Change Agents Research Articles

Using Structural Competencies for Faculty and Students to Integrate Principles of Social Justice and Health Equity Into a Doctor of Physical Therapy Program.

Integrating principles of social justice and health equity (SJHE) into Doctor of Physical Therapy (DPT) education may be one way to confront the root causes of health inequity. The purpose of this method/model presentation is to highlight structural competencies for faculty and students to integrate SJHE into a 3-year DPT program and a professional development program designed to provide core and clinical faculty with the tools to engage in critical discussions with students and support their development as agents of change. This presentation highlights how SJHE structural competencies can be integrated into existing course content (as opposed to presented as a standalone course). Researchers interviewed 10 DPT faculty and 10 DPT students about their experience learning about SJHE. Six clinical instructors (CIs) who supervised students during a full-time clinical education experience (CEE) discussed students' ability to apply SJHE concepts during CEEs. Faculty expressed the need for practice in low-stakes settings such as through simulation. Students valued learning about SJHE over 3 years with the opportunity to integrate content during CEEs but felt that SJHE could be better integrated in classroom content. Some peers were perceived to be resistant to SJHE. Clinical instructors described that although students were prepared to apply foundational SJHE concepts, students were surprised by the complexity of patient need. Exploratory analysis of faculty, CI, and students' perceptions confirm that SJHE is needed in DPT education but takes time to integrate well with a steep learning curve and additional faculty development needs that must be met.

Kaitiakitanga: A Proclamation for Indigenous Active Agency in Climate Change in Aotearoa, New Zealand

Kaitiakitanga: A Proclamation for Indigenous Active Agency in Climate Change in Aotearoa, New Zealand

Towards a stance de-centring model for the foreign language classroom: Training 21st-century agents of change

The present paper describes a new, theoretically grounded model for stance de-centring that advocates for enhancing foreign language learners’ intercultural awareness, sensitivity, and behaviours. This model embraces both three levels of stance de-centring: epistemic, emotional and effective, and three dimensions of intercultural competence: cognitive, affective and conative. Epistemic, emotional, and effective stance de-centring is carried out at the cognitive, affective and conative intercultural dimensions to raise foreign language learners’ intercultural awareness, develop their intercultural sensitivity, and activate their intercultural behaviours. Each intercultural dimension comprised within the model is rigorously examined, highlighting the importance of nurturing skills in critical thinking, empathy, and behavioural adaptability to counter ethnocentrism through stance de-centring. Practical examples illustrating the successful implementation of the stance de-centring model within the foreign language classroom are also presented. These examples elucidate the practical application and potential impact of the model, offering insights into fostering inclusive environments and preparing foreign language learners to navigate diverse cultural landscapes as future agents of change.

Breaking challenges: queer perspectives on solutions to establish inclusive sexual-reproductive healthcare in Gauteng Province, South Africa.

In South Africa's diverse population, queer voices emerge as change agents, proposing new and critical solutions to reform sexual and reproductive healthcare services in the pursuit of inclusivity and equality. Our research aimed to explore and describe queer individuals' perceptions and solutions for promoting sexual-reproductive healthcare services and needs (SRHSN) in Gauteng Province, South Africa. An explorative-descriptive study was performed for this research. A total of 22 queer individuals was recruited using respondent-driven sampling (RDS) within a queer-inclusive non-governmental organization (NGO) clinic in Gauteng Province, South Africa. Semi-structured interviews and an interview guide were utilized to collect data using English. Thematic content analysis was applied using NVivo 14. Four main themes and related sub-themes were revealed from the study including the creation of healthcare equity for queer individuals, empowering and supporting healthcare providers (HCPs) to enhance skills, knowledge, and expertise, raising awareness on queer-related issues, and different stakeholders' involvement. As we navigate South Africa's complex landscape of SRHSN for queer individuals, the crucial opinions and solutions offered by queer people not only challenge the status quo but also reveal an approach to a better, more equitable, empathetic, and accommodating healthcare system for everyone. Future studies should ensure the inclusiveness of queer individuals with the interest of improving their health not just for research outputs.

