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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2012-12-01

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

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

EPA Science Inventory

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

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

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

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

1994-12-31

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

Multicriteria decision analysis: Overview and implications for environmental decision making

USGS Publications Warehouse

Hermans, Caroline M.; Erickson, Jon D.; Erickson, Jon D.; Messner, Frank; Ring, Irene

2007-01-01

Environmental decision making involving multiple stakeholders can benefit from the use of a formal process to structure stakeholder interactions, leading to more successful outcomes than traditional discursive decision processes. There are many tools available to handle complex decision making. Here we illustrate the use of a multicriteria decision analysis (MCDA) outranking tool (PROMETHEE) to facilitate decision making at the watershed scale, involving multiple stakeholders, multiple criteria, and multiple objectives. We compare various MCDA methods and their theoretical underpinnings, examining methods that most realistically model complex decision problems in ways that are understandable and transparent to stakeholders.

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

ERIC Educational Resources Information Center

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

2017-01-01

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

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

PubMed

Fletcher, Stephen

2007-12-01

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

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

PubMed

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

2017-04-01

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

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.

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

USGS Publications Warehouse

Caughlan, L.

2002-01-01

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

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.

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

PubMed

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

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

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

PubMed

Lopes, Edilene; Carter, Drew; Street, Jackie

2015-06-01

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

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

PubMed

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

2014-01-01

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

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

PubMed Central

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

2014-01-01

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

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

USGS Publications Warehouse

Hermans, Caroline M.; Taketa, Richard

2006-01-01

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

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

PubMed

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

2017-08-01

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

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

PCOR, CER, and CBPR: alphabet soup or complementary fields of health research?

PubMed

Burke, Jessica G; Jones, Jennifer; Yonas, Michael; Guizzetti, Lisa; Virata, Maria C; Costlow, Monica; Morton, Sally C; Elizabeth, Miller

2013-12-01

Comparative effectiveness research (CER) and community- based participatory research (CBPR) are two fields of research that do not have a history of strong collaboration. However, CER and CBPR researchers could benefit from interdisciplinary collaboration to design and implement relevant, timely, action-oriented research. This commentary explores field-specific definitions of stakeholders and then outlines various roles stakeholders might play within grant-funded research. Questions such as "What stakeholders should be involved?" and "How are stakeholders involved?" are addressed. The goal of this commentary is to highlight how the expertise and experiences of CBPR investigators can enhance the field of CER and to describe strategies for encouraging stakeholder involvement in CER research through the lens of CBPR. It is recommended that a team-based approach to conducting stakeholder-engaged CER encourages multiple stakeholders and "end users" to contribute their diverse expertise to the research process and contributes to the development of research with an increased likelihood of improving patient health and healthcare. © 2013 Wiley Periodicals, Inc.

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.

Multi-Stakeholder Collaboration in the Redesign of Family-Centered Rounds Process

PubMed Central

Xie, Anping; Carayon, Pascale; Cartmill, Randi; Li, Yaqiong; Cox, Elizabeth D.; Plotkin, Julie A.; Kelly, Michelle M.

2014-01-01

A human factors approach to healthcare system redesign emphasizes the involvement of multiple healthcare stakeholders (e.g., patients and families, healthcare providers) in the redesign process. This study explores the experience of multiple stakeholders with collaboration in a healthcare system redesign project. Interviews were conducted with ten stakeholder representatives who participated in the redesign of the family-centered rounds process in a pediatric hospital. Qualitative interview data were analyzed using a phenomenological approach. A model of collaborative healthcare system redesign was developed, which defined four phases (i.e., setup of the redesign team, preparation for meetings, collaboration in meetings, follow-up after meetings) and two outcomes (i.e., team outcomes, redesign outcomes) of the collaborative process. Challenges to multi-stakeholder collaboration in healthcare system redesign, such as need to represent all relevant stakeholders, scheduling of meetings and managing different perspectives, were identified. PMID:25124394

Multi-stakeholder collaboration in the redesign of family-centered rounds process.

PubMed

Xie, Anping; Carayon, Pascale; Cartmill, Randi; Li, Yaqiong; Cox, Elizabeth D; Plotkin, Julie A; Kelly, Michelle M

2015-01-01

A human factors approach to healthcare system redesign emphasizes the involvement of multiple healthcare stakeholders (e.g., patients and families, healthcare providers) in the redesign process. This study explores the experience of multiple stakeholders with collaboration in a healthcare system redesign project. Interviews were conducted with ten stakeholder representatives who participated in the redesign of the family-centered rounds process in a pediatric hospital. Qualitative interview data were analyzed using a phenomenological approach. A model of collaborative healthcare system redesign was developed, which defined four phases (i.e., setup of the redesign team, preparation for meetings, collaboration in meetings, follow-up after meetings) and two outcomes (i.e., team outcomes, redesign outcomes) of the collaborative process. Challenges to multi-stakeholder collaboration in healthcare system redesign, such as need to represent all relevant stakeholders, scheduling of meetings and managing different perspectives, were identified. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Software Quality Perceptions of Stakeholders Involved in the Software Development Process

ERIC Educational Resources Information Center

Padmanabhan, Priya

2013-01-01

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

Engaging stakeholders for adaptive management using structured decision analysis

USGS Publications Warehouse

Irwin, Elise R.; Kathryn, D.; Kennedy, Mickett

2009-01-01

Adaptive management is different from other types of management in that it includes all stakeholders (versus only policy makers) in the process, uses resource optimization techniques to evaluate competing objectives, and recognizes and attempts to reduce uncertainty inherent in natural resource systems. Management actions are negotiated by stakeholders, monitored results are compared to predictions of how the system should respond, and management strategies are adjusted in a “monitor-compare-adjust” iterative routine. Many adaptive management projects fail because of the lack of stakeholder identification, engagement, and continued involvement. Primary reasons for this vary but are usually related to either stakeholders not having ownership (or representation) in decision processes or disenfranchisement of stakeholders after adaptive management begins. We present an example in which stakeholders participated fully in adaptive management of a southeastern regulated river. Structured decision analysis was used to define management objectives and stakeholder values and to determine initial flow prescriptions. The process was transparent, and the visual nature of the modeling software allowed stakeholders to see how their interests and values were represented in the decision process. The development of a stakeholder governance structure and communication mechanism has been critical to the success of the project.

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

PubMed Central

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

2012-01-01

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

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

PubMed

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

2012-03-01

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

Key Characteristics of Collaborative Leadership in Elementary Schools: Understanding the Perceptions of Principals and Teachers

ERIC Educational Resources Information Center

Vitale, Margaret Elizabeth

2017-01-01

Collaborative leadership is a process of leadership that allows all stakeholders to be actively involved in the decision-making process. This leadership process incorporates the perspectives and insight of the stakeholders in order to sustain effective change. The review of the literature expresses that leadership within the organization must have…

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…

A Practical Approach to Address Uncertainty in Stakeholder Deliberations.

PubMed

Gregory, Robin; Keeney, Ralph L

2017-03-01

This article addresses the difficulties of incorporating uncertainty about consequence estimates as part of stakeholder deliberations involving multiple alternatives. Although every prediction of future consequences necessarily involves uncertainty, a large gap exists between common practices for addressing uncertainty in stakeholder deliberations and the procedures of prescriptive decision-aiding models advanced by risk and decision analysts. We review the treatment of uncertainty at four main phases of the deliberative process: with experts asked to describe possible consequences of competing alternatives, with stakeholders who function both as individuals and as members of coalitions, with the stakeholder committee composed of all stakeholders, and with decisionmakers. We develop and recommend a model that uses certainty equivalents as a theoretically robust and practical approach for helping diverse stakeholders to incorporate uncertainties when evaluating multiple-objective alternatives as part of public policy decisions. © 2017 Society for Risk Analysis.

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

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

NASA Astrophysics Data System (ADS)

Bawole, Justice Nyigmah

2013-08-01

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

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

PubMed

Bawole, Justice Nyigmah

2013-08-01

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

Informing Hospital Change Processes through Visualization and Simulation: A Case Study at a Children's Emergency Clinic.

PubMed

Persson, Johanna; Dalholm, Elisabeth Hornyánszky; Johansson, Gerd

2014-01-01

To demonstrate the use of visualization and simulation tools in order to involve stakeholders and inform the process in hospital change processes, illustrated by an empirical study from a children's emergency clinic. Reorganization and redevelopment of a hospital is a complex activity that involves many stakeholders and demands. Visualization and simulation tools have proven useful for involving practitioners and eliciting relevant knowledge. More knowledge is desired about how these tools can be implemented in practice for hospital planning processes. A participatory planning process including practitioners and researchers was executed over a 3-year period to evaluate a combination of visualization and simulation tools to involve stakeholders in the planning process and to elicit knowledge about needs and requirements. The initial clinic proposal from the architect was discarded as a result of the empirical study. Much general knowledge about the needs of the organization was extracted by means of the adopted tools. Some of the tools proved to be more accessible than others for the practitioners participating in the study. The combination of tools added value to the process by presenting information in alternative ways and eliciting questions from different angles. Visualization and simulation tools inform a planning process (or other types of change processes) by providing the means to see beyond present demands and current work structures. Long-term involvement in combination with accessible tools is central for creating a participatory setting where the practitioners' knowledge guides the process. © 2014 Vendome Group, LLC.

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.

Sustaining Public Involvement in Long Range Planning Using a Stakeholder Based Process: A Case Study from Eugene-Springfield ,Oregon

DOT National Transportation Integrated Search

1998-09-16

The Intermodal Surface Transportation Efficiency Act requires a proactive : public involvement process that provides complete information, timely public : notice, full public access to key decisions, and supports early and continuing : involvement of...

Using social network analysis to examine the decision-making process on new vaccine introduction in Nigeria.

PubMed

Wonodi, C B; Privor-Dumm, L; Aina, M; Pate, A M; Reis, R; Gadhoke, P; Levine, O S

2012-05-01

The decision-making process to introduce new vaccines into national immunization programmes is often complex, involving many stakeholders who provide technical information, mobilize finance, implement programmes and garner political support. Stakeholders may have different levels of interest, knowledge and motivations to introduce new vaccines. Lack of consensus on the priority, public health value or feasibility of adding a new vaccine can delay policy decisions. Efforts to support country-level decision-making have largely focused on establishing global policies and equipping policy makers with the information to support decision-making on new vaccine introduction (NVI). Less attention has been given to understanding the interactions of policy actors and how the distribution of influence affects the policy process and decision-making. Social network analysis (SNA) is a social science technique concerned with explaining social phenomena using the structural and relational features of the network of actors involved. This approach can be used to identify how information is exchanged and who is included or excluded from the process. For this SNA of vaccine decision-making in Nigeria, we interviewed federal and state-level government officials, officers of bilateral and multilateral partner organizations, and other stakeholders such as health providers and the media. Using data culled from those interviews, we performed an SNA in order to map formal and informal relationships and the distribution of influence among vaccine decision-makers, as well as to explore linkages and pathways to stakeholders who can influence critical decisions in the policy process. Our findings indicate a relatively robust engagement of key stakeholders in Nigeria. We hypothesized that economic stakeholders and implementers would be important to ensure sustainable financing and strengthen programme implementation, but some economic and implementation stakeholders did not appear centrally on the map; this may suggest a need to strengthen the decision-making processes by engaging these stakeholders more centrally and earlier.

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

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

PubMed

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

2016-01-01

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

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.

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

PubMed

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

2017-01-01

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

Measuring societal effects of transdisciplinary research projects: design and application of an evaluation method.

PubMed

Walter, Alexander I; Helgenberger, Sebastian; Wiek, Arnim; Scholz, Roland W

2007-11-01

Most Transdisciplinary Research (TdR) projects combine scientific research with the building of decision making capacity for the involved stakeholders. These projects usually deal with complex, societally relevant, real-world problems. This paper focuses on TdR projects, which integrate the knowledge of researchers and stakeholders in a collaborative transdisciplinary process through structured methods of mutual learning. Previous research on the evaluation of TdR has insufficiently explored the intended effects of transdisciplinary processes on the real world (societal effects). We developed an evaluation framework for assessing the societal effects of transdisciplinary processes. Outputs (measured as procedural and product-related involvement of the stakeholders), impacts (intermediate effects connecting outputs and outcomes) and outcomes (enhanced decision making capacity) are distinguished as three types of societal effects. Our model links outputs and outcomes of transdisciplinary processes via the impacts using a mediating variables approach. We applied this model in an ex post evaluation of a transdisciplinary process. 84 out of 188 agents participated in a survey. The results show significant mediation effects of the two impacts "network building" and "transformation knowledge". These results indicate an influence of a transdisciplinary process on the decision making capacity of stakeholders, especially through social network building and the generation of knowledge relevant for action.

Challenges for a Sustainable Financial Foundation for Antimicrobial Stewardship.

PubMed

Dik, Jan-Willem H; Sinha, Bhanu

2017-03-30

Antimicrobial resistance is a worldwide threat and a problem with large clinical and economic impact. Antimicrobial Stewardship Programs are a solution to curb resistance development. A problem of resistance is a separation of actions and consequences, financial and clinical. Such a separation makes it difficult to create support among stakeholders leading to a lack of sense of responsibility. To counteract the resistance development it is important to perform diagnostics and know how to interpret the results. One should see diagnostics, therapy and resistance as one single process. Within this process all involved stakeholders need to work together on a more institutional level. We suggest therefore a solution: combining diagnostics and therapy into one single financial product . Such a product should act as an incentive to perform correct diagnostics. It also makes it easier to cover the costs of an antimicrobial stewardship program, which is often overlooked. Finally, such a product involves all stakeholders in the process and does not lay the costs at one stakeholder and the benefits somewhere else, solving the misbalance that is present nowadays.

Involving Research Stakeholders in Developing Policy on Sharing Public Health Research Data in Kenya: Views on Fair Process for Informed Consent, Access Oversight, and Community Engagement.

PubMed

Jao, Irene; Kombe, Francis; Mwalukore, Salim; Bull, Susan; Parker, Michael; Kamuya, Dorcas; Molyneux, Sassy; Marsh, Vicki

2015-07-01

Increased global sharing of public health research data has potential to advance scientific progress but may present challenges to the interests of research stakeholders, particularly in low-to-middle income countries. Policies for data sharing should be responsive to public views, but there is little evidence of the systematic study of these from low-income countries. This qualitative study explored views on fair data-sharing processes among 60 stakeholders in Kenya with varying research experience, using a deliberative approach. Stakeholders' attitudes were informed by perceptions of benefit and concerns for research data sharing, including risks of stigmatization, loss of privacy, and undermining scientific careers and validity, reported in detail elsewhere. In this article, we discuss institutional trust-building processes seen as central to perceptions of fairness in sharing research data in this setting, including forms of community involvement, individual prior awareness and agreement to data sharing, independence and accountability of governance mechanisms, and operating under a national framework. © The Author(s) 2015.

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

PubMed

Lord, Laura; Gale, Nicola

2014-01-01

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

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

PubMed Central

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

2015-01-01

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

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

PubMed

Lemke, Amy A; Harris-Wai, Julie N

2015-12-01

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

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

PubMed

Prager, Katrin; Freese, Jan

2009-02-01

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

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.

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.

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

Supporting return-to-work in the face of legislation: stakeholders' experiences with return-to-work after breast cancer in Belgium.

PubMed

Tiedtke, Corine; Donceel, Peter; Knops, Lieve; Désiron, Huget; Dierckx de Casterlé, Bernadette; de Rijk, Angelique

2012-06-01

The diagnosis of breast cancer increasingly implies a return-to-work (RTW) challenge as survival rates increase. RTW is regarded as a multidisciplinary process and a country's legislation affects the degree of involvement of the different stakeholders. We elucidated on bottlenecks and contributing factors and the relationship between policy and practice regarding RTW of employees with breast cancer as perceived by Belgian (Flemish) stakeholders. Three multidisciplinary groups (n = 7, n = 9, n = 10) were interviewed during a breast cancer conference. Treating physicians (n = 4), employers (n = 6), social security physicians (n = 3), occupational physicians (n = 4), survivors (n = 5) and representatives of patient associations (n = 4) were included. The major theme was the legal and practical role in the RTW process as experienced by the participants. Qualitative thematic analysis was performed to analyse stakeholders' experiences of women's RTW after breast cancer. The stakeholders reported different perspectives. Employees focus on treatment and feel ill-informed about the RTW options. Treating physicians do not feel competent about advising on work-related questions. Employers have to balance the interests of both the business and the employee. Social security physicians assess ability to work and facilitate RTW options. Occupational physicians see opportunities but the legislation does not support their involvement. Stakeholders expressed the need for coordination and reported finding ways to accommodate the employee's needs by being flexible with the legislation to support the RTW process. Two factors might hamper RTW for breast cancer patients: the varying stakeholder perspectives and Belgian legislation which emphasizes the patient or disability role, but not the employee role. When stakeholders are motivated they find ways to support RTW, but improved legislation could support the necessary coordination of RTW for these patients.

Facilitating comparative effectiveness research in cancer genomics: evaluating stakeholder perceptions of the engagement process.

PubMed

Deverka, Patricia A; Lavallee, Danielle C; Desai, Priyanka J; Armstrong, Joanne; Gorman, Mark; Hole-Curry, Leah; O'Leary, James; Ruffner, B W; Watkins, John; Veenstra, David L; Baker, Laurence H; Unger, Joseph M; Ramsey, Scott D

2012-07-01

The Center for Comparative Effectiveness Research in Cancer Genomics completed a 2-year stakeholder-guided process for the prioritization of genomic tests for comparative effectiveness research studies. We sought to evaluate the effectiveness of engagement procedures in achieving project goals and to identify opportunities for future improvements. The evaluation included an online questionnaire, one-on-one telephone interviews and facilitated discussion. Responses to the online questionnaire were tabulated for descriptive purposes, while transcripts from key informant interviews were analyzed using a directed content analysis approach. A total of 11 out of 13 stakeholders completed both the online questionnaire and interview process, while nine participated in the facilitated discussion. Eighty-nine percent of questionnaire items received overall ratings of agree or strongly agree; 11% of responses were rated as neutral with the exception of a single rating of disagreement with an item regarding the clarity of how stakeholder input was incorporated into project decisions. Recommendations for future improvement included developing standard recruitment practices, role descriptions and processes for improved communication with clinical and comparative effectiveness research investigators. Evaluation of the stakeholder engagement process provided constructive feedback for future improvements and should be routinely conducted to ensure maximal effectiveness of stakeholder involvement.

Implementing stakeholder-informed research in the substance abuse treatment sector: strategies used by Connections, a Canadian knowledge translation and exchange project.

PubMed

Henderson, Joanna; Sword, Wendy; Niccols, Alison; Dobbins, Maureen

2014-05-29

Researcher-stakeholder collaboration has been identified as critical to bridging research and health system change. While collaboration models vary, meaningful stakeholder involvement over time ("integrated knowledge translation") is advocated to improve the relevance of research to knowledge users. This short report describes the integrated knowledge translation efforts of Connections, a knowledge translation and exchange project to improve services for women with substance abuse problems and their children, and implementation barriers and facilitators. Strategies of varying intensities were used to engage diverse stakeholders, including policy makers and people with lived experience, and executive directors, program managers, and service providers from Canadian addiction agencies serving women. Barriers to participation included individual (e.g., interest), organizational (e.g., funding), and system level (e.g., lack of centralized stakeholder database) barriers. Similarly, facilitators included individual (e.g., perceived relevance) and organizational (e.g., support) facilitators, as well as initiative characteristics (e.g., multiple involvement opportunities). Despite barriers, Connections' stakeholder-informed research efforts proved essential for developing clinically relevant and feasible processes, measures, and implementation strategies. Stakeholder-researcher collaboration is possible and robust integrated knowledge translation efforts can be productive. Future work should emphasize developing and evaluating a range of strategies to address stakeholders' knowledge translation needs and to facilitate sustained and meaningful involvement in research.

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

PubMed Central

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

2015-01-01

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

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

PubMed

Mielke, Jahel; Vermaßen, Hannah; Ellenbeck, Saskia

2017-12-12

This paper evaluates current stakeholder involvement (SI) practices in science through a web-based survey among scholars and researchers engaged in sustainability or transition research. It substantiates previous conceptual work with evidence from practice by building on four ideal types of SI in science. The results give an interesting overview of the varied landscape of SI in sustainability science, ranging from the kinds of topics scientists work on with stakeholders, over scientific trade-offs that arise in the field, to improvements scientists wish for. Furthermore, the authors describe a discrepancy between scientists' ideals and practices when working with stakeholders. On the conceptual level, the data reflect that the democratic type of SI is the predominant one concerning questions on the understanding of science, the main goal, the stage of involvement in the research process, and the science-policy interface. The fact that respondents expressed agreement to several types shows they are guided by multiple and partly conflicting ideals when working with stakeholders. We thus conclude that more conceptual exchange between practitioners, as well as more qualitative research on the concepts behind practices, is needed to better understand the stakeholder-scientist nexus. Copyright © 2017 the Author(s). Published by PNAS.

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

PubMed

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

2015-01-01

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

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.

Players and processes behind the national health insurance scheme: a case study of Uganda

PubMed Central

2013-01-01

Background Uganda is the last East African country to adopt a National Health Insurance Scheme (NHIS). To lessen the inequitable burden of healthcare spending, health financing reform has focused on the establishment of national health insurance. The objective of this research is to depict how stakeholders and their power and interests have shaped the process of agenda setting and policy formulation for Uganda’s proposed NHIS. The study provides a contextual analysis of the development of NHIS policy within the context of national policies and processes. Methods The methodology is a single case study of agenda setting and policy formulation related to the proposed NHIS in Uganda. It involves an analysis of the real-life context, the content of proposals, the process, and a retrospective stakeholder analysis in terms of policy development. Data collection comprised a literature review of published documents, technical reports, policy briefs, and memos obtained from Uganda’s Ministry of Health and other unpublished sources. Formal discussions were held with ministry staff involved in the design of the scheme and some members of the task force to obtain clarification, verify events, and gain additional information. Results The process of developing the NHIS has been an incremental one, characterised by small-scale, gradual changes and repeated adjustments through various stakeholder engagements during the three phases of development: from 1995 to 1999; 2000 to 2005; and 2006 to 2011. Despite political will in the government, progress with the NHIS has been slow, and it has yet to be implemented. Stakeholders, notably the private sector, played an important role in influencing the pace of the development process and the currently proposed design of the scheme. Conclusions This study underscores the importance of stakeholder analysis in major health reforms. Early use of stakeholder analysis combined with an ongoing review and revision of NHIS policy proposals during stakeholder discussions would be an effective strategy for avoiding potential pitfalls and obstacles in policy implementation. Given the private sector’s influence on negotiations over health insurance design in Uganda, this paper also reviews the experience of two countries with similar stakeholder dynamics. PMID:24053551

Players and processes behind the national health insurance scheme: a case study of Uganda.

PubMed

Basaza, Robert K; O'Connell, Thomas S; Chapčáková, Ivana

2013-09-22

Uganda is the last East African country to adopt a National Health Insurance Scheme (NHIS). To lessen the inequitable burden of healthcare spending, health financing reform has focused on the establishment of national health insurance. The objective of this research is to depict how stakeholders and their power and interests have shaped the process of agenda setting and policy formulation for Uganda's proposed NHIS. The study provides a contextual analysis of the development of NHIS policy within the context of national policies and processes. The methodology is a single case study of agenda setting and policy formulation related to the proposed NHIS in Uganda. It involves an analysis of the real-life context, the content of proposals, the process, and a retrospective stakeholder analysis in terms of policy development. Data collection comprised a literature review of published documents, technical reports, policy briefs, and memos obtained from Uganda's Ministry of Health and other unpublished sources. Formal discussions were held with ministry staff involved in the design of the scheme and some members of the task force to obtain clarification, verify events, and gain additional information. The process of developing the NHIS has been an incremental one, characterised by small-scale, gradual changes and repeated adjustments through various stakeholder engagements during the three phases of development: from 1995 to 1999; 2000 to 2005; and 2006 to 2011. Despite political will in the government, progress with the NHIS has been slow, and it has yet to be implemented. Stakeholders, notably the private sector, played an important role in influencing the pace of the development process and the currently proposed design of the scheme. This study underscores the importance of stakeholder analysis in major health reforms. Early use of stakeholder analysis combined with an ongoing review and revision of NHIS policy proposals during stakeholder discussions would be an effective strategy for avoiding potential pitfalls and obstacles in policy implementation. Given the private sector's influence on negotiations over health insurance design in Uganda, this paper also reviews the experience of two countries with similar stakeholder dynamics.

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

PubMed

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

2017-10-01

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

Identifying the institutional decision process to introduce decentralized sanitation in the city of Kunming (China).

PubMed

Medilanski, Edi; Chuan, Liang; Mosler, Hans-Joachim; Schertenleib, Roland; Larsen, Tove A

2007-05-01

We conducted a study of the institutional barriers to introducing urine source separation in the urban area of Kunming, China. On the basis of a stakeholder analysis, we constructed stakeholder diagrams showing the relative importance of decision-making power and (positive) interest in the topic. A hypothetical decision-making process for the urban case was derived based on a successful pilot project in a periurban area. All our results were evaluated by the stakeholders. We concluded that although a number of primary stakeholders have a large interest in testing urine source separation also in an urban context, most of the key stakeholders would be reluctant to this idea. However, the success in the periurban area showed that even a single, well-received pilot project can trigger the process of broad dissemination of new technologies. Whereas the institutional setting for such a pilot project is favorable in Kunming, a major challenge will be to adapt the technology to the demands of an urban population. Methodologically, we developed an approach to corroborate a stakeholder analysis with the perception of the stakeholders themselves. This is important not only in order to validate the analysis but also to bridge the theoretical gap between stakeholder analysis and stakeholder involvement. We also show that in disagreement with the assumption of most policy theories, local stakeholders consider informal decision pathways to be of great importance in actual policy-making.

Identifying the Institutional Decision Process to Introduce Decentralized Sanitation in the City of Kunming (China)

NASA Astrophysics Data System (ADS)

Medilanski, Edi; Chuan, Liang; Mosler, Hans-Joachim; Schertenleib, Roland; Larsen, Tove A.

2007-05-01

We conducted a study of the institutional barriers to introducing urine source separation in the urban area of Kunming, China. On the basis of a stakeholder analysis, we constructed stakeholder diagrams showing the relative importance of decision-making power and (positive) interest in the topic. A hypothetical decision-making process for the urban case was derived based on a successful pilot project in a periurban area. All our results were evaluated by the stakeholders. We concluded that although a number of primary stakeholders have a large interest in testing urine source separation also in an urban context, most of the key stakeholders would be reluctant to this idea. However, the success in the periurban area showed that even a single, well-received pilot project can trigger the process of broad dissemination of new technologies. Whereas the institutional setting for such a pilot project is favorable in Kunming, a major challenge will be to adapt the technology to the demands of an urban population. Methodologically, we developed an approach to corroborate a stakeholder analysis with the perception of the stakeholders themselves. This is important not only in order to validate the analysis but also to bridge the theoretical gap between stakeholder analysis and stakeholder involvement. We also show that in disagreement with the assumption of most policy theories, local stakeholders consider informal decision pathways to be of great importance in actual policy-making.

A Second Opinion: A Case Narrative on Clinical Ethics Mediation.

PubMed

Weinstein, Michael S

2015-01-01

Contrasting traditional and common forms if ethics consultation with bioethics mediation. I describe the case of a "second opinion" consultation in the care of a patient with advanced cancer for whom treatment was futile. While the initial ethics consultation, performed by a colleague, let to a recommendation that some may deem ethical, the process failed to involve key stakeholders and failed to explore the underlying values and reasons for the opinions voiced by various stakeholders. The process of mediation ultimately led to creative solutions in which all stakeholders could reach consensus on a plan of care.

Analysis of a voluntary initiative to reduce sodium in processed and ultra-processed food products in Argentina: the views of public and private sector representatives.

PubMed

Castronuovo, Luciana; Allemandi, Lorena; Tiscornia, Victoria; Champagne, Beatriz; Campbell, Norm; Schoj, Verónica

2017-07-03

The Less Salt, More Life program was the first voluntary salt reduction initiative in Argentina. This article analyzes the perspectives of the stakeholders involved in this voluntary agreement between the Ministry of Health and the food industry to gradually reduce sodium content in processed foods. This exploratory case study used a qualitative approach including 29 in-depth interviews with stakeholders from the public and private sectors and identified the role of the different stakeholders and their perceptions regarding the challenges encountered in the policy process that contribute to the debate on public-private partnerships in health policies. The article also discusses the initiative's main challenges and controversies.

Evaluation utilization research--developing a theory and putting it to use.

PubMed

Neuman, Ari; Shahor, Neria; Shina, Ilan; Sarid, Anat; Saar, Zehava

2013-02-01

This article presents the findings of a two-stage study that had two key objectives: to develop a theory about evaluation utilization in an educational organization and to apply this theory to promote evaluation utilization within the organization. The first stage involved a theoretical conceptualization using a participatory method of concept mapping. This process identified the modes of evaluation utilization within the organization, produced a representation of the relationship between them and led to a theory. The second stage examined the practical implications of this conceptualization in terms of how different stakeholders in the organization perceive the actual and preferable state of evaluation utilization within the organization (i.e. to what extent is evaluation utilized and to what extent should it be utilized). The participatory process of the study promoted the evaluation utilization by involving stakeholders, thus giving them a sense of ownership and improving communication between the evaluation unit and the stakeholders. In addition, understanding the evaluation needs of the stakeholders in the organization helped generate relevant and realizable evaluation processes. On a practical level, the results are currently shaping the evaluation plan and the place of evaluations within the organization. Copyright © 2012 Elsevier Ltd. All rights reserved.

Linking stakeholder research needs and the federal data quality act: a case study of an endangered forest shrub in the southeastern Unitd States

Treesearch

Brian Roy Lockhart; Emile S. Gardiner; Theodor D. Leininger; Kristina F. Connor; Margaret S. Devall; Paul B. Hamel; Tracy Hawkins; Nathan M. Schiff; A. Dan Wilson

2009-01-01

The need for knowledge, ranging from development of new products or processes to the effects of specific actions on the environment, is greater now than at any point in the past. The greater need for research has generated stakeholder involvement in the research process. As a result, all facets of research, from planning through...

Public involvement, low budget can mean high effectiveness

DOT National Transportation Integrated Search

1998-09-16

Public involvement on a small budget can result in a more effective outreach : process. When an agency has more time than money, public involvement truly can : start at "the earliest possible moment." Once stakeholders and existing : organizations in...

Stakeholder Participation in System Change: A New Conceptual Model.

PubMed

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

2016-08-01

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

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.

Facilitating comparative effectiveness research in cancer genomics: evaluating stakeholder perceptions of the engagement process

PubMed Central

Deverka, Patricia A; Lavallee, Danielle C; Desai, Priyanka J; Armstrong, Joanne; Gorman, Mark; Hole-Curry, Leah; O’Leary, James; Ruffner, BW; Watkins, John; Veenstra, David L; Baker, Laurence H; Unger, Joseph M; Ramsey, Scott D

2013-01-01

Aims The Center for Comparative Effectiveness Research in Cancer Genomics completed a 2-year stakeholder-guided process for the prioritization of genomic tests for comparative effectiveness research studies. We sought to evaluate the effectiveness of engagement procedures in achieving project goals and to identify opportunities for future improvements. Materials & methods The evaluation included an online questionnaire, one-on-one telephone interviews and facilitated discussion. Responses to the online questionnaire were tabulated for descriptive purposes, while transcripts from key informant interviews were analyzed using a directed content analysis approach. Results A total of 11 out of 13 stakeholders completed both the online questionnaire and interview process, while nine participated in the facilitated discussion. Eighty-nine percent of questionnaire items received overall ratings of agree or strongly agree; 11% of responses were rated as neutral with the exception of a single rating of disagreement with an item regarding the clarity of how stakeholder input was incorporated into project decisions. Recommendations for future improvement included developing standard recruitment practices, role descriptions and processes for improved communication with clinical and comparative effectiveness research investigators. Conclusions Evaluation of the stakeholder engagement process provided constructive feedback for future improvements and should be routinely conducted to ensure maximal effectiveness of stakeholder involvement. PMID:23459832

The necessary burden of involving stakeholders in agent-based modelling for education and decision-making

NASA Astrophysics Data System (ADS)

Bommel, P.; Bautista Solís, P.; Leclerc, G.

2016-12-01

We implemented a participatory process with water stakeholders for improving resilience to drought at watershed scale, and for reducing water pollution disputes in drought prone Northwestern Costa Rica. The purpose is to facilitate co-management in a rural watershed impacted by recurrent droughts related to ENSO. The process involved designing "ContaMiCuenca", a hybrid agent-based model where users can specify the decisions of their agents. We followed a Companion Modeling approach (www.commod.org) and organized 10 workshops that included research techniques such as participatory diagnostics, actor-resources-interaction and UML diagrams, multi-agents model design, and interactive simulation sessions. We collectively assessed the main water issues in the watershed, prioritized their importance, defined the objectives of the process, and pilot-tested ContaMiCuenca for environmental education with adults and children. Simulation sessions resulted in debates about the need to improve the model accuracy, arguably more relevant for decision-making. This helped identify sensible knowledge gaps in the groundwater pollution and aquifer dynamics that need to be addressed in order to improve our collective learning. Significant mismatches among participants expectations, objectives, and agendas considerably slowed down the participatory process. The main issue may originate in participants expecting technical solutions from a positivist science, as constantly promoted in the region by dole-out initiatives, which is incompatible with the constructivist stance of participatory modellers. This requires much closer interaction of community members with modellers, which may be hard to attain in the current research practice and institutional context. Nevertheless, overcoming these constraints is necessary for a true involvement of water stakeholders to achieve community-based decisions that facilitate integrated water management. Our findings provide significant guidance for improving the trans-generational engagement of stakeholders in participatory modeling processes in a context of limited technical skills and information, research expectative mismatches, and poor multi-stakeholder interaction for decision-making.

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.

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

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.

Involving Stakeholders in Programme Theory Specification: Discussion of a Systematic, Consensus-Based Approach

ERIC Educational Resources Information Center

van Urk, Felix; Grant, Sean; Bonell, Chris

2016-01-01

The use of explicit programme theory to guide evaluation is widely recommended. However, practitioners and other partnering stakeholders often initiate programmes based on implicit theories, leaving researchers to explicate them before commencing evaluation. The current study aimed to apply a systematic method to undertake this process. We…

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

PubMed

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

2017-12-01

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

Evaluation of participatory planning: Lessons from Hungarian Natura 2000 management planning processes.

PubMed

Kovács, Eszter; Kelemen, Eszter; Kiss, Gabriella; Kalóczkai, Ágnes; Fabók, Veronika; Mihók, Barbara; Megyesi, Boldizsár; Pataki, György; Bodorkós, Barbara; Balázs, Bálint; Bela, Györgyi; Margóczi, Katalin; Roboz, Ágnes; Molnár, Dániel

2017-12-15

Stakeholder participation in nature conservation policies and especially in the management of protected areas has gained importance in the last decades. These changes are underlined by democratic principles and the perceived contribution of stakeholder involvement to the effectiveness of conservation management. Evaluating participatory processes is essential to learn about the past and thus increase the quality of future processes. The evaluation can be useful for the organisations responsible for planning and management, stakeholders and policy makers as well. The present paper shows the results of a systematic evaluation of 25 participatory processes related to the development of management plans for Natura 2000 sites in Hungary between 2007 and 2015. A conceptual framework was developed to evaluate the process and outcome of participatory management planning processes. Criteria were based on the scientific literature on public participation and tailored to conservation-related management planning and stakeholder involvement. Evaluated processes were grouped in three cases based on their time range and financial sources. Overall, the analysed processes scored at a medium level, showing better performance in the process criteria than in the outcome criteria. The best case scored significantly higher in four criteria compared to the other cases: representativeness, resource availability for facilitation, new, creative ideas and impact on the plan. The main factors behind the success were (1) embeddedness of the planning process in a larger project, where the plan was a tool for conservation, (2) carrying out only one process at a time, (3) previous experience of facilitators and planners with participatory planning and (4) the opportunity and capacity to propose a payment scheme as an incentive. But even this case received low scores in some criteria: conflict resolution, early involvement and well defined goals. Based on the results we suggest that more data is needed to evaluate the implementation of the plans and, in many cases, the impact of the process on the plan. Performance can be improved with the assistance of policy makers by further developing guidelines, harmonising payment schemes with the conservation measures of the plans and providing training on conflict resolution. The evaluation framework proved to be suitable for the assessment of a large set of conservation related management planning processes, but it also had some limitations, e.g. concerning the incorporation of stakeholders' views in the evaluation. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Regional Advisory Councils: what is their potential to incorporate stakeholder knowledge into fisheries governance?

PubMed

Linke, Sebastian; Dreyer, Marion; Sellke, Piet

2011-03-01

The protection of the Baltic Sea ecosystem is exacerbated by the social, environmental and economic complexities of governing European fisheries. Increased stakeholder participation and knowledge integration are suggested to improve the EU's Common Fisheries Policy (CFP), suffering from legitimacy, credibility and compliance problems. As a result, the CFP was revised in 2002 to involve fisheries representatives, NGOs and other stakeholders through so called Regional Advisory Councils (RACs) in the policy process. We address the RAC's task to incorporate stakeholder knowledge into the EU's fisheries governance system in empirical and theoretical perspectives. Drawing on a four-stage governance concept we subsequently suggest that a basic problem is a mismatch between participation purpose (knowledge inclusion) and the governance stage at which RACs are formally positioned (evaluation of management proposals). We conclude that, if the aim is to broaden the knowledge base of fisheries management, stakeholders need to be included earlier in the governance process.

The Direct Loan Demonstration Program: An Analysis of the Legislative Process Involving Federal Student Loan Policy.

ERIC Educational Resources Information Center

McCormick, Joe Lew

This study examined major stakeholders' perceptions of their involvement and role in the legislative process surrounding the introduction, deliberation, and ultimate passage of the Direct Loan Demonstration Program (DLDP), a federal pilot student loan program. Data analysis was based on a detailed description of the legislative process surrounding…

A Second Opinion: A Case Narrative on Clinical Ethics Mediation.

PubMed

Weinstein, Michael S

2015-01-01

Contrasting traditional and common forms of ethics consultation with bioethics mediation, I describe the case of a "second opinion" consultation in the care of a patient with advanced cancer for whom treatment was futile. While the initial ethics consultation, performed by a colleague, led to a recommendation that some may deem ethical, the process failed to involve key stakeholders and failed to explore the underlying values and reasons for the opinions voiced by various stakeholders. The process of mediation ultimately led to creative solutions in which all stakeholders could reach consensus on a plan of care. Copyright 2015 The Journal of Clinical Ethics. All rights reserved.

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

PubMed Central

Vermaßen, Hannah; Ellenbeck, Saskia

2017-01-01

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

Recording and accounting for stakeholder involvement in systematic reviews.

PubMed

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

2015-06-01

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

Integrating Comparative Effectiveness Design Elements and Endpoints Into a Phase III, Randomized Clinical Trial (SWOG S1007) Evaluating OncotypeDX-Guided Management for Women With Breast Cancer Involving Lymph Nodes

PubMed Central

Ramsey, Scott D.; Barlow, William E.; Gonzalez-Angulo, Ana M.; Tunis, Sean; Baker, Laurence; Crowley, John; Deverka, Patricia; Veenstra, David; Hortobagyi, Gabriel N.

2012-01-01

Women with breast cancer involving the lymph nodes are typically treated with cytotoxic chemotherapy. Retrospective evaluations of prior studies suggest that the 21-gene test (OncotypeDX®), may allow identification of those who can safely avoid chemotherapy. To better understand the performance of the 21-gene test, the RxPONDER (Rx for Positive Node, Endocrine Responsive breast cancer) study was designed, a multicenter Phase III trial randomizing women with hormone receptor-positive and HER2-negative breast cancer involving 1–3 lymph nodes and a 21-gene assay recurrence score (RS) of 25 or less to endocrine therapy alone versus chemotherapy followed by endocrine therapy. As one of the first large-scale comparative-effectiveness studies in oncology, RxPONDER utilized an external stakeholder group to help inform the design of the trial. Stakeholders met with representatives of SWOG over several months through a structured discussion process. The stakeholder engagement process resulted in several changes being made to the trial design. In addition, stakeholder representatives from the health insurance industry provided guidance regarding a mechanism whereby the costs of OncotypeDX® would be paid by the majority of health insurers as part of the trial. The process may serve as a template for future studies evaluating the comparative effectiveness of genomic tests in oncology, particularly those that are conducted within cooperative clinical trials groups. PMID:23000081

Relational responsibilities in responsive evaluation.

PubMed

Visse, Merel; Abma, Tineke A; Widdershoven, Guy A M

2012-02-01

This article explores how we can enhance our understanding of the moral responsibilities in daily, plural practices of responsive evaluation. It introduces an interpretive framework for understanding the moral aspects of evaluation practice. The framework supports responsive evaluators to better understand and handle their moral responsibilities. A case is introduced to illustrate our argument. Responsive evaluation contributes to the design and implementation of policy by working with stakeholders and coordinating the evaluation process as a relationally responsible practice. Responsive evaluation entails a democratic process in which the evaluator fosters and enters a partnership with stakeholders. The responsibilities of an evaluator generally involve issues such as 'confidentiality', 'accountability' and 'privacy'. The responsive evaluator has specific responsibilities, for example to include stakeholders and vulnerable groups and to foster an ongoing dialogue. In addition, responsive evaluation involves a relational responsibility, which becomes present in daily situations in which stakeholders express expectations and voice demands. In our everyday work as evaluators, it is difficult to respond to all these demands at the same time. In addition, this article demonstrates that novice evaluators experience challenges concerning over- and underidenfitication with stakeholders. Guidelines and quality criteria on how to act are helpful, but need interpretation and application to the unique situation at hand. Copyright © 2011 Elsevier Ltd. All rights reserved.

Stakeholder Evaluation for Canaan Valley National Wildlife Refuge: Completion Report

USGS Publications Warehouse

Sexton, Natalie R.; Burkardt, Nina; Swann, Margaret Earlene; Stewart, Susan C.

2009-01-01

The National Wildlife Refuge System, managed by the U.S. Fish and Wildlife Service (FWS), is the largest system of public lands in the world dedicated to wildlife conservation. There are over 545 national wildlife refuges nationwide, encompassing 95 million acres. As part of the National Wildlife Refuge System Improvement Act of 1997, each refuge is developing 15-year comprehensive conservation plans (CCPs). Each CCP describes a vision and desired future condition for the refuge and outlines goals, objectives, and management strategies for each refuge's habitat and visitor service programs. The CCP process for Canaan Valley National Wildlife Refuge (Refuge) in Davis, West Virginia was initiated in 2006. This planning process provides a unique opportunity for public input and involvement. Public involvement is an important part of the CCP process. Participation by parties with a stake in the resource (stakeholders) has the potential to increase understanding and support and reduce conflicts. Additionally, meaningful public participation in a decision process may increase trust and provide satisfaction in terms of both process and outcome for management and the public. Public meetings are a common way to obtain input from community members, visitors, and potential visitors. An 'Issues Workbook' is another tool the FWS uses to obtain public input and participation early in the planning process. Sometimes, however, these traditional methods do not capture the full range of perspectives that exist. A stakeholder evaluation is a way to more fully understand community preferences and opinions related to key topics in refuge planning. It can also help refuge staff understand how changes in management affect individuals in terms of their preference for services and experiences. Secondarily, a process such as this can address 'social goals' such as fostering trust in regulating agencies and reducing conflict among stakeholders. As part of the CCP planning effort at Canaan Valley National Wildlife Refuge, the FWS sponsored a stakeholder evaluation conducted by the Policy Analysis and Science Assistance Branch of U.S. Geological Survey, Fort Collins Science Center the winter of 2006-2007. The stakeholder evaluation was intended to answer the following questions: 1)Which Refuge management issues are most important, and to whom?, 2)How do opinions about what is most important to stakeholders overlap or conflict?, 3)Why do stakeholders emphasize specific issues, and what values are driving this?, and 4)What potential solutions do stakeholders have for addressing important issues? This information will be used by the Refuge to help guide development of their CCP as they strive to balance stakeholder desires with their charge to manage the unique wetlands and uplands of the Canaan Valley for wildlife conservation.

