Stakeholders Consumers Research Articles

Application of intuitionistic fuzzy set in social life cycle impact assessment

Abstract Purpose Intuitionistic fuzzy set (IFS) has been found promising for handling ambiguity forms of uncertainty in social data. This paper undertakes an application of an intuitionistic fuzzy set in the social life cycle impact assessment (S-LCIA) of a public building project. This work proposes to combine an intuitionistic fuzzy set (IFS) with multi-attribute decision-making in converting qualitative data into quantitative social impacts of the building project. This research utilises IFS to accommodate and handle experts’ imprecise cognitions in S-LCIA to facilitate the identification and prioritisation of the most pressing indicators accompanying social impacts in a project. Methods Data were collected using questionnaire(s), structured interviews, and through targeted focus group sessions. Intuitionistic fuzzy set (IFS) approach was used to model the obtained data from structured interviews. Using IFS, this research also accounts for missing or ambiguous data that emerged during the data elicitation process. In combining IFS with multi-attribute decision-making techniques, the social impacts of selected stakeholders were evaluated using fuzzy set and IFS approaches. Sensitivity analysis was then used to test the robustness of the results and ranking was conducted based on each social stakeholder subcategory. Results and discussion Results revealed that approximately 23% of missing datapoints in the public case study building were incorporated in the S-LCIA using IFS. The issues of highest priority in each of the considered subcategory in the public case study building project according to IFS are (i) consumer privacy by adopting more functional planning (0.27), (ii) public commitment to sustainability (0.33), and (iii) education provided in the local community by having an indigenous botanical element for children (0.39), respectively. Conversely, the FS technique inferred that the issue of highest priority in the consumer stakeholder is the feedback mechanism (0.26). The overall degree of correlation between the IFS and FS is only 0.234, revealing that IFS provides a different perspective from conventional FS when used in modelling social data. Conclusion The IFS method provides an objective and systematic approach for dealing with a heterogeneous scope of imprecise and inexact social data in achieving holistic social life cycle assessment results. Furthermore, expansive stakeholder involvement would rely on a robust approach for improving social well-being in public buildings, thereby leaving no one behind in accomplishing a sustainable world.

Stakeholders' Perceptions Regarding Digital Therapeutics Reimbursement in South Korea: Qualitative Study.

Digital therapeutics (DTx) are therapeutic interventions driven by software and directly provided to patients, allowing them to manage their health with ease in any setting. A growing interest in DTx has spurred a discussion concerning their reimbursement pathways. However, DTx are still at a premature stage, with insufficient evidence on effectiveness, efficiency, and safety. Currently, although industries desire to quickly enter the market, especially by getting their products reimbursed by the National Health Insurance (NHI) fund, the NHI is cautious about DTx due to their uncertainties. Thus, public discussion and social consensus are crucial in deciding whether to reimburse DTx by the NHI fund. This study examined multiple stakeholders' awareness and attitudes toward DTx and perceptions of regulatory pathways for adopting DTx. In-depth interviews were conducted with 11 stakeholders in South Korea (industry: n=4, health care: n=3, academia: n=2, and consumer: n=2) using semistructured guidelines. They were purposively sampled to identify individuals with expertise in DTx and NHI policies. The interviews were conducted either in person or via a videoconference for 45-70 minutes. Qualitative data were analyzed using directed content analysis, which uses interview guidelines as an analytical framework. Findings were divided into three categories: (1) awareness and attitude toward DTx, (2) perception of whether DTx are worth entering the market and being reimbursed by the NHI fund, and (3) perception of how to enter the market and how to reimburse DTx by the NHI fund if they are worth it. Although consumer stakeholders were not familiar with the basic concept of DTx, the other stakeholders understood it thoroughly. However, all participants showed positive attitudes and acceptance of DTx. Most of them responded that DTx are worth entering the market, but they could not reach an agreement on the pathways for DTx to enter the market. Although participants were in favor of the reimbursement of DTx in principle, they responded that a conservative approach is required due to insufficient clinical evidence for DTx. We found that stakeholders in South Korea had positive attitudes toward DTx, perceived them as worth using, and agreed to allow them to enter the market. The main issue was not the problem of the technology itself but the difference in opinion as to the pathways for reimbursement. Therefore, this study concluded that the NHI fund, which is operated very conservatively, is insufficient to quickly adopt and implement DTx. Various reimbursement methods, including tax-based financing, raising innovation funds for new technologies, and pilot studies using the NHI fund, should be used to rapidly generate clinical evidence and reduce the uncertainties of DTx to secure a stable market.

