Adaptive Service Research Articles

Intention to adopt blockchain technology for zakat management in Indonesia

Purpose This paper aims to analyze intention for applying blockchain-based technology in zakat management regarding the readiness of zakat institutions and muzakki in Indonesia. Design/methodology/approach This research is a mixed method, namely, using qualitative research to examine the readiness of practitioner and academics in welcoming blockchain-based financial technology and using quantitative research to measure people’s knowledge and intentions to adopt zakat using blockchain technology based on UTAUT theory (Unified Theory of Acceptance and Use of Technology). Findings The findings indicate that performance expectancy, social influence, facilitating conditions and sentiment positively affect the intention to adopt blockchain technology in zakat payments, while effort expectancy do not. Additionally, interviews reveal that practitioners and academics support blockchain technology but are unprepared for its implementation. Practical implications The implications of this study suggest important directions for policy makers, notably zakat institutions, supporting the application of blockchain technology and the adaptation of user-friendly information system services to meet the requirements of zakat service users. Originality/value This study fills the gap in previous research by offering a more comprehensive analysis of the collaboration between zakat and blockchain technology through three different perspectives, namely, practitioners (BAZNAS), academics and users of zakat services (muzakki).

091. Impact of the Covid-19 Pandemic on Breast Cancer Surgery Care in 8 Institutiona Around Southeast and South Asia

Background: The COVID-19 pandemic brought about unprecedented disruptions to surgical services globally, which could have led to delays in surgical care for breast cancer patients. This study analysed the institutional responses of tertiary hospitals from selected Asian countries to the COVID-19 pandemic. Methods: We identified all patients newly diagnosed with breast cancer from 16 institutions (9 countries: Singapore, Bangladesh, India, Indonesia, Malaysia, Pakistan, Philippines, Sri Lanka and Vietnam) from 11 Mar 2020 to 10 Mar 2021 (“covid”) and compared them to those diagnosed 11 Mar 2019 to 10 Mar 2020 (“precovid”). The following data were collected and retrospectively analysed: number of breast cancer surgeries and timeliness of surgery (days from diagnosis to surgery); type of surgery (breast conserving surgery [BCS], mastectomy without [Ms] and with reconstruction [MRecon]), and clinical stage at diagnosis. Results: 4816 patients (2550 in “precovid” and 2266 in “covid” cohort) were included. Median age at diagnosis was 57 for both cohorts (r, 20-117) (p=0.79). In overall number of cases (n=4877), there is no statistically significant difference between pre- (n=2515, 51.6%) v. covid (n=2362, 48.4%) period (p=0.26). Sequence of treatments was similar in both cohorts (upfront surgery [n=3983 cases, 53.7% v. 46.3%, p=0.08; or surgery after neoadjuvant therapy [n=878 cases, 48.9% v. 51.1%, p=0.79]). Five of 16 institutions experienced a decrease in number of surgeries (p<0.05) during the first year of the pandemic, and across all 3 types of surgery, while 1 institution received more cases (p=0.002). Two other institutions had statistically significant more patients with neoadjuvant therapy (p=0.003 and p<0.001) and 1 of these two showed an increase in BCS (p=0.04) and MRecon (p=0.04) cases during covid compared to the precovid period. Five of 12 institutions had significantly longer waiting time from diagnosis to surgery (p<0.05). Trend analysis per quartile during covid period demonstrated that number of surgeries and timeliness dipped mainly in the first quartile, followed by rapid rebound in surgeries across all institutions in the next 2 quartiles. There was no difference in clinical stage at presentation in the 2 time periods. Conclusion: The COVID-19 pandemic initially impacted the number of breast cancer surgeries performed by institutions in Asia. This was followed by rapid adaptation and restoration of surgical services by institutions.

