Delphi Analysis Research Articles

Implementation of the Sendai framework in the health system in Iran: identification of facilitators and obstacles

Sendai Framework is an international disaster risk reduction strategy that helps prioritization of disaster risk governance in all policies, strategies, and programs. Considering its geographical location and topographic characteristics, Iran experiences numerous hazards. Natural disasters adversely affect the health of population directly through injury and death, increased physical and mental illness, displacement and disruption of social networks. In addition, Iran's public health facilities have been increasingly impacted by such events during the last decade. This study aimed to investigate the implementation of Sendai framework in health system in Iran. In this mixed method study, first, throughout a literature review, all documents related to Disaster Risk Management (DRM) in Iran's health system were extracted. Then the obstacles and facilitators of DRM were found out based on the literature review and, a two-round Delphi, followed by an expert panel was performed. According to the results of the Delphi and expert panel Pareto analysis, and Fishbone model were used. 85 obstacles and 33 facilitators were extracted in total, which were divided into ten groups include Coordination, Actors, Intervention, Monitoring & Evaluation, Accountability, Attitude, Context, Budget, Idea, and Content. The most important obstacles were attributable to the intervention group, the Context, and the attitudes. The most important facilitators were the intervention group, monitoring and evaluation, and then Actors, policy content and Idea. Despite the existing facilitators for the implementation of the Sendai framework in Iran, there are far more obstacles along the pathway. These factors are relevant to all aspects of policy which would require long-term and continuous cultural change and educational planning. The online version contains supplementary material available at 10.1007/s40201-021-00715-9.

Community resilience for urban flood-prone areas: a methods paper on criteria selection using the Fuzzy Delphi method

PurposeCommunity resilience decides a lot on a city's ability to withstand an external shock. It has evolved naturally from a bounce-back approach to a more robust and meaningful bounce-forward process. The study explores gaps found in community resilience and finds that criteria specific to different disasters are absent.Design/methodology/approachThe study uses a multi-criteria decision analysis technique, fuzzy Delphi, to select criteria. Derivation of the initial list of criteria was from a pilot study, a focus group discussion and other literature studies which was followed by the fuzzy Delphi survey.FindingsAfter two rounds of fuzzy Delphi analysis, the consensus among 65 experts resulted in selecting 125 sub-sub-criteria within seven criteria. Findings show that many criteria previously not discussed in other pieces of literature project high fuzzy scores such as “availability of drinking water post-disaster” and “cracking down fake news spreaders by the police”. In addition, positive cooperation between political and religious institutions have proven to expedite disaster recovery.Research limitations/implicationsThe future scope also includes weighing the selected criteria using analytical hierarchy process (AHP).Practical implicationsPolicymakers in the disaster management domain can use the study findings in implementing effective disaster mitigation strategies.Originality/valueThe selection of criteria is based on the community resilience shown by the Kerala community during the floods of 2018 and 2019 (in Kerala). Measures demonstrated by the community need to be studied, which will help foster disaster mitigation better in future scenarios.

Investigating the barriers to growth in the Indian food processing sector

The Indian food processing sector (IFPS) has a tremendous capability for growth that can improve the socio-economic conditions of the rural masses. The performance of this sector is lagging behind substantially when compared to other developing nations. This study aims to identify growth barriers at different supply chain (SC) stages in the IFPS. Delphi analysis is performed to find out the barriers in the IFPS. Eighteen growth barriers have been found through expert opinion and extensive literature review spanning across three supply chain tiers: farm level, distribution level, and the consumer level. Further, to prioritize and identify the relative importance of various barriers, the analytic hierarchy process is employed. The results show that the top growth barriers in IFPS are—the lack of standardization and quality in the processed food, rain-dependent farming, and the high cost of cold chain facilities. The novel contribution of this study lies in capturing the intricacies of growth barriers in IFPS in an integrated manner across different SC tiers. Interactions between the identified drivers are important to both practitioners and researchers in understanding and driving process, quality, and technology improvements. Finally, the results also throw light on prioritized areas of concern that can be a game-changer for policymakers in India and other developing nations.

Total Interpretive Structure Model Strategic Consequences of Green Accounting: A Case Study of Tehran Stock Exchange Companies

Today, as societies grow and grow, environmental pollution is seen not as a global concern today, but as a future concern, and as a result the increasing level of green performance in various areas from accounting to production and supply chains. And ... one of the most important strategic approaches in this field can be considered. The need to focus on entrepreneurial orientation as a strategic principle will be a way to improve and develop these businesses effectively in the economies of societies, especially developing societies such as our own. Better management of environmental costs can also improve the company's environmental performance and bring significant benefits to the community and help sustainably develop companies in a competitive marketplace based on corporate social responsibility for the future. The Purpose of this research is Total Interpretive Structure Model Strategic Consequences of Green Accounting. Design/methodology/approach: In this research based on qualitative and quantitative methodology, 14 university experts in the field of accounting and finance were involved in meta-analysis and Delphi to identify the components and indicators of the research from the same research and then to reach the theoretical adequacy of the identified components and indices was analyzed using Delphi analysis. In quantitative part, with the participation of 5 managers of Tehran Stock Exchange companies, using matrix questionnaires, the identified indicators were stratified to range from the most influential to the least effective ones. Finding: The results in the qualitative analysis section indicate the existence of two main components in the form of the final index based on theoretical adequacy, and in the quantitative section, the index of higher market share (O4) and controlling stakeholder pressures to achieve demands (O5) Component Indicators of Green Accounting Competitive Outcomes; Reducing Information Asymmetry (O7); Feedback Information Flow to Shareholders (O8).

