Sustainable Change Research Articles

Sustainable Consumption and Environmental Change in Taiwan: Understanding Consumer Perceptions and Narratives of Practice

This study investigates the perceptions and behaviors related to sustainable food consumption among various demographic groups in northern Taiwan, focusing on the metropolitan areas of Taipei City and New Taipei City. The narratives of Taiwanese people practicing sustainable eating were analyzed by applying practice theory. Semi-structured interviews were conducted with 30 participants from diverse demographic backgrounds (e.g., university students, homemakers, professionals, and retirees). Their educational backgrounds and work experience were recorded. The research highlights the effects of urbanization on the food choices of consumers, highlighting challenges such as high costs, time constraints, and limited access to kitchen facilities among university students. High-income professionals and retirees exhibited a preference for organic and locally sourced foods, whereas middle-aged homemakers emphasized seasonality and support for small farmers. The crucial roles of information sources (e.g., online media and television) and various cultural factors (e.g., religious beliefs) in influencing sustainable food behaviors were also identified. Despite its regional focus, this study provides valuable insights and recommendations for policymakers that can support sustainable food consumption.

Large-scale school improvement: results of and conditions for systemic changes within coupled school systems

The aim of this study was to explore the results of and conditions for systemic large-scale school improvement. Through a multi-level analysis and a theoretical framework inspired by organization- and sensemaking-oriented theories, the study examines how a Swedish large-scale school improvement program, “Collaboration for the Best School Possible,” played out in two Swedish municipalities. School actors at four organizational levels (at the National Education Agency, Local Education Authority, school leader, and teacher levels) in the two municipalities were interviewed. Because these school actors’ sensemaking is linked to different aspects of the national largescale improvement program, the analysis shows a variation in the strengthening of the couplings between these organizational levels. The different nature of the couplings affected the implementation process and the results of the program. While the national large-scale program seemed to have contributed to an improvement in the schools’ quality assurance systems and leadership practices, there were difficulties in maintaining general and sustainable changes in schools’ instructional practices. The conclusion of the study was that, even if a national large-scale school improvement program is well designed and backed up with many resources, it must be perceived as legitimate among the local school actors at the different organizational levels. This points to the importance of managing the balance between top-down efforts and visions and local professional knowledge and experience.

Aquaponics in schools: Hands-on learning about healthy eating and a healthy planet.

Our food system is giving rise to a growing social, health and environmental crisis. Much of the food consumed in the United Kingdom is cheap, nutrient-poor and highly processed, leading to under-consumption of essential foods such as grains, beans, vegetables and fruit. This has contributed to a rise in diet-related diseases, with approximately 22% of primary school leavers being overweight or obese. Food production is unsustainable with agriculture responsible for 10% of the UK's greenhouse gas emissions and intensive farming practices have led to a significant loss of soil carbon and a decline in biodiversity. COVID-19 increased inequalities in our food system. Therefore, there is an urgent need for interventions to counteract these adverse social, health and environmental impacts. Education can play a crucial role as an intervention to address challenges in the food system. We tested an innovative school initiative using portable aquaponic pods and aligned to the national curriculum, to engage pupils in food production and foster learning about sustainability, climate change and healthy eating. The evaluation, based on teacher surveys, aquapod chart data, student blogs and postcards and feedback from the development team, revealed positive impacts on students' environmental awareness, as well as sustainability and practical food production knowledge. However, the programme encountered logistical challenges and we therefore highlight future improvements to produce a curriculum programme that can be delivered at scale to enhance food education and empower pupils to drive the agenda on tackling food sustainability and climate change.

Editorial: The impact that local governments and ruling bodies can have on implementing sustainable changes and practices

Editorial: The impact that local governments and ruling bodies can have on implementing sustainable changes and practices

Communication Strategy In Achieving Sustainable Environmental Development: Case Study Of The Ban On The Use Of Plastic Bags In Familymart Retail Stores

