Community Feedback Research Articles

A Science and Community-Driven Approach to Illustrating Urban Adaptation to Coastal Flooding to Inform Management Plans

Academic research plays a pivotal role in illustrating and testing potential future adaptation strategies to sea level rise in low-lying coastal communities and enhances local municipalities’ adaptation plans. In Waikīkī, Hawai‘i, the built environment is increasingly impacted by flooding from multiple drivers: sea level rise-induced direct marine inundation, storm-drain backflow, and groundwater inundation (GWI), compounded by high-wave runup, extreme tides, heavy rainfall, and a shallow groundwater table. Given Waikīkī’s economic and cultural importance, in-place accommodation of flooding is desired, yet implementation plans have not been developed. By combining current scientific research, urban design visualizations, and community feedback, the interdisciplinary research team advanced intentional communication between the many parties seeking increased flood resilience through the end of the 21st century. Site-specific architectural renderings were a key tool to prompt structured community input on the coordination, prioritization, policy, and feasibility of adaptation measures for buildings, utilities, transportation, and open space. Public outreach reports document that the majority of participants thought all adaptation strategies presented were applicable, especially relocating critical equipment in buildings and streets. Proposed methods to develop sea level rise-adjusted minimum building elevation requirements may inform local municipalities’ future codes to minimize coastal property damage. The multi-year iterative process fostered growing participation in hosted and invited events, further improving the publicly distributed research products.

Hexose/pentose ratio in rhizosphere exudates-mediated soil eutrophic/oligotrophic bacteria regulates the growth pattern of host plant in young apple-aromatic plant intercropping systems.

The positive effect of intercropping on host plant growth through plant-soil feedback has been established. However, the mechanisms through which intercropping induces interspecific competition remain unclear. In this study, we selected young apple trees for intercropping with two companion plants: medium growth-potential Mentha haplocalyx Briq. (TM) and high growth-potential Ageratum conyzoides L. (TA) and conducted mixed intercropping treatment with both types (TMA) and a control treatment of monocropping apples (CT). Our findings revealed that TM increased the under-ground biomass of apple trees and TA and TMA decreased the above-ground biomass of apple trees, with the lowest above-ground biomass of apple trees in TA. The above- and under-ground biomass of intercrops in TA and TMA were higher than those in TM, with the highest in TA, suggesting that the interspecific competition was the most pronounced in TA. TA had a detrimental effect on the photosynthesis ability and antioxidant capacity of apple leaves, resulting in a decrease in above-ground apple biomass. Furthermore, TA led to a reduction in organic acids, alcohols, carbohydrates, and hydrocarbons in the apple rhizosphere soil (FRS) compared to those in both soil bulk (BS) and aromatic plant rhizosphere soil (ARS). Notably, TA caused an increase in pentose content and a decrease in the hexose/pentose (C6/C5) ratio in FRS, while ARS exhibited higher hexose content and a higher C6/C5 ratio. The changes in exudates induced by TA favored an increase in taxon members of Actinobacteria while reducing Proteobacteria in FRS compared to that in ARS. This led to a higher eutrophic/oligotrophic bacteria ratio relative to TM. This novel perspective sheds light on how interspecific competition, mediated by root exudates and microbial community feedback, influences plant growth and development.

Implementation of Road Equipment Installation in South Sumatera Province (Case Study of Installation of Street Lighting Equipment on the Betung – BTS Section, Palembang City)

Road infrastructure plays a pivotal role in the development and functionality of urban areas, and installing road equipment, such as street lighting, is crucial for ensuring safety and accessibility. This study focuses on the implementation of road equipment installation, with a specific case study of installing street lighting equipment on the Betung – BTS section in Palembang City, South Sumatra Province. The research employs a comprehensive approach, combining technical assessments, project management analysis, and stakeholder engagement evaluations. It examines the planning and design phases of the street lighting installation, considering factors such as traffic patterns, safety requirements, and energy efficiency. The study also investigates the procurement process for the equipment, including vendor selection, quality control, and cost management. Furthermore, the research evaluates the installation process, including on-site challenges, coordination among involved parties, and adherence to established timelines. The effectiveness of the installed street lighting equipment in enhancing road safety and urban aesthetics is assessed through field observations and community feedback. The findings of this study aim to provide insights into the best practices and challenges encountered during the implementation of road equipment projects, mainly focusing on street lighting in the Betung – BTS section. Recommendations derived from the research contribute to optimizing future road equipment installations in South Sumatra Province, emphasizing the importance of efficient project management, technical considerations, and community engagement in achieving sustainable and safe urban infrastructure development.