Intra-Stakeholder Heterogeneity Perspective on the Hybridity of Competing Institutional Logics for Social Enterprises

Both academics and businesspeople are interested in how to make social enterprises sustainable. The focus of this research is on the different kinds of stakeholders within a group that make it easier for competing logics to coexist in social enterprises. Based on intra-stakeholder heterogeneity and competing institutional logics, we identify key sub-categories among market stakeholders such as investors, customers, and employees. We tested our hypotheses using survey data collected from 190 social enterprises in Korea. Our research shows that the hybridity of competing logics is better when there are more ethical investors in the investor stakeholder group and cross-sector employees in the employee stakeholder group. However, impure altruistic buyers do not have much of an impact on the hybridity of competing logics among consumer stakeholder groups. Our study’s analysis of intra-stakeholder heterogeneity provides theoretical insight into the hybridity of institutional logics in social entrepreneurship. This study also makes the practical suggestion that in order to achieve hybridity, managers of social enterprises should put in a lot of time and effort to understand the different institutional logics of within-group stakeholders.

Conceptual foundations of organizational structure: re-structuring of women's health services

PurposeResearchers often debate health service structure. Understanding of the practical implications of this debate is often limited by researchers' neglect to integrate participants' views on structural options with discourses those views represent. As a case study, this paper aims to discern the extent to which and how conceptual underpinnings of stakeholder views on women's health contextualize different positions in the debate over the ideal structure of health services.Design/methodology/approachThe researchers chose a self-standing, comprehensive women's health service facing the prospect of being dispersed into “mainstream” health services. The researchers gathered perspectives of 53 professional and consumer stakeholders in ten focus groups and seven semi-structured interviews, analyzed through inductive thematic analysis.Findings“Women's marginalization” was the core theme of the debate over structure. The authors found clear patterns between views on the function of women's health services, women's health needs, ideal client group, ideal health service structure and particular feminist discourses. The desire to re-organize services into separate mainstream units reflected a liberal feminist discourse, conceiving marginalization as explicit demonstration of its effects, such as domestic abuse. The desire to maintain a comprehensive women's health service variously reflected post-structural feminism's emphasis on plurality of identities, and a radical feminist discourse, holding that womanhood itself constituted a category of marginalization – that is, merely being at risk of unmet health needs.Originality/valueAs a contribution to health organizational theory, the paper shows that the discernment of discursive underpinnings of particular stakeholder views can clarify options for the structure of health services.

Social Consideration in Product Life Cycle for Product Social Sustainability

Social life cycle assessment (S-LCA) is an emerging and pivotal tool for sustainability evaluation of products throughout their life cycle. Understanding deeply published papers helps to modify methods and identify research gaps. The aim of this study is to discover the existing gap in the S-LCA of products and to find the weaknesses of the approach. The method of performing the review was a narrative review where published papers from 2006 to 2020 were included through the use of the Web of Science and Scopus databases. S-LCA is considered to be relevant to a majority of sectors and processes (agricultural, industrial, technology, energy, and tourism). However, there is not sufficient research on evaluation of S-LCA on cereal crops and livestock output. It is indicated that, in the present S-LCA studies, there has been a lack of attention paid to the society and value chain actors and final consumer stakeholders. The elements of sexual harassment and employment relationships are not considered in SLCA studies. Italy has the largest amount of cases of S-LCA studies. The major challenges of applying S-LCA (by using site specific data) is data collection, which is time-consuming. It is recommended to evaluate a comprehensive sustainability assessment by adding cost of social assessment to LCA since there has been a lack of attention on assessment of cost in S-LCA.

