health Guidelines in Four Lower-Income Countries: A GREAT Network Research Activity.

PubMed

Vogel, Joshua P; Moore, Julia E; Timmings, Caitlyn; Khan, Sobia; Khan, Dina N; Defar, Atkure; Hadush, Azmach; Minwyelet Terefe, Marta; Teshome, Luwam; Ba-Thike, Katherine; Than, Kyu Kyu; Makuwani, Ahmad; Mbaruku, Godfrey; Mrisho, Mwifadhi; Mugerwa, Kidza Yvonne; Puchalski Ritchie, Lisa M; Rashid, Shusmita; Straus, Sharon E; Gülmezoglu, A Metin

2016-01-01

Health systems often fail to use evidence in clinical practice. In maternal and perinatal health, the majority of maternal, fetal and newborn mortality is preventable through implementing effective interventions. To meet this challenge, WHO's Department of Reproductive Health and Research partnered with the Knowledge Translation Program at St. Michael's Hospital (SMH), University of Toronto, Canada to establish a collaboration on knowledge translation (KT) in maternal and perinatal health, called the GREAT Network (Guideline-driven, Research priorities, Evidence synthesis, Application of evidence, and Transfer of knowledge). We applied a systematic approach incorporating evidence and theory to identifying barriers and facilitators to implementation of WHO maternal heath recommendations in four lower-income countries and to identifying implementation strategies to address these. We conducted a mixed-methods study in Myanmar, Uganda, Tanzania and Ethiopia. In each country, stakeholder surveys, focus group discussions and prioritization exercises were used, involving multiple groups of health system stakeholders (including administrators, policymakers, NGOs, professional associations, frontline healthcare providers and researchers). Despite differences in guideline priorities and contexts, barriers identified across countries were often similar. Health system level factors, including health workforce shortages, and need for strengthened drug and equipment procurement, distribution and management systems, were consistently highlighted as limiting the capacity of providers to deliver high-quality care. Evidence-based health policies to support implementation, and improve the knowledge and skills of healthcare providers were also identified. Stakeholders identified a range of tailored strategies to address local barriers and leverage facilitators. This approach to identifying barriers, facilitators and potential strategies for improving implementation proved feasible in these four lower-income country settings. Further evaluation of the impact of implementing these strategies is needed.

Barriers, Facilitators and Priorities for Implementation of WHO Maternal and Perinatal Health Guidelines in Four Lower-Income Countries: A GREAT Network Research Activity

PubMed Central

Vogel, Joshua P.; Moore, Julia E.; Timmings, Caitlyn; Khan, Sobia; Khan, Dina N.; Defar, Atkure; Hadush, Azmach; Minwyelet Terefe, Marta; Teshome, Luwam; Ba-Thike, Katherine; Than, Kyu Kyu; Makuwani, Ahmad; Mbaruku, Godfrey; Mrisho, Mwifadhi; Mugerwa, Kidza Yvonne; Puchalski Ritchie, Lisa M.; Rashid, Shusmita; Straus, Sharon E.; Gülmezoglu, A. Metin

2016-01-01

Background Health systems often fail to use evidence in clinical practice. In maternal and perinatal health, the majority of maternal, fetal and newborn mortality is preventable through implementing effective interventions. To meet this challenge, WHO’s Department of Reproductive Health and Research partnered with the Knowledge Translation Program at St. Michael’s Hospital (SMH), University of Toronto, Canada to establish a collaboration on knowledge translation (KT) in maternal and perinatal health, called the GREAT Network (Guideline-driven, Research priorities, Evidence synthesis, Application of evidence, and Transfer of knowledge). We applied a systematic approach incorporating evidence and theory to identifying barriers and facilitators to implementation of WHO maternal heath recommendations in four lower-income countries and to identifying implementation strategies to address these. Methods We conducted a mixed-methods study in Myanmar, Uganda, Tanzania and Ethiopia. In each country, stakeholder surveys, focus group discussions and prioritization exercises were used, involving multiple groups of health system stakeholders (including administrators, policymakers, NGOs, professional associations, frontline healthcare providers and researchers). Results Despite differences in guideline priorities and contexts, barriers identified across countries were often similar. Health system level factors, including health workforce shortages, and need for strengthened drug and equipment procurement, distribution and management systems, were consistently highlighted as limiting the capacity of providers to deliver high-quality care. Evidence-based health policies to support implementation, and improve the knowledge and skills of healthcare providers were also identified. Stakeholders identified a range of tailored strategies to address local barriers and leverage facilitators. Conclusion This approach to identifying barriers, facilitators and potential strategies for improving implementation proved feasible in these four lower-income country settings. Further evaluation of the impact of implementing these strategies is needed. PMID:27806041

Community stakeholder responses to advocacy advertising

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

Miller, B.; Sinclair, J.

Focus group research was used to examine how community stakeholders, a group with local industry experience, responded to coal industry advocacy messages. The stakeholders expressed beliefs about both the advertiser and the coal industry, and while their knowledge led to critical consideration of the industry campaign, they also expressed a desire to identify with positive messages about their community. Applying a postpositivist research perspective, a new model is introduced to integrate these beliefs in terms of advertiser trust and industry accountability under the existing theoretical framework of persuasion knowledge. Agent and topic knowledge are combined in this model based onmore » responses to the industry advocacy campaign. In doing so, this study integrates a priori theory within a new context, extending the current theoretical framework to include an understanding of how community stakeholders - a common target for marketplace advocacy - interpret industry messages.« less

Stakeholder prioritization of zoonoses in Japan with analytic hierarchy process method.

PubMed

Kadohira, M; Hill, G; Yoshizaki, R; Ota, S; Yoshikawa, Y

2015-05-01

There exists an urgent need to develop iterative risk assessment strategies of zoonotic diseases. The aim of this study is to develop a method of prioritizing 98 zoonoses derived from animal pathogens in Japan and to involve four major groups of stakeholders: researchers, physicians, public health officials, and citizens. We used a combination of risk profiling and analytic hierarchy process (AHP). Profiling risk was accomplished with semi-quantitative analysis of existing public health data. AHP data collection was performed by administering questionnaires to the four stakeholder groups. Results showed that researchers and public health officials focused on case fatality as the chief important factor, while physicians and citizens placed more weight on diagnosis and prevention, respectively. Most of the six top-ranked diseases were similar among all stakeholders. Transmissible spongiform encephalopathy, severe acute respiratory syndrome, and Ebola fever were ranked first, second, and third, respectively.

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.

Organizational Responsibility for Age-Friendly Social Participation: Views of Australian Rural Community Stakeholders.

PubMed

Winterton, Rachel

2016-01-01

This qualitative study critically explores the barriers experienced by diverse rural community stakeholders in facilitating environments that enable age-friendly social participation. Twenty-six semi-structured interviews were conducted across two rural Australian communities with stakeholders from local government, health, social care, and community organizations. Findings identify that rural community stakeholders face significant difficulties in securing resources for groups and activities catering to older adults, which subsequently impacts their capacity to undertake outreach to older adults. However, in discussing these issues, questions were raised in relation to whose responsibility it is to provide resources for community groups and organizations providing social initiatives and whose responsibility it is to engage isolated seniors. These findings provide a much-needed critical perspective on current age-friendly research by acknowledging the responsibilities of various macro-level social structures-different community-level organizations, local government, and policy in fostering environments to enable participation of diverse rural older adults.

Social factors shaping the formation of a multi-stakeholder trails network group for the Monongahela National Forest, West Virginia

Treesearch

Karen Robinson; Steven Selin; Chad Pierskalla

2009-01-01

This paper reports the results and management implications of a longitudinal research study examining the social factors affecting the formation of a trails network advisory group for the Monongahela National Forest (MNF) in West Virginia. A collaborative process of creating an MNF trails network with input from local users and stakeholders has been largely...

Perceptions of stakeholder groups about the participation of African American family forest landowners in federal landowner assistance programs

Treesearch

Puneet Dwivedi; Arundhati Jagadish; John Schelhas

2016-01-01

This study examines perceptions of three stakeholder groups (African American Family Forest Landowner, Government Agency, and Nonprofit) regarding federal landowner assistance programs in the southern United States by combining a SWOT (strength, weakness, opportunity, and threat) analysis with the AHP (analytical hierarchy process). Factors with the highest priority...

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

PubMed Central

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

2003-01-01

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

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.

The perceived value of using BIM for energy simulation

NASA Astrophysics Data System (ADS)

Lewis, Anderson M.

Building Information Modeling (BIM) is becoming an increasingly important tool in the Architectural, Engineering & Construction (AEC) industries. Some of the benefits associated with BIM include but are not limited to cost and time savings through greater trade and design coordination, and more accurate estimating take-offs. BIM is a virtual 3D, parametric design software that allows users to store information of a model within and can be used as a communication platform between project stakeholders. Likewise, energy simulation is an integral tool for predicting and optimizing a building's performance during design. Creating energy models and running energy simulations can be a time consuming activity due to the large number of parameters and assumptions that must be addressed to achieve reasonably accurate results. However, leveraging information imbedded within Building Information Models (BIMs) has the potential to increase accuracy and reduce the amount of time required to run energy simulations and can facilitate continuous energy simulations throughout the design process, thus optimizing building performance. Although some literature exists on how design stakeholders perceive the benefits associated with leveraging BIM for energy simulation, little is known about how perceptions associated with leveraging BIM for energy simulation differ between various green design stakeholder user groups. Through an e-survey instrument, this study seeks to determine how perceptions of using BIMs to inform energy simulation differ among distinct design stakeholder groups, which include BIM-only users, energy simulation-only users and BIM and energy simulation users. Additionally, this study seeks to determine what design stakeholders perceive as the main barriers and benefits of implementing BIM-based energy simulation. Results from this study suggest that little to no correlation exists between green design stakeholders' perceptions of the value associated with using information from BIMs to inform energy simulation and their engagement level with BIM and/or energy simulation. However, green design stakeholder perceptions of the value associated with using information from BIMs to inform energy simulation and their engagement with BIM and/or energy simulation may differ between different user groups (i.e. BIM users only, energy simulation users only, and BIM and energy simulation users). For example, the BIM-only user groups appeared to have a strong positive correlation between the perceptions of the value associated with using information from BIMs to inform energy simulation and their engagement with BIM. Additionally, this study suggests that the top perceived benefits of using BIMs to inform energy simulations among green design stakeholders are: facilitation of communication, reducing of process related costs, and giving users the ability examine more design options. The main perceived barrier of using BIMs to inform energy simulations among green design stakeholders was a lack of BIM standards for model integration with multidisciplinary teams. Results from this study will help readers understand how to better implement BIM-based energy simulation while mitigating barriers and optimizing benefits. Additionally, examining discrepancies between user groups can lead the identification and improvement of shortfalls in current BIM-based energy simulation processes. Understanding how perceptions and engagement levels differ among different software user groups will help in developing a strategies for implementing BIM-based energy simulation that are tailored to each specific user group.

Policy responses to hepatitis C in the Nordic countries: Gaps and discrepant reporting in the Hep-Nordic study

PubMed Central

Safreed-Harmon, Kelly; Hetherington, Kristina L.

2018-01-01

Background and aims In the Nordic countries (Denmark, Finland, Iceland, Norway, Sweden), the prevalence of chronic hepatitis C virus (HCV) infection is relatively low in the general population, but is much higher among people who inject drugs (PWID). We conducted an exploratory study to investigate the extent to which these countries have policies supporting key elements of the public health response that is necessary to achieve the global goal of eliminating HCV as a public health threat. Methods Fourteen stakeholders representing government agencies, medical societies, and civil society organisations (CSOs) in the Nordic countries completed a cross-sectional online survey that included 21 policy questions related to national coordination, prevention, testing, linkage to care, and treatment. We summarised the findings in a descriptive analysis, and noted discrepant responses from stakeholders within the same country. Results Stakeholders reported that three of the five study countries have national viral hepatitis strategies, while only Iceland has a national HCV elimination goal. The availability of harm reduction services varies, with opioid substitution therapy provided for the general population throughout all countries, but not needle and syringe programmes. No country has access to anonymous HCV testing in all parts of the country. National HCV treatment guidelines are available in all countries except Finland, and all countries provide publicly funded direct-acting antiviral treatment. Disagreement regarding policies was observed across countries, and CSOs were the stakeholder group that most frequently answered survey questions incorrectly. Conclusion The Nordic region as a whole has not consistently expressed its commitment to tackling HCV, despite the existence of large HCV epidemics among PWID in these countries. Stakeholder alignment and an established elimination goal with an accompanying strategy and implementation plan should be recognised as the basis for coordinated national public health efforts to achieve HCV elimination in the Nordic region and elsewhere. PMID:29381697

Policy responses to hepatitis C in the Nordic countries: Gaps and discrepant reporting in the Hep-Nordic study.

PubMed

Safreed-Harmon, Kelly; Hetherington, Kristina L; Aleman, Soo; Alho, Hannu; Dalgard, Olav; Frisch, Tove; Gottfredsson, Magnus; Weis, Nina; Lazarus, Jeffrey V

2018-01-01

In the Nordic countries (Denmark, Finland, Iceland, Norway, Sweden), the prevalence of chronic hepatitis C virus (HCV) infection is relatively low in the general population, but is much higher among people who inject drugs (PWID). We conducted an exploratory study to investigate the extent to which these countries have policies supporting key elements of the public health response that is necessary to achieve the global goal of eliminating HCV as a public health threat. Fourteen stakeholders representing government agencies, medical societies, and civil society organisations (CSOs) in the Nordic countries completed a cross-sectional online survey that included 21 policy questions related to national coordination, prevention, testing, linkage to care, and treatment. We summarised the findings in a descriptive analysis, and noted discrepant responses from stakeholders within the same country. Stakeholders reported that three of the five study countries have national viral hepatitis strategies, while only Iceland has a national HCV elimination goal. The availability of harm reduction services varies, with opioid substitution therapy provided for the general population throughout all countries, but not needle and syringe programmes. No country has access to anonymous HCV testing in all parts of the country. National HCV treatment guidelines are available in all countries except Finland, and all countries provide publicly funded direct-acting antiviral treatment. Disagreement regarding policies was observed across countries, and CSOs were the stakeholder group that most frequently answered survey questions incorrectly. The Nordic region as a whole has not consistently expressed its commitment to tackling HCV, despite the existence of large HCV epidemics among PWID in these countries. Stakeholder alignment and an established elimination goal with an accompanying strategy and implementation plan should be recognised as the basis for coordinated national public health efforts to achieve HCV elimination in the Nordic region and elsewhere.

Recommendations from the European Working Group for Value Assessment and Funding Processes in Rare Diseases (ORPH-VAL).

PubMed

Annemans, Lieven; Aymé, Ségolène; Le Cam, Yann; Facey, Karen; Gunther, Penilla; Nicod, Elena; Reni, Michele; Roux, Jean-Louis; Schlander, Michael; Taylor, David; Tomino, Carlo; Torrent-Farnell, Josep; Upadhyaya, Sheela; Hutchings, Adam; Le Dez, Lugdivine

2017-03-10

Rare diseases are an important public health issue with high unmet need. The introduction of the EU Regulation on orphan medicinal products (OMP) has been successful in stimulating investment in the research and development of OMPs. Despite this advancement, patients do not have universal access to these new medicines. There are many factors that affect OMP uptake, but one of the most important is the difficulty of making pricing and reimbursement (P&R) decisions in rare diseases. Until now, there has been little consensus on the most appropriate assessment criteria, perspective or appraisal process. This paper proposes nine principles to help improve the consistency of OMP P&R assessment in Europe and ensure that value assessment, pricing and funding processes reflect the specificities of rare diseases and contribute to both the sustainability of healthcare systems and the sustainability of innovation in this field. These recommendations are the output of the European Working Group for Value Assessment and Funding Processes in Rare Diseases (ORPH-VAL), a collaboration between rare disease experts, patient representatives, academics, health technology assessment (HTA) practitioners, politicians and industry representatives. ORPH-VAL reached its recommendations through careful consideration of existing OMP P&R literature and through a wide consultation with expert stakeholders, including payers, regulators and patients. The principles cover four areas: OMP decision criteria, OMP decision process, OMP sustainable funding systems and European co-ordination. This paper also presents a guide to the core elements of value relevant to OMPs that should be consistently considered in all OMP appraisals. The principles outlined in this paper may be helpful in drawing together an emerging consensus on this topic and identifying areas where consistency in payer approach could be achievable and beneficial. All stakeholders have an obligation to work together to ensure that the promise of OMP's is realised.

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

PubMed

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

2013-12-01

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

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

PubMed

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

2016-04-01

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

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.

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.

Prioritizing comparative effectiveness research for cancer diagnostics using a regional stakeholder approach

PubMed Central

Klein, Gregory; Gold, Laura S; Sullivan, Sean D; Buist, Diana SM; Ramsey, Scott; Kreizenbeck, Karma; Snell, Kyle; Loggers, Elizabeth Trice; Gifford, Joseph; Watkins, John B; Kessler, Larry

2012-01-01

Aims This paper describes our process to engage regional stakeholders for prioritizing comparative effectiveness research (CER) in cancer diagnostics. We also describe a novel methodology for incorporating stakeholder data and input to inform the objectives of selected CER studies. Materials & methods As an integrated component to establishing the infrastructure for community-based CER on diagnostic technologies, we have assembled a regional stakeholder group composed of local payers, clinicians and state healthcare representatives to not only identify and prioritize CER topics most important to the western Washington State region, but also to inform the study design of selected research areas. A landscape analysis process combining literature searches, expert consultations and stakeholder discussions was used to identify possible CER topics in cancer diagnostics. Stakeholders prioritized the top topics using a modified Delphi/group-nominal method and a standardized evaluation criteria framework to determine a final selected CER study area. Implementation of the selected study was immediate due to a unique American Recovery and Reinvestment Act funding structure involving the same researchers and stakeholders in both the prioritization and execution phases of the project. Stakeholder engagement was enhanced after study selection via a rapid analysis of a subset of payers’ internal claims, coordinated by the research team, to obtain summary data of imaging patterns of use. Results of this preliminary analysis, which we termed an ‘internal analysis,’ were used to determine with the stakeholders the most important and feasible study objectives. Results Stakeholders identified PET and MRI in cancers including breast, lung, lymphoma and colorectal as top priorities. In an internal analysis of breast cancer imaging, summary data from three payers demonstrated utilization rates of advanced imaging increased between 2002 and 2009 in the study population, with a great deal of variability in use between different health plans. Assessing whether breast MRI affects treatment decisions was the top breast cancer study objective selected by the stakeholders. There were other high-priority research areas including whether MRI use improved survival that were not deemed feasible with the length of follow-up time following MRI adoption. Conclusion Continuous stakeholder engagement greatly enhanced their enthusiasm for the project. We believe CER implementation will be more successful when undertaken by regional stakeholders. PMID:23105966

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.

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

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

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

2012-02-15

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

Sixth national stakeholder workshop summary report

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

NONE

On June 17--18, 1998, the Department of Energy`s (DOE) Office of Worker and Community Transition convened its sixth National Stakeholder Workshop at the Ramada Plaza Hotel Old Town in Alexandria, Virginia. Approximately 325 stakeholders attended representing DOE headquarters and field offices, contractors, labor organizations, state and local government, education and community interest groups. The meeting addressed the progress made on the issues and challenges identified at the last stakeholder`s meeting in Oakland, California on April 9--11, 1997. Also discussed were the full range of the Department`s work force issues and creative solutions to the inherent challenges of simultaneously implementing themore » Department`s post Cold-War mission, work force restructuring guidance, contract reform objectives, asset disposition, performance-based management requirements, and business process improvement policies. The format of the Workshop included several plenary sessions and a number of small group discussion sessions. The small group sessions focused on topics related to labor issues, work force restructuring, work force planning, community transition, and employee concerns. The sessions provided a wide range of views on worker and community transition issues. The plenary sessions of the Workshop included presentations on the following topics: welcome and introductions; opening remarks; building a better labor-management relationship; keynote speech from Secretary of Energy Federico Pena; meeting tomorrow`s challenges (early site closures); harnessing the contracting process to encourage local growth; and, the British experience in economic conversion.« less

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.

Collaboration Practices: An Analysis Within an Army Acquisition Program Office

DTIC Science & Technology

2014-03-01

comprised of both intrinsic and extrinsic incentives and rewards. According to the survey results, this was not a high factor in this stakeholder group...people back alive.” This quote captures the essence of the type of reward and motivation the stakeholder group shares. It is an intrinsic reward...provide information about their general perceptions of inter-organizational collaborative capacity. They were not asked to think about a specific

Comparative analysis of sustainable value distribution for stakeholders in the mining industry

NASA Astrophysics Data System (ADS)

Lorenc, Sylwia; Kustra, Arkadiusz

2018-01-01

The objective of this article is the analysis and comparison of the value distribution process that takes place in enterprises for stakeholders. The following coal mining enterprises are subject of this work: JSW S.A., KGHM S.A., and LW Bogdanka S.A, for which the directions of value distribution in the years 2011-2016 were presented. The article defines the main groups of the partnerships' stakeholders, such as the owners, staff, suppliers, equity providers, the country budget and the local governments' budgets. The sustainable value benchmark was defined as the benefits received by the stakeholders through the allocation of financial surplus. The value defined for the abovementioned stakeholders was assessed according to the Free Cash Flow (FCF) methodology.

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

PubMed

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

2017-02-01

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

Web based collaborative decision making in flood risk management

NASA Astrophysics Data System (ADS)

Evers, Mariele; Almoradie, Adrian; Jonoski, Andreja

2014-05-01

Stakeholder participation in the development of flood risk management (FRM) plans is essential since stakeholders often have a better understanding or knowledge of the potentials and limitation of their local area. Moreover, a participatory approach also creates trust amongst stakeholders, leading to a successful implementation of measures. Stakeholder participation however has its challenges and potential pitfalls that could lead to its premature termination. Such challenges and pitfalls are the limitation of financial resources, stakeholders' spatial distribution and their interest to participate. Different type of participation in FRM may encounter diverse challenges. These types of participation in FRM can be classified into (1) Information and knowledge sharing (IKS), (2) Consultative participation (CP) or (3) Collaborative decision making (CDM)- the most challenging type of participation. An innovative approach to address these challenges and potential pitfalls is a web-based mobile or computer-aided environment for stakeholder participation. This enhances the remote interaction between participating entities such as stakeholders. This paper presents a developed framework and an implementation of CDM web based environment for the Alster catchment (Hamburg, Germany) and Cranbrook catchment (London, UK). The CDM framework consists of two main stages: (1) Collaborative modelling and (2) Participatory decision making. This paper also highlights the stakeholder analyses, modelling approach and application of General Public License (GPL) technologies in developing the web-based environments. Actual test and evaluation of the environments was through series of stakeholders workshops. The overall results based from stakeholders' evaluation shows that web-based environments can address the challenges and potential pitfalls in stakeholder participation and it enhances participation in flood risk management. The web-based environment was developed within the DIANE-CM project (Decentralised Integrated Analysis and Enhancement of Awareness through Collaborative Modelling and Management of Flood Risk) of the 2nd ERANET CRUE funding initiative.

The Role of Integrated Modelling and Assessment for Decision-Making: Lessons from Water Allocation Issues in Australia

NASA Astrophysics Data System (ADS)

Jakeman, A. J.; Guillaume, J. H. A.; El Sawah, S.; Hamilton, S.

2014-12-01

Integrated modelling and assessment (IMA) is best regarded as a process that can support environmental decision-making when issues are strongly contested and uncertainties pervasive. To be most useful, the process must be multi-dimensional and phased. Principally, it must be tailored to the problem context to encompass diverse issues of concern, management settings and stakeholders. This in turn requires the integration of multiple processes and components of natural and human systems and their corresponding spatial and temporal scales. Modellers therefore need to be able to integrate multiple disciplines, methods, models, tools and data, and many sources and types of uncertainty. These dimensions are incorporated into iteration between the various phases of the IMA process, including scoping, problem framing and formulation, assessing options and communicating findings. Two case studies in Australia are employed to share the lessons of how integration can be achieved in these IMA phases using a mix of stakeholder participation processes and modelling tools. One case study aims to improve the relevance of modelling by incorporating stakeholder's views of irrigated viticulture and water management decision making. It used a novel methodology with the acronym ICTAM, consisting of Interviews to elicit mental models, Cognitive maps to represent and analyse individual and group mental models, Time-sequence diagrams to chronologically structure the decision making process, an All-encompassing conceptual model, and computational Models of stakeholder decision making. The second case uses a hydro-economic river network model to examine basin-wide impacts of water allocation cuts and adoption of farm innovations. The knowledge exchange approach used in each case was designed to integrate data and knowledge bearing in mind the contextual dimensions of the problem at hand, and the specific contributions that environmental modelling was thought to be able to make.