Spatial adaptation in children with autism - a study based on behavioural dynamic video data

Children with autism show unique behavioural patterns and sensitivity to spatial elements; therefore, size and furniture arrangement at rehabilitation facilities can affect behaviour. In this study, spatial adaptation during three situations (learning, playing with toys, and finding objects) was evaluated for different spatial sizes in children with autism using video data. In particular, 330 videos of training sessions involving 15 boys with autism aged 4–6 years in spaces classified as training space (large, medium, and small) and immediate surroundings (activity areas and hallways) were evaluated. Skeletal data were acquired using AI motion capture technology and transformed into movement volume and positions using Grasshopper. Differences between children with autism in normal and aggressive states in different spaces were analyzed. The movement of volume increased in all space sizes during the aggressive state, especially in large spaces. In large spaces, the movement volume during learning was significantly larger, but object-seeking was significantly smaller in the aggressive state than in the normal state. In the immediate surrounding, the volume of movement varied significantly across behavioural states. Additionally, compared with the normal state, the movement location of children with autism in the aggressive state were more dispersed. The movement of location for learning, activity area and hallway were closer to the wall. Playing with toys and finding objects overlapped more with the furniture. This study provides a basis for the spatial adaptation of intervention services for children with autism and a reference for comparisons with current design standards.

Levekår, emosjonelle plager, resiliens og foreldrestress – en kartlegging av flyktningfamilier fra Ukraina

The integration program in Norway is mandatory and offered by all municipalities to newly arrived refugees. The program offers education-oriented activities on Norwegian society, including mandatory parent programs. In 2023, a decision was made to allow municipalities to shorten this element for families from Ukraine, due to capacity constraints. To make informed adjustments, the municipalities need more information about the needs of parents from Ukraine. This article aims to provide knowledge that can help decision-makers plan and implement further adaptations of social and health services. The participants were families with children aged 6-12 from seven municipalities. They answered an electronic questionnaire that included questions on the Hopkins Symptom Checklist (short version), the Resilience Scale for Adolescents, and the Parenting Stress Index (short version). Our study reveals that refugees from Ukraine are a vulnerable group with significantly low economic living conditions, and 26 % of the sample reported symptoms of anxiety and depression. Despite this, parents demonstrated resilience through their social resources, family cohesion, and low levels of parental stress. However, it is important to note that mental health issues and increased parental stress may emerge after a certain period following flight and settlement in Norway, and poor financial conditions can exacerbate these concerns. Keywords: parent programs, refugees, Ukraine, low economic conditions

Maternal support in preschool and child behavior problems: The mediating role of childhood emotion knowledge.

Children's emotion knowledge encompasses abilities to recognize and label emotions in the service of positive adaptation. Drawing on a sociodemographically diverse sample of 250 children (50% female sex assigned at birth; Mage_W1 = 49.02 months, SD = 2.99) and their maternal caregivers (55.6% Latina; 37.6% poverty), this study evaluated a multiple mediation model to integrate heretofore distinct bodies of research examining (a) parenting effects on the development of emotion knowledge and (b) emotion knowledge effects on socioemotional adaptation. Observations of maternal supportive presence at age 4 predicted increases in children's emotion recognition and labeling from ages 4 to 8. However, only emotion labeling skills explained children's behavioral adjustment outcomes with a significant pathway from supportive parenting at age 4 to fewer externalizing and internalizing behavior problems at age 10 via improved emotion labeling skills. These findings suggest that emotion knowledge, particularly labeling skills, partially explains the protective impact of supportive parenting on behavioral adaptation across childhood. Prevention and intervention efforts should target both supportive parenting practices and emotion knowledge skill development to support children's socioemotional functioning and reduce behavior problems. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Unmasking population undercounts, health inequities, and health service access barriers across Indigenous populations in urban Ontario.

