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This paper builds on a previous article describing an innovative approach to enhance the service user and practitioner's experience of novel collaborative approach to service improvement. It aims to explore the impact of this through the voices of service users as collaborators and co-authors. The Recovery and Collaborative Care Planning Café (RCCPC) designed with World Café principles, created a safe space to foster inquiry and learning about recovery between service users, carers, and practitioners in an NHS Trust. An important part of the method was in changing conversations towards recovery and living well with conditions applying CHIME concepts (Connectedness, Hope, Identity, Meaning, and Empowerment). Story is a qualitative method known as a well-established effective means of engaging others in sharing experiences and perspectives. Through the stories of service users' experiences participating in the RCCP Cafe, it was clear that they felt that CHIME concepts had a positive impact on the way that their conversations evolved. Accounts of how these conversations had resulted in personal growth and increased connectedness emerged. [ABSTRACT FROM AUTHOR]

Resilience is an important attribute of incident management teams (IMTs) for managing disasters. Previous research on resilience of IMTs has focused on comparing work-as-imagined (WAI) and work-as-done (WAD) but predominantly used narrative analyses which limited comparisons between IMTs. This paper presents a novel Interaction Episode Analysis (IEA) method to identify the IMT's WAI and WAD episodes by analyzing dynamic interactions that occur between different roles that carry out information management tasks. Observations and audio--visual recordings of two high-fidelity IMT exercises were conducted to capture WAD episodes, and semi-structured interviews with experts elicited corresponding WAI episodes. Quantitative analyses using five interaction-based measures were conducted to detect differences of the WAD episodes between two IMTs. Next, qualitative analyses were focused on identifying reasons why such differences have occurred by comparing the gaps between WAI and WAD episodes. Some of the reasons for WAI-WAD gaps included the non-occurrence of critical interactions that were expected and occurrence of unexpected interactions between IMT members. This paper also identifies cases of preparatory, proactive, and reactive performance adjustment that characterizes IMT resilience. The IEA method shows promise for investigating how and why the gaps between WAI and WAD in IMTs occur. With the identification of these gaps, future research can be conducted to reconcile the gaps between WAI and WAD episodes, and thus enhance resilience of IMTs in future disasters. [ABSTRACT FROM AUTHOR]

Introduction: Early stakeholder engagement is critical to the successful development and translation of rehabilitation technologies, a pivotal step of which is usability testing with intended end-users. To this end, several methods employ end-user feedback to identify usability and implementation issues. However, the process of prioritizing identified issues seldom leverages the knowledge and expertise of the range of stakeholders who will ultimately affect the demand and supply of a device. This paper describes a novel method to prioritize end-user feedback using transdisciplinary stakeholder consultation and address it in subsequent product development. The proposed approach was demonstrated using a case study relating to the development of a novel technology for neural recovery after spinal cord injury. Method: Feedback from five individuals with chronic spinal cord injury was collected during two-hour usability evaluation sessions with a fully functional high-fidelity system prototype. A think-aloud and semi-structured interview protocol was used with each participant to identify usability and acceptability issues relating to the system in a 3-phase approach. Phase 1 involved extracting usability issues from think-aloud and semi-structured interview data. Phase 2 involved rating the usability issues based on their significance, technical feasibility, and implementation priority by relevant internal and external stakeholders. Finally, Phase 3 involved aggregating the usability issues according to design and implementation elements to facilitate solution generation, and these solutions were then raised as action tasks for future design iterations. Results: Sixty usability issues representing nine facets of usability were rated. Eighty percent of issues were rated to be of moderate to high significance, 83% were rated as being feasible to address, and 75% were rated as addressable using existing project resources. Fifty percent of the issues were rated to be a high priority for implementation. Evaluation of the grouped issues identified 21 tasks which were mapped to the product roadmap for integration into future design iterations. Discussion: This paper presents a method for meaningful transdisciplinary stakeholder engagement in rehabilitation technology development that can extended to other projects. Alongside a worked example, we offer practical considerations for others seeking to co-develop rehabilitation technologies. [ABSTRACT FROM AUTHOR]

Background: The Partners in Recovery (PIR) program was implemented by the Australian Government Department of Health. Its overriding aim was to improve the coordination of services for people with severe and persistent mental illness, and who have complex needs that are not being met. The PIR capacity-building project (CBP) was funded to provide capacity building activities to the nationwide network of consortia that were set up in 2013 to deliver PIR over a 3-year period. The purpose of this paper is to describe the design and findings from an evaluation of the PIR CBP. Methods: The evaluation involved collecting feedback from consenting PIR staff via an online survey and follow-up semi-structured interviews. CBP activities included: state and national meetings; a web portal; teleconferences; webinars; a support facilitator mentor program; and tailored support from the CBP team. Results: The CBP made a positive contribution to the implementation and delivery of PIR. Staff highly valued activities that employed face-to-face interaction or provided informative knowledge exchange, and were appreciative of CBP staff being responsive and adaptable to their needs. Conclusions: From this evaluation, we recommend the following: identify relevant functions (e.g. prioritise networking), select the right mode of delivery (e.g. establish an online presence) and abide by key principles (e.g. be responsive to staff needs). This information is informing the mental health workforce capacity building activities that our team is currently undertaking. Capacity-building programs are necessary for advancing new public health initiatives, yet there remains limited evidence to inform best practices for delivering these in the context of mental health. This paper describes the design and findings of a capacity-building program developed to enhance the knowledge and skills of community-based mental health providers. From this evaluation, we recommend the following to ensure effective capacity-building programs: identify relevant functions (e.g. prioritise networking), select the right mode of delivery (e.g. establish an online presence) and abide by key principles (e.g. be responsive to staff needs). [ABSTRACT FROM AUTHOR]

Purpose: There is a growing call both globally and nationally for integrated multisectoral and multidisciplinary systems of care to be implemented for children's needs in the foundation stages of their growth to be met. Extant literature shows that historical, structural, epidemiological, political and social factors create many adversities for South African children both in the short and in the long term. South Africa's fragmented and weak service delivery compounds the situation. In this paper, the authors describe the lessons learnt from a multisectoral and multidisciplinary community of practice established to strengthen social systems to ensure child wellbeing outcomes. Design/methodology/approach: A qualitative research design was used, drawing on data collected over a two-year period. Data included meeting minutes, focus group discussions, and email communications between project partners. Focus group discussions were audio-recorded and transcribed verbatim. Data was analysed thematically. Findings: Findings show that having a shared goal, establishing supportive, mutually beneficial relationships and contributing to services that enhance child wellbeing outcomes enabled the community of practice, while differing organizational mandates and heavy workloads constrained the partnership. Research limitations/implications: The study shows the effectiveness of a Community of Practice (CoP) in integrating services across sectors for children's well-being and promoting collaborative learning and intersectoral work. However, this success also depends on the presence of strong leadership and efficient coordination.Limitation: Despite its benefits, the CoP model presents challenges, including securing active participation and buy-in from stakeholders, managing time and resource constraints, and dealing with issues in the existing service delivery system. Questions about long-term sustainability and the practicalities of scaling and institutionalizing the model need to be addressed. Originality/value: Through this paper, the authors contribute to a nascent area of research in the Global South, critically reflecting on the lessons the authors learnt from implementing an integrated community of practice approach to strengthen social sector systems toward the enhancement of children's wellbeing. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this paper is to empirically describe and analyze factors deemed to be relevant for the successful provision of coordinated paediatric oncology care by physicians and nurses involved. Design/methodology/approach: A qualitative case study primarily consisting of interviews. Findings: The paper's findings indicate that certain factors (i.e. distinct mission, clear treatment protocols and support from external stakeholders) relevant for the provision of coordinated paediatric oncology care have not received sufficient attention in previous research. In addition, emphasis is placed on the necessity of facilitating constructive working relationships and a bottom-up perspective when pursuing improved care coordination. Originality/value: The factors described and analyzed may act as insights for how paediatric oncology might be improved in terms of care coordination and thus facilitate care integration. In addition, the paper's findings identify factors relevant for further empirical studies in order to delineate their generalizability. [ABSTRACT FROM AUTHOR]

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Purpose: This research was conducted as part of a PhD study. The purpose of this paper is to explore the factors taken into consideration when multi-agency practitioners were considering financial harm in the context of adult protection and how this influenced their decision-making processes. Design/methodology/approach: An adapted q sort methodology initially established the areas of financial harm considered to have additional factors, which led to complexity in adult protection decision making. These factors were further explored in individual interviews or focus groups. Findings: The data identified that the decision-making process varied between thorough analysis, rationality and heuristics with evidence of cue recognition, factor weighting and causal thinking. This highlighted the relevance of Kahneman's (2011) dual processing model in social work practice. Errors that occurred through an over reliance on System 1 thinking can be identified and rectified through the use of System 2 thinking and strengthen social work decision-making. Originality/value: This paper considers the practice of multi-agency adult protection work in relation to financial harm and identifies the influences on decisions. [ABSTRACT FROM AUTHOR]

