“Watching from Your Own Residence Makes It More Accessible”: Identifying Supports and Barriers to Participatory Science for Racially-Minoritized, Disabled, and Neurodivergent Participants

A recurrent complaint of members who attend ESA Annual Meetings is that the large number of concurrent sessions make it impossible to attend all the ones of interest. Symposium Reports from the ESA Annual Meeting is one response to this dilemma. They provide, for those who could not attend, an overview of the symposium presentations and the resulting discussion, as well as a convenient means to identify the presenters. And attendees can review the session! The Editor hopes these Reports are useful, and encourages future Symposium organizers to write Reports for the Bulletin when the presentations are given. For detailed instruction for contributions see: 〈http://esapubs.org/esapubs/journals/Bulletin.htm#Typ〉. Until recently if one were to ask "who is a scientist?" a common response would be, someone who works at a university or a government agency or in a laboratory. In other words, many of us tend to think of scientists as professionals who have been academically trained and conduct research through the auspices of a research institution, agency, nonprofit organization, or academic institution. Historically, though, individuals from outside this circle of professionals have been instrumental in shaping and contributing to science. In fact, some of the most renowned scientists and ecologists could be considered citizen scientists (e.g., Charles Darwin, Harold Mayfield, Alexander Skutch). But the view that the public could actively contribute to science faded greatly over the course of the 20th century (particularly in the United States) to such an extent that we were left with the view that only someone who was professionally trained could be a scientist. Recently, however, we have witnessed an increase in the extent and acceptability of public participation and engagement in science. In particular, over the past decade we have seen a marked increase in such "citizen science" (Fig. 1). Although explanations of citizen science vary slightly, they converge on this definition: the involvement of citizens from the nonscientific community in academic research (Trumbull et al. 2000, Lee et al. 2006). Historical trend of citizen science articles. Data represent peer-reviewed articles as identified in ISI Web of Science using the search term "citizen science" from 1980 through 2008. The number of unique articles (n = 55) published is indicated by "articles," and the number of unique citations (n = 353) is indicated by "citations." Because citizen science has seen a dramatic increase in recent years, both in terms of the number of participants and its spread into new disciplines, a symposium was held at the 2008 Ecological Society of America Annual Meeting to address the role of such activity in ecology. Eleven speakers from around the world converged in Milwaukee, Wisconsin, to share their work in "Citizen Science in Ecology: The Intersection of Research and Education," a symposium organized by Christopher Lepczyk, Owen Boyle, and Timothy Vargo. The goals of the symposium were to explore the following questions: (1) Is citizen science a new discipline, sub-discipline, or tool, relative to ecology? (2) Are data collected by citizen scientists valid, and if so, comparable to data collected by professional ecologists or their assistants? (3) Can citizen science be an effective tool to help bridge the gap between ecological research, communities, and education, both for the public and students? (4) Is citizen science the same as or different from ecological monitoring, or is one a subset of the other? (5) Are citizen scientists actively participating in the scientific process as ecologists, thus increasing their ecological literacy? To address these questions, speakers discussed citizen science both in general conceptual terms and in case-specific contexts from around the world. Rick Bonney of Cornell University opened the symposium with an overview of the history and evolution of citizen science in academic research. He explained that citizen science began as a series of monitoring projects designed to put the findings of hobbyists, such as bird watchers and star gazers, to meaningful scientific use. Following these early monitoring projects were ones designed with educational goals and even some set up as experiments. Eventually citizen science started to become an accepted technique for data collection in several scientific disciplines. Today, new citizen science efforts are involving participants in data analysis as well as data collection, and some are even starting to collect data from online images such as nestcams (readouts from recorders aimed at birds' nests). Following on the heels of the history of citizen science was a series of four case studies describing ecological research and monitoring projects that rely upon volunteers for their success. These case studies were arranged along a continuum from large-scale national projects with thousands of volunteers to regional and local projects. In addition, each case study represented varying degrees of interaction between researchers and volunteers. Leading off the case studies was David Ziolkowski of Patuxent Wildlife Refuge, who discussed how citizens drive the North American Breeding Bird Survey (BBS). Specifically, the BBS protocol conducts annual bird surveys along >4000 routes (Fig. 2) across the United States, Canada, and Mexico, using a highly skilled volunteer workforce. Part of the success of the BBS program has been its relatively straightforward field protocol and standardized design. Moreover, the BBS program has resulted in over 400 bird species being surveyed annually at a cost of less than $900 per species per year. Without citizen scientists, such accomplishments could not be achieved. Similarly, in the United Kingdom, a long-running insect monitoring project has been led by citizen scientists in conjunction with Rothamsted Research, the oldest agricultural research station in the world. Philip Gould highlighted how the Rothamsted Insect Survey has used light traps (Fig. 3) to capture insects across 460 sites in the UK for the past 50 years. This survey takes about five minutes each day to collect insects, which are then sent to Rothamsted Research for sorting and identification of the macro-moth fraction of the catch. To ensure a robust monitoring project, volunteers are reimbursed for any trap maintenance and provided with annual summaries of the moths collected from their trap. The success of the program has been built upon: (1) keeping the monitoring system simple; (2) ensuring that the volunteers are trained; (3) knowing when to discontinue sites; and (4) providing all volunteers with feedback on their work. The value of the insect survey was demonstrated in recent findings that two-thirds of common moth species across the UK have declined over the last 35 years, with 20% declining so fast that they should be considered threatened. As a result, several more species have now been added to Biodiversity Action Plans in the UK. Both the BBS and the Rothamsted Insect Survey demonstrate how large-scale monitoring can be used to denote changes in diversity and abundance over time. Furthermore, they both use protocols to filter data, thereby allowing for robust data set production. Locations of breeding bird survey routes. Figure credit: Curtis Flahter and Mike Knowles. Examples of (A) a light trap station in use, and (B) placement in a back yard. Photo credits: (A) Syd Wright MBE, and (B) Philip Gould. At the regional scale, Susanne Masi, manager of Chicago Botanic Garden's Plants of Concern Program, presented an overview and findings from the garden's rare plant monitoring project. The Chicago Botanic Garden established this program to monitor listed and rare plants in the greater Chicago metropolitan area. Initiated in 2001, the program involves ~250 trained volunteers each year in collecting plant data (Fig. 4), and has now accumulated 8+ years of standardized data on 205 plant species at 245 sites. Aside from simply monitoring rare plants, the program has demonstrated several key findings related to using citizen scientists. First, a two-year volunteer data validation study comparing randomly selected volunteer data to professional data showed a high degree of correlation between the two groups. For example, there was >80% correspondence between the two groups in critical data fields such as population numbers and presence of threats. Second, the results of a Plants of Concern citizen science focus group showed that volunteers participated actively in, and understood critical elements