Identification and Critical Appraisal of Food Service Satisfaction Questionnaires for Use in Nursing Homes: A Systematic Review

BackgroundFood service provision in nursing homes is a complex, adaptive system through which multiple stakeholders interface. Organizational stakeholders include staff involved in preparing and delivering meals. Consumer stakeholders are the end users including residents and family. Questionnaires can be an economical and efficient method of measuring food service satisfaction in nursing homes and a powerful quality improvement tool. Objective(1) To identify questionnaires that measure food service satisfaction of various stakeholders in a nursing homes and (2) to critically appraise the psychometric properties of identified questionnaires. MethodsFive electronic databases were searched (Cumulative Index to Nursing and Allied Health Literature, Medline, ProQuest, Scopus, and Cochrane) in April 2020. Data from the eligible studies were extracted, and the psychometric properties were critically appraised using the Consensus-Based Standards for the Selection of Health Measurement Instruments. ResultsThis review identified 129 studies that used a questionnaire to measure food service satisfaction in nursing homes. Of those, 107 studies representing 75 unique general nursing home satisfaction questionnaires were excluded for failing to adequately explore aspects related to food service. From the remaining 22 studies, 7 food service satisfaction questionnaires were identified; 5 intended for consumers (residents) and 2 intended for organizational stakeholders (staff). Using the Consensus-Based Standards for the Selection of Health Measurement Instruments quality criteria, most questionnaires had flaws in content validity and construct validity, primarily due to small sample sizes. No questionnaires explored food service satisfaction from the family perspective. ConclusionsNursing homes collect satisfaction information for accreditation, marketing, benchmarking, and quality improvement. Although questionnaires are easy to administer, the quality of the data they collect is impacted by the validity and reliability of the questionnaires used. Using unreliable satisfaction data may mean that nursing homes are not accurately able to understand the impact of changes in the system on stakeholder satisfaction.

Exploring the role of issue involvement and brand attachment in shaping consumer response toward corporate social advocacy (CSA) initiatives: the case of Nike’s Colin Kaepernick campaign

This study adopts the consumer-centric perspective, through the lens of the consumer involvement theory and stakeholder theory, to examine the role of consumer involvement in shaping individuals’ attitudinal and behavioural responses toward Nike’s 30th Anniversary ad campaign featuring Colin Kaepernick. Specifically, a survey (N = 345) was conducted to examine how consumers’ cognitive and affective involvement regarding the issue of NFL national anthem protests, their brand attachment, and brand attitude guide their attitudes and word-of-mouth intentions in response to Nike’s corporate social advocacy practices. The findings of this study suggested that consumers’ support for a company’s CSA efforts could depend on their involvement in the social issue that a brand chose as well as their involvement in the brand. Moreover, the interaction of issue involvement and brand attachment factors can serve as a segmentation strategy to cement brand loyalty and strengthen the relationship with the existing stakeholders whose issue attitude was congruent with the corporation’s stances. Implications for theory and practice are discussed.

Prioritising models of healthcare service delivery for a more sustainable health system: a Delphi study of Australian health policy, clinical practice and management, academic and consumer stakeholders.