There has been a major growth in global health networks in recent decades to address health issues including tobacco use, alcohol abuse, and maternal mortality. Most conditions that incur high costs have provoked networks of advocates working to mitigate the impact, increase investment in research, and establish campaigns. Global health networks often work simultaneously across policy, knowledge creation, and advocacy. Until recently there has been limited activity in global health networks and advocacy addressing hearing loss and deafness which has contributed to its relatively low visibility with policymakers compared to other health conditions. This discussion paper reports on a global consultation that explored the views of advocacy groups and individuals on advocacy for the management of hearing loss, and cochlear implantation (CI). It focussed on stakeholders' views of current advocacy endeavours, opportunities and barriers, and the possible development of a global advocacy network to improve access to cochlear implantation and the supporting services. The subsequent development of a global health network, the Cochlear Implant International Community of Action (CIICA) is discussed and the conditions necessary for the successful development of health networks are explored. This paper will be of interest to those wishing to understand the factors influencing the development of health networks and advocacy. [ABSTRACT FROM AUTHOR]

Background: A practical test that measures the information and communication technology (ICT) skills students need for effectively using ICT in primary education has yet to be developed (Oh et al., 2021). This paper reports on the development, validation, and reliability of a test measuring primary school students' ICT skills required for effectively using ICT (the ECC‐ICT test). Objectives: Based on existing literature, three ICT use domains were identified for effectively using ICT: Effective, collaborative, and creativeuse of ICT. For these three domains, 24 corresponding teaching objectives were identified from a widely used digital literacy framework. Thirty‐four test items cover these teaching objectives in an online test. Methods: A mixed‐method approach was used for the ECC‐ICT test. Four pilot rounds (n=25) implemented qualitative interviews for cognitive validity and refining the test items, followed by a qualitative usability study(n=6). Confirmatory factor analysis and ANOVA provided quantitative insight into the large‐scale test administration(n=575). Results and Conclusions: Composite reliability of our conceptual 3‐factor confirmatory model showed that the test reliably measured primary school effective use of ICT (ω = 0.82), collaborative use of ICT (ω = 0.80) and creative use of ICT (ω = 0.64). Convergent validity (ranging from 0.41 to 0.46) was acceptable. Internal consistency (ranging from 0.84 to 0.91) and discriminant validity (HTMT values below 0.90) are good. ANOVA results show that mean test scores are higher for students in higher grade levels (p < 0.001). The post hoc Bonferroni results show that most grade‐by‐grade comparisons are significant (p < 0.001). Lay Description: What is already known about this topic: Information and communication technology (ICT) skills are finding their way into national curriculums as teachers implement more digital learning environments.Teachers currently do not have a measurement instrument for the ICT skills primary education students need to learn in a personalised way. What this paper adds: This paper gives teachers a test that reliably measures the effective, collaborative, and creative ICT skills required for primary school students to learn using ICT.To our knowledge, this test is the first of its kind.Al materials to reproduce the test are available digitally for teachers. The implications of study findings for practitioners: For policy, this test can be used to check if a student is ready to use ICT in a self‐regulated setting.With this test, teachers can assess and support students' growth on the effective, collaborative, and creative ICT skills required for primary school students using ICT. [ABSTRACT FROM AUTHOR]

Introduction. Within primary health care policy, there is an increasing focus on enhancing involvement with secondary health care, social care services and communities. Yet, translating these expectations into tangible changes frequently encounters significant obstacles. As part of an investigation into the progress made in achieving primary health care reform in Aotearoa New Zealand, realist research was undertaken with those charged with responsibility for national and local policies. The specific analysis in this paper probes primary health care leaders' assessments of progress towards more collaboration with other health and non-health agencies, and communities. Aim. This study aimed to investigate how ideas for more integration and joinedup care have found their way into the practice of primary health care in Aotearoa New Zealand. Methods. Applying a realist logic of inquiry, data from semi-structured interviews with primary health care leaders were analysed to identify key contextual characteristics and mechanisms. Explanations were developed of what influenced leaders to invest energy in joined-up and integrated care activities. Results. Our findings highlight three explanatory mechanisms and their associated contexts: a willingness to share power, build trusting relationships and manage task complexity. These underpin leaders' accounts of the success (or otherwise) of collaborative arrangements. Discussion. Such insights have import in the context of the current health reforms for stakeholders charged with developing local approaches to the planning and delivery of health services. [ABSTRACT FROM AUTHOR]

Background: Informal care features high on the policy agenda of many countries to deal with workforce shortages. As a consequence, care provision increasingly takes place in the care triad of care recipients, informal caregivers and care professionals. How collaboration between care partners takes shape depends on how the different partners perceive this collaboration. This paper aims to investigate the relative importance of the different aspects of collaboration from the perspectives of care recipients, informal caregivers and care professionals in the context of the care for older persons in The Netherlands. Methods: Using Q‐methodology, 32 participants ranked 28 statements that reflect different aspects of collaboration in the care triad and explained their ranking during a follow‐up interview. Participants comprised 9 older persons, 10 informal caregivers and 13 care professionals. Data were analysed using by‐person factor analysis to identify common patterns in the rankings of the statements. Emerging patterns were interpreted and described as views on collaboration using aggregated rankings and qualitative data from the interviews. Results: Five distinct views on collaboration were found: (1) Emphasizing warm collaboration, (2) trusting care professional's expertise, (3) open and compassionate care professionals, (4) responsive decision‐making by autonomous care professionals and (5) prioritizing care recipient's and informal caregiver's interests. Care recipients and/or informal caregivers were associated with views 1, 3 and, 5, whereas care professionals were associated with all five views. Conclusions: Our study highlights the importance of recognizing the potential diversity of views between and within different partner groups in care triads. Governmental and organizational policy makers, as well as healthcare professionals who aim to increase or support the involvement of informal caregivers, should take this heterogeneity into consideration. Patient or Public Contribution: An advisory board of older persons (care recipients and informal caregivers) was involved in the recruitment of the participants, the formulation of the statements and the reflection on the findings of the study and potential implications. [ABSTRACT FROM AUTHOR]

Introduction: Manual wheelchairs (MWC) users have limited mobility during winter months as they encounter many environmental barriers that restrict their community participation. This paper outlines the creation and standardization of an outdoor environment designed to simulate the real-life conditions and obstacles experienced by MWC users in winter. Methods and results: This study consisted of four phases. In Phase 1, researchers used a qualitative ethnographic approach to document the specific challenges and adaptive strategies used by MWC users in winter conditions. In Phase 2, key informants with expertise in MWC winter mobility were invited to co-design the Standardized Navigation Of Winter Mobility & Accessibility Network (SNOWMAN) course. Participants reviewed draft design solutions and offered their input and suggestions to expand upon the initial design. A second co-design workshop included additional key informants, including service providers, policymakers, and professionals with expertise in landscape architecture and engineering, to validate the design solution. The workshops resulted in a detailed illustration of the SNOWMAN course, including five sections: platforms with side slopes, a miniature ice rink, curbs and curb cuts, a path with uneven winter surfaces, and modular ramps at various slopes. Phases 3 and 4 marked the conclusion of the study and involved fabrication of the SNOWMAN course and establishment of a standardized protocol for course setup and maintenance. Discussion: The project aimed to offer several additional potential benefits, supported by the various stakeholders across the study phases, that extend beyond creation of a controlled and safe environment for wheelchair users to develop their winter mobility skills. Practicing wheelchair skills in this area may assist wheelchair users in gaining confidence which may ultimately translate to increased participation in the community. [ABSTRACT FROM AUTHOR]