of, the scientific process. Furthermore, participants unanimously experienced an increase of their involvement in stewardship and conservation activities as a result of the program, and reported sharing this scientific understanding and enhanced conservation commitment with the broader public. Volunteers (A) determining plot locations and conducting rare and listed plant inventories (B–D) as part of the Chicago Botanic Garden's Plants of Concern Program. Photo credits: (A) Peter Jacobs, (B) Robin Carlson, (C) Emily Kapler, and (D) Dani Drekich. Capping off the case studies was a presentation by Bill Mueller, who introduced the Milwaukee County Avian Migration Monitoring Partnership (MCAMMP), an avian monitoring study focused on migratory bird stopover ecology in the urban parks of Milwaukee County, Wisconsin. To date the project has utilized the assistance of >140 citizen scientists over six migrations (three years) to help address the major goals of assessing habitat use and quality in both riparian and upland sites, and quantifying habitat use by migratory birds. Citizen science volunteers involvement includes training for transect counts, assistance with bird-banding operations, vegetation sampling and analysis, and recording of data. One major aim of training the citizen scientists is that they will be able to establish a long-term, urban avian monitoring project that can expand in the future. The second main portion of the symposium was devoted to a set of talks on the issues of the philosophy, policy, and technology of citizen science. Rebecca Jordan began this second portion with a discussion of a framework for promoting ecological literacy within the context of citizen science programs. She stressed that program design must balance both the scientific goals, which include ensuring data accuracy, and educational goals. Together these goals promote conceptual knowledge about the system of study, epistemological knowledge about science processes, and behavioral change with respect to environmental and civic action. While there is much evidence to support the promotion of conceptual knowledge, the latter two areas warrant further investigation. Integrating cognitive and environmental action theory will likely prove useful as practitioners seek to broaden program impact. David Bonter of Cornell's Laboratory of Ornithology next discussed the issue of data validation processes for large citizen science databases, such as Project FeederWatch. Currently, Project FeederWatch receives >100,000 checklists from >14,000 citizen scientists annually, yielding over 5,000,000 bird observations of ~500 individual species. Thus, it is critical that such large volumes of data be inspected for any problems; this requirement has led to the development of a quality control and quality assurance protocol. This protocol uses a review system, whereby unusual observations or potential errors are flagged and sent to experts for follow-up with the citizen scientists. Unverified reports remain flagged and are excluded from data analyses and web-based data output. The system also allows researchers to identify volunteers who are in need of support and to focus educational efforts accordingly, ultimately improving data quality and integrity. Moving from data editing to data collecting, Louis Liebenberg, founder of CyberTracker Conservation, presented a talk on how technology can be used to get people back in touch with nature. Specifically, Louis has developed the free software program CyberTracker (available at 〈http://www.cybertracker.org/〉), which enables volunteers of all ages to collect biodiversity data on simple portable devices, such as smartphones and PDAs (Fig. 5). CyberTracker is already in active use for both citizen science projects and environmental education around the world. For instance, in the United States, NatureMapping, BioKIDS, and BioBlitz are using PDAs with CyberTracker software to enable volunteers of all ages to collect biodiversity data. Similarly, in South Africa, the NaturalWorld web site allows participants to share and view bird sightings, and in the Kalahari trackers from local communities are being employed to survey wildlife conservation corridors. Finally, the WhaleForce project involves yachtsmen around the world using CyberTracker to monitor whales. Ultimately, the software allows for easy data collection by citizen scientists and helps to promote people who engage the outdoors by collecting field data. Bushmen in Africa using CyberTracker. Photo credit: Louis Liebenberg. Michelle Prysby next discussed more efficient ways for interested citizens to find a project, and for projects to find interested volunteers. One partnership for scientists and educators interested in reaching trained citizen scientists consists of the Master Naturalist programs. These programs are volunteer training and service programs that involve the public in natural resource education, citizen science, and stewardship. Currently there are >25 Master Naturalist programs in the United States that represent a ready pool of volunteers who have been trained in core citizen science skills, such as recording field observations and using taxonomic keys to identify organisms. These volunteers are well connected to their local environments, and are part of an existing infrastructure that can support their citizen science volunteer activities. (For more information on natural resource education and stewardship programs such as Master Naturalists, Watershed Stewards, and Conservation Stewards, please see the Alliance of Natural Resource Outreach and Service Programs 〈http://www.anrosp.org〉). The final presentation of the morning was by Hague Vaughan, of Canada's Ecological Monitoring and Assessment Network (EMAN), who wove together the themes of the morning's talks. He described how citizen science fosters a desperately needed means to better link ecological monitoring to policy development and decision-making. His argument was that the emphasis on certainty in ecological monitoring leaves decision-makers lacking sentinel and feedback information where timeliness is a key factor. If focused on outcomes, complementary citizen science can be a means of enhancing effectiveness. To illustrate how to integrate citizen science into policy, Vaughan discussed a project that combined citizen data with targeted research and air quality monitoring stations in Hamilton, Ontario, Canada to identify pollution and lichen hot-spots that was used to deliver feedback on municipal and industrial choices (Fig. 6). A map of arboreal lichens in Hamilton, Ontario, Canada, based upon citizen science data. Darker green locations represent greater numbers of lichens, and points represent sampling locations. The symposium concluded with a round table discussion of the morning's talks. Following the symposium, an additional workshop on citizen science was held over the weekend at the Urban Ecology Center of Milwaukee. At this workshop many of the symposium speakers gave an additional talk during the morning portion, with an afternoon of hands-on activities designed to train and educate citizen scientists. Overall, the symposium sought to address five major goals related to citizen science. In reflecting upon these five goals it is clear that there was progress made on all, but not necessarily agreement. For instance, the general view was that citizen science has new elements to offer ecology, but there was no definitive agreement among the speakers that it was a new discipline or subdiscipline. Whether or not this will change remains to be seen; citizen science is still very much an area of new ideas and growth. On the other hand, several speakers presented data from their research illustrating that the quality of data collected by citizen scientists is of the same or better quality than that collected by professional ecologists. Such quality is enhanced further with the aid of both software (e.g., Project FeederWatch and CyberTracker) and expert assistance. Similarly, there was strong evidence that citizen science can be an effective tool to help bridge the gap between ecologists and the public. In terms of the overlap with monitoring, it is clear that they share a number of similarities and will likely continue to do so in the future. However, many of the citizen science projects were much broader than monitoring alone, because they engaged the public in the scientific process or served to enhance ecological literacy. Based upon the talks and concluding discussions, citizen science is an increasing part of ecology, and has great promise for contributing knowledge, improving ecological literacy, training scientists to work with the public, and providing information for policy-makers.

