Collaborative Development Approach Research Articles

Resident Participation in Environmental Governance of Sustainable Tourism in Rural Destination

The rapid development of rural tourism has placed significant pressure on the rural environment, and relying solely on the government and market forces is insufficient for effective governance. It is urgent to integrate endogenous rural forces into environmental governance. The development of social behavior theory offers new insights into exploring sustainable approaches for resident participation in environmental governance in rural tourism areas. This paper, based on the Stimulus-Organism-Response (SOR) theoretical framework from social behavior theory, outlines the entire process of rural tourism residents transitioning from individual stimuli to psychological responses and ultimately to participation in environmental governance. This study combines the Motivation-Opportunity-Ability (MOA) model to analyze the stimulus factors affecting local residents and jointly constructs a path mechanism model for resident participation in environmental governance in rural tourism areas. A total of 462 valid questionnaires were collected through a survey, and the Partial Least Squares Structural Equation Modeling (PLS-SEM) method was used for empirical testing to determine the path coefficients between variables. On this basis, a system dynamics model was constructed to simulate the dynamic evolution of the relationships between variables. This study found the following: (1) In the process of rural tourism, residents’ participation in environmental governance relies on motivational factors at the stimulus level to play a core leading role; opportunity factors act as catalysts, and ability factors serve as auxiliaries; participation willingness at the organism level plays a crucial role. (2) Material pursuit and formal institutions are the strongest single sustainable factors for residents’ participation in environmental governance in rural tourism areas; combinations of variables such as local attachment, governance knowledge, and governance identity have significant effects. It is recommended that future rural tourism leverage government guidance, coordinate interests, and adhere to a collaborative development approach to ensure the sustainable development of the rural tourism environment.

Development of an Emergency Department Case Management Case-Finding Tool.

Identifying emergency department (ED) patients who are at high risk for return visits is an important goal for case management to improve patient care. This quality improvement study describes the development and evaluation of the Emergency Department Case Management Priority Score (EDCMPS), an electronic medical record (EMR)-based "case-finding" system, and its ability to identify these high-risk patients. In addition, the authors present data about its acceptability among emergency department case managers (ED CMs). Emergency departments with case management availability and staffing. A retrospective analysis at Duke University Hospital ED compared patient data pre- and postimplementation of the EDCMPS. The tool was developed using the LEAN and Plan-Do-Study-Act (PDSA) quality improvement methodologies, with ED CM participation. ED return and hospitalization rates within 7 and 30 days between both methods were compared, and a survey evaluated CM satisfaction with the EDCMPS. The 2-month preintervention period (July 1, 2022, to August 31, 2022) included 8,677 patients discharged from the ED, with 897 patients (10.3%) identified as at high risk for return based on the previous manual methodology. In the 3-month postintervention period (September 1, 2022, to November 30, 2022), there were 13,566 patients discharged, with 692 patients (5.1%) identified as at high risk for return using the EDCMPS. The EDCMPS outperformed the manual method, yielding a significantly higher odds ratio (OR) for 7- and 30-day ED return or hospitalization (e.g., 30-day any return OR = 4.21 vs. 1.69). The survey showed broad ED CM agreement on the tool's superior performance, especially in organizing outpatient resources and referring to support programs. However, challenges in securing primary care follow-up, housing, and health insurance applications were identified. The tool's collaborative development approach ensured its fit to ED CM needs, contributing to its success. The EDCMPS showcases promise in enhancing ED CM efficiency, with strong frontline staff endorsement. It pinpoints areas needing focus for patient support and has the potential to reduce ED revisits and therefore health care utilization. Its methodology offers insights for similar future implementations in health care institutions.

The introduction of a standardised national licensing exam as a driver of change in medical education: A qualitative study from Switzerland

Introduction Only a few studies have described the impacts, strengths and needs for further development of national licensing exams (NLE). To gain such insights regarding the Swiss NLE, which includes a multiple-choice and a standardised clinical skills exam, we explored the perceptions of involved experts and stakeholders. Methods We explored participants’ perceptions in four focus group discussions. The interviews were recorded, transcribed verbatim and qualitatively analysed using a thematic analysis approach. Results The analysis resulted in five perceived impacts, two strengths and two needs for further developments of the NLE. Perceived impacts were (1) steering students’ learning behaviour, (2) supporting teachers and assessors to align teaching to competencies, (3) elevating the importance of the Swiss Catalogue of Learning Objectives, (4) setting incentives for the further development of curricula, and (5) fostering the collaboration between the faculties of medicine. Perceived strengths were the blend of assessment formats, including their competency-based orientation, and the collaborative development approach. Perceived needs lay in the NLE’s further development to sustain its fit for purpose and in incentives for people involved. Conclusion According to our study, this NLE had, and has, notable impacts on medical education in Switzerland. Our insights can be useful for others planning a similar undertaking.

Development of a Moderated Online Intervention to Treat Social Anxiety in First-Episode Psychosis.