The impact of simulation training on enhancing the understanding of providing aid for injury cases among the Healthy Student Cadres (HSCs) at Assalafiyyah II Mlangi Islamic Boarding School

Introduction: The students of Islamic boarding Schools, as agents of change, often experience complaints of muscle and joint injuries. Assalafiyyah II Mlangi Islamic Boarding School (IBS) was one of the pioneers of an integrated health system to improve health status. However, the condition of health facilities, especially those related to handling injuries, was still very minimal. In addition, the students had never received counseling regarding injury management. Therefore, it is necessary to conduct research related to the effect of health education in increasing knowledge about assisting in cases of injury to Healthy Student Cadres (HSCs) of Assalafiyah II Mlangi IBS. This study aimed to determine the effect of health education in increasing knowledge about assisting in cases of injury to healthy students Cadres Assalafiyyah II IBS. Methods: This study was carried out using a quantitative experimental design. A one-group, quasi-experimental pretest-posttest approach was adopted in this study. The 40 healthy student cadres from Assalafiyyah II Mlangi IBS were recruited. The knowledge scores of the pretest (before health education) and post-test (after health education) were compared using the paired sample t-test. Furthermore, the Kruskal-Wallis test examined the relationship between education level and knowledge score. Results: The pretest results showed that the level of knowledge of the subjects in the good category was 5%, adequate was 30%, and poor was 65%. In contrast, the post-test results showed an increase in knowledge scores. In particular, subjects in the good category were 47.5%, adequate was 40%, and poor were as much as 12.5%. This study also showed a significant change in the score of knowledge about assisting in cases of injury to subjects after providing health education in a positive correlation with p= 0.000. The level of education did not affect the results of the knowledge score about assisting in injury cases, with p= 0.072. Conclusion: Providing health education materials effectively increases knowledge about helping Healthy Student Cadres (HSCs) in injury cases. This increase in knowledge can make Healthy Student Cadres (HSCs) pioneers in the surrounding environment regarding the importance of assisting in injury cases.

Menumbuhkan Literasi Teknologi Melalui Pengenalan Aplikasi Computer Vision Di Kalangan Pelajar

The purpose of this community service project is to provide education to enhance technological literacy by introducing the basics of Computer Vision applications among students. The activities included a seminar attended by 170 students. An analysis using the Wilcoxon statistical test on pre-post test results showed a significant improvement in participants' understanding of Computer Vision applications. The test results indicated a significant difference before and after the activity with a value of 0.011. Through this community service, participants have successfully grasped the material presented to enhance literacy as change agents in the digital era, positively impacting societal progress through improved understanding of technology in the field of Computer Vision.

Ariadne's Thread Metacognition for emancipatory rationality in education

Emancipatory rationality in education empowers individuals and promotes social justice.Metacognition and critical thinking play vital roles in supporting this approach by encouraging learners and professionals to reflect on their thinking processes, question assumptions, and develop the ability to engage critically with information. The research presented in this paper falls within the action research framework, which provides for theinvestigation to be conducted in the field based on close collaboration between researchers and practitioners. Action research aims to generate improvement and change in the context in which it is implemented. The roots of this approach can be found in Dewey’s criticism of the traditional separation of knowledge and action and in Freire’s idea of conscientization, the process of developing critical awareness through reflection and action. In their view, learning depends upon uncovering real problems and actual needs. Starting from four criticalincidents, the paper demonstrates how reflective practices based on metacognition can be used to train education professionals. Metacognitive work is essential for analyzing problems and responsibilities and identifying any distortions preventing educational action from responding effectively to people's needs. When faced with an educational problem, the professional needs to be able to use two forms of rationality: heuristic-reflective andemancipatory. The first type of rationality guides through the investigation of the experience to build the necessary knowledge to interpret and manage it. The second makes the educator an agent of transformation and change.

