Change Program Research Articles

Research on the Encapsulation Device for Lunar Samples

The encapsulation of lunar samples is a core research area in the third phase of the Chinese Lunar Exploration Program. The seal assembly, opening and closing mechanism (OCM), and locking mechanism are the core components of the encapsulation device of the lunar samples, and the requirements of a tight seal, lightweight, and low power make the design of these core components difficult. In this study, a combined sealing assembly, OCM, and locking mechanism were investigated for the device. The sealing architecture consists of rubber and an Ag-In alloy, and a theory was built to analyze the seal. Experiments of the electroplate Au coating on the knife-edge revealed that the hermetic seal can be significantly improved. The driving principle for coaxial double-helical pairs was investigated and used to design the OCM. Moreover, a locking mechanism was created using an electric initiating explosive device with orifice damping. By optimizing the design, the output parameters were adjusted to meet the requirements of the lunar explorer. The experimental results showed that the helium leak rate of the test pieces were not more than 5 × 10−11 Pa·m3·s−1, the minimum power of the OCM was 0.3 W, and the total weight of the principle prototype was 2.9 kg. The explosive driven locking mechanism has low impact. This investigation solved the difficulties in achieving tight seal, light weight, and low power for the lunar explorer, and the results can also be used to explore other extraterrestrial objects in the future.

Make Me Black Music Video: A Project of DIVAS for Social Justice

The Make Me Black Music Video is a collaborative project created in 2022 by students of the STEAM for Social Change program to honor Black History Month. The initial idea for the music video was inspired when one of the STEAM for Social Change facilitators first heard the song while listening to a local Minnesota radio station, Purple Current. Also available as an internet stream, the Purple Current radio station focuses on Black music that honors the legacy of the late musician Prince Rogers Nelson. As the facilitator listened to the song Make Me Black, originally performed by Minnesotan Ashley Dubose, they saw it as a medium for teaching students the importance of seeing themselves as beautiful and joyful, while instilling pride in where they come from. Before creating their music video, students engaged in an 8-week session where they learned the history of MTV, including how the channel failed to play any artists of color until Michael Jackson’s Thriller became a global phenomenon in 1983. Students also analyzed the song lyrics, created storyboards using Polaroid cameras, and learned about the fundamentals of music video production. The original music was produced by Rich Lee and performed by Ashley DuBose. The students’ music video was filmed on location at their school sites and the DIVAS for Social Justice makerspace. It also features the artwork of educator and artist, Adam Johnson.

How university students view disabled people: The role of wheelchairs, canes, and unspecified mobility aids.

Mobility aids are important to disabled people as a functional tool that can enhance their participation in leisure activities and work; however, mobility aids may also have implications for how disabled people are viewed by others. Using theories from social psychology, this study aimed to understand how mobility aids contribute to the perception of mobility aid users. A total of 259 participants without disabilities, who were primarily young, Caucasian, female-identifying university students, completed the questionnaires. The primary questionnaires of interest included the Multidimensional Attitudes Scale Toward Persons with Disabilities and the Stereotype Content Model. Every participant completed three conditions of the questionnaires to examine their attitudes and stereotypes associated with three mobility aid conditions: a wheelchair, a cane, and a control condition without a specified mobility aid. Affective attitudes toward the unspecified mobility aid condition and the manual wheelchair condition were more negative than the cane condition. Perceived warmth was higher for the manual wheelchair condition compared to the unspecified mobility aid condition and perceived competence was higher for the cane and manual wheelchair conditions compared to the unspecified mobility aid condition. This study explored how young women without disabilities, and potentially nondisabled people more generally, may hold a range of attitudes and stereotypes about the use of mobility aids by disabled people. These findings have implications for the design of effective attitudinal change programs and for rehabilitation professionals who work with individuals as they adopt mobility aids following the onset of disability. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Regrounding the Unworldly: Carnap’s Politically Engaged Logical Pluralism

Recent discussions of logical pluralism trace its origins to Rudolf Carnap’s principle of tolerance; indeed, the principle is seen as one of Carnap’s lasting philosophical contributions. In this paper, I will argue that Carnap’s reasons for adopting this principle are not purely logical, but are rather founded in the Vienna Circle’s manifesto—a programmatic document that brings the Circle’s philosophical work together with a program of social change. Building on work by Uebel, Romizi, and others, I argue that we must understand the principle in light of Carnap’s role in writing the manifesto, and thus as integrated into the larger philosophical and political goals of the Circle. This history illuminates the often-ignored relationship between Carnap’s logical pluralism and his political views. Finally, I turn to the political situation of the post-World War 2 period in the United States. During this time, the Circle’s emigres in the USA transitioned their work from active efforts to reform society to the technical work that we recognize as the foundation of American analytic philosophy today. In this final section, I argue that the reasons that Carnap distanced himself from the political foundations of his view were due in large part to McCarthy-era persecution of left-wing academics.