Translating the regulatory landscape of medical devices to create fit-for-purpose artificial intelligence (AI) cytometry solutions.

The implementation of medical software and artificial intelligence (AI) algorithms into routine clinical cytometry diagnostic practice requires a thorough understanding of regulatory requirements and challenges throughout the cytometry software product lifecycle. To provide cytometry software developers, computational scientists, researchers, industry professionals, and diagnostic physicians/pathologists with an introduction to European Union (EU) and United States (US) regulatory frameworks. Informed by community feedback and needs assessment established during two international cytometry workshops, this article provides an overview of regulatory landscapes as they pertain to the application of AI, AI-enabled medical devices, and Software as a Medical Device in diagnostic flow cytometry. Evolving regulatory frameworks are discussed, and specific examples regarding cytometry instruments, analysis software and clinical flow cytometry in-vitro diagnostic assays are provided. An important consideration for cytometry software development is the modular approach. As such, modules can be segregated and treated as independent components based on the medical purpose and risk and become subjected to a range of context-dependent compliance and regulatory requirements throughout their life cycle. Knowledge of regulatory and compliance requirements enhances the communication and collaboration between developers, researchers, end-users and regulators. This connection is essential to translate scientific innovation into diagnostic practice and to continue to shape the development and revision of new policies, standards, and approaches.

The Gestalt of functioning in autism revisited: First revision of the International Classification of Functioning, Disability and Health Core Sets.

Autistic people experience individual strengths and challenges as well as barriers and facilitators in their environment. All of these factors contribute to how well autistic people can cope in everyday life, fulfill the roles they choose, and meet their needs. The World Health Organization has developed a system aiming to capture the many factors within people (like how someone thinks and feels) and outside of people (things around a person) that influence their daily living, called the International Classification of Functioning, Disability and Health. The International Classification of Functioning, Disability and Health can be used for different purposes in research and practice to assess people's situations and plan support measures. Previously in 2019, the International Classification of Functioning, Disability and Health was adapted to autism by developing so-called Core Sets, which are shorter International Classification of Functioning, Disability and Health versions for use in specific conditions. Here, we present the first revisions of the International Classification of Functioning, Disability and Health Core Sets for autism, based on research, development results, and community feedback. Some factors influencing daily life for autistic people were added to the Core Sets, and other factors deemed less relevant were removed. Changes were also made in Core Sets designed for different age groups (0-5, 6-16, and ⩾17 years). Particularly, contents for sensory processing (like smell, touch, seeing, hearing) were added. We recommend these updated Core Sets for future use in autism research and practice. These changes to the Core Sets after 4 years indicate that there should be ongoing updates based on research and experience from practice and involvement of stakeholders.

Understanding metric-related pitfalls in image analysis validation.

Validation metrics are key for tracking scientific progress and bridging the current chasm between artificial intelligence research and its translation into practice. However, increasing evidence shows that, particularly in image analysis, metrics are often chosen inadequately. Although taking into account the individual strengths, weaknesses and limitations of validation metrics is a critical prerequisite to making educated choices, the relevant knowledge is currently scattered and poorly accessible to individual researchers. Based on a multistage Delphi process conducted by a multidisciplinary expert consortium as well as extensive community feedback, the present work provides a reliable and comprehensive common point of access to information on pitfalls related to validation metrics in image analysis. Although focused on biomedical image analysis, the addressed pitfalls generalize across application domains and are categorized according to a newly created, domain-agnostic taxonomy. The work serves to enhance global comprehension of a key topic in image analysis validation.