Bridging clinical researcher perceptions and health IT realities: A case study of stakeholder creep.

PubMed

Panyard, Daniel J; Ramly, Edmond; Dean, Shannon M; Bartels, Christie M

2018-02-01

We present a case report detailing a challenge in health information technology (HIT) project implementations we term "stakeholder creep": not thoroughly identifying which stakeholders need to be involved and why before starting a project, consequently not understanding the true effort, skill sets, social capital, and time required to complete the project. A root cause analysis was performed post-implementation to understand what led to stakeholder creep. HIT project stakeholders were given a questionnaire to comment on these misconceptions and a proposed implementation tool to help mitigate stakeholder creep. Stakeholder creep contributed to an unexpected increase in time (3-month delayed go-live) and effort (68% over expected HIT work hours). Four main clinician/researcher misconceptions were identified that contributed to the development of stakeholder creep: 1) that EHR IT is a single group; 2) that all EHR IT members know the entire EHR functionality; 3) that changes to an EHR need the input of just a single EHR IT member; and 4) that the technological complexity of a project mirrors the clinical complexity. HIT project stakeholders similarly perceived clinicians/researchers to hold these misconceptions. The proposed stakeholder planning tool was perceived to be feasible and helpful. Stakeholder creep can negatively affect HIT project implementations. Projects may be susceptible to stakeholder creep when clinicians/researchers hold misconceptions related to HIT organization and processes. Implementation tools, such as the proposed stakeholder checklist, could be helpful in preempting and mitigating the effect of stakeholder creep. Copyright © 2017 Elsevier B.V. All rights reserved.

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.

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

PubMed

Maguire, Bernadine; Potts, Jonathan; Fletcher, Stephen

2011-11-01

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

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.

A quantitative study of attitudes toward the research participation of adults with intellectual disability: Do stakeholders agree?

PubMed

McDonald, Katherine E; Conroy, Nicole E; Olick, Robert S

2017-12-13

Attitudes toward the research participation of adults with intellectual disability inform research policy and practice, impact interest in and support for research participation, and promote or discourage the generation of new knowledge to promote health among adults with intellectual disability. Yet we know little about these beliefs among the public and the scientific community. We quantitatively studied attitudes among adults with intellectual disability, family and friends, disability service providers, researchers, and Institutional Review Board (IRB) members. We predicted that adults with intellectual disability, and researchers would espouse views most consistent with disability rights, whereas IRB members, and to a lesser degree family, friends, and service providers, would espouse more protective views. We surveyed five hundred and twelve members of the five participant stakeholder groups on their attitudes toward the research participation of adults with intellectual disability. We found broad support for research about people with intellectual disability, though slightly more tempered support for their direct participation therein. In general, IRB members and to some extent adults with intellectual disability endorsed direct participation less than others. We also found that adults with intellectual disability strongly believed in their consent capacity. Resources should be directed toward health-related research with adults with intellectual disability, and interventions should be pursued to address ethical challenges and promote beliefs consistent with human rights. Copyright © 2017 Elsevier Inc. All rights reserved.

Stakeholders' views on granting prescribing authority to pharmacists in Nigeria: a qualitative study.

PubMed

Auta, Asa; Strickland-Hodge, Barry; Maz, Julia

2016-08-01

Background In Nigeria, only medical doctors, dentists and some nurses in primary care facilities have the legal right to prescribe medicines to patients. Patients' access to prescription medicines can be seriously affected by the shortage of prescribers leading to longer waiting times in hospitals. Objective This research was carried out to investigate stakeholders' views on granting prescribing authority to pharmacists in Nigeria. Setting The study was conducted in Nigeria. Methods Qualitative, semi-structured interviews were conducted with 43 Nigerian stakeholders including policymakers, pharmacists, doctors and patient group representatives. Transcribed interviews were entered into the QSR NVivo 10 software and analysed using a thematic approach. Main outcome measure Stakeholders' perception on the granting of prescribing authority to pharmacists in Nigeria. Results Three major themes emerged from the interviews: (1) prescribing as a logical role for pharmacists, (2) pharmacist prescribing- an opportunity or a threat and (3) the potential barriers to pharmacist prescribing. Many non-medical stakeholders including pharmacists and patient group representatives supported an extended role for pharmacists in prescribing while the majority of medical doctors including those in policy making were reluctant to do so. Generally, all stakeholders perceived that pharmacist prescribing represents an opportunity to increase patients' access to medicines, reduce doctors' workload and promote the utilisation of pharmacists' skills. However, many stakeholders including pharmacists and doctors commonly identified pharmacists' inadequate skills in diagnosis, medical resistance and shortage of pharmacists as potential barriers to the introduction of pharmacist prescribing in Nigeria. Conclusion The present study showed a split of opinion between participants who were medical doctors and those who were non-doctors in their support for pharmacist prescribing. However, all stakeholders acknowledged the potential of pharmacist prescribing to increase patients' access to medicines in Nigeria.

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.

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

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.

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.

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/

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

Shaping innovations in long-term care for stroke survivors with multimorbidity through stakeholder engagement.

PubMed

Sadler, Euan; Porat, Talya; Marshall, Iain; Hoang, Uy; Curcin, Vasa; Wolfe, Charles D A; McKevitt, Christopher

2017-01-01

Stroke, like many long-term conditions, tends to be managed in isolation of its associated risk factors and multimorbidity. With increasing access to clinical and research data there is the potential to combine data from a variety of sources to inform interventions to improve healthcare. A 'Learning Health System' (LHS) is an innovative model of care which transforms integrated data into knowledge to improve healthcare. The objective of this study is to develop a process of engaging stakeholders in the use of clinical and research data to co-produce potential solutions, informed by a LHS, to improve long-term care for stroke survivors with multimorbidity. We used a stakeholder engagement study design informed by co-production principles to engage stakeholders, including service users, carers, general practitioners and other health and social care professionals, service managers, commissioners of services, policy makers, third sector representatives and researchers. Over a 10 month period we used a range of methods including stakeholder group meetings, focus groups, nominal group techniques (priority setting and consensus building) and interviews. Qualitative data were recorded, transcribed and analysed thematically. 37 participants took part in the study. The concept of how data might drive intervention development was difficult to convey and understand. The engagement process led to four priority areas for needs for data and information being identified by stakeholders: 1) improving continuity of care; 2) improving management of mental health consequences; 3) better access to health and social care; and 4) targeting multiple risk factors. These priorities informed preliminary design interventions. The final choice of intervention was agreed by consensus, informed by consideration of the gap in evidence and local service provision, and availability of robust data. This shaped a co-produced decision support tool to improve secondary prevention after stroke for further development. Stakeholder engagement to identify data-driven solutions is feasible but requires resources. While a number of potential interventions were identified, the final choice rested not just on stakeholder priorities but also on data availability. Further work is required to evaluate the impact and implementation of data-driven interventions for long-term stroke survivors.

Shaping innovations in long-term care for stroke survivors with multimorbidity through stakeholder engagement

PubMed Central

Porat, Talya; Marshall, Iain; Hoang, Uy; Curcin, Vasa; Wolfe, Charles D. A.; McKevitt, Christopher

2017-01-01

Background Stroke, like many long-term conditions, tends to be managed in isolation of its associated risk factors and multimorbidity. With increasing access to clinical and research data there is the potential to combine data from a variety of sources to inform interventions to improve healthcare. A ‘Learning Health System’ (LHS) is an innovative model of care which transforms integrated data into knowledge to improve healthcare. The objective of this study is to develop a process of engaging stakeholders in the use of clinical and research data to co-produce potential solutions, informed by a LHS, to improve long-term care for stroke survivors with multimorbidity. Methods We used a stakeholder engagement study design informed by co-production principles to engage stakeholders, including service users, carers, general practitioners and other health and social care professionals, service managers, commissioners of services, policy makers, third sector representatives and researchers. Over a 10 month period we used a range of methods including stakeholder group meetings, focus groups, nominal group techniques (priority setting and consensus building) and interviews. Qualitative data were recorded, transcribed and analysed thematically. Results 37 participants took part in the study. The concept of how data might drive intervention development was difficult to convey and understand. The engagement process led to four priority areas for needs for data and information being identified by stakeholders: 1) improving continuity of care; 2) improving management of mental health consequences; 3) better access to health and social care; and 4) targeting multiple risk factors. These priorities informed preliminary design interventions. The final choice of intervention was agreed by consensus, informed by consideration of the gap in evidence and local service provision, and availability of robust data. This shaped a co-produced decision support tool to improve secondary prevention after stroke for further development. Conclusions Stakeholder engagement to identify data-driven solutions is feasible but requires resources. While a number of potential interventions were identified, the final choice rested not just on stakeholder priorities but also on data availability. Further work is required to evaluate the impact and implementation of data-driven interventions for long-term stroke survivors. PMID:28475606

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

PubMed

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

2017-12-19

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

Acadia National Park ITS field operational test : key informant interviews

DOT National Transportation Integrated Search

2003-03-01

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

Opinions of maternity care professionals and other stakeholders about integration of maternity care: a qualitative study in the Netherlands.

PubMed

Perdok, Hilde; Jans, Suze; Verhoeven, Corine; Henneman, Lidewij; Wiegers, Therese; Mol, Ben Willem; Schellevis, François; de Jonge, Ank

2016-07-26

This study aims to give insight into the opinions of maternity care professionals and other stakeholders on the integration of midwife-led care and obstetrician-led care and on the facilitating and inhibiting factors for integrating maternity care. Qualitative study using interviews and focus groups from November 2012 to February 2013 in the Netherlands. Seventeen purposively selected stakeholder representatives participated in individual semi-structured interviews and 21 in focus groups. One face-to-face focus group included a combined group of midwives, obstetricians and a paediatrician involved in maternity care. Two online focus groups included a group of primary care midwives and a group of clinical midwives respectively. Thematic analysis was performed using Atlas.ti. Two researchers independently coded the interview and focus group transcripts by means of a mind map and themes and relations between them were described. Three main themes were identified with regard to integrating maternity care: client-centred care, continuity of care and task shifting between professionals. Opinions differed regarding the optimal maternity care organisation model. Participants considered the current payment structure an inhibiting factor, whereas a new modified payment structure based on the actual amount of work performed was seen as a facilitating factor. Both midwives and obstetricians indicated that they were afraid to loose autonomy. An integrated maternity care system may improve client-centred care, provide continuity of care for women during labour and birth and include a shift of responsibilities between health care providers. However, differences of opinion among professionals and other stakeholders with regard to the optimal maternity care organisation model may complicate the implementation of integrated care. Important factors for a successful implementation of integrated maternity care are an appropriate payment structure and maintenance of the autonomy of professionals.

Working with State Health Departments on Emerging Issues in Maternal and Child Health: Immediate Postpartum Long-Acting Reversible Contraceptives.

PubMed

Kroelinger, Charlan D; Waddell, Lisa F; Goodman, David A; Pliska, Ellen; Rudolph, Claire; Ahmed, Einas; Addison, Donna

2015-09-01

Immediate postpartum long-acting reversible contraceptives (LARC) are highly effective in preventing unintended pregnancy. State health departments are in the process of implementing a systems change approach to better apply policies supporting the use of immediate postpartum LARC. Beginning in 2014, a group of national organizations, federal agencies, and six states have convened a LARC Learning Community to share strategies and best practices in immediate postpartum LARC policy development and implementation. Community activities consist of in-person meetings and a webinar series as forums to discuss systems change. The Learning Community identified eight domains for discussion and development of resources: training, pay streams, stocking and supply, consent, outreach, stakeholder partnerships, service location, and data and surveillance. The community is currently developing resource materials and guidance for use by other state health departments. To effectively implement policies on immediate postpartum LARC, states must engage a number of stakeholders in the process, raise awareness of the challenges to implementation, and communicate strategies across agencies during policy development.

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

A Doctor is in the House: Stakeholder Focus Groups About Expanded Scope of Practice of Community Psychiatrists.

PubMed

Mangurian, Christina; Modlin, Chelsea; Williams, Lindsey; Essock, Susan; Riano, Nicholas S; Shumway, Martha; Newcomer, John W; Dilley, James W; Schillinger, Dean

2017-11-28

We sought to understand stakeholder perspectives on barriers to metabolic screening for people with severe mental illness. We additionally assessed the feasibility of expanding psychiatrists' scope of practice to include treatment of cardiometabolic abnormalities. We conducted four focus groups among patients with severe mental illness, community psychiatrists, primary care providers, and public health administrators. Focus group transcripts were thematically analyzed. Three domains emerged: challenges with patient navigation of the complex health care system, problem list prioritization difficulties, and concern that treatment of cardiometabolic abnormalities were beyond the scope of practice of psychiatrists. Stakeholders agreed that navigating the health care system was challenging for this population and led to undertreatment of cardiometabolic risk factors. Expansion of psychiatrists' scope of practice within community mental health appears acceptable to patients and may be a mechanism to improve cardiometabolic care among people with severe mental illness.

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.

Constraints to microbial food safety policy: opinions from stakeholder groups along the farm to fork continuum.

PubMed

Sargeant, J M; Ramsingh, B; Wilkins, A; Travis, R G; Gavrus, D; Snelgrove, J W

2007-01-01

This exploratory qualitative study was conducted to identify constraints to microbial food safety policy in Canada and the USA from the perspective of stakeholder groups along the farm to fork continuum. Thirty-seven stakeholders participated in interviews or a focus group where semi-structured questions were used to facilitate discussion about constraints to policy development and implementation. An emergent grounded theory approach was used to determine themes and concepts that arose from the data (versus fitting the data to a hypothesis or a priori classification). Despite the plurality of stakeholders and the range of content expertise, participant perceptions emerged into five common themes, although, there were often disagreements as to the positive or negative attributes of specific concepts. The five themes included challenges related to measurement and objectives of microbial food safety policy goals, challenges arising from lack of knowledge, or problems with communication of knowledge coupled with current practices, beliefs and traditions; the complexity of the food system and the plurality of stakeholders; the economics of producing safe food and the limited resources to address the problem; and, issues related to decision-making and policy, including ownership of the problem and inappropriate inputs to the decision-making process. Responsibilities for food safety and for food policy failure were attributed to all stakeholders along the farm to fork continuum. While challenges regarding the biology of food safety were identified as constraints, a broader range of policy inputs encompassing social, economic and political considerations were also highlighted as critical to the development and implementation of effective food safety policy. Strategies to address these other inputs may require new, transdisciplinary approaches as an adjunct to the traditional science-based risk assessment model.

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.

Stakeholders' attitude to genetically modified foods and medicine.

PubMed

Amin, Latifah; Jahi, Jamaluddin Md; Nor, Abd Rahim Md

2013-01-01

Public acceptance of genetically modified (GM) foods has to be adequately addressed in order for their potential economic and social benefits to be realized. The objective of this paper is to assess the attitude of the Malaysian public toward GM foods (GM soybean and GM palm oil) and GM medicine (GM insulin). A survey was carried out using self-constructed multidimensional instrument measuring attitudes towards GM products. The respondents (n = 1017) were stratified according to stakeholders' groups in the Klang Valley region. Results of the survey show that the overall attitude of the Malaysian stakeholders towards GM products was cautious. Although they acknowledged the presence of moderate perceived benefits associated with GM products surveyed and were moderately encouraging of them, they were also moderately concerned about the risks and moral aspects of the three GM products as well as moderately accepting the risks. Attitudes towards GM products among the stakeholders were found to vary not according to the type of all GM applications but rather depend on the intricate relationships between the attitudinal factors and the type of gene transfers involved. Analyses of variance showed significant differences in the six dimensions of attitude towards GM products across stakeholders' groups.

Stakeholders' Attitude to Genetically Modified Foods and Medicine

PubMed Central

Md Jahi, Jamaluddin; Md Nor, Abd Rahim

2013-01-01

Public acceptance of genetically modified (GM) foods has to be adequately addressed in order for their potential economic and social benefits to be realized. The objective of this paper is to assess the attitude of the Malaysian public toward GM foods (GM soybean and GM palm oil) and GM medicine (GM insulin). A survey was carried out using self-constructed multidimensional instrument measuring attitudes towards GM products. The respondents (n = 1017) were stratified according to stakeholders' groups in the Klang Valley region. Results of the survey show that the overall attitude of the Malaysian stakeholders towards GM products was cautious. Although they acknowledged the presence of moderate perceived benefits associated with GM products surveyed and were moderately encouraging of them, they were also moderately concerned about the risks and moral aspects of the three GM products as well as moderately accepting the risks. Attitudes towards GM products among the stakeholders were found to vary not according to the type of all GM applications but rather depend on the intricate relationships between the attitudinal factors and the type of gene transfers involved. Analyses of variance showed significant differences in the six dimensions of attitude towards GM products across stakeholders' groups. PMID:24381520

Patient-centered priorities for improving medication management and adherence.

PubMed

McMullen, Carmit K; Safford, Monika M; Bosworth, Hayden B; Phansalkar, Shobha; Leong, Amye; Fagan, Maureen B; Trontell, Anne; Rumptz, Maureen; Vandermeer, Meredith L; Brinkman, William B; Burkholder, Rebecca; Frank, Lori; Hommel, Kevin; Mathews, Robin; Hornbrook, Mark C; Seid, Michael; Fordis, Michael; Lambert, Bruce; McElwee, Newell; Singh, Jasvinder A

2015-01-01

The Centers for Education and Research on Therapeutics convened a workshop to examine the scientific evidence on medication adherence interventions from the patient-centered perspective and to explore the potential of patient-centered medication management to improve chronic disease treatment. Patients, providers, researchers, and other stakeholders (N = 28) identified and prioritized ideas for future research and practice. We analyzed stakeholder voting on priorities and reviewed themes in workshop discussions. Ten priority areas emerged. Three areas were highly rated by all stakeholder groups: creating tools and systems to facilitate and evaluate patient-centered medication management plans; developing training on patient-centered prescribing for providers; and increasing patients' knowledge about medication management. However, priorities differed across stakeholder groups. Notably, patients prioritized using peer support to improve medication management while researchers did not. Engaging multiple stakeholders in setting a patient-centered research agenda and broadening the scope of adherence interventions to include other aspects of medication management resulted in priorities outside the traditional scope of adherence research. Workshop participants recognized the potential benefits of patient-centered medication management but also identified many challenges to implementation that require additional research and innovation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

User testing and stakeholder feedback contributed to the development of understandable and useful Summary of Findings tables for Cochrane reviews.

PubMed

Rosenbaum, Sarah E; Glenton, Claire; Nylund, Hilde Kari; Oxman, Andrew D

2010-06-01

To develop a Summary of Findings (SoF) table for use in Cochrane reviews that is understandable and useful for health professionals, acceptable to Cochrane Collaboration stakeholders, and feasible to implement. We gathered stakeholder feedback on the format and content of an SoF table from an advisory group of more than 50 participants and their constituencies through e-mail consultations. We conducted user tests using a think-aloud protocol method, collecting feedback from 21 health professionals and researchers in Norway and the UK. We analyzed the feedback, defined problem areas, and generated new solutions in brainstorming workshops. Stakeholders were concerned about precision in the data representation and about production feasibility. User testing revealed unexpected comprehension problems, mainly confusion about what the different numbers referred to (class reference). Resolving the tension between achieving table precision and table simplicity became the main focus of the working group. User testing led to a table more useful and understandable for clinical audiences. We arrived at an SoF table that was acceptable to the stakeholders and in principle feasible to implement technically. Some challenges remain, including presenting continuous outcomes and technical/editorial implementation.

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

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.

Stakeholder Perspectives on Creating and Maintaining Trust in Community-Academic Research Partnerships.

PubMed

Frerichs, Leah; Kim, Mimi; Dave, Gaurav; Cheney, Ann; Hassmiller Lich, Kristen; Jones, Jennifer; Young, Tiffany L; Cene, Crystal W; Varma, Deepthi S; Schaal, Jennifer; Black, Adina; Striley, Catherine W; Vassar, Stefanie; Sullivan, Greer; Cottler, Linda B; Brown, Arleen; Burke, Jessica G; Corbie-Smith, Giselle

2017-02-01

Community-academic research partnerships aim to build stakeholder trust in order to improve the reach and translation of health research, but there is limited empirical research regarding effective ways to build trust. This multisite study was launched to identify similarities and differences among stakeholders' perspectives of antecedents to trust in research partnerships. In 2013-2014, we conducted a mixed-methods concept mapping study with participants from three major stakeholder groups who identified and rated the importance of different antecedents of trust on a 5-point Likert-type scale. Study participants were community members ( n = 66), health care providers ( n = 38), and academic researchers ( n = 44). All stakeholder groups rated "authentic communication" and "reciprocal relationships" the highest in importance. Community members rated "communication/methodology to resolve problems" ( M = 4.23, SD = 0.58) significantly higher than academic researchers ( M = 3.87, SD = 0.67) and health care providers ( M = 3.89, SD = 0.62; p < .01) and had different perspectives regarding the importance of issues related to "sustainability." The importance of communication and relationships across stakeholders indicates the importance of colearning processes that involve the exchange of knowledge and skills. The differences uncovered suggest specific areas where attention and skill building may be needed to improve trust within partnerships. More research on how partnerships can improve communication specific to problem solving and sustainability is merited.

Engaging stakeholders and target groups in prioritising a public health intervention: the Creating Active School Environments (CASE) online Delphi study

PubMed Central

Morton, Katie L; Atkin, Andrew J; Corder, Kirsten; Suhrcke, Marc; Turner, David; van Sluijs, Esther M F

2017-01-01

Objectives Stakeholder engagement and public involvement are considered as integral to developing effective public health interventions and is encouraged across all phases of the research cycle. However, limited guidelines and appropriate tools exist to facilitate stakeholder engagement—especially during the intervention prioritisation phase. We present the findings of an online ‘Delphi’ study that engaged stakeholders (including young people) in the process of prioritising secondary school environment-focused interventions that aim to increase physical activity. Setting Web-based data collection using an online Delphi tool enabling participation of geographically diverse stakeholders. Participants 37 stakeholders participated, including young people (age 13–16 years), parents, teachers, public health practitioners, academics and commissioners; 33 participants completed both rounds. Primary and secondary outcome measures Participants were asked to prioritise a (short-listed) selection of school environment-focused interventions (eg, standing desks, outdoor design changes) based on the criteria of ‘reach’, ‘equality’, ‘acceptability’, ‘feasibility’, ‘effectiveness’ and ‘cost’. Participants were also asked to rank the criteria and the effectiveness outcomes (eg, physical activity, academic achievement, school enjoyment) from most to least important. Following feedback along with any new information provided, participants completed round 2 4 weeks later. Results The intervention prioritisation process was feasible to conduct and comments from participants indicated satisfaction with the process. Consensus regarding intervention strategies was achieved among the varied groups of stakeholders, with ‘active lessons’ being the favoured approach. Participants ranked ‘mental health and well-being’ as the most important outcome followed by ‘enjoyment of school’. The most important criteria was ‘effectiveness’, followed by ‘feasibility’. Conclusions This novel approach to engaging a wide variety of stakeholders in the research process was feasible to conduct and acceptable to participants. It also provided insightful information relating to how stakeholders prioritise interventions. The approach could be extended beyond the specific project to be a useful tool for researchers and practitioners. PMID:28087549

Legitimacy of hospital reconfiguration: the controversial downsizing of Kidderminster hospital.

PubMed

Oborn, Eivor

2008-04-01

This paper examines the contested organizational legitimacy of hospital reconfiguration, which continues to be a central issue in health care management. A qualitative study which focuses on the controversial downsizing of Kidderminster Hospital, a highly publicized landmark case of district general hospital closure. Rhetorical strategies are analysed to examine how legitimacy was constructed by stakeholder groups and how these strategies were used to support or resist change. Stakeholders promoting change legitimized re-organization pragmatically and morally arguing the need for centralization as a rational necessity. Stakeholders resisting change argued for cognitive and moral legitimacy in current service arrangements, contrasting local versus regionalized aspects of safety and provision. Groups managed to talk past each other, failing to establish a dialogue, which led to significant conflict and political upheaval. Stakeholders value hospitals in different ways and argue for diverse accounts of legitimacy. Broader discourses of medical science and democratic participation were drawn into rhetorical texts concerning regionalization to render them more powerful.