Bringing the ecosystem services concept into marine management decisions, supporting ecosystems-based management.

NASA Astrophysics Data System (ADS)

Tweddle, J. F.; Byg, A.; Davies, I.; Gubbins, M.; Irvine, K.; Kafas, A.; Kenter, J.; MacDonald, A.; Murray, R. B. O.; Potts, T.; Slater, A. M.; Wright, K.; Scott, B. E.

2016-02-01

The marine environment is under increasing use, putting pressure on marine ecosystems and increasing competition for space. New activities (e.g. renewable energy developments), evolving marine policies (e.g. implementation of marine protected areas), and climate change may drive changes in biodiversity and resulting ecosystem services (ES) that society and business utilise from coastal and marine systems. A process is needed that integrates ecological assessment of changes with stakeholder perceptions and valuation of ES, whilst balancing ease of application with the ability to deal with complex social-economic-ecological issues. The project "Cooperative participatory assessment of the impact of renewable technology on ecosystem services: CORPORATES" involved natural and social scientists, law and policy experts, and marine managers, with the aim of promoting more integrated decision making using ES concepts in marine management. CORPORATES developed a process to bring ES concepts into stakeholders' awareness. The interactive process, involving 2 workshops, employs interludes of knowledge exchange by experts on ecological processes underpinning ES and on law and policy. These enable mapping of benefits linked to activities, participatory system modelling, and deliberation of policy impacts on different sectors. The workshops were attended by industry representatives, regulatory/advisory partners, and other stakeholders (NGOs, SMEs, recreationalists, local government). Mixed sector groups produced new insights into links between activities and ES, and highlighted cross-sector concerns. Here we present the aspects of the process that successfully built shared understanding between industry and stakeholders of inter-linkages and interactions between ES, benefits, activities, and economic and cultural values. These methods provide an ES-based decision-support model for exchanging societal-ecological knowledge and providing stakeholder interaction in marine planning, supporting ecosystem-based management.

Bringing the ecosystem services concept into marine management decisions, supporting ecosystems-based management.

NASA Astrophysics Data System (ADS)

Tweddle, J. F.; Byg, A.; Davies, I.; Gubbins, M.; Irvine, K.; Kafas, A.; Kenter, J.; MacDonald, A.; Murray, R. B. O.; Potts, T.; Slater, A. M.; Wright, K.; Scott, B. E.

2016-12-01

The marine environment is under increasing use, putting pressure on marine ecosystems and increasing competition for space. New activities (e.g. renewable energy developments), evolving marine policies (e.g. implementation of marine protected areas), and climate change may drive changes in biodiversity and resulting ecosystem services (ES) that society and business utilise from coastal and marine systems. A process is needed that integrates ecological assessment of changes with stakeholder perceptions and valuation of ES, whilst balancing ease of application with the ability to deal with complex social-economic-ecological issues. The project "Cooperative participatory assessment of the impact of renewable technology on ecosystem services: CORPORATES" involved natural and social scientists, law and policy experts, and marine managers, with the aim of promoting more integrated decision making using ES concepts in marine management. CORPORATES developed a process to bring ES concepts into stakeholders' awareness. The interactive process, involving 2 workshops, employs interludes of knowledge exchange by experts on ecological processes underpinning ES and on law and policy. These enable mapping of benefits linked to activities, participatory system modelling, and deliberation of policy impacts on different sectors. The workshops were attended by industry representatives, regulatory/advisory partners, and other stakeholders (NGOs, SMEs, recreationalists, local government). Mixed sector groups produced new insights into links between activities and ES, and highlighted cross-sector concerns. Here we present the aspects of the process that successfully built shared understanding between industry and stakeholders of inter-linkages and interactions between ES, benefits, activities, and economic and cultural values. These methods provide an ES-based decision-support model for exchanging societal-ecological knowledge and providing stakeholder interaction in marine planning, supporting ecosystem-based management.

Effective stakeholder participation in setting research priorities using a Global Evidence Mapping approach.

PubMed

Clavisi, Ornella; Bragge, Peter; Tavender, Emma; Turner, Tari; Gruen, Russell L

2013-05-01

We present a multistep process for identifying priority research areas in rehabilitation and long-term care of traumatic brain-injured (TBI) patients. In particular, we aimed to (1) identify which stakeholders should be involved; (2) identify what methods are appropriate; (3) examine different criteria for the generation of research priority areas; and (4) test the feasibility of linkage and exchange among researchers, decision makers, and other potential users of the research. Potential research questions were identified and developed using an initial scoping meeting and preliminary literature search, followed by a facilitated mapping workshop and an online survey. Identified research questions were then prioritized against specific criteria (clinical importance, novelty, and controversy). Existing evidence was then mapped to the high-priority questions using usual processes for search, screening, and selection. A broad range of stakeholders were then brought together at a forum to identify priority research themes for future research investment. Using clinical and research leaders, smaller targeted planning workshops prioritized specific research projects for each of the identified themes. Twenty-six specific questions about TBI rehabilitation were generated, 14 of which were high priority. No one method identified all high-priority questions. Methods that relied solely on the views of clinicians and researchers identified fewer high-priority questions compared with methods that used broader stakeholder engagement. Evidence maps of these high-priority questions yielded a number of evidence gaps. Priority questions and evidence maps were then used to inform a research forum, which identified 12 priority themes for future research. Our research demonstrates the value of a multistep and multimethod process involving many different types of stakeholders for prioritizing research to improve the rehabilitation outcomes of people who have suffered TBI. Enhancing stakeholder representation can be augmented using a combination of methods and a process of linkage and exchange. This process can inform decisions about prioritization of research areas. Copyright © 2013 Elsevier Inc. All rights reserved.

Cognitive mapping tools: review and risk management needs.

PubMed

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

2012-08-01

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

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.

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

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

Martell, Meritxell; Bergmans, Anne

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

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.

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

NASA Astrophysics Data System (ADS)

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

2016-02-01

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

Using an innovative criteria weighting tool for stakeholders involvement to rank MSW facility sites with the AHP.

PubMed

De Feo, Giovanni; De Gisi, Sabino

2010-11-01

The main aim of this study was to verify the efficacy of using an innovative criteria weighting tool (the "priority scale") for stakeholders involvement to rank a list of suitable municipal solid waste (MSW) facility sites with the multi-criteria decision-making (MCDM) technique known as analytic hierarchy process (AHP). One of the main objectives of the study was to verify the behaviour of the "priority scale" with both technical and non-technical decision-makers. All over the world, the siting of MSW treatment or disposal plants is a complex process involving politicians, technicians as well as citizens, where stakeholders who are not effectively involved strongly oppose (or even obstruct) the realization of new facilities. In this study, in order to pursue both the technical (select the best site) and social aims (all the stakeholders have to give their aware contribution), the use of the "priority scale" is suggested as a tool to easily collect non-contradictory criteria preferences by the various decision-makers. Every decision-maker filled in "priority scale", which was subsequently uploaded in the AHP tool in order to indirectly calculate the individual priority of alternatives given by each stakeholder (not using group aggregation techniques). The proposed method was applied to the siting of a composting plant in an area suffering from a serious MSW emergency, which has lasted for over 15 years, in the Campania Region, in Southern Italy. The best site (the "first choice") was taken as the one that appeared the most times at the first place of each decision-maker ranking list. The involved technical and non-technical decision-makers showed the same behaviour in (indirectly) selecting the best site as well as in terms of the most appraised criteria ("absence of areas of the highest value for natural habitats and species of plants and animals"). Moreover, they showed the same AHP inconsistency ratio as well as the same behaviour in comparison with a "balanced decision-maker" (who assigns identical weights to all the considered criteria). Therefore, the proposed criteria weighting tool could be widely as well as easily used for stakeholders involvement to rank MSW facility sites (or other kinds of alternatives) with the AHP or with other MCDM techniques, taking or not into consideration group aggregation methods. Copyright © 2010 Elsevier Ltd. All rights reserved.

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

PubMed

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

2018-02-01

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

Involving Research Stakeholders in Developing Policy on Sharing Public Health Research Data in Kenya

PubMed Central

Jao, Irene; Kombe, Francis; Mwalukore, Salim; Bull, Susan; Parker, Michael; Kamuya, Dorcas; Molyneux, Sassy

2015-01-01

Increased global sharing of public health research data has potential to advance scientific progress but may present challenges to the interests of research stakeholders, particularly in low-to-middle income countries. Policies for data sharing should be responsive to public views, but there is little evidence of the systematic study of these from low-income countries. This qualitative study explored views on fair data-sharing processes among 60 stakeholders in Kenya with varying research experience, using a deliberative approach. Stakeholders’ attitudes were informed by perceptions of benefit and concerns for research data sharing, including risks of stigmatization, loss of privacy, and undermining scientific careers and validity, reported in detail elsewhere. In this article, we discuss institutional trust-building processes seen as central to perceptions of fairness in sharing research data in this setting, including forms of community involvement, individual prior awareness and agreement to data sharing, independence and accountability of governance mechanisms, and operating under a national framework. PMID:26297748

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.

Some considerations on the attractiveness of participatory processes for researchers from natural science

NASA Astrophysics Data System (ADS)

Barthel, Roland

2013-04-01

Participatory modeling and participatory scenario development have become an essential part of environmental impact assessment and planning in the field of water resources management. But even if most people agree that participation is required to solve environmental problems in a way that satisfies both the environmental and societal needs, success stories are relatively rare, while many attempts to include stakeholders in the development of models are still reported to have failed. This paper proposes the hypothesis, that the lack of success in participatory modeling can partly be attributed to a lack of attractiveness of participatory approaches for researchers from natural sciences (subsequently called 'modelers'). It has to be pointed out that this discussion is mainly concerned with natural scientists in academia and not with modelers who develop models for commercial purposes or modelers employed by public agencies. The involvement of modelers and stakeholders in participatory modeling has been intensively studied during recent years. However, such analysis is rarely made from the viewpoint of the modelers themselves. Modelers usually don't see participatory modeling and scenario development as scientific targets as such, because the theoretical foundations of such processes usually lie far outside their own area of expertise. Thus, participatory processes are seen mainly as a means to attract funding or to facilitate the access to data or (relatively rarely) as a way to develop a research model into a commercial product. The majority of modelers very likely do not spend too much time on reflecting whether or not their new tools are helpful to solve real world problems or if the results are understandable and acceptable for stakeholders. They consider their task completed when the model they developed satisfies the 'scientific requirements', which are essentially different from the requirements to satisfy a group of stakeholders. Funding often stops before a newly developed model can actually be tested in a stakeholder process. Therefore the gap between stakeholders and modelers persists or is even growing. A main reason for this probably lies in the way that the work of scientists (modelers) is evaluated. What counts is the number of journal articles produced, while applicability or societal impact is still not a measure of scientific success. A good journal article on a model requires an exemplary validation but only very rarely would a reviewer ask if a model was accepted by stakeholders. So why should a scientist go through a tedious stakeholder process? The stakeholder process might be a requirement of the research grant, but whether this is taken seriously, can be questioned, as long as stakeholder dialogues do not lead to quantifiable scientific success. In particular for researchers in early career stages who undergo typical, publication-based evaluation processes, participatory research is hardly beneficial. The discussion in this contribution is based on three pillars: (i) a comprehensive evaluation of the literature published on participatory modeling and scenario development, (ii) a case study involving the development of an integrated model for water and land use management including an intensive stakeholder process and (iii) unstructured, personal communication - with mainly young scientists - about the attractiveness of multidisciplinary, applied research.

Downscaling SSPs in Bangladesh - Integrating Science, Modelling and Stakeholders Through Qualitative and Quantitative Scenarios

NASA Astrophysics Data System (ADS)

Allan, A.; Barbour, E.; Salehin, M.; Hutton, C.; Lázár, A. N.; Nicholls, R. J.; Rahman, M. M.

2015-12-01

A downscaled scenario development process was adopted in the context of a project seeking to understand relationships between ecosystem services and human well-being in the Ganges-Brahmaputra delta. The aim was to link the concerns and priorities of relevant stakeholders with the integrated biophysical and poverty models used in the project. A 2-stage process was used to facilitate the connection between stakeholders concerns and available modelling capacity: the first to qualitatively describe what the future might look like in 2050; the second to translate these qualitative descriptions into the quantitative form required by the numerical models. An extended, modified SSP approach was adopted, with stakeholders downscaling issues identified through interviews as being priorities for the southwest of Bangladesh. Detailed qualitative futures were produced, before modellable elements were quantified in conjunction with an expert stakeholder cadre. Stakeholder input, using the methods adopted here, allows the top-down focus of the RCPs to be aligned with the bottom-up approach needed to make the SSPs appropriate at the more local scale, and also facilitates the translation of qualitative narrative scenarios into a quantitative form that lends itself to incorporation of biophysical and socio-economic indicators. The presentation will describe the downscaling process in detail, and conclude with findings regarding the importance of stakeholder involvement (and logistical considerations), balancing model capacity with expectations and recommendations on SSP refinement at local levels.

Downscaling SSPs in the GBM Delta - Integrating Science, Modelling and Stakeholders Through Qualitative and Quantitative Scenarios

NASA Astrophysics Data System (ADS)

Allan, Andrew; Barbour, Emily; Salehin, Mashfiqus; Munsur Rahman, Md.; Hutton, Craig; Lazar, Attila

2016-04-01

A downscaled scenario development process was adopted in the context of a project seeking to understand relationships between ecosystem services and human well-being in the Ganges-Brahmaputra delta. The aim was to link the concerns and priorities of relevant stakeholders with the integrated biophysical and poverty models used in the project. A 2-stage process was used to facilitate the connection between stakeholders concerns and available modelling capacity: the first to qualitatively describe what the future might look like in 2050; the second to translate these qualitative descriptions into the quantitative form required by the numerical models. An extended, modified SSP approach was adopted, with stakeholders downscaling issues identified through interviews as being priorities for the southwest of Bangladesh. Detailed qualitative futures were produced, before modellable elements were quantified in conjunction with an expert stakeholder cadre. Stakeholder input, using the methods adopted here, allows the top-down focus of the RCPs to be aligned with the bottom-up approach needed to make the SSPs appropriate at the more local scale, and also facilitates the translation of qualitative narrative scenarios into a quantitative form that lends itself to incorporation of biophysical and socio-economic indicators. The presentation will describe the downscaling process in detail, and conclude with findings regarding the importance of stakeholder involvement (and logistical considerations), balancing model capacity with expectations and recommendations on SSP refinement at local levels.

Stakeholders and public involvement in river management: heterogeneous acceptance of participatory processes among Swiss institutions.

NASA Astrophysics Data System (ADS)

Buletti, Nora; Utz, Stephan; Ejderyan, Olivier; Graefe, Olivier; Lane, Stuart; Reynard, Emmanuel

2014-05-01

This research explores participatory processes in the domain of river management in Switzerland. The main objective is to better understand how participatory processes are incorporated into river management practice. Switzerland being a federal state, river management is a cantonal (regional) responsibility, under the supervision (and co-funding) of the State (a Confederation). The federal funding includes the opportunity to fund additional participatory activities to aid river management, not least because the federal authorities consider the involvement of wider stakeholders and the public in decision-making as a means of aiding the progression of projects. This is a particularly important goal in a Swiss setting where direct democracy (the possibility of calling the decision of any level of government into question through a popular vote) means that a reasonable level of project acceptance is a necessary element of project progression. River management in Switzerland now includes both flood protection and river restoration objectives, which has served to increase its controversy: river corridors contain competing interests with different objectives (e.g. ecological enhancement, protection of agricultural land, flood risk reduction). We were asked by the Confederation to evaluate participatory processes it sponsored and one element of this evaluation aimed to develop a typology of stakeholder participation. We conducted interviews with the 26 cantonal officers in charge of river management. These interviews were based upon thematically structured open ended questions, with the responses analyzed qualitatively. We have identified significant divergence in the implementation of participatory processes between the cantons. These appear to be related to two factors: (1) the canton's historical experience of river management; and (2) the methods used to select stakeholders for inclusion in the decisional process. Cantons that refer to guidelines or pre-established handbooks for the selection of stakeholders often conduct instrumental participation, limited to information dissemination. On the other hand, in some cantons participatory processes characterized by normative rationales take place. Here the goals of participatory processes are not limited to outcomes (e.g. acceptance of the project), but value the process of participation in itself. In these cantons actors are selected via social connections and the claimed 'common sense' of cantonal project officers. Here, the opportunity of public debate opens up, the inclusion of actors often start earlier in the decision-making processes and objectives are defined publicly and collectively. Cantonal authorities involved in river management do not all consider participatory processes as important. The acknowledgment of participatory processes is less related to an authority's recognition of the importance of participation and more to specific local experience.

Community Mobilization and Readiness: Planning Flaws which Challenge Effective Implementation of 'Communities that Care' (CTC) Prevention System.

PubMed

Basic, Josipa

2015-01-01

This article reviews the experience of implementing a community approach to drug use and youth delinquency prevention based on the 'Communities that Care' (CTC) system implemented in one Croatian county consisting of 12 communities, 2002 to 2013 (Hawkins, 1999; Hawkins & Catalano, 2004). This overview explores selected critical issues which are often not considered in substance use(r) community intervention planning, implementation as well as in associated process and outcome assessments. These issues include, among others, the mobilization process of adequate representation of people; the involvement of relevant key individual and organizational stakeholders and being aware of the stakeholders' willingness to participate in the prevention process. In addition, it is important to be aware of the stakeholders' knowledge and perceptions about the 'problems' of drug use and youth delinquency in their communities as well as the characteristics of the targeted population(s). Sometimes there are community members and stakeholders who block needed change and therefore prevention process enablers and 'bridges' should be involved in moving prevention programming forward. Another barrier that is often overlooked in prevention planning is community readiness to change and a realistic assessment of available and accessible resources for initiating the planned change(s) and sustaining them. All of these issues have been found to be potentially related to intervention success. At the end of this article, I summarize perspectives from prevention scientists and practitioners and lessons learned from communities' readiness research and practice in Croatian that has international relevance.

Stakeholder Bias.

ERIC Educational Resources Information Center

House, Ernest R.

2003-01-01

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

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.

Asbestos Ban in Italy: A Major Milestone, Not the Final Cut

PubMed Central

Marsili, Daniela; Bruno, Caterina; Marinaccio, Alessandro; Zona, Amerigo; Comba, Pietro

2017-01-01

Background and history: Italy was the main asbestos producer and one of the greatest consumers in 20th century Europe until the asbestos ban was introduced in 1992. Asbestos exposure affected the population in a wide range of working environments, namely mining and marketing of asbestos, asbestos cement production, shipyards and textile industries. This also determined a widespread environmental asbestos exposure affecting the surrounding communities. Methods: To investigate the drivers and difficulties of the process leading to the asbestos ban and its subsequent implementation, we focused on stakeholder involvement, environmental health policies, capacity building and communication. Results: In the past three decades, stakeholder involvement has been instrumental in advancing the industrial asbestos replacement process, prevention and remediation interventions. Furthermore, involvement also contributed to the integration of environmental and health policies at national, regional and local levels, including capacity building and communication. In a global public health perspective, international scientific cooperation has been established with countries using and producing asbestos. Discussion and Conclusions: Key factors and lessons learnt in Italy from both successful and ineffective asbestos policies are described to support the relevant stakeholders in countries still using asbestos contributing to the termination of its use. PMID:29137208

Asbestos Ban in Italy: A Major Milestone, Not the Final Cut.

PubMed

Marsili, Daniela; Angelini, Alessia; Bruno, Caterina; Corfiati, Marisa; Marinaccio, Alessandro; Silvestri, Stefano; Zona, Amerigo; Comba, Pietro

2017-11-13

Background and history: Italy was the main asbestos producer and one of the greatest consumers in 20th century Europe until the asbestos ban was introduced in 1992. Asbestos exposure affected the population in a wide range of working environments, namely mining and marketing of asbestos, asbestos cement production, shipyards and textile industries. This also determined a widespread environmental asbestos exposure affecting the surrounding communities. Methods: To investigate the drivers and difficulties of the process leading to the asbestos ban and its subsequent implementation, we focused on stakeholder involvement, environmental health policies, capacity building and communication. Results: In the past three decades, stakeholder involvement has been instrumental in advancing the industrial asbestos replacement process, prevention and remediation interventions. Furthermore, involvement also contributed to the integration of environmental and health policies at national, regional and local levels, including capacity building and communication. In a global public health perspective, international scientific cooperation has been established with countries using and producing asbestos. Discussion and Conclusions: Key factors and lessons learnt in Italy from both successful and ineffective asbestos policies are described to support the relevant stakeholders in countries still using asbestos contributing to the termination of its use.

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

PubMed

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

2016-01-01

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

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

PubMed Central

Romero-Brito, Tania P.; Byrne, Jason

2016-01-01

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

Methods for engaging stakeholders in comparative effectiveness research: a patient-centered approach to improving diabetes care.

PubMed

Schmittdiel, Julie A; Desai, Jay; Schroeder, Emily B; Paolino, Andrea R; Nichols, Gregory A; Lawrence, Jean M; O'Connor, Patrick J; Ohnsorg, Kris A; Newton, Katherine M; Steiner, John F

2015-06-01

Engaging stakeholders in the research process has the potential to improve quality of care and the patient care experience. Online patient community surveys can elicit important topic areas for comparative effectiveness research. Stakeholder meetings with substantial patient representation, as well as representation from health care delivery systems and research funding agencies, are a valuable tool for selecting and refining pilot research and quality improvement projects. Giving patient stakeholders a deciding vote in selecting pilot research topics helps ensure their 'voice' is heard. Researchers and health care leaders should continue to develop best-practices and strategies for increasing patient involvement in comparative effectiveness and delivery science research.

Increasing Public Access to Scientific Research through Stakeholder Involvement: Ecological Effects of Sea Level Rise in the Northern Gulf of Mexico

NASA Astrophysics Data System (ADS)

Hagen, S. C.; Stephens, S. H.; DeLorme, D. E.; Ruple, D.; Graham, L.

2013-12-01

Sea level rise (SLR) has the potential to have a myriad of deleterious effects on coastal ecology and human infrastructure. Stakeholders, including managers of coastal resources, must be aware of potential consequences of SLR and adjust their plans accordingly to protect and preserve the resources under their care. Members of the public, particularly those who live or work in coastal areas, should also be informed about the results of scientific research on the effects of SLR. However, research results are frequently published in venues or formats to which resource managers and the broader public have limited access. It is imperative for scientists to move beyond traditional publication venues in order to more effectively disseminate the results of their research (Dennison, W. 2007, Estu. Coast. Shelf Sci. 77, 185). One potentially effective way to advance public access to research is to incorporate stakeholder involvement into the research project process in order to target study objectives and tailor communication products toward stakeholder needs (Lemos, M. & Morehouse, B. 2005, Glob. Env. Chg. 15, 57). However, it is important to manage communication and clarify participant expectations during this type of research (Gawith, M. et al. 2009, Glob. Env. Chg. 19, 113). This presentation describes the process being undertaken by an ongoing 5-year multi-disciplinary NOAA-funded project, Ecological Effects of Sea Level Rise in the Northern Gulf of Mexico (EESLR-NGOM), to improve accessibility and utility of scientific research results through stakeholder engagement. The EESLR-NGOM project is assessing the ecological risks from SLR along the Mississippi, Alabama and Florida Panhandle coasts, coastal habitats, and floodplains. It has incorporated stakeholder involvement throughout the research process so as to better target and tailor the emerging research products to meet resource managers' needs, as well as to facilitate eventual public dissemination of results. An important component of the EESLR-NGOM project is annual stakeholder committee workshops that engage regional coastal resource managers. These workshops are designed to identify managers' concerns about the scientific project objectives, solicit input on the content and format of the emerging research products, identify gaps in products and target audiences, and connect this project to other ongoing SLR research and extension efforts. We describe how this innovative project process has functioned to shape scientific objectives, the eventual SLR impact decision support tools, and other products that will help managers and the public use the project's results most effectively.

User and stakeholder involvement for relevant, reliable and robust local-scale climate projections in Norway

NASA Astrophysics Data System (ADS)

Neby, Simon; Sobolowski, Stefan

2017-04-01

How can users and stakeholders be actively involved with providing input to and using output from local-scale climate projections? How can the scientific community better understand the needs of local actors? And how should communication and cooperation efforts be organized? These are critical questions we aim to answer in a climate services project funded by the Norwegian Research Council (R3: Relevant, Reliable and Robust local-scale climate projections for Norway). The project takes into consideration not only the scientific issues in establishing useful local-scale climate projections, but also addresses the "usability gap" between climate information and decision-making. The lack of effective communication between scientists and user communities often result in outputs and products that are not matched with decision-relevant climate information. In the R3 project, the scientific participants actively engage with a range of users that have quite different information needs: municipalities, infrastructure developers, agriculture, energy producers, insurance companies, and more. In this particular presentation, we present our experiences concerning three specific issues that relate to the stakeholder-science interface: 1) Preferences are not clear-cut and pre-defined. In practice, this means that stakeholders often do not have precise information about their needs, nor precise information about how, where and whether their needs can be voiced. Similarly, science communities tend to presuppose that stakeholders are interested and have well-articulated needs, which is hardly the case. Collectively, that means that there is a need for an approach that guides the articulation and prioritization of preferences in a manner that integrates both scientific and stakeholder perspectives and takes the integrity of both perspectives seriously. 2) Technologies are unclear. Although information may be produced and used, past experiences, trial and error processes and pragmatic considerations often dominate actual knowledge dissemination and application processes. Involved actors have very diverse interests, and equally varying modes of knowledge application and logics of action. Timeframes vary, as do the formats that climate information needs have, if it is to be applicable and relevant. Farmers' associations that formulate sector policies need information in a different form than municipalities engaged in urban planning. 3) Actor participation is fluid. All actors are marked by limitations in attention, engagement, resources, external demands and access to processes that are of (varying) relevance to them. Not all stakeholders (and not all scientists) can, will or wish to be equally active in co-production of knowledge. Similarly, the decision-making processes where information is put to use are subject to variation in engagement and participation.

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.

Health Care Systems Support to Enhance Patient-Centered Care: Lessons from a Primary Care-Based Chronic Pain Management Initiative.

PubMed

Elder, Charles R; Debar, Lynn L; Ritenbaugh, Cheryl; Rumptz, Maureen H; Patterson, Charlotte; Bonifay, Allison; Cowan, Penney; Lancaster, Lindsay; Deyo, Richard A

2017-01-01

Supporting day-to-day self-care activities has emerged as a best practice when caring for patients with chronic pain, yet providing this support may introduce challenges for both patients and primary care physicians. It is essential to develop tools that help patients identify the issues and outcomes that are most important to them and to communicate this information to primary care physicians at the point of care. We describe our process to engage patients, primary care physicians, and other stakeholders in the context of a pilot randomized controlled trial of a patient-centered assessment process implemented in an everyday practice setting. We identify lessons on how to engage stakeholders and improve patient-centered care for those with chronic conditions within the primary care setting. A qualitative analysis of project minutes, interviews, and focus groups was conducted to evaluate stakeholder experiences. Stakeholders included patients, caregivers, clinicians, medical office support staff, health plan administrators, an information technology consultant, and a patient advocate. Our stakeholders included many patients with no prior experience with research. This approach enriched the applicability of feedback but necessitated extra time for stakeholder training and meeting preparation. Types of stakeholders varied over the course of the project, and more involvement of medical assistants and Information Technology staff was required than originally anticipated. Meaningful engagement of patient and physician stakeholders must be solicited in a well-coordinated manner with broad health care system supports in place to ensure full execution of patient-centered processes.

A critical appraisal of guidelines used for management of severe acute malnutrition in South Africa's referral system.

PubMed

Mambulu-Chikankheni, Faith Nankasa; Eyles, John; Eboreime, Ejemai Amaize; Ditlopo, Prudence

2017-10-18

Focusing on healthcare referral processes for children with severe acute malnutrition (SAM) in South Africa, this paper discusses the comprehensiveness of documents (global and national) that guide the country's SAM healthcare. This research is relevant because South African studies on SAM mostly examine the implementation of WHO guidelines in hospitals, making their technical relevance to the country's lower level and referral healthcare system under-explored. To add to both literature and methods for studying SAM healthcare, we critically appraised four child healthcare guidelines (global and national) and conducted complementary expert interviews (n = 5). Combining both methods enabled us to examine the comprehensiveness of the documents as related to guiding SAM healthcare within the country's referral system as well as the credibility (rigour and stakeholder representation) of the guideline documents' development process. None of the guidelines appraised covered all steps of SAM referrals; however, each addressed certain steps thoroughly, apart from transit care. Our study also revealed that national documents were mostly modelled after WHO guidelines but were not explicitly adapted to local context. Furthermore, we found most guidelines' formulation processes to be unclear and stakeholder involvement in the process to be minimal. In adapting guidelines for management of SAM in South Africa, it is important that local context applicability is taken into consideration. In doing this, wider stakeholder involvement is essential; this is important because factors that affect SAM management go beyond in-hospital care. Community, civil society, medical and administrative involvement during guideline formulation processes will enhance acceptability and adherence to the guidelines.

Quality measurement and benchmarking of HPV vaccination services: a new approach.

PubMed

Maurici, Massimo; Paulon, Luca; Campolongo, Alessandra; Meleleo, Cristina; Carlino, Cristiana; Giordani, Alessandro; Perrelli, Fabrizio; Sgricia, Stefano; Ferrante, Maurizio; Franco, Elisabetta

2014-01-01

A new measurement process based upon a well-defined mathematical model was applied to evaluate the quality of human papillomavirus (HPV) vaccination centers in 3 of 12 Local Health Units (ASLs) within the Lazio Region of Italy. The quality aspects considered for evaluation were communicational efficiency, organizational efficiency and comfort. The overall maximum achievable value was 86.10%, while the HPV vaccination quality scores for ASL1, ASL2 and ASL3 were 73.07%, 71.08%, and 67.21%, respectively. With this new approach it is possible to represent the probabilistic reasoning of a stakeholder who evaluates the quality of a healthcare provider. All ASLs had margins for improvements and optimal quality results can be assessed in terms of better performance conditions, confirming the relationship between the resulting quality scores and HPV vaccination coverage. The measurement process was structured into three steps and involved four stakeholder categories: doctors, nurses, parents and vaccinated women. In Step 1, questionnaires were administered to collect different stakeholders' points of view (i.e., subjective data) that were elaborated to obtain the best and worst performance conditions when delivering a healthcare service. Step 2 of the process involved the gathering of performance data during the service delivery (i.e., objective data collection). Step 3 of the process involved the elaboration of all data: subjective data from step 1 are used to define a "standard" to test objective data from step 2. This entire process led to the creation of a set of scorecards. Benchmarking is presented as a result of the probabilistic meaning of the evaluated scores.

Lessons Learned by Community Stakeholders in the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) Project, 2013–2014

PubMed Central

Ganter, Claudia; Aftosmes-Tobio, Alyssa; Chuang, Emmeline; Kwass, Jo-Ann; Land, Thomas

2017-01-01

Introduction Childhood obesity is a multifaceted disease that requires sustainable, multidimensional approaches that support change at the individual, community, and systems levels. The Massachusetts Childhood Obesity Research Demonstration project addressed this need by using clinical and public health evidence-based methods to prevent childhood obesity. To date, little information is known about successes and lessons learned from implementing such large-scale interventions. To address this gap, we examined perspectives of community stakeholders from various sectors on successes achieved and lessons learned during the implementation process. Methods We conducted 39 semistructured interviews with key stakeholders from 6 community sectors in 2 low-income communities from November 2013 through April 2014, during project implementation. Interviews were audio-recorded, transcribed, and analyzed by using the constant comparative method. Data were analyzed by using QSR NVivo 10. Results Successes included increased parental involvement in children’s health and education, increased connections within participating organizations and within the broader community, changes in organizational policies and environments to better support healthy living, and improvements in health behaviors in children, parents, and stakeholders. Lessons learned included the importance of obtaining administrative and leadership support, involving key stakeholders early in the program planning process, creating buffers that allow for unexpected changes, and establishing opportunities for regular communication within and across sectors. Conclusion Study findings indicate that multidisciplinary approaches support health behavior change and provide insight into key issues to consider in developing and implementing such approaches in low-income communities. PMID:28125400

The process of social participation in primary health care: the case of Palencia, Guatemala

PubMed Central

Ruano, Ana L.; Sebastián, Miguel S.; Hurtig, Anna‐Karin

2014-01-01

Abstract Background  In 2008, the World Health Organization issued a callback to the principles of primary health care, which renewed interests in social participation in health. In Guatemala, social participation has been the main policy for the decentralization process since the late 1990s and the social development council scheme has been the main means for participation for the country’s population since 2002. Aim  The aim of this study was to explore the process of social participation at a municipal‐level health commission in the municipality of Palencia, Guatemala. Methods  Analysis of legal and policy documents and in‐depth interviews with institutional and community‐level stakeholders of the commission. Results  The lack of clear guidelines and regulations means that the stakeholders own motivations, agendas and power resources play an important part in defining the roles of the participants. Institutional stakeholders have the human and financial power to make policies. The community‐level stakeholders are token participants with little power resources. Their main role is to identify the needs of their communities and seek help from the authorities. Satisfaction and the perceived benefits that the stakeholders obtain from the process play an important part in maintaining the commission’s dynamic, which is unlikely to change unless the stakeholders perceive that the benefit they obtain does not outweigh the effort their role entails. Conclusion  Without more uniformed mechanisms and incentives for municipalities to work towards the national goal of equitable involvement in the development process, the achievements will be fragmented and will depend on the individual stakeholder’s good will. PMID:21902774

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

NASA Astrophysics Data System (ADS)

Avasilcăi, S.; Rusu, G.

2015-11-01

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

Developing Effective TMDLs: An Evaluation of the TMDL Process

EPA Pesticide Factsheets

The report explores whether various characteristics of data availability, funding resources, guidance materials, stakeholder involvement, scale of TMDLs and implementation planning positively influence development of effective TMDLs.

Multiple stakeholders in multi-criteria decision-making in the context of Municipal Solid Waste Management: A review.

PubMed

Soltani, Atousa; Hewage, Kasun; Reza, Bahareh; Sadiq, Rehan

2015-01-01

Municipal Solid Waste Management (MSWM) is a complicated process that involves multiple environmental and socio-economic criteria. Decision-makers look for decision support frameworks that can guide in defining alternatives, relevant criteria and their weights, and finding a suitable solution. In addition, decision-making in MSWM problems such as finding proper waste treatment locations or strategies often requires multiple stakeholders such as government, municipalities, industries, experts, and/or general public to get involved. Multi-criteria Decision Analysis (MCDA) is the most popular framework employed in previous studies on MSWM; MCDA methods help multiple stakeholders evaluate the often conflicting criteria, communicate their different preferences, and rank or prioritize MSWM strategies to finally agree on some elements of these strategies and make an applicable decision. This paper reviews and brings together research on the application of MCDA for solving MSWM problems with more focus on the studies that have considered multiple stakeholders and offers solutions for such problems. Results of this study show that AHP is the most common approach in consideration of multiple stakeholders and experts and governments/municipalities are the most common participants in these studies. Copyright © 2014 Elsevier Ltd. All rights reserved.

Stakeholder involvement in water management: necessity or luxury?

PubMed

Morrison, K

2003-01-01

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

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

Building Partnership to Improve Migrants' Access to Healthcare in Mumbai.

PubMed

Gawde, Nilesh Chandrakant; Sivakami, Muthusamy; Babu, Bontha V

2015-01-01

An intervention to improve migrants' access to healthcare was piloted in Mumbai with purpose of informing health policy and planning. This paper aims to describe the process of building partnership for improving migrants' access to healthcare of the pilot intervention, including the role played by different stakeholders and the contextual factors affecting the intervention. The process evaluation was based on Baranowski and Stables' framework. Observations in community and conversations with stakeholders as recorded in daily diaries, minutes of pre-intervention workshops, and stakeholder meetings served as data sources. Data were coded using the framework and descriptive summaries of evaluation components were prepared. Recruitment of stakeholders was easier than sustaining their interest. Community representatives led the intervention assisted by government officials. They planned community-level interventions to improve access to healthcare that involved predominantly information, education, and communication activities for which pre-existing formal and informal social networks and community events were used. Although the intervention reached migrants living with families, single male migrants neither participated nor did the intervention reach them consistently. Contextual factors such as culture differences between migrants and native population and illegality in the nature of the settlement, resulting in the exclusion from services, were the barriers. Inclusive multi-stakeholder partnership, including migrants themselves and using both formal and informal networks in community is a feasible strategy for health education and has potential to improve the migrants' access to healthcare. However, there are challenges to the partnership process and new strategies to overcome these challenges need to be tested such as peer-led models for involvement of single male migrants. For sustaining such efforts and mainstreaming migrants, addressing contextual factors and having formal mechanisms for their inclusion are equally important.

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.

Methods for Engaging Stakeholders in Comparative Effectiveness Research: A Patient-Centered Approach to Improving Diabetes Care

PubMed Central

Schmittdiel, Julie A.; Desai, Jay; Schroeder, Emily B.; Paolino, Andrea R.; Nichols, Gregory A.; Lawrence, Jean M.; O’Connor, Patrick J.; Ohnsorg, Kris A.; Newton, Katherine M.; Steiner, John F.

2016-01-01

ABSTRACT/Implementation Lessons Engaging stakeholders in the research process has the potential to improve quality of care and the patient care experience.Online patient community surveys can elicit important topic areas for comparative effectiveness research.Stakeholder meetings with substantial patient representation, as well as representation from health care delivery systems and research funding agencies, are a valuable tool for selecting and refining pilot research and quality improvement projects.Giving patient stakeholders a deciding vote in selecting pilot research topics helps ensure their ‘voice’ is heard.Researchers and health care leaders should continue to develop best-practices and strategies for increasing patient involvement in comparative effectiveness and delivery science research. PMID:26179728

How do environmental governance processes shape evaluation of outcomes by stakeholders? A causal pathways approach

PubMed Central

Plummer, Ryan; Dzyundzyak, Angela; Bodin, Örjan; Armitage, Derek; Schultz, Lisen

2017-01-01

Multi-stakeholder environmental management and governance processes are essential to realize social and ecological outcomes. Participation, collaboration, and learning are emphasized in these processes; to gain insights into how they influence stakeholders’ evaluations of outcomes in relation to management and governance interventions we use a path analysis approach to examine their relationships in individuals in four UNESCO Biosphere Reserves. We confirm a model showing that participation in more activities leads to greater ratings of process, and in turn, better evaluations of outcomes. We show the effects of participation in activities on evaluation of outcomes appear to be driven by learning more than collaboration. Original insights are offered as to how the evaluations of outcomes by stakeholders are shaped by their participation in activities and their experiences in management and governance processes. Understanding stakeholder perceptions about the processes in which they are involved and their evaluation of outcomes is imperative, and influences current and future levels of engagement. As such, the evaluation of outcomes themselves are an important tangible product from initiatives. Our research contributes to a future research agenda aimed at better understanding these pathways and their implications for engagement in stewardship and ultimately social and ecological outcomes, and to developing recommendations for practitioners engaged in environmental management and governance. PMID:28945792

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.

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

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

PubMed Central

Evans, Val; MacLeod, Sheona

2018-01-01

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

“Because we all trust and care about each other”: Exploring Tensions Translating a Theater-based HIV Prevention Intervention into a New Context

PubMed Central

Mouw, Mary Sherwyn; Taboada, Arianna; Steinert, Scarlett; Willis, Stephanie; Lightfoot, Alexandra F.

2016-01-01

Background A theater-based HIV prevention intervention developed in urban California was piloted with a new partnership in North Carolina. Objectives To describe the experience of translating a complex program with an enhanced partnership approach; barriers and facilitators of implementation in the new setting; and challenges and benefits of interdisciplinary, collaborative interventions. Methods We gathered perspectives of local stakeholders involved in program implementation through process evaluation interviews and focus groups with undergraduates, a college instructor, school district administrators, and high school teachers. Results Implementing the intervention in a new setting proved feasible and successful; however, mistaken assumptions and unrecognized similarities about teaching priorities, philosophies, and values produced latent tensions amongst stakeholder groups, and were a limiting factor in partnership functioning. Conclusions Implementing a cross-disciplinary intervention in a new setting is best achieved through a local community-engaged process, with active involvement of relevant stakeholders. We suggest strategies to strengthen community partnerships cooperating in implementation of complex, context-tailored interventions. PMID:27346770

Developing Effective Nonpoint Source TMDLs: An Evaluation of the TMDL Process

EPA Pesticide Factsheets

The report explores whether various characteristics of data availability, funding resources, guidance materials, stakeholder involvement, scale of TMDLs and implementation planning positively influence development of effective TMDLs.

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

PubMed

Kuhlmann, Ellen; Burau, Viola

2018-01-01

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

Multiple stakeholders in multi-criteria decision-making in the context of Municipal Solid Waste Management: A review

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

Soltani, Atousa; Hewage, Kasun; Reza, Bahareh

2015-01-15

Highlights: • We review Municipal Solid Waste Management studies with focus on multiple stakeholders. • We focus on studies with multi-criteria decision analysis methods and discover their trends. • Most studies do not offer solutions for situations where stakeholders compete for more benefits or have unequal voting powers. • Governments and experts are the most participated stakeholders and AHP is the most dominant method. - Abstract: Municipal Solid Waste Management (MSWM) is a complicated process that involves multiple environmental and socio-economic criteria. Decision-makers look for decision support frameworks that can guide in defining alternatives, relevant criteria and their weights, andmore » finding a suitable solution. In addition, decision-making in MSWM problems such as finding proper waste treatment locations or strategies often requires multiple stakeholders such as government, municipalities, industries, experts, and/or general public to get involved. Multi-criteria Decision Analysis (MCDA) is the most popular framework employed in previous studies on MSWM; MCDA methods help multiple stakeholders evaluate the often conflicting criteria, communicate their different preferences, and rank or prioritize MSWM strategies to finally agree on some elements of these strategies and make an applicable decision. This paper reviews and brings together research on the application of MCDA for solving MSWM problems with more focus on the studies that have considered multiple stakeholders and offers solutions for such problems. Results of this study show that AHP is the most common approach in consideration of multiple stakeholders and experts and governments/municipalities are the most common participants in these studies.« less

The Data Party: Involving Stakeholders in Meaningful Data Analysis

ERIC Educational Resources Information Center

Franz, Nancy K.

2013-01-01

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

Participatory Planning, Monitoring and Evaluation of Multi-Stakeholder Platforms in Integrated Landscape Initiatives.

PubMed

Kusters, Koen; Buck, Louise; de Graaf, Maartje; Minang, Peter; van Oosten, Cora; Zagt, Roderick

2018-07-01

Integrated landscape initiatives typically aim to strengthen landscape governance by developing and facilitating multi-stakeholder platforms. These are institutional coordination mechanisms that enable discussions, negotiations, and joint planning between stakeholders from various sectors in a given landscape. Multi-stakeholder platforms tend to involve complex processes with diverse actors, whose objectives and focus may be subjected to periodic re-evaluation, revision or reform. In this article we propose a participatory method to aid planning, monitoring, and evaluation of such platforms, and we report on experiences from piloting the method in Ghana and Indonesia. The method is comprised of three components. The first can be used to look ahead, identifying priorities for future multi-stakeholder collaboration in the landscape. It is based on the identification of four aspirations that are common across multi-stakeholder platforms in integrated landscape initiatives. The second can be used to look inward. It focuses on the processes within an existing multi-stakeholder platform in order to identify areas for possible improvement. The third can be used to look back, identifying the main outcomes of an existing platform and comparing them to the original objectives. The three components can be implemented together or separately. They can be used to inform planning and adaptive management of the platform, as well as to demonstrate performance and inform the design of new interventions.