BackgroundThere has been increased attention to the need for, and the positive impact of, engaged or participatory science in recent years. Implementation scientists have an opportunity to leverage and contribute to engagement science (ES) through the systematic integration of engagement into implementation science (IS). The purpose of this study was to gather information from researchers and others to develop a prioritized list of research needs and opportunities at the intersection of IS and ES.MethodsWe conducted three Zoom-based focus groups with 20 researchers to generate a list of unmet needs, barriers, and to describe normative themes about use of ES and IS. Then a panel of nine experts in IS and/or engagement ranked the needs and barriers using a survey and met via a Zoom meeting to discuss and generate research opportunities and questions, with reference to the focus group outputs.ResultsRespondents and experts concurred on the importance of engagement in IS. Focus group participants reported 28 needs and barriers under the themes of 1) need for best practice guidance related to engagement processes and outcomes and 2) structural barriers to integrating ES in IS. The expert panel prioritized six structural barriers and four barriers related to generating best practice guidance, with corresponding recommendations on research opportunities. Example research opportunities related to engagement processes included: define “successful” engagement in IS contexts; adapt engagement tools and best practices from other disciplines into IS. Example research opportunities related to outcomes included: assess the impact of engagement on IS outcomes; examine engagement practices that lead to optimal engaged research. Example research opportunities related to structural barriers included: leverage research evidence to create structural changes needed to expand support for engaged IS; examine factors that influence institutional buy-in of engagement in IS.ConclusionsResearch needs exist that relate to engagement processes, outcomes, and structural barriers, even for scientists who value engaged research. Expert panelists recommended sequential and reinforcing research opportunities that implementation and engagement scientists can tackle together to advance both fields and health equity. Future work should assess insights from broader invested parties, particularly patients and community members.