Our Health Counts (OHC) methods are designed to address gaps in urban-based Indigenous health information. In partnership with local Indigenous health service providers, we have successfully implemented OHC in six Ontario cities. The aim of this study is to summarize findings regarding Indigenous population undercount, health inequities, and health service access barriers across study sites. We estimated Indigenous population size using OHC census participation survey responses and a multiplier approach. Health inequities between Indigenous populations and overall populations in each city were examined using respondent-driven sampling (RDS), adjusted OHC survey results, and existing public data. Measures included health status outcomes; determinants of health; barriers to health service access, including discrimination by health service providers; and unmet health needs. Indigenous social networks were strong and extensive, and the urban populations demonstrate resilience and cultural continuity across multiple measures. Self-reported rates of census participation for Indigenous populations were markedly lower than those for the general population in each city, and OHC Indigenous population size estimates were consistently 2‒4 times higher than reported in the census. Indigenous to general population health inequities cut across measures of chronic disease, determinants of health, and unmet health needs. Indigenous populations experienced multiple barriers to health services access, including racial discrimination by health service providers. The Canadian census appears to markedly underestimate Indigenous population size in urban areas. Indigenous health inequities and service access barriers are striking and cross-cutting. Timely adaptation of health policies, services, and funding allocations in response to these findings is recommended.

Healthcare Provider Narratives of the Impacts of the COVID-19 Pandemic on Pregnant and Parenting Youth in Canada: A Qualitative Study

The COVID-19 pandemic led to significant challenges for healthcare providers working with pregnant and parenting youth. However, the impacts of the pandemic on this population and healthcare services from the perspective of healthcare providers are not well documented in Canada. We examined the narratives and experiences of healthcare providers regarding these impacts and explored the challenges to service provision. Using a qualitative interpretative description (ID) approach, we recruited 25 health and service providers from Alberta, Ontario, and British Columbia for individual qualitative interviews. Our analysis resulted in three themes: complexities of health service provision during COVID-19, healthcare providers’ accounts of impacts on pregnant and parenting youth, and leveraging challenges into opportunities for service provision. Participants described the influence of pandemic policies and distancing measures on accessibility of health services, availability of healthcare resources and personnel, and well-being of their clients. They also reported increased mental health issues, isolation, and exacerbation of inequities within this population. Providers highlighted the role of telemedicine in ensuring some degree of continuity of care. Additionally, they commented on service adaptations to address the evolving needs of their clients. Our findings underline the need for a resilient and adaptable healthcare system that can better support the needs of vulnerable populations during crises.

Digital Innovations and Competitive Advantage of Commercial Banks in Kenya

Purpose: The purpose of the study was to ascertain the role of digital banking technological innovations in enhancing competitive advantage among commercial banks in Kenya. Specifically, the study sought to examine the influence of digital technological innovations for market, digital banking innovations for differentiation, digital innovations for customer satisfaction and the influence of ICT infrastructure on competitive advantage of commercial banks in Kenya Methodology: Descriptive research design was adopted for the present study. The study was carried out in Kenya, covering all the 39 solvent commercial banks in Kenya as of 31st March 2024. The study adopted the census data collection method from the headquarters of the 22 solvent commercial banks belonging to Tier 3. Four key officers including the sales manager, loan officer, relationship manager, and risk manager totaling to 88 were sampled to participate in the study. Findings: The findings indicate that there is a significant relationship between market positioning and competitive advantage (B = 0.292, p = 0.003). On the other hand, Differentiation is established to have a negligible influence on competitive advantage in this model (B = 0.027, p = 0.852). Customer Satisfaction comes out strongly, as a factor that defines competitive advantage (Coefficient = 0.247, P = 0.046). Unique Contribution to Theory, Policy and Practice: The study recommends that Kenyan commercial banks invest in continuous digital innovation, particularly in mobile and Internet banking, to strengthen market positioning, improve brand perception, and offer personalized services. Banks should also enhance their ICT frameworks for better service delivery, data protection, and adaptability to market changes. Emphasizing mobile banking innovations and staying updated with emerging digital trends will help banks reduce customer acquisition costs, expand their customer base, and maintain a competitive edge in a dynamic industry.