Engagement of vulnerable communities in HIV prevention research in India: a qualitative investigation

BackgroundMeaningful community engagement (CE) in HIV prevention research is crucial for successful and ethically robust study implementation. We conducted a qualitative study to understand the current CE practices in HIV prevention research and to identify expressed and implicit reasons behind translational gaps highlighted by communities and researchers.MethodsFor this exploratory qualitative study, we recruited a purposive sample of participants from Indian government-recognised key populations such as men who have sex with men, transgender women, people who inject drugs and female sex workers; general population adults and adolescents/youth; and researchers. We conducted 13 virtual focus groups (n = 86) between July and October 2021. Data were explored from a critical realist perspective and framing analysis (i.e., examining how the participants framed the narratives).ResultsParticipants reported that study communities, especially those from key populations, were primarily involved in data collection, but not necessarily with optimal training. Involvement of communities before the start of the study (e.g., obtaining feedback on the study’s purpose/design) or once the study is completed (e.g., sharing of findings) were highlighted as priorities for meaningful engagement. Participants suggested meaningful CE in all stages of the study: (1) before the study—to get inputs in finalising the study design, drafting comprehensible informed consent forms and culturally-appropriate data collection tools, and deciding on appropriate monetary compensation; (2) during the study—adequate training of community field research staff; and (3) after the study—sharing the draft findings to get community inputs, and involving communities in advocacy activities towards converting evidence into action, policy or programs. Timely and transparent communications with communities were explicitly stated as critical for gaining and maintaining trust. Mutual respect, reciprocity (e.g., appropriate monetary compensation) and robust community feedback mechanisms were considered critical for meaningful CE. ConclusionsThe findings highlighted the translational gaps and priority areas for capacity building to strengthen CE in HIV prevention research. It is not only important to engage communities at various stages of research but to understand that trust, dignity, respect, and reciprocity are fundamentally preferred ways of meaningful community engagement.

Rapidly developing communications materials during public health emergencies: the Âu Cơ campaign in the USA.

During public health emergencies, health communication materials to contain the outbreak are needed promptly, which prevents the use of standard approaches for getting feedback from the intended audience. We propose a strategy for rapidly obtaining community feedback on new health communication materials during the public health emergencies. We illustrate this with COVID-19 testing campaign in a Vietnamese-American enclave in the USA. The project included community-based COVID-19 testing and communication activities to increase the awareness of the testing centers and encourage frequent testing. Our strategy involves two main components: (i) use of a research team with an existing trust relationship with the community and that includes researchers from that community and (ii) co-design of communication materials using community-based gatekeepers and a cultural broker. We developed brochures and posters to increase the awareness of the COVID-19 testing services. The cultural broker and community-based partners identified salient message concepts and worked with the researchers to define the objectives and content of the materials, which were then reviewed by the entire team. In lieu of standard pretesting, we relied on feedback on mockups of the materials and subsequent revisions from the community-based gatekeepers and cultural broker. Our strategy strikes a balance between the need to urgently disseminate new materials and the need for community input. One key takeaway is that effective planning for public health emergencies must start long before the crisis occurs.

Performance Evaluation of Community Welfare Programs: A Public Policy Analysis Approach

This journal article conducts a rigorous performance evaluation of community welfare programs using a public policy analysis approach. The research employs a systematic framework to assess the effectiveness, efficiency, and equity of existing community welfare initiatives. Drawing on principles of public policy analysis, the study critically examines the implementation processes, outcomes, and impacts of these programs on community well-being.
 The evaluation involves a combination of qualitative and quantitative methods, including surveys, interviews, and statistical analyses. It scrutinizes the alignment of program objectives with societal needs, the adequacy of resource allocation, and the inclusivity of program outcomes. By employing a multidimensional evaluation framework, the research aims to provide a nuanced understanding of the strengths and weaknesses of community welfare programs.
 The findings offer insights into the policy implications of the evaluated programs, highlighting areas of success and opportunities for improvement. The research emphasizes the importance of incorporating community feedback and participation in program design and implementation to enhance overall effectiveness. Additionally, it explores the role of government policies in shaping the landscape of community welfare initiatives, providing a foundation for evidence-based policymaking.
 In conclusion, this article contributes to the field of public policy analysis by offering a comprehensive evaluation of community welfare programs. It advocates for a continuous feedback loop between policymakers, program administrators, and the communities served, fostering a more adaptive and responsive approach to addressing societal needs.

Does soil history decline in influencing the structure of bacterial communities of Brassica napus host plants across different growth stages?