This study explores the communication strategies utilized by FamilyMart retail stores to enforce the ban on plastics bags, aiming to support sustainable environmental development. As environmental concerns become increasingly significant, retail businesses are at the forefront of promoting sustainable practices. This research investigates how FamilyMart conveys its environmental policies to customers and the broader community to encourage behavior change towards eco-friendly alternatives. Using qualitative methods, the research involves in-depth interviews with store managers, content analysis of promotional materials, and observations of in-store communication efforts. According to the research, FamilyMart has a thorough communication strategy that consists of educational initiatives for customers, conspicuous signage, and active participation on social media. These tactics aim to encourage consumers to use reusable bags by raising awareness of the negative environmental effects of plastic bag usage. Effective communication strategies make use of visual aids, customer incentives for program involvement, and compelling and informative messaging. The report also emphasizes how crucial it is to use consistent messages throughout a range of communication channels and how important employee involvement is to achieve the initiative's goals. The findings show that establishing a sustainable culture and obtaining consumer compliance depend heavily on efficient communication. The report ends with actionable suggestions for retailers looking to put similar environmental policies into place. These suggestions emphasize the importance of using multifaceted, transparent, and engaging communication tactics to support long-term, sustainable change.

Perceptions of Sustainability among Children and Teachers: Problems Revealed via the Lenses of Science Communication and Transformative Learning

Scholars and policymakers see sustainability as depending on the inter-relationships between the three pillars of the environment, society, and the economy. However, it remains less clear how key stakeholders with a responsibility for educating the next generation perceive the concept of sustainability and act accordingly. In order to gain new insights, this research scrutinises participant perceptions of sustainability and climate change in two eco-schools in England for primary children (aged 5–11 years). Our case study involved individual interviews with classroom teachers and headteachers, group interviews with fourth- and fifth-year students (ages 10–12 years), and in-class observations. We also analysed data from student exercise books and photographs of school grounds to understand participants’ self-reported knowledge and perceptions of sustainability and climate change. Within a framework drawing on theories of science communication and transformative learning (a learning approach based on having challenging experiences), the results show that the integration of sustainability into the curriculum was limited and problematic. That is despite the fact that all students and teachers were aware of the environmental dimensions of sustainability, such as climate change and the overuse of natural sources. These findings suggest that schools are no different to other institutional settings when it comes to dealing with the challenges of integrating sustainability into daily practice. We conclude that there is a need for in-service teacher education programmes to enable and motivate teachers to provide richer teaching-learning environments so as to enable effective learning in schools about sustainability and climate change.

Multidisciplinary care for patients with gastroesophageal cancers (GEC): A quality improvement initiative in community cancer clinics.

e16096 Background: Evidence-based guidelines for GEC management recommend multimodal care, which involves close coordination between medical, surgical, and radiation oncologists, together with specialists to manage symptoms and treatment-related adverse events (AEs). Optimizing the high level of multidisciplinary care required for effective GEC management poses substantial challenges for community oncology care teams. Methods: In August-October 2023, 57 healthcare providers (HCPs) from 4 US community oncology clinics completed surveys on challenges, barriers, and improvements needed in the multimodal care of patients with GEC. Based on findings from the baseline data, 70 HCPs participated in audit/feedback (AF) sessions to review site-specific gaps and challenges and develop action plans to address identified gaps. Follow-up surveys will evaluate the impact of changes in practice following action plan implementation. Results: Providers identified their 3 top challenges to providing care for patients with GEC: interdisciplinary care coordination, providing patient-centered supportive care, and managing AEs. They reported that care coordination was hampered by low frequency and poor-quality communication between medical oncology and surgical teams, by misalignment on methods of communication, and by a lack of relationship between the specialties. About one-third of HCPs reported recognizing and managing AEs as the most challenging aspect of caring for patients with GEC, including AEs that were immune-related (26%), dermatologic (19%), gastrointestinal (19%), neurologic (14%), immunosuppression-related (10%), and respiratory (5%). After the AF sessions, HCPs reported improving communication and coordination among care team members as an important means of improving and individualizing patient care plans and integrating new therapies into clinical workflows. Action plans included streamlining communication with surgical teams, increased use of patient navigation, and ensuring that every patient is reviewed through the multidisciplinary tumor board. With regard to AE management, action plans included improving patient education on AE identification, and better communication within the team on nutritional support. HCPs who participated showed improved confidence, knowledge, and competence in appropriately sequencing systemic therapy and surgical interventions. Conclusions: GEC care teams from community cancer clinics reported dissatisfaction with multidisciplinary care coordination, including poor communication between specialists involved in multimodal care of patients with GEC. Integration of sustainable changes in clinical workflows driven by this initiative improved oversight of multimodal care, improved workflows, and improved AE management.