Integrated wetland management: an analysis with group model building based on system dynamics model.

PubMed

Chen, Hsin; Chang, Yang-Chi; Chen, Kung-Chen

2014-12-15

The wetland system possesses diverse functions such as preserving water sources, mediating flooding, providing habitats for wildlife and stabilizing coastlines. Nonetheless, rapid economic growth and the increasing population have significantly deteriorated the wetland environment. To secure the sustainability of the wetland, it is essential to introduce integrated and systematic management. This paper examines the resource management of the Jiading Wetland by applying group model building (GMB) and system dynamics (SD). We systematically identify local stakeholders' mental model regarding the impact brought by the yacht industry, and further establish a SD model to simulate the dynamic wetland environment. The GMB process improves the stakeholders' understanding about the interaction between the wetland environment and management policies. Differences between the stakeholders' perceptions and the behaviors shown by the SD model also suggest that our analysis would facilitate the stakeholders to broaden their horizons and achieve consensus on the wetland resource management. Copyright © 2014 Elsevier Ltd. All rights reserved.

A practical approach to communicating benefit-risk decisions of medicines to stakeholders.

PubMed

Leong, James; Walker, Stuart; Salek, Sam

2015-01-01

The importance of a framework for a systematic structured assessment of the benefits and risks has been established, but in addition, it is necessary that the benefit-risk decisions and the processes to derive those decisions are documented and communicated to various stakeholders for accountability. Hence there is now a need to find appropriate tools to enhance communication between regulators and other stakeholders, in a manner that would uphold transparency, consistency and standards. A retrospective, non-comparative study was conducted to determine the applicability and practicality of a summary template in documenting benefit-risk assessment and communicating benefit-risk balance and conclusions for reviewers to other stakeholders. The benefit-risk (BR) Summary Template and its User Manual was evaluated by 12 reviewers within a regulatory agency in Singapore, the Health Sciences Authority (HSA). The BR Summary Template was found to be adequate in documenting benefits, risks, relevant summaries and conclusions, while the User Manual was useful in guiding the reviewer in completing the template. The BR Summary Template was also considered a useful tool for communicating benefit-risk decisions to a variety of stakeholders. The use of a template may be of value for the communicating benefit-risk assessment of medicines to stakeholders.

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

NASA Astrophysics Data System (ADS)

Verbrugge, Laura; van den Born, Riyan

2015-04-01

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

Barriers to and facilitators of implementing shared decision making and decision support in a paediatric hospital: A descriptive study.

PubMed

Boland, Laura; McIsaac, Daniel I; Lawson, Margaret L

2016-04-01

To explore multiple stakeholders' perceived barriers to and facilitators of implementing shared decision making and decision support in a tertiary paediatric hospital. An interpretive descriptive qualitative study was conducted using focus groups and interviews to examine senior hospital administrators', clinicians', parents' and youths' perceived barriers to and facilitators of shared decision making and decision support implementation. Data were analyzed using inductive thematic analysis. Fifty-seven stakeholders participated. Six barrier and facilitator themes emerged. The main barrier was gaps in stakeholders' knowledge of shared decision making and decision support. Facilitators included compatibility between shared decision making and the hospital's culture and ideal practices, perceptions of positive patient and family outcomes associated with shared decision making, and positive attitudes regarding shared decision making and decision support. However, youth attitudes regarding the necessity and usefulness of a decision support program were a barrier. Two themes were both a barrier and a facilitator. First, stakeholder groups were uncertain which clinical situations are suitable for shared decision making (eg, new diagnoses, chronic illnesses, complex decisions or urgent decisions). Second, the clinical process may be hindered if shared decision making and decision support decrease efficiency and workflow; however, shared decision making may reduce repeat visits and save time over the long term. Specific knowledge translation strategies that improve shared decision making knowledge and match specific barriers identified by each stakeholder group may be required to promote successful shared decision making and decision support implementation in the authors' paediatric hospital.

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.

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.

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

PubMed

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

2009-07-24

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

Exploring the effectiveness of sustainable water management structures in the Upper Pungwe river basin

NASA Astrophysics Data System (ADS)

Nyikadzino, B.; Chibisa, P.; Makurira, H.

The study endeavoured to assess the effectiveness of stakeholder structures and their participation in sustainable water resources management in the Upper Pungwe river basin shared by Zimbabwe and Mozambique. The study sought to assess the level and effectiveness of stakeholder, gender and the vulnerable groups representation in sustainable water resources management as well as the whole stakeholder participation process. The study employed both qualitative and quantitative methods for data collection and analysis. Sampling data was obtained from 15 stakeholder representatives (councillors) constituting Pungwe Subcatchment Council, 30 water users ranging from small scale to large scale users and professionals in water resources management. Two different questionnaires and three structured interviews were administered during the study. Water permit database, financial reports and other source documents were also analysed. The study established that the sustainability and effectiveness of stakeholder structures and their participation in water resources management is being compromised by lack of stakeholder awareness. Water utilisation is very high in the subcatchment (99%) while women participation is still low (20%). The study therefore recommends the use of quotas for the participation of women in stakeholder structures. Stakeholder structures are encouraged to intensify stakeholder awareness on issues of river protection, efficient water use and pollution control. Further research is recommended to be carried out on the effectiveness of stakeholder structures in combating water pollution and enhancing river protection.

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.

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.

Strategies for Sharing Scientific Research on Sea Level Rise: Suggestions from Stakeholder Focus Groups

NASA Astrophysics Data System (ADS)

DeLorme, D.; Hagen, S. C.; Stephens, S. H.

2013-12-01

This presentation reports results of focus groups with coastal resource managers on suggestions for effectively sharing sea level rise (SLR) scientific research with the public and other target audiences. The focus groups were conducted during three annual stakeholder workshops as an important and innovative component of an ongoing five-year multi-disciplinary NOAA-funded project, Ecological Effects of Sea Level Rise in the Northern Gulf of Mexico (EESLR-NGOM). The EESLR-NGOM project is assessing SLR risks to the natural and built environment along the Mississippi, Alabama, and Florida Panhandle coasts. The purpose was to engage stakeholders (e.g., coastal resource managers) in helping target, translate, and tailor the EESLR-NGOM project's scientific findings and emerging products so they are readily accessible, understandable, and useful. The focus groups provided insight into stakeholders' SLR informational and operational needs, solicited input on the project's products, and gathered suggestions for public communication and outreach. A total of three ninety-minute focus groups of between eight and thirteen participants each were conducted at annual workshops in Alabama, Florida, and Mississippi. The moderator asked a series of open-ended questions about SLR-related topics using an interview guide and encouraged participant interaction. All focus group audio-recordings were transcribed, and analyzed by carefully reading the 102 total pages of transcript data and identifying patterns and themes. Participants thought outreach about SLR impact and the EESLR-NGOM project scientific research/products was vital and acknowledged various communication challenges and opportunities. They identified three target audiences (local officials, general public, coastal resource managers themselves) that likely require different educational efforts and tools. Participants felt confident the EESLR-NGOM project products will benefit their resource planning and decision making and believed the project will have positive implications for diverse vested entities. Gaining public and local leader support was considered crucial in fostering funding and favorable policies with respect to project goals. However, it was expected that certain target audiences will need to be better educated on ecological aspects of the project and convinced of its significance for this to be achieved. Suggested formats for the EESLR-NGOM research results included maps with precision and flexibility for adjustments over time, across geographic domains, and for different levels of user sophistication, as well as simplified presentations that can be readily shared. There was emphasis on visuals and demonstrations for accessibility and engagement by multiple audiences. While participants thought handouts, brochures, and graphical illustrations would be effective, they also advocated using new digital media. Further, participants advised that time frames and language be adjusted to resonate with target audiences, especially in communicating risk. Branding a unique identity for the EESLR-NGOM project/products was encouraged. Message consistency was considered key for optimal outcomes. The ongoing feedback has resulted in year-by-year refinements of the research process and scientific product development, which has been central to gaining confidence of the target audiences.

Academic requirements for Certificate of Completion of Training in surgical training: Consensus recommendations from the Association of Surgeons in Training/National Research Collaborative Consensus Group.

PubMed

Lee, Mathew J; Bhangu, A; Blencowe, Natalie S; Nepogodiev, D; Gokani, Vimal J; Harries, Rhiannon L; Akinfala, M; Ali, O; Allum, W; Bosanquet, D C; Boyce, K; Bradburn, M; Chapman, S J; Christopher, E; Coulter, I; Dean, B J F; Dickfos, M; El Boghdady, M; Elmasry, M; Fleming, S; Glasbey, J; Healy, C; Kasivisvanathan, V; Khan, K S; Kolias, A G; Lee, S M; Morton, D; O'Beirne, J; Sinclair, P; Sutton, P A

2016-11-01

Surgical trainees are expected to demonstrate academic achievement in order to obtain their certificate of completion of training (CCT). These standards are set by the Joint Committee on Surgical Training (JCST) and specialty advisory committees (SAC). The standards are not equivalent across all surgical specialties and recognise different achievements as evidence. They do not recognise changes in models of research and focus on outcomes rather than process. The Association of Surgeons in Training (ASiT) and National Research Collaborative (NRC) set out to develop progressive, consistent and flexible evidence set for academic requirements at CCT. A modified-Delphi approach was used. An expert group consisting of representatives from the ASiT and the NRC undertook iterative review of a document proposing changes to requirements. This was circulated amongst wider stakeholders. After ten iterations, an open meeting was held to discuss these proposals. Voting on statements was performed using a 5-point Likert Scale. Each statement was voted on twice, with ≥80% of votes in agreement meaning the statement was approved. The results of this vote were used to propose core and optional academic requirements for CCT. Online discussion concluded after ten rounds. At the consensus meeting, statements were voted on by 25 delegates from across surgical specialties and training-grades. The group strongly favoured acquisition of 'Good Clinical Practice' training and research methodology training as CCT requirements. The group agreed that higher degrees, publications in any author position (including collaborative authorship), recruiting patients to a study or multicentre audit and presentation at a national or international meeting could be used as evidence for the purpose of CCT. The group agreed on two essential 'core' requirements (GCP and methodology training) and two of a menu of four 'additional' requirements (publication with any authorship position, presentation, recruitment of patients to a multicentre study and completion of a higher degree), which should be completed in order to attain CCT. This approach has engaged stakeholders to produce a progressive set of academic requirements for CCT, which are applicable across surgical specialties. Flexibility in requirements whilst retaining a high standard of evidence is desirable. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Dams and Salmon: A Northwest Choice

ERIC Educational Resources Information Center

Tucker, Michael; Tromley, Cheryl L.

2005-01-01

This article describes an experiential exercise in which participants assume the roles of various stakeholder groups in the controversy surrounding possible dam removal to revive northwestern U. S. salmon populations. The role-play (a) increases environmental awareness in the context of the competing interests various stakeholders have in our…

Business resiliency and stakeholder management.

PubMed

Carey, Noel; Perry, Tony

2014-01-01

The authors facilitated separate round table discussions at the City and Financial Conference in London on 29th January, 2014. The theme of these discussions was business resiliency and stakeholder management. This topic attracted the largest group of all the breakout sessions, as the issue continues to generate much interest across the business resilience community. In this paper, the authors summarise the discussions held at the event and add their own insights into the subject of who are stakeholders, and the different means and messages to communicate to them.

Making the Middle Count

PubMed Central

Esbenshade, Angie

2015-01-01

This article discusses three ways in which dramatic improvements in middle flow, or examination-to-disposition time, can be driven by emergency department (ED) nursing leadership. By operationalizing a “results pending” area, low-acuity patients who are unlikely to be admitted can await diagnostic results or be actively monitored by a dedicated nurse, ED rooms and beds may be reserved for higher acuity patients. Monthly operational stakeholder meetings can provide a consistent opportunity to track, monitor, and improve flow while also celebrating successes and identifying needed performance improvements based on objective metrics for shared goals. Internal customer rounding is a process that serves as effective follow-up from the stakeholder meeting to ensure aligned behaviors to meet identified goals. Frequency of rounding is identified during the stakeholder meeting. By using these three tools, ED stakeholders can effectively focus on solutions instead of barriers to improving middle flow. PMID:25569321

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

PubMed

Jacobson, Miriam R; Azzam, Tarek

2018-06-01

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

Stakeholder involvement facilitates decision making for UK nuclear accident recovery.

PubMed

Alexander, C; Burt, R; Nisbet, A F

2005-01-01

The importance of major stakeholders participating in the formulation of strategies for maintaining food safety and agricultural production following a nuclear accident has been successfully demonstrated by the UK 'Agriculture and Food Countermeasures Working Group' (AFCWG). The organisation, membership and terms of reference of the group are described. Details are given of the achievements of the AFCWG and its sub-groups, which include agreeing management options that would be included in a recovery handbook for decision-makers in the UK and tackling the disposal of large volumes of contaminated milk, potentially resulting from a nuclear accident.

Youth Apprenticeship Experiences in Wisconsin: A Stakeholder-Based Evaluation.

ERIC Educational Resources Information Center

Scribner, Jay Paredes; Wakelyn, David

The experiences of stakeholders in Wisconsin's youth apprenticeship programs are used to provide insights for other policy-makers and educators contemplating or currently implementing youth apprenticeship programs. In-depth interviews, focus group interviews, and surveys with more than 100 students, parents, employers, and instructors were used to…

Reducing the Observed Curriculum Perception Gaps between Stakeholders

ERIC Educational Resources Information Center

Chang, Amy; Churyk, Natalie Tatiana; Yu, Shaokun

2015-01-01

Developing a vibrant and relevant accounting curriculum requires involvement of many stakeholders such as interns, alumni, and firms. Each has a distinct perspective regarding the strengths and weaknesses of accounting education. Discussion of perception gaps between the three groups and the importance of aligning these perceptions are presented.…

Empowerment through public involvement functional interactive planning (PIFIP)

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

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

1993-05-01

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

What Do Stakeholders Know about School Library Programs? Results of a Focus Group Evaluation

ERIC Educational Resources Information Center

Everhart, Nancy

2014-01-01

Supporting the "Infrastructure Needs of 21st Century School Library Programs," also known as the Pennsylvania School Library Project, was a one-year project conducted in Pennsylvania to better identify and understand what stakeholders--teachers, administrators, parents, school and community leaders, and education associations--expect…

Discrepant Stakeholder Perspectives on Graduate Employability Strategies

ERIC Educational Resources Information Center

Kinash, Shelley; Crane, Linda; Judd, Madelaine-Marie; Knight, Cecily

2016-01-01

A literature review identified 12 strategies that have been empirically linked to improvements in graduate employability. A survey methodology was used to investigate self-reported use and/or perspectives on these strategies among four stakeholder groups. The following questions were asked: to students--What strategies are you using to improve…

Towards Typology of Stakeholders: A Case of Lithuanian Higher Education

ERIC Educational Resources Information Center

Švaikauskiene, Simona; Mikulskiene, Birute

2017-01-01

The purpose of this paper is to explore internal management, advocacy and partnerships of interest groups with the aim of representing their interests in public policy formation with a view to developing a stakeholder typology. This qualitative study involves eight in-depth, semi-structured interviews with representatives from stakeholder…

Engaging Watershed Stakeholders for Cost-Effective Environmental Management Planning with "Watershed Manager"

ERIC Educational Resources Information Center

Williams, Jeffery R.; Smith, Craig M.; Roe, Josh D.; Leatherman, John C.; Wilson, Robert M.

2012-01-01

"Watershed Manager" is a spreadsheet-based model that is used in extension education programs for learning about and selecting cost-effective watershed management practices to reduce soil, nitrogen, and phosphorus losses from cropland. It can facilitate Watershed Restoration and Protection Strategy (WRAPS) stakeholder groups' development…

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…

Serving the Needs of Various Groups of Stakeholders.

ERIC Educational Resources Information Center

Geva-May, Iris; Peretz, Hannah

1991-01-01

The extent to which evaluation results answer different stakeholders' needs was explored in the evaluation of a business English course at Van Leer Institute for the Development of Executive Assistants in Tel-Aviv (Israel), using diagnostic tests. Students (n=52), teachers, curriculum team, and administrators could use the evaluation results. (SLD)

Integrating stakeholder input into water policy development and analysis

USDA-ARS?s Scientific Manuscript database

Agricultural water use is becoming an issue in much of the South due to population growth. Results of projects evaluating the impacts of conservation strategies aimed at reallocating or extending the life of water supplies are being met with great skepticism by stakeholder groups. In order to gain a...

Tools for Achieving TQE.

ERIC Educational Resources Information Center

Latta, Raymond F.; Downey, Carolyn J.

This book presents a wide array of sophisticated problem-solving tools and shows how to use them in a humanizing way that involves all stakeholders in the process. Chapter 1 develops the rationale for educational stakeholders to consider quality tools. Chapter 2 highlights three quality group-process tools--brainstorming, the nominal group…

75 FR 47606 - Strategic Plan for Consumer Education via Cooperative Agreement (U18)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-06

... or quantitative research with stakeholders and meetings with stakeholder groups and consumer experts... and resulting from an extensive consumer research process. In 2007, PFSE joined with USDA to create... responsibilities of FDA. B. Research Objectives PFSE supports a large, complex, and multi-faceted consumer food...

Operating a Distance Learning Module within an Undergraduate Work Placement: Some Reflections.

ERIC Educational Resources Information Center

Gammie, Elizabeth; Gammie, Bob; Duncan, Fiona

2002-01-01

A distance learning module on auditing was implemented for accounting students on a 1-year full-time work placement. Review of stakeholder focus groups showed that they considered the module innovative; there were concerns about standards and equity. Initial groundwork with stakeholders, especially professional organizations and external…

Stakeholder Support for School Food Policy Expansions

ERIC Educational Resources Information Center

Pettigrew, Simone; Pescud, Melanie; Donovan, Robert J.

2012-01-01

The aim of this study was to assess the extent to which parents and school-based stakeholders (principals, teachers, canteen managers and Parents & Citizen Committee presidents) are supportive of potential expansions to a new school food policy. Eight additional policy components elicited in preliminary focus groups with parents and 19 additional…

Stakeholders' Perception of Sustainability Orientation within a Major Romanian University

ERIC Educational Resources Information Center

Dabija, Dan-Cristian; Postelnicu, Catalin; Dinu, Vasile; Mihaila, Alin

2017-01-01

Purpose: The research attempts to aim to evaluate the perception that different stakeholder groups have of one of the largest and most important Romanian university with respect to its sustainability orientation. The exploratory empirical research reveals some important aspects which must be closely pursued and properly implemented by the…

How to Develop a Logic Model for Districtwide Family Engagement Strategies

ERIC Educational Resources Information Center

Westmoreland, Helen; Lopez, M. Elena; Rosenberg, Heidi

2009-01-01

For family engagement to improve student learning, a wide range of stakeholders--from parents to principals to teachers--must share responsibility in developing, implementing, and assessing their school district's family engagement strategy. In order to help each of these stakeholder groups define their roles, superintendents and central…

Transparency in Canadian public drug advisory committees.

PubMed

Rosenberg-Yunger, Zahava R S; Bayoumi, Ahmed M

2014-11-01

Transparency in health care resource allocation decisions is a criterion of a fair process. We used qualitative methods to explore transparency across 11 Canadian drug advisory committees. We developed seven criteria to assess transparency (disclosure of members' names, disclosure of membership selection criteria, disclosure of conflict of interest guidelines and members' conflicts, public posting of decisions not to fund drugs, public posting of rationales for decisions, stakeholder input, and presence of an appeals mechanism) and two sub-criteria for when rationales were posted (direct website link and readability). We interviewed a purposeful sample of key informants who were conversant in English and a current or past member of either a committee or a stakeholder group. We analyzed data using a thematic approach. Interviewing continued until saturation was reached. We examined documents from 10 committees and conducted 27 interviews. The median number of criteria addressed by committees was 2 (range 0-6). Major interview themes included addressing: (1) accessibility issues, including stakeholders' degree of access to the decision making process and appeal mechanisms; (2) communication issues, including improving internal and external communication and public access to information; and (3) confidentiality issues, including the use of proprietary evidence. Most committees have some mechanisms to address transparency but none had a fully transparent process. The most important ways to improve transparency include creating formal appeal mechanisms, improving communication, and establishing consistent rules about the use of, and public access to, proprietary evidence. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Using concept mapping to design an indicator framework for addiction treatment centres.

PubMed

Nabitz, Udo; van Den Brink, Wim; Jansen, Paul

2005-06-01

The objective of this study is to determine an indicator framework for addiction treatment centres based on the demands of stakeholders and in alignment with the European Foundation for Quality Management (EFQM) Excellence Model. The setting is the Jellinek Centre based in Amsterdam, the Netherlands, which serves as a prototype for an addiction treatment centre. Concept mapping was used in the construction of the indicator framework. During the 1-day workshop, 16 stakeholders generated, prioritized and sorted 73 items concerning quality and performance. Multidimensional scaling and cluster analysis was applied in constructing a framework consisting of two dimensions and eight clusters. The horizontal axis of the indicator framework is named 'Organization' and has two poles, namely, 'Processes' and 'Results'. The vertical axis is named ' Task' and the poles are named 'Efficient treatment' and 'Prevention programs'. The eight clusters in the two-dimensional framework are arranged in the following, prioritized sequence: 'Efficient treatment network', 'Effective service', ' Target group', 'Quality of life', 'Efficient service', 'Knowledge transfer', 'Reducing addiction related problems', and 'Prevention programs'. The most important items in the framework are: 'patients are satisfied with their treatment', 'early interventions', and 'efficient treatment chain'. The indicator framework aligns with three clusters of the results criteria of the EFQM Excellence Model. It is based on the stakeholders' perspectives and is believed to be specific for addiction treatment centres. The study demonstrates that concept mapping is a suitable strategy for generating indicator frameworks.

Evaluation Framework for Telemedicine Using the Logical Framework Approach and a Fishbone Diagram

PubMed Central

2015-01-01

Objectives Technological advances using telemedicine and telehealth are growing in healthcare fields, but the evaluation framework for them is inconsistent and limited. This paper suggests a comprehensive evaluation framework for telemedicine system implementation and will support related stakeholders' decision-making by promoting general understanding, and resolving arguments and controversies. Methods This study focused on developing a comprehensive evaluation framework by summarizing themes across the range of evaluation techniques and organized foundational evaluation frameworks generally applicable through studies and cases of diverse telemedicine. Evaluation factors related to aspects of information technology; the evaluation of satisfaction of service providers and consumers, cost, quality, and information security are organized using the fishbone diagram. Results It was not easy to develop a monitoring and evaluation framework for telemedicine since evaluation frameworks for telemedicine are very complex with many potential inputs, activities, outputs, outcomes, and stakeholders. A conceptual framework was developed that incorporates the key dimensions that need to be considered in the evaluation of telehealth implementation for a formal structured approach to the evaluation of a service. The suggested framework consists of six major dimensions and the subsequent branches for each dimension. Conclusions To implement telemedicine and telehealth services, stakeholders should make decisions based on sufficient evidence in quality and safety measured by the comprehensive evaluation framework. Further work would be valuable in applying more comprehensive evaluations to verify and improve the comprehensive framework across a variety of contexts with more factors and participant group dimensions. PMID:26618028

Evaluation Framework for Telemedicine Using the Logical Framework Approach and a Fishbone Diagram.

PubMed

Chang, Hyejung

2015-10-01

Technological advances using telemedicine and telehealth are growing in healthcare fields, but the evaluation framework for them is inconsistent and limited. This paper suggests a comprehensive evaluation framework for telemedicine system implementation and will support related stakeholders' decision-making by promoting general understanding, and resolving arguments and controversies. This study focused on developing a comprehensive evaluation framework by summarizing themes across the range of evaluation techniques and organized foundational evaluation frameworks generally applicable through studies and cases of diverse telemedicine. Evaluation factors related to aspects of information technology; the evaluation of satisfaction of service providers and consumers, cost, quality, and information security are organized using the fishbone diagram. It was not easy to develop a monitoring and evaluation framework for telemedicine since evaluation frameworks for telemedicine are very complex with many potential inputs, activities, outputs, outcomes, and stakeholders. A conceptual framework was developed that incorporates the key dimensions that need to be considered in the evaluation of telehealth implementation for a formal structured approach to the evaluation of a service. The suggested framework consists of six major dimensions and the subsequent branches for each dimension. To implement telemedicine and telehealth services, stakeholders should make decisions based on sufficient evidence in quality and safety measured by the comprehensive evaluation framework. Further work would be valuable in applying more comprehensive evaluations to verify and improve the comprehensive framework across a variety of contexts with more factors and participant group dimensions.