Soil history has been shown to condition future rhizosphere microbial communities. However, previous experiments have also illustrated that mature, adult plants can "re-write," or mask, different soil histories through host plant-soil community feedbacks. This leaves a knowledge gap concerning how soil history influences bacterial community structure across different growth stages. Thus, here we tested the hypothesis that previously established soil histories will decrease in influencing the structure of Brassica napus bacterial communities over the growing season. We used an on-going agricultural field experiment to establish three different soil histories, plots of monocrop canola (B. napus), or rotations of wheat-canola, or pea-barley-canola. During the following season, we repeatedly sampled the surrounding bulk soil, rhizosphere, and roots of the B. napus hosts at different growth stages-the initial seeding conditions, seedling, rosette, bolting, and flower-from all three soil history plots. We compared composition and diversity of the B. napus soil bacterial communities, as estimated using 16S rRNA gene metabarcoding, to identify any changes associated with soil history and growth stages. We found that soil history remained significant across each growth stage in structuring the bacterial bulk soil and rhizosphere communities, but not the bacterial root communities. This suggests that the host plant's capacity to "re-write" different soil histories may be quite limited as key components that constitute the soil history's identity remain present, such that the previously established soil history continues to impact the bacterial rhizosphere communities, but not the root communities. For agriculture, this highlights how previously established soil histories persist and may have important long-term consequences on future plant-microbe communities, including bacteria.

The Effect of Characteristics of Patient Communication on Physician Feedback in Online Health Communities: An Observational Cross-Sectional Study

ABSTRACT With the rapid development of e-health and telemedicine, previous studies have explored the relationship between physician-patient communication and patient satisfaction; however, there is a paucity of research on the influence of the characteristics of patient communication on the characteristics of physician feedback. Based on the communication accommodation theory, as well as the computer-mediated communication theory and media richness theory, this study aimed to explore how characteristics of patient communication influence characteristics of physician feedback in online health communities. We employed a crawler software to download the communication data between 1652 physicians and 105,325 patients from the Good Doctor platform, the biggest online health community in China. We built an empirical model using this data and employed a multilevel model to test our hypotheses using Stata and Python software. The results indicate that the amount of patients’ rendered information positively influences the physicians’ text (α = 0.123, t = 33.147, P < .001) and voice feedback (β = 0.201, t = 40.011, P < .001). Patients’ hope for help signals and the provision of their electronic health records weaken the effect of the amount of patients’ rendered information on physicians’ text feedback (α = –0.040, t = –24.857, P < .001; α = –0.048, t = –15.784, P < .001), whereas, it strengthened the effect of the amount of patients’ rendered information on physicians’ voice feedback (β = 0.033, t = 14.789, P < .001; β = 0.017, t = 4.208, P < .001). Moreover, the occurrence of high-privacy diseases strengthened the effect of the amount of patients’ presented information on physicians’ text and voice feedback (α = 0.023, t = 4.870, P < .001; β = 0.028, t = 4.282, P < .001). This research contributes to the development of computer-mediated communication theories and sheds light on service delivery in the online health community.

Patient engagement in clinical trial design for rare neuromuscular disorders: impact on the DELIVER and ACHIEVE clinical trials

BackgroundEngaging individuals living with disease in drug development and regulatory processes leads to more thoughtful and sensitive trial designs, drives more informative and meaningful outcomes from clinical studies, and builds trust between the public, government, and industry stakeholders. This engagement is especially important in the case of rare diseases, where affected individuals and their families face many difficulties getting information, treatment, and support. Dyne Therapeutics is developing therapeutics for people with genetically-driven muscle diseases. During the development of potential treatments for Duchenne muscular dystrophy (DMD) and myotonic dystrophy type 1 (DM1), Dyne sought the opinions of individuals living with these diseases to inform its clinical trial design and to decrease the difficulties that participants and families might experience participating in them.MethodsDyne engaged individuals and families living with DMD and DM1 as expert partners in its clinical development programs. Dyne convened panels of affected individuals and care partners/parents of individuals living with DMD (n = 8) or DM1 (n = 18). Workshops focused on how affected individuals and their families evaluate and select clinical trials for participation, the importance, quality, and burden associated with individual trial design elements, participation considerations such as site location and the study visit design, patient privacy, the suitability and scope of travel and participant support programs, and the accessibility of content in the informed consent (or assent) forms. Dyne also engaged the DMD Community Advisory Board (CAB) to collect feedback and advice on designing optimal and meaningful clinical trials and measuring relevant outcomes.ResultsThe issues most important to individuals living with DM1 and DMD regarding clinical trials were the ability to participate/access to the trial, perceptions of benefit and risk of trials and potential treatments, the flexibility of participation, clear communication from the sponsor, availability of information from trusted sources, and patient enrollment. In response to the patient advisory workshops and CAB feedback, Dyne refined clinical trial inclusion/exclusion criteria and clinic visit design, developed a travel service program to address the burden of clinical trial travel and enable long-distance and cross-border participation, planned for home visits when feasible, and allowed for adequate rest before clinic visit initiation and between assessments. Additionally, Dyne developed and implemented a transparent and consistent communications plan (including age-appropriate content) for trial participants and community members, and assessed and adjusted procedures to provide maximum participant comfort and lower anxiety, particularly with younger participants.ConclusionsOngoing communication with the Duchenne CAB and with DMD and DM1 patient advisory committee members allows Dyne to stay current with disease community perspectives and feedback on the needs and preferences of those affected and has provided valuable insights into the participant experience thereby helping Dyne initiate clinical trials that better meet the needs of affected individuals and their families.