Pengaruh Aktivis Mahasiswa Dalam Perubahan Sosial Politik Di Era Digital 5.0

The study explores how student activists at the Islamic State University of North Sumatra (UINSU) influence the socio-political dynamics of the digital era 5.0. This era is marked by technological advances that integrate the physical, digital, and biological worlds, thus providing a new platform for student activism. Student activists not only act as agents of change through social and political activities, but they also use digital technology to expand their influence. The research uses a survey method with structured questionnaires distributed to UINSU student activists, as well as a qualitative approach to gaining an in-depth understanding of their views, attitudes, and experiences of socio-political change. Research findings indicate that student activists effectively use social media and digital technology for campaigns and mobilization. Through social media and internet platforms, activists can quickly mobilize people and draw attention to key topics such as gender equality, climate change, and human rights on a global scale. In the digital age of 5.0, student activists can also more successfully challenge existing forces by using digital tactics, including online campaigns, digital petitions, and online boycott movements, in addition to conducting physical demonstrations in public spaces. They not only use technology as a tool of struggle, but also as a new space for building critical awareness and solidarity. However, the research also finds challenges faced by student activists, such as the spread of disinformation and hoaxes, digital gaps, and technology access. Nonetheless, student activists continue to adapt quickly and innovate to overcome these barriers. The study provides significant insights into the role of digital technology in student activism and its implications for healthy political participation in the digital age 5.0, as well as solutions to strengthen the integrity of democracy at the local level.

Roles of gender in addressing structural inequality: assessment of Borana women’s endogenous institutional agents of gender amelioration in peace, conflict, and post-conflict settings

ABSTRACT The portrayal of women in traditional societies as victims of conflicts and gender inequalities often overlooks their roles as agents of change. This article examined the roles of Borana women in addressing structural inequality during peace, conflict, and post-conflict settings using endogenous institutions. The study utilized an ethnographic research design and a qualitative research approach. Both primary and secondary data were collected for the study. Key informant interviews and focus group discussions were used to collect primary data, while secondary data were obtained from relevant materials through desk review. The primary data were transcribed, translated, and analyzed using thematic analysis. The findings of the study reveal that Borana women play crucial roles in fighting structural inequality through endogenous institutions in preserving peace, protecting the vulnerables, challenging male dominance, maintaining community life and upholding women’s customary laws. The study also revealed the challenges women face in addressing structural inequality. These findings contribute to feminist theories by emphasizing women’s active and diverse roles in combating structural inequality. Consequently, assertive policy options that safeguard women’s customary rights and endogenous peacemaking practices are needed. Furthermore, the study calls for policy interventions and support systems that empower women and enhance their participation in decision-making processes.

Becoming Agents of Change: OT Students in Screening, Brief Intervention, & Treatment for Recovery From Substance Use Disorders

Abstract Date Presented 03/21/24 This study depicts how a 3-week delivery of educational experiences increased student knowledge, attitudes, competence, confidence, and readiness to conduct screening, brief intervention, and referral to treatment for individuals in recovery. Primary Author and Speaker: Jill Brown Contributing Authors: Kathleen Schachman, Meghan Baruth

Fragetypen zur Lösungsentwicklung im Business Coaching – Eine gesprächsanalytisch motivierte Untersuchung ihrer sprachlichen, frage- und interaktionstypspezifischen Charakteristika

Abstract According to coaching literature, coaches’ questions serve as a central intervention to support clients’ learning and development, i. e., solution-generation and change. To date, there is very little empirical research regarding coaching-specific questions and how they function as agents of change in this professional helping format. The few available psychological coaching outcome studies address ‘solution-focused questions’ due to its (theoretical) endemic orientation towards identifying solutions. Linguistic research, drawing on (methods of) Conversation Analysis, has only recently started to address coaching as a field of scientific inquiry. This paper builds on the scant available research and focusses on questions that support solution generation as the ‘target actions’ of question sequences. These question types are sequence-initiating actions that are intended to generate ideal solution projections and to help identify client’s resources or hindrances; they also focus on solution strategies and measures to find solutions as well as the interim results within the client’s change process. The goal of this contribution is to document and analyze the formal, functional, thematic, and semantic features of questions that generate solutions in business coaching and – on this basis of this analysis – to describe their interaction- and question-type specificities, something which has hitherto not been done. The data analysed here are 12 audio-/video-recorded and transcribed sessions from three authentic coaching processes that form part of a larger corpus of systemic solution-oriented business coaching in German.