Setting objectives for managing Key deer

USGS Publications Warehouse

Diefenbach, Duane R.; Wagner, Tyler; Stauffer, Glenn E.

2014-01-01

The U.S. Fish and Wildlife Service (FWS) is responsible for the protection and management of Key deer (Odocoileus virginianus clavium) because the species is listed as Endangered under the Endangered Species Act (ESA). The purpose of the ESA is to protect and recover imperiled species and the ecosystems upon which they depend. There are a host of actions that could possibly be undertaken to recover the Key deer population, but without a clearly defined problem and stated objectives it can be difficult to compare and evaluate alternative actions. In addition, management goals and the acceptability of alternative management actions are inherently linked to stakeholders, who should be engaged throughout the process of developing a decision framework. The purpose of this project was to engage a representative group of stakeholders to develop a problem statement that captured the management problem the FWS must address with Key deer and identify objectives that, if met, would help solve the problem. In addition, the objectives were organized in a hierarchical manner (i.e., an objectives network) to show how they are linked, and measurable attributes were identified for each objective. We organized a group of people who represented stakeholders interested in and potentially affected by the management of Key deer. These stakeholders included individuals who represented local, state, and federal governments, non-governmental organizations, the general public, and local businesses. This stakeholder group met five full days over the course of an eight-week period to identify objectives that would address the following problem:“As recovery and removal from the Endangered Species list is the purpose of the Endangered Species Act, the U.S. Fish and Wildlife Service needs a management approach that will ensure a sustainable, viable, and healthy Key deer population. Urbanization has affected the behavior and population dynamics of the Key deer and the amount and characteristics of available habitat. The identified management approach must balance relevant social and economic concerns, Federal (e.g., Endangered Species Act, Wilderness Act, Refuge Act) and state regulations, and the conservation of biodiversity (e.g., Endangered/Threatened species, native habitat) in the Lower Keys.”The stakeholder group identified four fundamental objectives that are essential to addressing the problem: 1) Maximize a sustainable, viable, and healthy Key deer population, 2) Maximize value of Key deer to the People, 3) Minimize deer-related negative impacts to biodiversity, and 4) Minimize costs. In addition, the group identified 25 additional objectives that, if met, would help meet the fundamental objectives. The objectives network and measurable attributes identified by the stakeholder group can be used in the future to develop and evaluate potential management alternatives.

[Not Available].

PubMed

Huber, Machteld; van Vliet, Marja; Boer, Inge

2016-01-01

A new, dynamic concept of health, which aims to convince critics of the static WHO definition of 1948, was based on an invitational conference in 2009. The concept highlights function, resilience and self-direction. This general concept of health was further elaborated in a follow-up study aiming towards operationalization, and involving Dutch healthcare stakeholder groups. The study revealed a number of differences between the opinions of stakeholder groups about the concept of health and, following the perception of patients, resulted in the broad concept of 'positive health' with six dimensions.

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.

Collaborative Visual Analytics: A Health Analytics Approach to Injury Prevention.

PubMed

Al-Hajj, Samar; Fisher, Brian; Smith, Jennifer; Pike, Ian

2017-09-12

Background : Accurate understanding of complex health data is critical in order to deal with wicked health problems and make timely decisions. Wicked problems refer to ill-structured and dynamic problems that combine multidimensional elements, which often preclude the conventional problem solving approach. This pilot study introduces visual analytics (VA) methods to multi-stakeholder decision-making sessions about child injury prevention; Methods : Inspired by the Delphi method, we introduced a novel methodology-group analytics (GA). GA was pilot-tested to evaluate the impact of collaborative visual analytics on facilitating problem solving and supporting decision-making. We conducted two GA sessions. Collected data included stakeholders' observations, audio and video recordings, questionnaires, and follow up interviews. The GA sessions were analyzed using the Joint Activity Theory protocol analysis methods; Results : The GA methodology triggered the emergence of ' common g round ' among stakeholders. This common ground evolved throughout the sessions to enhance stakeholders' verbal and non-verbal communication, as well as coordination of joint activities and ultimately collaboration on problem solving and decision-making; Conclusion s : Understanding complex health data is necessary for informed decisions. Equally important, in this case, is the use of the group analytics methodology to achieve ' common ground' among diverse stakeholders about health data and their implications.

Essential Medicines in a High Income Country: Essential to Whom?

PubMed Central

2015-01-01

Objective To explore the perspectives of a diverse group of stakeholders engaged in medicines decision making around what constitutes an “essential” medicine, and how the Essential Medicines List (EML) concept functions in a high income country context. Methods In-depth qualitative semi-structured interviews were conducted with 32 Australian stakeholders, recognised as decision makers, leaders or advisors in the area of medicines reimbursement or supply chain management. Participants were recruited from government, pharmaceutical industry, pharmaceutical wholesale/distribution companies, medicines non-profit organisations, academic health disciplines, hospitals, and consumer groups. Perspectives on the definition and application of the EML concept in a high income country context were thematically analysed using grounded theory approach. Findings Stakeholders found it challenging to describe the EML concept in the Australian context because many perceived it was generally used in resource scarce settings. Stakeholders were unable to distinguish whether nationally reimbursed medicines were essential medicines in Australia. Despite frequent generic drug shortages and high prices paid by consumers, many struggled to describe how the EML concept applied to Australia. Instead, broad inclusion of consumer needs, such as rare and high cost medicines, and consumer involvement in the decision making process, has led to expansive lists of nationally subsidised medicines. Therefore, improved communication and coordination is needed around shared interests between stakeholders regarding how medicines are prioritised and guaranteed in the supply chain. Conclusions This study showed that decision-making in Australia around reimbursement of medicines has strayed from the fundamental utilitarian concept of essential medicines. Many stakeholders involved in medicine reimbursement decisions and management of the supply chain did not consider the EML concept in their approach. The wide range of views of what stakeholders considered were essential medicines, challenges whether the EML concept is out-dated or underutilised in high income countries. PMID:26650544

Essential Medicines in a High Income Country: Essential to Whom?

PubMed

Duong, Mai; Moles, Rebekah J; Chaar, Betty; Chen, Timothy F

2015-01-01

To explore the perspectives of a diverse group of stakeholders engaged in medicines decision making around what constitutes an "essential" medicine, and how the Essential Medicines List (EML) concept functions in a high income country context. In-depth qualitative semi-structured interviews were conducted with 32 Australian stakeholders, recognised as decision makers, leaders or advisors in the area of medicines reimbursement or supply chain management. Participants were recruited from government, pharmaceutical industry, pharmaceutical wholesale/distribution companies, medicines non-profit organisations, academic health disciplines, hospitals, and consumer groups. Perspectives on the definition and application of the EML concept in a high income country context were thematically analysed using grounded theory approach. Stakeholders found it challenging to describe the EML concept in the Australian context because many perceived it was generally used in resource scarce settings. Stakeholders were unable to distinguish whether nationally reimbursed medicines were essential medicines in Australia. Despite frequent generic drug shortages and high prices paid by consumers, many struggled to describe how the EML concept applied to Australia. Instead, broad inclusion of consumer needs, such as rare and high cost medicines, and consumer involvement in the decision making process, has led to expansive lists of nationally subsidised medicines. Therefore, improved communication and coordination is needed around shared interests between stakeholders regarding how medicines are prioritised and guaranteed in the supply chain. This study showed that decision-making in Australia around reimbursement of medicines has strayed from the fundamental utilitarian concept of essential medicines. Many stakeholders involved in medicine reimbursement decisions and management of the supply chain did not consider the EML concept in their approach. The wide range of views of what stakeholders considered were essential medicines, challenges whether the EML concept is out-dated or underutilised in high income countries.

Towards the development of a comprehensive framework: Qualitative systematic survey of definitions of clinical research quality.

PubMed

von Niederhäusern, Belinda; Schandelmaier, Stefan; Mi Bonde, Marie; Brunner, Nicole; Hemkens, Lars G; Rutquist, Marielle; Bhatnagar, Neera; Guyatt, Gordon H; Pauli-Magnus, Christiane; Briel, Matthias

2017-01-01

To systematically survey existing definitions, concepts, and criteria of clinical research quality, both developed by stakeholder groups as well as in the medical literature. This study serves as a first step in the development of a comprehensive framework for the quality of clinical research. We systematically and in duplicate searched definitions, concepts and criteria of clinical research quality on websites of stakeholders in clinical research until no further insights emerged and in MEDLINE up to February 2015. Stakeholders included governmental bodies, regulatory agencies, the pharmaceutical industry, academic and commercial contract research organizations, initiatives, research ethics committees, patient organizations and funding agencies from 13 countries. Data synthesis involved descriptive and qualitative analyses following the Framework Method on definitions, concepts, and criteria of clinical research quality. Descriptive codes were applied and grouped into clusters to identify common and stakeholder-specific quality themes. Stakeholder concepts on how to assure quality throughout study conduct or articles on quality assessment tools were common, generally with no a priori definition of the term quality itself. We identified a total of 20 explicit definitions of clinical research quality including varying quality dimensions and focusing on different stages in the clinical research process. Encountered quality dimensions include ethical conduct, patient safety/rights/priorities, internal validity, precision of results, generalizability or external validity, scientific and societal relevance, transparency and accessibility of information, research infrastructure and sustainability. None of the definitions appeared to be comprehensive either in terms of quality dimensions, research stages, or stakeholder perspectives. Clinical research quality is often discussed but rarely defined. A framework defining clinical research quality across stakeholders' individual perspectives is desirable to facilitate discussion, assessment, and improvement of quality at all stages of clinical research.

Prospective political analysis for policy design: enhancing the political viability of single-payer health reform in Vermont.

PubMed

Blanchet, Nathan J; Fox, Ashley M

2013-06-01

In 2011 the state of Vermont adopted legislation that aims to create the nation's first state-level single-payer health care system, a system that would go well beyond national reform efforts. To conduct a prospective, institutional stakeholder analysis to guide development of a politically viable, universal health care reform proposal, as commissioned by Vermont's legislature in July 2010. A total of 64 semi-structured stakeholder interviews with nearly 120 individuals, representing 60 different groups/institutions, were conducted between July and December 2010. Interviews probed stakeholders regarding five major design components: financing options, decoupling insurance from employment, organization/governance, comprehensiveness of benefits, and payment reform. There was a range of opposition and support across stakeholder groups and components, and more remarkably a diversity of views within groups often believed to be unwavering supporters or detractors of comprehensive health reform. Given the balance of conflicting views, relative power, and acceptable trade-offs, the research team proposed a single-payer health care system financed through payroll taxes, decoupled from employment, with a generous benefit package, governed by a public-private intermediary. Prospective political analysis can assist in choosing among a range of technically sound policy options to create a more politically viable health reform package. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Civilizing the Conversation? Using Surveys to Inform Water Management and Science in the Sacramento-San Joaquin Delta

NASA Astrophysics Data System (ADS)

Hanak, E.; Phillips Chappelle, C.

2013-12-01

Improving ecosystem outcomes in California's Sacramento-San Joaquin Delta is a complex, high-stakes water resource management challenge. The Delta is a major hub for water supply conveyance and a valued ecological resource. Yet long-term declines in native fish populations have resulted in severe legal constraints on water exports and fueled growing public debates about the roles and responsibilities of flow modification and other sources of ecosystem stress. Meanwhile, scientific uncertainty, and the inability of the scientific community to effectively communicate what *is* known, has frustrated policymakers and encouraged 'combat science' - the commissioning and use of competing scientific opinions in the courtroom. This paper summarizes results from a study designed to inform the policy process through the use of confidential surveys of scientific researchers (those publishing in peer-reviewed journals, n=122) and engaged stakeholders and policymakers (n=240). The surveys, conducted in mid-2012, sought respondents' views on the sources of ecosystem stress and priority ecosystem management actions. The scientist survey is an example of the growing use of expert elicitation to address gaps in the scientific literature, particularly where there is uncertainty about priorities for decisionmaking (e.g., Cvitanovic et al. 2013, J. of Env. Mgmt; McDaniels et al. 2012, Risk Analysis). The stakeholder survey is a useful complement, enabling the identification of areas of consensus and divergence among stakeholder groups and between these groups and scientific experts. The results suggest such surveys are a promising tool for addressing complex water management problems. We found surprisingly high agreement among scientists on the relative roles of stressors and the most promising management actions; they emphasized restoring more natural processes through habitat and flow actions within the watershed, consistent with 'reconciliation ecology' approaches (Rosenzweig 2003, Oxford Univ. Press). In contrast, scientific consensus was far lower on the potential of relatively low-cost infrastructure and technology tools (e.g. gates, hatcheries) - underscoring the importance of building knowledge on such efforts. Surprisingly, and positively, stakeholders from groups with widely diverging public positions broadly agreed with scientists that multiple stressors are responsible for the Delta's plight. And most agreed with scientists on management priorities. However, individual groups were more likely to prioritize actions unrelated to their own uses of Delta resources and to shy away from actions that would be costly for them. The results point to the need for building shared understanding on Delta science for a more constructive policy process. To this end, the study proposed changes in the organization of Delta science drawing on 'common pool' models that have been effective for water quality research in both northern and southern California.

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

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.

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

PubMed Central

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

2009-01-01

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

Sensemaking, stakeholder discord, and long-term risk communication at a US Superfund site.

PubMed

Hoover, Anna Goodman

2017-03-01

Risk communication can help reduce exposures to environmental contaminants, mitigate negative health outcomes, and inform community-based decisions about hazardous waste sites. While communication best practices have long guided such efforts, little research has examined unintended consequences arising from such guidelines. As rhetoric informs stakeholder sensemaking, the language used in and reinforced by these guidelines can challenge relationships and exacerbate stakeholder tensions. This study evaluates risk communication at a U.S. Superfund site to identify unintended consequences arising from current risk communication practices. This qualitative case study crystallizes data spanning 6 years from three sources: 1) local newspaper coverage of site-related topics; 2) focus-group transcripts from a multi-year project designed to support future visioning of site use; and 3) published blog entries authored by a local environmental activist. Constant comparative analysis provides the study's analytic foundation, with qualitative data analysis software QSR NVivo 8 supporting a three-step process: 1) provisional coding to identify broad topic categories within datasets, 2) coding occurrences of sensemaking constructs and emergent intra-dataset patterns, and 3) grouping related codes across datasets to examine the relationships among them. Existing risk communication practices at this Superfund site contribute to a dichotomous conceptualization of multiple and diverse stakeholders as members of one of only two categories: the government or the public. This conceptualization minimizes perceptions of capacity, encourages public commitment to stances aligned with a preferred group, and contributes to negative expectations that can become self-fulfilling prophecies. Findings indicate a need to re-examine and adapt risk communication guidelines to encourage more pluralistic understanding of the stakeholder landscape.

An application of Social Values for Ecosystem Services (SolVES) to three national forests in Colorado and Wyoming

USGS Publications Warehouse

Sherrouse, Benson C.; Semmens, Darius J.; Clement, Jessica M.

2014-01-01

Despite widespread recognition that social-value information is needed to inform stakeholders and decision makers regarding trade-offs in environmental management, it too often remains absent from ecosystem service assessments. Although quantitative indicators of social values need to be explicitly accounted for in the decision-making process, they need not be monetary. Ongoing efforts to map such values demonstrate how they can also be made spatially explicit and relatable to underlying ecological information. We originally developed Social Values for Ecosystem Services (SolVES) as a tool to assess, map, and quantify nonmarket values perceived by various groups of ecosystem stakeholders. With SolVES 2.0 we have extended the functionality by integrating SolVES with Maxent maximum entropy modeling software to generate more complete social-value maps from available value and preference survey data and to produce more robust models describing the relationship between social values and ecosystems. The current study has two objectives: (1) evaluate how effectively the value index, a quantitative, nonmonetary social-value indicator calculated by SolVES, reproduces results from more common statistical methods of social-survey data analysis and (2) examine how the spatial results produced by SolVES provide additional information that could be used by managers and stakeholders to better understand more complex relationships among stakeholder values, attitudes, and preferences. To achieve these objectives, we applied SolVES to value and preference survey data collected for three national forests, the Pike and San Isabel in Colorado and the Bridger–Teton and the Shoshone in Wyoming. Value index results were generally consistent with results found through more common statistical analyses of the survey data such as frequency, discriminant function, and correlation analyses. In addition, spatial analysis of the social-value maps produced by SolVES provided information that was useful for explaining relationships between stakeholder values and forest uses. Our results suggest that SolVES can effectively reproduce information derived from traditional statistical analyses while adding spatially explicit, social-value information that can contribute to integrated resource assessment, planning, and management of forests and other ecosystems.

Citizen Participation in Collaborative Watershed Partnerships

NASA Astrophysics Data System (ADS)

Koehler, Brandi; Koontz, Tomas M.

2008-02-01

Collaborative efforts are increasingly being used to address complex environmental problems, both in the United States and abroad. This is especially true in the growing field of collaborative watershed management, where diverse stakeholders work together to develop and advance water-quality goals. Active citizen participation is viewed as a key component, yet groups often struggle to attract and maintain citizen engagement. This study examined citizen participation behavior in collaborative watershed partnerships by way of a written survey administered to citizen members of 12 collaborative watershed groups in Ohio. Results for the determination of who joins such groups were consistent with the dominant-status model of participation because group members were not demographically representative of the broader community. The dominant-status model, however, does not explain which members are more likely to actively participate in group activities. Instead, individual characteristics, including political activity, knowledge, and comfort in sharing opinions with others, were positively correlated with active participation. In addition, group characteristics, including government-based membership, rural location, perceptions of open communication, perceptions that the group has enough technical support to accomplish its goals, and perceived homogeneity of participant opinions, were positively correlated with active participation. Overall, many group members did not actively participate in group activities.

Citizen participation in collaborative watershed partnerships.

PubMed

Koehler, Brandi; Koontz, Tomas M

2008-02-01

Collaborative efforts are increasingly being used to address complex environmental problems, both in the United States and abroad. This is especially true in the growing field of collaborative watershed management, where diverse stakeholders work together to develop and advance water-quality goals. Active citizen participation is viewed as a key component, yet groups often struggle to attract and maintain citizen engagement. This study examined citizen participation behavior in collaborative watershed partnerships by way of a written survey administered to citizen members of 12 collaborative watershed groups in Ohio. Results for the determination of who joins such groups were consistent with the dominant-status model of participation because group members were not demographically representative of the broader community. The dominant-status model, however, does not explain which members are more likely to actively participate in group activities. Instead, individual characteristics, including political activity, knowledge, and comfort in sharing opinions with others, were positively correlated with active participation. In addition, group characteristics, including government-based membership, rural location, perceptions of open communication, perceptions that the group has enough technical support to accomplish its goals, and perceived homogeneity of participant opinions, were positively correlated with active participation. Overall, many group members did not actively participate in group activities.

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.

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.

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

PubMed

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

2016-01-01

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

NHS Diabetes Prevention Programme in England: formative evaluation of the programme in early phase implementation.

PubMed

Penn, Linda; Rodrigues, Angela; Haste, Anna; Marques, Marta M; Budig, Kirsten; Sainsbury, Kirby; Bell, Ruth; Araújo-Soares, Vera; White, Martin; Summerbell, Carolyn; Goyder, Elizabeth; Brennan, Alan; Adamson, Ashley J; Sniehotta, Falko F

2018-02-21

Evaluation of the demonstrator phase and first wave roll-out of the National Health Service (NHS) Diabetes Prevention Programme (DPP) in England. To examine: (1) intervention design, provision and fidelity assessment procedures; (2) risk assessment and recruitment pathways and (3) data collection for monitoring and evaluation. To provide recommendations informing decision makers on programme quality, improvements and future evaluation. We reviewed programme documents, mapping against the NHS DPP specification and National Institute for Health and Care Excellence (NICE) public health guideline: Type 2 diabetes (T2D) prevention in people at high risk (PH38), conducted qualitative research using individual interviews and focus group discussions with stakeholders and examined recruitment, fidelity and data collection procedures. Seven NHS DPP demonstrator sites and, subsequently, 27 first wave areas across England. Intensive behavioural intervention with weight loss, diet and physical activity goals. The national programme specifies at least 13 sessions over 9 months, delivered face to face to groups of 15-20 adults with non-diabetic hyperglycaemia, mainly recruited from primary care and NHS Health Checks. Participants for qualitative research were purposively sampled to provide a spread of stakeholder experience. Documents for review were provided via the NHS DPP Management Group. The NHS DPP specification reflected current evidence with a clear framework for service provision. Providers, with national capacity to deliver, supplied intervention plans compliant with this framework. Stakeholders highlighted limitations in fidelity assessment and recruitment and retention challenges, especially in reach and equity, that could adversely impact on implementation. Risk assessment for first wave eligibility differed from NICE guidance. The NHS DPP provides an evidence-based behavioural intervention for prevention of T2D in adults at high risk, with capacity to deliver nationally. Framework specification allows for balance between consistency and contextual variation in intervention delivery, with session details devolved to providers. Limitations in fidelity assurance, data collection procedures and recruitment issues could adversely impact on intervention effectiveness and restrict evaluation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The prevention and management of chronic disease in primary care: recommendations from a knowledge translation meeting.

PubMed

Ahmed, Sara; Ware, Patrick; Visca, Regina; Bareil, Celine; Chouinard, Maud-Christine; Desforges, Johanne; Finlayson, Roderick; Fortin, Martin; Gauthier, Josée; Grimard, Dominique; Guay, Maryse; Hudon, Catherine; Lalonde, Lyne; Lévesque, Lise; Michaud, Cecile; Provost, Sylvie; Sutton, Tim; Tousignant, Pierre; Travers, Stella; Ware, Mark; Gogovor, Amede

2015-10-15

Seven chronic disease prevention and management programs were implemented across Quebec with funding support from a provincial-private industry funding initiative. Given the complexity of implementing integrated primary care chronic disease management programs, a knowledge transfer meeting was held to share experiences across programs and synthesize common challenges and success factors for implementation. The knowledge translation meeting was held in February 2014 in Montreal, Canada. Seventy-five participants consisting of 15 clinicians, 14 researchers, 31 knowledge users, and 15 representatives from the funding agencies were broken up into groups of 10 or 11 and conducted a strengths, weaknesses, opportunities, and threats analysis on either the implementation or the evaluation of these chronic disease management programs. Results were reported back to the larger group during a plenary and recorded. Audiotapes were transcribed and summarized using pragmatic thematic analysis. Strengths to leverage for the implementation of the seven programs include: (1) synergy between clinical and research teams; (2) stakeholders working together; (3) motivation of clinicians; and (4) the fact that the programs are evidence-based. Weaknesses to address include: (1) insufficient resources; (2) organizational change within the clinical sites; (3) lack of referrals from primary care physicians; and (4) lack of access to programs. Strengths to leverage for the evaluation of these programs include: (1) engagement of stakeholders and (2) sharing of knowledge between clinical sites. Weaknesses to address include: (1) lack of referrals; (2) difficulties with data collection; and (3) difficulties in identifying indicators and control groups. Opportunities for both themes include: (1) fostering new and existing partnerships and stakeholder relations; (2) seizing funding opportunities; (3) knowledge transfer; (4) supporting the transformation of professional roles; (5) expand the use of health information technology; and (6) conduct cost evaluations. Fifteen recommendations related to mobilisation of primary care physicians, support for the transformation of professional roles, and strategies aimed at facilitating the implementation and evaluation of chronic disease management programs were formulated based on the discussions at this knowledge translation event. The results from this knowledge translation day will help inform the sustainability of these seven chronic disease management programs in Quebec and the implementation and evaluation of similar programs elsewhere.

Outcome Measures in Rheumatology - Interventions for medication Adherence (OMERACT-Adherence) Core Domain Set for Trials of Interventions for Medication Adherence in Rheumatology: 5 Phase Study Protocol.