Background: Crisis Resolution Teams (CRTs) offer home-based care for people in mental health crisis, as an alternative to hospital admission. The success of CRTs in England has been variable. In response to this, the CRT Optimization and RElapse prevention (CORE) study developed and trialled a 12-month Service Improvement Programme (SIP) based on a fidelity model. This paper describes a qualitative evaluation of the perspectives of CRT staff, managers, and programme facilitators. We identify barriers and facilitators to implementation, and mechanisms by which service improvements took place. Methods: Managers and staff from six purposively sampled CRTs were interviewed, as well as six facilitators who were employed to support the implementation of service improvement plans. Semi-structured focus groups and individual interviews were conducted and analysed using thematic analysis. Findings: A majority of participants viewed all components of the SIP as helpful in improving practice, although online resources were under-used. Perceived barriers to implementation centred principally around lack of staff time and ownership. Support from both senior staff and facilitators was essential in enabling teams to undertake the work associated with the SIP. All participating stakeholder groups reported that using the fidelity model to benchmark their CRT work to best practice and feel part of a 'bigger whole' was valuable. Conclusion: CRT staff, managers and programme facilitators thought that a structured service improvement programme helped to increase fidelity to a best practice model. Flexibility (from all stakeholders) was key to enable service improvement actions to be manageable within time- and resource-poor teams. [ABSTRACT FROM AUTHOR]

Community engagement (CE) at Rhodes University (RU) and community psychology draw on similar principles: using an asset‐based community development approach; recognising and drawing on the skills, capabilities, and knowledge of all parties, which they contribute to a partnership. Working from a strategic model of engagement, mutuality is foreground in all CE activities, where both student volunteers and community partners jointly benefit from the engagement. This paper examines CE at RU and how CE principles are translated into practise, using Siyakhana@Makana (S@M) as a case study. In S@M, a 19‐week‐long volunteer programme, community partners and student volunteers are jointly involved in planning, executing, and evaluating CE activities together. This paper illustrates how being involved in such CE activities has enabled community partners to mobilise for effective change in their communities. Community partners reflect on how they have been empowered to taken on leadership roles, addressing local challenges in collaborative ways, while drawing on the skills and knowledge that they have gained through their engagements in S@M. This resonates with the social action model of community psychology, a participatory approach that seeks to mobilise people to bring about change in the contexts in which they live. [ABSTRACT FROM AUTHOR]

Background: In Guatemala, Indigenous women have a maternal mortality ratio over twice that of non-Indigenous women. Long-standing marginalization of Indigenous groups and three decades of civil war have resulted in persistent linguistic, economic, cultural, and physical barriers to maternity care. Curamericas/Guatemala facilitated the development of three community-built, -owned, and -operated birthing centers, Casas Maternas Rurales (referred to here as Community Birthing Centers), where auxiliary nurses provided physically accessible and culturally acceptable clinical care. The objective of this paper is to assess the management of complications and the decision-making pathways of Birthing Center staff for complication management and referral. This is the sixth paper in the series of 10 articles. Birthing centers are part of the Expanded Census-based, Impact-oriented Approach, referred to as CBIO+. Methods: We undertook an explanatory, mixed-methods study on the handling of pregnancy complications at the Birthing Centers, including a chart review of pregnancy complications encountered among 1,378 women coming to a Birthing Center between 2009 and 2016 and inductively coded interviews with Birthing Center staff. Results: During the study period, 1378 women presented to a Birthing Center for delivery-related care. Of the 211 peripartum complications encountered, 42.2% were successfully resolved at a Birthing Center and 57.8% were referred to higher-level care. Only one maternal death occurred, yielding a maternal mortality ratio of 72.6 maternal deaths per 100,000 live births. The qualitative study found that staff attribute their successful management of complications to frequent, high-quality trainings, task-shifting, a network of consultative support, and a collaborative atmosphere. Conclusion: The Birthing Centers were able to resolve almost one-half of the peripartum complications and to promptly refer almost all of the others to a higher level of care, resulting in a maternal mortality ratio less than half that for all Indigenous Guatemalan women. This is the first study we are aware of that analyzes the management of obstetrical complications in such a setting. Barriers to providing high-quality maternity care, including obtaining care for complications, need to be addressed to ensure that all pregnant women in such settings have access to a level of care that is their fundamental human right. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this papers is to set out the advantages to local communities of independent representation of older people by older people through active and vibrant older people's forums and groups and the rationale for Councils in Wales to support their revitalisation and development. Design/methodology/approach: This paper describes how semi-structured action research and follow-up discussion and analysis over a two-year period was undertaken by older people with representatives of Older Peoples Forums and groups to identify a strategy to restart and revitalise independent forums post pandemic to represent the voice of older people to government at all levels. Findings: Facilitation of the independent and self-determined voice of older people through genuine co-production with Forums can help Councils meet statutory duties and ensure their policies and services for older people are developed and informed from the direct experience of those receiving them. This will also help address the impacts of an ageing population and meet the national aim to create age-friendly communities across Wales. Social implications: This research provides a basis for Councils to work with Independent Older Peoples Forums and groups to restart and regenerate the forums and promote the self-determined voice of older people to government at all levels. Originality/value: In an ageing society older people should be empowered and enabled to make their own decisions. The principle of self-determination by older people for older people directly and through co-productive engagement with them by local authorities has meaning and purpose that should be promoted and implemented. If age-friendly communities are to be developed across Wales, then collaboration on this basis is required including through independent 50+ forums in localities. [ABSTRACT FROM AUTHOR]

Aligning the skills addressed by higher education to the demands of industry is an ongoing challenge. This paper describes the rationale for developing and using a visualization application to highlight the skills demand and skills supply mismatch between work-integrated learning (WIL) stakeholders. The objective was to develop a minimal viable product (MVP) to be utilized as a visualization application. Visualization allows for the data to be structured in an organized way for comparison and pattern identification. Participatory action research informed the development of a MVP, referred to as a skills hub. This paper reports how the skills hub visualizes the skills mismatch through collaboration between participating higher education institutions, a multi-national financial institution, skills assessment partner, and a consulting partner. The research result is that WIL stakeholders benefit from the skills hub as an application that provides a visualization process to translate skills shared in the process of knowledge exchange. [ABSTRACT FROM AUTHOR]

Background: Given the developmental vulnerability of justice-involved youth, providing a safe environment in secure facilities is a paramount, yet challenging task. Within this complexity, a sound security framework is key. The security framework exists on three dimensions: physical, procedural and relational security. Existing knowledge points at the importance of a shift in focus on physical and procedural security towards relational security as the core of the security framework. At the same time there is a dearth of knowledge on relational security, particularly in the context of youth justice. This paper explores relational security and its working mechanisms in practice. Methods: This paper draws on findings of a comprehensive three-year evaluation of three small-scale, community-embedded facilities that are grounded in relational security. The approach of the evaluation was derived from action research, involving a cyclic process alternating between action, research and critical reflection, while engaging all stakeholders in the research process. The action research cycle involved qualitative research (a total of 63 semi-structured interviews) incorporating the perspective of staff, youth and parents. Results: Relational security is grounded in three distinct, but interrelated, elements – staff's basic attitude, a constructive alliance between staff and youth, staff presence – and promotes a safe and therapeutic environment through several mechanisms. Conclusions: Relational security can be defined in a practical conceptualization; outlining a way of working that guides staff in how to establish a safe and therapeutic environment in secure facilities. This conceptualization finds support in the well-established literature covering the therapeutic alliance and can be substantiated by two aligning theories concerning youth justice strategies: social-ecological theory and self-determination theory. Relational security is not only a way of working, but also a way of being. It encompasses a vision about security and mentality towards justice-involved youth that sees them not merely as 'risks to be managed', but primarly as 'resources to be developed'. [ABSTRACT FROM AUTHOR]

Aim: To identify barriers and facilitators impacting the implementation of a comprehensive transfer program aimed at parents of adolescents with chronic illness in clinical practice. Design: A real‐time, qualitative process evaluation. Methods: Individual interviews were conducted with 10 nurses and seven physicians from paediatric and adult outpatient clinics: Nephrology, hepatology, neurology, and rheumatology. Data were analysed through the lens of normalization process theory. Results: Themes were framed within the theory's four components. (1) Coherence: Healthcare professionals' views on their core tasks and on the parents' role influenced their perception of the program. (2) Cognitive participation: A named key worker, autonomy, and collaboration impacted healthcare professionals' involvement in the program. (3) Collective action: Department prioritization and understanding of the program's aim were key factors in its successful delivery. (4) Reflective monitoring: Participants experienced that the program helped parents during transfer but questioned if the program was needed by all families. Conclusion: We identified three barriers: Healthcare professionals' lack of understanding of the parental role during transfer, top‐down decisions among nurses, and physicians' uncertainty about their role in joint consultations. Facilitators: Healthcare professionals' understanding of the program's purpose and expected effect, the nurses' significant role as named keyworkers, and good collaboration across paediatric and adult departments. Implications for the Profession and/or Patient Care: Implementation strategies should be developed before implementing a transfer program in clinical practice. Impact: Implementing a parental transfer program in clinical practice can be challenging. Therefore, for successful implementation, it is crucial to identify barriers and facilitators.Barriers and facilitators exist at the personal, professional, and organizational levels, and it is important to understand them.The results of this qualitative study could support the implementation of transfer programs in other settings. Reporting Method: Consolidated criteria for reporting qualitative studies (COREQ). Patient or Public Contribution: No patient or public contribution. What does this paper contribute to the wider global clinical community?: Nurses' and physicians' experiences of ownership of the transfer program is essential for successful implementation.Clinics should appoint a named keyworker, preferably a nurse, as the driving force during the implementation of a transfer program.Nurses and physicians should receive training about the purpose, justification, and expected effect of a transfer program before implementation. [ABSTRACT FROM AUTHOR]