Developing the Healthy Actions and Lifestyles to Avoid Dementia or Hispanos y el ALTo a la Demencia program.

With Alzheimer's disease and related dementias (ADRD) representing an enormous public health challenge, there is a need to support individuals in learning about and addressing their modifiable risk factors (e.g., diet, sleep, and physical activity) to prevent or delay dementia onset. However, there is limited availability for evidence-informed tools that deliver both quality education and support for positive behavior change such as by increasing self-efficacy and personalizing goal setting. Tools that address the needs of Latino/a, at higher risk for ADRD, are even more scarce. We established a multidisciplinary team to develop the Healthy Actions and Lifestyles to Avoid Dementia or Hispanos y el ALTo a la Demencia (HALT-AD) program, a bilingual online personalized platform to educate and motivate participants to modify their risk factors for dementia. Grounded in social cognitive theory and following a cultural adaptation framework with guidance from a community advisory board, we developed HALT-AD iteratively through several cycles of rapid prototype development, user-centered evaluation through pilot testing and community feedback, and refinement. Using this iterative approach allowed for more than 100 improvements in the content, features, and design of HALT-AD to improve the program's usability and alignment with the interests and educational/behavior change support needs of its target audience. Illustrative examples of how pilot data and community feedback informed improvements are provided. Developing HALT-AD iteratively required learning through trial and error and flexibility in workflows, contrary to traditional program development methods that rely on rigid, pre-set requirements. In addition to efficacy trials, studies are needed to identify mechanisms for effective behavior change, which might be culturally specific. Flexible and personalized educational offerings are likely to be important in modifying risk trajectories in ADRD.

Social Media’s Influence on Tourists’ Choice of Destination

Social media are web-based communication platforms that let users communicate and exchange information with one another. It is an online communication network that facilitates online engagement, content sharing, community feedback, and collaboration. This study mainly explores how vital social media is in influencing the tourists’ choice of destination. The study aims to assess tourists’ social media engagement, factors affecting reliance on it for travel planning, its impact on destination choice, the correlation between social media reliance and destination choice, and propose a framework for social media’s influence on destination selection. A quantitative correlational research method was used in this study. Further, the research is a population study where all the respondents were tourism management students of Saint Mary’s University. As for the data collection method, the researchers used survey questionnaires. The results revealed that Facebook is the most popular social media network, and most respondents said they used TikTok, Facebook, and Instagram for more than five hours each, while tourists spent less than 1 hour on Pinterest. Additionally, most of the respondents rely on social media to provide them with information about new travel locations. Images of popular tourist sites shared on social media platforms indicate the amount to which social media influences their destination selections. As a result, the two variables had a significant relationship, implying that tourists’ extensive reliance on social media for travel-related information also has a significant impact on the destinations tourists choose. Moreover, as illustrated in the framework created by the researchers, the social media that the respondents utilized, their reliance on social media for travel information, and social media’s influence on decision-making are all interrelated to travel planning.

Microentrepreneurs in Public Health Promotion: Implementation of a Street Vendor-Led COVID-19 Recovery Initiative in Los Angeles, California.