Objectives Healthcare expenditure is growing at an unsustainable rate in developed countries. A recent scoping review identified several alternative healthcare delivery models with the potential to improve health system sustainability. Our objective was to obtain input and consensus from an expert Delphi panel about which alternative models they considered most promising for increasing value in healthcare delivery in Australia and to contribute to shaping a research agenda in the field. Methods The panel first reviewed a list of 84 models obtained through the preceding scoping review and contributed additional ideas in an open round. In a subsequent scoring round, the panel rated the priority of each model in terms of its potential to improve health care sustainability in Australia. Consensus was assumed when ≥50% of the panel rated a model as (very) high priority (consensus on high priority) or as not a priority or low priority (consensus on low priority). Results Eighty-two of 149 invited participants (55%) representing all Australian states/territories and wide expertise completed round one; 71 completed round two. Consensus on high priority was achieved for 59 alternative models; 14 were rated as (very) high priority by ≥70% of the panel. Top priorities included improving medical service provision in aged care facilities, providing single-point-access multidisciplinary care for people with chronic conditions and providing tailored early discharge and hospital at home instead of in-patient care. No consensus was reached on 47 models, but no model was deemed low priority. Conclusions Input from an expert stakeholder panel identified healthcare delivery models not previously synthesised in systematic reviews that are a priority to investigate. Strong consensus exists among stakeholders regarding which models require the most urgent attention in terms of (cost-)effectiveness research. These findings contribute to shaping a research agenda on healthcare delivery models and where stakeholder engagement in Australia is likely to be high. What is known about the topic? Healthcare expenditure is growing at an unsustainable rate in high-income countries worldwide. A recent scoping review of systematic reviews identified a substantial body of evidence about the effects of a wide range of models of healthcare service delivery that can inform health system improvements. Given the large number of systematic reviews available on numerous models of care, a method for gaining consensus on the models of highest priority for implementation (where evidence demonstrates this will lead to beneficial effects and resource savings) or for further research (where evidence about effects is uncertain) in the Australian context is warranted. What does this paper add? This paper describes a method for reaching consensus on high-priority alternative models of service delivery in Australia. Stakeholders with leadership roles in health policy and government organisations, hospital and primary care networks, academic institutions and consumer advocacy organisations were asked to identify and rate alternative models based on their knowledge of the healthcare system. We reached consensus among ≥70% of stakeholders that improving medical care in residential aged care facilities, providing single-point-access multidisciplinary care for patients with a range of chronic conditions and providing early discharge and hospital at home instead of in-patient stay for people with a range of conditions are of highest priority for further investigation. What are the implications for practitioners? Decision makers seeking to optimise the efficiency and sustainability of healthcare service delivery in Australia could consider the alternative models rated as high priority by the expert stakeholder panel in this Delphi study. These models reflect the most promising alternatives for increasing value in the delivery of health care in Australia based on stakeholders' knowledge of the health system. Although they indicate areas where stakeholder engagement is likely to be high, further research is needed to demonstrate the effectiveness and cost-effectiveness of some of these models.

A fuzzy-set approach for multiple criteria decision making in sustainable consumption of organic food

The study proposes a set of enablers of the consumer sustainable organic food consumption and detects the interrelationship between these attributes. This paper adopts the fuzzy set theory and decision-making trial and evaluation to explore the interrelationship between attributes, including consumer demographic aspect, psychological aspect, social-level aspect and stakeholder impact being explained through 13 criteria and being assessed by experts in the industry. The findings show that stakeholder impact and demographic aspect belong to a causal group and impact the other two aspects. The six most important attributes affecting sustainable consumption of organic foods are support and guidance from government support, mass media, education and research institutions, educational level, income status and consumer age. The study grants an alternative approach for sustainable consumption theory through providing a fuzzy-set theory for multiple criteria decisions making in sustainable consumption of organic food.

Enabling Secure Trustworthiness Assessment and Privacy Protection in Integrating Data for Trading Person-Specific Information

With increasing adoption of cloud services in the e-market, collaboration between stakeholders is easier than ever. Consumer stakeholders demand data from various sources to analyze trends and improve customer services. Data-as-a-service enables data integration to serve the demands of data consumers. However, the data must be of good quality and trustful for accurate analysis and effective decision making. In addition, a data custodian or provider must conform to privacy policies to avoid potential penalties for privacy breaches. To address these challenges, we propose a twofold solution: 1) we present the first information entropy-based trust computation algorithm, IEB_Trust, that allows a semitrusted arbitrator to detect the covert behavior of a dishonest data provider and chooses the qualified providers for a data mashup and 2) we incorporate the Vickrey-Clarke-Groves (VCG) auction mechanism for the valuation of data providers' attributes into the data mashup process. Experiments on real-life data demonstrate the robustness of our approach in restricting dishonest providers from participation in the data mashup and improving the efficiency in comparison to provenance-based approaches. Furthermore, we derive the monetary shares for the chosen providers from their information utility and trust scores over the differentially private release of the integrated dataset under their joint privacy requirements.

Health-enhancing foods: barriers to consumers' choice in Iran.

Given the growing market for health-enhancing or functional foods in Iran, the consumption rate is low. Identifying and understanding the causes is key for future decisions and interventions in the market. So, the present study was designed to provide this knowledge in Iran. The study was conducted in Tehran, the capital of Iran, between May and September 2014. In total, 105 people participated in this qualitative research, including 40 production/supply/health authority stakeholders and 65 consumer stakeholders (44 housewives and 21 employed women). The sampling strategy was the purposive method with maximum diversity, and snowball sampling was used to identify key stakeholders. The social marketing framework was used for analyzing the participants' views and experiences. To collect data, semi-structured focus group discussions and in-depth interviews were conducted. Data collection and content analysis were performed simultaneously, using MAXQDA® software. Categorization of the findings based on social marketing mix showed that the most important barriers to the consumption of functional dairy products were undesirable sensory and non-sensory characteristics, lack of physical and economic access to the product, the existence of product competitors in the market and inappropriate promotion strategies. Furthermore, personal barriers identified as a new dimension and included lack of knowledge about the product and its benefits, a negative attitude toward the product and personal taste and preference. Understanding these barriers might contribute to design and implement effective and appropriate interventions to increase the consumption of these products among consumers.