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

PubMed

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

2013-08-01

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

Barriers to and facilitators of implementing complex workplace dietary interventions: process evaluation results of a cluster controlled trial.

PubMed

Fitzgerald, Sarah; Geaney, Fiona; Kelly, Clare; McHugh, Sheena; Perry, Ivan J

2016-04-21

Ambiguity exists regarding the effectiveness of workplace dietary interventions. Rigorous process evaluation is vital to understand this uncertainty. This study was conducted as part of the Food Choice at Work trial which assessed the comparative effectiveness of a workplace environmental dietary modification intervention and an educational intervention both alone and in combination versus a control workplace. Effectiveness was assessed in terms of employees' dietary intakes, nutrition knowledge and health status in four large manufacturing workplaces. The study aimed to examine barriers to and facilitators of implementing complex workplace interventions, from the perspectives of key workplace stakeholders and researchers involved in implementation. A detailed process evaluation monitored and evaluated intervention implementation. Interviews were conducted at baseline (27 interviews) and at 7-9 month follow-up (27 interviews) with a purposive sample of workplace stakeholders (managers and participating employees). Topic guides explored factors which facilitated or impeded implementation. Researchers involved in recruitment and data collection participated in focus groups at baseline and at 7-9 month follow-up to explore their perceptions of intervention implementation. Data were imported into NVivo software and analysed using a thematic framework approach. Four major themes emerged; perceived benefits of participation, negotiation and flexibility of the implementation team, viability and intensity of interventions and workplace structures and cultures. The latter three themes either positively or negatively affected implementation, depending on context. The implementation team included managers involved in coordinating and delivering the interventions and the researchers who collected data and delivered intervention elements. Stakeholders' perceptions of the benefits of participating, which facilitated implementation, included managers' desire to improve company image and employees seeking health improvements. Other facilitators included stakeholder buy-in, organisational support and stakeholder cohesiveness with regards to the level of support provided to the intervention. Anticipation of employee resistance towards menu changes, workplace restructuring and target-driven workplace cultures impeded intervention implementation. Contextual factors such as workplace structures and cultures need to be considered in the implementation of future workplace dietary interventions. Negotiation and flexibility of key workplace stakeholders plays an integral role in overcoming the barriers of workplace cultures, structures and resistance to change. Current Controlled Trials: ISRCTN35108237. Date of registration: 02/07/2013.

Real-time hydrological early warning system at national scale for surface water and groundwater with stakeholder involvement

NASA Astrophysics Data System (ADS)

He, X.; Stisen, S.; Henriksen, H. J.

2015-12-01

Hydrological models are important tools to support decision making in water resource management in the past few decades. Nowadays, frequent occurrence of extreme hydrological events has put focus on development of real-time hydrological modeling and forecasting systems. Among the various types of hydrological models, it is only the rainfall-runoff models for surface water that are commonly used in the online real-time fashion; and there is never a tradition to use integrated hydrological models for both surface water and groundwater with large scale perspective. At the Geological Survey of Denmark and Greenland (GEUS), we have setup and calibrated an integrated hydrological model that covers the entire nation, namely the DK-model. So far, the DK-model has only been used in offline mode for historical and future scenario simulations. Therefore, challenges arise when operating the DK-model in real-time mode due to lack of technical experiences and stakeholder awareness. In the present study, we try to demonstrate the process of bringing the DK-model online while actively involving the opinions of the stakeholders. Although the system is not yet fully operational, a prototype has been finished and presented to the stakeholders which can simulate groundwater levels, streamflow and water content in the root zone with a lead time of 48 hours and refreshed every 6 hours. The active involvement of stakeholders has provided very valuable insights and feedbacks for future improvements.

Learner Centred Design for a Hybrid Interaction Application

ERIC Educational Resources Information Center

Wood, Simon; Romero, Pablo

2010-01-01

Learner centred design methods highlight the importance of involving the stakeholders of the learning process (learners, teachers, educational researchers) at all stages of the design of educational applications and of refining the design through an iterative prototyping process. These methods have been used successfully when designing systems…

Building an Identity Management Governance Process

ERIC Educational Resources Information Center

Berg, Joanne E.; Kraemer, Ron; Raatz, Carla; Devoti, Steve

2009-01-01

A particular challenge in any campus environment is determining how requests for access to services and resources are managed. Who decides the technology, infrastructure, policy, business process and procedure? The involvement of key institutional leaders and stakeholders in identity management governance is the driving force behind the way the…

Principal Evaluation in Catholic Elementary Schools

ERIC Educational Resources Information Center

Vincent, Kathleen B.

2013-01-01

Research on school leadership speaks to the importance of evaluating school administrators. Evidence suggests that involving school leaders in the design of the evaluation process as well as including feedback from stakeholders in the school community as part of the evaluation process can positively impact administrators' professional…

Scientists and Stakeholders in the Chesapeake Bay: How the Mid-Atlantic RISA Strengthens Climate Resilience Through Participatory Decision-Making Processes

NASA Astrophysics Data System (ADS)

Knopman, D.; Berg, N.

2017-12-01

The NOAA Mid-Atlantic Regional Integrated Sciences and Assessments (MARISA) program was formed in September 2016 to increase climate resilience in the Mid-Atlantic, with an initial focus on the Chesapeake Bay Watershed. In this talk, we will discuss how the program's unique structure and approach are designed to advance resilience to a changing climate through improved data, place-based decision support, and public engagement. Emphasis will be placed on MARISA's approach to integrating stakeholder perspectives from the onset of decision scoping, through the creation of actionable data sets, and concluding with the co-development of adaptation strategies between the scientific community, decision-makers, and stakeholders. Specific examples of this process involving climate-sensitive decisions and investments regarding water resources, land management, and urban corridors will be discussed.

Stakeholder Participation in Freshwater Monitoring and Evaluation Programs: Applying Thresholds of Potential Concern within Environmental Flows

NASA Astrophysics Data System (ADS)

Conallin, John; McLoughlin, Craig A.; Campbell, Josh; Knight, Roger; Bright, Troy; Fisher, Ian

2018-03-01

The complex nature of freshwater systems provides challenges for incorporating evidence-based techniques into management. This paper investigates the potential of participatory evidence-based techniques to involve local stakeholders and make decisions based on different "knowledge" sources within adaptive management programs. It focuses on the application of thresholds of potential concern (TPC) within strategic adaptive management (SAM) for facilitating inclusive decision-making. The study is based on the case of the Edward-Wakool (E-W) "Fish and Flows" SAM project in the Murray-Darling River Basin, Australia. We demonstrate the application of TPCs for improving collaborative decision-making within the E-W, associated with environmental watering requirements, and other natural resource management programs such as fish stocking. The development of TPCs in the E-W fish and flows SAM project helped improve stakeholder involvement and understanding of the system, and also the effectiveness of the implemented management interventions. TPCs ultimately helped inform environmental flow management activities. The TPC process complemented monitoring that was already occurring in the system and provided a mechanism for linking formal and informal knowledge to form explicit and measurable endpoints from objectives. The TPC process faced challenges due to the perceived reduction in scientific rigor within initial TPC development and use. However, TPCs must remain tangible to managers and other stakeholders, in order to aid in the implementation of adaptive management. Once accepted by stakeholders, over time TPCs should be reviewed and refined in order to increase their scientific rigor, as new information is generated.

An advocacy coalition framework analysis of the development of offshore wind energy in South Carolina

NASA Astrophysics Data System (ADS)

Bishop, Marines

Offshore winds blow considerably harder and more uniformly than on land, and can thus produce higher amounts of electricity. Design, installation, and distribution of an offshore wind farm is more difficult and expensive, but is nevertheless a compelling energy source. With its relatively shallow offshore waters South Carolina has the potential to offer one of the first offshore wind farms in the United States, arguably ideal for wind-farm construction and presenting outstanding potential for the state's growth and innovation. This study analyzes the policy process involved in the establishment of an offshore wind industry in South Carolina through the use of Advocacy Coalition Framework (ACF) concepts. The ACF studies policy process by analyzing policy subsystems, understanding that stakeholders motivated by belief systems influence policy subsystem affairs, and recognizing the assembly of these stakeholders into coalitions as the best way to simplify the analysis. The study interviewed and analyzed responses from stakeholders involved to different but significant degrees with South Carolina offshore wind industry development, allowing for their categorization into coalitions. Responses and discussion analysis through the implementation of ACF concepts revealed, among other observations, direct relationships of opinions to stakeholder's belief systems. Most stakeholders agreed that a potential for positive outputs is real and substantial, but differed in opinion when discussing challenges for offshore wind development in South Carolina. The study importantly considers policy subsystem implications at national and regional levels, underlining the importance of learning from other offshore wind markets and policy arenas worldwide. In this sense, this study's discussions and conclusions are a step towards the right direction.

Planning a graduate programme in public health nutrition for experienced nutrition professionals.

PubMed

Fox, Ann; Beyers, Joanne

2011-08-01

Public health renewal in Canada has highlighted the need for development and expansion of the public health nutrition workforce, particularly in northern and rural communities. The purpose of the present paper is to describe the planning of a more accessible graduate programme for experienced nutrition professionals. The planning effort was challenged by a short timeframe between programme approval and implementation and required intense collaboration with stakeholders and students. The programme planning model developed by The Health Communication Unit (THCU) at the Centre for Health Promotion was used to guide the process. This six-step model was familiar to key stakeholders and involved pre-planning, conducting a situational assessment, establishing goals and objectives, developing strategies and outcome indicators, and monitoring feedback. Resource constraints, short timelines and debates around distance education options presented challenges that were overcome by conducting a thorough needs assessment, creating an advisory committee, engaging key stakeholders in the planning process, and building on existing resources. Extensive involvement of the first cohort of students in ongoing planning and evaluation was particularly helpful in informing the evolution of the programme. The THCU planning model provided a useful framework for stakeholder collaboration and for planning and implementing the new graduate programme in public health nutrition. Preliminary data suggest that graduates are benefiting from their educational experiences through career enhancement opportunities. The evaluation strategies built into the programme design will be useful in informing ongoing programme development.

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.

Urological cancer care pathways: development and use in the context of systematic reviews and clinical practice guidelines.

PubMed

Maclennan, Sara Jane; Maclennan, Steven J; Imamura, Mari; Omar, Muhammad Imran; Vale, Luke; Lam, Thomas; Royle, Pamela; Royle, Justine; Swami, Satchi; Pickard, Rob; McClinton, Sam; Griffiths, T R Leyshon; Dahm, Philipp; N'dow, James

2011-06-01

Making healthcare treatment decisions is a complex process involving a broad stakeholder base including patients, their families, health professionals, clinical practice guideline developers and funders of healthcare. This paper presents a review of a methodology for the development of urological cancer care pathways (UCAN care pathways), which reflects an appreciation of this broad stakeholder base. The methods section includes an overview of the steps in the development of the UCAN care pathways and engagement with clinical content experts and patient groups. The development process is outlined, the uses of the urological cancer care pathways discussed and the implications for clinical practice highlighted. The full set of UCAN care pathways is published in this paper. These include care pathways on localised prostate cancer, locally advanced prostate cancer, metastatic prostate cancer, hormone-resistant prostate cancer, localised renal cell cancer, advanced renal cell cancer, testicular cancer, penile cancer, muscle invasive and metastatic bladder cancer and non-muscle invasive bladder cancer. The process provides a useful framework for improving urological cancer care through evidence synthesis, research prioritisation, stakeholder involvement and international collaboration. Although the focus of this work is urological cancers, the methodology can be applied to all aspects of urology and is transferable to other clinical specialties.

Interactions among stakehoklders involved in return to work after sick leave due to mental disorders: a meta-ethnography.

PubMed

Neves, Robson da Fonseca; Nunes, Mônica de Oliveira; Magalhães, Lilian

2015-11-01

Mental disorders cause impact in the work environment. Investigations of interaction among stakeholders who are involved in the return to work are scarce. Meta-ethnography serves to synthesize qualitative studies by means of ongoing interpretation and comparison of the ideas presented in the articles. The goal of this study is to present a meta-ethnography of the interactions among the stakeholders involved in the return to work process after leave of absence due to mental disorders. It aims: (1) to investigate the interactions among stakeholders involved in return to work; (2) to identify enablers or obstacles for the return to work. The database search found 619 articles, 16 of which met the inclusion criteria. Analysis of the articles revealed six second-order concepts that resulted in two syntheses. The first is about performance ethos in the return to work, and the second shows return to work as a catalyst of new life styles. Models that favor the worker's performance ethos, as well as a perspective oriented by psychosocial aspects may enable return to work practices after leave of absence due to mental disorders.

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

ERIC Educational Resources Information Center

Brandon, Paul R.; Fukunaga, Landry L.

2014-01-01

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

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

PubMed

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

2014-01-01

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

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

PubMed Central

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

2014-01-01

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

76 FR 621 - Agency Information Collection Activities: Request for Comments for a New Information Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-05

... establish a process for stakeholder input and involvement in the development, implementation, and evaluation of the Highways for LIFE Pilot Program. The process may include participation by representatives of... own that a particular innovation was important, yet never actually determined whether States would...

Understanding Quadruple Helix Relationships of University Technology Commercialisation: A Micro-Level Approach

ERIC Educational Resources Information Center

McAdam, Maura; Miller, Kristel; McAdam, Rodney

2018-01-01

Given recent demands for more co-creational university technology commercialisation processes involving industry and end users, this paper adopts a micro-level approach to explore the challenges faced by universities when managing Quadruple Helix stakeholders within technology commercialisation processes. To explore this research question, a…

Processes and Power in School Budgeting across Four Large Urban School Districts.

ERIC Educational Resources Information Center

Goertz, Margaret E.; Hess, G. Alfred, Jr.

1998-01-01

Uses data from four cities (Chicago, Fort Worth, New York, and Rochester) to explore schools' budgetary and personnel discretion under school-based budgeting; how resource-allocation decisions are made; and factors influencing expenditure decisions. A school-based-budgeting process may increase stakeholder involvement and satisfaction without…

Objectives of public participation: Which actors should be involved in the decision making for river restorations?

NASA Astrophysics Data System (ADS)

Junker, Berit; Buchecker, Mattias; Müller-BöKer, Ulrike

2007-10-01

River restoration as a measure to improve both flood protection and ecological quality has become a common practice in river management. This new practice, however, has also become a source of conflicts arising from a neglect of the social aspects in river restoration projects. Therefore appropriate public involvement strategies have been recommended in recent years as a way of coping with these conflicts. However, an open question remains: Which stakeholders should be involved in the decision-making process? This, in turn, raises the question of the appropriate objectives of public participation. This study aims to answer these questions drawing on two case studies of Swiss river restoration projects and a related representative nationwide survey. Our findings suggest that public involvement should not be restricted to a small circle of influential stakeholder groups. As restoration projects have been found to have a substantial impact on the quality of life of the local population, avoiding conflicts is only one of several objectives of the involvement process. Including the wider public provides a special opportunity to promote social objectives, such as trust building and identification of people with their local environment.

Science in the public process of ecosystem management: lessons from Hawaii, Southeast Asia, Africa and the US Mainland.

PubMed

Gutrich, John; Donovan, Deanna; Finucane, Melissa; Focht, Will; Hitzhusen, Fred; Manopimoke, Supachit; McCauley, David; Norton, Bryan; Sabatier, Paul; Salzman, Jim; Sasmitawidjaja, Virza

2005-08-01

Partnerships and co-operative environmental management are increasing worldwide as is the call for scientific input in the public process of ecosystem management. In Hawaii, private landowners, non-governmental organizations, and state and federal agencies have formed watershed partnerships to conserve and better manage upland forested watersheds. In this paper, findings of an international workshop convened in Hawaii to explore the strengths of approaches used to assess stakeholder values of environmental resources and foster consensus in the public process of ecosystem management are presented. Authors draw upon field experience in projects throughout Hawaii, Southeast Asia, Africa and the US mainland to derive a set of lessons learned that can be applied to Hawaiian and other watershed partnerships in an effort to promote consensus and sustainable ecosystem management. Interdisciplinary science-based models can serve as effective tools to identify areas of potential consensus in the process of ecosystem management. Effective integration of scientific input in co-operative ecosystem management depends on the role of science, the stakeholders and decision-makers involved, and the common language utilized to compare tradeoffs. Trust is essential to consensus building and the integration of scientific input must be transparent and inclusive of public feedback. Consideration of all relevant stakeholders and the actual benefits and costs of management activities to each stakeholder is essential. Perceptions and intuitive responses of people can be as influential as analytical processes in decision-making and must be addressed. Deliberative, dynamic and iterative decision-making processes all influence the level of stakeholder achievement of consensus. In Hawaii, application of lessons learned can promote more informed and democratic decision processes, quality scientific analysis that is relevant, and legitimacy and public acceptance of ecosystem management.

Can the impact of public involvement on research be evaluated? A mixed methods study.

PubMed

Barber, Rosemary; Boote, Jonathan D; Parry, Glenys D; Cooper, Cindy L; Yeeles, Philippa; Cook, Sarah

2012-09-01

  Public involvement is central to health and social research policies, yet few systematic evaluations of its impact have been carried out, raising questions about the feasibility of evaluating the impact of public involvement.   To investigate whether it is feasible to evaluate the impact of public involvement on health and social research.   Mixed methods including a two-round Delphi study with pre-specified 80% consensus criterion, with follow-up interviews. UK and international panellists came from different settings, including universities, health and social care institutions and charitable organizations. They comprised researchers, members of the public, research managers, commissioners and policy makers, self-selected as having knowledge and/or experience of public involvement in health and/or social research; 124 completed both rounds of the Delphi process. A purposive sample of 14 panellists was interviewed.   Consensus was reached that it is feasible to evaluate the impact of public involvement on 5 of 16 impact issues: identifying and prioritizing research topics, disseminating research findings and on key stakeholders. Qualitative analysis revealed the complexities of evaluating a process that is subjective and socially constructed. While many panellists believed that it is morally right to involve the public in research, they also considered that it is appropriate to evaluate the impact of public involvement.   This study found consensus among panellists that it is feasible to evaluate the impact of public involvement on some research processes, outcomes and on key stakeholders. The value of public involvement and the importance of evaluating its impact were endorsed. © 2011 Blackwell Publishing Ltd.

Can the impact of public involvement on research be evaluated? A mixed methods study

PubMed Central

Barber, Rosemary; Boote, Jonathan D; Parry, Glenys D; Cooper, Cindy L; Yeeles, Philippa; Cook, Sarah

2011-01-01

Abstract Background  Public involvement is central to health and social research policies, yet few systematic evaluations of its impact have been carried out, raising questions about the feasibility of evaluating the impact of public involvement. Objective  To investigate whether it is feasible to evaluate the impact of public involvement on health and social research. Methods  Mixed methods including a two‐round Delphi study with pre‐specified 80% consensus criterion, with follow‐up interviews. UK and international panellists came from different settings, including universities, health and social care institutions and charitable organizations. They comprised researchers, members of the public, research managers, commissioners and policy makers, self‐selected as having knowledge and/or experience of public involvement in health and/or social research; 124 completed both rounds of the Delphi process. A purposive sample of 14 panellists was interviewed. Results  Consensus was reached that it is feasible to evaluate the impact of public involvement on 5 of 16 impact issues: identifying and prioritizing research topics, disseminating research findings and on key stakeholders. Qualitative analysis revealed the complexities of evaluating a process that is subjective and socially constructed. While many panellists believed that it is morally right to involve the public in research, they also considered that it is appropriate to evaluate the impact of public involvement. Conclusions  This study found consensus among panellists that it is feasible to evaluate the impact of public involvement on some research processes, outcomes and on key stakeholders. The value of public involvement and the importance of evaluating its impact were endorsed. PMID:21324054

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/.

Setting priorities for safe motherhood programme evaluation: a participatory process in three developing countries.

PubMed

Madi, Banyana Cecilia; Hussein, Julia; Hounton, Sennen; D'Ambruoso, Lucia; Achadi, Endang; Arhinful, Daniel Kojo

2007-09-01

A participatory approach to priority setting in programme evaluation may help improve the allocation and more efficient use of scarce resources especially in low-income countries. Research agendas that are the result of collaboration between researchers, programme managers, policy makers and other stakeholders have the potential to ensure rigorous studies are conducted on matters of local priority, based on local, expert knowledge. This paper describes a process involving key stakeholders to elicit and prioritise evaluation needs for safe motherhood in three developing countries. A series of reiterative consultations with safe motherhood stakeholders from each country was conducted over a period of 36 months. In each country, the consultation process consisted of a series of participatory workshops; firstly, stakeholder's views on evaluation were elicited with parallel descriptive work on the contexts. Secondly, priorities for evaluation were identified from stakeholders; thirdly, the evaluation-priorities were refined; and finally, the evaluation research questions, reflecting the identified priorities, were agreed and finalised. Three evaluation-questions were identified in each country, and one selected, on which a full scale evaluation was undertaken. While there is a great deal written about the importance of transparent and participatory priority setting in evaluation; few examples of how such processes could be implemented exist, particularly for maternal health programmes. Our experience demonstrates that the investment in a participatory priority-setting effort is high but the process undertaken resulted in both globally and contextually-relevant priorities for evaluation. This experience provides useful lessons for public health practitioners committed to bridging the research-policy interface.

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

PubMed Central

van der Ree, Joost; Lebret, Erik

2017-01-01

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

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

PubMed

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

2017-12-11

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

Comprehensive Smart Grid Planning in a Regulated Utility Environment

NASA Astrophysics Data System (ADS)

Turner, Matthew; Liao, Yuan; Du, Yan

2015-06-01

This paper presents the tools and exercises used during the Kentucky Smart Grid Roadmap Initiative in a collaborative electric grid planning process involving state regulators, public utilities, academic institutions, and private interest groups. The mandate of the initiative was to assess the existing condition of smart grid deployments in Kentucky, to enhance understanding of smart grid concepts by stakeholders, and to develop a roadmap for the deployment of smart grid technologies by the jurisdictional utilities of Kentucky. Through involvement of many important stakeholder groups, the resultant Smart Grid Deployment Roadmap proposes an aggressive yet achievable strategy and timetable designed to promote enhanced availability, security, efficiency, reliability, affordability, sustainability and safety of the electricity supply throughout the state while maintaining Kentucky's nationally competitive electricity rates. The models and methods developed for this exercise can be utilized as a systematic process for the planning of coordinated smart grid deployments.

Patient and Other Stakeholder Engagement in Patient-Centered Outcomes Research Institute Funded Studies of Patients with Kidney Diseases.

PubMed

Cukor, Daniel; Cohen, Lewis M; Cope, Elizabeth L; Ghahramani, Nasrollah; Hedayati, S Susan; Hynes, Denise M; Shah, Vallabh O; Tentori, Francesca; Unruh, Mark; Bobelu, Jeanette; Cohen, Scott; Dember, Laura M; Faber, Thomas; Fischer, Michael J; Gallardo, Rani; Germain, Michael J; Ghahate, Donica; Grote, Nancy; Hartwell, Lori; Heagerty, Patrick; Kimmel, Paul L; Kutner, Nancy; Lawson, Susan; Marr, Lisa; Nelson, Robert G; Porter, Anna C; Sandy, Phillip; Struminger, Bruce B; Subramanian, Lalita; Weisbord, Steve; Young, Bessie; Mehrotra, Rajnish

2016-09-07

Including target populations in the design and implementation of research trials has been one response to the growing health disparities endemic to our health care system, as well as an aid to study generalizability. One type of community-based participatory research is "Patient Centered-Research", in which patient perspectives on the germane research questions and methodologies are incorporated into the study. The Patient-Centered Outcomes Research Institute (PCORI) has mandated that meaningful patient and stakeholder engagement be incorporated into all applications. As of March 2015, PCORI funded seven clinically-focused studies of patients with kidney disease. The goal of this paper is to synthesize the experiences of these studies to gain an understanding of how meaningful patient and stakeholder engagement can occur in clinical research of kidney diseases, and what the key barriers are to its implementation. Our collective experience suggests that successful implementation of a patient- and stakeholder-engaged research paradigm involves: (1) defining the roles and process for the incorporation of input; (2) identifying the particular patients and other stakeholders; (3) engaging patients and other stakeholders so they appreciate the value of their own participation and have personal investment in the research process; and (4) overcoming barriers and challenges that arise and threaten the productivity of the collaboration. It is our hope that the experiences of these studies will further interest and capacity for incorporating patient and stakeholder perspectives in research of kidney diseases. Copyright © 2016 by the American Society of Nephrology.

Patient and Other Stakeholder Engagement in Patient-Centered Outcomes Research Institute Funded Studies of Patients with Kidney Diseases

PubMed Central

Cukor, Daniel; Cohen, Lewis M.; Cope, Elizabeth L.; Ghahramani, Nasrollah; Hedayati, S. Susan; Hynes, Denise M.; Shah, Vallabh O.; Tentori, Francesca; Unruh, Mark; Bobelu, Jeanette; Cohen, Scott; Dember, Laura M.; Faber, Thomas; Fischer, Michael J.; Gallardo, Rani; Germain, Michael J.; Ghahate, Donica; Grote, Nancy; Hartwell, Lori; Heagerty, Patrick; Kimmel, Paul L.; Kutner, Nancy; Lawson, Susan; Marr, Lisa; Nelson, Robert G.; Porter, Anna C.; Sandy, Phillip; Struminger, Bruce B.; Subramanian, Lalita; Weisbord, Steve; Young, Bessie

2016-01-01

Including target populations in the design and implementation of research trials has been one response to the growing health disparities endemic to our health care system, as well as an aid to study generalizability. One type of community-based participatory research is “Patient Centered-Research”, in which patient perspectives on the germane research questions and methodologies are incorporated into the study. The Patient-Centered Outcomes Research Institute (PCORI) has mandated that meaningful patient and stakeholder engagement be incorporated into all applications. As of March 2015, PCORI funded seven clinically-focused studies of patients with kidney disease. The goal of this paper is to synthesize the experiences of these studies to gain an understanding of how meaningful patient and stakeholder engagement can occur in clinical research of kidney diseases, and what the key barriers are to its implementation. Our collective experience suggests that successful implementation of a patient- and stakeholder-engaged research paradigm involves: (1) defining the roles and process for the incorporation of input; (2) identifying the particular patients and other stakeholders; (3) engaging patients and other stakeholders so they appreciate the value of their own participation and have personal investment in the research process; and (4) overcoming barriers and challenges that arise and threaten the productivity of the collaboration. It is our hope that the experiences of these studies will further interest and capacity for incorporating patient and stakeholder perspectives in research of kidney diseases. PMID:27197911

Clinical simulation as a boundary object in design of health IT-systems.

PubMed

Rasmussen, Stine Loft; Jensen, Sanne; Lyng, Karen Marie

2013-01-01

Healthcare organizations are very complex, holding numerous stakeholders with various approaches and goals towards the design of health IT-systems. Some of these differences may be approached by applying the concept of boundary objects in a participatory IT-design process. Traditionally clinical simulation provides the opportunity to evaluate the design and the usage of clinical IT-systems without endangering the patients and interrupting clinical work. In this paper we present how clinical simulation additionally holds the potential to function as a boundary object in the design process. The case points out that clinical simulation provides an opportunity for discussions and mutual learning among the various stakeholders involved in design of standardized electronic clinical documentation templates. The paper presents and discusses the use of clinical simulation in the translation, transfer and transformation of knowledge between various stakeholders in a large healthcare organization.

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.

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.

Enhancing Effective Stakeholder Participation in Local Groundwater Sustainability Planning through Technical Assistance in California

NASA Astrophysics Data System (ADS)

Weintraub, C.; Christian-Smith, J.; Dobbin, K.; Cullen, K.

2017-12-01

This presentation will share content from UCS's new publication, Getting Involved in Groundwater; A Guide to Effective Engagement in California's Groundwater Sustainability Plans, as well as lessons learned from collaborating with community organizations to provide technical assistance to Groundwater Sustainability Agency (GSA) board members and stakeholders in the San Joaquin Valley on Groundwater Sustainability Plan (GSP) development. California's Sustainable Groundwater Management Act (SGMA) mandates extensive stakeholder engagement, presenting an opportunity for unincorporated, low-income communities that have historically been affected by but not included in water decisions. However, implementation requires a concerted, thoughtful effort. Through technical assistance and strategic outreach, the Union of Concerned Scientists (UCS) is working to ensure stakeholder engagement in GSP development is robust, diverse, and supported by the best science available. UCS created the GSP stakeholder engagement guide to equip GSA members, scientists and interested community members to meaningfully engage in the GSP development process. The guide serves as a technical primer on SGMA's GSP process and as a resource for understanding groundwater management in California. The guide is just one component of a larger effort to overcome barriers to effective engagement in sustainable groundwater management, especially those presented by technical information. In April, UCS co-hosted a technical assistance workshop for GSA and advisory committee members in Visalia, CA with the Community Water Center (CWC), a local environmental justice non-profit. The workshop was well received and UCS and the CWC were invited to host a second workshop in June. To deepen this engagement and provide one-on-one technical assistance, UCS developed a program to match relevant water experts in the UCS Science Network with GSA members or involved community members in need of specific technical support. Through these efforts, UCS is working to break down barriers to participation and ensure sound science is incorporated into the GSP process.

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.

Where Judgement Fails: Pitfalls in the Selection Process for Medical Personnel

ERIC Educational Resources Information Center

Eva, Kevin W.; Reiter, Harold I.

2004-01-01

Despite the critical importance of maintaining a valid and transparent selection process that serves the values held by all stakeholders involved in medical education (i.e., students, faculty, society), there continue to be problems with the current state of available admissions protocols. Some problems derive from inertia induced by inaccurate…

Participatory Plant Breeding with Traders and Farmers for White Pea Bean in Ethiopia

ERIC Educational Resources Information Center

Assefa, T.; Sperling, L.; Dagne, B.; Argaw, W.; Tessema, D.; Beebe, S.

2014-01-01

Purpose: This research, conducted in Ethiopia, involved select stakeholders in the variety evaluation process early: to identify a greater number of acceptable varieties and to shorten a lengthy research and release process. Design/methodology/approach: A Participatory Plant Breeding (PPB) approach was used in both on-station and community-based…

Creating an Effective Strategic Plan for the School District

ERIC Educational Resources Information Center

Lane, Randy J.; Bishop, Harold L.; Wilson-Jones, Linda

2005-01-01

The purpose of this study was to examine the process of developing a strategic plan for school districts through communication and involvement of all stakeholders. This process takes into consideration the diverse concerns and principles; supports scholarly and coherent decision making; and employs the development of a strategic plan through both…

Improving Requirements Generation Thoroughness in User-Centered Workshops: The Role of Prompting and Shared User Stories

ERIC Educational Resources Information Center

Read, Aaron

2013-01-01

The rise of stakeholder centered software development has led to organizations engaging users early in the development process to help define system requirements. To facilitate user involvement in the requirements elicitation process, companies can use Group Support Systems (GSS) to conduct requirements elicitation workshops. The effectiveness of…

Building a stakeholder network for the Indiana Climate Change Impacts Assessment

NASA Astrophysics Data System (ADS)

Dukes, J. S.; Widhalm, M.

2017-12-01

The Indiana Climate Change Impacts Assessment (IN CCIA) is a stakeholder-informed, service-driven resource developed under the coordination of the Purdue Climate Change Research Center (PCCRC) and with involvement from a diverse mix of contributors throughout the state. The IN CCIA brings together the best available climate change research into a series of reports aimed at helping Hoosiers better understand climate change-related risks so they can prepare for challenges and capitalize on opportunities. The IN CCIA development process aims to 1) increase the dialogue about climate change across the state, 2) provide Indiana decision makers with accessible, credible climate impact information, and 3) build a network of experts and stakeholders to support ongoing assessment efforts and knowledge sharing. This presentation will report on our experience with developing and maintaining a diverse stakeholder network. We will describe our efforts to connect with stakeholders before, during, and after the development of assessment reports and share the top themes that emerged from our pre-assessment inquires and other interactions.

Integration: valuing stakeholder input in setting priorities for socially sustainable egg production.

PubMed

Swanson, J C; Lee, Y; Thompson, P B; Bawden, R; Mench, J A

2011-09-01

Setting directions and goals for animal production systems requires the integration of information achieved through internal and external processes. The importance of stakeholder input in setting goals for sustainable animal production systems should not be overlooked by the agricultural animal industries. Stakeholders play an integral role in setting the course for many aspects of animal production, from influencing consumer preferences to setting public policy. The Socially Sustainable Egg Production Project (SSEP) involved the development of white papers on various aspects of egg production, followed by a stakeholder workshop to help frame the issues for the future of sustainable egg production. Representatives from the environmental, food safety, food retail, consumer, animal welfare, and the general farm and egg production sectors participated with members of the SSEP coordination team in a 1.5-d workshop to explore socially sustainable egg production. This paper reviews the published literature on values integration methodologies and the lessons learned from animal welfare assessment models. The integration method used for the SSEP stakeholder workshop and its outcome are then summarized. The method used for the SSEP stakeholder workshop can be used to obtain stakeholder input on sustainable production in other farm animal industries.

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

PubMed Central

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

2016-01-01

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

Influence of Selected Stakeholders of Construction Investment Projects on the Course of Project

NASA Astrophysics Data System (ADS)

Bizon-Górecka, Jadwiga; Górecki, Jarosław

2017-10-01

The article presents an entity perspective of the construction investment projects. In a course of the project there are stakeholders who have an indirect influence (e.g. decision-makers in the selection of projects) or a direct influence (e.g. members of the project team). An intuitive opinion about a significant influence of project stakeholders on the project’s course encouraged the authors to undertake a research in this area. The article illustrates the initial phases of the construction project life cycle in a perspective of the entities and, in particular, a role of different stakeholders in making decisions that affect a course of the project. An analysis of the structure of the construction project life cycle makes a substantial involvement of various subjects in the initial phases of the project, i.e. in an initial phase and during a creation of the structures. A key point is to underline the factors of decision-making by the participants of the construction process. It was indicated that the stakeholders have a different impact on the course of the project. In large projects, which have many stakeholders, their role in the implementation of the investment project can vary, depending on the life cycle of the project. They can have positive or negative impacts on achieving the project objectives. The paper presents the results of 100 surveys made among participants of the building processes, executors of the construction projects in the Kuyavian-Pomeranian region. The study was conducted in December 2016 and January 2017. It revealed what is the impact of individual stakeholders of the construction projects on the course of the project. A special attention was paid to a complex relationship between objectives of the project and stakeholders’ goals. A great care to the smallest possible number of risks, which may arise from the different objectives of the project and its stakeholders’ goals, should be focused on the augmentation of correlation of measures of the goals. It is crucial to identify the stakeholders, whereas it is a continuous and quite difficult process. However, when ignoring the impact of specific stakeholders on the implementation of the project, a duration of the project and its costs may increase. A main problem, in establishing a relationship of participants in the construction process, is to take into account the risk of all project stakeholders.

Using an Evaluation Hotline to Promote Stakeholder Involvement

ERIC Educational Resources Information Center

Skolits, Gary J.; Boser, Judith A.

2008-01-01

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

Collaboration versus communication: The Department of Energy's Amchitka Island and the Aleut Community.

PubMed

Burger, Joanna; Gochfeld, Michael; Pletnikoff, Karen

2009-05-01

Increasingly managers and scientists are recognizing that solving environmental problems requires the inclusion of a wide range of disciplines, governmental agencies, Native American tribes, and other stakeholders. Usually such inclusion involves communication at the problem-formulation phase, and at the end to report findings. This paper examines participatory research, the differences between the traditional stakeholder involvement method of communication (often one-way, at the beginning and the end), compared to full collaboration, where parties are actively involved in the scientific process. Using the Department of Energy's (DOE) Amchitka Island in the Aleutians as a case study, we demonstrate that the inclusion of Aleut people throughout the process resulted in science that was relevant not only to the agency's needs and to the interested and affected parties, but that led to a solution. Amchitka Island was the site of three underground nuclear tests from 1965 to 1971, and virtually no testing of radionuclide levels in biota, subsistence foods, or commercial fish was conducted after the 1970s. When DOE announced plans to close Amchitka, terminating its managerial responsibility, without any further testing of radionuclide levels in biota, there was considerable controversy, which resulted in the development of a Science Plan to assess the potential risks to the marine environment from the tests. The Consortium for Risk Evaluation with Stakeholder Participation (CRESP) was the principle entity that developed and executed the science plan. Unlike traditional science, CRESP embarked on a process to include the Alaskan Natives of the Aleutian Islands (Aleuts), relevant state and federal agencies, and other stakeholders at every phase. Aleuts were included in the problem-formulation, research design refinement, the research, analysis of data, dissemination of research findings, and public communication. This led to agreement with the results, and to developing a path forward (production of a biomonitoring plan designed to provide early warning of any future radionuclide leakage and ecosystem/human health risks). The process outlined was successful in resolving a previously contentious situation by inclusion and collaboration with the Aleuts, among others, and could be usefully applied elsewhere to complex environmental problems where severe data gaps exist.

Collaboration versus communication: The Department of Energy’s Amchitka Island and the Aleut Community

PubMed Central

Burger, Joanna; Gochfeld, Michael; Pletnikoff, Karen

2014-01-01

Increasingly managers and scientists are recognizing that solving environmental problems requires the inclusion of a wide range of disciplines, governmental agencies, Native American tribes, and other stakeholders. Usually such inclusion involves communication at the problem-formulation phase, and at the end to report findings. This paper examines participatory research, the differences between the traditional stakeholder involvement method of communication (often one-way, at the beginning and the end), compared to full collaboration, where parties are actively involved in the scientific process. Using the Department of Energy’s (DOE) Amchitka Island in the Aleutians as a case study, we demonstrate that the inclusion of Aleut people throughout the process resulted in science that was relevant not only to the agency’s needs and to the interested and affected parties, but that led to a solution. Amchitka Island was the site of three underground nuclear tests from 1965 to 1971, and virtually no testing of radionuclide levels in biota, subsistence foods, or commercial fish was conducted after the 1970s. When DOE announced plans to close Amchitka, terminating its managerial responsibility, without any further testing of radionuclide levels in biota, there was considerable controversy, which resulted in the development of a Science Plan to assess the potential risks to the marine environment from the tests. The Consortium for Risk Evaluation with Stakeholder Participation (CRESP) was the principle entity that developed and executed the science plan. Unlike traditional science, CRESP embarked on a process to include the Alaskan Natives of the Aleutian Islands (Aleuts), relevant state and federal agencies, and other stakeholders at every phase. Aleuts were included in the problem-formulation, research design refinement, the research, analysis of data, dissemination of research findings, and public communication. This led to agreement with the results, and to developing a path forward (production of a biomonitoring plan designed to provide early warning of any future radionuclide leakage and ecosystem/human health risks). The process outlined was successful in resolving a previously contentious situation by inclusion and collaboration with the Aleuts, among others, and could be usefully applied elsewhere to complex environmental problems where severe data gaps exist. PMID:19264301

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

PubMed

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

2017-08-01

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

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

PubMed

Lopes, Rita; Videira, Nuno

2016-08-01

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

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

NASA Astrophysics Data System (ADS)

Lopes, Rita; Videira, Nuno

2016-08-01

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

Using scoping as a design process

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

Mulvihill, P.R.; Jacobs, P.

1998-07-01

Skillful use of the scoping phase of environment assessment (EA) is critical in cases involving a wide diversity of stakeholders and perspectives. Scoping can exert a strong influence in shaping a relevant impact assessment and increasing the probability of a process that satisfies stakeholders. This article explores key challenges facing scoping processes conducted in highly pluralistic settings. Elements of a notable case study--the scoping process conducted in 1992 for the proposed Great Whale Hydroelectric project in Northern Quebec--are discussed to illustrate innovative approaches. When used as a design process, scoping can ensure that EA reflects the different value sets andmore » cultures that are at play, particularly where diverse knowledge systems and ways of describing environmental components and impacts exist. As it sets the stage for subsequent steps in the EA process, scoping needs to be a sufficiently broad umbrella that accommodates diverse approaches to identifying, classifying, and assessing impacts.« less

Harvesting Social Signals to Inform Peace Processes Implementation and Monitoring

PubMed Central

Nigam, Aastha; Dambanemuya, Henry K.; Joshi, Madhav; Chawla, Nitesh V.

2017-01-01

Abstract Peace processes are complex, protracted, and contentious involving significant bargaining and compromising among various societal and political stakeholders. In civil war terminations, it is pertinent to measure the pulse of the nation to ensure that the peace process is responsive to citizens' concerns. Social media yields tremendous power as a tool for dialogue, debate, organization, and mobilization, thereby adding more complexity to the peace process. Using Colombia's final peace agreement and national referendum as a case study, we investigate the influence of two important indicators: intergroup polarization and public sentiment toward the peace process. We present a detailed linguistic analysis to detect intergroup polarization and a predictive model that leverages Tweet structure, content, and user-based features to predict public sentiment toward the Colombian peace process. We demonstrate that had proaccord stakeholders leveraged public opinion from social media, the outcome of the Colombian referendum could have been different. PMID:29235916

Harvesting Social Signals to Inform Peace Processes Implementation and Monitoring.

PubMed

Nigam, Aastha; Dambanemuya, Henry K; Joshi, Madhav; Chawla, Nitesh V

2017-12-01

Peace processes are complex, protracted, and contentious involving significant bargaining and compromising among various societal and political stakeholders. In civil war terminations, it is pertinent to measure the pulse of the nation to ensure that the peace process is responsive to citizens' concerns. Social media yields tremendous power as a tool for dialogue, debate, organization, and mobilization, thereby adding more complexity to the peace process. Using Colombia's final peace agreement and national referendum as a case study, we investigate the influence of two important indicators: intergroup polarization and public sentiment toward the peace process. We present a detailed linguistic analysis to detect intergroup polarization and a predictive model that leverages Tweet structure, content, and user-based features to predict public sentiment toward the Colombian peace process. We demonstrate that had proaccord stakeholders leveraged public opinion from social media, the outcome of the Colombian referendum could have been different.

Automatic Requirements Specification Extraction from Natural Language (ARSENAL)

DTIC Science & Technology

2014-10-01

designers, implementers) involved in the design of software systems. However, natural language descriptions can be informal, incomplete, imprecise...communication of technical descriptions between the various stakeholders (e.g., customers, designers, imple- menters) involved in the design of software systems...the accuracy of the natural language processing stage, the degree of automation, and robustness to noise. 1 2 Introduction Software systems operate in

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.

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.

Coupling System Dynamics and Physically-based Models for Participatory Water Management - A Methodological Framework, with Two Case Studies: Water Quality in Quebec, and Soil Salinity in Pakistan

NASA Astrophysics Data System (ADS)

Boisvert-Chouinard, J.; Halbe, J.; Baig, A. I.; Adamowski, J. F.

2014-12-01

The principles of Integrated Water Resource Management outline the importance of stakeholder participation in water management processes, but in practice, there is a lack of meaningful engagement in water planning and implementation, and participation is often limited to public consultation and education. When models are used to support water planning, stakeholders are usually not involved in their development and use, and the models commonly fail to represent important feedbacks between socio-economic and physical processes. This paper presents the development of holistic models of the Du Chêne basin in Quebec, and the Rechna Doab basin in Pakistan, that simulate socio-economic and physical processes related to, respectively, water quality management, and soil salinity management. The models each consists of two sub-components: a System Dynamics (SD) model, and a physically based model. The SD component was developed in collaboration with key stakeholders in the basins. The Du Chêne SD model was coupled with a Soil and Water Assessment Tool (SWAT) model, while the Rechna Doab SD model was coupled with SahysMod, a soil salinity model. The coupled models were used to assess the environmental and socio-economic impacts of different management scenarios proposed by stakeholders. Results indicate that coupled SD - physically-based models can be used as effective tools for participatory water planning and implementation. The participatory modeling process provides a structure for meaningful stakeholder engagement, and the models themselves can be used to transparently and coherently assess and compare different management options.