The COVID-19 pandemic exacerbated long-standing inequities, galvanizing new investments and community feedback to improve recovery programs. This implementation evaluation offers descriptive evidence of the feasibility of engaging street vendors to (1) facilitate linkage to services for undocumented Latinx communities, (2) strengthen health promotion by gathering community feedback, and (3) enhance economic opportunity by recognizing and addressing systemic challenges in which vendors operate. Future work should assess the effectiveness of mobilizing existing community messengers around entrenched social determinants of health. (Am J Public Health. 2024;114(S1):S78-S81. https://doi.org/10.2105/AJPH.2023.307453).

Nyakaza-Move-for-Health: A Culturally Tailored Physical Activity Intervention for Adolescents in South Africa Using the Intervention Mapping Protocol.

The Nyakaza-Move-for-Health intervention program was developed in response to the alarming rise in non-communicable diseases (NCDs) globally, in sub-Saharan Africa and South Africa. The rise in NCDs is attributed to the low levels of participation in physical activity (PA) among adolescents. Therefore, this study aimed to design a culturally tailored PA intervention for adolescents, guided by the Intervention Mapping (IM) protocol. The intervention program aims to address the multifaceted determinants of physical activity behavior, promote healthy lifestyles and improve adolescent fitness levels. The Intervention Mapping protocol was applied to design the intervention program. The IM has 6 steps: (1) Needs assessment, (2) developing a logic model of the problem (LMP), (3) Formulating program outcomes and objectives, (4) Program design and production, (5) Generating implementation plan, and (6) Generating intervention evaluation plan. Participants included (n = 48) adolescent learners recruited from 8 (n = 8) participating schools. Adolescent learners participated in focus group discussions (FGD) to identify personal, interpersonal and environmental determinants of physical inactivity. Twenty-six (n = 26) key informant stakeholders participated in a stakeholder engagement workshop (SEW) to determine the motivators and constraints in implementing physical activity interventions. The Nyakaza intervention program's process development involved extensive stakeholder engagement, capacity development training, and integration of community feedback into the design. The intervention included a social marketing campaign and structured after-school physical activity sessions based on the Health Belief Model (HBM) and Transtheoretical Model (TTM). Implementation and evaluation plans were created, emphasizing real-time monitoring and adaptations. Strategies to enhance parental and community support were developed to address participation barriers. Although not tested in this study, these plans laid a robust foundation for fostering sustainable behavior change and improving physical activity among adolescents in resource-constrained settings. The Nyakaza-Move-for-Health intervention demonstrates a promising framework for promoting adolescent physical activity and addressing Non-Communicable Diseases in a culturally relevant manner. The systematic approach, grounded in the intervention mapping protocol, ensured a robust and replicable intervention design. Future research should focus on long-term follow-up, integrating objective physical activity measures, and expanding the program to include nutrition education. Addressing identified barriers, such as parental involvement, is crucial for enhancing the intervention's effectiveness and sustainability.

Comprehensive Review on Low-Cost, Solar-Powered Water Purification Technologies for Remote Areas

The research article explores the increasing need for readily available potable water in geographically remote and deprived areas. The main objective of this research is to design and perform a cost-efficient water purification system which utilizes solar power. This system is specially designed to function in locations where electricity and standard water treatment infrastructures are rare. It focuses on the research, development, and execution of cuttingedge technologies that employ solar energy for powering filtration and purification systems, which improves the accessibility of clean water in remote and under-served areas. The study involves a choice of materials based on their value for money and long-lasting properties, the addition of solar panels together with filtering systems, and assessing the capacity of the system to function well in different environmental situations. The system design is improved through the application of field tests and the integration of community feedback. The main purpose of this study is to propose a sustainable solution to the issue of water shortage in remote regions. While doing so, it will contribute to worldwide initiatives dedicated to enhancing the availability of water and advancing the health of the public.

Emergency Scenario-Based Training Curriculum Development: Enhancement of Caregivers for the Elderly' Emergency Assistance Competency in a Rural Thai Community.