Near-Optimal Adaptive Policies for Serving Stochastically Departing Customers

In, “Near-Optimal Adaptive Policies for Serving Stochastically Departing Customers,” Segev considers a multistage stochastic optimization problem originally introduced by Cygan et al. [Cygan M, Englert M, Gupta A, Mucha M, Sankowski P (2013) Catch them if you can: How to serve impatient users. Proc. 4th Innovations Theoretical Comput. Sci. Conf., 485–494], studying how a single server should prioritize stochastically departing customers. In this setting, the objective is to determine an adaptive service policy that maximizes the expected total reward collected along a discrete planning horizon, in the presence of customers who are independently departing between one stage and the next with known stationary probabilities. The paper’s main contribution resides in proposing a quasi-polynomial-time approximation scheme for serving impatient customers. Specifically, letting n be the number of underlying customers, our algorithm identifies in [Formula: see text] time a service policy whose expected reward is within factor [Formula: see text] of the optimal adaptive reward. The method for deriving this approximation scheme synthesizes various stochastic analyses in order to investigate how the adaptive optimum is affected by alterations to several instance parameters, including the reward values, the departure probabilities, and the collection of customers itself.

MG+: Towards Efficient Context Inconsistency Detection by Minimized Link Generation

ABSTRACTSelf‐adaptive applications are becoming increasingly attractive, with the ability to smartly understand their runtime environments (or contexts) and deliver adaptive services, for example, location‐aware navigation or resource‐sensitive suggestions. However, due to inherent noises in the process of sensing and interpreting environmental information, there is a growing demand for guarding the consistency of collected contexts to avoid application misbehaviour and, at the same time, minimize extra costs. Existing work attempted to achieve this by speeding up the kernel constraint checking module inside the consistency guarding process. Most of these efforts were spent on reusing previous checking results or parallelizing the checking process, but they all leave one central step of constraint checking, that is, link generation, untouched. In this step, the checking engine provides reasons to explain the violation of constraints under check. It occupies a substantial part of the total time cost. Focusing on this key link generation step, we proposed MG, which deploys a rigourous analysis to automatically identify and avoid redundancy in the link generation without harming any correctness of the checking results. MG has been proven sound (always guaranteeing correctness) and complete (entirely removing redundancy). Moreover, based on our observation that MG's redundancy elimination also assists another core step of constraint checking to reduce unnecessary computation further, we additionally enhance MG with an escape‐condition optimization to escape unnecessary evaluation of truth values to further improve the efficiency of constraint checking in an aspect other than link generation. We call it MG+ for distinguishing. Our experiments with synthesized and real‐world consistency constraints reported that, compared with existing work, MG eliminates all link redundancy (83% to 0%), and based on it, MG+ further reduces significant truth value calculations (e.g., 49.74% reduction when combined with ECC and Con‐C). Generally, MG brought 14–500 speed‐ups in link generation, and MG+ further made 1.2–1.9 speed‐ups in truth value evaluation. Altogether, MG reduced the total constraint checking time up to 45.4%, and MG+ reduced it up to 61.0%.

Coping with parental migration: A qualitative study on the social adaptation of left-behind children in Henan, China

This study explores the key challenges faced by left-behind children and examines their coping strategies, with the aim of proposing methods to enhance their social adaptation. Employing qualitative in-depth interviews, the research gathers data from left-behind children in rural areas, identifying a spectrum of coping strategies related to parental migration and evaluating their effects on social adaptation. These strategies include acceptance, environmental adaptation, the use of social media platforms like short-video apps, seeking social support, engaging in recreational activities, emotional self-regulation, and maintaining a positive outlook. The study offers a fresh perspective and framework for the social adaptation service system and advocates for the development of a social work model tailored to rural left-behind children.