Beyond the binary: A transformative implementation science initiative to improve LGBTQ+ cancer care.

11010 Background: Patient, provider, and system-level barriers contribute to significant disparities in care of LGBTQ+ persons, including delays in screening and diagnosis, and poorer outcomes. This implementation science initiative was designed to identify and address root causes of disparities in care for LGBTQ+ patients (pts) and drive sustainable change to improve health equity in LGBTQ+ cancer care. Methods: In 2023, a steering committee of 3 expert oncologists and 5 LGBTQ+ cancer pts convened to develop survey instruments and a point-of-care LGBTQ+ Cancer Care Toolkit. Next, LGBTQ+ pts with cancer (N = 817) and oncology providers (OPs) from 2 academic and 5 community-based practices (N = 115) completed surveys to reveal alignments and discordances in beliefs, perceptions, and practices regarding cancer care. OPs participated in audit-feedback (AF) sessions to critically assess system-specific practice gaps, prioritize areas for improvement, and develop action plans for improving LGBTQ+ cancer care. Results: Provider-reported top challenges in care included: unsure how sexual orientation/gender identity (SOGI) affect treatment considerations (35%), unsure how to discuss SOGI (30%),and systemic barriers that limit inclusion (29%). While most providers (84%) were at least moderately comfortable treating LGBTQ+ pts, these data suggest they overestimated the level of comfort of their pts. For example, only 24% of pts reported feeling safe disclosing their LGBTQ+ identity, while 65% of providers thought pts felt safe. Additionally, while most providers (73%) thought it was important to know a pt’s gender identity, only 46% thought it was important to know sexual orientation, and only 3% of providers reported routinely discussing SOGI with new pts. Patients and providers were not concordant in several other key areas, including the experience of pts’ partners, measures of inclusivity, and supportive care services offered, such as fertility preservation. Survey data also revealed systemic barriers to equitable care, such as EMR documentation of SOGI. In AF sessions, teams reviewed survey outcomes, and developed action plans for improvement, including integrating the toolkit, updating EMR documentation, developing LGBTQ+ education, and adopting measures of inclusivity. Notably, following the intervention, there were considerable gains in provider confidence and knowledge, and ~70% of providers committed to discussing SOGI with their pts at first introduction. Conclusions: Through this QI initiative, teams identified patient-, provider-, and systemic-level barriers that affect LGBTQ+ cancer care in their own practices and implemented action plans to address key challenges. The sustainable changes implemented in this QI initiative represent key opportunities for improvement that can be implemented in clinics across the country to improve equitable LGBTQ+ cancer care.

Green radiography: Exploring perceptions, practices, and barriers to sustainability

IntroductionPrevious research has delved into the attitudes and behaviors of diverse professions regarding environmental sustainability. However, there needs to be more research specifically targeting radiographers. This study aims to survey radiographers' perceptions, practices, and barriers to change concerning environmental sustainability in radiology. MethodsInstitutional ethical approval was obtained (IRB–COHS–FAC-110-2024) and data collection was conducted using Google Forms (Google Inc., Mountain View, CA). The survey targeted 104 practicing radiographers across several countries. Questions were structured around five domains to gather insights into demographics, training in global warming and climate change, perceptions of sustainability and climate change, sustainability barriers, and current radiology practices on sustainability. Data analysis utilized descriptive and d inferential statistics. ResultsOne hundred and four radiographers completed the study. Females had a significantly higher attendance rate in environmental protection campaigns (P = 0.01). The majority of respondents (68%) believe in climate change's knowledge and impact on the natural world. Our survey findings demonstrate that 74% of respondents believe there's a need to improve sustainability practices. The most commonly used strategies to decrease energy consumption and emissions were low-energy lighting (60%), real-time power monitoring tools (41%), and energy-efficient heating systems (32%). A significant concern regarding sustainability emerges among respondents: time (50%) and lack of leadership (48%) are prevalent concerns among the identified barriers. ConclusionParticipants are recognising the importance of environmental sustainability in radiology, but lack of leadership, support, authority, and facility limitations hinder their adoption. Impact on practiceRadiology must prioritize environmental sustainability by providing resources and training for radiographers and collaborating with healthcare professionals, policymakers, and environmental experts to develop comprehensive strategies for a sustainable healthcare system.