An assessment of priority setting process and its implication on availability of emergency obstetric care services in Malindi District, Kenya.

PubMed

Nyandieka, Lilian Nyamusi; Kombe, Yeri; Ng'ang'a, Zipporah; Byskov, Jens; Njeru, Mercy Karimi

2015-01-01

In spite of the critical role of Emergency Obstetric Care in treating complications arising from pregnancy and childbirth, very few facilities are equipped in Kenya to offer this service. In Malindi, availability of EmOC services does not meet the UN recommended levels of at least one comprehensive and four basic EmOC facilities per 500,000 populations. This study was conducted to assess priority setting process and its implication on availability, access and use of EmOC services at the district level. A qualitative study was conducted both at health facility and community levels. Triangulation of data sources and methods was employed, where document reviews, in-depth interviews and focus group discussions were conducted with health personnel, facility committee members, stakeholders who offer and/ or support maternal health services and programmes; and the community members as end users. Data was thematically analysed. Limitations in the extent to which priorities in regard to maternal health services can be set at the district level were observed. The priority setting process was greatly restricted by guidelines and limited resources from the national level. Relevant stakeholders including community members are not involved in the priority setting process, thereby denying them the opportunity to contribute in the process. The findings illuminate that consideration of all local plans in national planning and budgeting as well as the involvement of all relevant stakeholders in the priority setting exercise is essential in order to achieve a consensus on the provision of emergency obstetric care services among other health service priorities.

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

PubMed

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

2013-10-01

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

When is good, good enough? Methodological pragmatism for sustainable guideline development.

PubMed

Browman, George P; Somerfield, Mark R; Lyman, Gary H; Brouwers, Melissa C

2015-03-06

Continuous escalation in methodological and procedural rigor for evidence-based processes in guideline development is associated with increasing costs and production delays that threaten sustainability. While health research methodologists are appropriately responsible for promoting increasing rigor in guideline development, guideline sponsors are responsible for funding such processes. This paper acknowledges that other stakeholders in addition to methodologists should be more involved in negotiating trade-offs between methodological procedures and efficiency in guideline production to produce guidelines that are 'good enough' to be trustworthy and affordable under specific circumstances. The argument for reasonable methodological compromise to meet practical circumstances is consistent with current implicit methodological practice. This paper proposes a conceptual tool as a framework to be used by different stakeholders in negotiating, and explicitly reporting, reasonable compromises for trustworthy as well as cost-worthy guidelines. The framework helps fill a transparency gap in how methodological choices in guideline development are made. The principle, 'when good is good enough' can serve as a basis for this approach. The conceptual tool 'Efficiency-Validity Methodological Continuum' acknowledges trade-offs between validity and efficiency in evidence-based guideline development and allows for negotiation, guided by methodologists, of reasonable methodological compromises among stakeholders. Collaboration among guideline stakeholders in the development process is necessary if evidence-based guideline development is to be sustainable.

Environmental impact assessment in urban transport planning: Exploring process-related barriers in Spanish practice

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

Soria-Lara, Julio A., E-mail: j.a.sorialara@uva.nl; Bertolini, Luca, E-mail: l.bertolini@uva.nl; Brömmelstroet, Marco te, E-mail: M.C.G.teBrommelstroet@uva.nl

The effectiveness of EIA for evaluating transport planning projects is increasingly being questioned by practitioners, institutions and scholars. The academic literature has traditionally focused more on solving content-related problems with EIA (i.e. the measurement of environmental effects) than on process-related issues (i.e. the role of EIA in the planning process and the interaction between key actors). Focusing only on technical improvements is not sufficient for rectifying the effectiveness problems of EIA. In order to address this knowledge gap, the paper explores how EIA is experienced in the Spanish planning context and offers in-depth insight into EIA process-related issues in themore » field of urban transport planning. From the multitude of involved actors, the research focuses on exploring the perceptions of the two main professional groups: EIA developers and transport planners. Through a web-based survey we assess the importance of process-related barriers to the effective use of EIA in urban transport planning. The analyses revealed process issues based fundamentally on unstructured stakeholders involvement and an inefficient public participation - Highlights: • Qualitative research on perceptions of EIA participants on EIA processes. • Web-based survey with different participants (EIA-developers; transport planners). • It was seen an inefficient participation of stakeholders during the EIA processes.« less

76 FR 18228 - Best Pharmaceuticals for Children Act (BPCA) Priority List of Needs in Pediatric Therapeutics

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-01

... frequency of use and frequency of condition) as well as expert input, a better approach for mass outreach... process, including transparency, stakeholder input, and leadership; and Expert involvement to inform and... BPCA Web site, http://bpca.nichd.nih.gov . As a final step in the process, the NICHD, with input from...

I’m Positive, But I’m Negative

PubMed Central

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

2015-01-01

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

Civil and Constitutional Rights of Adjudicated Youth.

PubMed

Landess, Jacqueline

2016-01-01

Mental health clinicians serving child and adolescent patients are frequently asked to evaluate youth who have been arrested for various offenses or who are otherwise involved with the juvenile justice system. To help orient clinicians and other stakeholders involved with such cases, this article describes the evolution of the juvenile justice system and summarizes the history and current status of the civil and constitutional rights of youth involved in the adjudicatory process. This article also points out key areas in which due process rights are still evolving, particularly in the case of status offenders. Copyright © 2016 Elsevier Inc. All rights reserved.

Risk Assessment and Risk Governance of Liquefied Natural Gas Development in Gladstone, Australia.

PubMed

van der Vegt, R G

2018-02-26

This article is a retrospective analysis of liquefied natural gas development (LNG) in Gladstone, Australia by using the structure of the risk governance framework developed by the International Risk Governance Council (IRGC). Since 2010 the port of Gladstone has undergone extensive expansion to facilitate the increasing coal export as well as the new development of three recently completed LNG facilities. Significant environmental and socio-economic impacts and concerns have occurred as a result of these developments. The overall aim of the article, therefore, is to identify the risk governance deficits that arose and to formulate processes capable of improving similar decision-making problems in the future. The structure of the IRGC framework is followed because it represents a broad analytical approach for considering risk assessment and risk governance in Gladstone in ways that include, but also go beyond, the risk approach of the ISO 31000:2009 standard that was employed at the time. The IRGC risk framework is argued to be a consistent and comprehensive risk governance framework that integrates scientific, economic, social, and cultural aspects and advocates the notion of inclusive risk governance through stakeholder communication and involvement. Key aspects related to risk preassessment, risk appraisal, risk tolerability and acceptability, risk management, and stakeholder communication and involvement are considered. The results indicate that the risk governance deficits include aspects related to (i) the risk matrix methodology, (ii) reflecting uncertainties, (iii) cumulative risks, (iv) the regulatory process, and (v) stakeholder communication and involvement. © 2018 Society for Risk Analysis.

Stakeholder Involvement in the Higher Education Sector in Cambodia

ERIC Educational Resources Information Center

Sam, Chanphirun; Dahles, Heidi

2017-01-01

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

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

NASA Astrophysics Data System (ADS)

Baba, K.

2014-12-01

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

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

PubMed

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

2013-08-19

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

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.

The Pennsylvania quality initiative : a synthesis of customer satisfaction and additional research needs

DOT National Transportation Integrated Search

1999-10-29

Customer satisfaction is at the heart of the Pennsylvania Quality Initiative (PQI), which was created in 1994 to build a more effective partnership among all the stakeholders involved in the process of designing, building, operating, and maintaining ...

Research Stakeholders' Views on Benefits and Challenges for Public Health Research Data Sharing in Kenya: The Importance of Trust and Social Relations.

PubMed

Jao, Irene; Kombe, Francis; Mwalukore, Salim; Bull, Susan; Parker, Michael; Kamuya, Dorcas; Molyneux, Sassy; Marsh, Vicki

2015-01-01

There is increasing recognition of the importance of sharing research data within the international scientific community, but also of the ethical and social challenges this presents, particularly in the context of structural inequities and varied capacity in international research. Public involvement is essential to building locally responsive research policies, including on data sharing, but little research has involved stakeholders from low-to-middle income countries. Between January and June 2014, a qualitative study was conducted in Kenya involving sixty stakeholders with varying experiences of research in a deliberative process to explore views on benefits and challenges in research data sharing. In-depth interviews and extended small group discussions based on information sharing and facilitated debate were used to collect data. Data were analysed using Framework Analysis, and charting flow and dynamics in debates. The findings highlight both the opportunities and challenges of communicating about this complex and relatively novel topic for many stakeholders. For more and less research-experienced stakeholders, ethical research data sharing is likely to rest on the development and implementation of appropriate trust-building processes, linked to local perceptions of benefits and challenges. The central nature of trust is underpinned by uncertainties around who might request what data, for what purpose and when. Key benefits perceived in this consultation were concerned with the promotion of public health through science, with legitimate beneficiaries defined differently by different groups. Important challenges were risks to the interests of study participants, communities and originating researchers through stigmatisation, loss of privacy, impacting autonomy and unfair competition, including through forms of intentional and unintentional 'misuse' of data. Risks were also seen for science. Given background structural inequities in much international research, building trust in this low-to-middle income setting includes ensuring that the interests of study participants, primary communities and originating researchers will be promoted as far as possible, as well as protected. Important ways of building trust in data sharing include involving the public in policy development and implementation, promoting scientific collaborations around data sharing and building close partnerships between researchers and government health authorities to provide checks and balances on data sharing, and promote near and long-term translational benefits.

A combined ANP-delphi approach to evaluate sustainable tourism

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

Garcia-Melon, Monica, E-mail: mgarciam@dpi.upv.es; Gomez-Navarro, Tomas, E-mail: tgomez@dpi.upv.es; Acuna-Dutra, Silvia, E-mail: sacuna@unime.edu.ve

The evaluation of sustainable tourism strategies promoted by National Parks (NP) related stakeholders is a key concern for NP managers. To help them in their strategic evaluation procedures, in this paper we propose a methodology based on the Analytic Network Process and a Delphi-type judgment-ensuring procedure. The approach aims at involving stakeholders in a participatory and consensus-building process. The methodology was applied to Los Roques NP in Venezuela. The problem included three sustainable tourism strategies defined by the stakeholders: eco-efficient resorts, eco-friendly leisure activities and ecological transportation systems. Representatives of eight stakeholders participated in the methodology. 13 sustainability criteria weremore » selected. Results provide some important insights into the overall philosophy and underlying participants' conception of what sustainable development of Los Roques NP means. This conception is broadly shared by stakeholders as they coincided in the weights of most of the criteria, which were assigned individually through the questionnaire. It is particularly noteworthy that tourists and environmentalists almost fully match in their assessments of criteria but not of the alternatives. Moreover, there is a great agreement in the final assessment. This suggests that the regular contact among the different stakeholders, i.e. tourists with inhabitants, authorities with environmentalists, tour operators with representatives of the ministry, etc. has led to a common understanding of the opportunities and threats for the NP. They all agreed that the procedure enhances participation and transparency and it is a necessary source of information and support for their decisions.« less

Controlling equine influenza: policy networks and decision-making during the 2007 Australian equine influenza outbreak.

PubMed

Schemann, K; Gillespie, J A; Toribio, J-A L M L; Ward, M P; Dhand, N K

2014-10-01

Rapid, evidence-based decision-making is critical during a disease outbreak response; however, compliance by stakeholders is necessary to ensure that such decisions are effective - especially if the response depends on voluntary action. This mixed method study evaluated technical policy decision-making processes during the 2007 outbreak of equine influenza in Australia by identifying and analysing the stakeholder network involved and the factors driving policy decision-making. The study started with a review of the outbreak literature and published policy documents. This identified six policy issues regarding policy modifications or differing interpretations by different state agencies. Data on factors influencing the decision-making process for these six issues and on stakeholder interaction were collected using a pre-tested, semi-structured questionnaire. Face-to-face interviews were conducted with 24 individuals representing 12 industry and government organizations. Quantitative data were analysed using social network analysis. Qualitative data were coded and patterns matched to test a pre-determined general theory using a method called theory-oriented process-tracing. Results revealed that technical policy decisions were framed by social, political, financial, strategic and operational considerations. Industry stakeholders had influence through formal pre-existing channels, yet specific gaps in stakeholder interaction were overcome by reactive alliances formed during the outbreak response but outside the established system. Overall, the crisis management system and response were seen as positive, and 75-100% of individuals interviewed were supportive of, had interest in and considered the outcome as good for the majority of policy decisions, yet only 46-75% of those interviewed considered that they had influence on these decisions. Training to increase awareness and knowledge of emergency animal diseases (EADs) and response systems will improve stakeholder participation in emergency disease management and preparedness for future EAD incursions. © 2012 Blackwell Verlag GmbH.

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

PubMed

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

2010-05-01

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

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

PubMed

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

2017-10-16

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

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.

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

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

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

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

Eco-efficiency improvements in industrial water-service systems: assessing options with stakeholders.

PubMed

Levidow, Les; Lindgaard-Jørgensen, Palle; Nilsson, Asa; Skenhall, Sara Alongi; Assimacopoulos, Dionysis

2014-01-01

The well-known eco-efficiency concept helps to assess the economic value and resource burdens of potential improvements by comparison with the baseline situation. But eco-efficiency assessments have generally focused on a specific site, while neglecting wider effects, for example, through interactions between water users and wastewater treatment (WWT) providers. To address the methodological gap, the EcoWater project has developed a method and online tools for meso-level analysis of the entire water-service value chain. This study investigated improvement options in two large manufacturing companies which have significant potential for eco-efficiency gains. They have been considering investment in extra processes which can lower resource burdens from inputs and wastewater, as well as internalising WWT processes. In developing its methodology, the EcoWater project obtained the necessary information from many agents, involved them in the meso-level assessment and facilitated their discussion on alternative options. Prior discussions with stakeholders stimulated their attendance at a workshop to discuss a comparative eco-efficiency assessment for whole-system improvement. Stakeholders expressed interest in jointly extending the EcoWater method to more options and in discussing investment strategies. In such ways, optimal solutions will depend on stakeholders overcoming fragmentation by sharing responsibility and knowledge.

Stakeholder Engagement in a Patient-Reported Outcomes (PRO) Measure Implementation: A Report from the SAFTINet Practice-based Research Network (PBRN).

PubMed

Kwan, Bethany M; Sills, Marion R; Graham, Deborah; Hamer, Mika K; Fairclough, Diane L; Hammermeister, K E; Kaiser, Alicyn; de Jesus Diaz-Perez, Maria; Schilling, Lisa M

2016-01-01

Patient-reported outcome (PRO) measures offer value for clinicians and researchers, although priorities and value propositions can conflict. PRO implementation in clinical practice may benefit from stakeholder engagement methods to align research and clinical practice stakeholder perspectives. The objective is to demonstrate the use of stakeholder engagement in PRO implementation. Engaged stakeholders represented researchers and clinical practice representatives from the SAFTINet practice-based research network (PBRN). A stakeholder engagement process involving iterative analysis, deliberation, and decision making guided implementation of a medication adherence PRO measure (the Medication Adherence Survey [MAS]) for patients with hypertension and/or hyperlipidemia. Over 9 months, 40 of 45 practices (89%) implemented the MAS, collecting 3,247 surveys (mean = 72, median = 30, range: 0 - 416). Facilitators included: an electronic health record (EHR) with readily modifiable templates; existing staff, tools and workflows in which the MAS could be integrated (e.g., health risk appraisals, hypertension-specific visits, care coordinators); and engaged leadership and quality improvement teams. Stakeholder engagement appeared useful for promoting PRO measure implementation in clinical practice, in a way that met the needs of both researchers and clinical practice stakeholders. Limitations of this approach and opportunities for improving the PRO data collection infrastructure in PBRNs are discussed. © Copyright 2016 by the American Board of Family Medicine.

Development of a strategic plan by the Mozambican Association of Obstetricians and Gynaecologists: direct and indirect effects.

PubMed

Osman, Nafissa B; Almeida, Maria L; Ustá, Momade B; Bique, Cassimo; David, Ernestina

2014-10-01

The Mozambican Association of Obstetricians and Gynaecologists (AMOG) received support from the FIGO Leadership in Obstetrics and Gynecology for Impact and Change (LOGIC) Initiative in Maternal and Newborn Health (MNH) to strengthen its organizational capacity and to assume leadership in MNH through the development of a strategic plan. The planning process involved identification of key stakeholders; analysis of strengths and weaknesses; stakeholder consultation; consultation with AMOG members; and ratification at the annual general meeting. The participatory process led to the development of vision and mission statements. Furthermore, core values and strategic goals were identified: (1) to contribute to the implementation of governmental plans for improving MNH; (2) to assume leadership in advancing the practice of obstetrics and gynecology through education and training; and (3) to continue to strengthen organizational capacity. Consequently, relationships among members were reinforced and the visibility and recognition of AMOG as a key stakeholder in MNH increased. Copyright © 2014. Published by Elsevier Ireland Ltd.

Patient-centred outcomes research: perspectives of patient stakeholders.

PubMed

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

2017-11-01

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

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.

An Analysis of Hospital Accreditation Policy in Iran

PubMed Central

YOUSEFINEZHADI, Taraneh; MOSADEGHRAD, Ali Mohammad; ARAB, Mohammad; RAMEZANI, Mozhdeh; SARI, Ali AKBARI

2017-01-01

Background: Public policymaking is complex and lacks research evidences, particularly in the Eastern Mediterranean Region (EMR). This policy analysis aims to generate insights about the process of hospital accreditation policy making in Iran, to identify factors influencing policymaking and to evaluate utilization of evidence in policy making process. Methods: The study examined the policymaking process using Walt and Gilson framework. A qualitative research design was employed. Thirty key informant interviews with policymakers and stakeholders were conducted. In addition hundred and five related documents were reviewed. Data was analyzed using framework analysis. Results: The accreditation program was a decision made at Ministry of Health and Medical Education in Iran. Many healthcare stakeholders were involved and evidence from leading countries was used to guide policy development. Poor hospital managers’ commitment, lack of physicians’ involvement and inadequate resources were the main barriers in policy implementation. Furthermore, there were too many accreditations standards and criteria, surveyors were not well-trained, had little motivation for their work and there was low consistency among them. Conclusion: This study highlighted the complex nature of policymaking cycle and highlighted various factors influencing policy development, implementation and evaluation. An effective accreditation program requires a robust well-governed accreditation body, various stakeholders’ involvement, sufficient resources and sustainable funds, enough human resources, hospital managers’ commitment, and technical assistance to hospitals. PMID:29308378

Prioritizing the organization and management of intensive care services in the United States: the PrOMIS Conference.

PubMed

Barnato, Amber E; Kahn, Jeremy M; Rubenfeld, Gordon D; McCauley, Kathleen; Fontaine, Dorrie; Frassica, Joseph J; Hubmayr, Rolf; Jacobi, Judith; Brower, Roy G; Chalfin, Donald; Sibbald, William; Asch, David A; Kelley, Mark; Angus, Derek C

2007-04-01

Adult critical care services are a large, expensive part of U.S. health care. The current agenda for response to workforce shortages and rising costs has largely been determined by members of the critical care profession without input from other stakeholders. We sought to elicit the perceived problems and solutions to the delivery of critical care services from a broad set of U.S. stakeholders. A consensus process involving purposive sampling of identified stakeholders, preconference Web-based survey, and 2-day conference. Participants represented healthcare providers, accreditation and quality-oversight groups, federal sponsoring institutions, healthcare vendors, and institutional and individual payers. We identified 39 stakeholders for the field of critical care medicine. Thirty-six (92%) completed the preconference survey and 37 (95%) attended the conference. None. Participants expressed moderate to strong agreement with the concerns identified by the critical care professionals and additionally expressed consternation that the critical care delivery system was fragmented, variable, and not patient-centered. Recommended solutions included regionalizing the adult critical care system into "tiers" defined by explicit triage criteria and professional competencies, achieved through voluntary hospital accreditation, supported through an expanded process of competency certification, and monitored through process and outcome surveillance; implementing mechanisms for improved communication across providers and settings and between providers and patients/families; and conducting market research and a public education campaign regarding critical care's promises and limitations. This consensus conference confirms that agreement on solutions to complex healthcare delivery problems can be achieved and that problem and solution frames expand with broader stakeholder participation. This process can be used as a model by other specialties to address priority setting in an era of shifting demographics and increasing resource constraints.

Engagement strategies that foster community self-determination in participatory research: Insider ownership through outsider championship.

PubMed

Salsberg, Jon; Macridis, Soultana; Garcia Bengoechea, Enrique; Macaulay, Ann C; Moore, Spencer

2017-06-01

In order to maximize the benefits of community-based participatory research, effective ownership over the research process must be at least equally in the hands of the community. A previous social network analysis documented that the participatory research process shifted ownership from academic to community partners, but did not show what actions and strategies fostered this shift. This study follows the trajectory of a community-academic partnership and asks, from the perspective of the project stakeholders, which actions and strategies over the lifespan of the research led to the observed shift in ownership and decision-making from the original external academics to the community stakeholders? Qualitative description using inductive thematic analysis. One academic and five community stakeholders identified as central in a previous social network analysis, participated in retrospective, semi-structured interviews. Actions deemed to have fostered the observed shift in ownership included: existence of a strong champion; stimulating 'outside' ideas; emergence of core people; alignment of project goals with stakeholders' professional roles; involving the right people; personal qualities of the champion; trust-building; and active use of participatory engagement strategies. Although communities must take ownership over the research process to assure sustained action and change, a strong, trusted and accepted outside champion who actively enacts participatory engagement strategies can facilitate the participatory process and provide community stakeholders the time and support they need to achieve meaningful and sustained leadership roles. These findings have implications for how partnership research is designed and implemented, both in community and in clinical organisational settings. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

CALFED--An experiment in science and decisionmaking

USGS Publications Warehouse

Taylor, Kimberly A.; Jacobs, Katharine L.; Luoma, Samuel N.

2003-01-01

The CALFED Bay-Delta Program faces a challenging assignment: to develop a collaborative state-federal management plan for the complex river system and involve multiple stakeholders (primarily municipal, agricultural, and environmental entities) whose interests frequently are in direct conflict. Although many resource-management issues involve multiple stakeholders and conflict is integral to their discussion, the CALFED experience is unique because of its shared state and federal roles, the magnitude and significance of stakeholder participation, and the complexity of the scientific issues involved.

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

PubMed

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

2017-11-12

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

Application of participatory ergonomics to the redesign of the family-centred rounds process.

PubMed

Xie, Anping; Carayon, Pascale; Cox, Elizabeth D; Cartmill, Randi; Li, Yaqiong; Wetterneck, Tosha B; Kelly, Michelle M

2015-01-01

Participatory ergonomics (PE) can promote the application of human factors and ergonomics (HFE) principles to healthcare system redesign. This study applied a PE approach to redesigning the family-centred rounds (FCR) process to improve family engagement. Various FCR stakeholders (e.g. patients and families, physicians, nurses, hospital management) were involved in different stages of the PE process. HFE principles were integrated in both the content (e.g. shared mental model, usability, workload consideration, systems approach) and process (e.g. top management commitment, stakeholder participation, communication and feedback, learning and training, project management) of FCR redesign. We describe activities of the PE process (e.g. formation and meetings of the redesign team, data collection activities, intervention development, intervention implementation) and present data on PE process evaluation. To demonstrate the value of PE-based FCR redesign, future research should document its impact on FCR process measures (e.g. family engagement, round efficiency) and patient outcome measures (e.g. patient satisfaction).

Application of participatory ergonomics to the redesign of the family-centered rounds process

PubMed Central

Xie, Anping; Carayon, Pascale; Cox, Elizabeth D.; Cartmill, Randi; Li, Yaqiong; Wetterneck, Tosha B.; Kelly, Michelle M.

2015-01-01

Participatory ergonomics (PE) can promote the application of human factors and ergonomics (HFE) principles to healthcare system redesign. This study applied a PE approach to redesigning the family-centered rounds (FCR) process to improve family engagement. Various FCR stakeholders (e.g., patients and families, physicians, nurses, hospital management) were involved in different stages of the PE process. HFE principles were integrated in both the content (e.g., shared mental model, usability, workload consideration, systems approach) and process (e.g., top management commitment, stakeholder participation, communication and feedback, learning and training, project management) of FCR redesign. We describe activities of the PE process (e.g., formation and meetings of the redesign team, data collection activities, intervention development, intervention implementation) and present data on PE process evaluation. To demonstrate the value of PE-based FCR redesign, future research should document its impact on FCR process measures (e.g., family engagement, round efficiency) and patient outcome measures (e.g., patient satisfaction). PMID:25777042

A comparative study of contemporary user involvement within healthcare systems across England, Poland and Slovenia.

PubMed

Lichon, Mateusz; Kavcic, Matic; Masterson, Daniel

2015-01-01

The purpose of this paper is to explore how healthcare-users' engagement is perceived, how it occurs and how these perceptions differ between three European countries: England, Poland and Slovenia, using the concepts of voice, choice and coproduction. This comparative, qualitative study is based on a review of legal documents, academic literature and semi-structured interviews conducted in October and November 2011. A research sample consisted of 21 interviewees representing various stakeholders including healthcare-users, doctors and managers. Primary and secondary data were analysed using theoretical thematic analysis. Emerging themes were identified from the interviews and related to the indicators describing healthcare-users' involvement in the voice, choice and coproduction model. Results of the comparative qualitative research suggest that the healthcare-users' influence is strongly grounded in England where the healthcare system and professionals are prepared to include healthcare-users in the decision-making process. In Slovenia, cultural development of healthcare-users' involvement seems to proceed the institutional development. In Poland, institutions are ready to involve healthcare-users in decision-making process although the cultural desirability of involving users among doctors and patients is lacking. The notion of user involvement is increasingly gaining importance and research attention, yet there is still little known about the way cultural, political, historical differences between various European countries influence it. This paper explores this little known area using the original approach of user involvement (Dent et al., 2011) with input from various stakeholders including patients, healthcare representatives and academics.

Unmanned aircraft systems integration into the national airspace

NASA Astrophysics Data System (ADS)

Wolf, H. G.

This paper examines the Federal Aviation Administration (FAA) Regulation Roadmap as set forth in the FAA Modernization and Reform Act of 2012 as well as the evolutionary process of relative legal framework. The paper will also explore the role of industry stakeholders and semi-governmental, advisory groups such as the RTCA SC-203 to show the involvement of non-governmental organizations. Leveraging the author's involvement with RTCA on the Safety Work Group of Special Committee 203, two processes within the context of safety will be explained and problems identified.

Stakeholder participation in research design and decisions: scientists, fishers, and mercury in saltwater fish.

PubMed

Burger, Joanna; Gochfeld, Michael; Fote, Tom

2013-03-01

Individuals who fish and eat self-caught fish make decisions about where to fish, the type to eat, and the quantity to eat. Federal and state agencies often issue consumption advisories for some fish with high mercury (Hg) concentrations, but seldom provide either the actual metal levels to the general public, or identify the fish that have low contaminant levels. Community participatory research is of growing importance in defining, studying, and resolving complex exposure and risk issues, and this paper is at the intersection of traditional stakeholder approaches and community-based participatory research. The objective of this paper is to describe the process whereby stakeholders (fishers), were involved in directing and refining research questions to address their particular informational needs about mercury levels in fish, potential risks, and methods to maintain health, by balancing the risks and benefits of fish consumption. A range of stakeholders, mainly individual fishers, fishing organizations, and other scientists, were involved at nearly every stage. Community participants influenced many aspects of the design and implementation of the research, in the determination of which fish species to sample, in the collection of the samples, and in the final analyses and synthesis, as well as the communication of results and implications of the research through their fishing club publications, talks and gatherings. By involving the most interested and affected communities, the data and conclusions are relevant to their needs because the fish examined were those they ate and wanted information about, and directly address concerns about the risk from consuming self-caught fish. Although mercury levels in fish presumed to be high in mercury are known, little information was available to the fishermen on mercury levels in fish that were low and thus provided little risk to their families. While community participatory research is more time-consuming and expensive than traditional scientific research, both the process and results are better scientifically in terms of community relevance.

Stakeholder Participation in Research Design and Decisions: Scientists, Fishers, and Mercury in Saltwater Fish

PubMed Central

Burger, Joanna; Gochfeld, Michael; Fote, Tom

2015-01-01

Individuals who fish and eat self-caught fish make decisions about where to fish, the type to eat, and the quantity to eat. Federal and state agencies often issue consumption advisories for some fish with high mercury (Hg) concentrations, but seldom provide either the actual metal levels to the general public, or identify the fish that have low contaminant levels. Community participatory research is of growing importance in defining, studying, and resolving complex exposure and risk issues, and this paper is at the intersection of traditional stakeholder approaches and community-based participatory research. The objective of this paper is to describe the process whereby stakeholders (fishers), were involved in directing and refining research questions to address their particular informational needs about mercury levels in fish, potential risks, and methods to maintain health, by balancing the risks and benefits of fish consumption. A range of stakeholders, mainly individual fishers, fishing organizations, and other scientists, were involved at nearly every stage. Community participants influenced many aspects of the design and implementation of the research, in the determination of which fish species to sample, in the collection of the samples, and in the final analyses and synthesis, as well as the communication of results and implications of the research through their fishing club publications, talks and gatherings. By involving the most interested and affected communities, the data and conclusions are relevant to their needs because the fish examined were those they ate and wanted information about, and directly address concerns about the risk from consuming self-caught fish. Although mercury levels in fish presumed to be high in mercury are known, little information was available to the fishermen on mercury levels in fish that were low and thus provided little risk to their families. While community participatory research is more time-consuming and expensive than traditional scientific research, both the process and results are better scientifically I in terms of community relevance. PMID:23413085

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

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

PubMed

Trimble, Micaela; Berkes, Fikret

2013-10-15

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

Supporting Language Arts Innovations That Endure (Reading Leadership).

ERIC Educational Resources Information Center

Sanacore, Joseph

1996-01-01

Discusses how language arts educators can promote enduring change, including the need for continuous cooperation, collaboration, and reflection; the active involvement of all the stakeholders during every stage of nurturing visions; and how to support this complex growth process with flexibility and with an enduring commitment. (SR)

The making of nursing practice law in Lebanon: a policy analysis case study.

PubMed

El-Jardali, Fadi; Hammoud, Rawan; Younan, Lina; Nuwayhid, Helen Samaha; Abdallah, Nadine; Alameddine, Mohammad; Bou-Karroum, Lama; Salman, Lana

2014-09-05

Evidence-informed decisions can strengthen health systems, improve health, and reduce health inequities. Despite the Beijing, Montreux, and Bamako calls for action, literature shows that research evidence is underemployed in policymaking, especially in the East Mediterranean region (EMR). Selecting the draft nursing practice law as a case study, this policy analysis exercise aims at generating in-depth insights on the public policymaking process, identifying the factors that influence policymaking and assessing to what extent evidence is used in this process. This study utilized a qualitative research design using a case study approach and was conducted in two phases: data collection and analysis, and validation. In the first phase, data was collected through key informant interviews that covered 17 stakeholders. In the second phase, a panel discussion was organized to validate the findings, identify any gaps, and gain insights and feedback of the panelists. Thematic analysis was conducted and guided by the Walt & Gilson's "Policy Triangle Framework" as themes were categorized into content, actors, process, and context. Findings shed light on the complex nature of health policymaking and the unstructured approach of decision making. This study uncovered the barriers that hindered the progress of the draft nursing law and the main barriers against the use of evidence in policymaking. Findings also uncovered the risk involved in the use of international recommendations without the involvement of stakeholders and without accounting for contextual factors and implementation barriers. Findings were interpreted within the context of the Lebanese political environment and the power play between stakeholders, taking into account equity considerations. This policy analysis exercise presents findings that are helpful for policymakers and all other stakeholders and can feed into revising the draft nursing law to reach an effective alternative that is feasible in Lebanon. Our findings are relevant in local and regional context as policymakers and other stakeholders can benefit from this experience when drafting laws and at the global context, as international organizations can consider this case study when developing global guidance and recommendations.

Evaluation of decision making and negotiation processes under uncertainties regarding the water management of Peiros-Parapeiros Dam, in Achaia Region (Greece).

NASA Astrophysics Data System (ADS)

Podimata, Marianthi V.; Yannopoulos, Panayotis C.

2015-04-01

Water managers, decision-makers, water practitioners and others involved in Integrated Water Resources Management often encounter the problem of finding a joint agreement among stakeholders concerning the management of a common water body. Handling conflict situations/disputes over water issues and finding an acceptable joint solution remain a thorny issue in water negotiation processes, since finding a formula for wise, fair and sustainable management of a water resource is a complex process that includes environmental, economic, technical, socio-political criteria and their uncertainties. Decision Support Systems and Adaptive Management are increasingly used in that direction. To assist decision makers in handling water disputes and execute negotiations, a conceptual tool is required. The Graph Model for Conflict Resolution is a Decision Support flexible tool for negotiation support regarding water conflicts. It includes efficient algorithms for estimating strategic moves of water stakeholders, even though there is a lack of detail concerning their real motives and prospects. It calculates the stability of their states and encourages what-if analyses. This paper presents a case study of water decision makers' evaluations concerning the management of up-coming technical infrastructure Peiros-Parapeiros Dam, in Achaia Region (Greece). The continuous consultations between institutions and representatives revealed that the formation of a joint agreement between stakeholders is not easy, due to arising conflicts and contradictions regarding the jurisdiction and legal status of the dam operator and the cost undertaking of the dam operation. This paper analyzes the positions of the parties involved in the consultation process and examines possible conflict resolution states, using GMCR II. This methodology tries to minimize uncertainty to a certain extent concerning the possible moves/decisions of involved parties regarding the operation and management of the dam by developing and simulating potential strategic interactions and multilateral negotiations and finding confidence-building cooperation schemes (cooperative arrangements) over water use and management.

Tailoring an educational program on the AHRQ Patient Safety Indicators to meet stakeholder needs: lessons learned in the VA.

PubMed

Shin, Marlena H; Rivard, Peter E; Shwartz, Michael; Borzecki, Ann; Yaksic, Enzo; Stolzmann, Kelly; Zubkoff, Lisa; Rosen, Amy K

2018-02-14

Given that patient safety measures are increasingly used for public reporting and pay-for performance, it is important for stakeholders to understand how to use these measures for improvement. The Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSIs) are one particularly visible set of measures that are now used primarily for public reporting and pay-for-performance among both private sector and Veterans Health Administration (VA) hospitals. This trend generates a strong need for stakeholders to understand how to interpret and use the PSIs for quality improvement (QI). The goal of this study was to develop an educational program and tailor it to stakeholders' needs. In this paper, we share what we learned from this program development process. Our study population included key VA stakeholders involved in reviewing performance reports and prioritizing and initiating quality/safety initiatives. A pre-program formative evaluation through telephone interviews and web-based surveys assessed stakeholders' educational needs/interests. Findings from the formative evaluation led to development and implementation of a cyberseminar-based program, which we tailored to stakeholders' needs/interests. A post-program survey evaluated program participants' perceptions about the PSI educational program. Interview data confirmed that the concepts we had developed for the interviews could be used for the survey. Survey results informed us on what program delivery mode and content topics were of high interest. Six cyberseminars were developed-three of which focused on two content areas that were noted of greatest interest: learning how to use PSIs for monitoring trends and understanding how to interpret PSIs. We also used snapshots of VA PSI reports so that participants could directly apply learnings. Although initial interest in the program was high, actual attendance was low. However, post-program survey results indicated that perceptions about the program were positive. Conducting a formative evaluation was a highly important process in program development. The useful information that we collected through the interviews and surveys allowed us to tailor the program to stakeholders' needs and interests. Our experiences, particularly with the formative evaluation process, yielded valuable lessons that can guide others when developing and implementing similar educational programs.

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

PubMed

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

2016-07-18

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

Policy on manager involvement in work re-integration: managers' experiences in a Canadian setting.

PubMed

Maiwald, Karin; Meershoek, Agnes; de Rijk, Angelique; Nijhuis, Frans J N

2014-01-01

In Canada and other countries, sickness absence among workers is a significant concern. Local return-to-work policies developed by both management and workers' representatives are preferred to tackle the problem. This article examines how managers perceive this local bipartite agreed upon return-to-work policy, wherein a social constructivist view on the policy process is taken. In-depth interviews were held with 10 managers on their experiences with execution of this policy in a Canadian healthcare organization. Interviews were transcribed verbatim and qualitative analyses were completed to gain deep insight into the managers' perspectives. Results show that the managers viewed themselves as a linchpin between the workplace and the worker. They did not feel heard by the other stakeholders, wrestled with worker's limitations, struggled getting plans adjusted and became overextended to meet return-to-work objectives. The study shows that the managers felt unable to meet the responsibilities the policy demanded and got less involved in the return-to-work process than this policy intended. RTW policy needs to balance on the one hand, flexibility to safeguard active involvement of managers and, on the other hand, strictness regarding taking responsibility by stakeholders, particularly the health care and re-integration professionals.

Tracing the Influence of Stakeholders of the Nusantara Masjid Architecture

NASA Astrophysics Data System (ADS)

Asyraf Mahyuddin, Izzat; Rahim, Zaiton Abdul; Nawawi, Norwina Mohd

2017-12-01

Masjids or mosques were built across the Malay Archipelago or the Nusantara, as a statement on the rise and strengths of the Islamic community since the arrival of Islam in the 1300s. As the latest religion to the South-East Asia after Hindu-Buddhist, the mass often discusses the form and make of the masjid but seldom question who’s who constitutes the design and the rigmarole of masjids. This paper aim at identifying the stakeholders of masjid architecture of Nusantara through analysing the involvement of stakeholders from historical and primary data, covering the process of initiation, through masjid construction including the conceptions and perceptions on the factors influencing the architecture of the masjid. The paper intents to demystify the sole responsibility of the architect in designing masjid of Nusantara region and places the will of Islam as the religion of initiation and stakeholders, whom are the rulers, scholars and common Muslims, as the Ummah, the reason of its make and form it is today.

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

NASA Astrophysics Data System (ADS)

Ryder, Jim; Banner, Indira

2011-03-01

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

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

PubMed

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

2012-07-01

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

Stakeholder contributions to assessment, monitoring, and conservation of threatened species: black skimmer and red knot as case studies.

PubMed

Burger, Joanna; Gochfeld, Michael; Niles, Larry; Tsipoura, Nellie; Mizrahi, David; Dey, Amanda; Jeitner, Christian; Pittfield, Taryn

2017-02-01

Stakeholder contributions to conservation projects often occur during the problem formulation stage, yet the role of stakeholders throughout the process is seldom considered. We examine the diversity of state and federal agencies, conservation organizations, other non-governmental organizations, environmental justice communities, consultants, industry, and the general public in the conservation of red knot (Calidris canutus rufa) and black skimmer (Rynchops niger) in New Jersey. We suggest that (1) governmental agencies provide the legal, regulatory, and management framework, but it is often the universities, conservation organizations, consultants, and the public that conduct the research and perform activities that lead to increased research and conservation efforts; (2) departments within agencies may have conflicting mandates, making it difficult to resolve differences in actions; (3) there is often conflict among and within state agencies and conservation organizations about roles and priorities; and (4) the role of the public is critical to ongoing research and conservation efforts. Identification of all the relevant stakeholders is necessary to recognizing competing claims, identifying the threats, deciding how to manage the threats, and enhancing population viability. Conflicts occur even within an agency when one department oversees science and protection of populations and another oversees and fosters an industry (aquaculture or fisheries, or permits for off-road vehicles). Conflicts also occur between resource agencies, industry, and conservation organizations. Recognizing the different stakeholders and their mandates, and encouraging participation in the process, leads to a better understanding of the threats, risks, and possible solutions when conflicts arise. Tracking stakeholder viewpoints and actions can lead to increased involvement and conflict resolution.

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

Making the Grade: Describing Inherent Requirements for the Initial Teacher Education Practicum

ERIC Educational Resources Information Center

Sharplin, Elaine; Peden, Sanna; Marais, Ida

2016-01-01

This study explores the development, description, and illustration of inherent requirement (IR) statements to make explicit the requirements for performance on an initial teacher education (ITE) practicum. Through consultative group processes with stakeholders involved in ITE, seven IR domains were identified. From interviews with academics,…

The Role of Local Leaders in Cultural Transformation and Development

ERIC Educational Resources Information Center

Carm, Ellen

2012-01-01

Through cross-disciplinary and participatory processes involving key stakeholders from the Zambian education sector, as well as from the traditional leadership structure, a localized HIV/AIDS-prevention strategy, Interactive School and Community Approach (ISACA), was developed and implemented throughout one province between 2002 and 2006. The…

Strategic Plan, 1999-2001.

ERIC Educational Resources Information Center

North Carolina Community Coll. System, Raleigh.

This document is the result of a six-month process of obtaining input from a variety of community college stakeholders in North Carolina to help determine a direction for the state's 59 community colleges. Several hundred people were involved in developing these strategic initiatives, goals, and objectives. There are two main sections in the…

One perspective on stakeholder involvement at Hanford.

PubMed

Martin, Todd

2011-11-01

The Hanford nuclear site in Washington State had a major role in the production of nuclear weapons materials during the Manhattan Project in World War II and during the Cold War that followed. The production of weapons-grade radionuclides produced a large amount of radioactive byproducts that have been stored since the mid-1900s at the Hanford Site. These by-product radionuclides have leaked from containment facilities into the groundwater, contaminated buildings used for radionuclide processing, and also contaminated the nuclear reactors used to produce weapons-grade uranium and plutonium. This issue has been a major concern to Hanford stakeholders for several decades, and the U.S. Department of Energy, the U.S. Environmental Protection Agency, and the Washington State Department of Ecology established a Tri-Party Agreement in 1989, at which time Hanford ceased production of nuclear weapons materials and began a major effort to clean up and remediate the Hanford Site's contaminated groundwater, soil, and facilities. This paper describes the concerns of stakeholders in the production of nuclear weapons, the secrecy of Hanford operations, and the potential impacts to public health and the environment from the unintended releases of weapons-grade materials and by-products associated with their production at the Hanford Site. It also describes the involvement of public stakeholders in the development and oversight by the Hanford Advisory Board of the steps that have been taken in cleanup activities at the Hanford Site that began as a major effort about two decades ago. The importance of involvement of the general public and public interest organizations in developing and implementing the Hanford cleanup strategy are described in detail.

Risk perception, risk communication, and stakeholder involvement for biosolids management and research.

PubMed

Beecher, Ned; Harrison, Ellen; Goldstein, Nora; McDaniel, Mary; Field, Patrick; Susskind, Lawrence

2005-01-01

An individual's perception of risk develops from his or her values, beliefs, and experiences. Social scientists have identified factors that affect perceptions of risk, such as whether the risk is knowable (uncertainty), voluntary (can the individual control exposure?), and equitable (how fairly is the risk distributed?). There are measurable differences in how technical experts and citizen stakeholders define and assess risk. Citizen knowledge and technical expertise are both relevant to assessing risk; thus, the 2002 National Research Council panel on biosolids recommended stakeholder involvement in biosolids risk assessments. A survey in 2002 identified some of the factors that influence an individual's perception of the risks involved in a neighbor's use of biosolids. Risk communication was developed to address the gap between experts and the public in knowledge of technical topics. Biosolids management and research may benefit from applications of current risk communication theory that emphasizes (i) two-way communications (dialogue); (ii) that the public has useful knowledge and concerns that need to be acknowledged; and (iii) that what may matter most is the credibility of the purveyor of information and the levels of trustworthiness, fairness, and respect that he or she (or the organization) demonstrates, which can require cultural change. Initial experiences in applying the dialogue and cultural change stages of risk communication theory--as well as consensus-building and joint fact-finding--to biosolids research suggest that future research outcomes can be made more useful to decision-makers and more credible to the broader public. Sharing control of the research process with diverse stakeholders can make research more focused, relevant, and widely understood.