Co-design helps to align research with end-user needs, but there is no consistent method for reporting co-design methodology and evaluation. We share our experiences co-designing the Love Your Brain digital platform for stroke prevention. We evaluated the core attributes that guided our co-design approach, including recruitment, focus group coordination, participant engagement and satisfaction. Online co-design focus groups were conducted fortnightly (May 2023 to March 2024) with two cohorts (health knowledge experts and community members; n = 8 sessions per cohort) to design the content and structure of Love Your Brain. Snowballing methods and purposive sampling were used to recruit participants in Australia. Coordination involved tracking the time spent by the research team for one round of focus groups. Participant engagement was measured through focus group attendance and survey feedback and analysed using descriptive statistics and thematic analysis. Count and length of verbal and/or written contributions during focus groups were summarised with descriptive statistics as a measure of engagement, with differences between cohorts assessed using χ2/Wilcoxon rank-sum tests. Participant satisfaction was evaluated using survey responses and input at a final evaluative focus group. Sixteen health knowledge experts (clinicians/researchers) and 28 community members expressed interest, of which 10 health knowledge experts and 12 community members (including 9 people with lived experience of stroke) participated. Conducting two identical focus groups required 29 h of project manager/coordinator time, 8-11 h for facilitators and 6.5-8.5 h for chief investigators. Most participants (86%) attended ≥ 5/8 focus groups. Engagement was enhanced through pre-reading material, structured/well-organised focus groups and experienced facilitators. All participants contributed at each focus group, with varying levels of input. Health knowledge experts preferred written contributions over verbal contributions and wrote longer messages compared to community members. Community members spoke for a longer duration than health knowledge experts. Participant satisfaction was high, with participants reporting that the research team 'always valued our opinions'. Importance was placed on a final evaluative focus group, and participants stated that their contributions were incorporated into the final product. Our research emphasises relationships between coordination, participant engagement and satisfaction and the importance of considering resourcing requirements for successful co-design of digital health projects. People with lived experience, including caregivers of people with stroke, and members of the public, participated in the co-design focus groups. The Love Your Brain Management Committee includes people with lived experience of stroke who contributed to the oversight of this study and the preparation of this manuscript.