Barriers and Enablers to Maintaining Behaviour Changes Following a Lifestyle Intervention for Adults With Type 2 Diabetes

Aim To explore short-term barriers and enablers to maintaining behaviour changes in adults with type 2 diabetes who had completed a lifestyle behaviour change program. Methods Focus groups with 44 participants identified barriers and enablers at the end-of-program (n = 8 groups: anticipated); and, 1-month post-program (n = 6 groups: experienced). Thematic inductive analysis was undertaken independently by two authors, discussed, then deductively grouped according to the Capability (physical, psychological), Opportunity (physical, social), Motivation (automatic, reflective) – Behaviour (COM-B) model. Results Nine barriers were identified: two anticipated, one experienced, and six common to both timepoints. Key barriers related to physical capability (health ability), physical opportunity (difficulty accessing and using resources), social opportunity (unwillingness to invest in social networks), and reflective motivation (lack of internal drive). Eleven enablers were identified: all across both timepoints. Key enablers related to psychological capability (knowledge), physical opportunity (access and use of program resources), social opportunity (sense of belonging and safety within the program), automatic motivation (beliefs and awareness around perceived risk; monitoring of progress), and reflective motivation (committed to change). Discussion Findings suggest diabetes management programs should enable ongoing access to their resources. Investing in mechanisms to scaffold program graduates into suitable community-based activities may also be beneficial.

Assessment of surgical, anesthesia, and obstetric workforce in Somalia.

One of the core indicators recommended by the Lancet Commission is surgical workforce density, aiming to improve the number of surgery, anesthetists, and obstetric (SAO) providers to 20 per 100,000 population by 2030. We assessed SAO workforce capacity in Somalia and made recommendations for improvement. A cross-sectional study was conducted using a structured questionnaire from the WHO Program for Global Surgery and Social Change (PGSSC) Surgical Assessment Tool. All hospitals that offer surgical care services were included. A descriptive analysis was conducted using the statistical software SPSS. Of the 55 surveyed facilities providing surgical care services, 28 (50.9%) were public, mainly in urban areas. We found that there were 474 SAO specialists and non-specialists (SAO providers) and 446 other important personnel (e.g., midwives, radiologists, and pathologists). Out of 474 SAOs, Banadir had 288. Overall, surgery specialties were the most prevalent profession among SAO providers' workforce, accounting for 160 (33.7%) surgery specialists, with 1.2 per 100,000 population. The six states of Somalia have 54 OB/GYN specialists (0.4 per 100,000 population). There were a total of 22 anesthesia specialists, with a ratio of 0.2 anesthesia specialists per 100,000 population. We found a serious shortage of the SAO workforce in Somalia, and it is unlikely to meet the 2030 Lancet Commission on Global Surgery targets. There is a need for additional training of SAO providers who can offer effective leadership in surgical care services to combat the extremely avoidable surgical-related morbidities and mortalities.

An Observational Study of a Digital Substance Use and Recovery Program.

Digital substance use treatment programs present an opportunity to provide nonresidential care for people with problematic substance use. In June 2021, the provincial government in Ontario provided free access to Breaking Free Online (BFO), a digital behavioral change program for people with substance use disorders. An observational study was conducted with retrospective data to characterize clients' use and engagement patterns in BFO and examine changes in self-reported outcomes. In total, 6,370 individuals registered for BFO between June 2021 and October 2022, of whom 3,650 completed the intake assessment. Most of these clients were self-referred (64%), with 37% having been referred by health service providers. More than one-half of the clients (52%) resided in Ontario West or East regions. Support for addressing problematic alcohol use was the most requested program (40%). By October 2022, about 44% of the clients had completed between one and four of 12 program strategies. Analysis revealed significant changes in pre-post scores across four validated scales (p<0.001), indicating a decrease in anxiety and depression, an increase in quality of life, an improvement in recovery progression, and a decrease in severity of symptoms associated with substance use disorders. BFO clients with higher completion rates had the most improvement across the scales used; however, clients with lower and medium completion rates also had improvements. Because of the shame and stigma associated with substance use, digital supports with low barriers to entry can help support the autonomy, privacy, and preferences of individuals seeking help for problematic substance use.