Development, implementation and evaluation of an online course on evidence-based healthcare for consumers

BackgroundEvidence-based healthcare (EBHC) principles are essential knowledge for patient and consumer (“consumer”) engagement as research and research implementation stakeholders. The aim of this study was to assess whether participation in a free, self-paced online course affects confidence in explaining EBHC topics. The course comprises six modules and evaluations which together take about 6 h to complete.MethodsConsumers United for Evidence-based Healthcare (CUE) designed, tested and implemented a free, online course for consumers, Understanding Evidence-based Healthcare: A Foundation for Action (“Understanding EBHC”). The course is offered through the Johns Hopkins Bloomberg School of Public Health. Participants rated their confidence in explaining EBHC topics on a scale of 1 (lowest) to 5 (highest), using an online evaluation provided before accessing the course (“Before”) and after (“After”) completing all six course modules. We analyzed data from those who registered for the course from May 31, 2007 to December 31, 2018 (n = 15,606), and among those persons, the 11,522 who completed the “Before” evaluation and 4899 who completed the “After” evaluation. Our primary outcome was the overall mean of within-person change (“overall mean change”) in self-reported confidence levels on EBHC-related topics between “Before” and “After” evaluations among course completers. Our secondary outcomes were the mean within-person change for each of the 11 topics (mean change by topic).ResultsFrom May 31, 2007 to December 31, 2018, 15,606 individuals registered for the course: 11,522 completed the “Before” evaluation, and 4899 of these completed the “After” evaluation (i.e., completed the course). The overall mean change in self-reported confidence levels (ranging from 1 to 5) from the “Before” to “After” evaluation was 1.27 (95% CI, 1.24–1.30). The mean change by topic ranged from 1.00 (95% CI, 0.96–1.03) to 1.90 (95% CI, 1.87–1.94).ConclusionThose who seek to involve consumer stakeholders can offer Understanding EBHC as a step toward meaningful consumer engagement. Future research should focus on long-term impact assessment of online course such as ours to understand whether confidence is retained post-course and applied appropriately.

T236. A PROGRAM TO INCREASE THE APPROPRIATE USE OF LONG-ACTING ANTIPSYCHOTIC MEDICATIONS IN COMMUNITY SETTINGS

BackgroundAntipsychotic medications are evidence-based treatments for schizophrenia that improve health outcomes and reduce costs. However, rates of non-adherence to oral antipsychotic medications can exceed 60%. We examined whether a simple checklist to identify individuals not receiving optimum benefit from current oral antipsychotic treatment (NOB Checklist) and The Multi-level Facilitation of Long-acting Antipsychotic Medication Program (MAP) could increase the appropriate use of long-acting injectable antipsychotic medication (LAI) in community clinics.MethodsTwo clinics in Texas and two in Ohio changed clinical procedures in one of two ways 1) NOB only clinics--providers used a five-item checklist to identify individuals with schizophrenia on oral antipsychotics who were Not receiving Optimum Benefit from current treatment and may therefore benefit from a switch to LAI. 2) MAP- providers used the NOB checklist AND received MAP; MAP is a novel behavior change intervention designed to improve the identification of individuals who could benefit from LAI, improve their outcomes and reduce inappropriate use of resources associated with poor adherence. MAP targets 3 stakeholder groups 1) the consumer for whom peer specialists showed a video describing shared decision making and how to make a choice between tablets and injections, and provided a balanced shared-decision making tool to assist them in choosing medication route,2) the provider who received academic detailing describing various LAI options, how to make good offers as part of a shared decision making dialogue, and important benefits of LAI including the ability to disentangle efficacy versus poor adherence and to help individuals with cognitive and practical problems that lead to poor adherence, and 3) the administrators who received information on how LAI could improve outcomes for individuals and clinic processes, how to encourage the use of LAI among providers and how to provide regular feedback to providers about prescribing practices. The primary outcome was the percentage of LAI versus oral antipsychotic medication prescribed to individuals with schizophrenia.ResultsHigher NOB checklist scores were associated with an increased provider likelihood of LAI offers and increased consumer acceptance of LAI. All clinics increased use of LAI over time. In Texas, where MAP was fully implemented, the MAP clinic had greater use of LAI over time (eventually reaching about 50% of all antipsychotic use) vs. the NOB only clinic. In Cleveland, the patient stakeholder curriculum was not delivered and there was no significant difference in LAI use between MAP and NOB clinics.DiscussionThe NOB checklist appears to be a useful tool to help identify patients who might be appropriate candidates for LAI and the full MAP program may help clinicians and consumers to work together to optimize the appropriate use of LAI in outpatient settings. Implementation must be customized for clinics and workflows to determine which parts of the MAP program are practical and appropriate. Participation of consumer stakeholders may be essential to delivery of the MAP Program.