PubMed

Kelly, Ayano; Tong, Allison; Tymms, Kathleen; March, Lyn; Craig, Jonathan C; De Vera, Mary; Evans, Vicki; Hassett, Geraldine; Toupin-April, Karine; van den Bemt, Bart; Teixeira-Pinto, Armando; Alten, Rieke; Bartlett, Susan J; Campbell, Willemina; Dawson, Therese; Gill, Michael; Hebing, Renske; Meara, Alexa; Nieuwlaat, Robby; Shaw, Yomei; Singh, Jasvinder A; Suarez-Almazor, Maria; Sumpton, Daniel; Wong, Peter; Christensen, Robin; Beaton, Dorcas; de Wit, Maarten; Tugwell, Peter

2018-03-27

Over the last 20 years, there have been marked improvements in the availability of effective medications for rheumatic conditions such as gout, osteoporosis and rheumatoid arthritis (RA), which have led to a reduction in disease flares and the risk of re-fracture in osteoporosis, and the slowing of disease progression in RA. However, medication adherence remains suboptimal, as treatment regimens can be complex and difficult to continue long term. Many trials have been conducted to improve adherence to medication. Core domains, which are the outcomes of most relevance to patients and clinicians, are a pivotal component of any trial. These core domains should be measured consistently, so that all relevant trials can be combined in systematic reviews and meta-analyses to reach conclusions that are more valid. Failure to do this severely limits the potential for trial-based evidence to inform decisions on how to support medication adherence. The Outcome Measures in Rheumatology (OMERACT) - Interventions for Medication Adherence study by the OMERACT-Adherence Group aims to develop a core domain set for interventions that aim to support medication adherence in rheumatology. This OMERACT-Adherence study has five phases: (1) a systematic review to identify outcome domains that have been reported in interventions focused on supporting medication adherence in rheumatology; (2) semi-structured stakeholder interviews with patients and caregivers to determine their views on the core domains; (3) focus groups using the nominal group technique with patients and caregivers to identify and rank domains that are relevant to them, including the reasons for their choices; (4) an international three-round modified Delphi survey involving patients with diverse rheumatic conditions, caregivers, health professionals, researchers and other stakeholders to develop a preliminary core domain set; and (5) a stakeholder workshop with OMERACT members to review, vote on and reach a consensus on the core domain set for interventions to support medication adherence in rheumatology. Establishing a core domain set to be reported in all intervention studies undertaken to support patients with medication adherence will enhance the relevance and the impact of these results and improve the lives of people with rheumatic conditions.

NHS Diabetes Prevention Programme in England: formative evaluation of the programme in early phase implementation

PubMed Central

Penn, Linda; Rodrigues, Angela; Haste, Anna; Marques, Marta M; Budig, Kirsten; Sainsbury, Kirby; Bell, Ruth; Araújo-Soares, Vera; White, Martin; Summerbell, Carolyn; Goyder, Elizabeth; Brennan, Alan; Adamson, Ashley J; Sniehotta, Falko F

2018-01-01

Objectives Evaluation of the demonstrator phase and first wave roll-out of the National Health Service (NHS) Diabetes Prevention Programme (DPP) in England. To examine: (1) intervention design, provision and fidelity assessment procedures; (2) risk assessment and recruitment pathways and (3) data collection for monitoring and evaluation. To provide recommendations informing decision makers on programme quality, improvements and future evaluation. Design We reviewed programme documents, mapping against the NHS DPP specification and National Institute for Health and Care Excellence (NICE) public health guideline: Type 2 diabetes (T2D) prevention in people at high risk (PH38), conducted qualitative research using individual interviews and focus group discussions with stakeholders and examined recruitment, fidelity and data collection procedures. Setting Seven NHS DPP demonstrator sites and, subsequently, 27 first wave areas across England. Interventions Intensive behavioural intervention with weight loss, diet and physical activity goals. The national programme specifies at least 13 sessions over 9 months, delivered face to face to groups of 15–20 adults with non-diabetic hyperglycaemia, mainly recruited from primary care and NHS Health Checks. Participants Participants for qualitative research were purposively sampled to provide a spread of stakeholder experience. Documents for review were provided via the NHS DPP Management Group. Findings The NHS DPP specification reflected current evidence with a clear framework for service provision. Providers, with national capacity to deliver, supplied intervention plans compliant with this framework. Stakeholders highlighted limitations in fidelity assessment and recruitment and retention challenges, especially in reach and equity, that could adversely impact on implementation. Risk assessment for first wave eligibility differed from NICE guidance. Conclusions The NHS DPP provides an evidence-based behavioural intervention for prevention of T2D in adults at high risk, with capacity to deliver nationally. Framework specification allows for balance between consistency and contextual variation in intervention delivery, with session details devolved to providers. Limitations in fidelity assurance, data collection procedures and recruitment issues could adversely impact on intervention effectiveness and restrict evaluation. PMID:29467134

Creating a public space and dialogue on sexuality and rights: a case study from Bangladesh.

PubMed

Rashid, Sabina Faiz; Standing, Hilary; Mohiuddin, Mahrukh; Ahmed, Farah Mahjabeen

2011-06-16

This article describes and analyses a research based engagement by a university school of public health in Bangladesh aimed at raising public debate on sexuality and rights and making issues such as discrimination more visible to policy makers and other key stakeholders in a challenging context. The impetus for this work came from participation in an international research programme with a particular interest in bridging international and local understandings of sexual and reproductive rights. The research team worked to create a platform to broaden discussions on sexuality and rights by building on a number of research activities on rural and urban men's and women's sexual health concerns, and on changing concepts of sexuality and understandings of sexual rights among specific population groups in Dhaka city, including sexual minorities. Linked to this on-going process of improving the evidence base, there has been a series of learning and capacity building activities over the last four years consisting of training workshops, meetings, conferences and dialogues. These brought together different configurations of stakeholders - members of sexual minorities, academics, service providers, advocacy organisations, media and policy makers. This process contributed to developing more effective advocacy strategies through challenging representations of sexuality and rights in the public domain. Gradually, these efforts brought visibility to hidden or stigmatised sexuality and rights issues through interim outcomes that have created important steps towards changing attitudes and policies. These included creating safe spaces for sexual minorities to meet and strategise, development of learning materials for university students and engagement with legal rights groups on sexual rights. Through this process, it was found to be possible to create a public space and dialogue on sexuality and rights in a conservative and challenging environment like Bangladesh by bringing together a diverse group of stakeholders to successfully challenge representations of sexuality in the public arena. A further challenge for BRAC University has been to assess its role as a teaching and research organisation, and find a balance between the two roles of research and activism in doing work on sexuality issues in a very sensitive political context.

Stakeholder analysis of the Programme for Improving Mental health carE (PRIME): baseline findings.

PubMed

Makan, Amit; Fekadu, Abebaw; Murhar, Vaibhav; Luitel, Nagendra; Kathree, Tasneem; Ssebunya, Joshua; Lund, Crick

2015-01-01

The knowledge generated from evidence-based interventions in mental health systems research is seldom translated into policy and practice in low and middle-income countries (LMIC). Stakeholder analysis is a potentially useful tool in health policy and systems research to improve understanding of policy stakeholders and increase the likelihood of knowledge translation into policy and practice. The aim of this study was to conduct stakeholder analyses in the five countries participating in the Programme for Improving Mental health carE (PRIME); evaluate a template used for cross-country comparison of stakeholder analyses; and assess the utility of stakeholder analysis for future use in mental health policy and systems research in LMIC. Using an adapted stakeholder analysis instrument, PRIME country teams in Ethiopia, India, Nepal, South Africa and Uganda identified and characterised stakeholders in relation to the proposed action: scaling-up mental health services. Qualitative content analysis was conducted for stakeholder groups across countries, and a force field analysis was applied to the data. Stakeholder analysis of PRIME has identified policy makers (WHO, Ministries of Health, non-health sector Ministries and Parliament), donors (DFID UK, DFID country offices and other donor agencies), mental health specialists, the media (national and district) and universities as the most powerful, and most supportive actors for scaling up mental health care in the respective PRIME countries. Force field analysis provided a means of evaluating cross-country stakeholder power and positions, particularly for prioritising potential stakeholder engagement in the programme. Stakeholder analysis has been helpful as a research uptake management tool to identify targeted and acceptable strategies for stimulating the demand for research amongst knowledge users, including policymakers and practitioners. Implementing these strategies amongst stakeholders at a country level will hopefully reduce the knowledge gap between research and policy, and improve health system outcomes for the programme.

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,…

Tip Sheet for SEAs: Engaging Parents and Family Members in Postschool Outcome Stakeholder Groups

ERIC Educational Resources Information Center

National Post-School Outcomes Center, 2013

2013-01-01

Involving parents and other family representatives in the Indicator B-14 Post-School Outcomes (PSO) Survey activities can help State Education Agencies (SEAs) develop strategies to increase annual response rates, communicate results to stakeholders, and build support for program improvement and systems change. Perspectives expressed by families of…

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…

The Service Learning Projects: Stakeholder Benefits and Potential Class Topics

ERIC Educational Resources Information Center

Rutti, Raina M.; LaBonte, Joanne; Helms, Marilyn Michelle; Hervani, Aref Agahei; Sarkarat, Sy

2016-01-01

Purpose: The purpose of this paper is to summarize the benefits of including a service learning project in college classes and focusses on benefits to all stakeholders, including students, community, and faculty. Design/methodology/approach: Using a snowball approach in academic databases as well as a nominal group technique to poll faculty, key…

The Internet as Potential Equalizer: New Leverage for Confronting Social Irresponsibility.

ERIC Educational Resources Information Center

Coombs, W. Timothy

1998-01-01

Contends activists have a new weapon (the Internet) which can change the organization-stakeholder dynamic. Uses recent development in stakeholder theory to explain how the Internet, when used effectively, can allow activist groups to become more powerful and to command the attention of organizations. Illustrates the theoretical points presented…

Incident Management Organization succession planning stakeholder feedback

Treesearch

Anne E. Black

2013-01-01

This report presents complete results of a 2011 stakeholder feedback effort conducted for the National Wildfire Coordination Group (NWCG) Executive Board concerning how best to organize and manage national wildland fire Incident Management Teams in the future to meet the needs of the public, agencies, fire service and Team members. Feedback was collected from 858...

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

PubMed

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

2015-03-26

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

Using Concept Mapping in the Development of a School of Public Health.

PubMed

Hsu, Laura J; Pacheco, Misty Y; Crabtree, Christopher; Maddock, Jay E

2015-07-01

Schools of Public Health have a wide variety of essential stakeholders. Broad input in program planning should assist in ensuring well-developed plans and strong community buy-in. The planning of a school can better address the needs of multiple stakeholders from systematic broad-based input from these constituents using concept mapping. In this study, we used concept mapping to prioritize a set of recommendations from diverse stakeholders to assist in the process of planning a school. A set of statements was generated on essential elements for the proposed school from a broad group of stakeholders. The statements were then distilled into unique themes, which were then rated on importance and feasibility. Cluster maps and pattern matches were used to analyze the ratings. Unique themes (N = 147) were identified and grouped into 12 clusters. Cluster themes included leadership, faculty, culture, school, and curriculum. Pattern matches revealed a significant, modest correlation between importance and feasibility (r = 0.27). A broad range of perspectives was used to identify relevant areas to address in the development of a school.

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.

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

USGS Publications Warehouse

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

2015-01-01

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

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

NASA Astrophysics Data System (ADS)

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

2015-04-01

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

How Do Principals Conceptualize Success: Are Their Actions Consistent with Their Definitions?

ERIC Educational Resources Information Center

Patience, Brian J.

2012-01-01

My research study explored how principals allocated their time, their perceptions of success, and whether their actions were consistent with their definition of success. Findings revealed participants spent time performing three primary behaviors including communicating with school stakeholders, completing managerial practices, and serving as…

Identification of preliminary core outcome domains for communication about childhood vaccination: An online Delphi survey.

PubMed

Kaufman, Jessica; Ryan, Rebecca; Lewin, Simon; Bosch-Capblanch, Xavier; Glenton, Claire; Cliff, Julie; Oyo-Ita, Angela; Muloliwa, Artur Manuel; Oku, Afiong; Ames, Heather; Rada, Gabriel; Cartier, Yuri; Hill, Sophie

2017-08-20

Communication interventions for childhood vaccination are promising strategies to address vaccine hesitancy, but current research is limited by the outcomes measured. Most studies measure only vaccination-related outcomes, with minimal consideration of vaccine hesitancy-relevant intermediate outcomes. This impedes understanding of which interventions or elements are effective. It is also unknown which outcomes are important to the range of stakeholders affected by vaccine hesitancy. Outcome selection shapes the evidence base, informing future interventions and trials, and should reflect stakeholder priorities. Therefore, our aim was to identify which outcome domains (i.e. broad outcome categories) are most important to different stakeholders, identifying preliminary core outcome domains to inform evaluation of three common vaccination communication types: (i) communication to inform or educate, (ii) remind or recall, and (iii) enhance community ownership. We conducted a two-stage online Delphi survey, involving four stakeholder groups: parents or community members, healthcare providers, researchers, and government or non-governmental organisation representatives. Participants rated the importance of eight outcome domains for each of the three communication types. They also rated specific outcomes within one domain ("attitudes or beliefs") and provided feedback about the survey. Collectively, stakeholder groups prioritised outcome domains differently when considering the effects of different communication types. For communication that aims to (i) inform or educate, the most important outcome domain is "knowledge or understanding"; for (ii) reminder communication, "vaccination status and behaviours"; and for (iii) community engagement communication, "community participation". All stakeholder groups rated most outcome domains as very important or critical. The highest rated specific outcome within the "attitudes or beliefs" domain was "trust". This Delphi survey expands the field of core outcomes research and identifies preliminary core outcome domains for measuring the effects of communication about childhood vaccination. The findings support the argument that vaccination communication is not a single homogenous intervention - it has a range of purposes, and vaccination communication evaluators should select outcomes accordingly. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Cultural Accommodation of Substance Abuse Treatment for Latino Adolescents

PubMed Central

Burrow-Sanchez, Jason; Martinez, Charles; Hops, Hyman; Wrona, Megan

2011-01-01

Collaborating with community stakeholders is an often suggested step when integrating cultural variables into psychological treatments for members of ethnic minority groups. However, there is a dearth of literature describing how to accomplish this process within the context of substance abuse treatment studies. This paper describes a qualitative study conducted through a series of focus groups with stakeholders in the Latino community. Data from focus groups were used by researchers to guide the integration of cultural variables into an empirically-supported substance abuse treatment for Latino adolescents currently being evaluated for efficacy. A model for culturally accommodating empirically-supported treatments for ethnic minority participants is also described. PMID:21888499

MOMENT--Management of Otitis Media with Effusion in Cleft Palate: protocol for a systematic review of the literature and identification of a core outcome set using a Delphi survey.

PubMed

Harman, Nicola L; Bruce, Iain A; Callery, Peter; Tierney, Stephanie; Sharif, Mohammad Owaise; O'Brien, Kevin; Williamson, Paula R

2013-03-12

Cleft palate (CP) has an incidence of approximately 1 in 700. Children with CP are also susceptible to otitis media with effusion (OME), with approximately 90% experiencing nontrivial OME. There are several approaches to the management of OME in children with CP. The Management of Otitis Media with Effusion in Children with Cleft Palate (MOMENT) study is a feasibility study that includes the development of a core outcome set for use in future trials of the management of OME in children with CP. The MOMENT study will include a systematic review of the literature to identify a list of outcomes that have previously been reported. This list of outcomes will be used in a Delphi study with cleft clinicians. The Delphi study is anticipated to include three rounds. The first round will ask clinicians to score the outcome list and to add any outcomes they think are relevant. The second round involves presentation of scores according to stakeholder group and the opportunity for participants to rescore outcomes. To ensure that the opinion of parents and children are sought, qualitative interviews will be completed with a purposive sample in parallel. In the final round of the Delphi process, participants will be shown the distribution of scores, for each outcome, for all stakeholder groups separately as well as a summary of the results concerning outcomes from the qualitative interviews with parents. A final consensus meeting will be held with all stakeholders, including parents and children, to review outcomes. A core outcome set represents the minimum that should be measured in a clinical trial for a particular condition. The MOMENT study will aim to identify a core outcome set that can be used in future trials of the management of OME, improving the consistency of research in this clinical area.

Promoting development and uptake of health innovations: The Nose to Tail Tool

PubMed Central

Gupta, Archna; Thorpe, Cathy; Bhattacharyya, Onil; Zwarenstein, Merrick

2016-01-01

Introduction Health sector management is increasingly complex as new health technologies, treatments, and innovative service delivery strategies are developed. Many of these innovations are implemented prematurely, or fail to be implemented at scale, resulting in substantial wasted resources.   Methods A scoping review was conducted to identify articles that described the scale up process conceptually or that described an instance in which a healthcare innovation was scaled up. We define scale up as the expansion and extension of delivery or access to an innovation for all end users in a jurisdiction who will benefit from it. Results Sixty nine articles were eligible for review. Frequently described stages in the innovation process and contextual issues that influence progress through each stage were mapped. 16 stages were identified: 12 deliberation and 4 action stages. Included papers suggest that innovations progress through stages of maturity and the uptake of innovation depends on the innovation aligning with the interests of 3 critical stakeholder groups (innovators, end users and the decision makers) and is also influenced by 3 broader contexts (social and physical environment, the health system, and the regulatory, political and economic environment). The 16 stages form the rows of the Nose to Tail Tool (NTT) grid and the 6 contingency factors form columns. The resulting stage-by-issue grid consists of 72 cells, each populated with cell-specific questions, prompts and considerations from the reviewed literature. Conclusion We offer a tool that helps stakeholders identify the stage of maturity of their innovation, helps facilitate deliberative discussions on the key considerations for each major stakeholder group and the major contextual barriers that the innovation faces. We believe the NTT will help to identify potential problems that the innovation will face and facilitates early modification, before large investments are made in a potentially flawed solution. PMID:27239275

Healthy Start vitamins—a missed opportunity: findings of a multimethod study

PubMed Central

McFadden, Alison; Green, Josephine M; McLeish, Jenny; McCormick, Felicia; Williams, Victoria; Renfrew, Mary J

2015-01-01

Objective To evaluate and provide a real-life view of the operation of the Healthy Start vitamins scheme. Setting The study took place in primary care and community settings that served rural, urban and ethnically diverse populations, in two sentinel sites: London, and Yorkshire and the Humber. An online consultation and stakeholder workshops elicited views from across England. Participants 669 health and social care practitioners including health visitors, midwives, public health practitioners, general practitioners, paediatricians and support staff participated in focus group discussions (n=49) and an online consultation (n=620). 56 participants representing health and social care practitioners, policymakers, service commissioners, and voluntary and independent sectors took part in stakeholder workshops. Methods Three-phase multimethod study comprising focus group discussions, an online consultation and stakeholder workshops. Qualitative data were analysed thematically and quantitative data from the online survey were analysed using descriptive statistics. Results Study participants were concerned about the low uptake of Healthy Start vitamin supplements and the consequences of this for health outcomes for women and young children. They experienced Healthy Start vitamin distribution as logistically complex, requiring the time, resources and creative thinking of a range of local and regional practitioners from senior strategists to administrative support workers. In the light of this, many participants argued that moving to universal provision of vitamin supplements would be more cost-effective than the current system. Conclusions There is consistency of views of health practitioners that the current targeted system of providing free vitamin supplements for low-income childbearing women and young children via the Healthy Start programme is not fulfilling its potential to address vitamin deficiencies. There is wide professional and voluntary sector support for moving from the current targeted system to provision of free vitamin supplements for all pregnant and new mothers, and children up to their fifth birthday. PMID:25573526

California Geothermal Forum: A Path to Increasing Geothermal Development in California

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

Young, Katherine R.

The genesis of this report was a 2016 forum in Sacramento, California, titled 'California Geothermal Forum: A Path to Increasing Geothermal Development in California.' The forum was held at the California Energy Commission's (CEC) headquarters in Sacramento, California with the primary goal being to advance the dialogues for the U.S. Department of Energy's Geothermal Technologies Office (GTO) and CEC technical research and development (R&D) focuses for future consideration. The forum convened a diverse group of stakeholders from government, industry, and research to lay out pathways for new geothermal development in California while remaining consistent with critical Federal and State conservationmore » planning efforts, particularly at the Salton Sea.« less

The Impact of Stakeholders’ Roles within the Livestock Industry on Their Attitudes to Livestock Welfare in Southeast and East Asia

PubMed Central

Sinclair, Michelle; Zito, Sarah; Phillips, Clive J. C.

2017-01-01

Simple Summary Improving stakeholder attitudes to livestock welfare may help to facilitate the better welfare that is increasingly demanded by the public for livestock. Knowledge of the existing attitudes towards the welfare of livestock during transport and slaughter provides a starting point that may help to target efforts. We compared the attitudes of different stakeholders within the livestock industries in east (E) and southeast (SE) Asia. Farmers were more motivated to improve animal welfare during transport and slaughter by peer pressure, business owners by monetary gain, and business managers by what is prescribed by their company. Veterinarians showed the most support for improving animal welfare. The results suggest that the role that stakeholders play in their sector of the livestock industry must be considered when attempting to change attitudes towards animal welfare during transport and slaughter. Abstract Stakeholders in the livestock industry are in a position to make critical choices that directly impact on animal welfare during slaughter and transport. Understanding the attitudes of stakeholders in livestock-importing countries, including factors that motivate the stakeholders to improve animal welfare, can lead to improved trade relations with exporting developed countries and improved animal welfare initiatives in the importing countries. Improving stakeholder attitudes to livestock welfare may help to facilitate the better welfare that is increasingly demanded by the public for livestock. Knowledge of the existing attitudes towards the welfare of livestock during transport and slaughter provides a starting point that may help to target efforts. This study aimed to investigate the animal welfare attitudes of livestock stakeholders (farmers, team leaders, veterinarians, business owners, business managers, and those working directly with animals) in selected countries in E and SE Asia (China, Thailand, Viet Nam, and Malaysia). The factors that motivated them to improve animal welfare (in particular their religion, knowledge levels, monetary gain, the availability of tools and resources, more pressing community issues, and the approval of their supervisor and peers) were assessed for their relationships to stakeholder role and ranked according to their importance. Stakeholder roles influenced attitudes to animal welfare during livestock transport and slaughter. Farmers were more motivated by their peers compared to other stakeholders. Business owners reported higher levels of motivation from monetary gain, while business managers were mainly motivated by what was prescribed by the company for which they worked. Veterinarians reported the highest levels of perceived approval for improving animal welfare, and all stakeholder groups were least likely to be encouraged to change by a ‘western’ international organization. This study demonstrates the differences in attitudes of the major livestock stakeholders towards their animals’ welfare during transport and slaughter, which advocacy organisations can use to tailor strategies more effectively to improve animal welfare. The results suggest that animal welfare initiatives are more likely to engage their target audience when tailored to specific stakeholder groups. PMID:28125058

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

PubMed

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

2016-12-01

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

School staff, parent and student perceptions of a Breakfast in the Classroom model during initial implementation.

PubMed

Folta, Sara C; Carmichael Djang, Holly; Halmo, Megan; Metayer, Nesly; Blondin, Stacy A; Smith, Kathleen S; Economos, Christina D

2016-06-01

To understand perspectives of stakeholders during initial district-wide implementation of a Breakfast in the Classroom (BIC) model of the School Breakfast Program. Qualitative data were collected from twenty-nine focus groups and twenty interviews with stakeholders in a school district early in the process of implementing a BIC model of the School Breakfast Program. Ten elementary schools within a large, urban school district in the USA that served predominantly low-income, racial/ethnic minority students. Purposively selected stakeholders in elementary schools that had implemented BIC for 3-6 months: students (n 85), parents/guardians (n 86), classroom teachers (n 44), cafeteria managers (n 10) and principals (n 10). Four primary themes emerged, which were interpreted based on the Diffusion of Innovations model. School staff had changed their perceptions of both the relative disadvantages and costs related to time and effort of BIC over time; the majority of each stakeholder group expressed an appreciation for BIC; student breakfast consumption varied from day to day, related to compatibility of foods with child preferences; and stakeholders held mixed and various impressions of BIC's potential impacts. The study underscores the importance of engaging school staff and parents in discussions of BIC programming prior to its initiation to pre-emptively address concerns related to cost, relative disadvantages and compatibility with child preferences and school routines/workflow. Effectively communicating with stakeholders about positive impacts and nutritional value of the meals may improve support for BIC. These findings provide new information to policy makers, districts and practitioners that can be used to improve implementation efforts, model delivery and outcomes.

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.