Relationships between students and external partners in work-integrated learning can vary and power dynamics, hierarchies and student agency have been under explored in research to date. Integrated research involving workintegrated learning, students as partners and transdisciplinarity presents an opportunity to enrich each of these fields. This paper presents the results of a case study of transdisciplinary project-based work-integrated learning in Australia. Our results highlight that reciprocity and the valuing of student knowledge are key elements in breaking down traditional power dynamics and enabling student agency, in line with the transdisciplinary principle of mutual learning. Participants who valued these elements in their relationship were less likely to frame the relationship in hierarchical terms and were more open to learning from one another. By empowering students to draw on their expertise and reframe challenges while also preparing partners for this kind of relationship, all parties can be positioned as learners within work-integrated learning. [ABSTRACT FROM AUTHOR]

Introduction: In England, primary care networks (PCNs) offer opportunities to improve access to and sustainability of general practice through collaboration between groups of practices to provide care with a broader range of practitioner roles. However, there are concerns that these changes may undermine continuity of care. Our study investigates what the organisational shift to PCNs means for continuity of care. Methods: The paper uses thematic analysis of qualitative data from interviews with general practitioners and other healthcare professionals (HCPs, n = 33) in 19 practices in five PCNs, and their patients (n = 35). Three patient cohorts within each participating practice were recruited, based on anticipated higher or lower needs for continuity of care: patients over 65 years with polypharmacy, patients with anxiety or depression and 'working age' adults aged between 18 and 45 years. Findings: Patients and clinicians perceived changes to continuity in PCNs in our study. Larger‐scale care provision in PCNs required better care coordination and information‐sharing processes, aimed at improving care for 'vulnerable' patients in target groups. However, new working arrangements and ways of delivering care in PCNs undermine HCPs' ability to maintain continuity through ongoing relationships with patients. Patients experience this in terms of reduced availability of their preferred clinician, inefficiencies in care and unfamiliarity of new staff, roles and processes. Conclusions: New practitioners need to be effectively integrated to support effective team‐based care. However, for patients, especially those not deemed 'vulnerable', this may not be sufficient to counter the loss of relationship with their practice. Therefore, caution is required in relation to designating patients as in need of, or not in need of continuity. Rather, continuity for all patients could be maintained through a dynamic understanding of the need for it as fluctuating and situational and by supporting clinicians to provide follow‐up care. Patient and Public Involvement (PPI): A PPI group was recruited and consulted during the study for feedback on the study design, recruitment materials and interpretation of findings. [ABSTRACT FROM AUTHOR]

Background: Partnerships between Higher Education Institutions (HEIs) in the global north and south have commonly been used as a vehicle to drive global health research and initiatives. Among these initiatives, include health system strengthening, research capacity building, and human resource training in developing countries. However, the partnership functioning of many global north-south partnerships still carry legacies of colonialism through unrecognized behavior patterns, attitudes, and belief systems in how they function. Even with research literature calling for a shift from equality to equity in the functioning of these partnerships, many still struggle with issues of complex and unspoken power dynamics. To understand the successes and challenges of north-south partnerships, this paper explored partnership development and functioning of a northern and multi-southern HEIs partnership focused on nutrition education and research. Methods: A qualitative research approach was used; data were collected through in-depth interviews (IDIs) with questions developed from the Bergen Model of Collective Functioning (BMCF). Thirteen IDIs were conducted with partners from all institutions including stakeholders. Findings: The partnership was built on the foundation of experiences and lessons of a previous partnership. Partners used these experiences and lessons to devise strategies to improve partnership inputs, communication, leadership, roles and structures, and maintenance and communication tasks. However, these strategies had an impact on partnership functioning giving rise to issues of inequitable power dynamics. The northern partner had two roles: one as an equal partner and another as distributor of project funds; this caused a conflict in roles for this partner. The partners distinguished themselves according to partner resources – two partners were named implementing partners and two named supportive partners. Roles and partner resources were the greatest contributors to power imbalances and caused delays in project activities. Conclusion: Using the BMCF to examine partnership dynamics illuminated that power imbalances caused a hierarchical stance in the partnership with northern partners having overall control and power of decision-making in the partnership. This could impact the effectiveness and sustainability of project in the southern institutions going forward. [ABSTRACT FROM AUTHOR]

Reducing the prevalence of acute kidney injury (AKI) is an important patient safety objective set forth by the National Quality Forum. Despite international guidelines to prevent AKI, there continues to be an inconsistent uptake of these interventions by cardiac teams across practice settings. The IMPROVE-AKI study was designed to test the effectiveness and implementation of AKI preventive strategies delivered through team-based coaching activities. Qualitative methods were used to identify factors that shaped sites' implementation of AKI prevention strategies. Semi-structured interviews were conducted with staff in a range of roles within the cardiac catheterization laboratories, including nurses, laboratory managers, and interventional cardiologists (N = 50) at multiple time points over the course of the study. Interview transcripts were qualitatively coded, and aggregated code reports were reviewed to construct main themes through memoing. In this paper, we report insights from semi-structured interviews regarding workflow, organizational culture, and leadership factors that impacted implementation of AKI prevention strategies. [ABSTRACT FROM AUTHOR]

For workers living with a disability, pathways to sustainable employment in the open labour market are inhibited by barriers operating at different structural and societal levels. The culture of Australia's government employment services has applied a 'work-first' approach that emphasises finding people employment rather than supporting the acquisition of skills and education. The net effect of this approach is the preferencing of short-term employment solutions, with a focus on individual behaviour or so-called resilience and an emphasis on personal responsibility instead of addressing structural issues. In this paper, we explore how people with disability can be supported in finding employment through a shared resilience approach offered by a Work Integration Social Enterprise (WISE). We suggest that WISEs can provide the conditions for shared resilience by developing and sustaining networks needed to generate hybrid pathways to work and by role modelling inclusive work conditions in the open labour market. [ABSTRACT FROM AUTHOR]

Introduction: The implementation and evaluation of patient participation to obtain high‐quality transitional care for older people is an international priority. Intermediate care (IC) services are regarded as an important part of the patient's pathway from the specialist to the primary care levels, bridging the gap between the hospital and the home. Patients may experience varying capacities and conditions for patient participation. Yet, few tools for evaluating patients' preferences for patient participation within IC services are at hand. Accordingly, further knowledge is needed to understand and scaffold processes for patient participation in IC. Therefore, the aim of this project was to translate, validate and pilot test the Patient Preferences for Patient Participation (the 4Ps) with patients in IC services in Norway. Methods: This project comprised two phases: (1) a careful translation and cultural adaptation process, followed by a content validity trial among 15 patients and staff in Norwegian IC and (2) a cross‐sectional survey of the instrument with 60 patients admitted to IC. Results: The translation between Swedish and Norwegian required no conceptual or contextual adaptations. The subsequent cross‐sectional study, designed as a dialogue between the patients and staff, revealed that only 50% of the participants received a sufficient level of patient participation based on their preferences, mostly indicating that patients were receiving less‐than‐preferred conditions for engaging in their health and healthcare issues. Conclusion: The 4Ps instrument was deemed suitable for measuring patient participation based on patient preferences in the IC context and was feasible for both healthcare professionals and patients to complete in an interview when arriving at and leaving services. This may support person‐centred communication and collaboration, calling for further research on what facilitates patient participation and the implementation of person‐centred services for patients in IC. Patient or Public Contribution: First, the current paper is part of the IPIC study (i.e., the implementation of patient participation in IC). Influenced by a James Lind Alliance process, the study addresses research uncertainties identified by patients, next of kin, staff and researchers in the cocreation process. Second, cognitive interviewing was conducted with 15 representatives of the target population: seven patients receiving IC services, one home‐dwelling previous IC patient (altogether four women and four men, most of them 80 years or older) and seven healthcare staff working in IC services. The interviews determined the relevance, comprehensiveness and clarity of the 4Ps. Finally, 60 patients admitted to IC took part in the cross‐sectional study. [ABSTRACT FROM AUTHOR]