Developing a fall prevention program in an inpatient spinal cord injury rehabilitation unit: A participatory action research study.

Spinal cord injury is a lifelong disability necessitating early management of falls during inpatient admissions. However, there is a paucity of research on fall prevention and management in Spinal cord injury rehabilitation. This study aimed at developing a fall prevention program in an inpatient rehabilitation Spinal cord injury unit. A participatory action research approach utilizing a before-and-after, mixed-method design was employed for this study. The study was performed at Rofaydeh Rehabilitation Hospital in Tehran, Iran, from 2021 to 2022. the study implemented Cohen's four-stage model, encompassing the design of a change program, action, observation and evaluation, and feedback stages. A purposeful sampling method was utilized to select 19 nurses and members of the rehabilitation team from the hospital, ensuring maximum diversity. Data collection involved semi-structured interviews, focus groups, and a checklist for fall prevention measures. Qualitative content analysis, alongside descriptive (frequency, mean, and standard deviation) and inferential statistics (paired t-tests and Chi-square tests), were employed for data analysis. The study adhered to COREQ guidelines. Falls were most common among patients aged fifty years or older (P = 0.026). Throughout the study period, men were more likely to experience falls than women (P = 0.01). Preventive interventions have led to significant improvements in indicators of patient monitoring and care, patient education, and environmental safety, as demonstrated by a paired-sample t-test (P<0.001). Moreover, factors contributing to patients' falls included "shortcomings in fall prevention policies" and "lack of knowledge and participation among patients and caregivers." Changes implemented in the Spinal Cord Injury unit involved enhancing interprofessional interactions, conducting educational workshops for patients and their companions, and identifying high-risk patients. These findings indicate a significant decrease in the incidence of falls following the intervention (P = 0.02). The study found that a multifaceted intervention can increase knowledge about fall risks and substantially reduce both falls and associated minor injuries.

Real-world impacts from a decade of Quality Enhancement Research Initiative-partnered projects to translate the Diabetes Prevention Program in the Veterans Health Administration.

To describe the impacts of four Veterans Health Administration (VA) Quality Enhancement Research Initiative (QUERI) projects implementing an evidence-based lifestyle intervention known as the Diabetes Prevention Program (DPP). 2012-2024 VA administrative and survey data. This is a summary of findings and impacts from four effectiveness-implementation projects focused on in-person and/or online DPP across VA sites. Patient demographics, participation data, and key findings and impacts were summarized across reports from the VA Diabetes-Mellitus Quality Enhancement Research Initiative (QUERI-DM) Diabetes Prevention Program (VA DPP) Trial, QUERI-DM Online DPP Trial, the Enhancing Mental and Physical Health of Women through Engagement and Retention (EMPOWER) QUERI DPP Project, and EMPOWER 2.0 QUERI Program. Between 2012 and 2024, four VA QUERI studies enrolled 963 Veterans in DPP across 16 VA sites. All participants had overweight/obesity with one additional risk factor for type 2 diabetes (i.e., prediabetes, elevated risk score, or history of gestational diabetes) and 56% (N = 536) were women. In addition to enhancing the reach of and engagement in diabetes prevention services among Veterans, these projects resulted in three key impacts as follows: (1) informing the national redesign of VA MOVE! including recommendations to increase the number of MOVE! sessions and revise guidelines across 150+ VA sites, (2) enhancing the national evidence base to support online DPP delivery options with citations in national care guidelines outside VA, and (3) demonstrating the importance of gender-tailoring of preventive care services by and for women Veterans to enhance engagement in preventive services. Over the past decade, the evolution of VA QUERI DPP projects increased the reach of and engagement in diabetes prevention services among Veterans, including women Veterans who have been harder to engage in lifestyle change programs in VA, and resulted in three key impacts informing type 2 diabetes and obesity prevention efforts within and outside of VA.

A Sociopsychological Study of Dystopia in Price's Starters

Dystopia and utopia work in parallel in the same sphere. Every Dystopia has a Utopia, and every negativity has traces of positivity. Utopia is an attribute of modern thought and one of the most obvious results. With a contradiction at its core that does not need to be resolved, it was clear early on in its history that it could take on new meanings, serve new purposes, and crystallize into new structures. This study describes the issues raised by the psychological condition of the protagonist in Lissa Price's Starters, which relates her situation to a dystopian world and leads her to Utopia. In contrast, a descendant of satirical Utopia and anti-utopia, dystopia rejects the idea that humans can attain perfection. Taking mainly the shape of a process and refusing the label of an 'impossible dream', Utopia is a program for change and a gradual betterment of the present; in that sense, it operates at different levels, as a means of political, economic, social, moral and pedagogical reorientation. Finally, Utopia has become a strategy of creativity, clearing the path humans can only follow: the path of creation.