Caregivers for the elderly are a critical component of the health care system, especially in rural communities. They play a crucial role, assisting older people in confronting emergency illnesses. The study describes the process of developing an emergency scenario-based training curriculum (ESBTC) for caregivers of the elderly, focusing on geriatric life-threatening surveillance and emergency assistance (GLTSEA) in rural communities. The descriptive qualitative research utilized for developing the ESBTC followed Karn's six steps of curriculum development: (1) needs assessment, (2) targeted needs assessment, (3) goals and objectives, (4) educational strategies, (5) implementation, and (6) evaluation and feedback. The research sample comprised community representatives engaged in providing care during emergency illnesses, emergency experts, and health care providers. A group discussion and focus group were conducted along with semi-structured interviews. The data were analyzed by content analysis following Creswell's six steps. The results revealed problems and needs related to the care and management of emergency illnesses in rural communities. Five main themes emerged, including insufficient knowledge, difficulties in communication, mindfulness and self-confidence, Unable to assess the initial symptoms, and a need for skills development. In the development step, the curriculum focused on skill development and continued follow-up to ensure necessary skills, such as providing basic life support, using automated external defibrillators, through training scenarios. In the evaluation step, the participants indicated that their emergency assistance skills had improved. The six main themes that emerged regarding the training continuity, courses, and competencies needed to support the emergency system for caregivers were benefits and value, competence enhancements, upstreaming confidence, sustainable development, challenges in curriculum development, and effective strategies. The ESBTC combines community-based and realistic scenarios, involving the participation of community stakeholders. It is crucial to gather community feedback and needs assessments to formulate potential strategies as part of the curriculum.

Analysis of Halal Certification Management in Jakim through Public Complaint Feedback

Halal Certification Processing is one of the themes found in one of the Client Charters in Jakim, where it is a promise given to applicants within a certain period to complete the Halal Certificate. In realizing good management in an organization, the staff of the organization must be sensitive to the promises made as set out in their Client Charter. The Client's Charter is a written statement by the organization to provide quality services to customers to meet the needs of the community, especially to customers who deal with any organization. A problem or issue that arises is when some organization ignore the promises made in their Client Charter. The community's public complaints and feedback are evidence of this. This study aims to identify the various difficulties and suggestions for improvement that Jakim made in managing halal certification in response to feedback from the general public. This qualitative study uses the interview method, whereby three staff from Jakim will be recruited and made into respondents for the interview. In addition, documentation methods are also used, such as Client Charter reports, Halal Certification Procedure Manual Reports, etc. Also included are the reports on Jakim's website. The results revealed some difficulties, including the applicant's lack of understanding of the start of the 30 days, the time factor in managing the halal certification, and the inability of the applicant to review or comprehend the protocols. However, Jakim did not give up on addressing it by improving and formulating several strategic plans, such as improving the document upload system (My Ingredients), adjusting the online halal certificate registration fee, opening more counters, strengthening the Fast Track system, holding conferences with the industry, training on halal, and adding halal staff. The implications of the study can be seen, especially for civil servants as well as the rights of customers when dealing with the organization. This can be observed by analyzing the significance of adopting an effective Client Charter, which entails successfully carrying out all commitments outlined within it, hence attaining client pleasure through the responsible fulfillment of promises.

KABUPATEN CILACAP MENUJU SMARTCITY: PENERIMAAN GEN Z-MILLENIAL DALAM VISI CILACAP SMART REGENCY

The development of Cilacap Smart City must consider the needs of its population, even though generally, districts and cities adopt similar Smart City systems. Cilacap is striving to develop Cilacap Smart City with a focus on achieving a balance between urban and rural areas. However, there has been no research on how rural communities, deeply rooted in cultural traditions and local wisdom, respond to this concept. This study aims to uncover the acceptance of the millennial and Gen Z generations in Cilacap towards Smart City, particularly the Cilacap Smart Regency program. In this research, the "Cilacap Smart Regency Millennial-Gen Z Adoption" model based on UTAUT2 theory is employed. The research methodology utilizes an online survey with 163 millennial and Gen Z respondents from Cilacap. Data is analyzed using PLS-SEM techniques and validated for reliability. The research findings indicate that perceptions of security and privacy influence trust in technology, although this trust does not affect the intention to use technology. Self-efficacy and effort expectations influence the intention to use Smart City technology. Trust in the government impacts the perceived value of technology, which in turn affects the intention to use Smart City technology. This study underscores the importance of involving the millennial and Gen Z generations in the development of Cilacap Smart Regency. Other critical factors include robust infrastructure, sustainability, sector collaboration, privacy protection, education, startup support, inclusivity, as well as community evaluation and feedback efforts to achieve success in the Smart City initiative in Cilacap Regency.