Artificial Intelligence (AI) in the Banking Industry: A Review of Service Areas and Customer Service Journeys in Emerging Economies

The banking industry's shift towards digitalization, particularly Web 2.0 banking, signifies a profound change in the bank-client relationship. This transformation integrates digital elements into consumers' lives, digitising everyday activities and highlighting the importance of online social platforms and digital business operations. AI's growing interest in academia and commerce underscores its significant role in customer service. The study examines AI strategies in the banking industry, focusing on service areas and adaptation to the evolving technological landscape, particularly in customer service in developing economies. By adopting an interpretivist philosophy emphasising practicality, a qualitative approach was employed through a systematic literature review of 90 articles using thematic analysis. The research highlights AI's growing use in process automation, customer experience, stock market trend prediction, credit risk management, online banking, marketing management, and auditing. It concludes AI's positive impact on banking operational efficiency and customer service by recommending ethical AI usage, stakeholder collaboration, trust in data handling, and robust internal control systems. Additionally, it suggests exploring the association between organisational culture, leadership, and AI integration in developing economies. The research contributes to the theoretical and empirical frameworks that explain how AI is optimally integrated into banking operations, guiding policymakers and practitioners in leveraging AI to foster financial inclusion and economic growth. Future researchers should include non-profit institutions and non-financial performance metrics to gain insights into AI’s sustainability implications in banks beyond financial metrics.

Health Care Utilisation in a Cohort of Patients with Primary and Secondary Antibody Deficiency in the United Kingdom

IntroductionThis study investigates the frequency of hospital attendances, emergency care attendances and geographical influences on service interaction in cohorts of patients with primary and secondary antibody deficiency, to inform future service planning and delivery.MethodsThe COVID-19 in Antibody Deficiency (COV-AD) study was a United Kingdom study that enrolled 525 participants between April 2021 and September 2022. Data on health care utilisation was extracted from a screening cohort of participants at one participating site (Birmingham, UK). Hospital attendance (i.e. all outpatient and inpatient care episodes, including hospital-based IVIG treatment) and emergency care attendance patterns were analysed. Geographical differences in travel times to hospitals and associated costs were considered for all participants at all recruiting sites.ResultsIndividuals with antibody deficiency had a median of 7 hospital attendances per year. A diagnosis of secondary antibody deficiency, and antibody deficiency severe enough to require treatment with immunoglobulin replacement were associated with an increased frequency of hospital attendance. 12.7% of the cohort attended the Emergency Department at least once in the preceding twelve months. Individuals with secondary antibody deficiency were at greater risk of requiring emergency care over the preceding one-year and five-year periods. Individuals receiving subcutaneous immunoglobulin lived further from their local immunology centre and were more likely to engage with the COV-AD research study remotely, via dried blood spots sampling.ConclusionThis study highlights the utilisation of emergency and secondary care usage amongst patient with immunodeficiency and may inform service adaptation and development to better accommodate patient needs and circumstances.

Contributions of digital technologies for resilience capacity in a type 1 diabetes transition clinic: A qualitative study

A type 1 diabetes (T1D) transition clinic in Sydney, Australia, provides age specific care for young adults (aged 16–25 years) and for adults (aged 21 years and above), and has reported improved clinical outcomes post transition to adult care over a 21-year period. This study investigated the contribution of digital technology to long-term resilient capacity of the clinic. Clinic observations and interviews with eight providers and 17 young adults were conducted. Using a framework to analyze resilient capacity in healthcare, seven strong themes emerged from the data: Leadership, Involvement, Communication, Coordination, Risk Awareness, Competence and Alignment with three themes, Structure, Learning and Facilitators also supported. Patient service adaptations included offering out of hours appointment times and telehealth to accommodate young adults’ availability. This study provides evidence for the important role that digital technologies contribute to a system of care with capacity for resilience. Our findings contribute to the understanding of the factors needed to support young adults with T1D and may be valuable to inform models of care for young adults living with other chronic health conditions.