"A cuff is not enough": A community-based participatory research approach to soliciting perspectives of African Americans with hypertension and their family members on self-management intervention features.

We aimed to solicit the perspectives of African Americans with hypertension and their family members on the desired features of a behavioral hypertension self-management intervention. Using a community-based participatory approach to intervention design, we conducted four dyadic focus groups, including African American community members with hypertension (n = 23) and their family members (n = 23), recruited from African American-serving Christian churches in a large, southern metropolitan area. We used open-ended questions to elicit participants' perspectives regarding program features they would recommend, intervention delivery, and barriers necessary to address. Our grounded theory analysis identified themes reflecting participants' recommendations for hypertension self-management interventions to enhance health literacy and provide communication training via an accessible, population-tailored, family-based approach, which they believed has the potential to create family-level impact on health across generations. Participants also recommended intervention researchers engage in advocacy (i.e., via physician education and policy change) as part of a broader impact on structural inequities driving worse hypertension and health outcomes for African Americans. The perceptions and recommendations of African Americans with a lived experience of hypertension, as well as their family members, aid in shaping acceptable and efficacious behavioral interventions aiming to promote hypertension self-management behavior while leveraging the unique power of family relationships to create sustained behavior change.

Socio-demographic and cross-country differences in attention to sustainable certifications and changes in food consumption

Food labeling can influence, sometimes facilitate, changes in consumer diets to support environmental sustainability and in response to climate change. However, a significant impediment to this dietary shift may arise from the consumers’ tendency to underestimate the environmental impact of their food choices and from their limited knowledge about sustainable certifications. These aspects are influenced by the characteristics and geographical affiliations of individuals. In such a context, the aim of this research has been to identify the main factors that drive the food purchasing frequency and the changes in food consumption associated with consumers’ concerns about climate change and interest in sustainable food certifications by comparing different food products and countries (Italy, France, Germany, Denmark, the USA, and China). A cross-country survey was conducted on 6500 consumers of various food products. The obtained mean scores were then compared, using generalized linear mixed-effect models, to evaluate the associations between the consumers’ food purchasing frequency, the importance of sustainable certifications, and changes in food consumption due to climate change concerns. Much of the variation in food consumption, purchasing behaviors, and interest in sustainable certifications was found to depend on such factors as age, gender, and country of origin. Indeed, Chinese consumers exhibited a heightened interest in sustainable food certifications, yet their consumption scores for all food products overall were higher. Conversely, adult and elderly Danish consumers demonstrated a decrease in the consumption of cheeses, meat, fruits, and vegetables, and their interest scores in all sustainable food certifications were lower. Despite the challenges posed by various consumers’ interests and minimal changes in food consumption patterns, our findings suggest that sustainable certifications present a promising avenue for straightforward interventions to promote the adoption of sustainable diets and to address climate change.

What Effect Do Goal Setting Interventions Have on Physical Activity and Psychological Outcomes in Insufficiently Active Adults? A Systematic Review and Meta-Analysis.

Goal setting is commonly used for promoting physical activity (PA) among insufficiently active individuals. Previous reviews have analyzed the effects of goal setting on PA, but the purpose of this systematic review was to examine the concurrent effects of goal setting on PA and psychological outcomes in insufficiently active individuals to support interventions aiming to produce sustained PA behavior change. In this review (PROSPERO: CRD42021243970), we identified 13 studies with 1208 insufficiently active adults that reported the effects of goal-setting interventions (range 3-24wk) on both PA and psychological outcomes (eg,self-efficacy, motivation, and affect). We used meta-analysis and narrative synthesis to analyze these effects. All goals used in the included studies were specific goals. Setting specific goals had a large, positive effect on PA (g [standard mean difference] = 1.11 [P < .001]; 95% confidence interval, 0.74-1.47), but only a small, positive effect on the combined psychological outcomes (g [standard mean difference] = 0.25 [P < .001]; 95% CI, 0.10-0.40). Moderator analyses revealed that interventions that did not reward participants had a significantly greater effect on PA than interventions that did provide rewards (g = 1.30 vs 0.60, respectively, P ≤ .003). No other significant moderators were found. Our review offers initial insight into the long-term effects of specific goals on PA and psychological outcomes in insufficiently active adults. Further research that examines the PA and psychological effects of goal-setting interventions and investigates a wider range of goal types could develop a stronger evidence base to inform intervention for insufficiently active individuals.