Regional-scale brine migration along vertical pathways due to CO2 injection - Part 1: The participatory modeling approach

NASA Astrophysics Data System (ADS)

Scheer, Dirk; Konrad, Wilfried; Class, Holger; Kissinger, Alexander; Knopf, Stefan; Noack, Vera

2017-06-01

Saltwater intrusion into potential drinking water aquifers due to the injection of CO2 into deep saline aquifers is one of the potential hazards associated with the geological storage of CO2. Thus, in a site selection process, models for predicting the fate of the displaced brine are required, for example, for a risk assessment or the optimization of pressure management concepts. From the very beginning, this research on brine migration aimed at involving expert and stakeholder knowledge and assessment in simulating the impacts of injecting CO2 into deep saline aquifers by means of a participatory modeling process. The involvement exercise made use of two approaches. First, guideline-based interviews were carried out, aiming at eliciting expert and stakeholder knowledge and assessments of geological structures and mechanisms affecting CO2-induced brine migration. Second, a stakeholder workshop including the World Café format yielded evaluations and judgments of the numerical modeling approach, scenario selection, and preliminary simulation results. The participatory modeling approach gained several results covering brine migration in general, the geological model sketch, scenario development, and the review of the preliminary simulation results. These results were included in revised versions of both the geological model and the numerical model, helping to improve the analysis of regional-scale brine migration along vertical pathways due to CO2 injection.

Mapping the Views of Adolescent Health Stakeholders.

PubMed

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

2016-01-01

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

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

Continuing and developing the engagement with Mediterranean stakeholders in the CLIM-RUN project

NASA Astrophysics Data System (ADS)

Goodess, Clare

2013-04-01

The CLIM-RUN case studies provide a real-world and Mediterranean context for bringing together experts on the demand and supply side of climate services. They are essential to the CLIM-RUN objective of using iterative and bottom-up (i.e., stakeholder led) approaches for optimizing the two-way information transfer between climate experts and stakeholders - and focus on specific locations and sectors (such as tourism and renewable energy). Stakeholder involvement has been critical from the start of the project in March 2011, with an early series of targeted workshops used to define the framework for each case study as well as the needs of stakeholders. Following these workshops, the user needs were translated into specific requirements from climate observations and models and areas identified where additional modelling and analysis are required. The first set of new products and tools produced by the CLIM-RUN modelling and observational experts are presented in a series of short briefing notes. A second round of CLIM-RUN stakeholder workshops will be held for each of the case studies in Spring 2013 as an essential part of the fourth CLIM-RUN key stage: Consolidation and collective review/assessment. During these workshops the process of interaction between CLIM-RUN scientists and case-study stakeholders will be reviewed, as well as the utility of the products and information developed in CLIM-RUN. Review questions will include: How far have we got? How successful have we been? What are the remaining problems/gaps? How to sustain and extend the interactions? The process of planning for and running these second workshops will be outlined and emerging outcomes presented, focusing on common messages which are relevant for development of the CLIM-RUN protocol for providing improved climate services to stakeholders together with the identification of best practices and policy recommendations for climate services development.

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

A framework for multi-stakeholder decision-making and ...

EPA Pesticide Factsheets

We propose a decision-making framework to compute compromise solutions that balance conflicting priorities of multiple stakeholders on multiple objectives. In our setting, we shape the stakeholder dis-satisfaction distribution by solving a conditional-value-at-risk (CVaR) minimization problem. The CVaR problem is parameterized by a probability level that shapes the tail of the dissatisfaction distribution. The proposed approach allows us to compute a family of compromise solutions and generalizes multi-stakeholder settings previously proposed in the literature that minimize average and worst-case dissatisfactions. We use the concept of the CVaR norm to give a geometric interpretation to this problem +and use the properties of this norm to prove that the CVaR minimization problem yields Pareto optimal solutions for any choice of the probability level. We discuss a broad range of potential applications of the framework that involve complex decision-making processes. We demonstrate the developments using a biowaste facility location case study in which we seek to balance stakeholder priorities on transportation, safety, water quality, and capital costs. This manuscript describes the methodology of a new decision-making framework that computes compromise solutions that balance conflicting priorities of multiple stakeholders on multiple objectives as needed for SHC Decision Science and Support Tools project. A biowaste facility location is employed as the case study

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.

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

PubMed

Hanson, H M; Salmoni, A W

2011-08-01

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

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…

Stakeholder involvement for management of the coastal zone.

PubMed

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

2016-10-01

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

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

PubMed

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

2017-05-01

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

Prospects for Enabling Middle School Student Success: Families as Stakeholders

ERIC Educational Resources Information Center

Saddler, Patricia

2016-01-01

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

A transdisciplinary approach for supporting the integration of ecosystem services into land and water management

NASA Astrophysics Data System (ADS)

Fatt Siew, Tuck; Döll, Petra

2015-04-01

Transdisciplinary approaches are useful for supporting integrated land and water management. However, the implementation of the approach in practice to facilitate the co-production of useable socio-hydrological (and -ecological) knowledge among scientists and stakeholders is challenging. It requires appropriate methods to bring individuals with diverse interests and needs together and to integrate their knowledge for generating shared perspectives/understanding, identifying common goals, and developing actionable management strategies. The approach and the methods need, particularly, to be adapted to the local political and socio-cultural conditions. To demonstrate how knowledge co-production and integration can be done in practice, we present a transdisciplinary approach which has been implemented and adapted for supporting land and water management that takes ecosystem services into account in an arid region in northwestern China. Our approach comprises three steps: (1) stakeholder analysis and interdisciplinary knowledge integration, (2) elicitation of perspectives of scientists and stakeholders, scenario development, and identification of management strategies, and (3) evaluation of knowledge integration and social learning. Our adapted approach has enabled interdisciplinary and cross-sectoral communication among scientists and stakeholders. Furthermore, the application of a combination of participatory methods, including actor modeling, Bayesian Network modeling, and participatory scenario development, has contributed to the integration of system, target, and transformation knowledge of involved stakeholders. The realization of identified management strategies is unknown because other important and representative decision makers have not been involved in the transdisciplinary research process. The contribution of our transdisciplinary approach to social learning still needs to be assessed.

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

PubMed

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

2015-04-01

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

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

PubMed

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

2012-09-01

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

Design of the North Carolina Prostate Cancer Comparative Effectiveness and Survivorship Study (NC ProCESS).

PubMed

Chen, Ronald C; Carpenter, William R; Kim, Mimi; Hendrix, Laura H; Agans, Robert P; Meyer, Anne-Marie; Hoffmeyer, Anna; Reeve, Bryce B; Nielsen, Matthew E; Usinger, Deborah S; Strigo, Tara S; Jackman, Anne M; Anderson, Mary; Godley, Paul A

2015-01-01

The North Carolina Prostate Cancer Comparative Effectiveness & Survivorship Study (NC ProCESS) was designed in collaboration with stakeholders to compare the effectiveness of different treatment options for localized prostate cancer. Using the Rapid Case Ascertainment system of the North Carolina Central Cancer Registry, 1,419 patients (57% of eligible) with newly-diagnosed localized prostate cancer were enrolled from January 2011 to June 2013, on average 5 weeks after diagnosis. All participants were enrolled prior to treatment and this population-based cohort is sociodemographically diverse. Prospective follow-up continues to collect data on treatments received, disease control, survival and patient-reported outcomes. This study highlights several important considerations regarding stakeholder involvement, study design and generalizability regarding comparative effectiveness research in prostate cancer.

Creating Shared Mental Models: The Support of Visual Language

NASA Astrophysics Data System (ADS)

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

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

Using health technology assessment to support optimal use of technologies in current practice: the challenge of "disinvestment".

PubMed

Henshall, Chris; Schuller, Tara; Mardhani-Bayne, Logan

2012-07-01

Health systems face rising patient expectations and economic pressures; decision makers seek to enhance efficiency to improve access to appropriate care. There is international interest in the role of HTA to support decisions to optimize use of established technologies, particularly in "disinvesting" from low-benefit uses. This study summarizes main points from an HTAi Policy Forum meeting on this topic, drawing on presentations, discussions among attendees, and an advance background paper. Optimization involves assessment or re-assessment of a technology, a decision on optimal use, and decision implementation. This may occur within a routine process to improve safety and quality and create "headroom" for new technologies, or ad hoc in response to financial constraints. The term "disinvestment" is not always helpful in describing these processes. HTA contributes to optimization, but there is scope to increase its role in many systems. Stakeholders may have strong views on access to technology, and stakeholder involvement is essential. Optimization faces challenges including loss aversion and entitlement, stakeholder inertia and entrenchment, heterogeneity in patient outcomes, and the need to demonstrate convincingly absence of benefit. While basic HTA principles remain applicable, methodological developments are needed better to support optimization. These include mechanisms for candidate technology identification and prioritization, enhanced collection and analysis of routine data, and clinician engagement. To maximize value to decision makers, HTA should consider implementation strategies and barriers. Improving optimization processes calls for a coordinated approach, and actions are identified for system leaders, HTA and other health organizations, and industry.

Engaging partners to initiate evaluation efforts: tactics used and lessons learned from the prevention research centers program.

PubMed

Wright, Demia Sundra; Anderson, Lynda A; Brownson, Ross C; Gwaltney, Margaret K; Scherer, Jennifer; Cross, Alan W; Goodman, Robert M; Schwartz, Randy; Sims, Tom; White, Carol R

2008-01-01

The Centers for Disease Control and Prevention's (CDC's) Prevention Research Centers (PRC) Program underwent a 2-year evaluation planning project using a participatory process that allowed perspectives from the national community of PRC partners to be expressed and reflected in a national logic model. The PRC Program recognized the challenge in developing a feasible, useable, and relevant evaluation process for a large, diverse program. To address the challenge, participatory and utilization-focused evaluation models were used. Four tactics guided the evaluation planning process: 1) assessing stakeholders' communication needs and existing communication mechanisms and infrastructure; 2) using existing mechanisms and establishing others as needed to inform, educate, and request feedback; 3) listening to and using feedback received; and 4) obtaining adequate resources and building flexibility into the project plan to support multifaceted mechanisms for data collection. Participatory methods resulted in buy-in from stakeholders and the development of a national logic model. Benefits included CDC's use of the logic model for program planning and development of a national evaluation protocol and increased expectations among PRC partners for involvement. Challenges included the time, effort, and investment of program resources required for the participatory approach and the identification of whom to engage and when to engage them for feedback on project decisions. By using a participatory and utilization-focused model, program partners positively influenced how CDC developed an evaluation plan. The tactics we used can guide the involvement of program stakeholders and help with decisions on appropriate methods and approaches for engaging partners.

Stakeholder perceptions of aid coordination implementation in the Zambian health sector.

PubMed

Sundewall, Jesper; Jönsson, Kristina; Cheelo, Caesar; Tomson, Göran

2010-05-01

In this study, we analysed stakeholder perceptions of the process of implementing the coordination of health-sector aid in Zambia, Africa. The aim of coordination of health aid is to increase the effectiveness of health systems and to ensure that donors comply with national priorities. With increases in the number of donors involved and resources available for health aid globally, the attention devoted to coordination worldwide has risen. While the theoretical basis of coordination has been relatively well-explored, less research has been carried out on the practicalities of how such coordination is to be implemented. In our study, we focused on potential differences between the views of the stakeholders, both government and donors, on the systems by which health aid is coordinated. A qualitative case study was conducted comprising interviews with government and donor stakeholders in the health sector, as well as document review and observations of meetings. Results suggested that stakeholders are generally satisfied with the implementation of health-sector aid coordination in Zambia. However, there were differences in perceptions of the level of coordination of plans and agreements, which can be attributed to difficulties in harmonizing and aligning organizational requirements with the Zambian health-sector plans. In order to achieve the aims of the Paris Declaration; to increase harmonization, alignment and ownership--resources from donors must be better coordinated in the health sector planning process. This requires careful consideration of contextual constraints surrounding each donor. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

How do local stakeholders respond to the uncertain implications of an innovative flood infrastructure project?

NASA Astrophysics Data System (ADS)

van den Hoek, Ronald; Brugnach, Marcela; Hoekstra, Arjen

2013-04-01

In the 20th century, flood management was dominated by rigid structures - such as dikes and dams - which intend to strictly regulate and control water systems. Although the application of these rigid structures has been successful in the recent past, their negative implications for ecosystems and natural processes is often not properly taken into account. Therefore, flood management practices are currently moving towards more nature-inclusive approaches. Building with Nature (BwN) is such a new approach of nature-inclusive flood management in the Netherlands, which aims to utilize natural dynamics (e.g., wind and currents) and natural materials (e.g., sediment and vegetation) for the realization of effective flood infrastructure, while providing opportunities for nature development. However, the natural dynamics driving a project based on BwN design principles are inherently unpredictable. Furthermore, our factual knowledge base regarding the socio-ecological system in which the BwN initiative is implemented is incomplete. Moreover, in recent years, it is increasingly aimed for by decision-makers to involve local stakeholders in the development of promising flood management initiatives. These stakeholders and other actors involved can have diverging views regarding the project, can perceive unanticipated implications and could choose unforeseen action paths. In short, while a project based on BwN design principles - like any human intervention - definitely has implications for the socio-ecological system, both the extent to which these particular implications will occur and the response of stakeholders are highly uncertain. In this paper, we study the Safety Buffer Oyster Dam case - a BwN pilot project - and address the interplay between the project's implications, the uncertainties regarding these implications and the action paths chosen by the local stakeholders and project team. We determine how the implications of the Safety Buffer project are viewed by local stakeholders, identify the frames and uncertainties related to these implications, and classify these uncertainties according to their nature and level. We describe which action paths are chosen by the local stakeholders and project team regarding the implications identified. Our research shows that there is a correspondence between the level of uncertainty about the implications identified and the action paths chosen by the actors involved. This suggests that the inherent deep uncertainty in projects based on BwN principles calls for more adaptable and flexible strategies to cope with the implications of these initiatives.

Universal Free School Breakfast: A Qualitative Process Evaluation According to the Perspectives of Senior Stakeholders.

PubMed

Harvey-Golding, Louise; Donkin, Lynn Margaret; Defeyter, Margaret Anne

2016-01-01

In the last decade, the provision of school breakfast has increased significantly in the UK. However, there is an absence of knowledge regarding senior stakeholder views on the processes and potential outcomes on different groups, within the communities served by school breakfast programs. The purpose of this study was to examine the views and experiences of senior level stakeholders and thereby provide an original qualitative contribution to the research. A sample of senior level stakeholders was recruited, including senior officers, directors, and elected members, from within a Local Authority (LA) involved in the leadership, implementation and delivery of a council-wide universal free school breakfast (UFSB) program, and from the senior staff body of mainstream primary and special schools, participating in the program. A grounded theory analysis of the data collected identified issues encountered in the implementation and delivery, and views on the funding and future of a USFB program, in addition to perceived outcomes for children, parents, families, schools, and the wider community. The results refer to both positive and negative issues and implications associated with the program, according to the perspectives of senior level stakeholders. Perceived positive outcomes included benefits to children, families, schools, and the community. For instance, alleviating hunger, improving health outcomes, and conferring financial benefits, with the potential to cumulate in overall improvements in educational, social, and behavioral outcomes. Reported negative implications included the absence of an effective communication strategy in implementing the USFB program; in addition to concerns about the impacts of "double-breakfasting" on obesity levels among children, particularly in less deprived communities. Findings were validated using theoretical sampling and saturation, triangulation methods, member checks, and inter-rater reliability measures. In presenting these findings, this paper provides a unique qualitative insight into the processes, issues and outcomes of a council-wide UFSB program within a socioeconomically deprived community, according to the perceptions of senior level stakeholders.

Setting and meeting priorities in Indigenous health research in Australia and its application in the Cooperative Research Centre for Aboriginal health.

PubMed

Monk, Johanna M; Rowley, Kevin G; Anderson, Ian Ps

2009-11-20

Priority setting is about making decisions. Key issues faced during priority setting processes include identifying who makes these decisions, who sets the criteria, and who benefits. The paper reviews the literature and history around priority setting in research, particularly in Aboriginal health research. We explore these issues through a case study of the Cooperative Research Centre for Aboriginal Health (CRCAH)'s experience in setting and meeting priorities.Historically, researchers have made decisions about what research gets done. Pressures of growing competition for research funds and an increased public interest in research have led to demands that appropriate consultation with stakeholders is conducted and that research is of benefit to the wider society. Within Australian Aboriginal communities, these demands extend to Aboriginal control of research to ensure that Aboriginal priorities are met.In response to these demands, research priorities are usually agreed in consultation with stakeholders at an institutional level and researchers are asked to develop relevant proposals at a project level. The CRCAH's experience in funding rounds was that scientific merit was given more weight than stakeholders' priorities and did not necessarily result in research that met these priorities. After reviewing these processes in 2004, the CRCAH identified a new facilitated development approach. In this revised approach, the setting of institutional priorities is integrated with the development of projects in a way that ensures the research reflects stakeholder priorities.This process puts emphasis on identifying projects that reflect priorities prior to developing the quality of the research, rather than assessing the relevance to priorities and quality concurrently. Part of the CRCAH approach is the employment of Program Managers who ensure that stakeholder priorities are met in the development of research projects. This has enabled researchers and stakeholders to come together to collaboratively develop priority-driven research. Involvement by both groups in project development has been found to be essential in making decisions that will lead to robust and useful research.

Work Disability Prevention: A Primer for Occupational Therapists.

PubMed

McDougall, Alicia; Nowrouzi-Kia, Behdin

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

Vulnerability assessment of a port and harbor community to earthquake and tsunami hazards: Integrating technical expert and stakeholder input

USGS Publications Warehouse

Wood, Nathan J.; Good, James W.; Goodwin, Robert F.

2002-01-01

Research suggests that the Pacific Northwest could experience catastrophic earthquakes and tsunamis in the near future, posing a significant threat to the numerous ports and harbors along the coast. A collaborative, multiagency initiative is underway to increase the resiliency of Pacific Northwest ports and harbors to these hazards, involving Oregon Sea Grant, Washington Sea Grant, the National Oceanic and Atmospheric Administration Coastal Services Center, and the U.S. Geological Survey Center for Science Policy. One element of this research, planning, and outreach initiative is a natural hazard mitigation and emergency preparedness planning process that combines technical expertise with local stakeholder values and perceptions. This paper summarizes and examines one component of the process, the vulnerability assessment methodology, used in the pilot port and harbor community of Yaquina River, Oregon, as a case study of assessing vulnerability at the local level. In this community, stakeholders were most concerned with potential life loss and other nonstructural vulnerability issues, such as inadequate hazard awareness, communication, and response logistics, rather than structural issues, such as damage to specific buildings or infrastructure.

Marine Hydrokinetic Energy Regulators Workshop: Lessons from Wind

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

Baring-Gould, E. Ian

2015-09-03

Ian Baring-Gould presented these lessons learned from wind energy to an audience of marine hydrokinetic regulators. Lessons learned spanned the areas of technology advances, using collaborative approaches to involve key stakeholders; using baseline studies to measure and prioritize wildlife impacts, and look at avoidance and mitigation options early in the process.

What Does an Inventory of Recent Innovation Experiences Tell Us about Agricultural Innovation in Africa?

ERIC Educational Resources Information Center

Triomphe, Bernard; Floquet, Anne; Kamau, Geoffrey; Letty, Brigid; Vodouhe, Simplice Davo; Ng'ang'a, Teresiah; Stevens, Joe; van den Berg, Jolanda; Selemna, Nour; Bridier, Bernard; Crane, Todd; Almekinders, Cornelia; Waters-Bayer, Ann; Hocde, Henri

2013-01-01

Purpose: Within the context of the European-funded JOLISAA project (JOint Learning in and about Innovation Systems in African Agriculture), an inventory of agricultural innovation experiences was made in Benin, Kenya and South Africa. The objective was to assess multi-stakeholder agricultural innovation processes involving smallholders. Approach:…

Educational Reforms in Malta: A Missed Opportunity to Establish Distributed Governance

ERIC Educational Resources Information Center

Cutajar, Mario; Bezzina, Christopher; James, Chris

2013-01-01

This article critically analyses the current Maltese educational reform process, which aimed to transform educational governance in Malta from a centralized system to a more decentralized one. This longitudinal study adopted a multi-site inquiry of a sample of the colleges involving different stakeholders, including key policy-makers, college…

Teacher Collaborative Curriculum Design in Technical Vocational Colleges: A Strategy for Maintaining Curriculum Consistency?

ERIC Educational Resources Information Center

Albashiry, Nabeel M.; Voogt, Joke M.; Pieters, Jules M.

2015-01-01

The Technical Vocational Education and Training (TVET) curriculum requires continuous renewal and constant involvement of stakeholders in the redesign process. Due to a lack of curriculum design expertise, TVET institutions in developing contexts encounter challenges maintaining and advancing the quality and relevance of their programmes to the…

Site-Based Management. Research Brief

ERIC Educational Resources Information Center

Walker, Karen

2012-01-01

In the literature, site-based management was defined as authority for decisions on programs is in the hands of those who are directly affected and it involves all stakeholders (students, parents, teachers, principal, superintendent, Board of Education, and community members). It is not seen as a means to an end, but as an on-going process to…

Using CBPR Methods in College Health Research: Exploring Excessive Alcohol Consumption

ERIC Educational Resources Information Center

Bulmer, Sandra M.; Barton, Barbara A.; Liefeld, Julie; Montauti, Sara; Santos, Stephanie; Richard, Melissa; Hnath, Laura; Pelletier, Kara; Lalanne, Jude

2016-01-01

Community-based participatory research (CBPR) is a collaborative methodology that uniquely involves stakeholders in all stages of the research process. CBPR has been widely utilized in the field of public health, but not widely employed with college populations. This study utilized CBPR methods within a college community to gain insight into…

Planning Good Change with Technology and Literacy.

ERIC Educational Resources Information Center

McKenzie, Jamie

This book describes strategies to put information literacy and student learning at the center of technology planning. Filled with stories of success and with models of good planning, the book shows how to clarify purpose, involve important stakeholders, and pace the change process to maximize the daily use of new technologies. The following…

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

NASA Astrophysics Data System (ADS)

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

2018-04-01

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

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

PubMed

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

2016-01-01

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

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

PubMed

Hwabamungu, Boroto; Brown, Irwin; Williams, Quentin

2018-01-01

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

'Ethical responsibility' or 'a whole can of worms': differences in opinion on incidental finding review and disclosure in neuroimaging research from focus group discussions with participants, parents, IRB members, investigators, physicians and community members.

PubMed

Cole, Caitlin; Petree, Linda E; Phillips, John P; Shoemaker, Jody M; Holdsworth, Mark; Helitzer, Deborah L

2015-10-01

To identify the specific needs, preferences and expectations of the stakeholders impacted by returning neuroimaging incidental findings to research participants. Six key stakeholder groups were identified to participate in focus group discussions at our active neuroimaging research facility: Participants, Parents of child participants, Investigators, Institutional Review Board (IRB) Members, Physicians and Community Members. A total of 151 subjects attended these discussions. Transcripts were analysed using principles of Grounded Theory and group consensus coding. A series of similar and divergent themes were identified across our subject groups. Similarities included beliefs that it is ethical for researchers to disclose incidental findings as it grants certain health and emotional benefits to participants. All stakeholders also recognised the potential psychological and financial risks to disclosure. Divergent perspectives elucidated consistent differences between our 'Participant' subjects (Participants, Parents, Community Members) and our 'Professional' subjects (IRB Members, Investigators and Physicians). Key differences included (1) what results should be reported, (2) participants' autonomous right to research information and (3) the perception of the risk-benefit ratio in managing results. Understanding the perceived impact on all stakeholders involved in the process of disclosing incidental findings is necessary to determine appropriate research management policy. Our data further demonstrate the challenge of this task as different stakeholders evaluate the balance between risk and benefit related to their unique positions in this process. These findings offer some of the first qualitative insight into the expectations of the diverse stakeholders affected by incidental finding disclosure. 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's experiences, expectations and decision making on reproductive care: An ethnographic study of three districts in northern Ghana.

PubMed

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

2017-01-01

In Ghana, priority-setting for reproductive health service interventions is known to be rudimentary with little wider stakeholder involvement. In recognizing the need for broad stakeholder engagement to advance reproductive care provision and utilization, it is necessary to jointly study the varied stakeholder views on reproductive care services. We applied an ethnographic study approach where field data was collected between March-May 2015 in three rural districts of northern Ghana. Data was collected among women with recent births experiences (n = 90), health care providers (n = 16) and policy actors (n = 6). In-depth interviews and focus group discussions was applied to collect all data. Each stakeholder participant's audio file was transcribed, and repeatedly read through to identify similar and divergent views in data. A coding scheme guided coding processes. All transcripts were then imported into QSR NVivo 11 for further analysis. Four themes emerged. Women participants accentuated that sex and sexuality values of men have changed over time, and drives gender roles, parity levels and decision making on reproductive care needs at community levels. Sexual stigma on reproductive care reduces the willingness of women to voice poor experiences related to their previous reproductive experiences. All stakeholders' highlighted clinical treatments for post-abortion care are minimally covered under the fee exemption policy for antenatal and postnatal care. Policy processes on service delivery protocols still is top-down in Ghana. Health teams working to improve sexual and reproductive health care must find suitable context strategies that effectively work to improve women reproductive care needs at their operational levels. Private sector participation and informal community support clutches are encouraged to advance the delivery of reproductive care services.

The European Water Framework Directive: Challenges For A New Type of Social and Policy Analysis

NASA Astrophysics Data System (ADS)

Pahl-Wostl, C.

Water resources managment is facing increasing uncertainties in all areas. Socio- economic boundary conditions change quickly and require more flexible management strategies. Climate change, for example results in an increase in uncertainties, in par- ticular extreme events. Given the fact that current management practices deal with extreme events by designing the technical systems to manage the most extreme of all cases (e.g. higher dams for the protection against extreme floods, larger water reser- voirs for droughts and to meet daily peak demand) a serious problem is posed for long-term planning and risk management. Engineering planning has perceived the hu- man dimension as exogenous boundary conditions. Legislation focused largely on the environmental and technological dimensions that set limits and prescribe new tech- nologies without taking the importance of institutional change into account. However, technology is only the "hardware" and it is becoming increasingly obvious that the "software", the social dimension, has to become part of planning and management processes. Hence, the inclusion of the human dimension into integrated models and processes will be valuable in supporting the introduction of new elements into plan- ning processes in water resources management. With the European Water Framework Directive environmental policy enters a new era. The traditional approach to solving isolated environmental problems with technological fixes and end-of-pipe solutions has started to shift towards a more thoughtful attitude which involves the development of integrated approaches to problem solving. The WFD introduces the river basin as the management unit, thus following the experience of some European countries (e.g. France) and the example of the management of some international rivers (e.g. the Rhine). Overall the WFD represents a general shift towards a polycentric understand- ing of policy making that requires the involvement of stakeholders as active partic- ipants into the policy process at different levels of societal organization. The WFD requires the inclusion of stakeholders in the process of developing and adopting a river basin management plan. In order to improve stakeholder-based policy design and modeling processes innovation and research is required in linking analytical methods and participatory approaches. Factual knowledge and analytical techniques have to be combined with local knowledge and subjective perceptions of the various stakeholder groups. The talk will summarize current approaches and point out research needs.

models of congenital heart disease.

PubMed

Biglino, Giovanni; Capelli, Claudio; Leaver, Lindsay-Kay; Schievano, Silvia; Taylor, Andrew M; Wray, Jo

2015-01-01

To develop a participatory approach in the evaluation of 3D printed patient-specific models of congenital heart disease (CHD) with different stakeholders who would potentially benefit from the technology (patients, parents, clinicians and nurses). Workshops, focus groups and teaching sessions were organised, targeting different stakeholders. Sessions involved displaying and discussing different 3D models of CHD. Model evaluation involved response counts from questionnaires and thematic analysis of audio-recorded discussions and written feedback. Stakeholders’ responses indicated the scope and potential for clinical translation of 3D models. As tangible, three-dimensional artefacts, these can have a role in communicative processes. Their patient-specific quality is also important in relation to individual characteristics of CHD. Patients indicated that 3D models can help them visualise ‘what’s going on inside’. Parents agreed that models can spark curiosity in young people. Clinicians indicated that teaching might be the most relevant application. Nurses agreed that 3D models improved their learning experience during a CHD course. Engagement of different stakeholders to evaluate 3D printing technology for CHD identified the potential of the models for improving patient– doctor communication, patient empowerment and training. A participatory approach could benefit the clinical evaluation and translation of 3D printing technology.

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...

Implementing non-invasive prenatal testing for aneuploidy in a national healthcare system: global challenges and national solutions.

PubMed

van Schendel, Rachèl V; van El, Carla G; Pajkrt, Eva; Henneman, Lidewij; Cornel, Martina C

2017-09-19

Since the introduction of non-invasive prenatal testing (NIPT) in 2011, mainly by commercial companies, a growing demand for NIPT from the public and healthcare professionals has been putting pressure on the healthcare systems of various countries. This study identifies the challenges of establishing a responsible implementation of NIPT for aneuploidy in prenatal healthcare, by looking at the Netherlands. A mixed methods approach involving 13 stakeholder interviews, document analysis and (participatory) observations of the Dutch NIPT Consortium meetings were used. The Diffusion of Innovation Theory and a Network of Actors model were used to interpret the findings. Implementation of NIPT was facilitated by several factors. The set-up of a national NIPT Consortium enabled discussion and collaboration between stakeholders. Moreover, it led to the plan to offer NIPT through a nationwide research setting (TRIDENT studies), which created a learning phase for careful implementation. The Dutch legal context was perceived as a delaying factor, but eventually gave room for the parties involved to organise themselves and their practices. This study shows that implementing advanced technologies with profound effects on prenatal care benefit from a learning phase that allows time to carefully evaluate the technical performance and women's experiences and to enable public debate. Such a coordinated learning phase, involving all stakeholders, will stimulate the process of responsible and sustainable implementation.

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

PubMed

Zhu; Dale

2000-10-01

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

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

PubMed

Benn, Suzanne; Dunphy, Dexter; Martin, Andrew

2009-04-01

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

New care home admission following hospitalisation: How do older people, families and professionals make decisions about discharge destination? A case study narrative analysis.

PubMed

Rhynas, Sarah J; Garrido, Azucena Garcia; Burton, Jennifer K; Logan, Gemma; MacArthur, Juliet

2018-03-24

To gain an in-depth understanding of the decision-making processes involved in the discharge of older people admitted to hospital from home and discharged to a care home, as described in the case records. The decision for an older person to move into a care home is significant and life-changing. The discharge planning literature for older people highlights the integral role of nurses in supporting and facilitating effective discharge. However, little research has been undertaken to explore the experiences of those discharged from hospital to a care home or the processes involved in decision-making. A purposive sample of 10 cases was selected from a cohort of 100 individuals admitted to hospital from home and discharged to a care home. Cases were selected to highlight important personal, relational and structural factors thought to affect the decision-making process. Narrative case studies were created and were thematically analysed to explore the perspectives of each stakeholder group and the conceptualisations of risk which influenced decision-making. Care home discharge decision-making is a complex process involving stakeholders with a range of expertise, experience and perspectives. Decisions take time and considerable involvement of families and the multidisciplinary team. There were significant deficits in documentation which limit the understanding of the process and the patient's voice is often absent from case records. The experiences of older people, families and multidisciplinary team members making care home decisions in the hospital setting require further exploration to identify and define best practice. Nurses have a critical role in the involvement of older people making discharge decisions in hospital, improved documentation of the patient's voice is essential. Health and social care systems must allow older people time to make significant decisions about their living arrangements, adapting to changing medical and social needs. © 2018 John Wiley & Sons Ltd.

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

DOT National Transportation Integrated Search

2011-12-01

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

Sustainable development goals for global health: facilitating good governance in a complex environment.

PubMed

Haffeld, Just

2013-11-01

Increasing complexity is following in the wake of rampant globalization. Thus, the discussion about Sustainable Development Goals (SDGs) requires new thinking that departs from a critique of current policy tools in exploration of a complexity-friendly approach. This article argues that potential SDGs should: treat stakeholders, like states, business and civil society actors, as agents on different aggregate levels of networks; incorporate good governance processes that facilitate early involvement of relevant resources, as well as equitable participation, consultative processes, and regular policy and programme implementation reviews; anchor adoption and enforcement of such rules to democratic processes in accountable organizations; and include comprehensive systems evaluations, including procedural indicators. A global framework convention for health could be a suitable instrument for handling some of the challenges related to the governance of a complex environment. It could structure and legitimize government involvement, engage stakeholders, arrange deliberation and decision-making processes with due participation and regular policy review, and define minimum standards for health services. A monitoring scheme could ensure that agents in networks comply according to whole-systems targets, locally defined outcome indicators, and process indicators, thus resolving the paradox of government control vs. local policy space. A convention could thus exploit the energy created in the encounter between civil society, international organizations and national authorities. Copyright © 2013 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Long-term care information systems: an overview of the selection process.

PubMed

Nahm, Eun-Shim; Mills, Mary Etta; Feege, Barbara

2006-06-01

Under the current Medicare Prospective Payment System method and the ever-changing managed care environment, the long-term care information system is vital to providing quality care and to surviving in business. system selection process should be an interdisciplinary effort involving all necessary stakeholders for the proposed system. The system selection process can be modeled following the Systems Developmental Life Cycle: identifying problems, opportunities, and objectives; determining information requirements; analyzing system needs; designing the recommended system; and developing and documenting software.

Monitoring and Evaluating the Transition of Large-Scale Programs in Global Health

PubMed Central

Bao, James; Rodriguez, Daniela C; Paina, Ligia; Ozawa, Sachiko; Bennett, Sara

2015-01-01

Purpose: Donors are increasingly interested in the transition and sustainability of global health programs as priorities shift and external funding declines. Systematic and high-quality monitoring and evaluation (M&E) of such processes is rare. We propose a framework and related guiding questions to systematize the M&E of global health program transitions. Methods: We conducted stakeholder interviews, searched the peer-reviewed and gray literature, gathered feedback from key informants, and reflected on author experiences to build a framework on M&E of transition and to develop guiding questions. Findings: The conceptual framework models transition as a process spanning pre-transition and transition itself and extending into sustained services and outcomes. Key transition domains include leadership, financing, programming, and service delivery, and relevant activities that drive the transition in these domains forward include sustaining a supportive policy environment, creating financial sustainability, developing local stakeholder capacity, communicating to all stakeholders, and aligning programs. Ideally transition monitoring would begin prior to transition processes being implemented and continue for some time after transition has been completed. As no set of indicators will be applicable across all types of health program transitions, we instead propose guiding questions and illustrative quantitative and qualitative indicators to be considered and adapted based on the transition domains identified as most important to the particular health program transition. The M&E of transition faces new and unique challenges, requiring measuring constructs to which evaluators may not be accustomed. Many domains hinge on measuring “intangibles” such as the management of relationships. Monitoring these constructs may require a compromise between rigorous data collection and the involvement of key stakeholders. Conclusion: Monitoring and evaluating transitions in global health programs can bring conceptual clarity to the transition process, provide a mechanism for accountability, facilitate engagement with local stakeholders, and inform the management of transition through learning. Further investment and stronger methodological work are needed. PMID:26681706

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2015-07-01

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

Global change impact on water resources at the regional scale - a reflection on participatory modeling

NASA Astrophysics Data System (ADS)

Barthel, Roland; Büttner, Hannah; Nickel, Darla; Seidl, Roman

2015-04-01

Participatory modeling (PM) has become an essential part of environmental impact assessment and planning in the field of water resources research and management. This is mainly because of the notion that models developed by scientists for scientific purposes are often not suitable for practical management for several reasons, such as (too) high complexity, low user-friendliness and lack of problem/solution orientation. Participation is seen as a key concept for bridging the gap between modelers and stakeholders. In this submission we focus on the PM-process in the GLOWA-Danube (GD) project (German Ministry of Education and Research, 2001-2011). GD was carried out by an interdisciplinary consortium of 17 research organizations. The main goal was to develop and to use the integrated modelling system DANUBIA as a tool to evaluate the impact of global change on the Upper Danube Catchment (Southern Germany, 77,000 km^2) and to discuss the implications with relevant stakeholders. An intensive stakeholder dialoged was carried out to include the perspective of stakeholders and end-users in the model and scenario development - with the final goal of facilitating implementation of DANUBIA in practical management after termination of the scientific project. This contribution looks at the specific conditions for PM in the field of global change scenarios and complex integrated models. The different phases of the PM process in GD are presented along with a discussion of the respective results. Overall, the impact of stakeholder interaction on the model development was much lower than expected. The ultimate goal of using the PM process to develop DANUBIA as a tool used in practical management after termination of the scientific project was not reached. However, implications of climate change and modelling could be discussed with the stakeholders involved and relevant learning processes on both sides (scientists and stakeholders) were facilitated in the final phase. In the discussion we therefore focus on the following three questions: • Can a stakeholder dialogue be successfully used to support the development of new, complex modelling systems, in particular at the regional scale? • What is the right timing for stakeholder interaction in the case of unclear problem definition - i.e. global (climate) change impact on regions where climate is not (yet) a threat to water or land use related demands and activities? • To what degree can scientists be motivated to carry out participatory research at all? We conclude that the PM process in GD was only partly successful because the project set overambitious goals, including the application of fundamentally new approaches to interdisciplinary science, the use of new modelling technologies, the focus upon and evaluation of potential and therefore characteristically uncertain future problems, including stakeholder demands, and the development of a ready-to-use, user-friendly tool. Furthermore, GD also showed that an externally and professionally moderated stakeholder dialogue is an absolute necessity to achieve successful participation of stakeholders in model development. The modelers themselves neither had the time, the skills and the ambitions to do this. Furthermore, there is a lack of incentives for scientists, particularly natural scientists, to commit to PM activities. Given the fact that the outcomes of PM are supposed to be relevant for societal decision making, this issue needs further attention.

Opportunities and challenges in developing a whole-of-government national food and nutrition policy: lessons from Australia's National Food Plan.

PubMed

Carey, Rachel; Caraher, Martin; Lawrence, Mark; Friel, Sharon

2016-01-01

The present article tracks the development of the Australian National Food Plan as a 'whole of government' food policy that aimed to integrate elements of nutrition and sustainability alongside economic objectives. The article uses policy analysis to explore the processes of consultation and stakeholder involvement in the development of the National Food Plan, focusing on actors from the sectors of industry, civil society and government. Existing documentation and submissions to the Plan were used as data sources. Models of health policy analysis and policy streams were employed to analyse policy development processes. Australia. Australian food policy stakeholders. The development of the Plan was influenced by powerful industry groups and stakeholder engagement by the lead ministry favoured the involvement of actors representing the food and agriculture industries. Public health nutrition and civil society relied on traditional methods of policy influence, and the public health nutrition movement failed to develop a unified cross-sector alliance, while the private sector engaged in different ways and presented a united front. The National Food Plan failed to deliver an integrated food policy for Australia. Nutrition and sustainability were effectively sidelined due to the focus on global food production and positioning Australia as a food 'superpower' that could take advantage of the anticipated 'dining boom' as incomes rose in the Asia-Pacific region. New forms of industry influence are emerging in the food policy arena and public health nutrition will need to adopt new approaches to influencing public policy.

Involving the public in epidemiological public health research: a qualitative study of public and stakeholder involvement in evaluation of a population-wide natural policy experiment

PubMed Central

Nylén, Lotta; Burström, Bo; Whitehead, Margaret

2018-01-01

Background Public involvement in research is considered good practice by European funders; however, evidence of its research impact is sparse, particularly in relation to large-scale epidemiological research. Objectives To explore what difference public and stakeholder involvement made to the interpretation of findings from an evaluation of a natural policy experiment to influence the wider social determinants of health: ‘Flexicurity’. Setting Stockholm County, Sweden. Participants Members of the public from different occupational groups represented by blue-collar and white-collar trade union representatives. Also, members of three stakeholder groups: the Swedish national employment agency; an employers’ association and politicians sitting on a national labour market committee. Total: 17 participants. Methods Qualitative study of process and outcomes of public and stakeholder participation in four focused workshops on the interpretation of initial findings from the flexicurity evaluation. Outcome measures New insights from participants benefiting the interpretation of our research findings or conceptualisation of future research. Results Participants sensed more drastic and nuanced change in the Swedish welfare system over recent decades than was evident from our literature reviews and policy analysis. They also elaborated hidden developments in the Swedish labour market that were increasingly leading to ‘insiders’ and ‘outsiders’, with differing experiences and consequences for financial and job security. Their explanation of the differential effects of the various collective agreements for different occupational groups was new and raised further potential research questions. Their first-hand experience provided new insights into how changes to the social protection system were contributing to the increasing trends in poverty among unemployed people with limiting long-standing illness. The politicians provided further reasoning behind some of the policy changes and their intended and unintended consequences. These insights fed into subsequent reporting of the flexicurity evaluation results, as well as the conceptualisation of new research that could be pursued in a future programme. PMID:29678973

‘But is it a question worth asking?’ A reflective case study describing how public involvement can lead to researchers’ ideas being abandoned

PubMed Central

Boote, Jonathan D.; Dalgleish, Mary; Freeman, Janet; Jones, Zena; Miles, Marianne; Rodgers, Helen

2012-01-01

Abstract Background  It is good practice for the public to be involved in developing research ideas into grant applications. Some positive accounts of this process have been published, but little is known about when their reactions are negative and when researchers’ ideas are abandoned. Objective  To present a case study account of when an academic‐led idea for funding was not supported by stroke survivors and carers who were asked to contribute to its development, together with a reflection on the implications of the case from all the stakeholders involved. Design  A reflective case study of a research idea, developed by an academic researcher, on which stakeholders were consulted. Participants  University researchers, clinicians, public involvement managers, and stroke survivors and carers from the NIHR’s Stroke Research Network. Findings  Although the idea met with the approval of health professionals, who were keen to develop it into a funding bid, the stroke survivors and carers did not think the idea worth pursuing. This lack of patient and carer support led to the idea being abandoned. Reflecting on this, those involved in the consultation believed that the savings accrued from abandoning the idea, in terms of ensuring that public money is not wasted, should be seen as an important benefit of public involvement in the research process. Conclusion  Little is known about the role of the public in the abandonment of research ideas. We recommend that further research is undertaken into this important contribution that patients and the public can make to health research. PMID:22646745

Stakeholder challenges in purchasing medical devices for patient safety.

PubMed

Hinrichs, Saba; Dickerson, Terry; Clarkson, John

2013-03-01

This study identifies the stakeholders who have a role in medical device purchasing within the wider system of health-care delivery and reports on their particular challenges to promote patient safety during purchasing decisions. Data was collected through observational work, participatory workshops, and semi-structured qualitative interviews, which were analyzed and coded. The study takes a systems-based and engineering design approach to the study. Five hospitals took part in this study, and the participants included maintenance, training, clinical end-users, finance, and risk departments. The main stakeholders for purchasing were identified to be staff from clinical engineering (Maintenance), device users (Clinical), device trainers (Training), and clinical governance for analyzing incidents involving devices (Risk). These stakeholders display varied characteristics in terms of interpretation of their own roles, competencies for selecting devices, awareness and use of resources for purchasing devices, and attitudes toward the purchasing process. The role of "clinical engineering" is seen by these stakeholders to be critical in mediating between training, technical, and financial stakeholders but not always recognized in practice. The findings show that many device purchasing decisions are tackled in isolation, which is not optimal for decisions requiring knowledge that is currently distributed among different people within different departments. The challenges expressed relate to the wider system of care and equipment management, calling for a more systemic view of purchasing for medical devices.

Stakeholders identify similar barriers but different strategies to facilitate return-to-work: A vignette of a worker with an upper extremity condition.