Background: The recent surge in applications to nursing in the United Kingdom together with the shift towards providing virtual interviews through the use of video platforms has provided an opportunity to review selection methodologies to meet a new set of challenges. However there remains the requirement to use selection methods which are evidence-based valid and reliable even under these new challenges. Method: This paper reports an evaluation study of applicants to nursing and midwifery and reports on how to plan and use online interviews for in excess of 3000 applicants to two schools of nursing in Northern Ireland. Data is reported from Participants, Assessors and Administrators who were asked to complete an online evaluation using Microsoft Forms. Results: A total of 1559 participants completed the questionnaire. The majority were aged 17–20. The findings provide evidence to support the validity and reliability of the online interview process. Importantly the paper reports on the design and implementation of a fully remote online interview process that involved a collaboration with two schools of nursing without compromising the rigour of the admissions process. The paper provides practical, quantitative, and qualitative reasons for concluding that the online remote selection process generated reliable data to support its use in the selection of candidates to nursing and midwifery. Conclusion: There are significant challenges in moving to online interviews and the paper discusses the challenges and reflects on some of the broader issues associated with selection to nursing and midwifery. The aim of the paper is to provide a platform for discussion amongst other nursing schools who might be considering major changes to their admissions processes. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to examine the use of coproduction to create a film "Do You See Me?", to amplify the voices of a "hard to reach" group: older lesbian, gay, bisexual (LGB) victim-survivors of domestic abuse (DA). Design/methodology/approach: Qualitative methods were used as part of the co-production, which included two practitioner focus groups and 14 narrative interviews with lesbian, gay, bisexual, transgender, queer or questioning persons or the community (LGBTQ+) victim-survivors. Findings: Despite differences in gender, sexualities, roles and "lived experiences" across stakeholders, there was a shared aim to ensure victim-survivors had a sense of ownership in this endeavour. Consequently, a positive reciprocity existed that helped to foster effective communication, allow for capacity building and subsequent knowledge exchange. The collaboration produced a nuanced meta-narrative making visible the "lived experiences" of LGB victim-survivors' perceptions of perpetrator behaviours. Originality/value: To the best of the authors' knowledge, this paper is original in two ways, firstly, providing insights into the "lived experiences" of an invisible group; older LGBTQ+ victim-survivors, and secondly, in involving them in the co-production of a film. The paper aims to reveal how interdependencies that developed between stakeholders helped to disrupt understandings, develop new ways of knowing and build levels of trust. Group interactions helped to dismantle hierarchies, so those with experiential knowledge: the survivors, had greater control throughout the research process. The paper is significant in providing a critical reflection on the ethical, methodological and resource challenges involved in co-production. It also makes recommendations for researchers and funders about the value of using co-production as a method to engage with hard-to-reach groups. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to consider how a South East project approached systems change to improve unsupported temporary accommodation (UTA) and the changes made for people experiencing multiple disadvantage ("multiple and complex needs"). This paper also covers some matters that are hard to change or uncertain, such as housing shortages and financial constraints. The paper focuses on a case study of the East Sussex Temporary Accommodation Action Group (TAAG) – a multi-agency action group. Design/methodology/approach: A qualitative case study involving a thematic analysis of seven semi-structured interviews, with a review of published literature and internal documentation. Findings: This example of setting up a TAAG shows us the value of having a dedicated forum to look at a part of the system that requires changing and to identify what works well. Creating a collaborative and democratic space with a common purpose brings different stakeholders and perspectives together and opens discussions to new ways of working. Equalising partners creates an opportunity to create change from the bottom-up within a system traditionally governed by statutory bodies. This study found that the TAAG has facilitated learning around trauma-informed practice and nurtured more sustainable changes towards a Standards Charter and women-only safe UTA. Originality/value: This is one of the first qualitative case studies of a local systems change approach to improving UTA for people experiencing multiple disadvantage in East Sussex. [ABSTRACT FROM AUTHOR]

Copyright of Rostrum of Asclepius / Vima tou Asklipiou is the property of Technological Educational Institute of Athens and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: This qualitative study set within Northern Ireland aims to explore professional perspectives on the application of evidence-informed practice to the adult safeguarding threshold screening process. Design/methodology/approach: Data was gathered from seven social workers in one health and social care trust area, who perform the designated adult protection role, through individual semi-structured interviews in one region of Northern Ireland. The interview schedule comprised of a series of questions examining the role of the designated adult protection officer and included three vignettes (Appendix). A thematic analysis was undertaken using NVIVO software. Findings: This paper reports main findings under the themes of: the role of the designated adult protection officer, threshold decision-making, evidence-informed practice and service improvement. One of the main findings was that professionals viewed the current process as too bureaucratic, and there was a desire to engage in more preventive safeguarding in collaboration with service users. There was a need to promote awareness of evidence-informed practice as it applies to the threshold screening process. Furthermore, the study raised the question of the need to consider the application of models or methods of assessment to the threshold screening process. Originality/value: This in-depth exploration of the role of designated adult protection officers in Northern Ireland provides a valuable insight into the complexity involved in managing adult safeguarding referrals and investigations. This study adds to the existing knowledge base, identifies potential service improvements and highlights the gap in evidence-based practice as it applies to the threshold screening process. Threshold screening of adult safeguarding referrals remains a subjective process and is open to interpretation and differences in professional judgement. The study highlights the need to consider the application of quality improvement methodology to the threshold screening assessment and the need to promote the exchange of safeguarding knowledge. [ABSTRACT FROM AUTHOR]

Partnerships between public health and faith-based organizations draw on the strengths of both sectors to achieve a shared interest in promoting health and reducing disparities. However, information about implementation of faith and public health partnerships-particularly those involving diverse racial-ethnic groups-is limited. This paper reports on findings from qualitative interviews conducted with 16 public health and congregational leaders around the country as part of the early phase of the development of a faith and public health partnership to address health disparities in Los Angeles, CA. We identified eight themes regarding the barriers and facilitators to building faith and public health partnerships and distilled these into 10 lessons for developing such approaches. These interviews identified that engaging religious organizations often requires building congregational capacity of the congregation to participate in health programs; and that trust is a critically important element of these relationships. Further, trust is closely related to how well each organization involved in the partnership understands their partners' belief structures, approaches to addressing health and well-being and capacities to contribute to the partnership. Tailoring congregational health programs to match the interests, needs and capacity of partners was identified as an important approach to ensuring that the partnership is successful. But, this is complicated by working across multiple faith traditions and the racial-ethnic backgrounds, thus requiring increased and diverse communication strategies on the part of the partnership leadership. These lessons provide important information for faith and public health leaders interested in developing partnered approaches to address health in diverse urban communities. [ABSTRACT FROM AUTHOR]

Context: The majority of people with serious health-related suffering in low- and middle-income countries lack access to palliative care (PC). Increased access to PC education is greatly needed. Objectives: This paper describes the process to adapt an advanced PC training course for a Chilean context. Methods: A joint team of intercultural PC educators from the US and Chile conducted a series of key informant interviews and a target audience survey to iteratively design a PC training course in Chile. Results: Eight key informant interviews identified a strong need for formal PC education pathways, confirmed the five central learning domains, and helped to identify potential course sub-topics. A target audience survey of 59 PC providers from across Chile confirmed a strong desire to participate in such a course. Conclusion: Our team of intercultural PC educators adapted an advanced PC course to the unique context of Chilean providers. [ABSTRACT FROM AUTHOR]

Purpose: Maternal substance use and deaths due to overdoses are increasing nationwide. Evidence suggests that the rate of resumed substance use, and fatal and non-fatal overdose is greatest in the first year after birth, particularly around six months postpartum, compared to other parts of the perinatal period. Doula care has been linked to improvements in perinatal health and outcomes. Description: In response to the opioid epidemic, the Philadelphia Department of Public Health developed and implemented the Doula Support Program (DSP), with a focus on one year of postpartum care for birthing people with a substance use disorder (SUD). In this paper, we describe the program and its formation and report on the early challenges and successes of the program implementation, based on information we received from program founders and managers in a group interview. Assessment: Early successes of the program include partnering with local community-based programs to recruit and retain doulas, supplementing traditional doula education with perinatal SUD-specific trainings, and maximizing client referrals by collaborating with local organizations and treatment centers that serve birthing people with SUD. Client retention, however, has proven to be challenging, especially during the COVID-19 pandemic. Conclusion: The DSP continues to grow, and lessons learned will facilitate program improvements. The goal of this paper is to outline the development and launch of the DSP and to act as a model for other state and local health departments interested in providing doula care for birthing people with SUD. Significance: Maternal substance use and fatal overdoses are increasing in Philadelphia, Pennsylvania. In response to this crisis, the Philadelphia Department of Public Health's Division of Maternal, Child and Family Health developed the Doula Support Program (DSP), offering doula care to pregnant people with a current or past SUD history up to one-year postpartum. To our knowledge, this is the only doula program in Pennsylvania offering one-year postpartum support to birthing people affected by SUD. [ABSTRACT FROM AUTHOR]