A methodological framework to support the initiation, design and institutionalization of participatory modeling processes in water resources management

NASA Astrophysics Data System (ADS)

Halbe, Johannes; Pahl-Wostl, Claudia; Adamowski, Jan

2018-01-01

Multiple barriers constrain the widespread application of participatory methods in water management, including the more technical focus of most water agencies, additional cost and time requirements for stakeholder involvement, as well as institutional structures that impede collaborative management. This paper presents a stepwise methodological framework that addresses the challenges of context-sensitive initiation, design and institutionalization of participatory modeling processes. The methodological framework consists of five successive stages: (1) problem framing and stakeholder analysis, (2) process design, (3) individual modeling, (4) group model building, and (5) institutionalized participatory modeling. The Management and Transition Framework is used for problem diagnosis (Stage One), context-sensitive process design (Stage Two) and analysis of requirements for the institutionalization of participatory water management (Stage Five). Conceptual modeling is used to initiate participatory modeling processes (Stage Three) and ensure a high compatibility with quantitative modeling approaches (Stage Four). This paper describes the proposed participatory model building (PMB) framework and provides a case study of its application in Québec, Canada. The results of the Québec study demonstrate the applicability of the PMB framework for initiating and designing participatory model building processes and analyzing barriers towards institutionalization.

Adapting an Evidence-Based Intervention Targeting HIV-Infected Prisoners in Malaysia

PubMed Central

Copenhaver, Michael M.; Tunku, Noor; Ezeabogu, Ifeoma; Potrepka, Jessica; Zahari, Muhammad Muhsin A.; Kamarulzaman, Adeeba; Altice, Frederick L.

2011-01-01

HIV-infected prisoners in Malaysia represent a critical target population for secondary HIV risk reduction interventions and care. We report on the process and outcome of our formative research aimed at systematically selecting and adapting an EBI designed to reduce secondary HIV risk and improve adherence to antiretroviral therapy among soon-to-be-released HIV-infected prisoners. Our formative work involved a critical examination of established EBIs and associated published reports complemented by data elicited through structured interviews and focus groups with key stakeholders, members of the target population, and their family members. Based on all information, we adapted the Holistic Health Recovery Program targeting people living with HIV (HHRP+), an EBI, to consist of eight 2-hour sessions that cover a range of specified topics so that participants may individually apply intervention content as needed to accommodate their particular substance abuse, HIV risk, and antiretroviral adherence issues. This study provides a complete example of the process of selecting and adapting an EBI—taking into account both empirical evidence and input from target organization stakeholders and target population members and their families—for use in real world prison settings where high-risk populations are concentrated. PMID:21860786

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.

Barriers to teaching ocean science in Greek schools

NASA Astrophysics Data System (ADS)

Papathanassiou, Martha; McHugh, Patricia; Domegan, Christine; Gotensparre, Susan; Fauville, Geraldine; Parr, Jon

2017-04-01

Most European citizens are not aware of the full extent of the medical, economic, social, political and environmental importance of the sea to Europe and beyond. Most citizens are not aware of how our day-to-day actions can have a cumulative effect on the health of the ocean - a necessary resource that must be protected for all life on the planet Earth to exist. In other words, European citizens lack a sense of "Ocean Literacy" - an understanding of the ocean's influence on us and our influence on the ocean. Sea Change, a 3.5 million EU-funded project started in March 2015, is designed to bring about a fundamental 'Sea Change' in the way European citizens view their relationship with the sea, by empowering them as 'Ocean Literate' citizens - to take direct and sustainable action towards healthy seas and ocean, healthy communities and ultimately, a healthy planet. The project involves 17 partners from nine countries across Europe and will bring about real actions using behavior change and social engagement methodologies. Building upon the latest research on citizen and stakeholder attitudes, perceptions and values, the Sea Change partnership will design and implement mobilisation activities focused on education, community, government agencies, policy makers and citizens. Eight consultations were held around Europe with regards to barriers to teaching ocean science at schools. All project partners used a Collective Intelligence (CI) methodology to involve target group(s) in active, direct participation for Sea Change. CI is a "barriers and value" structuring methodology, a process of critical learning and reflection followed by action, and then by more critical learning to enable mobilisation, design and development 'with' people rather than on their behalf. In Greece, the consultation was carried out by HCMR, the lead partner for Greece. Participants were recruited through personal contact and existing education networks that the HCMR has previously worked with. In total, 13 stakeholders participated in the event, consisting of Incumbents, Challengers and Regulating agencies. The aim of this consultation was to gain a deep insight into stakeholders' barriers, attitudes and perceptions towards teaching 12-19 years olds about the ocean. The Greek education stakeholders identified 41 barriers in seven different categories to teaching 12-19 year olds about the ocean. Lastly, 18 options were proposed in order to overcome these barriers.

AMCP Partnership Forum: Managing Care in the Wave of Precision Medicine.

PubMed

2018-05-23

Precision medicine, the customization of health care to an individual's genetic profile while accounting for biomarkers and lifestyle, has increasingly been adopted by health care stakeholders to guide the development of treatment options, improve treatment decision making, provide more patient-centered care, and better inform coverage and reimbursement decisions. Despite these benefits, key challenges prevent its broader use and adoption. On December 7-8, 2017, the Academy of Managed Care Pharmacy convened a group of stakeholders to discuss these challenges and provide recommendations to facilitate broader adoption and use of precision medicine across health care settings. These stakeholders represented the pharmaceutical industry, clinicians, patient advocacy, private payers, device manufacturers, health analytics, information technology, academia, and government agencies. Throughout the 2-day forum, participants discussed evidence requirements for precision medicine, including consistent ways to measure the utility and validity of precision medicine tests and therapies, limitations of traditional clinical trial designs, and limitations of value assessment framework methods. They also highlighted the challenges with evidence collection and data silos in precision medicine. Interoperability within and across health systems is hindering clinical advancements. Current medical coding systems also cannot account for the heterogeneity of many diseases, preventing health systems from having a complete understanding of their patient population to inform resource allocation. Challenges faced by payers, such as evidence limitations, to inform coverage and reimbursement decisions in precision medicine, as well as legal and regulatory barriers that inhibit more widespread data sharing, were also identified. While a broad range of perspectives was shared throughout the forum, participants reached consensus across 2 overarching areas. First, there is a greater need for common definitions, thresholds, and standards to guide evidence generation in precision medicine. Second, current information silos are preventing the sharing of valuable data. Collaboration among stakeholders is needed to support better information sharing, awareness, and education of precision medicine for patients. The recommendations brought forward by this diverse group of experts provide a set of solutions to spur widespread use and application of precision medicine. Taken together, successful adoption and use of precision medicine will require input and collaboration from all sectors of health care, especially patients. DISCLOSURES This AMCP Partnership Forum and the development of the proceedings document were supported by Amgen, Foundation Medicine, Genentech, Gilead, MedImpact, National Pharmaceutical Council, Precision for Value, Sanofi, Takeda, and Xcenda.

Designing eHealth that Matters via a Multidisciplinary Requirements Development Approach.

PubMed

Van Velsen, Lex; Wentzel, Jobke; Van Gemert-Pijnen, Julia Ewc

2013-06-24

Requirements development is a crucial part of eHealth design. It entails all the activities devoted to requirements identification, the communication of requirements to other developers, and their evaluation. Currently, a requirements development approach geared towards the specifics of the eHealth domain is lacking. This is likely to result in a mismatch between the developed technology and end user characteristics, physical surroundings, and the organizational context of use. It also makes it hard to judge the quality of eHealth design, since it makes it difficult to gear evaluations of eHealth to the main goals it is supposed to serve. In order to facilitate the creation of eHealth that matters, we present a practical, multidisciplinary requirements development approach which is embedded in a holistic design approach for eHealth (the Center for eHealth Research roadmap) that incorporates both human-centered design and business modeling. Our requirements development approach consists of five phases. In the first, preparatory, phase the project team is composed and the overall goal(s) of the eHealth intervention are decided upon. Second, primary end users and other stakeholders are identified by means of audience segmentation techniques and our stakeholder identification method. Third, the designated context of use is mapped and end users are profiled by means of requirements elicitation methods (eg, interviews, focus groups, or observations). Fourth, stakeholder values and eHealth intervention requirements are distilled from data transcripts, which leads to phase five, in which requirements are communicated to other developers using a requirements notation template we developed specifically for the context of eHealth technologies. The end result of our requirements development approach for eHealth interventions is a design document which includes functional and non-functional requirements, a list of stakeholder values, and end user profiles in the form of personas (fictitious end users, representative of a primary end user group). The requirements development approach presented in this article enables eHealth developers to apply a systematic and multi-disciplinary approach towards the creation of requirements. The cooperation between health, engineering, and social sciences creates a situation in which a mismatch between design, end users, and the organizational context can be avoided. Furthermore, we suggest to evaluate eHealth on a feature-specific level in order to learn exactly why such a technology does or does not live up to its expectations.

Do You Have Their Support? How to Make Informed Decisions Using Focus Groups

ERIC Educational Resources Information Center

Brent, Brian O.; Finnigan, Kara S.; Stewart, Tricia

2009-01-01

The authors spend their days making decisions. Often, the consequences of their choices seemingly affect only a handful of stakeholders. Regrettably, when they rely on a scattershot approach to gauging stakeholders' opinions, they often find themselves off the mark. Perhaps, they give too much credence to "squeaky wheels" even though their views…

Using Internet-Based Applications to Increase Collaboration among Stakeholders in Special Education

ERIC Educational Resources Information Center

Riggleman, Samantha; Buchter, Jennifer M.

2017-01-01

Input from parents of children with disabilities is highly valuable; however, barriers such as lack of time or travel can hinder the partnership between parents and stakeholders. Internet-based applications (e.g., Google Groups, Google Drive, and OneDrive) can alleviate some of the difficulties in collaborating. This article describes the use and…

Core Clinical Data Elements for Cancer Genomic Repositories: A Multi-stakeholder Consensus.

PubMed

Conley, Robert B; Dickson, Dane; Zenklusen, Jean Claude; Al Naber, Jennifer; Messner, Donna A; Atasoy, Ajlan; Chaihorsky, Lena; Collyar, Deborah; Compton, Carolyn; Ferguson, Martin; Khozin, Sean; Klein, Roger D; Kotte, Sri; Kurzrock, Razelle; Lin, C Jimmy; Liu, Frank; Marino, Ingrid; McDonough, Robert; McNeal, Amy; Miller, Vincent; Schilsky, Richard L; Wang, Lisa I

2017-11-16

The Center for Medical Technology Policy and the Molecular Evidence Development Consortium gathered a diverse group of more than 50 stakeholders to develop consensus on a core set of data elements and values essential to understanding the clinical utility of molecularly targeted therapies in oncology. Copyright © 2017 Elsevier Inc. All rights reserved.

The Stakeholder Approach to the Construction of Performance Measures.

ERIC Educational Resources Information Center

Crawford, John C.

Glasgow Caledonian University Library (Scotland) conducted a pilot study to design a set of user chosen performance measures which can be used in British academic libraries for data collection. Members of 8 stakeholder groups were identified and given an 103-question survey, with each question to be rated on a 1-5 scale of importance. Stakeholder…

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…

Stakeholders' resistance to telemedicine with focus on physicians: utilizing the Delphi technique.

PubMed

Choi, Woo Seok; Park, Joowoong; Choi, Jin Young Brian; Yang, Jae-Suk

2018-01-01

Introduction Sufficient infrastructure for information and communications technology (ICT) and a well-established policy are necessary factors for smooth implementation of telemedicine. However, despite these necessary conditions being met, there are situations where telemedicine still fails to be accepted as a system due to the low receptivity of stakeholders. In this study, we analyse stakeholders' resistance to an organization's implementation of telemedicine. Focusing on the physicians' interests, we propose a strategy to minimize conflicts and improve acceptance. Methods The Delphi study involved 190 telemedicine professionals who were recommended by 485 telemedicine-related personnel in South Korea. Results Out of 190 professionals, 60% of enrolled participants completed the final questionnaires. The stakeholders were categorized into four groups: policy-making officials, physicians, patients, and industrialists. Among these, the physicians were most opposed to the adoption of telemedicine. The main causes of such opposition were found to be the lack of a medical services delivery system and the threat of disruption for primary care clinics. Very little consensus was observed among the stakeholders, except on the following points: the need for expansion of the national health insurance budget by the government, and the need for enhancement of physicians' professional autonomy to facilitate smooth agreements. Discussion Our analysis on the causes of the resistance to telemedicine, carried out with the groups mentioned above, has important implications for policy-makers deriving strategies to achieve an appropriate consensus.

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.

Dental Providers' Perspectives on Diagnosis-Driven Dentistry: Strategies to Enhance Adoption of Dental Diagnostic Terminology.

PubMed

Obadan-Udoh, Enihomo; Simon, Lisa; Etolue, Jini; Tokede, Oluwabunmi; White, Joel; Spallek, Heiko; Walji, Muhammad; Kalenderian, Elsbeth

2017-07-13

The routine use of standardized diagnostic terminologies (DxTMs) in dentistry has long been the subject of academic debate. This paper discusses the strategies suggested by a group of dental stakeholders to enhance the uptake of DxTMs. Through unstructured interviewing at the 'Toward a Diagnosis-Driven Profession' National Conference held on 19 March 2016 in Los Angeles, CA, USA participants were asked how enthusiastic they were about implementing and consistently using DxTMs at their work. They also brainstormed on strategies to improve the widespread use of DxTMs. Their responses are summarized by recursive abstraction and presented in themes. Conference participants were very enthusiastic about using a DxTM in their place of work. Participants enumerated several strategies to make DxTMs more appealing including: the use of mandates, a value proposition for providers, communication and education, and integration with EHRs and existing systems. All groups across the dental healthcare delivery spectrum will need to work together for the success of the widespread and consistent use of DxTMs. Understanding the provider perspective is however the most critical step in achieving this goal, as they are the group who will ultimately be saddled with the critical task of ensuring DxTM use at the point of care.

Dental Providers’ Perspectives on Diagnosis-Driven Dentistry: Strategies to Enhance Adoption of Dental Diagnostic Terminology

PubMed Central

Obadan-Udoh, Enihomo; Etolue, Jini; Tokede, Oluwabunmi; White, Joel; Spallek, Heiko; Walji, Muhammad; Kalenderian, Elsbeth

2017-01-01

The routine use of standardized diagnostic terminologies (DxTMs) in dentistry has long been the subject of academic debate. This paper discusses the strategies suggested by a group of dental stakeholders to enhance the uptake of DxTMs. Through unstructured interviewing at the ‘Toward a Diagnosis-Driven Profession’ National Conference held on 19 March 2016 in Los Angeles, CA, USA participants were asked how enthusiastic they were about implementing and consistently using DxTMs at their work. They also brainstormed on strategies to improve the widespread use of DxTMs. Their responses are summarized by recursive abstraction and presented in themes. Conference participants were very enthusiastic about using a DxTM in their place of work. Participants enumerated several strategies to make DxTMs more appealing including: the use of mandates, a value proposition for providers, communication and education, and integration with EHRs and existing systems. All groups across the dental healthcare delivery spectrum will need to work together for the success of the widespread and consistent use of DxTMs. Understanding the provider perspective is however the most critical step in achieving this goal, as they are the group who will ultimately be saddled with the critical task of ensuring DxTM use at the point of care. PMID:28703751

Health system effects of implementing integrated community case management (iCCM) intervention in private retail drug shops in South Western Uganda: a qualitative study

PubMed Central

Mayora, Chrispus; Johansson, Emily White; Peterson, Stefan; Wamani, Henry; Bigdeli, Maryam; Shroff, Zubin Cyrus

2017-01-01

Background Intervening in private drug shops to improve quality of care and enhance regulatory oversight may have health system effects that need to be understood before scaling up any such interventions. We examine the processes through which a drug shop intervention culminated in positive unintended effects and other dynamic interactions within the underlying health system. Methods A multifaceted intervention consisting of drug seller training, supply of diagnostics and subsidised medicines, use of treatment algorithms, monthly supervision and community sensitisation was implemented in drug shops in South Western Uganda, to improve paediatric fever management. Focus group discussions and in-depth interviews were conducted with stakeholders (drug sellers, government officials and community health workers) at baseline, midpoint and end-line between September 2013 and September 2015. Using a health market and systems lens, transcripts from the interviews were analysed to identify health system effects associated with the apparent success of the intervention. Findings Stakeholders initially expressed caution and fears about the intervention’s implications for quality, equity and interface with the regulatory framework. Over time, these stakeholders embraced the intervention. Most respondents noted that the intervention had improved drug shop standards, enabled drug shops to embrace patient record keeping, parasite-based treatment of malaria and appropriate medicine use. There was also improved supportive supervision, and better compliance to licensing and other regulatory requirements. Drug seller legitimacy was enhanced from the community and client perspective, leading to improved trust in drug shops. Conclusion The study showed how effectively using health technologies and the perceived efficacy of medicines contributed to improved legitimacy and trust in drug shops among stakeholders. The study also demonstrated that using a combination of appropriate incentives and consumer empowerment strategies can help harmonise common practices with medicine regulations and safeguard public health, especially in mixed health market contexts. PMID:29259824

Health system effects of implementing integrated community case management (iCCM) intervention in private retail drug shops in South Western Uganda: a qualitative study.

PubMed

Kitutu, Freddy Eric; Mayora, Chrispus; Johansson, Emily White; Peterson, Stefan; Wamani, Henry; Bigdeli, Maryam; Shroff, Zubin Cyrus

2017-01-01

Intervening in private drug shops to improve quality of care and enhance regulatory oversight may have health system effects that need to be understood before scaling up any such interventions. We examine the processes through which a drug shop intervention culminated in positive unintended effects and other dynamic interactions within the underlying health system. A multifaceted intervention consisting of drug seller training, supply of diagnostics and subsidised medicines, use of treatment algorithms, monthly supervision and community sensitisation was implemented in drug shops in South Western Uganda, to improve paediatric fever management. Focus group discussions and in-depth interviews were conducted with stakeholders (drug sellers, government officials and community health workers) at baseline, midpoint and end-line between September 2013 and September 2015. Using a health market and systems lens, transcripts from the interviews were analysed to identify health system effects associated with the apparent success of the intervention. Stakeholders initially expressed caution and fears about the intervention's implications for quality, equity and interface with the regulatory framework. Over time, these stakeholders embraced the intervention. Most respondents noted that the intervention had improved drug shop standards, enabled drug shops to embrace patient record keeping, parasite-based treatment of malaria and appropriate medicine use. There was also improved supportive supervision, and better compliance to licensing and other regulatory requirements. Drug seller legitimacy was enhanced from the community and client perspective, leading to improved trust in drug shops. The study showed how effectively using health technologies and the perceived efficacy of medicines contributed to improved legitimacy and trust in drug shops among stakeholders. The study also demonstrated that using a combination of appropriate incentives and consumer empowerment strategies can help harmonise common practices with medicine regulations and safeguard public health, especially in mixed health market contexts.

Integrating partner professionals. The Early Explorers project: Peers Early Education Partnership and the health visiting service.

PubMed

Barlow, J; Coe, C

2013-01-01

  A range of voluntary sector organizations are involved in the delivery of services to children, particularly within the Early Year's sector and children's centres. Peers Early Education Partnership (PEEP) Early Explorers project is one example of the way in which explicit partnerships are being forged across statutory and voluntary sectors with the aim of improving outcomes for children and families. This paper reports an exploration of stakeholder views and experiences of two Early Explorer clinics located in areas of high deprivation.   Semi-structured interviews were conducted with a purposive sample of stakeholders (n= 25) from children's centres, PEEP, the health visiting service and service users. Data were fully transcribed and analysed using a thematic approach.   The data suggest that the two key groups of stakeholders providing Early Explorer clinics (i.e. health visitors and PEEP practitioners) had quite different objectives in terms of their early goals for the clinic, but that despite these differences good progress was achieved in terms of working together effectively. All stakeholders including service users referred to the presence of PEEP as having improved the quality of the clinic environment, and participating mothers identified a wide range of benefits from the enhanced service. However, somewhat restricted views about the role of practitioners within the clinics were identified by users, and the findings suggest that although the early goals for the clinic had been exceeded, these may have been limited in terms of true 'partnership' working.   Early Explorer clinics appeared to have enhanced the service provided within traditional child health clinics and to have provided practitioners with access to hard-to-reach families and parents with access to services that are consistent with the broader policy aims of improving parent-infant interaction. However, questions remain as to whether the benefit of 'partnership' working was fully realized. © 2011 Blackwell Publishing Ltd.

Trusting telemedicine: A discussion on risks, safety, legal implications and liability of involved stakeholders.

PubMed

Parimbelli, E; Bottalico, B; Losiouk, E; Tomasi, M; Santosuosso, A; Lanzola, G; Quaglini, S; Bellazzi, R

2018-04-01

The main purpose of the article is to raise awareness among all the involved stakeholders about the risks and legal implications connected to the development and use of modern telemedicine systems. Particular focus is given to the class of "active" telemedicine systems, that imply a real-world, non-mediated, interaction with the final user. A secondary objective is to give an overview of the European legal framework that applies to these systems, in the effort to avoid defensive medicine practices and fears, which might be a barrier to their broader adoption. We leverage on the experience gained during two international telemedicine projects, namely MobiGuide (pilot studies conducted in Spain and Italy) and AP@home (clinical trials enrolled patients in Italy, France, the Netherlands, United Kingdom, Austria and Germany), whose development our group has significantly contributed to in the last 4 years, to create a map of the potential criticalities of active telemedicine systems and comment upon the legal framework that applies to them. Two workshops have been organized in December 2015 and March 2016 where the topic has been discussed in round tables with system developers, researchers, physicians, nurses, legal experts, healthcare economists and administrators. We identified 8 features that generate relevant risks from our example use cases. These features generalize to a broad set of telemedicine applications, and suggest insights on possible risk mitigation strategies. We also discuss the relevant European legal framework that regulate this class of systems, providing pointers to specific norms and highlighting possible liability profiles for involved stakeholders. Patients are more and more willing to adopt telemedicine systems to improve home care and day-by-day self-management. An essential step towards a broader adoption of these systems consists in increasing their compliance with existing regulations and better defining responsibilities for all the involved stakeholders. Copyright © 2018 Elsevier B.V. All rights reserved.

Consortium for Atlantic Regional Assessment: information tools for community adaptation to changes in climate or land use.

PubMed

Dempsey, Rachael; Fisher, Ann

2005-12-01

To inform local and regional decisions about protecting short-term and long-term quality of life, the Consortium for Atlantic Regional Assessment (CARA) provides data and tools (for the northeastern United States) that can help decision makers understand how outcomes of their decisions could be affected by potential changes in both climate and land use. On an interactive, user-friendly website, CARA has amassed data on climate (historical records and future projections for seven global climate models), land cover, and socioeconomic and environmental variables, along with tools to help decision makers tailor the data for their own decision types and locations. CARA Advisory Council stakeholders help identify what information and tools stakeholders would find most useful and how to present these; they also provide in-depth feedback for subregion case studies. General lessons include: (1) decision makers want detailed local projections for periods short enough to account for extreme events, in contrast to the broader spatial and temporal observations and projections that are available or consistent at a regional level; (2) stakeholders will not use such a website unless it is visually appealing and easy to find the information they want; (3) some stakeholders need background while others want to go immediately to data, and some want maps while others want text or tables. This article also compares what has been learned across case studies of Cape May County, New Jersey, Cape Cod, Massachusetts, and Hampton Roads, Virginia, relating specifically to sea-level rise. Lessons include: (1) groups can be affected differently by physical dangers compared with economic dangers; (2) decisions will differ according to decision makers' preferences about waiting and risk tolerance; (3) future scenarios and maps can help assess the impacts of dangers to emergency evacuation routes, homes, and infrastructure, and the natural environment; (4) residents' and decision makers' perceptions are affected by information about potential local impacts from global climate change.

Improving implementation of mental health services for trauma in multicultural elementary schools: stakeholder perspectives on parent and educator engagement.