Eradication Suggestions For Infectious Diseases Based on the Fractional Guinea-Worm Disease Model

Guine-worm disease (GWD) is considered one of the most fascinating infectious diseases that almost no one is aware of. On the other hand, unfortunately, there is no medicine or vaccine to treat this tropical disease transmitted through drinking water. However, GWD is about to be miraculously eradicated. This feature makes it the first parasitic disease to be eradicated without biomedical interventions. Accordingly, this situation brings the question: How can a disease be eradicated without medicine, vaccine or immunity? In light of this question, the current study offers recommendations on how to stop the spread of infectious diseases. One of the best ways to eliminate existing diseases is to benefit from the strategies followed for diseases that have been eradicated. Our results obtained by utilizing the fractional Caputo derivative show that behavior change programs aimed at reducing or stopping the spread of infectious diseases are effective tools in eradicating the disease

Evaluation of a mobile behavior change program for weight loss in breast cancer survivors

Post-diagnosis weight gain is common in early-stage breast cancer and is associated with increased risk of recurrence and mortality. Intentional weight loss is difficult to maintain, and digital lifestyle interventions may provide a scalable approach to address this challenge. In this prospective single-arm study (ClinicalTrials.gov NCT04753268; February 15, 2021), key eligibility criteria included: stage I–III breast cancer, body mass index (BMI) ≥ 27.5 kg/m2, and completion of cancer treatment ≥6 months before study enrollment. Participants were provided with a behavioral change mobile application (Noom®). The primary endpoint was a change in self-reported weight from baseline to 26 weeks. Secondary endpoints included engagement, changes in physical activity, dietary patterns, and patient-reported outcomes (PRO). In total, 31 patients were enrolled (mean age 56.8 ± 9.9, mean baseline BMI 33.5 kg/m2 ± 6.5). The mean weight change was −4.8 kg ( ± 4.4, P < 0.001), mean percent weight change was −5.6% ( ± 5.0%); 11/31 patients (35.5%) lost ≥5% of their initial weight. Metrics of digital application engagement associated with weight loss ≥5% included articles read (P = 0.012), weights logged (P = 0.006), food records logged (P = 0.001), messages sent (P = 0.001), and application open count (P = 0.014). Significant increases were seen in mean daily step count (P = 0.004), GPAQ scores (P = 0.002), and Body Image Scale scores (P < 0.001). Mean energy intake remained consistently in a calorie-restricted range of 1300–1400 kcal/day. In this study, breast cancer survivors were highly engaged with a behavioral change smartphone application which led to clinically significant weight loss, increased physical activity, maintenance of an energy-restricted diet, and improvements in body image.

Carbon offset funding in developing countries: challenges and rеspects

The article reveals the problems, prospects and contemporary mechanisms of carbon financing, the relevance of which is increasing in the face of new challenges associated with the development of reproductive processes in developing countries. At the same time, it is indicated that in some cases there are problems associated with the administration of business processes that ensure measurable emission reductions, which requires careful selection, monitoring and intergovernmental support for multilateral projects that contribute to the implementation of environmental protection and climate change programs. The article contains practical recommendations aimed at ensuring the economic interests of business entities based on the usage of additional financing mechanisms for development programs, including carbon emissions compensation, green bonds, carbon tax, climate funds, environmental certificates, etc. The conclusion is made about the expediency of using carbon financing mechanisms in business process that contribute to the cooperation between partner countries, accumulation of resources for project implementation, reduction of greenhouse gas emissions and sustainable economic growth of developing countries.

Changes in Health-Related Quality of Life by Patient Education and Rehabilitation Based on a Behavior Change Program in Knee Osteoarthritis.