Background: Cross-sectoral collaborations are considered necessary to address detrimental health, social, educational and economic outcomes that impact marginalised and disadvantaged populations. There is a strong relationship between the health of children and their educational attainment; good health promotes positive learning. This paper reports cross-sectoral executive and senior management level systems changes required to enable the design of a collaborative primary healthcare service model for children and young people in rural Australia. Methods: A descriptive qualitative design was used. Data were collected from executive and senior managers from three organisations (Education, Health and a University Department of Rural Health [ n = 6]) through individual semi-structured interviews. Data were analysed using an inductive, thematic approach. The study draws on Lewin's Model of Change. Results: Three overarching themes were generated from the data: an embedded challenge and experimental solutions; building a shared language and understanding; and the role of relationships and trust. Despite the unique geographical and social context of the study area, strategies emerged from the data on how a solution to an embedded challenge, through design of a primary healthcare model, was established and how the strategies described could be transferred and scaled to other rural and remote communities. Conclusion: Contextual differences make each rural and remote area unique. In this study, strategies that are described in the managing change literature were evident. The authors conclude that drawing on strong management of change principles could mean that a service model designed for one remote community might be transferrable to other communities. There is a strong relationship between children's health and their educational attainment. Poorer health, educational and social attainment are experienced by children and young people residing within the study area. Despite unique geographical contexts and demography, strategies that align strong leadership and effective management of change across three organisations were key and may make it possible to transfer a primary health care model designed to improve health and education outcomes for children and young people to other rural and remote communities. [ABSTRACT FROM AUTHOR]

Copyright of Revista Electrónica de Psicología Iztacala is the property of Facultad de Estudios Superiores Iztacala and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Older carers or 'care partners' of older people experiencing care needs often provide essential support, at times while neglecting their own health and well‐being. This is an increasingly frequent scenario due to both demographic changes and policy shifts towards ageing in place. Multiple community stakeholders within the care and support ecosystem hold valuable expertise about the needs of older care partners, and the programme and policy responses that may better support their health and well‐being. The aim of this study was to identify the perspectives of stakeholders obtained through the codesign phase of a multicomponent research project investigating new models of care and support for older care partners suitable for the Australian context. Methods: Principles of codesign were used to engage a purposeful sample of older care partners, health professionals, researchers, policy makers and health service administrators. Participants took part in a series of three codesign workshops conducted remotely via video conferencing. The workshops were supported with briefing material and generated consensus‐based summaries, arriving at a preferred service model. Findings: This paper reports the research design and structure of the codesign panels, the range of findings identified as important to support the health and well‐being of older carers of older people, and the resulting service model principles. The codesigned and preferred model of care is currently being prepared for implementation and evaluation in Australia. Public Contribution: This study was conducted using codesign methodology, whereby stakeholders including older care partners and others involved in supporting older carers, were integrally involved with design, development, results and conclusions. [ABSTRACT FROM AUTHOR]

Background: A cluster randomised controlled trial demonstrated the effectiveness of the SMART Work & Life (SWAL) behaviour change intervention, with and without a height-adjustable desk, for reducing sitting time in desk-based workers. Staff within organisations volunteered to be trained to facilitate delivery of the SWAL intervention and act as workplace champions. This paper presents the experiences of these champions on the training and intervention delivery, and from participants on their intervention participation. Methods: Quantitative and qualitative feedback from workplace champions on their training session was collected. Participants provided quantitative feedback via questionnaires at 3 and 12 month follow-up on the intervention strategies (education, group catch ups, sitting less challenges, self-monitoring and prompts, and the height-adjustable desk [SWAL plus desk group only]). Interviews and focus groups were also conducted at 12 month follow-up with workplace champions and participants respectively to gather more detailed feedback. Transcripts were uploaded to NVivo and the constant comparative approach informed the analysis of the interviews and focus groups. Results: Workplace champions rated the training highly with mean scores ranging from 5.3/6 to 5.7/6 for the eight parts. Most participants felt the education increased their awareness of the health consequences of high levels of sitting (SWAL: 90.7%; SWAL plus desk: 88.2%) and motivated them to change their sitting time (SWAL: 77.5%; SWAL plus desk: 85.77%). A high percentage of participants (70%) reported finding the group catch up session helpful and worthwhile. However, focus groups highlighted mixed responses to the group catch-up sessions, sitting less challenges and self-monitoring intervention components. Participants in the SWAL plus desk group felt that having a height-adjustable desk was key in changing their behaviour, with intrinsic as well as time based factors reported as key influences on the height-adjustable desk usage. In both intervention groups, participants reported a range of benefits from the intervention including more energy, less fatigue, an increase in focus, alertness, productivity and concentration as well as less musculoskeletal problems (SWAL plus desk group only). Work-related, interpersonal, personal attributes, physical office environment and physical barriers were identified as barriers when trying to sit less and move more. Conclusions: Workplace champion and participant feedback on the intervention was largely positive but it is clear that different behaviour change strategies worked for different people indicating that a 'one size fits all' approach may not be appropriate for this type of intervention. The SWAL intervention could be tested in a broader range of organisations following a few minor adaptations based on the champion and participant feedback. Trial registration: ISCRCTN registry (ISRCTN11618007). [ABSTRACT FROM AUTHOR]

Background and aims: Participatory research involves academic partners working together with the community that is affected by research to make decisions about that research. Such approaches often result in research that is more respectful of, and responsive to, community preferences – and is vital in the context of autism research with culturally and linguistically diverse (CALD) communities. Whilst participatory approaches are becoming more commonplace within CALD autism research, no studies have explored the experiences of being involved in autism research from the perspectives of CALD community partners over the course of a study. This paper intended to address this gap by reporting on the experiences of CALD parents of autistic children who were community partners in a 1-year Australian research project exploring home–school partnerships for CALD parents of autistic children. We aimed to: (1) report on how parents' involvement in the research process shaped the home–school partnerships study over time and (2) understand their experiences of being community partners on the home–school partnerships project. Methods: Using key principles of participatory approaches, we established Chinese and Vietnamese parent advisory groups to contribute to a project exploring home–school partnerships for parents of autistic children from CALD backgrounds in Australia. Advisory groups included parents of autistic children from Chinese/Vietnamese backgrounds, as well as interpreters, professionals and researchers. We documented how parents' participation as community partners shaped the home–school partnerships study over the course of the project. We also elicited parents' own views and experiences of being community partners through informal, open-ended questions at the beginning and end of the study. Results: We found that parents' input fundamentally shaped the broader home–school partnership study, from meaningful, accurate translation of interview schedules through to making decisions regarding community-specific recommendations and dissemination plans. Parents themselves reported being keen to collaborate and to hear and share opinions for the purpose of the home–school partnership study – although they noted how emotionally difficult sharing their stories could be. While they initially had some concerns about combining being involved as a community partner with their existing responsibilities, ultimately, parents were surprised by the scope of the home–school partnership study and their level of involvement as community partners. Through hearing others' stories and sharing their own in advisory group meetings, parents reported ancillary benefits of their involvement, including increased self-advocacy and well-being. Conclusions: These findings show how research that is conducted in partnership with diverse members of the autism community has the capacity to improve the quality of the research and benefit community partners. Implications: This study clearly documents the benefits and potential challenges of participatory approaches with CALD communities. These findings emphasise to researchers and funders the importance of including extra time and money within budgets in order to produce meaningful research that is respectful and responsive to communities. [ABSTRACT FROM AUTHOR]

The independent review of children's social care (2022) has proposed a radical reset of England's children's services, shifting a remote, assessment heavy system towards one that works alongside communities to help prevent statutory interventions. However, notions around the harnessing of community resources to deliver Early Help are often underpinned by assumptions regarding the voluntary, community and social enterprise (VCSE) sector and the ease with which such organizations can be integrated into preventative strategies. This paper reports findings from embedded research within a unitary authority in Southwest England during remodelling of its Early Help service to work more collaboratively with local VCSE organizations. The study generated data from ethnographic observations, semi‐structured interviews and focus groups with 95 participants, including local parents, service providers, VCSE organizations and Council leaders. The findings illustrate that families value the compassionate, responsive and flexible support available within many VCSE settings. However, differences in practice cultures, regulatory pressures on statutory providers, the need to (re)build trust in communities and sensitivities around power‐sharing and resourcing meant negotiating VCSE sector integration was fraught with complexities. Few studies have gained such privileged access to a Local Authority's remodelling of Early Help services, and this paper has significant insights for the debates surrounding the independent review of children's social care (2022) and its recommendation to bring services 'closer to communities'. [ABSTRACT FROM AUTHOR]