PubMed

Peters, Susan E; Truong, Anthony P; Johnston, Venerina

2018-01-01

Stakeholders involved in the return-to-work (RTW) process have different roles and qualificationsOBJECTIVE:To explore the perspectives of Australian stakeholders of the RTW barriers and strategies for a worker with an upper extremity condition and a complex workers' compensation case. Using a case vignette, stakeholders were asked to identify barriers and recommend strategies to facilitate RTW. Content analysis was performed on the open-ended responses. The responses were categorised into RTW barriers and strategies using the biopsychosocial model. Pearson's Chi Square and ANOVA were performed to establish group differences. 621 participants (488 healthcare providers (HCPs), 62 employers, 55 insurers and 16 lawyers) identified 36 barriers (31 modifiable): 4 demographic; 8 biological; 15 psychological and 9 social barriers. 484 participants reported 16 RTW strategies: 4 biological; 6 psychological and 6 social strategies. 'Work relationship stressors' (83.4%) and 'Personal relationship stressors' (64.7%) were the most frequently nominated barriers. HCPs most frequently nominated 'Pain management' (49.6%), while employers, insurers and lawyers nominated 'RTW planning/Suitable duties programs' (40.5%; 42.9%; 80%). Stakeholders perceived similar barriers for RTW but recommended different strategies. Stakeholders appeared to be more proficient in identifying barriers than recommending strategies. Future research should focus on tools to both identify RTW barriers and direct intervention.

Towards a new definition of return-to-work outcomes in common mental disorders from a multi-stakeholder perspective.

PubMed

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

2012-01-01

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). 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. 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. 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.

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

PubMed

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

2015-10-01

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

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.

Curriculum Redesign in Veterinary Medicine: Part I.

PubMed

Chaney, Kristin P; Macik, Maria L; Turner, Jacqueline S; Korich, Jodi A; Rogers, Kenita S; Fowler, Debra; Scallan, Elizabeth M; Keefe, Lisa M

Curricular review is considered a necessary component for growth and enhancement of academic programs and requires time, energy, creativity, and persistence from both faculty and administration. At Texas A&M College of Veterinary Medicine & Biomedical Sciences (TAMU), the faculty and administration partnered with the university's Center for Teaching Excellence to create a faculty-driven, data-enhanced curricular redesign process. The 8-step process begins with the formation of a dedicated faculty curriculum design team to drive the redesign process and to support the college curriculum committee. The next steps include defining graduate outcomes and mapping the current curriculum to identify gaps and redundancies across the curriculum. Data are collected from internal and external stakeholders including veterinary students, faculty, alumni, and employers of graduates. Data collected through curriculum mapping and stakeholder engagement substantiate the curriculum redesign. The guidelines, supporting documents, and 8-step process developed at TAMU are provided to assist other veterinary schools in successful curricular redesign. This is the first of a two-part report that provides the background, context, and description of the process for charting the course for curricular change. The process involves defining expected learning outcomes for new graduates, conducting a curriculum mapping exercise, and collecting stakeholder data for curricular evaluation (steps 1-4). The second part of the report describes the development of rubrics that were applied to the graduate learning outcomes (steps 5-8) and engagement of faculty during the implementation phases of data-driven curriculum change.

Safeguarding Cultural Heritage against Climate Change and Natural Hazards through Stakeholder Involvement

NASA Astrophysics Data System (ADS)

de Wit, Rosmarie; Zuvela-Aloise, Maja; Hollosi, Brigitta; Anders, Ivonne; Höfler, Angelika; Boi, Silvia; Resta, Vanni; Patrikakis, Charalampos

2017-04-01

Europe's cultural heritage is among the richest in the world, and draws millions of visitors to archeological sites, museums, monuments, castles, and other sites each year. The protection and conservation of European heritage is of utmost importance for our society, not only in order to preserve the European cultural identity, but also because cultural heritage is a wealth creator bringing tourism-related business opportunities on which many communities depend. However, Europe's heritage assets are extremely exposed to climate change and natural hazards, which threatens their integrity and may compromise their value. The goal of the STORM (Safeguarding Cultural Heritage through Technical and Organisational Management) project is to provide critical decision-making tools to European cultural heritage stakeholders affected by climate change and natural hazards. Here, the STORM project will be presented with a focus on climate change and natural hazard risk communication to the involved stakeholders. However, climate change communication is not a one-way process, and discussions with stakeholders are necessary to identify their specific needs. Hence, the STORM concept is tested through pilot site studies in five different countries: the Diocletian Baths in Rome, Italy; the Mellor Heritage site, Manchester, UK; the Roman Ruins of Tróia, Portugal; the Historical Centre of Rethymno on Crete, Greece and Ephesus, Izmir, Turkey. Furthermore, the past and future climatic conditions at the project's pilot sites are analysed in terms of mean state and extreme events (for example temperature and precipitation changes evident from observations and climate scenarios), which will be discussed with regard to their relevance for the local cultural heritage protection based on discussions with the stakeholders.

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

DOT National Transportation Integrated Search

2011-12-01

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

Research Stakeholders’ Views on Benefits and Challenges for Public Health Research Data Sharing in Kenya: The Importance of Trust and Social Relations

PubMed Central

Jao, Irene; Kombe, Francis; Mwalukore, Salim; Bull, Susan; Parker, Michael; Kamuya, Dorcas; Molyneux, Sassy; Marsh, Vicki

2015-01-01

Background There is increasing recognition of the importance of sharing research data within the international scientific community, but also of the ethical and social challenges this presents, particularly in the context of structural inequities and varied capacity in international research. Public involvement is essential to building locally responsive research policies, including on data sharing, but little research has involved stakeholders from low-to-middle income countries. Methods Between January and June 2014, a qualitative study was conducted in Kenya involving sixty stakeholders with varying experiences of research in a deliberative process to explore views on benefits and challenges in research data sharing. In-depth interviews and extended small group discussions based on information sharing and facilitated debate were used to collect data. Data were analysed using Framework Analysis, and charting flow and dynamics in debates. Findings The findings highlight both the opportunities and challenges of communicating about this complex and relatively novel topic for many stakeholders. For more and less research-experienced stakeholders, ethical research data sharing is likely to rest on the development and implementation of appropriate trust-building processes, linked to local perceptions of benefits and challenges. The central nature of trust is underpinned by uncertainties around who might request what data, for what purpose and when. Key benefits perceived in this consultation were concerned with the promotion of public health through science, with legitimate beneficiaries defined differently by different groups. Important challenges were risks to the interests of study participants, communities and originating researchers through stigmatisation, loss of privacy, impacting autonomy and unfair competition, including through forms of intentional and unintentional 'misuse' of data. Risks were also seen for science. Discussion Given background structural inequities in much international research, building trust in this low-to-middle income setting includes ensuring that the interests of study participants, primary communities and originating researchers will be promoted as far as possible, as well as protected. Important ways of building trust in data sharing include involving the public in policy development and implementation, promoting scientific collaborations around data sharing and building close partnerships between researchers and government health authorities to provide checks and balances on data sharing, and promote near and long-term translational benefits. PMID:26331716

Towards an Approach for an Accessible and Inclusive Virtual Education Using ESVI-AL Project Results

ERIC Educational Resources Information Center

Amado-Salvatierra, Hector R.; Hilera, Jose R.

2015-01-01

Purpose: This paper aims to present an approach to achieve accessible and inclusive Virtual Education for all, but especially intended for students with disabilities. This work proposes main steps to take into consideration for stakeholders involved in the educational process related to an inclusive e-Learning. Design/methodology/approach: The…

Promoting Inclusive Practices in Primary Schools in Cyprus: Empowering Pupils to Build Supportive Networks

ERIC Educational Resources Information Center

Nicolaidou, Maria; Sophocleous, Antreas; Phtiaka, Helen

2006-01-01

Having ownership of a dream is a core element for school improvement and effectiveness. Believing in the effectiveness of a programme is the beginning of reviving a school's internal capacities for improvement. Any improvement and development programme needs to be inviting and non-threatening, a holistic process involving all stakeholders. In this…

Towards an Interdisciplinary Model of Practice for Participatory Building Design in Education

ERIC Educational Resources Information Center

Könings, Karen D.; Bovill, Catherine; Woolner, Pamela

2017-01-01

It is recognised that educational environments influence learning experiences, so it is important to ensure that educational buildings are designed to be fit for purpose. In order to ensure that educational buildings meet the needs of those who use them, all relevant stakeholders should be involved in the design process. However, this is not…

Using Problem-Based Case Studies to Learn about Knowledge Translation Interventions: An Inside Perspective

ERIC Educational Resources Information Center

Bhogal, Sanjit K.; Murray, Mary Ann; McLeod, Katherine M.; Bergen, Anne; Bath, Brenna; Menon, Anita; Kho, Michelle E.; Stacey, Dawn

2011-01-01

Knowledge translation (KT) interventions can facilitate the successful implementation of best practices by engaging and actively involving various stakeholders in the change process. However, for novices, the design of KT interventions can be overwhelming. In this article, we describe our experience as participants in a problem-based case study on…

Library Spaces for 21st-Century Learners: A Planning Guide for Creating New School Library Concepts

ERIC Educational Resources Information Center

Sullivan, Margaret

2013-01-01

"Library Spaces for 21st-Century Learners: A Planning Guide for Creating New School Library Concepts" focuses on planning contemporary school library spaces with user-based design strategies. The book walks school librarians and administrators through the process of gathering information from students and other stakeholders involved in…

Design Thinking: A Process for Developing and Implementing Lasting District Reform. Knowledge Brief

ERIC Educational Resources Information Center

Rice, Erik

2011-01-01

Traditionally, challenges such as how to sustain district reform, how to build a leadership pipeline, how to create an integrated project, or how to best intervene with struggling students would be resolved with a team of "experts" developing a solution in isolation of the stakeholders involved. By contrast, design thinking centers on the…

Beyond Resistance: Exploring Health Managers' Propensity for Participatory Evaluation in a Developing Country

ERIC Educational Resources Information Center

Smits, Pernelle A.; Champagne, Francois; Farand, Lambert

2012-01-01

The evaluation of interventions is becoming increasing common and now often seeks to involve managers in the process. Such practical participatory evaluation (PPE) aims to increase the use of evaluation results through the participation of stakeholders. This study focuses on the propensity of health managers for PPE, as measured through the…

Participatory Governance in Secondary Schools: The Students' Viewpoint in Eastern Region of Kenya

ERIC Educational Resources Information Center

Mulwa, David M.; Kimosop, Maurice K.; Kasivu, Gedion M.

2015-01-01

The purpose of the study was to determine the students' view on participatory school governance in secondary schools of the Eastern region, Kenya. Participatory school governance implies the involvement of stakeholders in the decision making process in schools. The objectives of the study were to identify the key decision makers in selected…

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

PubMed

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

2018-04-01

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

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

PubMed

Grygoruk, Mateusz; Rannow, Sven

2017-01-15

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

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

PubMed

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

2016-08-17

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

How can we make progress with decision support systems in landscape and river basin management? Lessons learned from a comparative analysis of four different decision support systems.

PubMed

Volk, Martin; Lautenbach, Sven; van Delden, Hedwig; Newham, Lachlan T H; Seppelt, Ralf

2010-12-01

This article analyses the benefits and shortcomings of the recently developed decision support systems (DSS) FLUMAGIS, Elbe-DSS, CatchMODS, and MedAction. The analysis elaborates on the following aspects: (i) application area/decision problem, (ii) stakeholder interaction/users involved, (iii) structure of DSS/model structure, (iv) usage of the DSS, and finally (v) most important shortcomings. On the basis of this analysis, we formulate four criteria that we consider essential for the successful use of DSS in landscape and river basin management. The criteria relate to (i) system quality, (ii) user support and user training, (iii) perceived usefulness and (iv) user satisfaction. We can show that the availability of tools and technologies for DSS in landscape and river basin management is good to excellent. However, our investigations indicate that several problems have to be tackled. First of all, data availability and homogenisation, uncertainty analysis and uncertainty propagation and problems with model integration require further attention. Furthermore, the appropriate and methodological stakeholder interaction and the definition of 'what end-users really need and want' have been documented as general shortcomings of all four examples of DSS. Thus, we propose an iterative development process that enables social learning of the different groups involved in the development process, because it is easier to design a DSS for a group of stakeholders who actively participate in an iterative process. We also identify two important lines of further development in DSS: the use of interactive visualization tools and the methodology of optimization to inform scenario elaboration and evaluate trade-offs among environmental measures and management alternatives.

How Can We Make Progress with Decision Support Systems in Landscape and River Basin Management? Lessons Learned from a Comparative Analysis of Four Different Decision Support Systems

NASA Astrophysics Data System (ADS)

Volk, Martin; Lautenbach, Sven; van Delden, Hedwig; Newham, Lachlan T. H.; Seppelt, Ralf

2010-12-01

This article analyses the benefits and shortcomings of the recently developed decision support systems (DSS) FLUMAGIS, Elbe-DSS, CatchMODS, and MedAction. The analysis elaborates on the following aspects: (i) application area/decision problem, (ii) stakeholder interaction/users involved, (iii) structure of DSS/model structure, (iv) usage of the DSS, and finally (v) most important shortcomings. On the basis of this analysis, we formulate four criteria that we consider essential for the successful use of DSS in landscape and river basin management. The criteria relate to (i) system quality, (ii) user support and user training, (iii) perceived usefulness and (iv) user satisfaction. We can show that the availability of tools and technologies for DSS in landscape and river basin management is good to excellent. However, our investigations indicate that several problems have to be tackled. First of all, data availability and homogenisation, uncertainty analysis and uncertainty propagation and problems with model integration require further attention. Furthermore, the appropriate and methodological stakeholder interaction and the definition of `what end-users really need and want' have been documented as general shortcomings of all four examples of DSS. Thus, we propose an iterative development process that enables social learning of the different groups involved in the development process, because it is easier to design a DSS for a group of stakeholders who actively participate in an iterative process. We also identify two important lines of further development in DSS: the use of interactive visualization tools and the methodology of optimization to inform scenario elaboration and evaluate trade-offs among environmental measures and management alternatives.

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

PubMed

Popa, Adela Elena

2014-01-01

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

Decision-making and evidence use during the process of prenatal record review in Canada: a multiphase qualitative study.

PubMed

Semenic, Sonia; Edwards, Nancy; Premji, Shahirose; Olson, Joanne; Williams, Beverly; Montgomery, Phyllis

2015-03-31

Prenatal records are potentially powerful tools for the translation of best-practice evidence into routine prenatal care. Although all jurisdictions in Canada use standardized prenatal records to guide care and provide data for health surveillance, their content related to risk factors such as maternal smoking and alcohol use varies widely. Literature is lacking on how prenatal records are developed or updated to integrate research evidence. This multiphase project aimed to identify key contextual factors influencing decision-making and evidence use among Canadian prenatal record committees (PRCs), and formulate recommendations for the prenatal record review process in Canada. Phase 1 comprised key informant interviews with PRC leaders across 10 Canadian jurisdictions. Phase 2, was a qualitative comparative case study of PRC factors influencing evidence-use and decision-making in five selected jurisdictions. Interview data were analysed using qualitative content analysis. Phase 3 involved a dissemination workshop with key stakeholders to review and refine recommendations derived from Phases 1 and 2. Prenatal record review processes differed considerably across Canadian jurisdictions. PRC decision-making was complex, revealing the competing functions of the prenatal record as a clinical guide, documentation tool and data source. Internal contextual factors influencing evidence use included PRC resources to conduct evidence reviews; group composition and dynamics; perceived function of the prenatal record; and expert opinions. External contextual factors included concerns about user buy-in; health system capacities; and pressures from public health stakeholders. Our recommendations highlight the need for: broader stakeholder involvement and explicit use of decision-support strategies to support the revision process; a national template of evidence-informed changes that can be used across jurisdictions; consideration of both clinical and surveillance functions of the prenatal record; and dissemination plans to communicate prenatal record modifications. Decision-making related to prenatal record content involves a negotiated effort to balance research evidence with the needs and preferences of prenatal care providers, health system capacities as well as population health priorities. The development of a national template for prenatal records would reduce unnecessary duplication of PRC work and enhance the consistency of prenatal care delivery and perinatal surveillance data across Canada.

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

PubMed

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

2010-08-31

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

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

PubMed Central

2010-01-01

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

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

PubMed Central

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

2015-01-01

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

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

PubMed

Duke, Karen; Thom, Betsy

2014-09-01

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

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

PubMed

Aakhus, Mark

2011-11-01

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

A conceptual framework for negotiating public involvement in municipal waste management decision-making in the UK.

PubMed

Garnett, Kenisha; Cooper, Tim; Longhurst, Philip; Jude, Simon; Tyrrel, Sean

2017-08-01

The technical expertise that politicians relied on in the past to produce cost-effective and environmentally sound solutions no longer provides sufficient justification to approve waste facilities. Local authorities need to find more effective ways to involve stakeholders and communities in decision-making since public acceptance of municipal waste facilities is integral to delivering effective waste strategies. This paper presents findings from a research project that explored attitudes towards greater levels of public involvement in UK waste management decision-making. The study addressed questions of perception, interests, the decision context, the means of engagement and the necessary resources and capacity for adopting a participatory decision process. Adopting a mixed methods approach, the research produced an empirical framework for negotiating the mode and level of public involvement in waste management decision-making. The framework captures and builds on theories of public involvement and the experiences of practitioners, and offers guidance for integrating analysis and deliberation with public groups in different waste management decision contexts. Principles in the framework operate on the premise that the decision about 'more' and 'better' forms of public involvement can be negotiated, based on the nature of the waste problem and wider social context of decision-making. The collection of opinions from the wide range of stakeholders involved in the study has produced new insights for the design of public engagement processes that are context-dependent and 'fit-for-purpose'; these suggest a need for greater inclusivity in the case of contentious technologies and high levels of uncertainty regarding decision outcomes. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

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

PubMed

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

2014-07-01

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

Ethics, economics and the regulation and adoption of new medical devices: case studies in pelvic floor surgery

PubMed Central

2010-01-01

Background Concern has been growing in the academic literature and popular media about the licensing, introduction and adoption of surgical devices before full effectiveness and safety evidence is available to inform clinical practice. Our research will seek empirical survey evidence about the roles, responsibilities, and information and policy needs of the key stakeholders in the introduction into clinical practice of new surgical devices for pelvic floor surgery, in terms of the underlying ethical principals involved in the economic decision-making process, using the example of pelvic floor procedures. Methods/Design Our study involves three linked case studies using, as examples, selected pelvic floor surgery devices representing Health Canada device safety risk classes: low, medium and high risk. Data collection will focus on stakeholder roles and responsibilities, information and policy needs, and perceptions of those of other key stakeholders, in seeking and using evidence about new surgical devices when licensing and adopting them into practice. For each class of device, interviews will be used to seek the opinions of stakeholders. The following stakeholders and ethical and economic principles provide the theoretical framework for the study: Stakeholders - federal regulatory body, device manufacturers, clinicians, patients, health care institutions, provincial health departments, and professional societies. Clinical settings in two centres (in different provinces) will be included. Ethics - beneficence, non-maleficence, autonomy, justice. Economics - scarcity of resources, choices, opportunity costs. For each class of device, responses will be analysed to compare and contrast between stakeholders. Applied ethics and economic theory, analysis and critical interpretation will be used to further illuminate the case study material. Discussion The significance of our research in this new area of ethics will lie in providing recommendations for regulatory bodies, device manufacturers, clinicians, health care institutions, policy makers and professional societies, to ensure surgical patients receive sufficient information before providing consent for pelvic floor surgery. In addition, we shall provide a wealth of information for future study in other areas of surgery and clinical management, and provide suggestions for changes to health policy. PMID:20738887

Stakeholder involvement in establishing a milk quality sub-index in dairy cow breeding goals: a Delphi approach.

PubMed

Henchion, M; McCarthy, M; Resconi, V C; Berry, D P; McParland, S

2016-05-01

The relative weighting on traits within breeding goals are generally determined by bio-economic models or profit functions. While such methods have generally delivered profitability gains to producers, and are being expanded to consider non-market values, current approaches generally do not consider the numerous and diverse stakeholders that affect, or are affected, by such tools. Based on principles of respondent anonymity, iteration, controlled feedback and statistical aggregation of feedback, a Delphi study was undertaken to gauge stakeholder opinion of the importance of detailed milk quality traits within an overall dairy breeding goal for profit, with the aim of assessing its suitability as a complementary, participatory approach to defining breeding goals. The questionnaires used over two survey rounds asked stakeholders: (a) their opinion on incorporating an explicit sub-index for milk quality into a national breeding goal; (b) the importance they would assign to a pre-determined list of milk quality traits and (c) the (relative) weighting they would give such a milk quality sub-index. Results from the survey highlighted a good degree of consensus among stakeholders on the issues raised. Similarly, revelation of the underlying assumptions and knowledge used by stakeholders to make their judgements illustrated their ability to consider a range of perspectives when evaluating traits, and to reconsider their answers based on the responses and rationales given by others, which demonstrated social learning. Finally, while the relative importance assigned by stakeholders in the Delphi survey (4% to 10%) and the results of calculations based on selection index theory of the relative emphasis that should be placed on milk quality to halt any deterioration (16%) are broadly in line, the difference indicates the benefit of considering more than one approach to determining breeding goals. This study thus illustrates the role of the Delphi technique, as a complementary approach to traditional approaches, to defining breeding goals. This has implications for how breeding goals will be defined and in determining who should be involved in the decision-making process.

Business analysis for a sustainable, multi-stakeholder ecosystem for leveraging the Electronic Health Records for Clinical Research (EHR4CR) platform in Europe.

PubMed

Dupont, Danielle; Beresniak, Ariel; Sundgren, Mats; Schmidt, Andreas; Ainsworth, John; Coorevits, Pascal; Kalra, Dipak; Dewispelaere, Marc; De Moor, Georges

2017-01-01

The Electronic Health Records for Clinical Research (EHR4CR) technological platform has been developed to enable the trustworthy reuse of hospital electronic health records data for clinical research. The EHR4CR platform can enhance and speed up clinical research scenarios: protocol feasibility assessment, patient identification for recruitment in clinical trials, and clinical data exchange, including for reporting serious adverse events. Our objective was to seed a multi-stakeholder ecosystem to enable the scalable exploitation of the EHR4CR platform in Europe, and to assess its economic sustainability. Market analyses were conducted by a multidisciplinary task force to define an EHR4CR emerging ecosystem and multi-stakeholder value chain. This involved mapping stakeholder groups and defining their unmet needs, incentives, potential barriers for adopting innovative solutions, roles and interdependencies. A comprehensive business model, value propositions, and sustainability strategies were developed accordingly. Using simulation modelling (including Monte Carlo simulations) and a 5-year horizon, the potential financial outcomes of the business model were forecasted from the perspective of an EHR4CR service provider. A business ecosystem was defined to leverage the EHR4CR multi-stakeholder value chain. Value propositions were developed describing the expected benefits of EHR4CR solutions for all stakeholders. From an EHR4CR service provider's viewpoint, the business model simulation estimated that a profitability ratio of up to 1.8 could be achieved at year 1, with potential for growth in subsequent years depending on projected market uptake. By enhancing and speeding up existing processes, EHR4CR solutions promise to transform the clinical research landscape. The ecosystem defined provides the organisational framework for optimising the value and benefits for all stakeholders involved, in a sustainable manner. Our study suggests that the exploitation of EHR4CR solutions appears profitable and sustainable in Europe, with a growth potential depending on the rates of market and hospital adoption. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Ethics, economics and the regulation and adoption of new medical devices: case studies in pelvic floor surgery.

PubMed

Ross, Sue; Weijer, Charles; Gafni, Amiram; Ducey, Ariel; Thompson, Carmen; Lafreniere, Rene

2010-08-26

Concern has been growing in the academic literature and popular media about the licensing, introduction and adoption of surgical devices before full effectiveness and safety evidence is available to inform clinical practice. Our research will seek empirical survey evidence about the roles, responsibilities, and information and policy needs of the key stakeholders in the introduction into clinical practice of new surgical devices for pelvic floor surgery, in terms of the underlying ethical principals involved in the economic decision-making process, using the example of pelvic floor procedures. Our study involves three linked case studies using, as examples, selected pelvic floor surgery devices representing Health Canada device safety risk classes: low, medium and high risk. Data collection will focus on stakeholder roles and responsibilities, information and policy needs, and perceptions of those of other key stakeholders, in seeking and using evidence about new surgical devices when licensing and adopting them into practice. For each class of device, interviews will be used to seek the opinions of stakeholders. The following stakeholders and ethical and economic principles provide the theoretical framework for the study: Stakeholders--federal regulatory body, device manufacturers, clinicians, patients, health care institutions, provincial health departments, and professional societies. Clinical settings in two centres (in different provinces) will be included. Ethics--beneficence, non-maleficence, autonomy, justice. Economics--scarcity of resources, choices, opportunity costs.For each class of device, responses will be analysed to compare and contrast between stakeholders. Applied ethics and economic theory, analysis and critical interpretation will be used to further illuminate the case study material. The significance of our research in this new area of ethics will lie in providing recommendations for regulatory bodies, device manufacturers, clinicians, health care institutions, policy makers and professional societies, to ensure surgical patients receive sufficient information before providing consent for pelvic floor surgery. In addition, we shall provide a wealth of information for future study in other areas of surgery and clinical management, and provide suggestions for changes to health policy.

Food Service Perspectives on National School Lunch Program Implementation.

PubMed

Tabak, Rachel G; Moreland-Russell, Sarah

2015-09-01

Explore barriers and facilitators to implementation of the new National School Lunch Program (NSLP) policy guidelines. Interviews with eight food service directors using an interview guide informed by the Consolidated Framework for Implementation Research. Food service personnel; parents, teachers, school staff; and students were important stakeholders. Characteristics of the new NSLP policy guidelines were reported to create increased demands; resources alleviated some barriers. Directors reported increased food and labor costs, food sourcing challenges, decreased student participation, and organizational constraints as barriers to implementation. Creativity in menu planning facilitated success. Factors within the food service department, characteristics of implementing individuals and the new NSLP policy guidelines, and stakeholder involvement in the implementation process relate to successful implementation.

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.

Stakeholder Relationships in Higher Education

ERIC Educational Resources Information Center

Kettunen, Juha

2015-01-01

The purpose of this study is to develop a stakeholder map to describe the most important stakeholders and the process of stakeholder relationships in higher education. According to the perspective of the balanced scorecard, the classification of stakeholders integrates stakeholders into strategic management. Stakeholder maps are essential in…

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.

A method to assess how interactive water simulation tools influence transdisciplinary decision-making processes in water management

NASA Astrophysics Data System (ADS)

Leskens, Johannes

2015-04-01

In modern water management, often transdisciplinary work sessions are organized in which various stakeholders participate to jointly define problems, choose measures and divide responsibilities to take actions. Involved stakeholders are for example policy analysts or decision-makers from municipalities, water boards or provinces, representatives of pressure groups and researchers from knowledge institutes. Parallel to this increasing attention for transdisciplinary work sessions, we see a growing availability of interactive IT-tools that can be applied during these sessions. For example, dynamic flood risk maps have become recently available that allow users during a work sessions to instantaneously assess the impact of storm surges or dam breaches, displayed on digital maps. Other examples are serious games, realistic visualizations and participatory simulations. However, the question is if and how these interactive IT-tools contribute to better decision-making. To assess this, we take the process of knowledge construction during a work session as a measure for the quality of decision-making. Knowledge construction can be defined as the process in which ideas, perspectives and opinions of different stakeholders, all having their own expertise and experience, are confronted with each other and new shared meanings towards water management issues are created. We present an assessment method to monitor the process of knowledge construction during work sessions in water management in which interactive IT tools are being used. The assessment method is based on a literature review, focusing on studies in which knowledge construction was monitored in other contexts that water management. To test the applicability of the assessment method, we applied it during a multi-stakeholder work session in Westland, located in the southwest of the Netherlands. The discussions during the work session were observed by camera. All statements, expressed by the various members of a stakeholder session, were classified according to our assessment method. We can draw the following preliminary conclusions. First, the case study showed that the method was useful to show the knowledge construction process over time, in terms of content and cognitive level of statements and interaction, attention and response between stakeholders. It was observed that the various aspects of knowledge construction all were influenced by the use of the 3Di model. The model focused discussions on technical issues of flood risk management, non-flood specialists were able to participate in discussions and in suggesting solutions and more topics could be evaluated in respect to non-interactive flood maps. Second, the method is considered useful as a benchmark for different interactive IT tools. The method is also considered useful to gain insight in how to optimally set-up multi-stakeholder meetings in which interactive IT-tools are being used. Further, the method can provide model developers insight in how to better meet the technical requirements of interactive IT tools to support the knowledge construction process during multi-stakeholder meeting

Developing an Integrative Treatment Program for Cancer-Related Fatigue Using Stakeholder Engagement - A Qualitative Study.

PubMed

Canella, Claudia; Mikolasek, Michael; Rostock, Matthias; Beyer, Jörg; Guckenberger, Matthias; Jenewein, Josef; Linka, Esther; Six, Claudia; Stoll, Sarah; Stupp, Roger; Witt, Claudia M

2017-11-01

Although cancer-related fatigue (CRF) has gained increased attention in the past decade, it remains difficult to treat. An integrative approach combining conventional and complementary medicine interventions seems highly promising. Treatment programs are more likely to be effective if the needs and interests of the people involved are well represented. This can be achieved through stakeholder engagement. The aim of the study was to develop an integrative CRF treatment program using stakeholder engagement and to compare it to an expert version. In a qualitative study, a total of 22 stakeholders (4 oncologists, 1 radiation-oncologist, 1 psycho-oncologist, 5 nurses/nurse experts, 9 patients, 1 patient family member, 1 representative of a local Swiss Cancer League) were interviewed either face-to-face or in a focus group setting. For data analysis, qualitative content analysis was used. With stakeholder engagement, the integrative CRF treatment program was adapted to usual care using a prioritizing approach and allowing more patient choice. Unlike the expert version, in which all intervention options were on the same level, the stakeholder engagement process resulted in a program with 3 different levels. The first level includes mandatory nonpharmacological interventions, the second includes nonpharmacological choice-based interventions, and the third includes pharmacological interventions for severe CRF. The resulting stakeholder based integrative CRF treatment program was implemented as clinical practice guideline at our clinic (Institute for Complementary and Integrative Medicine, University Hospital Zurich). Through the stakeholder engagement approach, we integrated the needs and preferences of people who are directly affected by CRF. This resulted in an integrative CRF treatment program with graded recommendations for interventions and therefore potentially greater sustainability in a usual care setting.

a Continual Engagement Approach Through Gis-Mcda Conflict Resolution of Loggerhead Sea Turtle Bycatch in Mexico

NASA Astrophysics Data System (ADS)

Bojórquez-Tapia, L. A.

2015-12-01

Continual engagement is an approach that emphasizes of uninterrupted interaction with the stakeholders with the purpose of fully integrating their knowledge into policymaking process. It focuses on the creation of hybrid scientific-local knowledge highly relevant to community and policy makers needs, while balancing the power asymmetries among stakeholders. Hence, it presupposes a capacity for a continuous revision and adjustment of the analyses that support the policymaking process. While continual engagement implies a capacity for enabling an effective communication, translation and mediation of knowledge among the diverse stakeholders, experts and policymakers, it also means keeping a close eye out for how knowledge evolves and how new data and information is introduced along a policymaking process. Through a case study, the loggerhead sea turtle (Caretta caretta) fishing bycatch in Mexico, a geographical information system-multicriteria modeling (GIS-MCDA) approach is presented to address the challenges of implementing continual engagement in conflict resolution processes. The GIS-MCDA combined the analytical hierarchy process (AHP) and compromise programming (CP) to generate consensus regarding the spatial pattern of conflicts. The AHP was fundamental for synthesizing the different sources of knowledge into a geospatial model. In particular, the AHP enabled the assess the salience, legitimacy, and credibility of the information produced for all involved. Results enabled the development of specific policies based upon an assessment of the risk of the loggerhead population to different levels of fishing bycatch, and the needs of the fishing communities in the region.

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

PubMed

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

2017-09-11

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

Facilitating Evaluations of Innovative, Competence-Based Assessments: Creating Understanding and Involving Multiple Stakeholders

ERIC Educational Resources Information Center

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

2010-01-01

Schools are held more responsible for evaluating, quality assuring and improving their student assessments. Teachers' lack of understanding of new, competence-based assessments as well as the lack of key stakeholders' involvement, hamper effective and efficient self-evaluations by teachers of innovative, competence-based assessments (CBAs). While…

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

ERIC Educational Resources Information Center

Wilkins, Stephen; Huisman, Jeroen

2015-01-01

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

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.

The PCORI Engagement Rubric: Promising Practices for Partnering in Research

PubMed Central

Sheridan, Susan; Schrandt, Suzanne; Forsythe, Laura; Hilliard, Tandrea S.; Paez, Kathryn A.

2017-01-01

PURPOSE Engaging patients, caregivers, and other health care stakeholders as partners in planning, conducting, and disseminating research is a promising way to improve clinical decision making and outcomes. Many researchers, patients, and other stakeholders, however, lack clarity about when and how to engage as partners within the clinical research process. To address the need for guidance on creating meaningful stakeholder partnerships in patient-centered clinical comparative effectiveness research, the Patient-Centered Outcomes Research Institute (PCORI) developed the PCORI Engagement Rubric (Rubric). METHODS PCORI developed the Rubric drawing from a synthesis of the literature, a qualitative study with patients, a targeted review of engagement plans from PCORI-funded project applications, and a moderated discussion and review with PCORI’s Advisory Panel on Patient Engagement. RESULTS The Rubric provides a framework for operationalizing engagement to incorporate patients and other stakeholders in all phases of research. It includes: principles of engagement; definitions of stakeholder types; key considerations for planning, conducting, and disseminating engaged research; potential engagement activities; and examples of promising practices from PCORI-funded projects. CONCLUSIONS PCORI designed the Rubric to illustrate opportunities for engagement to researchers interested in applying for PCORI funding and to patients and other stakeholders interested in greater involvement in research. By encouraging PCORI applicants, awardees, and others to apply the rubric, PCORI hopes to shift the research paradigm from one of conducting research on patients as subjects to a pursuit carried out in collaboration with patients and other stakeholders to better reflect the values, preferences, and outcomes that matter to the patient community. PMID:28289118

The PCORI Engagement Rubric: Promising Practices for Partnering in Research.

PubMed

Sheridan, Susan; Schrandt, Suzanne; Forsythe, Laura; Hilliard, Tandrea S; Paez, Kathryn A

2017-03-01

Engaging patients, caregivers, and other health care stakeholders as partners in planning, conducting, and disseminating research is a promising way to improve clinical decision making and outcomes. Many researchers, patients, and other stakeholders, however, lack clarity about when and how to engage as partners within the clinical research process. To address the need for guidance on creating meaningful stakeholder partnerships in patient-centered clinical comparative effectiveness research, the Patient-Centered Outcomes Research Institute (PCORI) developed the PCORI Engagement Rubric (Rubric). PCORI developed the Rubric drawing from a synthesis of the literature, a qualitative study with patients, a targeted review of engagement plans from PCORI-funded project applications, and a moderated discussion and review with PCORI's Advisory Panel on Patient Engagement. The Rubric provides a framework for operationalizing engagement to incorporate patients and other stakeholders in all phases of research. It includes: principles of engagement; definitions of stakeholder types; key considerations for planning, conducting, and disseminating engaged research; potential engagement activities; and examples of promising practices from PCORI-funded projects. PCORI designed the Rubric to illustrate opportunities for engagement to researchers interested in applying for PCORI funding and to patients and other stakeholders interested in greater involvement in research. By encouraging PCORI applicants, awardees, and others to apply the rubric, PCORI hopes to shift the research paradigm from one of conducting research on patients as subjects to a pursuit carried out in collaboration with patients and other stakeholders to better reflect the values, preferences, and outcomes that matter to the patient community. © 2017 Annals of Family Medicine, Inc.

A Web-Based Common Framework to Support the Test and Evaluation Process Any Time, Anywhere, and Anyhow

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

Schur, Anne; Brown, James C.; Eaton, Sharon L.

Test and evaluation (T and E) is an enterprise. For any product, large or small, performance data is desired on many aspects to evaluate the product?s effectiveness for the intended users. Representing the many T and E facets without bewildering the user is challenging when there is a range of people, from the system developers to the manager of the organization, that want specific feedback. A web-based One-Stop Evaluation Center was created to meet these needs for a particular project. The evaluation center is usable at any time in the systems development lifecycle and streamlines the T and E enterprise.more » This paper discusses a common framework that unifies the T and E process with many stakeholders involved and is flexible to accommodate each stakeholders?specific evaluative processes and content. Our success has translated to many cost savings by enabling quick responses to change and a better line of communication between the users, developers, and managers.« less

Shared governance in a clinic system.

PubMed

Meyers, Michelle M; Costanzo, Cindy

2015-01-01

Shared governance in health care empowers nurses to share in the decision-making process, which results in decentralized management and collective accountability. Share governance practices have been present in hospitals since the late 1970s. However, shared governance in ambulatory care clinics has not been well established. The subjects of this quality project included staff and administrative nurses in a clinic system. The stakeholder committee chose what model of shared governance to implement and educated clinic staff. The Index of Professional Nursing Governance measured a shared governance score pre- and postimplementation of the Clinic Nursing Council. The Clinic Nursing Council met bimonthly for 3 months during this project to discuss issues and make decisions related to nursing staff. The Index of Professional Nursing Governance scores indicated traditional governance pre- and postimplementation of the Clinic Nursing Council, which is to be expected. The stakeholder committee was beneficial to the initial implementation process and facilitated staff nurse involvement. Shared governance is an evolutionary process that develops empowered nurses and nurse leaders.

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2015-01-01

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

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

USDA-ARS?s Scientific Manuscript database

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

Examining Stakeholder Expectations for Guiding School Reform: Including Students

ERIC Educational Resources Information Center

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

2011-01-01

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

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

EPA Science Inventory

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

Leveraging design thinking to build sustainable mobile health systems.

PubMed

Eckman, Molly; Gorski, Irena; Mehta, Khanjan

Mobile health, or mHealth, technology has the potential to improve health care access in the developing world. However, the majority of mHealth projects do not expand beyond the pilot stage. A core reason why is because they do not account for the individual needs and wants of those involved. A collaborative approach is needed to integrate the perspectives of all stakeholders into the design and operation of mHealth endeavours. Design thinking is a methodology used to develop and evaluate novel concepts for systems. With roots in participatory processes and self-determined pathways, design thinking provides a compelling framework to understand and apply the needs of diverse stakeholders to mHealth project development through a highly iterative process. The methodology presented in this article provides a structured approach to apply design thinking principles to assess the feasibility of novel mHealth endeavours during early conceptualisation.

Engagement practices that join scientific methods with community wisdom: Designing a patient-centered, randomized control trial with a Pacific Islander Community

PubMed Central

Goulden, Peter A.; Bursac, Zoran; Hudson, Jonell; Purvis, Rachel S.; Yeary, Karen H. Kim; Aitaoto, Nia; Kohler, Peter O.

2016-01-01

This article illustrates how a collaborative research process can successfully engage an underserved minority community to address health disparities. Pacific Islanders, including the Marshallese, are one of the fastest growing US populations. They face significant health disparities, including extremely high rates of type 2 diabetes. This article describes the engagement process of designing patient-centered outcomes research with Marshallese stakeholders, highlighting the specific influences of their input on a randomized control trial to address diabetes. Over 18 months, an interdisciplinary research team used community-based participatory principles to conduct patient-engaged outcomes research that involved 31 stakeholders in all aspects of research design, from defining the research question to making decisions about budgets and staffing. This required academic researcher flexibility, but yielded a design linking scientific methodology with community wisdom. PMID:27325179

Evolving Best Practice in Learning About Air Quality and Climate Change Science in ACCENT

NASA Astrophysics Data System (ADS)

Schuepbach, E.

2008-12-01

Learning about air quality and climate change science has developed into a transdisciplinary impact generator, moulded by academic-stakeholder partnerships, where complementary skills and competences lead to a culture of dialogue, mutual learning and decision-making. These sweeping changes are mirrored in the evolving best practice within the European Network of Excellence on Atmospheric Composition Change (ACCENT). The Training and Education Programme in ACCENT pursues an integrated approach and innovative avenues to sharing knowledge and communicating air quality and climate change science to various end-user groups, including teachers, policy makers, stakeholders, and the general public. Early career scientists are involved in the process, and are trained to acquire new knowledge in a variety of learning communities and environments. Here, examples of both the open system of teaching within ACCENT training workshops for early career scientists, and the engagement of non-academic audiences in the joint learning process are presented.

Social and ethical perspectives of landslide risk mitigation measures

NASA Astrophysics Data System (ADS)

Kalsnes, Bjørn; Vangelsten, Bjørn V.

2015-04-01

Landslide risk may be mitigated by use of a wide range of measures. Mitigation and prevention options may include (1) structural measures to reduce the frequency, severity or exposure to the hazard, (2) non-structural measures, such as land-use planning and early warning systems, to reduce the hazard frequency and consequences, and (3) measures to pool and transfer the risks. In a given situation the appropriate system of mitigation measures may be a combination of various types of measures, both structural and non-structural. In the process of choosing mitigation measures for a given landslide risk situation, the role of the geoscientist is normally to propose possible mitigation measures on basis of the risk level and technical feasibility. Social and ethical perspectives are often neglected in this process. However, awareness of the need to consider social as well as ethical issues in the design and management of mitigating landslide risk is rising. There is a growing understanding that technical experts acting alone cannot determine what will be considered the appropriate set of mitigation and prevention measures. Issues such as environment versus development, questions of acceptable risk, who bears the risks and benefits, and who makes the decisions, also need to be addressed. Policymakers and stakeholders engaged in solving environmental risk problems are increasingly recognising that traditional expert-based decision-making processes are insufficient. This paper analyse the process of choosing appropriate mitigation measures to mitigate landslide risk from a social and ethical perspective, considering technical, cultural, economical, environmental and political elements. The paper focus on stakeholder involvement in the decision making process, and shows how making strategies for risk communication is a key for a successful process. The study is supported by case study examples from Norway and Italy. In the Italian case study, three different risk mitigation options was presented to the local community. The options were based on a thorough stakeholder involvement process ending up in three different views on how to deal with the landslide risk situation: i) protect lives and properties (hierarchical) ; ii) careful stewardship of the mountains (egalitarian); and iii) rational individual choice (individualist).

Engaging multilevel stakeholders in an implementation trial of evidence-based quality improvement in VA women's health primary care.

PubMed

Hamilton, Alison B; Brunner, Julian; Cain, Cindy; Chuang, Emmeline; Luger, Tana M; Canelo, Ismelda; Rubenstein, Lisa; Yano, Elizabeth M

2017-09-01

The Veterans Health Administration (VHA) has undertaken primary care transformation based on patient-centered medical home (PCMH) tenets. VHA PCMH models are designed for the predominantly male Veteran population, and require tailoring to meet women Veterans' needs. We used evidence-based quality improvement (EBQI), a stakeholder-driven implementation strategy, in a cluster randomized controlled trial across 12 sites (eight EBQI, four control) that are members of a Practice-Based Research Network. EBQI involves engaging multilevel, inter-professional leaders and staff as stakeholders in reviewing evidence and setting QI priorities. The goal of this analysis was to examine processes of engaging stakeholders in early implementation of EBQI to tailor VHA's medical home for women. Four inter-professional regional stakeholder planning meetings were conducted; these meetings engaged stakeholders by providing regional data about gender disparities in Veterans' care experiences. Subsequent to each meeting, qualitative interviews were conducted with 87 key stakeholders (leaders and staff). Stakeholders were asked to describe QI efforts and the use of data to change aspects of care, including women's health care. Interview transcripts were summarized and coded using a hybrid deductive/inductive analytic approach. The presentation of regional-level data about gender disparities resulted in heightened awareness and stakeholder buy-in and decision-making related to women's health-focused QI. Interviews revealed that stakeholders were familiar with QI, with regional and facility leaders aware of inter-disciplinary committees and efforts to foster organizational change, including PCMH transformation. These efforts did not typically focus on women's health, though some informal efforts had been undertaken. Barriers to engaging in QI included lack of communication across clinical service lines, fluidity in staffing, and lack of protected time. Inter-professional, multilevel stakeholders need to be engaged in implementation early, with data and discussion that convey the importance and relevance of a new initiative. Stakeholder perspectives on institutional norms (e.g., gender norms) and readiness for population-specific QI are useful drivers of clinical initiatives designed to transform care for clinical subpopulations.