The purpose of this study was to examine how rehabilitation and patient education for knee osteoarthritis improves health-related quality of life (HRQOL) and to identify factors influencing HRQOL. Between May 2020 and March 2022, 30 patients with osteoarthritis of the knee were treated conservatively and rehabilitated with a patient education program. The patient education program was based on the health belief model by Sedlak et al., and patient education using pamphlets was provided during the rehabilitation intervention. The survey items were patient basic information, instrumental activities of daily living (ADL) (FAI), fear of falling (FES), degree of depression (GDS), HRQOL (SF-8), knee function assessment (JOA score), and X-ray classification (K-L classification), and the survey method was a self-administered questionnaire at the start of rehabilitation, 1 month after the intervention, and at the end of the rehabilitation intervention. We examined factors affecting the physical component summary (PCS) and mental component summary (MCS) of HRQOL scores. JOA score, FES, FAI, GDS, and SF-8 improved significantly (p<0.01). MCS was also negatively correlated with FES and age (r=-0.486, -0.368). Sex was extracted as a factor for PCS as a factor affecting HRQOL (p<0.01). MCS was extracted with FES as a factor (p=0.046). A rehabilitation intervention incorporating patient education in osteoarthritis of the knee showed improvement in HRQOL and may be useful for improving depression, fear of falling, and instrumental ADL.

Evaluation of a culture change program to reduce unprofessional behaviours by hospital co-workers in Australian hospitals

BackgroundUnprofessional behaviours between healthcare workers are highly prevalent. Evaluations of large-scale culture change programs are rare resulting in limited evidence of intervention effectiveness. We conducted a multi-method evaluation of a professional accountability and culture change program “Ethos” implemented across eight Australian hospitals. The Ethos program incorporates training for staff in speaking-up; an online system for reporting co-worker behaviours; and a tiered accountability pathway, including peer-messengers who deliver feedback to staff for ‘reflection’ or ‘recognition’. Here we report the final evaluation component which aimed to measure changes in the prevalence of unprofessional behaviours before and after Ethos.MethodsA survey of staff (clinical and non-clinical) experiences of 26 unprofessional behaviours across five hospitals at baseline before (2018) and 2.5–3 years after (2021/2022) Ethos implementation. Five of the 26 behaviours were classified as ‘extreme’ (e.g., assault) and 21 as incivility/bullying (e.g., being spoken to rudely). Our analysis assessed changes in four dimensions: work-related bullying; person-related bullying; physical bullying and sexual harassment. Change in experience of incivility/bullying was compared using multivariable ordinal logistic regression. Change in extreme behaviours was assessed using multivariable binary logistic regression. All models were adjusted for respondent characteristics.ResultsIn total, 3975 surveys were completed. Staff reporting frequent incivility/bullying significantly declined from 41.7% (n = 1064; 95% CI 39.7,43.9) at baseline to 35.5% (n = 505; 95% CI 32.8,38.3; χ2(1) = 14.3; P < 0.001) post-Ethos. The odds of experiencing incivility/bullying declined by 24% (adjusted odds ratio [aOR] 0.76; 95% CI 0.66,0.87; P < 0.001) and odds of experiencing extreme behaviours by 32% (aOR 0.68; 95% CI 0.54,0.85; P < 0.001) following Ethos. All four dimensions showed a reduction of 32–41% in prevalence post-Ethos.Non-clinical staff reported the greatest decrease in their experience of unprofessional behaviour (aOR 0.41; 95% CI 0.29, 0.61). Staff attitudes and reported skills to speak-up were significantly more positive at follow-up. Awareness of the program was high (82.1%; 95% CI 80.0, 84.0%); 33% of respondents had sent or received an Ethos message.ConclusionThe Ethos program was associated with significant reductions in the prevalence of reported unprofessional behaviours and improved capacity of hospital staff to speak-up. These results add to evidence that staff will actively engage with a system that supports informal feedback to co-workers about their behaviours and is facilitated by trained peer messengers.

MyBack - effectiveness and implementation of a behavior change informed exercise programme to prevent low back pain recurrences: a hybrid effectiveness-implementation randomized controlled study protocol