Background: It is well established that social anxiety disorder (SAD) is a significant clinical problem for individuals with a psychotic disorder. Comorbid social anxiety in individuals with psychosis has been associated with poorer premorbid functioning, increased depression, and a reduced quality of life. Cognitive behavior therapy (CBT) is recommended for people with psychosis as a first-line psychological treatment; however, its focus and evaluation primarily revolves around reducing psychotic symptoms and not necessarily targeting comorbid social anxiety symptoms. We developed a novel online social cognitive behavioral intervention (entitled EMBRACE) specifically designed to treat social anxiety symptoms in first episode psychosis (FEP). Methods: The key clinical and engagement features of the intervention were established through integrating evidence-based material derived from 1) CBT-based treatment models for SAD, 2) relevant literature findings related to psychosis and its clinical correlates (e.g., shame, social rank, and its relationship with social anxiety and paranoia), 3) feedback from youth focus groups in order to inform a user-centered intervention design, and 4) a highly multidisciplinary collaborative development approach to design therapy comics. Results: A detailed description of the final version of the 12-week online social intervention to treat social anxiety in FEP is presented. Conclusion: The EMBRACE intervention was designed to provide young people with the necessary skills and confidence to overcome social anxiety within a supportive, safe online space. By design, it allows young people the opportunity to practice their newly learnt skills to connect with others and in doing so, learn to embrace their true authentic selves.

Blockchain Based Network for Tuberculosis: A Data Sharing Initiative in Brazil.

Data sharing, information exchange, knowledge acquisition and health intelligence are the basis of an efficient and effective evidence-based decision-making tool. A decentralized blockchain architecture is a flexible solution that can be adapted to institutional and managerial culture of organizations and services. Blockchain can play a fundamental role in enabling data sharing within a network and, to achieve that, this work defines the high-level resources necessary to apply this technology to Tuberculosis related issues. Thus, relying in open-source tools and in a collaborative development approach, we present a proposal of a blockchain based network, the TB Network, to underpin an initiative of sharing of Tuberculosis scientific, operational and epidemiologic data between several stakeholders across Brazilian cities.

Positive health check: developing a web-based video counseling tool for HIV primary care clinics

ABSTRACTHIV prevention efforts are increasingly aimed at engaging people living with HIV (PLWH) in healthcare to enhance treatment adherence and retention in care. Clinics need evidence-based interventions to support these goals and guidance on how to successfully implement these interventions in clinical settings. We describe the development of Positive Health Check (PHC) digital health intervention to support adherence and retention in care as well as a pilot implementation to determine feasibility. We developed PHC using input from seven HIV primary care providers. Over 15 months, providers gave feedback on the development of PHC by participating in nine inquiries, via online methods or webinars, addressing topics related to intervention development and implementation. After a 1-month pilot test, four providers shared their impressions of PHC implementation via a structured, open-ended interview. Providers’ comments resulted in script revisions, feedback on the filming of four virtual doctors (actors) balanced by race and gender, a user-friendly visual design, and more engaging messaging. Implementation feedback informed protocols to increase privacy and strategies to gain buy-in from clinics. Providers responded positively after using the final version of PHC, and again after the 1-month pilot implementation. Using a collaborative development approach with healthcare providers is a viable method for developing clinic-based interventions to support clinical encounters for PLWH. Intervention development should include strategies to support integrating mobile interventions into clinic workflows.

융복합 소셜 앱 제작 플랫폼에서 참여자의 기여도 평가 방법에 관한 연구

The convergence social app manufacturing platform for both demander and developer in worldwide provides a collective collaborative development approach. This platform can bring enhanced productivity with exchange of views among participants. If the assessment is not fair that many participants will leave the collective collaborative project. The previous studies verified the reliability of the evaluation based on statistical techniques. Because the previous studies did not consider the task performance of participants, do not reflect the feature of project tasks. So, the contribution scores of the participants can be distorted. In this study, we suggest the method for evaluating the development contributions value. This is considered the task performance of participants and involved the method of equitable and consistency peer assessment.

Developing a school-based drug prevention program to overcome barriers to effective program implementation: The CLIMATE schools: Alcohol module

Although effective school-based alcohol prevention programs do exist, the overall efficacy of these programs has been compromised by implementation failure. The CLIMATE Schools: Alcohol Module was developed to overcome some of the obstacles to high fidelity program implementation. This paper details this development of the CLIMATE Schools: Alcohol Module. The development involved two stages, both of which were considered essential. The first stage, involved reviewing the literature to ensure the program was based on the most effecttive pedagogy and health promotion practice and the second stage involved collaborating with teachers, students and specialists in the area of alcohol and other drugs, to ensure these goals were realised. The final CLIMATE Schools: Alcohol Module consists of computer-driven harm minimisation program which is based on a social influence approach. The program consists of six lessons, each with two components. The first component involves students completing an interactive computer-based program, with the second consisting of a variety of individual, small group and class-based activities. This program was developed to provide an innovative new platform for the delivery of drug education and has proven to be both feasible and effective in the school environment. The success of this program is considered to be testament to this collaborative development approach.