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.

Documentation Driven Development for Complex Real-Time Systems

DTIC Science & Technology

2004-12-01

This paper presents a novel approach for development of complex real - time systems , called the documentation-driven development (DDD) approach. This... time systems . DDD will also support automated software generation based on a computational model and some relevant techniques. DDD includes two main...stakeholders to be easily involved in development processes and, therefore, significantly improve the agility of software development for complex real

Secondary Science Teachers' and Students' Involvement in a Primary School Community of Science Practice: How It Changed Their Practices and Interest in Science

ERIC Educational Resources Information Center

Forbes, Anne; Skamp, Keith

2016-01-01

"MyScience" is a primary science education initiative in which being in a community of practice is integral to the learning process. In this initiative, stakeholder groups--primary teachers, primary students and mentors--interact around the "domain" of "investigating scientifically". This paper builds on three earlier…

Catalan Universities and the Entrepreneurial Discovery Process: Challenges and Opportunities Emerging from the RIS3CAT Communities

ERIC Educational Resources Information Center

Marinelli, Elisabetta; Elena-Perez, Susana

2017-01-01

This article provides new insights into the role of public universities in regional development by looking at their involvement in Research and Innovation Strategies for Smart Specialization (RIS3), a key element of the current European Cohesion Policy. In the latter, stakeholders from the triple or Quadruple Helix (public, private, research and…

From framework to action: the DESIRE approach to combat desertification.

PubMed

Hessel, R; Reed, M S; Geeson, N; Ritsema, C J; van Lynden, G; Karavitis, C A; Schwilch, G; Jetten, V; Burger, P; van der Werff Ten Bosch, M J; Verzandvoort, S; van den Elsen, E; Witsenburg, K

2014-11-01

It has become increasingly clear that desertification can only be tackled through a multi-disciplinary approach that not only involves scientists but also stakeholders. In the DESIRE project such an approach was taken. As a first step, a conceptual framework was developed in which the factors and processes that may lead to land degradation and desertification were described. Many of these factors do not work independently, but can reinforce or weaken one another, and to illustrate these relationships sustainable management and policy feedback loops were included. This conceptual framework can be applied globally, but can also be made site-specific to take into account that each study site has a unique combination of bio-physical, socio-economic and political conditions. Once the conceptual framework was defined, a methodological framework was developed in which the methodological steps taken in the DESIRE approach were listed and their logic and sequence were explained. The last step was to develop a concrete working plan to put the project into action, involving stakeholders throughout the process. This series of steps, in full or in part, offers explicit guidance for other organizations or projects that aim to reduce land degradation and desertification.

Defining Nano, Nanotechnology and Nanomedicine: Why Should It Matter?

PubMed

Satalkar, Priya; Elger, Bernice Simone; Shaw, David M

2016-10-01

Nanotechnology, which involves manipulation of matter on a 'nano' scale, is considered to be a key enabling technology. Medical applications of nanotechnology (commonly known as nanomedicine) are expected to significantly improve disease diagnostic and therapeutic modalities and subsequently reduce health care costs. However, there is no consensus on the definition of nanotechnology or nanomedicine, and this stems from the underlying debate on defining 'nano'. This paper aims to present the diversity in the definition of nanomedicine and its impact on the translation of basic science research in nanotechnology into clinical applications. We present the insights obtained from exploratory qualitative interviews with 46 stakeholders involved in translational nanomedicine from Europe and North America. The definition of nanomedicine has implications for many aspects of translational research including: fund allocation, patents, drug regulatory review processes and approvals, ethical review processes, clinical trials and public acceptance. Given the interdisciplinary nature of the field and common interest in developing effective clinical applications, it is important to have honest and transparent communication about nanomedicine, its benefits and potential harm. A clear and consistent definition of nanomedicine would significantly facilitate trust among various stakeholders including the general public while minimizing the risk of miscommunication and undue fear of nanotechnology and nanomedicine.

Maximizing work integration in job placement of individuals facing mental health problems: Supervisor experiences.

PubMed

Skarpaas, Lisebet Skeie; Ramvi, Ellen; Løvereide, Lise; Aas, Randi Wågø

2015-01-01

Many people confronting mental health problems are excluded from participation in paid work. Supervisor engagement is essential for successful job placement. To elicit supervisor perspectives on the challenges involved in fostering integration to support individuals with mental health problems (trainees) in their job placement at ordinary companies. Explorative, qualitative designed study with a phenomenological approach, based on semi-structured interviews with 15 supervisors involved in job placements for a total of 105 trainees (mean 7, min-max. 1-30, SD 8). Data were analysed using qualitative content analysis. Superviors experience two interrelated dilemmas concerning knowledge of the trainee and degree of preferential treatment. Challenges to obtaining successful integration were; motivational: 1) Supervisors previous experience with trainees encourages future engagement, 2) Developing a realistic picture of the situation, and 3) Disclosure and knowledge of mental health problems, and continuity challenges: 4) Sustaining trainee cooperation throughout the placement process, 5) Building and maintaining a good relationship between supervisor and trainee, and 6) Ensuring continuous cooperation with the social security system and other stakeholders. Supervisors experience relational dilemmas regarding pre-judgment, privacy and equality. Job placement seem to be maximized when the stakeholders are motivated and recognize that cooperation must be a continuous process.

Antiretroviral procurement and supply chain management.

PubMed

Ripin, David J; Jamieson, David; Meyers, Amy; Warty, Umesh; Dain, Mary; Khamsi, Cyril

2014-01-01

Procurement, the country-level process of ordering antiretrovirals (ARVs), and supply chain management, the mechanism by which they are delivered to health-care facilities, are critical processes required to move ARVs from manufacturers to patients. To provide a glimpse into the ARV procurement and supply chain, the following pages provide an overview of the primary stakeholders, principal operating models, and policies and regulations involved in ARV procurement. Also presented are key challenges that need to be addressed to ensure that the supply chain is not a barrier to the goal of universal coverage. This article will cover the steps necessary to order and distribute ARVs, including different models of delivery, key stakeholders involved, strategic considerations that vary depending on context and policies affecting them. The single drug examples given illustrate the complications inherent in fragmented supply and demand-driven models of procurement and supply chain management, and suggest tools for navigating these hurdles that will ultimately result in more secure and reliable ARV provision. Understanding the dynamics of ARV supply chain is important for the global health community, both to ensure full and efficient treatment of persons living with HIV as well as to inform the supply chain decisions for other public health products.

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

PubMed Central

2010-01-01

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

Increasing resilience through participative flood risk map design

NASA Astrophysics Data System (ADS)

Fuchs, Sven; Spira, Yvonne; Stickler, Therese

2013-04-01

In recent years, an increasing number of flood hazards has shown to the European Commission and the Member States of the European Union the importance of flood risk management strategies in order to reduce losses and to protect the environment and the citizens. Exposure to floods as well as flood vulnerability might increase across Europe due to the ongoing economic development in many EU countries. Thus even without taking climate change into account an increase of flood disasters in Europe might be foreseeable. These circumstances have produced a reaction in the European Commission, and a Directive on the Assessment and Management of Flood Risks was issued as one of the three components of the European Action Programme on Flood Risk Management. Floods have the potential to jeopardise economic development, above all due to an increase of human activities in floodplains and the reduction of natural water retention by land use activities. As a result, an increase in the likelihood and adverse impacts of flood events is expected. Therefore, concentrated action is needed at the European level to avoid severe impacts on human life and property. In order to have an effective tool available for gathering information, as well as a valuable basis for priority setting and further technical, financial and political decisions regarding flood risk mitigation and management, it is necessary to provide for the establishment of flood risk maps which show the potential adverse consequences associated with different flood scenarios. So far, hazard and risk maps are compiled in terms of a top-down linear approach: planning authorities take the responsibility to create and implement these maps on different national and local scales, and the general public will only be informed about the outcomes (EU Floods Directive, Article 10). For the flood risk management plans, however, an "active involvement of interested parties" is required, which means at least some kind of multilateral consultation on the management plans that allows stakeholders to discuss relevant issues and to contribute to arguments and propositions put forward by the stakeholders. Through a wider stakeholder participation and more effective communication, awareness of flood risks should be raised. With the term participation diverse voluntary and informal forms of inclusion are summarized (in contrast to legal forms of participation like the status as a party). When discussing the theoretical and practical implications of participation in flood risk management, it is important to make a clear distinction between public and stakeholder participation. The broad public is "everybody" and refers to the participation by non-organised individuals as members of the general public, and specifically to individuals whose profession is not connected to flood risk management. As such, they have to be regarded as lay persons, which, nevertheless, does not mean that these individuals do not have any idea about the hazard they are exposed to or can contribute to the quality of an decision making process. In contrast to professionally interested parties, this group is typically comprised of individuals with different individual perspectives on flood risk management. It is argued that including practical knowledge and perceptions (reflecting values and preferences) into the flood risk management process is - apart from professional assessments (as systematic knowledge) - a milestone towards adequate governance structures in any institutional process with political legitimacy. Neither normative concepts like sustainable development or "Good Governance" nor the European Water Framework Directive 2000/60/EC do specify what public participation or the participation of user means in detail. As also scientific literature offers no consistent definition of public participation and stakeholder participation we developed an innovative approach used in the pilot project Krems, Austria. The most innovative step regarding participation was not the methods used for participation but the involvement of concerned lay persons not only in the design of the hazard and risk maps or the risk assessments itself but the cooperative elaboration of the risk assessment approach especially for the harbour area. Following these principles, flood risk maps were created in the underlying EU-project DANUBE FLOODRISK. In this ETC SEE project "DANUBE FLOODRISK - Stakeholder Oriented Assessment of the Danube Floodplains" (2009-2012), hazard and risk maps harmonized across borders for the Danube main stream were produced. This way the overall DANUBE FLOODRISK project contributed to Article 6 of the EU Floods Directive, the hazard and risk maps for international river basins, and provides with the involvement of the national and regional stakeholders the first step to the implementation of Article 7, the Flood Risk Management Plans. By testing the involvement of the broad public and local stakeholders, first exemplary steps were taken for local flood risk management planning. A first set of maps was created for an underlying hazard scenario of a 1-in-100 year flood affecting the city of Krems assuming a failure of the temporal flood protection due to the impact of a ship in the area of the pier. Moreover, both, hazard scenarios with and without a second line of defence were visualised. The set of maps includes (a) an evaluative risk map showing the risk qualitatively aggregated for each building exposed and the number of affected citizens, (b) an evaluative risk map showing the risk qualitatively aggregated per square footage for each building exposed and the number of affected citizens, (c) an evaluative risk map showing the risk quantitatively in monetary units per square footage for each building exposed and the number of affected citizens, and (d) as well as (e) risk maps according to (a) and (b) without the second line of defence in order to communicate the effectiveness of temporal flood protection. For the harbour of Krems, a risk map was compiled based on a self-evaluation of the effects of flooding by the harbour companies. This risk map was based on the assumption of a failure of the harbour gate during a flood event. The self-evaluation was undertaken based on a developed risk matrix which includes significant adverse impacts on human health, the environment, cultural heritage and economic activity. Insights on stakeholder-oriented risk communication were gained with respect to the design and the layout of the maps. Specific elements of semiology for the cartographic representation were deduced. The pilot initiative discussed in this paper is brought added value to all involved parties so far. All participants brought in knowledge, data and time resources. The project team was involved in a social learning process and gained additional know-how about adequate stakeholder involvement and communication as well as about risk assessment methods and mapping. It could be shown that it is possible to involve lay persons in topics such as risk assessments so far only defined by technical experts. Stakeholders from the harbour area were not only involved in the risk assessment but also in the development of the methods for this risk assessment. Such approaches may be increasingly used to develop a better understanding of flood risk within affected communities, and thus increase flood resilience.

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

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

PubMed

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

2015-12-01

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

Stakeholders' views of the introduction of assistive technology in the classroom: How family-centred is Australian practice for students with cerebral palsy?

PubMed

Karlsson, P; Johnston, C; Barker, K

2017-07-01

With family-centred care widely recognized as a cornerstone for effective assistive technology service provision, the current study was undertaken to investigate to what extent such approaches were used by schools when assistive technology assessments and implementation occurred in the classroom. In this cross-sectional study, we compare survey results from parents (n = 76), school staff (n = 33) and allied health professionals (n = 65) with experience in the use of high-tech assistive technology. Demographic characteristics and the stakeholders' perceived helpfulness and frequency attending assessment and set-up sessions were captured. To evaluate how family-centred the assistive technology services were perceived to be, the parents filled out the Measure of Processes of Care for Caregivers, and the professionals completed the Measure of Processes of Care for Service Providers. Descriptive statistics and one-way analysis of variance were used to conduct the data analysis. Findings show that parents are more involved during the assessment stage than during the implementation and that classroom teachers are often not involved in the initial stage. Speech pathologists in particular are seen to be to a great extent helpful when implementing assistive technology in the classroom. This study found that family-centred service is not yet fully achieved in schools despite being endorsed in early intervention and disability services for over 20 years. No statistically significant differences were found with respect to school staff and allied health professionals' roles, their years of experience working with students with cerebral palsy and the scales in the Measure of Processes of Care for Service Providers. To enhance the way technology is matched to the student and successfully implemented, classroom teachers need to be fully involved in the whole assistive technology process. The findings also point to the significance of parents' involvement, with the support of allied health professionals, in the process of selecting and implementing assistive technology in the classroom. © 2017 John Wiley & Sons Ltd.

Interventionist and participatory approaches to flood risk mitigation decisions: two case studies in the Italian Alps

NASA Astrophysics Data System (ADS)

Bianchizza, C.; Del Bianco, D.; Pellizzoni, L.; Scolobig, A.

2012-04-01

Flood risk mitigation decisions pose key challenges not only from a technical but also from a social, economic and political viewpoint. There is an increasing demand for improving the quality of these processes by including different stakeholders - and especially by involving the local residents in the decision making process - and by guaranteeing the actual improvement of local social capacities during and after the decision making. In this paper we analyse two case studies of flood risk mitigation decisions, Malborghetto-Valbruna and Vipiteno-Sterzing, in the Italian Alps. In both of them, mitigation works have been completed or planned, yet following completely different approaches especially in terms of responses of residents and involvement of local authorities. In Malborghetto-Valbruna an 'interventionist' approach (i.e. leaning towards a top down/technocratic decision process) was used to make decisions after the flood event that affected the municipality in the year 2003. In Vipiteno-Sterzing, a 'participatory' approach (i.e. leaning towards a bottom-up/inclusive decision process) was applied: decisions about risk mitigation measures were made by submitting different projects to the local citizens and by involving them in the decision making process. The analysis of the two case studies presented in the paper is grounded on the results of two research projects. Structured and in-depth interviews, as well as questionnaire surveys were used to explore residents' and local authorities' orientations toward flood risk mitigation. Also a SWOT analysis (Strengths, Weaknesses, Opportunities and Threats) involving key stakeholders was used to better understand the characteristics of the communities and their perception of flood risk mitigation issues. The results highlight some key differences between interventionist and participatory approaches, together with some implications of their adoption in the local context. Strengths and weaknesses of the two approaches, as well as key challenges for the future are also discussed.

SimBasin: A serious gaming framework for integrated and cooperative decision-making in water management

NASA Astrophysics Data System (ADS)

Angarita, H.; Craven, J.; Caggiano, F.; Corzo, G.

2016-12-01

An Integrated approach involving extensive stakeholder dialogue is widely advocated in sustainable water management. However, it requires a social learning process in which scientist and stakeholders become aware of the relationship between their own frames of reference and those of others, differences can be dealt with constructively, and shared ideas can be used to facilitate cooperation. Key obstacles in this process are heritage systems, attitudes and processes, factually wrong, incomplete or unshared mental models, and lack of science-policy dialogue (Pahl-Wostl et al., 2005) To overcome these barriers, a space is required which is free of heritage systems, where mental models can be safely and easily compared and corrected, and where scientists and policy-makers can come together. A "serious game" can serve as such a space - Serious games are games or simulations used to achieve an organizational or educational goal, and such games have already been used to facilitate stakeholder cooperation in the water management sector (Rusca et al., 2005). As well as bringing stakeholders together, they can be an accessible interface between scientific models and non-experts. Here we present SimBasin, a multiplayer serious game framework and development engine. The engine allows to easily create a simulated multiplayer basin management game using WEAP water resources modelling software (SEI, 1992-2015), to facilitate the communication of the complex, long term and wide range relationships between hydrologic, climate, and human systems present in river basins, and enable dialogue between policy-makers and scientists. Different games have been created using the Sim-Basin engine and used in various contexts. Here are discussed experiences with stakeholders at a national forum in Bogotá, flood risk management agencies in the lower Magdalena River Basin in Colombia and with water professionals in Bangkok. The experience shows that the game is a useful tool for enabling dialogue and provides interesting insights into the way computer models and stakeholders' mental models can interact with and enrich each other. SimBasin software and supporting materials are freely available online for download at http://simbasin.hilab.nl.

Respective influence of veterinarians and local institutional stakeholders on the event-driven surveillance system for bovine brucellosis in France.

PubMed

Bronner, Anne; Morignat, Eric; Calavas, Didier

2015-08-01

The event-driven surveillance system for bovine brucellosis implemented in France aims to ensure the early detection of cases of bovine brucellosis, a disease of which the country has been declared free since 2005. It consists of mandatory notification of bovine abortions by farmers and veterinarians. However, as underlined by a previous qualitative study, several factors influence the decision-making process of actors in the field. This process is particularly influenced by the level of cooperation between institutional stakeholders in their département (a French département being an administrative and territorial unit), veterinarians and farmers. In this context, the objectives of this study were 1) to quantify the respective influence of veterinarians and all local institutional stakeholders on the proportion of notifying farmers and identify which actors have most influence on farmers' decisions; 2) to analyse whether the influence of veterinarians is correlated with that of local institutional stakeholders. In addition to factors relating to the farm itself (production type and herd size), the proportion of notifying farmers was influenced by the number of veterinarians per practice and the veterinary practice's membership of a technical association. This proportion was also influenced by unknown factors relating to the veterinary practice and, to a lesser extent, the département in which the farm was located. There was no correlation between variability in the proportion of notifying farmers among veterinary practices per département and the effect of the département itself. To our knowledge, this is the first study to quantify the influence of veterinarians and local institutional stakeholders on the notification process for a mandatory disease. In addition to carrying out regulatory interventions, veterinarians play a major role in encouraging farmers to participate in the surveillance systems. The results of this study, combined with a previous qualitative study, shed light on the need to consolidate the involvement of veterinarians and local stakeholders in the organisation of surveillance by national institutional bodies.

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

PubMed

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

2018-02-01

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

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

PubMed

Caniato, M; Tudor, T; Vaccari, M

2015-01-01

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

Indicators for evaluating European population health: a Delphi selection process.

PubMed

Freitas, Ângela; Santana, Paula; Oliveira, Mónica D; Almendra, Ricardo; Bana E Costa, João C; Bana E Costa, Carlos A

2018-04-27

Indicators are essential instruments for monitoring and evaluating population health. The selection of a multidimensional set of indicators should not only reflect the scientific evidence on health outcomes and health determinants, but also the views of health experts and stakeholders. The aim of this study is to describe the Delphi selection process designed to promote agreement on indicators considered relevant to evaluate population health at the European regional level. Indicators were selected in a Delphi survey conducted using a web-platform designed to implement and monitor participatory processes. It involved a panel of 51 experts and 30 stakeholders from different areas of knowledge and geographies. In three consecutive rounds the panel indicated their level of agreement or disagreement with indicator's relevance for evaluating population health in Europe. Inferential statistics were applied to draw conclusions on observed level of agreement (Scott's Pi interrater reliability coefficient) and opinion change (McNemar Chi-square test). Multivariate analysis of variance was conducted to check if the field of expertise influenced the panellist responses (Wilk's Lambda test). The panel participated extensively in the study (overall response rate: 80%). Eighty indicators reached group agreement for selection in the areas of: economic and social environment (12); demographic change (5); lifestyle and health behaviours (8); physical environment (6); built environment (12); healthcare services (11) and health outcomes (26). Higher convergence of group opinion towards agreement on the relevance of indicators was seen for lifestyle and health behaviours, healthcare services, and health outcomes. The panellists' field of expertise influenced responses: statistically significant differences were found for economic and social environment (p < 0.05 in round 1 and 2), physical environment (p < 0.01 in round 1) and health outcomes (p < 0.01 in round 3). The high levels of participation observed in this study, by involving experts and stakeholders and ascertaining their views, underpinned the added value of using a transparent Web-Delphi process to promote agreement on what indicators are relevant to appraise population health.

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.

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.

Stakeholder Participation in Marine Spatial Plan Making Process in Lampung Province

NASA Astrophysics Data System (ADS)

Asirin; Asbi, A. M.; Pakpahan, V. H.

2018-05-01

Lampung Province has coastal areas, seas and small islands facing conflicts of interest between tourism, conservation areas for defense, environmental conservation, and the threat of unsustainable marine resource utilization. Indonesia (including Lampung Province) has committed itself to achieving the objectives of conservation and sustainable use of oceans, seas and marine resources in view of sustainable development. One of the instruments used to achieve this goal is by using marine spatial planning (MSP). The purpose of this research was to analyse the marine spatial plan making process in Lampung Province. This research also evaluated the participation process and participation level based on plan-making process criteria and the stakeholder participation ladder. This research can be useful as a recommendation in the evaluation step to improve the plan-making process in order to address conflicts of interest between various related interest groups, so that planning can be accomplished with the involvement of all relevant parties to reach consensus on how to achieve a sustainable marine environment. This research used a qualitative research method as well as a case study approach. The scope of this study was limited by the conceptual framework of marine spatial planning and the stakeholder participation ladder. The authors recommend study of the preparation of marine spatial planning in addition to a technocratic approach considering the results of the study aspects of spatial allocation and physical aspects of marine resources, while prioritizing building consensus among various interest groups related to the utilization of marine resources. Thus, it is necessary to develop technical steps to build consensus in the marine spatial plan-making process.

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

PubMed

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

2015-12-01

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

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

PubMed

Sinden, Kathryn; MacDermid, Joy C

2014-03-01

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

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.

Enhancing School HIV and AIDS Strategic Plan through Expanded Stakeholder Involvement

ERIC Educational Resources Information Center

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

2011-01-01

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

Stakeholder's experiences, expectations and decision making on reproductive care: An ethnographic study of three districts in northern Ghana

PubMed Central

Pavlova, Milena; Biesma, Regien; Groot, Wim

2017-01-01

Background In Ghana, priority-setting for reproductive health service interventions is known to be rudimentary with little wider stakeholder involvement. In recognizing the need for broad stakeholder engagement to advance reproductive care provision and utilization, it is necessary to jointly study the varied stakeholder views on reproductive care services. Methods We applied an ethnographic study approach where field data was collected between March-May 2015 in three rural districts of northern Ghana. Data was collected among women with recent births experiences (n = 90), health care providers (n = 16) and policy actors (n = 6). In-depth interviews and focus group discussions was applied to collect all data. Each stakeholder participant’s audio file was transcribed, and repeatedly read through to identify similar and divergent views in data. A coding scheme guided coding processes. All transcripts were then imported into QSR NVivo 11 for further analysis. Results Four themes emerged. Women participants accentuated that sex and sexuality values of men have changed over time, and drives gender roles, parity levels and decision making on reproductive care needs at community levels. Sexual stigma on reproductive care reduces the willingness of women to voice poor experiences related to their previous reproductive experiences. All stakeholders’ highlighted clinical treatments for post-abortion care are minimally covered under the fee exemption policy for antenatal and postnatal care. Policy processes on service delivery protocols still is top-down in Ghana. Conclusions Health teams working to improve sexual and reproductive health care must find suitable context strategies that effectively work to improve women reproductive care needs at their operational levels. Private sector participation and informal community support clutches are encouraged to advance the delivery of reproductive care services. PMID:29091916

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

KLIMOPASS: Water-use conflicts during periods of low flow - a stakeholder analysis of the rivers Murg and Kocher in Baden-Wuerttemberg and sustainable recommendations for action

NASA Astrophysics Data System (ADS)

Zeitler, Florian; Dotterweich, Markus; Rothstein, Benno

2017-04-01

The 2003 and 2015 occurring heatwaves in Central Europe demonstrated on how dangerous long-lasting droughts and water stress can be for nature, people and companies relying on water. Climate change will increase the chance of low flow events along rivers in Baden-Wuerttemberg in the future leading to possible water-use conflicts amongst the users. This KLIMOPASS project focuses on the identification of existing and potential occurring conflicts of usage and interest for water resources. The main research concentrates on two exemplary river basins in Baden-Wuerttemberg (the Murg and the Kocher River) including all involved stakeholders and sectors (hydropower, agriculture, industry, sewage plants, ecology, tourism etc.). With the examples of the two rivers, the identification of conflicts, possible strategies for solutions and recommendations for action during current and future events of low flow have been researched. Quantitative and qualitative surveys, interviews, excursions and workshops have been conducted to analyse the stakeholder's potential for conflict. For this process it is necessary to equally consider all economic, societal and ecological interests and include all relevant stakeholders in the participatory process. According to the results, water related conflicts are not present in all sectors, but rather exclusive to certain sectors. Furthermore, these sectors are in conflict with more than one stakeholder group at the same time. In contrast, other users have not experienced any water related conflicts yet. Moreover, it is noticeable that conflicts in water use are only partly caused due to low flow events: regarding both rivers, low flow events are not only related to natural causes but particularly to anthropogenic influences.

Proposal for adaptive management to conserve biotic integrity in a regulated segment of the Tallapoosa River, Alabama, U.S.A

USGS Publications Warehouse

Irwin, Elise R.; Freeman, Mary C.

2002-01-01

Conserving river biota will require innovative approaches that foster and utilize scientific understanding of ecosystem responses to alternative river-management scenarios. We describe ecological and societal issues involved in flow management of a section of the Tallapoosa River (Alabama, U.S.A.) in which a species-rich native fauna is adversely affected by flow alteration by an upstream hydropower dam. We hypothesize that depleted Iow flows, flow instability and thermal alteration resulting from pulsed flow releases at the hydropower dam are most responsible for changes in the Tallapoosa River biota. However, existing data are insufficient to prescribe with certainty minimum flow levels or the frequency and duration of stable flow periods that would be necessary or sufficient to protect riverine biotic integrity. Rather than negotiate a specific change in the flow regime, we propose that stakeholders--including management agencies, the power utility, and river advocates--engage in a process of adaptive-flow management. This process would require that stakeholders (1) develop and agree to management objectives; (2) model hypothesized relations between dam operations and management objectives; (3) implement a change in dam operations; and (4) evaluate biological responses and other stakeholder benefits through an externally reviewed monitoring program. Models would be updated with monitoring data and stakeholders would agree to further modify flow regimes as necessary to achieve management objectives. A primary obstacle to adaptive management will be a perceived uncertainty of future costs for the power utility and other stakeholders. However, an adaptive, iterative approach offers the best opportunity for improving flow regimes for native biota while gaining information critical to guiding management decisions in other flow-regulated rivers.

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

PubMed

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

2009-05-01

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

Patient-centred performance monitoring systems and multi-agency care provision: a case study using a stakeholder participative approach.

PubMed

Connell, N A; Goddard, A R; Philp, I; Bray, J

1998-05-01

We describe the processes involved in the development of an information system which can assess how care given by a number of agencies could be monitored by those agencies. In particular, it addresses the problem of sharing information as the boundaries of each agency are crossed. It focuses on the care of one specific patient group--the rehabilitation of elderly patients in the community, which provided an ideal multi-agency setting. It also describes: how a stakeholder participative approach to information system development was undertaken, based in part on the Soft Systems Methodology (SSM) approach (Checkland, 1981, 1990); some of the difficulties encountered in using such an approach; and the ways in which these were addressed. The paper goes on to describe an assessment tool called SCARS (the Southampton Community Ability Rating Scale). It concludes by reflecting on the management lessons arising from this project. It also observes, inter alia, how stakeholders have a strong preference for simpler, non-IT based systems, and comments on the difficulties encountered by stakeholders in attempting to reconcile their perceptions of the needs of their discipline or specialty with a more patient-centred approach of an integrated system.

Nursing Home Stakeholder Views of Resident Involvement in Medical Care Decisions

PubMed Central

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

2017-01-01

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

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

ERIC Educational Resources Information Center

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

2002-01-01

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

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

ERIC Educational Resources Information Center

Bak, Nelleke; Paterson, Andrew

1997-01-01

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

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

ERIC Educational Resources Information Center

Birdthistle, Naomi; Hynes, Briga; Fleming, Patricia

2007-01-01

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

The Skinny on Big Data in Education: Learning Analytics Simplified

ERIC Educational Resources Information Center

Reyes, Jacqueleen A.

2015-01-01

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

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

ERIC Educational Resources Information Center

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

2013-01-01

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

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

PubMed

Perni, Angel; Martínez-Paz, José M

2013-08-01

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

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.

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.

Strategic planning--a plan for excellence for South Haven Health System.

PubMed

Urbanski, Joanne; Baskel, Maureen; Martelli, Mary

2011-01-01

South Haven Health System has developed an innovative approach to strategic planning. The key to success of this process has been the multidisciplinary involvement of all stakeholders from the first planning session through the final formation of a strategic plan with measurable objectives for each goal. The process utilizes a Conversation Café method for identifying opportunities and establishing goals, Strategic Oversight Teams to address each goal and a Champion for implementation of each objective. Progress is measured quarterly by Strategic Oversight Team report cards. Transparency of communication within the organization and the sharing of information move the plan forward. The feedback from participant evaluations has been overwhelmingly positive. They are involved and excited.

Food Service Perspectives on National School Lunch Program Implementation

PubMed Central

Tabak, Rachel G.; Moreland-Russell, Sarah

2015-01-01

Objectives Explore barriers and facilitators to implementation of the new National School Lunch Program (NSLP) policy guidelines. Methods Interviews with eight food service directors using an interview guide informed by the Consolidated Framework for Implementation Research. Results Food service personnel; parents, teachers, school staff; and students were important stakeholders. Characteristics of the new NSLP policy guidelines were reported to create increased demands; resources alleviated some barriers. Directors reported increased food and labor costs, food sourcing challenges, decreased student participation, and organizational constraints as barriers to implementation. Creativity in menu planning facilitated success. Conclusions Factors within the food service department, characteristics of implementing individuals and the new NSLP policy guidelines, and stakeholder involvement in the implementation process relate to successful implementation. PMID:26417607

Building Stakeholder Partnerships for an On-Site HIV Testing Programme

PubMed Central

Woods, William J.; Erwin, Kathleen; Lazarus, Margery; Serice, Heather; Grinstead, Olga; Binson, Diane

2009-01-01

Because of the large number of individuals at risk for HIV infection who visit gay saunas and sex clubs, these venues are useful settings in which to offer HIV outreach programmes for voluntary counselling and testing (VCT). Nevertheless, establishing a successful VCT programme in such a setting can be a daunting challenge, in large part because there are many barriers to managing the various components likely to be involved. Using qualitative data from a process evaluation of a new VCT programme at a gay sauna in California, USA, we describe how the various stakeholders overcame barriers of disparate interests and responsibilities to work together to successfully facilitate a regular and frequent on-site VCT programme that was fully utilized by patrons. PMID:18432424

Structured decision making as a framework for large-scale wildlife harvest management decisions

USGS Publications Warehouse

Robinson, Kelly F.; Fuller, Angela K.; Hurst, Jeremy E.; Swift, Bryan L.; Kirsch, Arthur; Farquhar, James F.; Decker, Daniel J.; Siemer, William F.

2016-01-01

Fish and wildlife harvest management at large spatial scales often involves making complex decisions with multiple objectives and difficult tradeoffs, population demographics that vary spatially, competing stakeholder values, and uncertainties that might affect management decisions. Structured decision making (SDM) provides a formal decision analytic framework for evaluating difficult decisions by breaking decisions into component parts and separating the values of stakeholders from the scientific evaluation of management actions and uncertainty. The result is a rigorous, transparent, and values-driven process. This decision-aiding process provides the decision maker with a more complete understanding of the problem and the effects of potential management actions on stakeholder values, as well as how key uncertainties can affect the decision. We use a case study to illustrate how SDM can be used as a decision-aiding tool for management decision making at large scales. We evaluated alternative white-tailed deer (Odocoileus virginianus) buck-harvest regulations in New York designed to reduce harvest of yearling bucks, taking into consideration the values of the state wildlife agency responsible for managing deer, as well as deer hunters. We incorporated tradeoffs about social, ecological, and economic management concerns throughout the state. Based on the outcomes of predictive models, expert elicitation, and hunter surveys, the SDM process identified management alternatives that optimized competing objectives. The SDM process provided biologists and managers insight about aspects of the buck-harvest decision that helped them adopt a management strategy most compatible with diverse hunter values and management concerns.

Understanding stakeholders' perspectives and experiences of general practice accreditation.

PubMed

Debono, Deborah; Greenfield, David; Testa, Luke; Mumford, Virginia; Hogden, Anne; Pawsey, Marjorie; Westbrook, Johanna; Braithwaite, Jeffrey

2017-07-01

To examine general practice accreditation stakeholders' perspectives and experiences to identify program strengths and areas for improvements. Individual (n=2) and group (n=9) interviews were conducted between September 2011-March 2012 with 52 stakeholders involved in accreditation in Australian general practices. Interviews were recorded, transcribed and thematically analysed. Member checking activities in April 2016 assessed the credibility and currency of the findings in light of current reforms. Overall, participants endorsed the accreditation program but identified several areas of concern. Noted strengths of the program included: program ownership, peer review and collaborative learning; access to Practice Incentives Program payments; and, improvements in safety and quality. Noted limitations in these and other aspects of the program offer potential for improvement: evidence for the impact of accreditation; resource demands; clearer outcome measures; and, specific experiences of accreditation. The effectiveness of accreditation as a strategy to improve safety and quality was shaped by the attitudes and experience of stakeholders. Strengths and weaknesses in the accreditation program influence, and are influenced by, stakeholder engagement and disengagement. After several accreditation cycles, the sector has the opportunity to reflect on, review and improve the process. This will be important if the continued or extended engagement of practices is to be realised to assure the continuation and effectiveness of the accreditation program. Copyright © 2017 Elsevier B.V. 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.

Futuragua: Fostering Cross-Scale Knowledge to Inform Social-Environmental Decision Processes for Building Drought Resilience in Highly Seasonal Environments

NASA Astrophysics Data System (ADS)

McDaniels, T.; Steyn, D. G.; Johnson, M. S.; Small, M.; Leclerc, G.; Vignola, R.; Chan, K.; Grossmann, I.; Wong-Parodi, G.

2014-12-01

Improving resilience to drought in complex social-environmental systems (SES) is extraordinarily important, particularly for rural tropical locations where small changes in climate regimes can have dramatic SES impacts. Efforts to build drought resilience must necessarily be planned and implemented within SES governance systems that involve linkages in water and land use administration from local to national levels. These efforts require knowledge and understanding that links climate and weather forecasts to regional and local hydrology, to social-economic and environmental systems, and to governance processes. In order to provide structure for such complex choices and investments, we argue that a focus on structured decision processes that involve linkages among science, technological perspectives, and public values conducted with agencies and stakeholders will provide a crucial framework for comparing and building insight for pursuing alternative courses of action to build drought resilience. This paper focuses on a regional case study in the seasonally-dry northwest region of Costa Rica, in watersheds rated as most threatened in the country in terms of drought. We present the overall framework guiding the transdisciplinary efforts to link scientific and technical understanding to public values, in order to foster civil society actions that lead to improved drought resilience. Initial efforts to characterize hydrological and climate regimes will be reported along with our approach to linking natural science findings, social inventories in terms of perspectives on SES, and the psychology and patterns of reliance on forecast information that provide the basis for characterizing public understanding. The overall linkage of technical and value information is focused on creating and comparing alternative actions that can potentially build resilience in short and long time frames by building decision making processes involving stakeholders, agencies and interested parties.

The Virtual Research and Extension Communication Network (VRECN): An Interactive Learning and Communication Network for Research and Extension Personnel. Concept Paper for the Food & Agriculture Organisation of the United Nations (FAO).

ERIC Educational Resources Information Center

Richardson, Don

A Virtual Research and Extension Communication Network (VRECN) is a set of networked electronic tools facilitating improvement in communication processes and information sharing among stakeholders involved in agricultural development. In developing countries, research and extension personnel within a ministry of agriculture, in consultation and…

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

PubMed

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

2004-02-01

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

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.

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....

Research Project Evaluation-Learnings from the PATHWAYS Project Experience.

PubMed

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

2018-05-25

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

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

PubMed

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

2018-02-01

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

Participatory modeling - engineering and social sciences in tandem

NASA Astrophysics Data System (ADS)

Class, Holger; Kissinger, Alexander; Knopf, Stefan; Konrad, Wilfried; Noack, Vera; Scheer, Dirk

2017-04-01

The modeling of flow and transport processes in the context of engineering in the subsurface often takes place within a field of conflict from different interests, where societal issues are touched or involved. Carbon Capture and Storage, Fracking, or nuclear waste disposal are just a few prominent examples, where engineering (or: natural sciences) and social sciences have a common field of research. It is only consequent for both disciplines to explore methods and tools to achieve best possible mutual benefits. Participatory modeling (PM) is such an idea, where so-called stakeholders can be involved during different phases of the modeling process. This can be accomplished by very different methods of participation and for different reasons (public acceptance, public awareness, transparency, improved understanding through collective learning, etc). Therefore, PM is a generic approach, open for different methods to be used in order to facilitate early expert and stakeholder integration in science development. We have used PM recently in two examples, both in the context of Carbon Capture and Storage. The first one addressed the development and evaluation (by stakeholders) of a screening criterion for site selection. The second one deals with a regional-scale brine migration scenario where stakeholders have been involved in evaluating the general importance of brine migration, the design of a representative geological model for a case study and in the definition of scenarios to be simulated. This contribution aims at summarizing our experiences and share it with the modeling community. References: A Kissinger, V Noack, S Knopf, D Scheer, W Konrad, H Class Characterization of reservoir conditions for CO2 storage using a dimensionless gravitational number applied to the North German Basin, Sustainable Energy Technologies and Assessments 7, 209-220, 2014 D Scheer, W Konrad, H Class, A Kissinger, S Knopf, V Noack Expert involvement in science development: (re-) evaluation of an early screening tool for carbon storage site characterization, International Journal of Greenhouse Gas Control 37, 228-236, 2015 D Scheer, W Konrad, H Class, A Kissinger, S Knopf, V Noack Regional-scale brine migration along vertical pathways due to CO2 injection - Part 1: the participatory modeling approach, currently under review in Hydrology and Earth System Sciences A Kissinger, V Noack, S Knopf, W Konrad, D Scheer, H Class Regional-scale brine migration along vertical pathways due to CO2 injection - Part 2: a simulated case study in the North German Basin, currently under review in Hydrology and Earth System Sciences Schrader, C.: 13. October 2014. Expressfahrstuhl für Salzwasser, Süddeutsche Zeitung, p. 16

Involving the public in epidemiological public health research: a qualitative study of public and stakeholder involvement in evaluation of a population-wide natural policy experiment.

PubMed

Anderson de Cuevas, Rachel; Nylén, Lotta; Burström, Bo; Whitehead, Margaret

2018-04-20

Public involvement in research is considered good practice by European funders; however, evidence of its research impact is sparse, particularly in relation to large-scale epidemiological research. To explore what difference public and stakeholder involvement made to the interpretation of findings from an evaluation of a natural policy experiment to influence the wider social determinants of health: 'Flexicurity'. Stockholm County, Sweden. Members of the public from different occupational groups represented by blue-collar and white-collar trade union representatives. Also, members of three stakeholder groups: the Swedish national employment agency; an employers' association and politicians sitting on a national labour market committee. Total: 17 participants. Qualitative study of process and outcomes of public and stakeholder participation in four focused workshops on the interpretation of initial findings from the flexicurity evaluation. New insights from participants benefiting the interpretation of our research findings or conceptualisation of future research. Participants sensed more drastic and nuanced change in the Swedish welfare system over recent decades than was evident from our literature reviews and policy analysis. They also elaborated hidden developments in the Swedish labour market that were increasingly leading to 'insiders' and 'outsiders', with differing experiences and consequences for financial and job security. Their explanation of the differential effects of the various collective agreements for different occupational groups was new and raised further potential research questions. Their first-hand experience provided new insights into how changes to the social protection system were contributing to the increasing trends in poverty among unemployed people with limiting long-standing illness. The politicians provided further reasoning behind some of the policy changes and their intended and unintended consequences. These insights fed into subsequent reporting of the flexicurity evaluation results, as well as the conceptualisation of new research that could be pursued in a future programme. © 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.

Involving Patients and Families in the Analysis of Suicides, Suicide Attempts, and Other Sentinel Events in Mental Healthcare: A Qualitative Study in The Netherlands.

PubMed

Bouwman, Renée; de Graaff, Bert; de Beurs, Derek; van de Bovenkamp, Hester; Leistikow, Ian; Friele, Roland

2018-05-29

Involving patients and families in mental healthcare is becoming more commonplace, but little is known about how they are involved in the aftermath of serious adverse events related to quality of care (sentinel events, including suicides). This study explores the role patients and families have in formal processes after sentinel events in Dutch mental healthcare. We analyzed the existing policies of 15 healthcare organizations and spoke with 35 stakeholders including patients, families, their counselors, the national regulator, and professionals. Respondents argue that involving patients and families is valuable to help deal with the event emotionally, provide additional information, and prevent escalation. Results indicate that involving patients and families is only described in sentinel event policies to a limited extent. In practice, involvement consists mostly of providing aftercare and sharing information about the event by providers. Complexities such as privacy concerns and involuntary admissions are said to hinder involvement. Respondents also emphasize that involvement should not be obligatory and stress the need for patients and families to be involved throughout the process of treatment. There is no one-size-fits-all strategy for involving patients and families after sentinel events. The first step seems to be early involvement during treatment process itself.

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

NASA Astrophysics Data System (ADS)

Madruga de Brito, Mariana; Evers, Mariele

2016-04-01

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

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

NASA Astrophysics Data System (ADS)

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

2017-10-01

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

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

PubMed

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

2016-04-01

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

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

PubMed

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

2012-01-17

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

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

PubMed

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

2017-12-22

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

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

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

Kalinina, Elena Arkadievna; Samsa, Michael

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

Replacing Concrete with Natural and Social Engineering: Learning the Lessons of Stakeholder Engagement from South West Water's Upland Catchment Management Programme

NASA Astrophysics Data System (ADS)

Smith, David; Grand-Clement, Emile; Brazier, Richard

2014-05-01

Replacing Concrete with Natural and Social Engineering: Learning the Lessons of Stakeholder Engagement from South West Water's Upland Catchment Management Programme Smith, D., Grand-Clement, E., Anderson, K., Luscombe, D., G, N., Bratis, Brazier, R.E Peatlands in the South West of the British Isles have been extensively drained for agricultural reclamation and peat cutting. The improvement in food production resulting from this management practice has never clearly been observed. Instead, we are now faced with several detrimental consequences on a whole suite of ecosystem services, such as the delivery of water, water quality, biodiversity and carbon storage. Alongside the direct environmental implications, poor water quality is increasing water treatment costs and will drive significant future investment. As a result, water companies now need to find appropriate solutions to varying water levels and decreasing water quality through catchment management. The Mires Project, the catchment management programme used by South West Water (SWW) is working with a wide range of stakeholders to restore the hydrological functioning of peatlands, and the ecosystem services they provide. This programme is driven by overarching legal requirements (i.e. the water framework directive, Natura 2000), future climate change predictions, corporate responsibility and commercial needs. Post-restoration scientific monitoring is at the heart of the project improving of our understanding of the eco-hydrological and chemical process driving changes in management practice. The challenges faced from the involvement of a wide range of stakeholders will be explored, focusing on the benefits from stakeholder involvement in catchment management and hydrological research, but also considering the difficulties to be overcome. SWW is working with private land-owners, government agencies, local and national park Authorities, community and single interest groups and research institutions to achieve its catchment management objectives. To achieve this it has replaced the traditional water company approach of hard engineering solutions with a mixture of softer natural and social engineering.