Using Consumer Stakeholder Input to Inform a Community-Based Pilot of Value-Added Products Sold at Local NJ Farmers Markets

Using Consumer Stakeholder Input to Inform a Community-Based Pilot of Value-Added Products Sold at Local NJ Farmers Markets

What is the role of consensus statements in a risk society?

This paper explores the role of consensus statements in a risk society. It uses Beck’s theory of risk to show that scientists have employed consensus statements in order to re-establish faith in science. Through analysing the goals of participants in consensus fora and comparing them to the fora processes, this paper considers how consensus statements and guidelines in public health can be viewed as remedies for the decline in expert trust experienced in the current risk society. To collect data, 25 interviews were undertaken with consensus panel participants from the USA, UK and Australia. Interviewees were from peak national agencies/commissioning agencies and were categorised as policymaker, practitioner and consumer stakeholders. Participants made recommendations for improving consensus processes in order to mitigate perceptions of risk. These were: (1) clearly stated goals; (2) robust, evidence-based and transparent processes of methodological development and participation/deliberation/decision-making; (3) diverse stakeholder representation, including increased consumer participation; (4) transparency about conflicts of interest; and, (5) robust, carefully worded recommendations. Poor-quality consensus statements can further entrench scepticism about the scientific enterprise. While consensus statements can be seen as a tool for moderating perceptions of risk, policymakers and scientists must ensure the integrity, strength and transparency of their research methods. This has the potential to facilitate policy, improve scientific accountability to the public and legitimise processes. While fostering greater trust is not a primary objective for scientists, an increase in legitimacy of process can be an important unintended consequence of improved quality consensus statements and an important antidote to the risk society.

Gold Award: Building the Capacity of Frontline Providers to Treat Mental and Substance Use Disorders Among Pregnant and Postpartum Women.

Gold Award: Building the Capacity of Frontline Providers to Treat Mental and Substance Use Disorders Among Pregnant and Postpartum Women.

Exploring Consumer Associations Between Corporate Reputation, Corporate Sustainability, and Product Attributes Within Utilitarian Market Contexts

Much of the extant literature proposes that contemporary motivated consumers assess, evaluate, and differentiate firms based not only on their corporate reputation (CR), but also on their corporate sustainability (CS) strategy. However, research that examines the inter-relationship and cognitive associations between CR, CS strategy, and a firm’s product attributes among consumer stakeholders remains scant. To address this gap, we take a holistic perspective that draws on the pertinent literature to develop a conceptual framework and subsequently explore consumer stakeholder cognitive associations between CR, CS, and product attributes within a utilitarian context. Adopting an exploratory methodology, findings are structured so as to reflect the components of the proposed framework. Reflecting the specificity of consumers’ associations between CS and market context, participants do not associate the telecommunications industry with CS despite many firms having a clear and positive Web-based communications strategy. Tangential proxies used in other market contexts such as point-of-sale communication, package design, and information communicated on the package would appear to be also pertinent within this context, particularly if standardized and adopted on an industry-wide basis.