Tailored community engagement to address the genetics diversity gap

ObjectivesTo investigate the magnitude of barriers in access to health services for chronic patients and the socioeconomic and demographic characteristics that affect them.MethodsA cross-sectional study was conducted in 1,594 chronic patients suffering from diabetes, hypertension, COPD and Alzheimer. Logistic regression analyses were carried out in order to explore the factors related to economic and geographical barriers in access, as well as the determinants of barriers due to waiting lists.ResultsA total of 25% of chronic patients face geographical barriers while 63.5% and 58.5% of them are in front of economic and waiting list barriers, respectively. Unemployed, low-income and low-educated are more likely to face economic barriers in access. Moreover, women, low-income patients, and patients with lower health status are more likely to be in front of geographical barriers. In addition, the probability of waiting lists occurrence is greater for unemployed, employees and low income patients.ConclusionsBarriers in access can be mainly attributed to income decrease and unemployment. In this context, health policy measures are essential for removing barriers in access. Otherwise, inequalities may increase and chronic patients’ health status will be deteriorated. These consequences imply adverse effects on health expenditure.

The use and utility of science in society is often influenced by the structure, legitimacy, and efficacy of the scientific research process. Public participation in scientific research (PPSR) is a growing field of practice aimed at enhancing both public knowledge and understanding of science (education outreach) and the efficacy and responsiveness of scientific research, practice, and policy (participatory engagement). However, PPSR objectives focused on "education outreach" and "participatory engagement" have each emerged from diverse theoretical traditions that maintain distinct indicators of success used for program development and evaluation. Although areas of intersection and overlap among these two traditions exist in theory and practice, a set of comprehensive standards has yet to coalesce that supports the key principles of both traditions in an assimilated fashion. To fill this void, a comprehensive indicators framework is proposed with the goal of promoting a more integrative and synergistic PPSR program development and assessment process.