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

PubMed

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

2018-01-22

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

A protocol for the development of Mediterranean climate services based on the experiences of the CLIM-RUN case studies

NASA Astrophysics Data System (ADS)

Goodess, Clare; Ruti, Paolo; Rousset, Nathalie

2014-05-01

During the closing stages of the CLIM-RUN EU FP7 project on Climate Local Information in the Mediterranean region Responding to User Needs, the real-world experiences encountered by the case-study teams are being assessed and synthesised to identify examples of good practice and, in particular, to produce the CLIM-RUN protocol for the development of Mediterranean climate services. The specific case studies have focused on renewable energy (Morocco, Spain, Croatia, Cyprus), tourism (Savoie, Tunisia, Croatia, Cyprus) and wild fires (Greece) as well as one cross-cutting case study (Veneto region). They have been implemented following a common programme of local workshops, questionnaires and interviews, with Climate Expert Team and Stakeholder Expert Team members collaborating to identify and translate user needs and subsequently develop climate products and information. Feedback from stakeholders has been essential in assessing and refining these products. The protocol covers the following issues: the overall process and methodological key stages; identification and selection of stakeholders; communication with stakeholders; identification of user needs; translation of needs; producing products; assessing and refining products; methodologies for evaluating the economic value of climate services; and beyond CLIM-RUN - the lessons learnt. Particular emphasis is given to stakeholder analysis in the context of the participatory, bottom-up approach promoted by CLIM-RUN and to the iterative approach taken in the development of climate products. Recommendations are also made for an envisioned three-tier business model for the development of climate services involving climate, intermediary and stakeholder tiers.

How normative interpretations of climate risk assessment affect local decision-making: an exploratory study at the city scale in Cork, Ireland.

PubMed

McDermott, T K J; Surminski, S

2018-06-13

Urban areas already suffer substantial losses in both economic and human terms from climate-related disasters. These losses are anticipated to grow substantially, in part as a result of the impacts of climate change. In this paper, we investigate the process of translating climate risk data into action for the city level. We apply a commonly used decision-framework as our backdrop and explore where in this process climate risk assessment and normative political judgements intersect. We use the case of flood risk management in Cork city in Ireland to investigate what is needed for translating risk assessment into action at the local city level. Evidence presented is based on focus group discussions at two stakeholder workshops, and a series of individual meetings and phone-discussions with stakeholders involved in local decision-making related to flood risk management and adaptation to climate change, in Ireland. Respondents were chosen on the basis of their expertise or involvement in the decision-making processes locally and nationally. Representatives of groups affected by flood risk and flood risk management and climate adaptation efforts were also included. The Cork example highlights that, despite ever more accurate data and an increasing range of theoretical approaches available to local decision-makers, it is the normative interpretation of this information that determines what action is taken. The use of risk assessments for decision-making is a process that requires normative decisions, such as setting 'acceptable risk levels' and identifying 'adequate' protection levels, which will not succeed without broader buy-in and stakeholder participation. Identifying and embracing those normative views up-front could strengthen the urban adaptation process-this may, in fact, turn out to be the biggest advantage of climate risk assessment: it offers an opportunity to create a shared understanding of the problem and enables an informed evaluation and discussion of remedial action.This article is part of the theme issue 'Advances in risk assessment for climate change adaptation policy'. © 2018 The Author(s).

How normative interpretations of climate risk assessment affect local decision-making: an exploratory study at the city scale in Cork, Ireland

NASA Astrophysics Data System (ADS)

McDermott, T. K. J.; Surminski, S.

2018-06-01

Urban areas already suffer substantial losses in both economic and human terms from climate-related disasters. These losses are anticipated to grow substantially, in part as a result of the impacts of climate change. In this paper, we investigate the process of translating climate risk data into action for the city level. We apply a commonly used decision-framework as our backdrop and explore where in this process climate risk assessment and normative political judgements intersect. We use the case of flood risk management in Cork city in Ireland to investigate what is needed for translating risk assessment into action at the local city level. Evidence presented is based on focus group discussions at two stakeholder workshops, and a series of individual meetings and phone-discussions with stakeholders involved in local decision-making related to flood risk management and adaptation to climate change, in Ireland. Respondents were chosen on the basis of their expertise or involvement in the decision-making processes locally and nationally. Representatives of groups affected by flood risk and flood risk management and climate adaptation efforts were also included. The Cork example highlights that, despite ever more accurate data and an increasing range of theoretical approaches available to local decision-makers, it is the normative interpretation of this information that determines what action is taken. The use of risk assessments for decision-making is a process that requires normative decisions, such as setting `acceptable risk levels' and identifying `adequate' protection levels, which will not succeed without broader buy-in and stakeholder participation. Identifying and embracing those normative views up-front could strengthen the urban adaptation process-this may, in fact, turn out to be the biggest advantage of climate risk assessment: it offers an opportunity to create a shared understanding of the problem and enables an informed evaluation and discussion of remedial action. This article is part of the theme issue `Advances in risk assessment for climate change adaptation policy'.

Quality Assurance Framework Implementation Guide for Isolated Community Power Systems

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

Esterly, Sean R.; Baring-Gould, Edward I.; Burman, Kari A.

This implementation guide is a companion document to the 'Quality Assurance Framework for Mini-Grids' technical report. This document is intended to be used by one of the many stakeholder groups that take part in the implementation of isolated power systems. Although the QAF could be applied to a single system, it was designed primarily to be used within the context of a larger national or regional rural electrification program in which many individual systems are being installed. This guide includes a detailed overview of the Quality Assurance Framework and provides guidance focused on the implementation of the Framework from themore » perspective of the different stakeholders that are commonly involved in expanding energy development within specific communities or regions. For the successful long-term implementation of a specific rural electrification program using mini-grid systems, six key stakeholders have been identified that are typically engaged, each with a different set of priorities 1. Regulatory agency 2. Governmental ministry 3. System developers 4. Mini-utility 5. Investors 6. Customers/consumers. This document is broken into two distinct sections. The first focuses on the administrative processes in the development and operation of community-based mini-grid programs, while the second focuses on the process around the installation of the mini-grid project itself.« less

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

PubMed

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

2018-03-12

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

Establishing a process for conducting cross-jurisdictional record linkage in Australia.

PubMed

Moore, Hannah C; Guiver, Tenniel; Woollacott, Anthony; de Klerk, Nicholas; Gidding, Heather F

2016-04-01

To describe the realities of conducting a cross-jurisdictional data linkage project involving state and Australian Government-based data collections to inform future national data linkage programs of work. We outline the processes involved in conducting a Proof of Concept data linkage project including the implementation of national data integration principles, data custodian and ethical approval requirements, and establishment of data flows. The approval process involved nine approval and regulatory bodies and took more than two years. Data will be linked across 12 datasets involving three data linkage centres. A framework was established to allow data to flow between these centres while maintaining the separation principle that serves to protect the privacy of the individual. This will be the first project to link child immunisation records from an Australian Government dataset to other administrative health datasets for a population cohort covering 2 million births in two Australian states. Although the project experienced some delays, positive outcomes were realised, primarily the development of strong collaborations across key stakeholder groups including community engagement. We have identified several recommendations and enhancements to this now established framework to further streamline the process for data linkage studies involving Australian Government data. © 2015 Public Health Association of Australia.

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

PubMed

Galárraga, Omar; Bertozzi, Stefano M

2008-07-01

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

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

ERIC Educational Resources Information Center

Hoyle, Jeffrey A.

2013-01-01

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

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

PubMed Central

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

2018-01-01

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

Building Common Ground for Environmental Flows using Traditional Techniques and Novel Engagement Approaches.

PubMed

Mott Lacroix, Kelly E; Xiu, Brittany C; Megdal, Sharon B

2016-04-01

Despite increased understanding of the science of environmental flows, identification and implementation of effective environmental flow policies remains elusive. Perhaps the greatest barrier to implementing flow policies is the framework for water management. An alternative management approach is needed when legal rights for environmental flows do not exist, or are ineffective at protecting ecosystems. The research presented here, conducted in the U.S. state of Arizona, provides an empirical example of engagement to promote social learning as an approach to finding ways to provide water for the environment where legal rights for environmental flows are inadequate. Based on our engagement process we propose that identifying and then building common ground require attention to the process of analyzing qualitative data and the methods for displaying complex information, two aspects not frequently discussed in the social learning or stakeholder engagement literature. The results and methods from this study can help communities develop an engagement process that will find and build common ground, increase stakeholder involvement, and identify innovative solutions to provide water for the environment that reflect the concerns of current water users.

The decision-making process in Brazil's ratification of the World Health Organization Framework Convention on Tobacco Control.

PubMed

Rangel, Erica Cavalcanti; Pereira, Andre; Cavalcante, Tania Maria; Oliveira, Egléubia Andrade; Silva, Vera Luiza da Costa E

2017-09-21

Tobacco consumption is a leading cause of various types of cancer and other tobacco-related diseases. In 2003, the World Health Assembly adopted the World Health Organization Framework Convention on Tobacco Control (WHO-FCTC), which aims to protect citizens from the health, social, environmental, and economic consequences of tobacco consumption and exposure to tobacco smoke. The Convention was to be ratified by the Member States of the WHO; in Brazil's case, ratification involved the National Congress, which held public hearings in the country's leading tobacco growing communities (municipalities). The current study analyzes this decision-making process according to the different interests, positions, and stakeholders. In methodological terms, this is a qualitative study based on document research, drawing primarily on the shorthand notes from the public hearings. We analyze the interests and arguments for and against ratification. The article shows that although preceded by intense debates, the final decision in favor of ratification was made by a limited group of government stakeholders, characterizing a decision-making process similar to a funnel.

Collaborative partnership in age-friendly cities: two case studies from Quebec, Canada.

PubMed

Garon, Suzanne; Paris, Mario; Beaulieu, Marie; Veil, Anne; Laliberté, Andréanne

2014-01-01

This article aims to explain the collaborative partnership conditions and factors that foster implementation effectiveness within the age-friendly cities (AFC) in Quebec (AFC-QC), Canada. Based on a community-building approach that emphasizes collaborative partnership, the AFC-QC implementation process is divided into three steps: (1) social diagnostic of older adults' needs; (2) an action plan based on a logic model; and (3) implementation through collaborations. AFC-QC promotes direct involvement of older adults and seniors' associations at each of the three steps of the implementation process, as well as other stakeholders in the community. Based on two contrasting case studies, this article illustrates the importance of collaborative partnership for the success of AFC implementation. Results show that stakeholders, agencies, and organizations are exposed to a new form of governance where coordination and collaborative partnership among members of the steering committee are essential. Furthermore, despite the importance of the senior associations' participation in the process, they encountered significant limits in the capacity of implementing age-friendly environments solely by themselves. In conclusion, we identify the main collaborative partnership conditions and factors in AFC-QC.

Stakeholders' perspectives on quality indicators for diabetes care: a qualitative study.

PubMed

Markhorst, Joekie; Martirosyan, Liana; Calsbeek, Hiske; Braspenning, Jozé

2012-01-01

Transparency in diabetes care requires quality indicators that are of interest to stakeholders in order to optimise their usage. Indicator development is often focused on consensus, and little is known about stakeholders' preferences for information on quality. To explore the preferences of consumers, providers, purchasers and policy makers for different quality domains and indicators in relation to the intended use of quality indicators. Between June and December 2009, 14 semi-structured interviews were held with stakeholders who have a decisive vote in the selection of the national indicator set for diabetes care in the Netherlands. The following subjects were explored: (1) the aims of using information on quality; (2) the interpretation of and preferences for the quality domains of safety, timeliness, effectiveness and patient-centredness in relation to the user aims; and (3) the preferences for structure, process or outcome indicators. Content analysis was used to analyse qualitative data. Stakeholders had similar and different aims according to their roles. The interpretations of quality domains varied greatly between the stakeholders. Besides differences in interpretation, their preferences were similar. Most stakeholders prioritised patient-centredness above the other domains of quality, ranked in order of priority as safety, effectiveness and timeliness, whereas purchasers also prioritised efficiency. All stakeholders preferred to use process indicators or a mix of process and outcome indicators. The preferences of the stakeholders for quality indicators seem to be neither well-refined nor congruent. The implementation of an indicator set can probably be improved if the stakeholders' definitions and preferences for quality domains become more explicit during the selection process for indicators.

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

PubMed

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

2017-02-01

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

Voice, Collaboration and School Culture: Creating a Community for School Improvement. Evaluation of the Pioneer SCBM Schools, Hawaii's School/Community-Based Management Initiative. Executive Summary.

ERIC Educational Resources Information Center

Izu, Jo Ann; And Others

Site-based management is designed to bring decision making to the school level and involve all stakeholders in a process that will result ultimately in improved student outcomes. Enacted into law in June 1989, Hawaii's School/Community-Based Management Initiative (SCBM) is part of a national trend toward decentralizing decision making and…

The Degree to Which Students and Teachers Are Involved in Second-Level School Processes and Participation in Decision-Making: An Irish Case Study

ERIC Educational Resources Information Center

Harrison, Kathy; Taysum, Alison; McNamara, Gerry; O'Hara, Joe

2016-01-01

The Education Act (1998) is a key policy document in Irish education, emphasising the rights, roles and responsibilities of key stakeholders, including parents, teachers and pupils in schools. Since 1998 the Department of Education and Skills (DES) has stressed the need to introduce an increased role for teachers and pupils in decision-making. It…

Investing in Their Future: Portland’s Purchase and Conversion of an LED Street Lighting System

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

Kinzey, B. R.; Rosinbum, T.

During the ongoing process of converting its streetlights from high-pressure sodium to LED, the city of Portland, Oregon, purchased a large portion of its street lighting system and encountered a range of issues among the stakeholders. This report identifies some of the challenges involved and discusses how they were addressed, in order to help inform and facilitate future lighting transitions elsewhere.

Feasibility and acceptability of interventions to delay gun access in VA mental health settings.

PubMed

Walters, Heather; Kulkarni, Madhur; Forman, Jane; Roeder, Kathryn; Travis, Jamie; Valenstein, Marcia

2012-01-01

The majority of VA patient suicides are completed with firearms. Interventions that delay patients' gun access during high-risk periods may reduce suicide, but may not be acceptable to VA stakeholders or may be challenging to implement. Using qualitative methods, stakeholders' perceptions about gun safety and interventions to delay gun access during high-risk periods were explored. Ten focus groups and four individual interviews were conducted with key stakeholders, including VA mental health patients, mental health clinicians, family members and VA facility leaders (N=60). Transcripts were consensus-coded by two independent coders, and structured summaries were developed and reviewed using a consensus process. All stakeholder groups indicated that VA health system providers had a role in increasing patient safety and emphasized the need for providers to address gun access with their at-risk patients. However, VA mental health patients and clinicians reported limited discussion regarding gun access in VA mental health settings during routine care. Most, although not all, patients and clinicians indicated that routine screening for gun access was acceptable, with several noting that it was more acceptable for mental health patients. Most participants suggested that family and friends be involved in reducing gun access, but expressed concerns about potential family member safety. Participants generally found distribution of trigger locks acceptable, but were skeptical about its effectiveness. Involving Veteran Service Organizations or other individuals in temporarily holding guns during high-risk periods was acceptable to many participants but only with numerous caveats. Patients, clinicians and family members consider the VA health system to have a legitimate role in addressing gun safety. Several measures to delay gun access during high-risk periods for suicide were seen as acceptable and feasible if implemented thoughtfully. Published by Elsevier Inc.

Advancement of the Artificial Pancreas through the Development of Interoperability Standards

PubMed Central

Picton, Peter E.; Yeung, Melanie; Hamming, Nathaniel; Desborough, Lane; Dassau, Eyal; Cafazzo, Joseph A.

2013-01-01

Despite advancements in the development of the artificial pancreas, barriers in the form of proprietary data and communication protocols of diabetes devices have made the integration of these components challenging. The Artificial Pancreas Standards and Technical Platform Project is an initiative funded by the JDRF Canadian Clinical Trial Network with the goal of developing device communication standards for the interoperability of diabetes devices. Stakeholders from academia, industry, regulatory agencies, and medical and patient communities have been engaged in advancing this effort. In this article, we describe this initiative along with the process involved in working with the standards organizations and stakeholders that are key to ensuring effective standards are developed and adopted. Discussion from a special session of the 12th Annual Diabetes Technology Meeting is also provided. PMID:23911190

‘If no one else stands up, you have to’: a story of community participation and water in rural Guatemala

PubMed Central

Lorena Ruano, Ana; Dahlblom, Kjerstin; Hurtig, Anna-Karin; San Sebastián, Miguel

2011-01-01

Background Access to water is a right and a social determinant of health that should be provided by the state. However, when it comes to access to water in rural areas, the current trend is for communities to arrange for the service themselves through locally run projects. This article presents a narrative of a single community's process of participation in implementing and running a water project in the village of El Triunfo, Guatemala. Methods Using an ethnographic approach, we conducted a series of interviews with five village leaders, field visits, and participant observations in different meetings and activities of the community. Findings El Triunfo has had a long tradition of community participation, where it has been perceived as an important value. The village has a council of leaders who have worked together in various projects, although water has always been a priority. When it comes to participation, this community has achieved its goals when it collaborated with other stakeholders who provided the expertise and/or the funding needed to carry out a project. At the time of the study, the challenge was to develop a new phase of the water project with the help of other stakeholders and to maintain and sustain the tradition of participation by involving new generations in the process. Discussion This narrative focuses on the participation in this village's efforts to implement a water project. We found that community participation has substituted the role of the central and local governments, and that the collaboration between the council and other stakeholders has provided a way for El Triunfo to satisfy some of its demand for water. Conclusion El Triunfo's case shows that for a participatory scheme to be successful it needs prolonged engagement, continued support, and successful experiences that can help to provide the kind of stable participatory practices that involves community members in a process of empowered decision-making and policy implementation. PMID:21977011

Accountability in Community Colleges Using Stakeholder Theory

ERIC Educational Resources Information Center

Pitcher, Paula R.

2012-01-01

The purpose of the present study is to analyze stakeholder theory and its applicability to community college accountability. Community colleges have been using strategic planning as a management approach that includes the process of strategic action, and many organizations claim that they collaborate with their stakeholders during this process.…

How does the context and design of participatory decision-making processes affect their outcomes? Evidence from sustainable land management in global drylands.

NASA Astrophysics Data System (ADS)

de Vente, Joris; Reed, Mark; Stringer, Lindsay; Valente, Sandra; Newig, Jens

2014-05-01

It is widely accepted that the design of participatory processes in environmental management needs to be adapted to local contexts. Yet, it is not clear which elements of process design are universal, making it difficult to design processes that deliver beneficial outcomes across different contexts. We used empirical evidence to analyse the extent to which context and process design can enable or impede stakeholder participation and facilitate beneficial environmental and social outcomes in a range of decision-making contexts where stakeholders are engaged in environmental management. To explore the role of national-scale context on the outcomes of participatory processes, we interviewed facilitators from a process that was replicated across 13 dryland study sites around the world, which focussed on selecting Sustainable Land Management (SLM) options in close collaboration with stakeholders. To explore the role of process design and local context, we interviewed participants and facilitators in 11 case studies in Spain and Portugal in which different process designs were used. Interview data were analysed using a combination of quantitative and qualitative approaches to characterise relationships between process design, context and process outcomes. The similarity of outcomes across the 13 international study sites suggested that the national socio-cultural context in which a participatory process is conducted has little impact on its outcomes. However, analysis of cases from Spain and Portugal showed that some aspects of local context may affect outcomes. Having said this, factors associated with process design and participant selection played a more significant role in influencing outcomes in both countries. Processes that led to more beneficial outcomes for the environment and/or participants were likely to include: the legitimate representation of stakeholders; professional facilitation including structured methods for eliciting and aggregating information and balancing power dynamics between participants; and the provision of information and decision-making power to all participants. Participatory processes initiated or facilitated by government bodies led to significantly less trust, information gain, learning, and flexible solutions. However, in these processes, decisions were more acceptable to and likely to be implemented by governments and by those who had to apply them on the ground. These findings provide a solid empirical basis for best practice in the design of participatory processes in SLM in a number of contexts internationally, which if followed, increase the likelihood of providing beneficial environmental and social outcomes for those involved.

Stakeholder engagement: a model for tobacco policy planning in Oklahoma Tribal communities.

PubMed

Blanchard, Jessica W; Petherick, J T; Basara, Heather

2015-01-01

Oklahoma law pre-empts local governments from enacting smoking restrictions inside public places that are stricter than state law, but the sovereign status of Oklahoma's 38 Tribal nations means they are uniquely positioned to stand apart as leaders in the area of tobacco policy. To provide recommendations for employing university-Tribal partnerships as an effective strategy for tobacco policy planning in tribal communities. Using a community-based participatory research approach, researchers facilitated a series of meetings with key Tribal stakeholders in order to develop a comprehensive tobacco policy plan. Ongoing engagement activities held between January 2011 and May 2012, including interdepartmental visits, facility site tours, interviews, and attendance at tribal activities, were critical for fostering constructive and trusting relationships between all partners involved in the policy planning process. The 17-month collaborative engagement produced a plan designed to regulate the use of commercial tobacco in all Tribally owned properties. The extended period of collaboration between the researchers and Tribal stakeholders facilitated: (1) levels of trust between partners; and (2) a steadfast commitment to the planning process, ensuring completion of the plan amid uncertain political climates and economic concerns about tobacco bans. Extended engagement produced an effective foundation for policy planning that promoted collaboration between otherwise dispersed Tribal departments, and facilitated communication of diverse stakeholder interests related to the goal of tobacco policies. The findings of this study provide useful strategies and best practices for those looking to employ Tribal-university partnerships as strategies for tobacco control planning and policy-based research. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Translating reference doses into allergen management practice: challenges for stakeholders.

PubMed

Crevel, René W R; Baumert, Joseph L; Luccioli, Stefano; Baka, Athanasia; Hattersley, Sue; Hourihane, Jonathan O'B; Ronsmans, Stefan; Timmermans, Frans; Ward, Rachel; Chung, Yong-joo

2014-05-01

Risk assessment describes the impact of a particular hazard as a function of dose and exposure. It forms the foundation of risk management and contributes to the overall decision-making process, but is not its endpoint. This paper outlines a risk analysis framework to underpin decision-making in the area of allergen cross-contact. Specifically, it identifies challenges relevant to each component of the risk analysis: risk assessment (data gaps and output interpretation); risk management (clear and realistic objectives); and risk communication (clear articulation of risk and benefit). Translation of the outputs from risk assessment models into risk management measures must be informed by a clear understanding of the model outputs and their limitations. This will lead to feasible and achievable risk management objectives, grounded in a level of risk accepted by the different stakeholders, thereby avoiding potential unintended detrimental consequences. Clear, consistent and trustworthy communications actively involving all stakeholders underpin these objectives. The conclusions, integrating the perspectives of different stakeholders, offer a vision where clear, science-based benchmarks form the basis of allergen management and labelling, cutting through the current confusion and uncertainty. Finally, the paper recognises that the proposed framework must be adaptable to new and emerging evidence. Copyright © 2014 ILSI Europe. Published by Elsevier Ltd.. All rights reserved.

Creative tensions: mutual responsiveness adapted to private sector research and development.

PubMed

Sonck, Matti; Asveld, Lotte; Landeweerd, Laurens; Osseweijer, Patricia

2017-09-07

The concept of mutual responsiveness is currently based on little empirical data in the literature of Responsible Research and Innovation (RRI). This paper explores RRI's idea of mutual responsiveness in the light of recent RRI case studies on private sector research and development (R&D). In RRI, responsible innovation is understood as a joint endeavour of innovators and societal stakeholders, who become mutually responsive to each other in defining the 'right impacts' of the innovation in society, and in steering the innovation towards realising those impacts. Yet, the case studies identified several reasons for why the idea of mutual responsiveness does not always appear feasible or desirable in actual R&D situations. Inspired by the discrepancies between theory and practice, we suggest three further elaborations for the concept of responsiveness in RRI. Process-responsiveness is suggested for identifying situations that require stakeholder involvement specifically during R&D. Product-responsiveness is suggested for mobilising the potential of innovation products to be adaptable according to diverse stakeholder needs. Presponsiveness is suggested as responsiveness towards stakeholders that are not (yet) reachable at a given time of R&D. Our aim is to contribute to a more tangible understanding of responsiveness in RRI, and suggest directions for further analysis in upcoming RRI case studies.

Adaptive Biomedical Innovation: Evolving Our Global System to Sustainably and Safely Bring New Medicines to Patients in Need

PubMed Central

Trusheim, M; Cobbs, E; Bala, M; Garner, S; Hartman, D; Isaacs, K; Lumpkin, M; Lim, R; Oye, K; Pezalla, E; Saltonstall, P; Selker, H

2016-01-01

The current system of biomedical innovation is unable to keep pace with scientific advancements. We propose to address this gap by reengineering innovation processes to accelerate reliable delivery of products that address unmet medical needs. Adaptive biomedical innovation (ABI) provides an integrative, strategic approach for process innovation. Although the term “ABI” is new, it encompasses fragmented “tools” that have been developed across the global pharmaceutical industry, and could accelerate the evolution of the system through more coordinated application. ABI involves bringing stakeholders together to set shared objectives, foster trust, structure decision‐making, and manage expectations through rapid‐cycle feedback loops that maximize product knowledge and reduce uncertainty in a continuous, adaptive, and sustainable learning healthcare system. Adaptive decision‐making, a core element of ABI, provides a framework for structuring decision‐making designed to manage two types of uncertainty – the maturity of scientific and clinical knowledge, and the behaviors of other critical stakeholders. PMID:27626610

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

NASA Astrophysics Data System (ADS)

Romulus, Elijah Rey Asse

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

A cloud based tool for knowledge exchange on local scale flood risk.

PubMed

Wilkinson, M E; Mackay, E; Quinn, P F; Stutter, M; Beven, K J; MacLeod, C J A; Macklin, M G; Elkhatib, Y; Percy, B; Vitolo, C; Haygarth, P M

2015-09-15

There is an emerging and urgent need for new approaches for the management of environmental challenges such as flood hazard in the broad context of sustainability. This requires a new way of working which bridges disciplines and organisations, and that breaks down science-culture boundaries. With this, there is growing recognition that the appropriate involvement of local communities in catchment management decisions can result in multiple benefits. However, new tools are required to connect organisations and communities. The growth of cloud based technologies offers a novel way to facilitate this process of exchange of information in environmental science and management; however, stakeholders need to be engaged with as part of the development process from the beginning rather than being presented with a final product at the end. Here we present the development of a pilot Local Environmental Virtual Observatory Flooding Tool. The aim was to develop a cloud based learning platform for stakeholders, bringing together fragmented data, models and visualisation tools that will enable these stakeholders to make scientifically informed environmental management decisions at the local scale. It has been developed by engaging with different stakeholder groups in three catchment case studies in the UK and a panel of national experts in relevant topic areas. However, these case study catchments are typical of many northern latitude catchments. The tool was designed to communicate flood risk in locally impacted communities whilst engaging with landowners/farmers about the risk of runoff from the farmed landscape. It has been developed iteratively to reflect the needs, interests and capabilities of a wide range of stakeholders. The pilot tool combines cloud based services, local catchment datasets, a hydrological model and bespoke visualisation tools to explore real time hydrometric data and the impact of flood risk caused by future land use changes. The novel aspects of the pilot tool are; the co-evolution of tools on a cloud based platform with stakeholders, policy and scientists; encouraging different science disciplines to work together; a wealth of information that is accessible and understandable to a range of stakeholders; and provides a framework for how to approach the development of such a cloud based tool in the future. Above all, stakeholders saw the tool and the potential of cloud technologies as an effective means to taking a whole systems approach to solving environmental issues. This sense of community ownership is essential in order to facilitate future appropriate and acceptable land use management decisions to be co-developed by local catchment communities. The development processes and the resulting pilot tool could be applied to local catchments globally to facilitate bottom up catchment management approaches. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Factors influencing the introduction of physical activity interventions in primary health care: a qualitative study.

PubMed

Huijg, Johanna M; van der Zouwe, Nicolette; Crone, Mathilde R; Verheijden, Marieke W; Middelkoop, Barend J C; Gebhardt, Winifred A

2015-06-01

The introduction of efficacious physical activity (PA) interventions in routine primary health care (PHC) is a complex process. Understanding factors influencing the process can enhance the development of successful introduction strategies. The aim of this qualitative study was to explore stakeholders' perceptions on factors influencing the introduction, i.e., adoption, implementation, and continuation, of PA interventions in PHC. Twenty-eight semistructured interviews were held with intervention managers, PHC advisors, intervention providers, and referring general practitioners of five PA interventions delivered in PHC. A theoretical framework on the introduction of innovations in health care was used to guide the data collection. Influencing factors were identified using thematic analysis. Stakeholders reported preconditions for the introduction of PA interventions in PHC (e.g., support, resources, and networks and collaborations), in addition to characteristics of PA interventions (e.g., compatibility, flexibility, and intervention materials) and characteristics of PHC professionals (e.g., knowledge, positive attitudes, and beliefs about capabilities) perceived to enhance the introduction process. Furthermore, they proposed strategies for the development of PA interventions (e.g., involvement of future stakeholders, full development, and refinement) and strategies to introduce PA interventions in PHC (e.g., training, assistance, and reinforcement). The majority of the influencing factors were discussed specifically in relation to one or two stages. This study presents an overview of factors that are perceived to influence the introduction of PA interventions in PHC. It underscores the importance of taking these factors into account when designing introduction strategies and of giving special attention to the distinct stages of the process.

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

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

PubMed Central

2014-01-01

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

Value Assessment Frameworks for HTA Agencies: The Organization of Evidence-Informed Deliberative Processes.

PubMed

Baltussen, Rob; Jansen, Maarten Paul Maria; Bijlmakers, Leon; Grutters, Janneke; Kluytmans, Anouck; Reuzel, Rob P; Tummers, Marcia; der Wilt, Gert Jan van

2017-02-01

Priority setting in health care has been long recognized as an intrinsically complex and value-laden process. Yet, health technology assessment agencies (HTAs) presently employ value assessment frameworks that are ill fitted to capture the range and diversity of stakeholder values and thereby risk compromising the legitimacy of their recommendations. We propose "evidence-informed deliberative processes" as an alternative framework with the aim to enhance this legitimacy. This framework integrates two increasingly popular and complementary frameworks for priority setting: multicriteria decision analysis and accountability for reasonableness. Evidence-informed deliberative processes are, on one hand, based on early, continued stakeholder deliberation to learn about the importance of relevant social values. On the other hand, they are based on rational decision-making through evidence-informed evaluation of the identified values. The framework has important implications for how HTA agencies should ideally organize their processes. First, HTA agencies should take the responsibility of organizing stakeholder involvement. Second, agencies are advised to integrate their assessment and appraisal phases, allowing for the timely collection of evidence on values that are considered relevant. Third, HTA agencies should subject their decision-making criteria to public scrutiny. Fourth, agencies are advised to use a checklist of potentially relevant criteria and to provide argumentation for how each criterion affected the recommendation. Fifth, HTA agencies must publish their argumentation and install options for appeal. The framework should not be considered a blueprint for HTA agencies but rather an aspirational goal-agencies can take incremental steps toward achieving this goal. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Responsible decision-making for plant research and breeding innovations in the European Union.

PubMed

Eriksson, Dennis; Chatzopoulou, Sevasti

2018-01-02

Plant research and breeding has made substantial technical progress over the past few decades, indicating a potential for tremendous societal impact. Due to this potential, the development of policies and legislation on plant breeding and the technical progress should preferably involve all relevant stakeholders. However, we argue here that there is a substantial imbalance in the European Union (EU) regarding the influence of the various stakeholder groups on policy makers. We use evidence from three examples in order to show that the role of science is overlooked: 1) important delays in the decision process concerning the authorization of genetically modified (GM) maize events, 2) the significance attributed to non-scientific reasons in new legislation concerning the prohibition of GM events in EU member states, and 3) failure of the European Commission to deliver legal guidance to new plant breeding techniques despite sufficient scientific evidence and advisory reports. We attribute this imbalance to misinformation and misinterpretation of public perceptions and a disproportionate attention to single outlier reports, and we present ideas on how to establish a better stakeholder balance within this field.

Automated negotiation in environmental resource management: Review and assessment.

PubMed

Eshragh, Faezeh; Pooyandeh, Majeed; Marceau, Danielle J

2015-10-01

Negotiation is an integral part of our daily life and plays an important role in resolving conflicts and facilitating human interactions. Automated negotiation, which aims at capturing the human negotiation process using artificial intelligence and machine learning techniques, is well-established in e-commerce, but its application in environmental resource management remains limited. This is due to the inherent uncertainties and complexity of environmental issues, along with the diversity of stakeholders' perspectives when dealing with these issues. The objective of this paper is to describe the main components of automated negotiation, review and compare machine learning techniques in automated negotiation, and provide a guideline for the selection of suitable methods in the particular context of stakeholders' negotiation over environmental resource issues. We advocate that automated negotiation can facilitate the involvement of stakeholders in the exploration of a plurality of solutions in order to reach a mutually satisfying agreement and contribute to informed decisions in environmental management along with the need for further studies to consolidate the potential of this modeling approach. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

PubMed

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

2016-01-01

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

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

PubMed

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

2017-04-01

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

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

PubMed

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

2017-09-01

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

"Dis-able bodied" or "dis-able minded": stakeholders' return-to-work experiences compared between physical and mental health conditions.

PubMed

Vossen, Emmie; Van Gestel, Nicolette; Van der Heijden, Beatrice I J M; Rouwette, Etiënne A J A

2017-05-01

This study aimed to explore if and why the return-to-work (RTW) experiences of various workplace stakeholders in the Netherlands and Denmark differ between physical and mental health conditions, and to understand the consequences of potentially different experiences for the RTW process in both health conditions. We studied 21 cases of long-term sickness absence, and held a total of 61 semi-structured interviews with the various actors involved in these cases. Physical cases were seen as "easy" and mental cases as "difficult" to manage, based on the visibility and predictability of health complaints. On this ground, assessing work ability and following required RTW actions were perceived as more urgent in mental than in physical cases. Despite these perceptions, in practice, the assessment of work ability seemed to impair the RTW process in mental cases (but not in physical ones), and the (non-)uptake of RTW actions appeared to have similar results in both mental and physical cases. With these outcomes, the effectiveness of a differential approach is questioned, and the relevance of a bidirectional dialog on work ability and a phased RTW plan is highlighted, regardless of the absence cause. Our study also demonstrates how policymakers need to strike a balance between obligatory and permissive legislation to better involve workplaces in RTW issues. Implications for rehabilitation Both physically and mentally sick-listed employees could benefit from a bidirectional dialog on work ability as well as from a phased RTW plan. A greater role for employers in the RTW process should be accompanied with a support for sick-listed employees, in both physical and mental sickness absence cases. Dutch and Danish RTW legislation could be improved by carefully balancing obligatory and permissive rules and regulations to involve workplaces in RTW matters.

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

PubMed

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

2017-06-13

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

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

PubMed

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

2017-04-11

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

Value driven innovation in medical device design: a process for balancing stakeholder voices.

PubMed

de Ana, F J; Umstead, K A; Phillips, G J; Conner, C P

2013-09-01

The innovation process has often been represented as a linear process which funnels customer needs through various business and process filters. This method may be appropriate for some consumer products, but in the medical device industry there are some inherent limitations to the traditional innovation funnel approach. In the medical device industry, there are a number of stakeholders who need to have their voices heard throughout the innovation process. Each stakeholder has diverse and unique needs relating to the medical device, the needs of one may highly affect the needs of another, and the relationships between stakeholders may be tenuous. This paper describes the application of a spiral innovation process to the development of a medical device which considers three distinct stakeholder voices: the Voice of the Customer, the Voice of the Business and the Voice of the Technology. The process is presented as a case study focusing on the front-end redesign of a class III medical device for an orthopedics company. Starting from project initiation and scope alignment, the process describes four phases, Discover, Envision, Create, and Refine, and concludes with value assessment of the final design features.

Public Participation Planning of Environmental Impact Assessment (EIA) and Regulations: Analysis of Inconsistency for Some Cases in Indonesia

NASA Astrophysics Data System (ADS)

Hindrayani, Aniek; Purwanto

2018-02-01

The failure in community involvement during the environmental documents planning may result in the failure of the planned project implementation. This study aims to determine the gap between practices and regulations that apply to the process of community involvement in the environmental documents planning, and find out inconsistency of implementation on each stakeholder in the planning of the Environmental Impact Assessment (EIA) and the environmental permit. The method used was qualitative through interview and literature study which is analyzed using triangulation model and presented in the form of concept map. The results of the study indicate that 1) the determination of community representatives based on the criteria of the impacted communities is not clearly described, 3) suggestions, opinions, and responses to the environmental impact management are not well implemented by the project proponent, 3) implementation of the environmental management of other licensed activities affecting the behavior (4) stakeholders (project proponent, EIA consultants, and EIA appraisal committee) do not play their role as mandated in applicable legislation.

The role of experts in postaccident recovery: lessons learnt from Chernobyl and Fukushima.

PubMed

Gariel, J C; Rollinger, F; Schneider, T

2018-01-01

Following a nuclear accident, a major dilemma for affected people is whether to stay or leave the affected area, or, for those who have been evacuated, whether or not to return to the decontaminated zones. Populations who have to make such decisions have to consider many parameters, one of which is the radiological situation. Feedback from Chernobyl and Fukushima has demonstrated that involvement and empowerment of the affected population is a way to provide them with the necessary elements to make informed decisions and, if they decide to return to decontaminated areas, to minimise exposure by contributing to the development of a prudent attitude and vigilance towards exposure. However, involving stakeholders in postaccident management raises the question of the role of experts and public authorities in supporting the inhabitants who have to make decisions about their future. Based on experiences in Chernobyl and Fukushima, this paper will discuss various principles that have to be taken into account by experts and public authorities about their role and position when dealing with stakeholders in a postaccident recovery process.

76 FR 34087 - Broad Stakeholder Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-10

... DEPARTMENT OF HOMELAND SECURITY [Docket No. DHS-2011-0027] Broad Stakeholder Survey AGENCY... Survey. DATES: Comments are encouraged and will be accepted until August 9, 2011. This process is... Stakeholder Survey is designed to gather stakeholder feedback on the effectiveness of OEC services and to...

77 FR 50144 - Broad Stakeholder Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-20

... DEPARTMENT OF HOMELAND SECURITY [Docket No. DHS-2012-0042] Broad Stakeholder Survey AGENCY... Survey. DATES: Comments are encouraged and will be accepted until October 19, 2012. This process is.... The Broad Stakeholder Survey is designed to gather stakeholder feedback on the effectiveness of OEC...

[Needs assessment to improve the applicability and methodological quality of a German S3 guideline].

PubMed

Burckhardt, Marion; Hoffmann, Cristina; Nink-Grebe, Brigitte; Sänger, Sylvia

2018-04-01

Clinical practice guidelines can change the practice in healthcare only if their recommendations are implemented in a comprehensive way. The German S3 guideline "Local Therapy of Chronic Wounds in Patients with Peripheral Vascular Disease, Chronic Venous Insufficiency, and Diabetes" will be updated in 2017. The emphasis here is on the guideline's validity, user-friendliness and implementation into practice. Therefore, the aim was to identify the improvements required in regard to the guideline's methods and content presentation. The methodological approach used was the critical appraisal of the guideline according to established quality criteria and an additional stakeholder survey. Both were conducted between August and November 2016. The guideline and its related documents were reviewed independently by two researchers according to the criteria of the "Appraisal of Guidelines for Research and Evaluation" (AGREE-II). Published reviews and peer reviews by external experts and organisations were also taken into account. For the stakeholder survey, a questionnaire with open questions was distributed by e-mail and via the Internet to health professionals and organisations involved in the care of patients with leg ulcers in Germany. The questions were aimed at amendments and new topics based on the stakeholders' experience in inpatient and outpatient care. In addition, the survey focused on gathering suggestions to improve the applicability of the guideline. Suggested new topics and amendments were summarised thematically. The stakeholders' suggestions to improve the applicability, the results of the critical appraisal and the relevant aspects of the external reviews were then summarised according to the AGREE-II domains and presented in a cause and effect diagram. 17 questionnaires (out of 864 sent out by e-mail) were returned. Due to high practice relevance, the stakeholders suggested an expansion of the inclusion criteria to patients with infected wounds and pressure ulcers. They also proposed that plastic surgical procedures, several specific wound products and complementary measures should be included. The guideline is of high methodical quality with respect to the systematic synthesis and the formal expert recommendations. From both the stakeholders' and reviewers' perspectives, the guideline should be more in line with what guideline users regarded as key issues. The recommendations should be more action-oriented. Implementation concepts should be provided to teach, implement and evaluate the guideline in healthcare facilities. The updating process should also follow current standards for guideline development, for systematic reviews and for managing conflict of interests. The guideline is of high methodological quality but currently difficult to implement in clinical practice. The structured evaluation clearly reflects not only the potential for improvement but also provides a transparent theoretical framework for experts and scientific medical societies involved in the guideline updating process. Although some valuable insights were gained from the stakeholders' perspective, the representativeness is limited by the low response rate. Copyright © 2018. Published by Elsevier GmbH.

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.

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

PubMed

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

2017-05-11

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

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

PubMed

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

2013-12-01

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

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

Physical Activity and Exercise Interventions in the Workplace Impacting Work Outcomes: A Stakeholder-Centered Best Evidence Synthesis of Systematic Reviews.

PubMed

White, M I; Dionne, C E; Wärje, O; Koehoorn, M; Wagner, S L; Schultz, I Z; Koehn, C; Williams-Whitt, K; Harder, H G; Pasca, R; Hsu, V; McGuire, L; Schulz, W; Kube, D; Wright, M D

2016-04-01

The prevention of work disability is beneficial to employees and employers, and mitigates unnecessary societal costs associated with social welfare. Many service providers and employers have initiated workplace interventions designed to reduce unnecessary work disability. To conduct a best-evidence synthesis of systematic reviews on workplace interventions that address physical activities or exercise and their impact on workplace absence, work productivity or financial outcomes. Using a participatory research approach, academics and stakeholders identified inclusion and exclusion criteria, built an abstraction table, evaluated systematic review quality and relevance, and interpreted the combined findings. A minimum of two scientists participated in a methodological review of the literature followed by a consensus process. Stakeholders and researchers participated as a collaborative team. 3363 unique records were identified, 115 full text articles and 46 systematic reviews were included, 18 assessed the impact of physical fitness or exercise interventions. 11 focused on general workers rather than workers who were absent from work at baseline; 16 of the reviews assessed work absence, 4 assessed productivity and 6 assessed financial impacts. The strongest evidence supports the use of short, simple exercise or fitness programs for both workers at work and those absent from work at baseline. For workers at work, simple exercise programs (1-2 modal components) appear to provide similar benefits to those using more complex multimodal interventions. For workers off-work with subacute low back pain, there is evidence that some complex exercise programs may be more effective than simple exercise interventions, especially if they involve workplace stakeholder engagement, communication and coordination with employers and other stakeholders. The development and utilization of standardized definitions, methods and measures and blinded evaluation would improve research quality and strengthen stakeholder-centered guidance.

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

NASA Astrophysics Data System (ADS)

Setiawan, Muhammad Arif; Muhammad, Fuad

2018-02-01

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