Institutional sustainable purchasing priorities

PurposeThis purpose of this paper is to understand the environmental impacts of stakeholder-driven sustainable purchasing policies in institutional settings.Design/methodology/approachThe research is framed using stakeholder and life cycle assessment (LCA) theories. The study uses a multi-method approach. Starting with interviews to understand the breadth of sustainability issues and significant food purchases facing institutional purchasing managers, the authors subsequently perform LCA of these various policies using the most popular food item in different categories.FindingsFrom the interview results, the authors found that food purchasers focus predominately on cost, thus, are committed to food and packaging reduction. They are driven to buy local foods based on their consumer stakeholders but share their commitment to buying local products if the cost is appropriate. In the LCA of popular food items in multiple scenarios, avoiding food waste of various forms had significantly higher carbon emissions savings than packaging reduction or transportation minimizing (buy local) strategies.Research limitations/implicationsThe sample relied solely on the perceptions of institutional purchasing managers in university dining services. Future research should involve collecting data from other stakeholder groups such as the customers themselves, institutional leaders, and in other types of institutional settings such as hospitals and government agencies.Practical implicationsThe research provides managers with insights concerning the trade-offs between different sustainability objectives. In particular, findings show that reducing waste related animal protein has a bigger impact on environmental performance than many other popular sustainability objectives such as buying local or reducing packaging waste.Social implicationsThe paper focuses on the purchasing trade-offs of buying local vs national food products, different packaging solutions, and food waste generation. These decisions offer some social benefits (improve the economic situation for local farms vs consolidated food producers) as well as multiple environmental benefits.Originality/valueThe paper presents new findings on the sustainability purchasing priorities of stakeholders in institutional food settings and subsequent LCA of those policies to show which might have the most environmental impact.

Corporate Sustainability Reporting and Stakeholder Concerns: Is There a Disconnect?

SYNOPSIS The number of companies reporting their corporate sustainability (CS) activities has significantly increased over the last decade. The result being a wide variability in the types of activities being reported and the ways the information is presented. An unanswered question is whether the information being reported by companies following the Global Reporting Initiative (GRI) CS framework is of interest to arguably one of the primary stakeholder groups, customers. Our study seeks to fill this knowledge gap by comparing the content of CS reports to results from a large-scale consumer stakeholder survey. By performing factor analysis on stakeholder evaluation of the importance of CS activities, we find that consumers see different dimensions than those put forth by the GRI framework, thereby suggesting a disconnect between corporate sustainability reporting and stakeholder views and interests. Our results indicate that risk and compliance are dimensions of interest to customers, while the GRI economic dimension is not viewed as important. Additionally, a new dimension of social justice is the most important to consumer stakeholders. Furthermore, the study highlights particular activities within each factor that are most important to the consumer stakeholder group. This research has implications for preparers of sustainability reports and organizations, such as the GRI, that establish guidance for sustainability reporting.

A collaborative process for developing a weight management toolkit for general practitioners in Australia-an intervention development study using the Knowledge To Action framework.

BackgroundObesity is commonly seen in the Australian general practice population; however, few resources are specifically targeted at GPs working with these patients. The National Health and Medical Research Council (Australia) guideline for managing patients who are overweight and obese supports the involvement of a regular health professional. As 85 % of the population visit a GP annually, resources to support GPs working with this patient population are needed.This study describes the collaborative process used to develop an obesity management programme based on current Australian guidelines for GPs and their patients to be used in primary care. The Knowledge To Action framework was applied to develop a weight management toolkit for GPs based on current Australian guidelines. This draft was then reviewed by clinical GPs, GP registrars, consumer representatives and allied health professionals using focus groups and interviews. The participants gave feedback on the content, layout and acceptability of the documents. The feedback from the stakeholder groups was evaluated, and changes were incorporated into the final documents. A graphic designer was contracted to assist with the layout to improve useability and attractiveness of the documents. ResultsA total of 38 participants gave feedback on the draft weight management programme, and the research team amalgamated their responses to further improve the documents. The general response from GPs and consumer representatives was positive with most conveying their wish to try the programme themselves.Conclusions“The Change Program” is a practical tool for Australian GPs to use with their patients who are overweight or obese. It was developed in collaboration with GPs, allied health professionals and consumer stakeholders based on current Australian guidelines. It is currently being piloted in five general practices.