BackgroundLow back pain (LBP) is a common health condition and the leading cause of years lived with disability worldwide. Most LBP episodes have a favourable prognosis, but recurrences within a year are common. Despite the individual and societal impact related to LBP recurrences, there is limited evidence on effective strategies for secondary prevention of LBP and successful implementation of intervention programmes in a real-world context. The aim of this study is to analyse the effectiveness of a tailored exercise and behavioural change programme (MyBack programme) in the secondary prevention of LBP; and evaluate acceptability, feasibility and determinants of implementation by the different stakeholders, as well as the implementation strategy of the MyBack programme in real context.MethodsThis protocol describes a hybrid type I, randomized controlled trial to evaluate the effectiveness and implementation of MyBack programme in the context of primary health care. The Behaviour Change Wheel framework and FITT-VP principles will inform the development of the behaviour change and exercise component of MyBack programme, respectively. Patients who have recently recovered from an episode of non-specific LBP will be randomly assigned to MyBack and usual care group or usual care group. The primary outcome will be the risk of LBP recurrence. The secondary outcomes will include disability, pain intensity, musculoskeletal health, and health-related quality of life. Participants will be followed monthly for 1 year. Costs data related to health care use and the MyBack programme will be also collected. Implementation outcomes will be assessed in parallel with the effectiveness study using qualitative methods (focus groups with participants and health providers) and quantitative data (study enrolment and participation data; participants adherence).DiscussionTo our knowledge, this is the first study assessing the effectiveness and implementation of a tailored exercise and behaviour change programme for prevention of LBP recurrences. Despite challenges related to hybrid design, it is expected that data on the effectiveness, cost-effectiveness, and implementation of the MyBack programme may contribute to improve health care in patients at risk of LBP recurrences, contributing to direct and indirect costs reduction for patients and the health system.Trial registration numberNCT05841732.

Climate protection, health and other motives for active transport – results of a cross-sectional survey in Germany

BackgroundActive transport– for example walking and bicycling to travel from place to place– may improve physical fitness and health and mitigate climate change if it replaces motorised transport. The aim of this study is to analyse the active transport behaviour of adults living in Germany, to investigate differences among population groups and to determine whether climate protection is a frequent motive for this behaviour.MethodsThis study uses self-reported data of 4,971 adults who participated in a national health survey (German Health Update 2021), which was conducted as a telephone survey from July to December 2021. Associations between active transport behaviour and corresponding motives with sociodemographic and health-related variables were analysed using logistic regression models.ResultsOf the adult population, 83% use active transport at least once a week. The frequency and duration of walking per week are significantly higher than those for bicycling (walking 214 min/week; bicycling 57 min/week). Those with a lower education level are less likely to practise active transport than those with a higher education level. Furthermore, women are less likely to use a bicycle for transport than men. Among those practising active transport, the most frequently mentioned motive is “is good for health” (84%) followed by “to be physically active” (74%) and “is good for the climate/environment” (68%). Women and frequent bicyclists (at least 4 days/week) mention climate protection as a motive more often than men and those bicycling occasionally.ConclusionsThe improvement of active transport, especially among people with lower education and women (for bicycling), may benefit from better insights into motives and barriers. Climate protection is an important motivator for practising active transport within the adult population living in Germany and should therefore have greater emphasis in behavioural change programmes.

Lifestyle predictors of colorectal cancer in European populations: a systematic review

BackgroundColorectal cancer (CRC) is the second most prevalent cancer in Europe, with one-fifth of cases attributable to unhealthy lifestyles. Risk prediction models for quantifying CRC risk and identifying high-risk groups...

Evaluation of a 4-week interdisciplinary primary care cardiovascular health programme: impact on knowledge, Mediterranean Diet adherence and biomarkers

BackgroundCardiovascular disease (CVD) is the second-leading cause of death among Canadians. Clinical practice guidelines suggest that improvements to lifestyle, including dietary intake, can reduce the risk of CVD.ObjectivesThe primary aim...

Designing development programmes for climate change and uncertainty in Pacific Melanesia – the role for knowledge brokers

ABSTRACT With rapid globalization and climate change, development programmes face increasingly complex problems. New approaches to programme design and delivery are required, and knowledge brokers can contribute to this reorientation. To understand how community development initiatives in Melanesia address complexity, and their needs for knowledge brokering, we surveyed designers, managers and implementers in eight programmes from Papua New Guinea and Solomon Islands. Applying the ‘Cynefin’ framework to describe complexity, we mapped programmes’ problem identification and solution design to elucidate their framing of problems. Whilst respondents identified uncertainties and complexities related to climate change, natural disasters and socio-economic conditions, programmes were designed with minimal consideration of these risks. Respondents attributed this to limited capacity and support networks to access and understand future risk information; poor information-sharing due to a lack of trust between partners; and minimal engagement between communities and the government. We highlight competencies that brokers need to enable more effective responses to rapid systems change, including fostering collaborations among partners, generating knowledge co-production, systems thinking, understanding complexity and uncertainty, and the promotion of learning and reflection. By incorporating brokering capacity, programmes in Melanesia could be better designed to account for future uncertainty, and tackle increasingly complex development challenges more effectively.