Modeling Approach of Cloud 4D Printing Service Composition Optimization Based on Non-Dominated Sorting Genetic Algorithm III

The manufacturing industry is currently experiencing a paradigm shift from traditional centralized systems to distributed, personalized, and cloud-based intelligent manufacturing ecosystems. The advent of 4-dimensional (4D) printing technology introduces dynamic characteristics to manufacturing design and functionality, necessitating the effective management of these emergent 4D printing services. This study aims to bridge the gap between the static nature of existing cloud manufacturing services and the dynamic requirements imposed by 4D printing technology. We propose a comprehensive multiobjective optimization model for cloud-based 4D printing service portfolios, incorporating the intricate complexities of 4D printing services and assessing the efficacy of the Non-Dominated Sorting Genetic Algorithm III (NSGA III) in optimizing these service portfolios to meet dynamic demands. In this research, the NSGA III algorithm is employed to develop a multiobjective optimization framework for 4D printing service portfolios, addressing critical issues such as service cost, time, quality, adaptability, and overall service optimization amidst fluctuating demand and service availability. The findings indicate that the NSGA III algorithm demonstrates superior performance in terms of generational distance (GD) and inverted generational distance (IGD), particularly excelling in convergence and diversity for high-dimensional optimization problems when compared to the comparison algorithms. The study concludes that the NSGA III algorithm exhibits significant potential in optimizing the orchestration of cloud-based 4D printing service portfolios, underscoring its effectiveness in managing the complexities associated with these services. This research provides valuable insights for the advancement of intelligent cloud-based 4D printing systems, paving the way for future developments in this field.

Business model structuration in Industry 4.0: an analysis of the value-based strategies of smart service providers in Brazil

PurposeThis study examines the use of a dynamic value-based approach to analyze the business model structuration of smart service providers in Brazil, mapping their value creation, configuration and appropriation strategies, and determining how well-defined their current business models are.Design/methodology/approachThis is a qualitative study based on semi-structured interviews with entrepreneurs (or CEOs and directors of technology) of seven business ventures in three different phases of business model structuration: (1) academic: companies or innovation and research centers linked to universities; (2) startups: technology-based companies originating from the technological needs of clients, be they new branches of the traditional business of incumbents or new entrants and (3) autonomous service providers whose offerings are related to master’s or doctoral projects.FindingsWe propose a typology of business model structuration with four stages. At first (individual or initial business model), albeit with high skilling of owners, only manual or adaptation services are offered. In the second stage (platform business model), although services offered are oriented toward the entire process automatization of the client (Factory integrated), technologies are restricted to the client company (or even one department) and these clients' needs are mainly data processing and connectivity. In the third stage (scaling digital business model), although the services offered are oriented toward greater digitalization through an entire array of field devices connected to the internet (IoT) and organized in a more formalized structure, the business model is still being constructed, companies in this stage are mainly startups. In the fourth stage (innovation ecosystem business model), the entire manufacturing process is digitized, with integration and network connectivity, both between service providers and the extended supply chain of their clients, and new technologies are customized and developed through the interaction of a whole innovation ecosystem.Research limitations/implicationsMapping value-based strategies aids in understanding business model structuration in Industry 4.0. Future research should focus on parameterizing the dimensions founded of each value strategy.Originality/valueThis study advances the comprehension of the business model in |Industry 4.0 by providing a value-based strategy perspective of business model structuration. Practically, by focusing on smart service providers, it contributes to a greater understanding of smart service providers in Brazil and their strategic challenges.