Drawing the past to envision the future: supporting the development of primary STEM teacher identity

ABSTRACT Growing interest in STEM education and imminent curricular reform places new demands on teachers, giving impetus to re-examining how we prepare primary teachers for more integrated approaches. In addition to the acquisition of knowledge and skills, sustainable change demands the development of teacher identity, in which teachers are seen by themselves and others as STEM teachers. This paper reports on the emerging STEM teacher identities of five preservice primary teachers. Using STEM story-lines as an innovative graphing exercise, participants were prompted to reflect on key events that shaped their journey and share future-oriented narratives through drawing and storytelling, as they negotiated becoming STEM teachers. Findings suggest that although their own school experiences were varied and influential, an integrated STEM intervention was the common turning point in their STEM identity development, whereby participants aligned critical components of STEM with personal experiences and values. The reflective tools used supported identity work, by triggering a rediscovery and reinterpretation of their experiences with the benefit of increased knowledge for teaching STEM and, in turn, provided a means to re-envisage the future.

The barriers and facilitators to the design and delivery of sustainable healthcare across NHS Scotland: A forcefield analysis

Healthcare systems around the world have set ambitious targets to design and deliver more environmentally sustainable healthcare. To achieve these targets, individuals, teams, organisations, and whole systems will have to change current attitudes, practices and processes. Change management theory advocates for early identification of the influencing forces to change, so that actions can be taken to overcome the barriers and strengthen the facilitators to increase the likelihood of success. This project undertook a forcefield analysis exercise to identify the barriers and facilitators to the design and delivery of sustainable healthcare in Scotland. The exercise identified 12 facilitators and 12 barriers to sustainable change and formulated ten recommendations to strengthen the former and overcome the latter. It is hoped that the results will raise awareness of the factors that influence the design and delivery of sustainable healthcare and will inform what actions can be taken to increase the likelihood of success.

Sustaining the benefits of structured education: Participants' experiences of receiving structured individual support during a programme (DAFNEplus) informed by behavioural science.

The DAFNEplus programme seeks to promote sustained improvements in glycaemic management by incorporating techniques from behavioural science. It includes five sessions of structured individual support delivered over 12 months following group education. As part of a broader evaluation, and to inform decision-making about roll-out in routine care, we explored participants' experiences of, and engagement with, that individual support. We interviewed DAFNEplus participants (n = 28) about their experiences of receiving individual support and the impact they perceived it as having on their self management practices. We analysed data thematically. Participants described several important ways individual support had helped strengthen their self management, including: consolidating and expanding their understandings of flexible intensive insulin therapy; promoting ongoing review and refinement of behaviour; encouraging continued and effective use of data; and facilitating access to help from healthcare professionals to pre-empt or resolve emergent difficulties. Participants characterised themselves as moving towards independence in self management over the time they received individual support, with their accounts suggesting three key stages in that journey: 'Working with healthcare professionals'; 'Growing sense of responsibility'; and, 'Taking control'. Whilst all portrayed themselves as changed, participants' progress through those stages varied; a few continued to depend heavily on DAFNEplus facilitators for advice and/or direction at 12 months. While all participants benefited from individual support, our findings suggest that some may need, or gain further benefit from, longer-term, tailored support. This has important implications for decision-making about roll-out of DAFNEplus post-trial and for the development of future programmes seeking to bring about sustainable changes in self management practices.

Multidisciplinary perspective on a Finnish general upper-secondary school’s educational change: strengthening and hindering factors

ABSTRACT Sustaining change beyond individual teachers is challenging and understanding factors making educational change effective is needed. We aimed to identify the factors that educators and construction specialists considered influential to educational change of a general upper-secondary school that was under construction and was to meet the pedagogical goals of the concurrently renewed national core curriculum and legislation. The analysis of multidisciplinary interviews (n = 22) conducted during the early phase of the construction process assisted in identifying the factors that the participants perceived as strengthening and hindering educational change. The strengthening factors related to leadership support, collaboration opportunities, and teachers’ professional training, engagement, and transformative agency. The hindrances were constraints that related, for instance, to issues in funding, large group sizes and those that lacked applicable cross-curricular examples. We postulate the need to assist schools and individual teachers in creating conditions for educational change at all levels of municipal education.