Ayahuasca Tourism: Curating Authenticity in Transformative Times (Field Note)

ABSTRACT: Motivated by multiple factors collectively related to what is often termed the Psychedelic Renaissance, people increasingly consume psychedelics for recreational, medicinal, psychotherapeutic, and even spiritual or religious reasons. In the broader psychedelic ecosystem, ayahuasca (a psychoactive "tea" made from plants indigenous to the Amazon jungle) is becoming one of the more popular psychoactive substances. Ayahuasca churches, retreat centers, and informal "circles" are forming in multiple countries around the world; however, many people who want to drink ayahuasca travel to or near the Amazon, where they seek what they deem an authentic shamanic ayahuasca experience. The lure of authenticity draws people to the Amazon, where they encounter a rather diverse ayahuasca ecosystem. The limited historical and archaeological data suggest that this diversity predates colonialism; however, various factors including the tourists themselves are now agents of change.

PELATIHAN AKUNTANSI DAN KEWIRAUSAHAAN PADA PONDOK PESANTREN AL-TSANIYYAH SEBAGAI ALTERNATIF PEMBERDAYAAN MASYARAKAT MANDIRI

Research and Community Service (PKM) is one of the manifestations of the Tri Dharma of Higher Education. PKM activities is to foster lecturers in improving their abilities and skills as well as the existence of Pamulang University which is an agent of change in order to provide significant benefits to society. The Unpam Accounting Study Program held PKM at Al-Tsaniyyah Islamic Boarding School in South Tangerang Banten. PKM at Al Tsaniyah Islamic Boarding School is to provide accounting and entrepreneurship training and improve hard skills in the field of digital entrepreneurship and utilization in terms of data collection, use of digital interpreneurship content to students as provisions in their future. The materials of PKM are throughout presentations, discussions and training, at the end of the session to find out the extent to which the material can be absorbed, questions and answers are asked to the students and door prizes are given.

Realising systemic justice-oriented reform in education in postcolonial contexts

Drawing on and responding to the articles in this special collection, this provocation makes the case that realising justice in education requires a focus on the processes and politics of justice-oriented reform in postcolonial, low- and middle-income counties (LMICs). In implementing reform, it is argued that it is crucial to take account of similarities and differences in context between LMICs. At the heart of reform must be a holistic, coherent and systemic approach at the level of the education system of the institution. Key priorities include reforming the curriculum, investing in educators as agents of change and developing endogenous system leadership that can drive justice-oriented reform. Here, however, it is necessary to engage with the politics of justice-oriented reform, including challenging global, neoliberal agendas, democratising the governance of education and engaging with popular struggles for social, epistemic, transitional and environmental justice.

FRAP 2.0: a community engagement method applied to cervical cancer disparities among Hispanic women

focused Rapid Assessment Process (fRAP) 2.0 is a community engagement approach combining geospatial mapping with rapid qualitative assessment in cyclical fashion within communities to capture multifactorial and multilevel features impacting...

Intersecting perspectives: Advocating for sustainable family meals across generations

Adolescents in Germany eat fewer animal products than their parents, often for sustainability reasons. We investigated how adolescents differ from their parents' generation in sustainability food-choice motives, consumption of animal products, and corresponding behaviors such as advocating for and influencing decisions towards more sustainable family meals. In an online questionnaire, an educationally diverse sample of 500 adolescents (M = 17.9 years, range = 15–20) and 500 adults of their parents' generation (M = 52.2 years, range = 45–60) reported food-choice motives, their own and their family's diet style, how they advocate for sustainable food decisions at family meals (e.g., less meat), and how they influence different steps in family meal planning (e.g., grocery shopping). The two generations did not differ in sustainable food motives and mean consumption frequency of meat and animal products, but adolescents reported three times more often than their parents' generation to never eat meat. At shared family meals they advocated for eating plant-based substitutes (d = 0.27, p < 0.001) and other animal products (β = −0.15, p = 0.02) more often than their parents' generation, but not for eating less meat. Adolescents advocated more frequently for sustainable food decisions at shared meals the more important sustainability motives were to them (β = 0.53, p < 0.001), and the less meat (β = −0.35, p < 0.001) and fewer other animal products (β = −0.11, p = 0.015) they consumed. Adolescents motivated towards sustainability have the potential to impact the family's dietary choices through reverse socialization processes. These findings challenge current theories that suggest only parents influence their children, neglecting the role of adolescents as potential agents of change for improved family and planetary health.