WP3.14 - A Single Unit Service Review in Northern Ireland: The Ever-increasing Acute Surgical Take and the Need for Service Adaptation

Abstract Aims Referrals to the on-call general surgeons in the unit has increased significantly over the past year. Staff levels and hospital resources have not changed to reflect this increasing demand on the service. Our aim is to evaluate the increase in numbers and develop a strategic plan for resolution. Methods A database of referrals to the on-call surgical team was developed using the daily handover records. Two periods of data collection were undertaken, each lasting a duration of 30 days, taking place approximately one year apart. Patient demographics and clinical information was gathered using our electronic care record and electronic notes record. Data gathered included diagnosis, treatment, investigations, interventions, length of stay, suitability for ambulation and follow up. Results The total number of patients referred to the on-call team during cycle one was 233, compared with 405 in cycle two; this is a 74% increase in referrals. During the windows of data collection, 75% of patients with an unscheduled admission did not undergo any intervention and 80% were deemed suitable for ambulation. Conclusion Increasing demands on the NHS require a forward-thinking approach to how we provide an acute surgical service. This study demonstrates that a large proportion of patients are suitable for an ambulatory model of care and development of this service would be a valuable adjunct to the unit. To propose an ambulatory service providing urgent surgical assessment would be an asset to the Trust; potential outcomes would include improving the patient experience, reducing inpatient admissions and bed days, with the associated cost-saving.

The relationship between entrepreneurial personality patterns linked to risk, innovation and gender across industrial sectors

This study examines the personality patterns of solo founders in both high-tech and non-high-tech sectors during the first seven years of their entrepreneurial journey to emphasize the patterns’ implications during policymaking, investment decisions, and self-assessments. IAB/ZEW startup panel microdata for the sector classification of 4470 solo entrepreneurs in Germany were analyzed to identify Big Five trait patterns influenced by risk propensities, innovation inclination, and gender. The entrepreneurial profiles indicate positive openness, emotional resilience, and sector-specific clusters. Conscientiousness suggests flexibility, and while variations in extraversion and agreeableness exist, negative neuroticism was predominantly found, except for gender-related differences and multidimensional service innovators. Big Five traits provide information about important foundational profile patterns to describe unique solo entrepreneur types influenced by risk, innovation, and gender. Originality and value: Risk propensity characterizes ‘Adaptive Services,’ ‘Dynamic Knowledge Innovators,’ and ‘Strategic Risk Navigators.’ Additionally, ‘Multidimensional Service Innovators’ and ‘Focused Tech Innovators’ signify innovation understanding. The Big Five profiles show openness and emotional stability across sectors, providing crucial insights for effective entrepreneurial support and investment strategies.

How to Meet Elders’ Needs: A Strategy for Community Healthcare Service

The elderly care services model based on community involvement is a significant approach to address challenges posed by aging populations. Nevertheless, there is a noticeable gap in effectively gauging the actual needs and preferences of the elderly regarding these services, which is particularly prevalent in developing regions like China. Therefore, we conducted a comprehensive analysis through literature reviews; data surveys; and interviews with 16 elderly individuals, their family members, and caregivers in a community in Shenyang City. Additionally, a Delphi test was conducted to identify the specific needs related to elderly care services. Next, the Kano model explored the genuine needs of the elderly for community-based care services. This model helped us understand how various factors of demand influence satisfaction levels of the elderly, and we designed a service blueprint based on these findings. The study involved 102 participants. Our findings revealed that the extent to which different service needs are met varyingly impact elderly users’ satisfaction. Catering to these needs in a targeted manner enhances the adaptability of services and boosts the subjective satisfaction of the elderly. Consequently, future research should focus on developing suitable community elderly care service plans that are more aligned with their needs.

Benefits and Challenges of Addressing Cultural Intersectionality for Program Development and Evaluation.

Program development and evaluation that promote health equity are driven by community-based participatory research and led by people from select communities to adhere to the principles of diversity, equity, inclusion, and accessibility (DEIA). This process is enriched when these communities represent intersections within DEIA, such as, for example, Korean American women with depression. Research shows that culture-specific adaptations of services are significantly more effective for these communities than is the standard of care for the broader population. However, cultural specificity decreases generalizability of findings and scalability of interventions. Decisions about intersectionality are affected by implications for science as well as real-world benefits for individuals participating in this process.