Probing the Practicality of Ethical School Leadership Amid Socio-Political and Economic Turmoil

This study aims to probe the practicality of ethical school leadership amid socio-political and economic turmoil. This was necessitated by the collapse of the Zimbabwean economy in 2000 up until 2009 when they abandoned their currency due to hyperinflation. The downturn of the economy has not been abated to date, and education, together with other social services has been affected tremendously. The objective of this study is to find out the practicality of school leadership amid social, political, and economic turmoil, such as the one prevailing in Zimbabwe. Based on the findings, the study aims to suggest ways of dealing with ethical school leadership in such an environment. A qualitative study was conducted involving two primary and two secondary schools, where four school heads and sixteen teachers constituted the sample. Semi-structured interviews and focus group interviews were conducted. The findings indicated that school heads and teachers are finding it very difficult to practice ethical school leadership in the environment prevailing in Zimbabwe. This paper proposes that ethical leadership be promoted in these schools through engaging the 'reusable past' from their African Indigenous Knowledge and additionally applying a multi-dimensional and multi-sectoral intervention strategy to bring sustainable and practical change.

Beyond carbon-centric estimates: revisiting the interplay between hydroclimatic conditions and dryland forestation

In the global pursuit of climate mitigation, extensive tree planting initiatives have targeted the vast drylands. However, the carbon sequestration potential of forestation in these regions remains uncertain, primarily due to the oversight of crucial factors like vegetation-climate interactions. By revisiting the benefits of dryland forestation using comprehensive Earth System Modeling, we underscore the vital role of hydroclimatic factors in shaping the effectiveness of nature-based solutions, urging a reassessment of criteria for accurate carbon-centric estimates and sustainable global climate change mitigation strategies.

The COVID-19 pandemic and dynamics of livelihood assets in the Kwahu South District of Ghana: determinants and policy implications

ABSTRACT The debate on the changes in livelihood assets as a function of health shocks remains inconclusive, thus spurring attention from scientists and development practitioners across the globe. This paper analyses COVID-19-induced changes in the livelihood assets of rural households in Ghana. While content analysis was employed in qualitative data analysis, the quantitative data set was analysed using a binary logistic regression model. The analyses led to the following conclusions: The COVID-19 pandemic led to a more significant decline in financial assets than social assets. Although several socio-economic factors determine changes in the livelihood assets of households, the assets base of migrants was disproportionately affected by the pandemic. Further, women were disproportionately affected since market access restrictions significantly affected their income and savings and, consequently, their ability to buy farm necessities. These results suggest the need to emphasise the resilience of financial assets in times of pandemics, especially for migrants. This study provides new insights to inform the sustainable livelihoods framework, emphasising pandemics and changing livelihood strategies. Studies to uncover the coping strategies of migrants in the context of health shocks are required to complement this position.

Mapping sustainability: A comparative analysis proposal across EU countries and regions

This paper addresses the need to understand the structure of sustainability change in the face of the unpredictability of modern civilization. The aim of the paper is to examine the structure of sustainability change in relation to smaller spatial units such as the regions of the European Union and to compare these results with those achieved at the country level. For this purpose, the sustainable development indicators available in the Eurostat database were analyzed. Studies published to date have tended to focus on the performance of national economies or selected regions. In this article, the available data on regions are also analyzed. The study aims to compare the level of sustainable development achieved at the level of EU countries and regions located within them. Methodologically, the study uses advanced methods of comparative analysis, and the synthesis of the data enables the construction of a synthetic measure using taxonomic methods, facilitating the classification of EU countries and regions into clusters. The results highlight significant divergences in sustainability achievements between EU countries and regions. The study reveals the importance of studying sustainable development in smaller geographical cross-sections. The results highlight the need to expand access to data at the regional level (sustainability indicators) to facilitate more comprehensive analyses and inform targeted policy interventions. Looking to the future, the study recommends further research into the inter-linkages between sustainability and other critical areas in EU regions, such as innovation and competitiveness.