Background: "CoviSainik Program" was implemented in collaboration with the Ambuja Cement Foundation and Community Medicine Department in rural districts of eight states of India from May to December 2021 to create a cadre of volunteers. The aim of the present paper is to describe the program and evaluate it so that the findings can be the guiding tool for policymakers to replicate a similar program. Material and Method: A cross-sectional, mixed-method – concurrent study design was adopted to evaluate the program for its short-term outcomes such as gain in the basic knowledge of COVID-19 amongst master trainers and their feedback and program output viz – the proportion of volunteers trained and their profile by census sampling. Motivational factors, experiences of volunteers, and outcomes of COVID-19 work in their villages were explored by purposive with maximum diversity sampling with 62 online in-depth interviews and 8 online focus group discussions (FGDs). Results: There was a statistically significant difference in the pre-test (12.8 ± 5.6) and post-test (25.9 ± 9.3) scores of the Master Training Program evaluation test. Out of 6534 trained volunteers, 5901 worked as volunteers, and amongst those, 47.1%, 35.1%, and 17.8% worked for ≤3 months, 3 to 6 months, and ≥6 months, respectively, in their villages. The major themes generated for motivational factors to join the program were altruism, savior nature, generating awareness, and concern for others. The major outcomes generated by trained volunteers COVID-19 vaccination were in raising awareness on COVID-19 appropriate behavior and early identification of COVID-19 cases in their villages. Conclusion: The "CoviSainik Program" was successful in creating cadres of trained volunteers. [ABSTRACT FROM AUTHOR]

Location-based activities can challenge citizens to explore their neighbourhood in new playful ways. This paper presents a classification of such playful activities based on the literature and experience gained (1) in co-creation sessions and (2) gameplay for neighbourhood exploration with citizens in the Hague. The location-based game designed for this purpose encouraged neighbourhood exploration and social interaction that went beyond the everyday normal. Results showed that citizens are specifically interested in activities that allow them to discover new information about, and places in, their neighbourhood when these are related to their own life. The results of this paper provide new knowledge on game design to inform designers on which type of interactions and activities foster neighbourhood exploration and social interaction. [ABSTRACT FROM AUTHOR]

Introduction: Involving service users in health service design and delivery is considered important to improve the quality of healthcare because it ensures that the delivery of healthcare is adapted to the needs of the users. Co‐production is a process used to involve service users, but multiple papers have highlighted the need for the mechanisms and values guiding co‐production to be more clearly stated. The aim of this paper was to evaluate the mechanisms and values that guided the co‐production approach of the Stories for Change project, which used Public Narrative as part of the co‐design process to create change in National Health Service maternity services. Methods: This study was conducted using a rapid feedback evaluation approach. Semistructured interviews (n = 16) were the main source of data, six of which were maternity service users, with observations (5 h) and documentary analysis also carried out in parallel. RREAL sheets were used for data analysis to organize data based on key topics of interest. Results: This study identified three broad mechanisms and values underpinning the co‐production approach: creating an open and safe space to share ideas, learning how to tell stories using Public Narrative and having service providers who play a key role in strengthening the health system listen to stories compelling them to action. This study identified the main areas for improvement of the Stories for Change project related to recruitment, the inclusion of participants, the co‐design process, the Skills Session and the Learning Event. Conclusion: Our study provided a deeper understanding of the co‐production approach that addresses the need to uncover the mechanism and values underlying co‐production and co‐design approaches. This study expands on the literature pertaining to the influence of storytelling in creating meaningful change in health care. We propose a co‐design methodology that uses Public Narrative as a model for service user engagement to help inform future healthcare development processes. Patient or Public Contribution: The experiences and perceptions of maternity service users and health professionals informed this evaluation. The project organizers were involved in the manuscript preparation stage by providing feedback, and service users wrote a commentary on the project from the lived experience perspective. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore and understand the barriers perceived by Italian nurses to adopting self‐monitoring for managing oral anticoagulation in real‐life settings. Background: Barriers to self‐monitoring implementation for managing oral anticoagulation have been poorly described. Design: The study had a qualitative descriptive and exploratory design with a hybrid approach. Methods: A literature review was conducted to identify a priori barriers (deductive approach), while a small and semi‐structured focus group discussion was performed to explore the contextual barriers experienced by Italian nurses (inductive approach). A classic content analysis technique was adopted. Data were collected in 2019. Findings Two main categories were identified. Organizational barriers referred to the lack of inter‐professional collaboration and health‐care system strategies to provide clinical pathways for self‐monitoring. Individual barriers encompassed professional characteristics (e.g. university background, professional knowledge, continuum education and accountability/responsibility) and patient characteristics (e.g. patient health literacy and knowledge, engagement/empowerment and educational programmes). Finally, unwarranted clinical variation in oral anticoagulation management arose as a barrier determined by organizational and individual elements. Conclusions: The results of this study pointed out an urgent public health issue in addressing barriers influencing self‐monitoring practice and in sustaining care models that might enhance the quality improvement of self‐monitoring for managing oral anticoagulation. Summary statement: What is already known about this topic? Anticoagulation therapy is one of the leading chronic treatments worldwide to prevent stroke in atrial fibrillation patients.Self‐monitoring is a valuable option to further improve the quality of anticoagulation surveillance and patient medication adherence compared to standard care models.Thus far, the barriers underpinning self‐monitoring implementation experienced by Italian nurses are mainly unexplored.What does this paper add? This study is the first Italian description regarding the main barriers perceived by Italian nurses to adopting SM in patients treated using oral anticoagulation therapy.Organizational barriers refer to the lack of inter‐professional collaboration and health‐care system strategies to provide clinical pathways for self‐monitoring.Individual barriers encompass professional characteristics and patient characteristics, and unwarranted clinical variation arose as a barrier determined by both organizational and individual barriers.The implications of this paper Description of the main barriers perceived by Italian nurses to adopt self‐monitoring of oral anticoagulation is required to prioritize policies and system‐level interventions.Health institutions, patient associations and scientific societies should develop policies that enhance the continuum of professional education of nurses regarding self‐monitoring for oral anticoagulation.Integrated care models where nurses have a leadership role in providing self‐monitoring practice are required to implement self‐monitoring widely. [ABSTRACT FROM AUTHOR]

Purpose: People experiencing homelessness often have complex needs requiring a range of support. These may include health problems (physical illness, mental health and/or substance misuse) as well as social, financial and housing needs. Addressing these issues requires a high degree of coordination amongst services. It is, thus, an example of a wicked policy issue. The purpose of this paper is to examine the challenge of integrating care in this context using evidence from an evaluation of English hospital discharge services for people experiencing homelessness. Design/methodology/approach: The paper undertakes secondary analysis of qualitative data from a mixed methods evaluation of hospital discharge schemes and uses an established framework for understanding integrated care, the Rainbow Model of Integrated Care (RMIC), to help examine the complexities of integration in this area. Findings: Supporting people experiencing homelessness to have a good discharge from hospital was confirmed as a wicked policy issue. The RMIC provided a strong framework for exploring the concept of integration, demonstrating how intertwined the elements of the framework are and, hence, that solutions need to be holistically organised across the RMIC. Limitations to integration were also highlighted, such as shortages of suitable accommodation and the impacts of policies in aligned areas of the welfare state. Research limitations/implications: The data for this secondary analysis were not specifically focussed on integration which meant the themes in the RMIC could not be explored directly nor in as much depth. However, important issues raised in the data directly related to integration of support, and the RMIC emerged as a helpful organising framework for understanding integration in this wicked policy context. Practical implications: Integration is happening in services directly concerned with the discharge from hospital of people experiencing homelessness. Key challenges to this integration are reported in terms of the RMIC, which would be a helpful framework for planning better integrated care for this area of practice. Social implications: Addressing homelessness not only requires careful planning of integration of services at specific pathway points, such as hospital discharge, but also integration across wider systems. A complex set of challenges are discussed to help with planning the better integration desired, and the RMIC was seen as a helpful framework for thinking about key issues and their interactions. Originality/value: This paper examines an application of integrated care knowledge to a key complex, or wicked policy issue. [ABSTRACT FROM AUTHOR]