BackgroundParents are integral to the implementation of obesity prevention and management recommendations for children. Exploration of barriers to and facilitators of parental decisions to adopt obesity prevention recommendations will inform future efforts to reduce childhood obesity.MethodsWe conducted 4 focus groups (2 English, 2 Spanish) among a total of 19 parents of overweight (BMI ≥ 85th percentile) children aged 5-17 years. The main discussion focused on 7 common obesity prevention recommendations: reducing television (TV) watching, removing TV from child's bedroom, increasing physically active games, participating in community or school-based athletics, walking to school, walking more in general, and eating less fast food. Parents were asked to discuss what factors would make each recommendation more difficult (barriers) or easier (facilitators) to follow. Participants were also asked about the relative importance of economic (time and dollar costs/savings) barriers and facilitators if these were not brought into the discussion unprompted.ResultsParents identified many barriers but few facilitators to adopting obesity prevention recommendations for their children. Members of all groups identified economic barriers (time and dollar costs) among a variety of pertinent barriers, although the discussion of dollar costs often required prompting. Parents cited other barriers including child preference, difficulty with changing habits, lack of information, lack of transportation, difficulty with monitoring child behavior, need for assistance from family members, parity with other family members, and neighborhood walking safety. Facilitators identified included access to physical activity programs, availability of alternatives to fast food and TV which are acceptable to the child, enlisting outside support, dietary information, involving the child, setting limits, making behavior changes gradually, and parental change in shopping behaviors and own eating behaviors.ConclusionsParents identify numerous barriers to adopting obesity prevention recommendations, most notably child and family preferences and resistance to change, but also economic barriers. Intervention programs should consider the context of family priorities and how to overcome barriers and make use of relevant facilitators during program development.

The Diabetes Prevention Program (DPP), an effective evidence-based strategy to reduce the incidence of type 2 diabetes, has been widely implemented in various locations, including workplaces. However, most people do not remain engaged in the program for the recommended full year. Limited qualitative research exists around participant engagement in the workplace DPP. Our study aimed to explore participant engagement in the DPP delivered through the employer-based clinic (EBC) at a large technology company. The DPP was implemented through the EBC at a large technology company in Southern California, beginning in September 2019 by using in-person and virtual synchronous group classes before and during the COVID-19 pandemic. Virtual focus groups with DPP participants from 2 inaugural cohorts were conducted via Zoom from October 2020 to February 2021. Data were analyzed by using inductive thematic analysis. Five focus groups with 2 to 3 participants in each (total n = 12) were conducted, 2 focus groups per cohort and 1 focus group with the group instructors. Barriers and facilitators to engagement in the DPP were grouped into thematic domains: Individual Drivers, Small Group Community, Workplace Setting, Integrated EBC, and the COVID-19 Pandemic. Results showed that prepandemic workplace demands (ie, meetings, travel) affected DPP participation, yet the group setting provided social support in the workplace to engage in and maintain healthy habits. With the move to a virtual synchronous offering during the pandemic, participants valued the group setting but expressed a preference for in-person meetings. Collectively, participant engagement was bolstered by shared buy-in and collaboration between the employer and the EBC. Our findings suggest that engagement in a workplace DPP can be supported by addressing workplace-specific barriers and gaining buy-in from employers. Delivering the DPP, in person and virtually, through an EBC has the potential to engage employees who have prediabetes.

Participant Redemption and Engagement in Produce Prescription Programs: A Qualitative Analysis of Implementer Perspectives

Enhancing Nutrition and Obesity Research Collaborations across Institutions: Lessons from a North Carolina Focus Group.

Disadvantaged Youth in Southern Scotland Experience Greater Barriers to Information Access Resulting from Poor Technology Skills, Information Literacy, and Social Structures and Norms

BackgroundSub-Saharan African populations are growing in many European countries. Data on the health of these populations are rare. Additionally, many sub-Saharan African migrants are confronted with issues of low socio-economic status, acculturation and language difficulties, which may hamper their access to health care. Despite the identification of some of those barriers, little is known about the enabling factors. Knowledge about the enablers and barriers in access to healthcare experienced is important in addressing their health needs and promoting healthcare access. This study aimed to investigate the enabling factors as well as barriers in access to the Dutch healthcare system among the largest sub-Saharan African migrant group (Ghanaians) living in Amsterdam, the Netherlands.MethodsSix focus groups were conducted from November 2009 to February 2010. A semi-structured interview guideline was used. Discussions were conducted in English or Twi (Ghanaian dialect), recorded and transcribed verbatim. Analysis was based on the Andersen model of healthcare utilisation using MAXQDA software.ResultsKnowledge and perceived quality of the health system, awareness of diseases, family and community support, community initiatives and availability of social support were the main enablers to the healthcare system. Difficulties with the Dutch language and mistrust in health care providers were major barriers in access to healthcare.ConclusionsAccess to healthcare is facilitated mainly by knowledge of and the perceived efficiency and quality of the Dutch healthcare system. However, poor Dutch language proficiency and mistrust in health care providers appear to be important barriers in accessing healthcare. The enablers and barriers identified by this study provide useful information for promoting healthcare access among this and similar Sub-Saharan African communities.