PubMed

Langley, Audra; Santiago, Catherine DeCarlo; Rodríguez, Adriana; Zelaya, Jennifer

2013-07-01

Although more schools are offering mental health programs, few studies have involved the school community in research to improve their successful implementation. In this community-partnered study, focus groups were conducted with school staff and parents to explore issues related to community engagement and feasibility of a mental health intervention for elementary school students exposed to trauma. Four educator focus groups, including 23 participants, and 2 parent focus groups, consisting of 9 Spanish-speaking and 7 English-speaking parents were conducted. Participants discussed facilitators and barriers to successful implementation of the program. Participants identified the importance of pre-implementation parent education, raising awareness of the impact of student mental health among educators, maintaining ongoing communication during the intervention, and addressing logistical concerns. Participants described clear considerations for parent and educator engagement, both at the pre-implementation phase and during implementation of the program. Implications for next steps of this community-partnered approach are described.

Improving Implementation of Mental Health Services for Trauma in Multicultural Elementary Schools: Stakeholder Perspectives on Parent and Educator Engagement

PubMed Central

Santiago, Catherine DeCarlo; Rodríguez, Adriana; Zelaya, Jennifer

2013-01-01

Although more schools are offering mental health programs, few studies have involved the school community in research to improve their successful implementation. In this community partnered study, focus groups were conducted with school staff and parents to explore issues related to community engagement and feasibility of a mental health intervention for elementary school students exposed to trauma. Four educator focus groups, including 23 participants, and 2 parent focus groups, consisting of 9 Spanish-speaking and 7 English-speaking parents were conducted. Participants discussed facilitators and barriers to successful implementation of the program. Participants identified the importance of pre-implementation parent education, raising awareness of the impact of student mental health among educators, maintaining ongoing communication during the intervention, and addressing logistical concerns. Participants described clear considerations for parent and educator engagement both at the pre implementation phase and during implementation of the program. Implications for next steps of this community partnered approach are described. PMID:23576136

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/.

Factors for success in mental health advocacy

PubMed Central

Hann, Katrina; Pearson, Heather; Campbell, Doris; Sesay, Daniel; Eaton, Julian

2015-01-01

Background Mental health advocacy groups are an effective way of pushing the mental health agenda and putting pressure on national governments to observe the right to health; however, there is limited research that highlights best practices for such groups in low-resource settings. In an effort to improve the scaling up of mental health in Sierra Leone, stakeholders came together to form the country's first mental health advocacy group: the Mental Health Coalition – Sierra Leone. Since its inception, the group has worked towards raising the profile of mental health in Sierra Leone and developing as an advocacy organisation. Design The study's aim was to investigate views on enabling factors and barriers associated with mental health advocacy in a low-income country using a community-based participatory approach and qualitative methodology. Focus groups (N=9) were held with mental health stakeholders, and key informant interviews (N=15) were conducted with advocacy targets. Investigators analysed the data collaboratively using coding techniques informed by grounded theory. Results Investigators reveal viewpoints on key factors in networking, interacting with government actors, and awareness raising that enabled mental health advocacy aims of supporting policy, service delivery, service user rights, training for service delivery, and awareness raising. The investigators outline viewpoints on barriers for advocacy aims in framing the issue of mental health, networking, interacting with government actors, resource mobilization, and awareness raising. Conclusions The findings outline enabling factors, such as networking with key stakeholders, and barriers, such as lack of political will, for achieving mental health advocacy aims within a low-resource setting, Sierra Leone. Stakeholder coalitions can further key policy development aims that are essential to strengthen mental health systems in low-resource settings. PMID:26689456

Factors for success in mental health advocacy.

PubMed

Hann, Katrina; Pearson, Heather; Campbell, Doris; Sesay, Daniel; Eaton, Julian

2015-01-01

Mental health advocacy groups are an effective way of pushing the mental health agenda and putting pressure on national governments to observe the right to health; however, there is limited research that highlights best practices for such groups in low-resource settings. In an effort to improve the scaling up of mental health in Sierra Leone, stakeholders came together to form the country's first mental health advocacy group: the Mental Health Coalition - Sierra Leone. Since its inception, the group has worked towards raising the profile of mental health in Sierra Leone and developing as an advocacy organisation. The study's aim was to investigate views on enabling factors and barriers associated with mental health advocacy in a low-income country using a community-based participatory approach and qualitative methodology. Focus groups (N=9) were held with mental health stakeholders, and key informant interviews (N=15) were conducted with advocacy targets. Investigators analysed the data collaboratively using coding techniques informed by grounded theory. Investigators reveal viewpoints on key factors in networking, interacting with government actors, and awareness raising that enabled mental health advocacy aims of supporting policy, service delivery, service user rights, training for service delivery, and awareness raising. The investigators outline viewpoints on barriers for advocacy aims in framing the issue of mental health, networking, interacting with government actors, resource mobilization, and awareness raising. The findings outline enabling factors, such as networking with key stakeholders, and barriers, such as lack of political will, for achieving mental health advocacy aims within a low-resource setting, Sierra Leone. Stakeholder coalitions can further key policy development aims that are essential to strengthen mental health systems in low-resource settings.

A process for developing standards to promote quality in general practice.

PubMed

Khoury, Julie; Krejany, Catherine J; Versteeg, Roald W; Lodewyckx, Michaela A; Pike, Simone R; Civil, Michael S; Jiwa, Moyez

2018-06-02

Since 1991, the Royal Australian College of General Practitioners' (RACGP) Standards for General Practices (the Standards) have provided a framework for quality care, risk management and best practice in the operation of Australian general practices. The Standards are also linked to incentives for general practice remuneration. These Standards were revised in 2017. The objective of this study is to describe the process undertaken to develop the fifth edition Standards published in 2017 to inform future standards development both nationally and internationally. A modified Delphi process was deployed to develop the fifth edition Standards. Development was directed by the RACGP and led by an expert panel of GPs and representatives of stakeholder groups who were assisted and facilitated by a team from RACGP. Each draft was released for stakeholder feedback and tested twice before the final version was submitted for approval by the RACGP board. Four rounds of consultation and two rounds of piloting were carried out over 32 months. The Standards were redrafted after each round. One hundred and fifty-two individuals and 225 stakeholder groups participated in the development of the Standards. Twenty-three new indicators were recommended and grouped into three sections in a new modular structure that was different from the previous edition. The Standards represent the consensus view of national stakeholders on the indicators of quality and safety in Australian general practice and primary care.

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.

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.

Sensemaking, Stakeholder Discord, and Long-Term Risk Communication at a U.S. Superfund Site

PubMed Central

Hoover, Anna Goodman

2018-01-01

Introduction Risk communication can help reduce exposures to environmental contaminants, mitigate negative health outcomes, and inform community-based decisions about hazardous waste sites. While communication best practices have long guided such efforts, little research has examined unintended consequences arising from such guidelines. As rhetoric informs stakeholder sensemaking, the language used in and reinforced by these guidelines can challenge relationships and exacerbate stakeholder tensions. Objectives This study evaluates risk communication at a U.S. Superfund site to identify unintended consequences arising from current risk communication practices. Methods This qualitative case study crystallizes data spanning 6 years from three sources: 1) local newspaper coverage of site-related topics; 2) focus-group transcripts from a multi-year project designed to support future visioning of site use; and 3) published blog entries authored by a local environmental activist. Constant comparative analysis provides the study’s analytic foundation, with qualitative data analysis software QSR NVivo 8 supporting a three-step process: 1) provisional coding to identify broad topic categories within datasets, 2) coding occurrences of sensemaking constructs and emergent intra-dataset patterns, and 3) grouping related codes across datasets to examine the relationships among them. Results Existing risk communication practices at this Superfund site contribute to a dichotomous conceptualization of multiple and diverse stakeholders as members of one of only two categories: the government or the public. This conceptualization minimizes perceptions of capacity, encourages public commitment to stances aligned with a preferred group, and contributes to negative expectations that can become self-fulfilling prophecies. Conclusion Findings indicate a need to re-examine and adapt risk communication guidelines to encourage more pluralistic understanding of the stakeholder landscape. PMID:28282297

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

PubMed

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

2008-01-01

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

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".

Stakeholders' perceptions of rehabilitation services for individuals living with disability: a survey study.

PubMed

Darzi, Andrea J; Officer, Alana; Abualghaib, Ola; Akl, Elie A

2016-01-08

The World Health Organization (WHO) was tasked with developing health system guidelines for the implementation of rehabilitation services. Stakeholders' perceptions are an essential factor to take into account in the guideline development process. The aim of this study was to assess stakeholders' perceived feasibility and acceptability of eighteen rehabilitation services and the values they attach to ten rehabilitation outcomes. We disseminated an online self-administered questionnaire through a number of international and regional organizations from the different WHO regions. Eligible individuals included persons with disability, caregivers of persons with disability, health professionals, administrators and policy makers. The answer options consisted of a 9-point Likert scale. Two hundred fifty three stakeholders participated. The majority of participants were health professional (64 %). In terms of outcomes, 'Increasing access' and 'Optimizing utilization' were the top service outcomes rated as critical (i.e., 7, 8 or 9 on the Likert scale) by >70 % of respondents. 'Fewer hospital admissions', 'Decreased burden of care' and 'Increasing longevity' were the services rated as least critical (57 %, 63 % and 58 % respectively). In terms of services, 'Community based rehabilitation' and 'Home based rehabilitation' were found to be both definitely feasible and acceptable (75 % and 74 % respectively). 'Integrated and decentralized rehabilitation services' was found to be less feasible than acceptable according to stakeholders (61 % and 71 % respectively). As for 'Task shifting', most stakeholders did not appear to find task shifting as either definitely feasible or definitely acceptable (63 % and 64 % respectively). The majority of stakeholder's perceived 'Increasing access' and 'Optimizing utilization' as most critical amongst rehabilitation outcomes. The feasibility of the 'Integrated and decentralized rehabilitation services' was perceived to be less than their acceptability. The majority of stakeholders found 'Task shifting' as neither feasible nor acceptable.

Enhancing school asthma action plans: qualitative results from southeast Minnesota beacon stakeholder groups.

PubMed

Egginton, Jason S; Textor, Lauren; Knoebel, Erin; McWilliams, Deborah; Aleman, Marty; Yawn, Barbara

2013-12-01

This study explores ways southeast Minnesota schools currently address asthma problems, identifies areas for improvement, and assesses the potential value of asthma action plans (AAPs) in schools. Focus groups were used to query stakeholder groups on asthma care in schools. Groups were held separately for elementary school personnel, parents of elementary school children with asthma, and health professionals (N = 103). Transcripts were analyzed by hand and by using NVivo 9 software. Overall 103 stakeholders participated in focus groups. Major themes were (1) Communication; no uniform way of exchanging information between schools and health professionals. (2) Asthma Control Continuum; students require individualized instructions and information related to their asthma care. (3) Policy/Protocol; school staff roles and rules vary and are unclear. (4) Self-Reliance; older children self-manage their asthma and are unknown until they need emergent support. Solution recommended included AAPs used systematically with a method to communicate back from schools to physicians and parents. The AAP may solve several of the school's concerns regarding their ability to provide asthma support in school. However, the AAP must reach the school, and that is currently not happening. In addition, schools would like tools and systems to assess asthma control and share information back with parents and physicians. © 2013, American School Health Association.

The role of public schools in HIV prevention: perspectives from African Americans in the rural South.

PubMed

Lloyd, Stacey W; Ferguson, Yvonne Owens; Corbie-Smith, Giselle; Ellison, Arlinda; Blumenthal, Connie; Council, Barbara J; Youmans, Selena; Muhammad, Melvin R; Wynn, Mysha; Adimora, Adaora; Akers, Aletha

2012-02-01

Though African-American youth in the South are at high risk for HIV infection, abstinence until marriage education continues to be the only option in some public schools. Using community-based participatory research methods, we conducted 11 focus groups with African-American adults and youth in a rural community in North Carolina with high rates of HIV infection with marked racial disparities. Focus group discussions explored participant views on contributors to the elevated rates of HIV and resources available to reduce transmission. Participants consistently identified the public schools' sex education policies and practices as major barriers toward preventing HIV infection among youth in their community. Ideas for decreasing youth's risk of HIV included public schools providing access to health services and sex education. Policymakers, school administrators, and other stakeholders should consider the public school setting as a place to provide HIV prevention education for youth in rural areas.

Stakeholders' views on data sharing in multicenter studies.

PubMed

Mazor, Kathleen M; Richards, Allison; Gallagher, Mia; Arterburn, David E; Raebel, Marsha A; Nowell, W Benjamin; Curtis, Jeffrey R; Paolino, Andrea R; Toh, Sengwee

2017-09-01

To understand stakeholders' views on data sharing in multicenter comparative effectiveness research studies and the value of privacy-protecting methods. Semistructured interviews with five US stakeholder groups. We completed 11 interviews, involving patients (n = 15), researchers (n = 10), Institutional Review Board and regulatory staff (n = 3), multicenter research governance experts (n = 2) and healthcare system leaders (n = 4). Perceptions of the benefits and value of research were the strongest influences toward data sharing; cost and security risks were primary influences against sharing. Privacy-protecting methods that share summary-level data were acknowledged as being appealing, but there were concerns about increased cost and potential loss of research validity. Stakeholders were open to data sharing in multicenter studies that offer value and minimize security risks.

Perceptions of pharmacists' roles in the era of expanding scopes of practice.

PubMed

Schindel, Theresa J; Yuksel, Nese; Breault, Rene; Daniels, Jason; Varnhagen, Stanley; Hughes, Christine A

Alberta was the first province in Canada to enact legislative changes to permit expansion of pharmacists' scope of practice, including allowing pharmacists to prescribe. However, such changes to the scope of practice can blur professional boundaries and obscure the roles of pharmacists. Understanding perceptions about the pharmacist's role may provide insight into recent and historical changes in pharmacy practice. This study clarifies perceptions held by pharmacists and other stakeholders concerning the role of the pharmacist in society. To understand the perceptions of pharmacists, pharmacy students, technicians, other health care professionals, and the public of the pharmacist's role in Alberta. A mixed methods approach was used: focus group sessions (n = 9) and individual interviews (n = 4) of pharmacists and other stakeholders were conducted and analyzed using qualitative-descriptive approach. A web-based survey of Alberta pharmacists (n = 416) explored pharmacists' perceptions of their own roles. Data analysis revealed the following: participants perceived that the pharmacist's role was transitioning to focus more on patient care; consistency in pharmacist uptake of this new role shaped the public's expectations; pharmacists with expanded scopes of practice were assuming greater responsibility; collaboration and relationships with other health care professionals were essential. The survey confirmed that changes in the roles of pharmacists were primarily related to patient care. Following legislative changes and implementation of a compensation framework for pharmacy services, pharmacists and other stakeholders perceived the pharmacist's role to be shifting toward patient care. Periodic revisiting of pharmacists' roles and professional activities is needed to evaluate changes over time. Copyright © 2016 Elsevier Inc. All rights reserved.

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

PubMed

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

2011-08-01

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

Data Safe Havens in health research and healthcare.

PubMed

Burton, Paul R; Murtagh, Madeleine J; Boyd, Andy; Williams, James B; Dove, Edward S; Wallace, Susan E; Tassé, Anne-Marie; Little, Julian; Chisholm, Rex L; Gaye, Amadou; Hveem, Kristian; Brookes, Anthony J; Goodwin, Pat; Fistein, Jon; Bobrow, Martin; Knoppers, Bartha M

2015-10-15

The data that put the 'evidence' into 'evidence-based medicine' are central to developments in public health, primary and hospital care. A fundamental challenge is to site such data in repositories that can easily be accessed under appropriate technical and governance controls which are effectively audited and are viewed as trustworthy by diverse stakeholders. This demands socio-technical solutions that may easily become enmeshed in protracted debate and controversy as they encounter the norms, values, expectations and concerns of diverse stakeholders. In this context, the development of what are called 'Data Safe Havens' has been crucial. Unfortunately, the origins and evolution of the term have led to a range of different definitions being assumed by different groups. There is, however, an intuitively meaningful interpretation that is often assumed by those who have not previously encountered the term: a repository in which useful but potentially sensitive data may be kept securely under governance and informatics systems that are fit-for-purpose and appropriately tailored to the nature of the data being maintained, and may be accessed and utilized by legitimate users undertaking work and research contributing to biomedicine, health and/or to ongoing development of healthcare systems. This review explores a fundamental question: 'what are the specific criteria that ought reasonably to be met by a data repository if it is to be seen as consistent with this interpretation and viewed as worthy of being accorded the status of 'Data Safe Haven' by key stakeholders'? We propose 12 such criteria. paul.burton@bristol.ac.uk. © The Author 2015. Published by Oxford University Press.

One size fits all partnerships? What explains community partnership leadership skills?

PubMed

El Ansari, Walid; Oskrochi, Reza; Phillips, Ceri J

2010-07-01

The authors evaluated W. K. Kellogg-funded Community Partnerships (CPs) between academic, health service, and community partners in South Africa. Stakeholders (N = 668 respondents) completed questionnaires to explore the operational, functional and organisational factors that contribute to members' perceptions of the skills of their CPs' leadership. Ten factors accounted for 53% of leadership skills across five participating CPs and six stakeholder groups. Each CP displayed its unique footprint of factors that accounted for its leadership levels. Similarly, each stakeholder group had its unique signature of factors that were associated with its leadership. Two factors (communication mechanisms and operational understanding) accounted for more than 25% of leadership skills; management capabilities and participation benefits accounted for 4% and 3%; and effectiveness, benefits to difficulties ratio of being a member, engagement in education, flow of information and sense of ownership accounted for 2% to 3% each. Attention to these and other factors is warranted.

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

Safety assessment of a home-based telecare system for adults with developmental disabilities in Indiana: a multi-stakeholder perspective.

PubMed

Brewer, Jeffrey L; Taber-Doughty, Teresa; Kubik, Sara

2010-01-01

We investigated the perceptions of people about the safety, security and privacy of a telecare monitoring system for adults with developmental disabilities living in residential settings. The telecare system was used by remote caregivers overnight, when staff were not present in the homes. We surveyed 127 people from different stakeholder groups in the state of Indiana. The people surveyed included those with knowledge or experience of telecare, and those without. The stakeholders were clients, their advocates, service provider administrators and independent case coordinators. The responses in each category for every group were positive except one: only 4 of the 11 telecare case coordinators agreed that the telecare system provided a secure environment. Overall, the telecare system was perceived to be as safe, secure and private as the conventional alternative of having staff in the home.

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.

Changing social norms: a mass media campaign for youth ages 12-18.

PubMed

Schmidt, Eileen; Kiss, Susan Mide; Lokanc-Diluzio, Wendi

2009-01-01

To create a mass media campaign that endeavours to a) denormalize tobacco use among youth aged 12-18, b) empower youth to stay tobacco product free, and c) increase awareness of the dangers of tobacco use, while using positive messaging. Target age group was youth between the ages of 12 and 18 years. The mass media campaign was developed, implemented, and evaluated within the city of Calgary. The mass media campaign consisted of posters for schools and other venues frequented by youth (e.g., community centres, libraries, fitness centres, restaurants, movie theatres), posters for transit (e.g., bus shelters, LRT shelters, back of bus) print advertisements, television/radio public service announcements, an interactive community website for youth, a media launch event, promotional items, and organizational efforts to cross-promote the campaign. The creative concept was based on intercept interviews, focus group testing, and other research conducted by the campaign's creative team and youth volunteers in order to identify the key elements of this campaign. A total of 149 students completed both a baseline and follow-up survey to evaluate the marketing activities of the campaign. A total of 27 youth participated in prototype testing to compare this positive-messaging campaign with negative-toned tobacco reduction campaigns. Six stakeholders/partners participated in stakeholder interviews to assess their thoughts and learnings regarding the campaign process. The evaluation respondents viewed the campaign positively and showed strong recall of the messaging.

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

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

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

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

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.

Using the theoretical domains framework to guide the development of a self-management program for individuals with spinal cord injury: Results from a national stakeholder advisory group.

PubMed

Munce, Sarah E P; Allin, Sonya; Wolfe, Dalton L; Anzai, Karen; Linassi, Gary; Noonan, Vanessa K; Jaglal, Susan B

2017-11-01

To determine the implementation considerations for a targeted self-management program for individuals with spinal cord injury (SCI) from the perspective of a national stakeholder advisory group using the Theoretical Domains Framework (TDF) as a guide. Qualitative descriptive approach. Two focus groups held at the 6 th National Spinal Cord Injury Conference (October 2-4 th , 2014) in Toronto, Ontario, Canada. A total of 25 stakeholders from across Canada participated in focus groups or "brainstorming sessions". The stakeholders included 5 clinicians, 14 researchers, 3 policy makers, and 3 individuals with SCI. Not applicable. Not applicable. All 14 theoretical domains were identified in the brainstorming sessions. No new themes or domains were identified. The need to consider the theoretical domains of Knowledge, Skills, Reinforcement, Intentions, Goals (e.g. the readiness of the individual with SCI), Environmental Context and Resources (e.g. considerations for governance and ownership of the program and a business model for sustainability), as well as Social Influences (e.g. issues of privacy and security in the context of on-line delivery) was identified. The current study provides complementary results to our previous series of studies on the implementation considerations for the development of a targeted self-management program for individuals with SCI by emphasizing the health care professional/health policy perspective. It is anticipated that such a program could not only reduce secondary complications and subsequent inappropriate health care use but it may also improve the quality of life for individuals with SCI and their caregivers.

Collaboration for Actionable Climate Science in Hawaii and the US-Affiliated Pacific Islands

NASA Astrophysics Data System (ADS)

Keener, V. W.; Grecni, Z. N.; Helweg, D. A.

2016-12-01

Hawaii and the US-Affiliated Pacific Islands (USAPI) encompass more than 2000 islands spread across millions of square miles of ocean. Islands can be high volcanic or low atolls, and vary widely in terms of geography, climate, ecology, language, culture, economies, government, and vulnerability to climate change impacts. For these reasons, meaningful collaboration across research groups and climate organizations is not only helpful, it is mandatory. No single group can address all the needs of every island, stakeholder, or sector, which has led to close collaboration and leveraging of research in the region to fill different niches. The NOAA-funded Pacific Regional Integrated Sciences & Assessments (RISA) program, DOI Pacific Islands Climate Science Center (PICSC), and the DOI LCC the Pacific Islands Climate Change Cooperative (PICCC) all take a stakeholder oriented approach to climate research, and have successfully collaborated on both specific projects and larger initiatives. Examples of these collaborations include comprising the core team of the Pacific Islands Regional Climate Assessment (PIRCA), the regional arm of the US National Climate Assessment, co-sponsoring a workshop on regional downscaling for scientists and managers, leveraging research projects across multiple sectors on a single island, collaborating on communication products such as handouts and websites to ensure a consistent message, and in the case of the Pacific RISA and the PICSC, jointly funding a PIRCA Sustained Assessment Specialist position. Barriers to collaboration have been around topics such as roles of research versus granting groups, perceived research overlap, and funding uncertainties. However, collaborations have been overwhelming positive in the Pacific Islands region due to communication, recognition of partners' strengths and expertise, and especially because of the "umbrella" organization and purpose provided by the PIRCA structure, which provides a shared platform for all regional groups working on climate science and adaptation, not owned by any one group. This work will give examples of successes and barriers encountered in the region.

Barriers and Facilitators Affecting Patient Portal Implementation from an Organizational Perspective: Qualitative Study.

PubMed Central

Kooij, Laura; Groen, Wim G

2018-01-01

Background The number of patient portals is rising, and although portals can have positive effects, their implementation has major impacts on the providing health care institutions. However, little is known about the organizational factors affecting successful implementation. Knowledge of the specific barriers to and facilitators of various stakeholders is likely to be useful for future implementations. Objective The objective of this study was to identify the barriers to and facilitators of patient portal implementation facing various stakeholders within hospital organizations in the Netherlands. Methods Purposive sampling was used to select hospitals of various types. A total of 2 university medical centers, 3 teaching hospitals, and 2 general hospitals were included. For each, 3 stakeholders were interviewed: (1) medical professionals, (2) managers, and (3) information technology employees. In total, 21 semistructured interviews were conducted using the Grol and Wensing model, which describes barriers to and facilitators of change in health care practice at 6 levels: (1) innovation; (2) individual professional; (3) patient; (4) social context; (5) organizational context; and (6) economic and political context. Two researchers independently selected and coded quotes by applying this model using a (deductive) directed content approach. Additional factors related to technical and portal characteristics were added using the model of McGinn et al, developed for implementation of electronic health records. Results In total, we identified 376 quotes, 26 barriers, and 28 facilitators. Thirteen barriers and 12 facilitators were common for all stakeholder groups. The facilitators’ perceived usefulness (especially less paperwork) was mentioned by all the stakeholders, followed by subjects’ positive attitude. The main barriers were lack of resources (namely, lack of staff and materials), financial difficulties (especially complying with high costs, lack of reimbursements), and guaranteeing privacy and security (eg, strict regulations). Both similarities and differences were found between stakeholder groups and hospital types. For example, managers and information technology employees mainly considered guaranteeing privacy and security as a predominant barrier. Financial difficulties were particularly mentioned by medical professionals and managers. Conclusions Patient portal implementation is a complex process and is not only a technical process but also affects the organization and its staff. Barriers and facilitators occurred at various levels and differed among hospital types (eg, lack of accessibility) and stakeholder groups (eg, sufficient resources) in terms of several factors. Our findings underscore the importance of involving multiple stakeholders in portal implementations. We identified a set of barriers and facilitators that are likely to be useful in making strategic and efficient implementation plans. PMID:29752253

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

PubMed

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

2016-01-01

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

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.