Purpose: Following serious case review, the Transforming Care agenda (DH, 2015) highlights the need for adults with learning disabilities, autism, mental health issues or behaviors that challenge to be supported within communities rather than hospitals. Poor or absent leadership has been identified as contributing to serious cases of abuse in health-care settings [Department of Health (DH), 2012]. This paper aims to focus on identifying the elements required for good leadership and service delivery in community forensic services (CFS). Design/methodology/approach: The perspectives of 12 support workers working in CFS were obtained through semi-structured interviews. Findings: Thematic analysis identified two predominant themes, namely, authentic leadership and effective team practice. A culture of trust and learning occurs when teams are well led. This culture leads to consistent practice which benefits services users and reduces risk of poor practice. Analysis suggests a framework for service delivery which is complimented by aspects of the Total Attachment model. Research limitations/implications: The data set was collected from the same organisation and views may have been aligned to existing organisational policy. However, the sample was taken across different teams and geographical locations to collate more generalised experiences of team dynamics. The lead researcher works for the organisation and this dual role may have affected the candour with which individuals shared information during interviews. Practical implications: Using a model to understand the functional dynamics of teams within CFS may support leaders and practitioners to improve service delivery. Social implications: Improving service delivery within CFS may increase opportunity to meet the Transforming Care Agenda. Originality/value: This paper examines staff perspectives and the application of theoretical frameworks to propose a unique service delivery model for supported living within CFS. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has created an unprecedented natural experiment in drug policy, treatment delivery, and harm reduction strategies by exposing wide variation in public health infrastructures and social safety nets around the world. Using qualitative data including ethnographic methods, questionnaires, and semi-structured interviews with people who use drugs (PWUD) and Delphi-method with experts from field sites spanning 13 different countries, this paper compares national responses to substance use during the first wave of the COVID-19 pandemic. Field data was collected by the Substance Use x COVID-19 (SU x COVID) Data Collaborative, an international network of social scientists, public health scientists, and community health practitioners convened to identify and contextualise health service delivery models and social protections that influence the health and wellbeing of PWUD during COVID-19. Findings suggest that countries with stronger social welfare systems pre-COVID introduced durable interventions targeting structural drivers of health. Countries with fragmented social service infrastructures implemented temporary initiatives for PWUD led by non-governmental organisations. The paper summarises the most successful early pandemic responses seen across countries and ends by calling for greater systemic investments in social protections for PWUD, diversion away from criminal-legal systems toward health interventions, and integrated harm reduction, treatment and recovery supports for PWUD. [ABSTRACT FROM AUTHOR]

Background: Despite the compelling case for engaging parents in speech and language therapy, research indicates that speech and language therapists (SLTs) currently have a leading role in the goal‐setting process of therapy for children with developmental language disorder (DLD). Therefore, we set out to develop a tool that aims to support the dialogue between SLTs and parents and enhance shared decision‐making about children's communicative participation goals. We used co‐design techniques with SLT–practitioners to include their perspectives throughout the design process. Although co‐design has been used for some years in healthcare research, it is still a relatively new research methodology in the field of speech and language therapy. Aims: To provide a detailed description of the co‐design process that led to the development of a physical artefact that can support SLTs to engage parents of children with DLD in collaborative goal‐setting. Methods & Procedures: The Design Council's Double Diamond model was used to develop a tool in co‐design, together with eight SLTs, who participated in all stages of the development process. Usability was tested in actual goal‐setting conversations between four SLTs and 11 parents of a child with DLD resulting in stepwise improvements. In addition, usability of the first and final prototypes was tested with five usability criteria that were rated on a 10‐point scale by 64 SLTs. Outcomes & Results: The co‐design process resulted in the development of a physical prototype of the tool called 'ENGAGE', consisting of a metal 'tree trunk' on which parents can stick magnetic 'leaves' containing potential participation goals for their child. The 'tree' shape represents a child's development and opportunities for growth. This first prototype received marks between 7.0 and 8.0 out of 10 on attractiveness, user‐friendliness, safety, functionality and affordability. After several iterations, there were significantly higher marks for attractiveness, user‐friendliness and safety in favour for the final prototype. Marks for functionality and affordability did not change significantly. Conclusions & Implications: As researchers we usually develop pen‐and‐paper tools, interview protocols, apps or questionnaires to support clinical practice. Including the SLTs' perspectives in the design process resulted in a tree‐shaped physical artefact that, according to the SLTs, helps to order information and encourages and guides their dialogue with parents. We strongly advocate the inclusion of end‐users in developing innovative user‐centred tools for speech and language therapy and we hope that this will become widespread practice. WHAT THIS PAPER ADDS: What is already known on the subject: Collaborative goal‐setting is at the heart of family‐centred speech and language therapy. However, research indicates that goal‐setting processes for children with DLD are currently predominantly therapist‐led, instead of family‐centred. Reasons for the lack of parental engagement are that effective communication with parents throughout the goal‐setting process appears to be complex, and parents are not always invited and supported to engage in this. We used co‐design to develop a tool that aims to support SLTs in their dialogue about therapy goals with parents. What this paper adds to existing knowledge: This paper provides an example of applying a co‐design approach for the development of a shared goal‐setting tool for SLTs and parents of young children with DLD. The co‐design approach enabled us to incorporate needs, experiences and ideas of SLTs in the design process. We report the four stages in the co‐design process from (1) discovering the needs, wants and desires of the people involved, (2) defining the problem that SLTs experience, (3) developing several solutions and selecting the best solution, and (4) developing and testing the prototype. The detailed description of this process can add to an understanding of the advantages and disadvantages of a design process that includes the perspective of end‐users. The result is a physical artefact representing a tree, which aims to support the conversation between SLTs and parents about a child's communicative participation. Items describing facets of communicative participation are printed on 'leaves' that can be hung on a tree trunk by parents. The tree shape is a positive metaphor for the growth and development of a child. What are the potential or actual clinical implications of this work?: This study describes how SLTs can be meaningfully involved as partners in a co‐design research approach. Incorporating experience from clinical practice was highly relevant since our study aimed to create a solution that would support goal‐setting and service delivery by SLTs. We want to show that it is inspiring and beneficial for SLTs to partner with researchers in innovation of their own clinical practice and provide examples of co‐design activities that illustrate the involvement and influence of end‐users in a design process. Including the perspective of SLTs in the development of a new tool to facilitate the dialogue between SLTs and parents of children with DLD regarding therapy goal‐setting is expected to add value and enhance its implementation in clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: Theoretically, a health system has been described in terms of integration being the coordination of health services and collaboration amongst provider organizations. The components of an integrated health system remain inconclusive. Although senior healthcare executives establish structures and designs which facilitate the delivery of integrated care, their perspectives of a health system have not been explored. The purpose of this paper is to present senior healthcare executives' perspectives of a health system which, when combined, form a model for developing an integrated health system. Design/methodology/approach: Using a qualitative methodology and a multi-case study design, 11 presidents and 4 senior vice presidents of major healthcare organizations or systems in Ontario Canada were selected from a target population of 246 senior healthcare executives to engage in 1 h interviews each. Critical case sampling was applied in the selection of the study sample. Interviews were conducted between December 2017 and February 2018. Findings: Senior healthcare executives expressed four distinct perspectives of a health system: systems, institutional, clinical and governance. When combined, the four perspectives form an original research-based concept or model for an integrated health system. Originality/value: This paper conveys results of personal interviews with senior healthcare executives and presents a proposed model for an integrated health system based on their four distinct perspectives of a health system. [ABSTRACT FROM AUTHOR]

The assistive equipment provision process is routinely carried out with patients to mitigate fall risk factors via the fitment of assistive equipment within the home. However, currently, over 50% of assistive equipment is abandoned by the patients due to poor fit between the patient and the assistive equipment. This paper explores clinician perceptions of an early stage three-dimensional measurement aid prototype, which provides enhanced assistive equipment provision process guidance to clinicians. Ten occupational therapists trialled the three-dimensional measurement aid prototype application; think-aloud and semi-structured interview data was collected. Usability was measured with the System Usability Scale. Participants scored three-dimensional measurement aid prototype as 'excellent' and agreed strongly with items relating to the usability and learnability of the application. The qualitative analysis identified opportunities for improving existing practice, including, improved interpretation/recording measurements; enhanced collaborative practice within the assistive equipment provision process. Future research is needed to determine the clinical utility of this application compared with two-dimensional counterpart paper-based guidance leaflets. [ABSTRACT FROM AUTHOR]