BackgroundIndividuals from minority groups have historically faced social injustices. Those from underrepresented groups have been less likely to access both healthcare services and higher education. Little is known about the experiences of underrepresented students during their undergraduate studies in osteopathy in the UK. The aim of this project was to explore awareness of cultural diversity and beliefs about patients from underrepresented groups in current osteopathic educational environments and evaluate students’ preparedness to manage patients from diverse groups. The project also aimed to investigate the educational experiences of students from underrepresented backgrounds during their training and their opinions on changes that could support better levels of recruitment and achievement. The findings were discussed with stakeholders in interactive workshops with the aim to develop recommendations for action and change.MethodsA transformative action research paradigm informed this mixed methods project. It included: 1/ a survey of students from all seven osteopathic educational providers in the UK using the Multidimensional Cultural Humility Scale (MCHS); 2/ a series of focus groups with students from underrepresented groups (women, students with disabilities, students from minority ethnic backgrounds, and students identifying as LGBTQIA+); and 3/ a workshop forum to discuss findings.ResultsA total of 202 participants completed the MCHS and demographic questionnaire and seven focus groups were conducted. A model was developed to describe participants’ training experiences comprising two main themes: institutional contextual obstacles (with four sub-themes) and underrepresented students’ conceptual understanding of Equity, Diversity and Inclusion (EDI). Recommendations for change identified in the workshops were based on three topics: institutions, staff, and students.ConclusionOur findings confirm conclusions from other institutions that staff education is urgently needed to create and maintain equitable, inclusive environments in osteopathic educational institutions in the UK to support all students, particularly those from underrepresented groups. Institutional EDI processes and policies also need to be clarified or modified to ensure their usefulness, accessibility, and implementation.

User involvement in transport decision-making (often referred to as ‘public participation’) has been actively encouraged by government for many years. However, the methods used for engaging the public are mostly traditional (e.g. questionnaires, consultation documents and focus groups) with very little use of creative techniques. Furthermore, the level of involvement is generally ‘passive’ (i.e. agreeing pre-established local authority priorities) rather than ‘active’ (i.e. generation of problem areas, priorities or potential solutions using participatory approaches).‘Participatory design’ encompasses a broad range of methods and is often resource-heavy but leads to user-centric outcomes. If it is to be more widely employed in the development of sustainable transport solutions, then there needs to be more evidence of its value in this context, more exploration of which participants and which methods are beneficial, and more exploration of novel ways to engage with the travelling public. To address the latter, there is an opportunity to utilise the affordances of technology (e.g. mobile accessibility, location-enabled, immediacy, content-creation, mass-engagement) to understand what is needed, to co-create ideas and to collaborate in the pursuance of these solutions. It is this overlapping of direct user involvement, innovative approaches and technology affordances that is explored in this thesis in the context of sustainable transport innovations.This thesis presents ten publications that, as a collection, show how the author has investigated the role of user participation in the development of transport service innovations. This body of work makes a contribution to knowledge predominantly in participatory design but also in other domains including transport studies, crowdsourcing and grassroots innovation. The work has provided evidence of the benefits of user participation at different stages of the design process including problem identification via crowdsourced content, identifying novel and diverse solutions using generative methods and actively creating solutions using ‘volunteered information’.

2087 Tool to assess opportunities to augment health literacy and culturally responsive components of research design to enhance diverse engagement