Stakeholder analysis: a review.

PubMed

Brugha, R; Varvasovszky, Z

2000-09-01

The growing popularity of stakeholder analysis reflects an increasing recognition of how the characteristics of stakeholders--individuals, groups and organizations--influence decision-making processes. This paper reviews the origins and uses of stakeholder analysis, as described in the policy, health care management and development literature. Its roots are in the political and policy sciences, and in management theory where it has evolved into a systematic tool with clearly defined steps and applications for scanning the current and future organizational environment. Stakeholder analysis can be used to generate knowledge about the relevant actors so as to understand their behaviour, intentions, interrelations, agendas, interests, and the influence or resources they have brought--or could bring--to bear on decision-making processes. This information can then be used to develop strategies for managing these stakeholders, to facilitate the implementation of specific decisions or organizational objectives, or to understand the policy context and assess the feasibility of future policy directions. Policy development is a complex process which frequently takes place in an unstable and rapidly changing context, subject to unpredictable internal and external factors. As a cross-sectional view of an evolving picture, the utility of stakeholder analysis for predicting and managing the future is time-limited and it should be complemented by other policy analysis approaches.

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.

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.

Serious-game for water resources management adaptation training to climatic changes

NASA Astrophysics Data System (ADS)

Leroy, Eve; Saulnier, Georges-Marie

2013-04-01

Water resources access is a main issue for territorial development to ensure environmental and human well-being. Indeed, sustainable development is vulnerable to water availability and climate change may affect the quantity and temporality of available water resources for anthropogenic water uses. How then to adapt, how to change water management rules and practices and how to involve stakeholders is such process? To prevent water scarcity situations, which may generate conflicts and impacts on ecosystems, it is important to think about a sustainable development where anthropogenic water uses are in good balance with forecasted water resources availability. This implies to raise awareness and involve stakeholders for a sustainable water management. Stakeholders have to think about future territorial development taking into account climate change impacts on water resources. Collaboration between scientists and stakeholders is essential to insure consistent climate change knowledge, well identification of anthropogenic uses, tensions and stakes of the territory. However sharing information on complex questions such as climate change, hydro-meteorological modeling and practical constraints may be a difficult task. Therefore to contribute to an easier debate and to the global training of all the interested actors, a serious game about water management was built. The serious game uses scientist complex models with real data but via a simple and playful web-game interface. The advantage of this interface is that it may help stakeholders, citizen or the target group to raise their understandings of impacts of climate change on water resources and to raise their awareness to the need for a sustainable water management while using state-of-the-art knowledge. The principle of the game is simple. The gamer is a mayor of a city and has to manage the water withdrawals from hydro systems, water distribution and consumption, water retreatment etc. In the same time, a clock is running and climate change occurs on the territory which impacts the water resources. The gamer has to deal with this evolution and try to help its municipality in growing. If the water management plays well the city can develop. At the opposite, wrong player decisions may generate water, energy or food scarcities, which lead the city to decrease. A first version of this game still under development was built. It makes uses of data from a famous French ski resort: Megève municipality. A demo of this game will be presented. Under a playful approach the serious game helps to discuss essential but strained topics between stakeholders, scientists and citizens. It may be considered as a useful tool for decision support and explanation of a complex topic. It is also hoped that this approach offers new ways of collaboration with stakeholders to approach complex situations in order to find the best paths for future water management.

Impact of an Institutional Merger on Four Internal Stakeholder Groups of a College of Business?

ERIC Educational Resources Information Center

Williams, Henry; Feldman, Lori; Conners, Susan

2017-01-01

This paper compares the pre- and post-impact of a merger of two regional campuses in a statewide university system on its students, faculty, administrative, and professional support staff. Specifically, it looks at stakeholder impacts of the merger of the two Colleges of Business on these regional campuses into one entity. The second year of a…

A Case Study on the Personal Constructs of How Stakeholders of a Regional Alternative Day School Facility Make Meaning of the Physical Plant

ERIC Educational Resources Information Center

Schultz, Penny D.

2011-01-01

This case study involved an examination of stakeholders' (parents, community members, staff members, students) perceptions of how they made meaning of a regional alternative day school located in the Commonwealth of Virginia. Individual interviews were conducted with the parents, community members, and students. One focus group interview was…

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...

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.

The development of an instrument for evaluating clinical teachers: involving stakeholders to determine content validity.

PubMed

Stalmeijer, Renée E; Dolmans, Diana H J M; Wolfhagen, Ineke H A P; Muijtjens, Arno M M; Scherpbier, Albert J J A

2008-01-01

Research indicates that the quality of supervision strongly influences the learning of medical students in clinical practice. Clinical teachers need feedback to improve their supervisory skills. The available instruments either lack a clear theoretical framework or are not suitable for providing feedback to individual teachers. We developed an evaluation instrument based on the 'cognitive apprenticeship model'. The aim was to estimate the content validity of the developed instrument. Item relevance was rated on a five-point scale (1 = highly irrelevant, 5 = highly relevant) by three groups of stakeholders in undergraduate clinical teaching: educationalists (N = 12), doctors (N = 16) and students (N = 12). Additionally, stakeholders commented on content, wording and omission of items. The items were generally rated as very relevant (Mean = 4.3, SD = 0.38, response = 95%) and any differences between the stakeholder groups were small. The results led to elimination of 4 items, rewording of 13 items and addition of 1 item. The cognitive apprenticeship model appears to offer a useful framework for the development of an evaluation instrument aimed at providing feedback to individual clinical teachers on the quality of student supervision. Further studies in larger populations will have to establish the instrument's statistical validity and generalizability.

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

PubMed

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

2013-07-01

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

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

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

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

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

Equine Welfare Assessment: Exploration of British Stakeholder Attitudes Using Focus-Group Discussions.

PubMed

Horseman, Susan V; Hockenhull, Jo; Buller, Henry; Mullan, Siobhan; Barr, Alistair R S; Whay, Helen R

2017-01-01

The equine industry in Great Britain has not been subject to the same pressures as the farming industry to engage with welfare assessment, but this may change as concern about equine welfare increases. Stakeholder attitudes toward welfare assessment may impact the implementation of welfare assessment practices. Focus-group discussions regarding welfare assessment were conducted with 6 equine stakeholder groups: leisure horse owners (caregivers; n = 4), grooms (n = 5), veterinary surgeons (n = 3), welfare scientists (n = 4), welfare charity workers (n = 5), and professional riders (n = 4). Three themes emerged from the discussions: (a) Participants predominantly interpreted welfare assessment as a means of identifying and correcting poor welfare in an immediate way; (b) participants believed that horse welfare varied over time; and (c) attributes of the assessor were viewed as an important consideration for equine welfare assessment. The views of equine industry members give insight into the value welfare assessments may have to the industry and how equine welfare assessment approaches can achieve credibility within the industry and increase the positive impact of welfare assessments on equine welfare.

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

PubMed

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

2016-01-01

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

Designing a cultural competency curriculum: asking the stakeholders.

PubMed

Kamaka, Martina L

2010-06-01

The design of a cultural competency curriculum can be challenging. The 2002 Institute of Medicine report, Unequal Treatment, challenged medical schools to integrate cross-cultural education into the training of all current and future health professionals. However, there is no current consensus on how to do this. The Department of Native Hawaiian Health at the John A. Burns School of Medicine formed a Cultural Competency Curriculum Development team that was charged with developing a curriculum for the medical school to address Native Hawaiian health disparities. By addressing cultural competency training of physicians, the team is hoping to help decrease the health disparities found in Native Hawaiians. Prior attempts to address culture at the time consisted of conferences sponsored by the Native Hawaiian Center of Excellence for faculty and clinicians and Problem Based Learning cases that have imbedded cultural issues. Gather ideas from focus groups of Native Hawaiian stake- holders. The stakeholders consisted of Native Hawaiian medical students, patients and physicians. Information from the focus groups would be incorporated into a medical school curriculum addressing Native Hawaiian health and cultural competency training. Focus groups were held with Native Hawaiian medical students, patients and physicians in the summer and fall of 2006. Institutional Review Board approval was obtained from the University of Hawaii as well as the Native Hawaiian Health Care Systems. Qualitative analysis of tape recorded data was performed by looking for recurrent themes. Primary themes and secondary themes were ascertained based on the number of participants mentioning the topic. Amongst all three groups, cultural sensitivity training was either a primary theme or secondary theme. Primary themes were mentioned by all students, by 80% of the physicians and were mentioned in all 4 patient groups. Secondary themes were mentioned by 75% of students, 50% of the physicians and by 75% of patient group. All groups wanted medical students to receive cultural sensitivity training, and all wanted traditional healing to be included in the training. The content of the training differed slightly between groups. Students wanted a diversity of teaching modalities as well as cultural issues in exams in order to emphasize their importance. They also felt that faculty needed cultural competency training. Patients wanted students to learn about the host culture and its values. Physicians felt that personal transformation was an important and effective tool in cultural sensitivity training. Cultural immersion is a potential teaching tool but physicians were concerned about student stages of readiness and adequate preparation for cultural competency training modalities such as cultural immersion. Cultural competency or sensitivity training was important to patients, students and physicians. The focus group data is being used to help guide the development of the Department of Native Hawaiian Health's cultural competency curriculum. Hawaii Medical Journal Copyright 2010.

75 FR 54872 - Drinking Water Strategy Contaminants as Group(s)-Notice of Public Stakeholder Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-09

... technologies to address health risks posed by a broad array of contaminants; using the authority of multiple... potential contaminant groups, share advantages and disadvantages of various groups, identify issues needing...

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.

Making Research Results Relevant and Useable: Presenting Complex Organizational Context Data to Nonresearch Stakeholders in the Nursing Home Setting.

PubMed

Estabrooks, Carole A; Knopp-Sihota, Jennifer A; Cummings, Greta G; Norton, Peter G

2016-08-01

The success of evidence-based practice depends on clearly and effectively communicating often complex data to stakeholders. In our program of research, Translating Research in Elder Care (TREC), we focus on improving the quality and safety of care delivered to nursing home residents in western Canada. More specifically, we investigate associations among organizational context, the use of best practices and resident outcomes. Our data are complex and we have been challenged with presenting these data in a way that is not only intuitive, but also useful for our stakeholders. To illustrate a technique of organizing and presenting complex data to nonresearch stakeholders. Using observational data previously collected within the TREC study, we used k-means cluster analysis to categorize nursing home resident care units or facilities within our sample into two distinct groups-those with more favorable contexts (work environment) and those with less favorable contexts. We then produced scatter plots to illustrate group differences between context and various quality indicators among resident care units or facilities. Care aides working on units with more favorable context reported higher use of best practices. When aggregated at the nursing home facility level, facilities with low rates of both urinary tract infections and indwelling catheter use are higher in organizational context. When feeding back these results to stakeholders, we identify their units so that they are able to visually assess their units, both relative to each other and relative to all other units and facilities both within and among provinces. Although we have not formally evaluated this method, we have used it extensively as part of the feedback we provide to stakeholders. As we are examining modifiable aspects of context, the stakeholder can then identify areas for improvement and thus implement a focused plan. © 2016 Sigma Theta Tau International.

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.

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

PubMed

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

2015-01-01

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

Facilitating ethical reflection among scientists using the ethical matrix.

PubMed

Jensen, Karsten Klint; Forsberg, Ellen-Marie; Gamborg, Christian; Millar, Kate; Sandøe, Peter

2011-09-01

Several studies have indicated that scientists are likely to have an outlook on both facts and values that are different to that of lay people in important ways. This is one significant reason it is currently believed that in order for scientists to exercise a reliable ethical reflection about their research it is necessary for them to engage in dialogue with other stakeholders. This paper reports on an exercise to encourage a group of scientists to reflect on ethical issues without the presence of external stakeholders. It reports on the use of a reflection process with scientists working in the area of animal disease genomics (mainly drawn from the EADGENE EC Network of Excellence). This reflection process was facilitated by using an ethical engagement framework, a modified version of the Ethical Matrix. As judged by two criteria, a qualitative assessment of the outcomes and the participants' own assessment of the process, this independent reflective exercise was deemed to be successful. The discussions demonstrated a high level of complexity and depth, with participants demonstrating a clear perception of uncertainties and the context in which their research operates. Reflection on stakeholder views and values appeared to be embedded within the discussions. The finding from this exercise seems to indicate that even without the involvement of the wider stakeholder community, valuable reflection and worthwhile discourse can be generated from ethical reflection processes involving only scienitific project partners. Hence, the previous assumption that direct stakeholder engagement is necessary for ethical reflection does not appear to hold true in all cases; however, other reasons for involving a broad group of stakeholders relating to governance and social accountability of science remain.

Towards the development of a comprehensive framework: Qualitative systematic survey of definitions of clinical research quality

PubMed Central

von Niederhäusern, Belinda; Schandelmaier, Stefan; Mi Bonde, Marie; Brunner, Nicole; Hemkens, Lars G.; Rutquist, Marielle; Bhatnagar, Neera; Guyatt, Gordon H.; Pauli-Magnus, Christiane; Briel, Matthias

2017-01-01

Objective To systematically survey existing definitions, concepts, and criteria of clinical research quality, both developed by stakeholder groups as well as in the medical literature. This study serves as a first step in the development of a comprehensive framework for the quality of clinical research. Study design and setting We systematically and in duplicate searched definitions, concepts and criteria of clinical research quality on websites of stakeholders in clinical research until no further insights emerged and in MEDLINE up to February 2015. Stakeholders included governmental bodies, regulatory agencies, the pharmaceutical industry, academic and commercial contract research organizations, initiatives, research ethics committees, patient organizations and funding agencies from 13 countries. Data synthesis involved descriptive and qualitative analyses following the Framework Method on definitions, concepts, and criteria of clinical research quality. Descriptive codes were applied and grouped into clusters to identify common and stakeholder-specific quality themes. Results Stakeholder concepts on how to assure quality throughout study conduct or articles on quality assessment tools were common, generally with no a priori definition of the term quality itself. We identified a total of 20 explicit definitions of clinical research quality including varying quality dimensions and focusing on different stages in the clinical research process. Encountered quality dimensions include ethical conduct, patient safety/rights/priorities, internal validity, precision of results, generalizability or external validity, scientific and societal relevance, transparency and accessibility of information, research infrastructure and sustainability. None of the definitions appeared to be comprehensive either in terms of quality dimensions, research stages, or stakeholder perspectives. Conclusion Clinical research quality is often discussed but rarely defined. A framework defining clinical research quality across stakeholders’ individual perspectives is desirable to facilitate discussion, assessment, and improvement of quality at all stages of clinical research. PMID:28715491

Addressing the Neglected Tropical Disease Podoconiosis in Northern Ethiopia: Lessons Learned from a New Community Podoconiosis Program

PubMed Central

Tomczyk, Sara; Tamiru, Abreham; Davey, Gail

2012-01-01

Background Despite its great public health importance, few control initiatives addressing podoconiosis (non-filarial elephantiasis, a geochemical neglected tropical disease) exist. In June 2010, the first podoconiosis program in Northern Ethiopia, consisting of prevention, awareness, and care and support activities, began in Debre Markos, Northern Ethiopia. This study aims to document and disseminate the lessons learned from a new community podoconiosis program in Debre Markos. Methods/Principal Findings We used a content analysis approach to examine and evaluate data from a series of sources. These sources include conducted interview transcripts, a focus group discussion transcript and secondary sources including monitoring and evaluation field reports, observation notes, and research obtained from a literature review. Themes were identified and grouped into matrix tables. Overall, sixteen program steps were identified and grouped into 6 domains: Initial preparation, training and sensitization, foundation building, treatment activity implementation, awareness, and follow-up. Emphasis is placed on the need for baseline data, effective training, local leadership, experience-sharing, mass-awareness, cross-cutting sector issues (i.e., water and waste management), and integration with government health systems. Related successes and challenges are also described, as are stakeholder roles and misconceptions and socio-cultural challenges affecting the program start-up. Many of the identified successes and challenges are relevant to the aim of the podoconiosis program to be sustainable and community-led. Conclusions/Significance Much of this information has already been used to improve the Debre Markos program. We also anticipate that the domains and steps identified will be useful in guiding new programs in other settings where podoconiosis is highly prevalent. We hope to encourage partnerships and collaboration among podoconiosis stakeholders in future growth and disease control expansion. PMID:22428078

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.

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.

Developing standards for the development of glaucoma virtual clinics using a modified Delphi approach.

PubMed

Kotecha, Aachal; Longstaff, Simon; Azuara-Blanco, Augusto; Kirwan, James F; Morgan, James Edwards; Spencer, Anne Fiona; Foster, Paul J

2018-04-01

To obtain consensus opinion for the development of a standards framework for the development and implementation of virtual clinics for glaucoma monitoring in the UK using a modified Delphi methodology. A modified Delphi technique was used that involved sampling members of the UK Glaucoma and Eire Society (UKEGS). The first round scored the strength of agreement to a series of standards statements using a 9-point Likert scale. The revised standards were subjected to a second round of scoring and free-text comment. The final standards were discussed and agreed by an expert panel consisting of seven glaucoma subspecialists from across the UK. A version of the standards was submitted to external stakeholders for a 3-month consultation. There was a 44% response rate of UKEGS members to rounds 1 and 2, consisting largely of consultant ophthalmologists with a specialist interest in glaucoma. The final version of the standards document was validated by stakeholder consultation and contains four sections pertaining to the patient groups, testing methods, staffing requirements and governance structure of NHS secondary care glaucoma virtual clinic models. Use of a modified Delphi approach has provided consensus agreement for the standards required for the development of virtual clinics to monitor glaucoma in the UK. It is anticipated that this document will be useful as a guide for those implementing this model of service delivery. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

76 FR 70751 - Trinity Adaptive Management Working Group

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-15

...] Trinity Adaptive Management Working Group AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: The Trinity Adaptive Management Working Group (TAMWG) affords stakeholders the opportunity to give policy, management, and technical input concerning Trinity River (California) restoration...

76 FR 52345 - Trinity Adaptive Management Working Group

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-22

...] Trinity Adaptive Management Working Group AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: The Trinity Adaptive Management Working Group (TAMWG) affords stakeholders the opportunity to give policy, management, and technical input concerning Trinity River (California) restoration...

75 FR 17158 - Trinity Adaptive Management Working Group

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-05

...] Trinity Adaptive Management Working Group AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: The Trinity Adaptive Management Working Group (TAMWG) affords stakeholders the opportunity to give policy, management, and technical input concerning Trinity River (California) restoration...

76 FR 14044 - Trinity Adaptive Management Working Group

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-15

...] Trinity Adaptive Management Working Group AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: The Trinity Adaptive Management Working Group (TAMWG) affords stakeholders the opportunity to give policy, management, and technical input concerning Trinity River (California) restoration...

75 FR 70947 - Trinity Adaptive Management Working Group

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-19

...] Trinity Adaptive Management Working Group AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: The Trinity Adaptive Management Working Group (TAMWG) affords stakeholders the opportunity to give policy, management, and technical input concerning Trinity River (California) restoration...

76 FR 23621 - Trinity Adaptive Management Working Group

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-27

...] Trinity Adaptive Management Working Group AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: The Trinity Adaptive Management Working Group (TAMWG) affords stakeholders the opportunity to give policy, management, and technical input concerning Trinity River (California) restoration...

75 FR 10501 - Trinity Adaptive Management Working Group

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-08

...] Trinity Adaptive Management Working Group AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: The Trinity Adaptive Management Working Group (TAMWG) affords stakeholders the opportunity to give policy, management, and technical input concerning Trinity River (California) restoration...

76 FR 34248 - Trinity Adaptive Management Working Group

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-13

...] Trinity Adaptive Management Working Group AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: The Trinity Adaptive Management Working Group (TAMWG) affords stakeholders the opportunity to give policy, management, and technical input concerning Trinity River (California) restoration...

75 FR 51284 - Trinity Adaptive Management Working Group

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-19

...] Trinity Adaptive Management Working Group AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: The Trinity Adaptive Management Working Group (TAMWG) affords stakeholders the opportunity to give policy, management, and technical input concerning Trinity River (California) restoration...

Working to Increase Vaccination for Human Papillomavirus: A Survey of Wisconsin Stakeholders, 2015.

PubMed

Mroz, Sarah; Zhang, Xiao; Williams, Mercedes; Conlon, Amy; LoConte, Noelle K

2017-09-28

Infection with human papillomavirus (HPV) is common and can progress to various types of cancer. HPV infection can be prevented through vaccination; however, vaccination rates among adolescents are low. The objective of this study was to assess efforts among Wisconsin stakeholders in HPV vaccination and organizational capacity for future collaborative work. We conducted a cross-sectional online survey of 277 stakeholders in HPV vaccination activities, from April 30, 2015, through June 30, 2015. Stakeholders were public health professionals, health care providers, educators, quality improvement professionals, researchers, and advocates identified as engaged in HPV vaccination work. Of the 277 invited stakeholders, 117 (42%) responded to the survey. Findings showed that most current HPV vaccination activities targeted 3 groups: adolescents and parents, clinical and health professionals, and communities and health systems. The main activities directed at these groups were providing printed educational materials, professional education, and media campaigns to raise awareness. Common barriers reported were lack of understanding about the link between HPV and cancer, requests to delay vaccination, difficulty completing the 3-dose vaccine series, and reluctance to discuss sexuality. HPV vaccination rates are far below those of other vaccinations administered to adolescents in Wisconsin. Our study showed that various local efforts were being made to increase HPV vaccination uptake; however, many barriers exist to initiation and completion of the vaccine series. Future interventions should address barriers and employ evidence-based strategies for increasing HPV vaccination rates.

Toward defining and measuring social accountability in graduate medical education: a stakeholder study.

PubMed

Reddy, Anjani T; Lazreg, Sonia A; Phillips, Robert L; Bazemore, Andrew W; Lucan, Sean C

2013-09-01

Since 1965, Medicare has publically financed graduate medical education (GME) in the United States. Given public financing, various advisory groups have argued that GME should be more socially accountable. Several efforts are underway to develop accountability measures for GME that could be tied to Medicare payments, but it is not clear how to measure or even define social accountability. We explored how GME stakeholders perceive, define, and measure social accountability. Through purposive and snowball sampling, we completed semistructured interviews with 18 GME stakeholders from GME training sites, government agencies, and health care organizations. We analyzed interview field notes and audiorecordings using a flexible, iterative, qualitative group process to identify themes. THREE THEMES EMERGED IN REGARDS TO DEFINING SOCIAL ACCOUNTABILITY: (1) creating a diverse physician workforce to address regional needs and primary care and specialty shortages; (2) ensuring quality in training and care to best serve patients; and (3) providing service to surrounding communities and the general public. All but 1 stakeholder believed GME institutions have a responsibility to be socially accountable. Reported barriers to achieving social accountability included training time constraints, financial limitations, and institutional resistance. Suggestions for measuring social accountability included reviewing graduates' specialties and practice locations, evaluating curricular content, and reviewing program services to surrounding communities. Most stakeholders endorsed the concept of social accountability in GME, suggesting definitions and possible measures that could inform policy makers calls for increased accountability despite recognized barriers.

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.

Music Makes You Smarter: A New Paradigm for Music Education? Perceptions and Perspectives from Four Groups of Elementary Education Stakeholders

ERIC Educational Resources Information Center

Vitale, John Luke

2011-01-01

Through 14 years of teaching music in the Greater Toronto Area, the "music makes you smarter" notion has imbued many of the conversations I have had with multiple stakeholders in public education. Such conversations have suggested that the ancillary benefits of teaching music have now become the principal reason why we teach music--what…