Reducing personal protective equipment waste in the emergency department of a large regional hospital: codesign informed by system science

BackgroundThis study aimed to bring together health workers from an emergency department (ED) and broader health system changemakers to cocreate a system-oriented understanding of the drivers of single-use personal protective...

Inside “Operation Change Agent”: Mallinckrodt's Plan for Capturing the Opioid Market

Context: The United States is deeply entangled in an opioid crisis that began with the overuse of prescription painkillers. At the height of the prescription opioid crisis (2006–2012), Mallinckrodt Pharmaceuticals was the nation's largest opioid manufacturer. This study explores Mallinckrodt's strategies for expanding its market share by promoting a new opioid. Methods: The authors used the Opioid Industry Document Archive to analyze the incentive structures, sales contests, and rhetorical strategy behind Mallinckrodt's “Operation Change Agent,” a campaign to switch patients from OxyContin to Mallinckrodt-manufactured painkillers. A structured search of the archive in October 2022 retrieved 464 documents dated between 2010 and 2020. Findings: The authors identified a range of Mallinckrodt's sales force motivational techniques, including hypertargeting high-decile prescribers, providing free trial kits, using emotion-based language to connect with prescribers, and strategies for opposing prescriber resistance. Throughout, managers used specific incentivization metaphors to frame strategies in terms of sport and ultramarathons. Conclusions: This research on internal corporate strategy joins the growing challenges to industry claims that opioid sales teams simply educated providers and helped fill existing demand for their products. It has important implications for regulatory policy and consumer protections that can better protect health in the face of competitive market forces.

Robots as behavior change agents: Can robots teach behavior technicians to implement differential reinforcement?

Robots as behavior change agents: Can robots teach behavior technicians to implement differential reinforcement?

The Effectiveness of Leadership Interventions on Cardiologists' Performance Using Benchmarking as a Tool.

Aligned with the Health Sector Transformation Strategy of Saudi Vision 2030, the study analyzed the attitudes and behaviors of cardiologists toward change and identified factors that could either facilitate or hinder the success of leadership interventions. At our cardiac center, the cath lab department is at the forefront of operations, accounting for 80% of the procedures. Our team members may not be fully equipped with the necessary attitudes and behaviors to drive successful improvement projects. Therefore, our top priority is ensuring they remain productive and engaged throughout the process. This is especially crucial because 60% of our budget is allocated to the cath lab department. The study aimed to assess the effectiveness of a leadership intervention on cardiologists' performance in terms of safety, speed, and cost. The research analyzed the behavior and attitude of cardiologists towards change and encouraged progress and collaborative learning between doctors, using benchmarking as a tool. Besides, the study sought to determine the contribution of the interventions used to overall efficiency in performing interventions. This case study focuses on four main aspects of the program. First, it aims to explore an innovative approach to improving the PSCCQ cath lab for patients. Second, it assesses the collective effort of all participants involved in the program. Third, it analyzes the program results and compares them with those of international experiences. And finally, it examines the program's potential benefits for our patients. The study's objectives were evaluated through qualitative analysis of in-depth interviews and quantitative data analysis of three variables in the cath lab: radiation dose, time, and inventory. The reason for using mixed methods was to comprehensively understand the same concept from different angles. According to the study, participants improved the safety and effectiveness of our cath lab by reducing the radiation dose and its cost. The study revealed a 52% decrease in the radiation dose for diagnostic cases and an 11% decrease for interventional cases. Similarly, the cost of the radiation dose decreased by 28% for diagnostic cases and 11% for interventional cases. During the observation, it was noted that the participants were highly engaged and willing to adapt to the situation. Some even viewed it as an opportunity for personal growth and improvement in the cath lab. However, they stressed the significance of awareness as a crucial element in improving their behavior and reinforcing it as the foundation for maintaining progress. Furthermore, the study revealed that collaborative work among the participants could have been more optimal. The study concludes that implementing innovative improvements to the cath lab was a necessary yet complex undertaking. Participants were more inclined to embrace the changes when they were easily understandable and motivating. The study recommends the appointment of a change agent, the establishment of benchmarks, and the creation of a collaborative working environment between leaders and staff. Above all, the leader should support and sponsor the change to facilitate the transition at various levels.