Evaluation of a Paleontological Museum as Geosite and Base for Geotourism. A Case Study

The Santa Elena province in Ecuador has outstanding geological potential in petroleum, mining and geosite resources. All the wealth of palaeontological samples and their inherent link to the history of this territory require a recognised museum with educational and scientific material to support the potential and promotion of geotourism development. The Megatherium Palaeontological Museum is located in this province and was the first Palaeontological Museum in Ecuador. It exhibits samples corresponding to the Late Pleistocene Megafauna that inhabited the area. This study aims to evaluate the museum (a geoheritage element) as a possible (palaeontological) geosite by analysing its contributions to the geoheritage of the Santa Elena province. Thus, we also aim to enhance the geotourism of the area and promote its collections as a geotouristic attraction. The methodological process was based on: (i) information processing and systematisation in the museum and its environment; (ii) assessment of the museum’s geological interest through the method of the Geological Survey of Spain, the Brilha method and the Geosites Assessment Model; and (iii) a qualitative evaluation using the Delphi and the Strengths, Weaknesses, Opportunities and Threats methodologies to define strategies and proposals for museum development. Based on the results of the applied quantitative assessment, the museum has a “very high” (277/400) degree of geological interest, due to the high values of scientific (310/400), academic (310/400) and touristic (210/400) interest. In this same way, the results obtained through the Brilha method reflect a high scientific (290/400), educational (280/400), and tourist (315/400) interest and a low degradation risk (190/400) value in the museum. Furthermore, the applied Geosites Assessment Model shows the museum as a geosite with high main and additional values, placing it between the Z23 and Z33 fields of the global valuation matrix. The evaluation approached through Delphi analysis and Strengths, Weaknesses, Opportunities and Threats matrix allowed us to propose improvement strategies to take advantage of the museum resources as an alternative that strengthens the geotouristic development of the area.

Stakeholder relationship capability and investment efficiency: a mosaic theory test

PurposeConsidering the constraints on resources and the need for firms’ planning to avoid recession and underdevelopment, enhanced investment efficiency would promote the capital market attractiveness and increase the performance of capital market investment. Empowering these markets through investment efficiency requires to promote the flow of information disclosure to stakeholders to provide the greater coherence and integration of information, enhance equal decision-making capabilities and promote trust and confidence in the company. The present study aims to examine the impact of stakeholder relationship capability on investment efficiency through testing the mosaic theory.Design/methodology/approachIn this study, two criteria (namely, the ratio of net fixed assets to total assets and investment level) were used to measure investment efficiency. Furthermore, meta-synthesis and Delphi analyses were adopted based on a five-point Likert scale to measure the development of stakeholder relationship capability. To collect the research data, the questionnaires were sent to 142 companies in 2019, of which 112 questionnaires were returned by the managers of the firms listed in Tehran Stock Exchange. To fit and test the research hypothesis, partial least squares analysis was used.FindingsAfter confirming the fit of the model, the results revealed that the stakeholder relationship capability had a positive and significant effect on investment efficiency.Originality/valueWith regard to the mosaic theory, this finding confirms that the equity of information in reflecting news and knowledge among stakeholders can promote the role of the firm’s stakeholder relationship capability, thus enhancing the investment efficiency.

Spatio-temporal characteristics of regional sustainable economic growth drivers of China

Intellectual capital (IC) has become a universal performance indicator for the socioeconomic development of countries and regions. Based on a review of national intellectual capital (NIC) and regional intellectual capital (RIC) evaluation literature, we used the regional intellectual capital indicator (RICI) as a model for China’s RIC evaluation to indirectly understand China’s potential economic growth drivers. Specifically, we collected statistical data of 31 provinces (including municipalities and autonomous regions) in China from 2004 to 2016 to measure RICI and analyze its dynamic characteristics from temporal and spatial perspectives. In this paper, Delphi analysis was used to construct RICI model, and cluster analysis and exploratory spatial data analysis were used to analyze the temporal and spatial characteristics of RICI in China. The results showed that RICI, which represents China’s overall economic growth drivers, increases annually and is consistent with economic development level during the study period. Regarding the geo-spatial space, RICI follows the trend of “high in the east and low in the west”, gradually decreasing from eastern to western China. For RIC structure, the shape of the radar chart of IC structure located in the eastern coastal areas is usually biased towards strong external relational capital, while that in western China is generally biased towards structural capital. For spatial correlation, China’s RICI has dependence on geographical adjacent space and economic space. Our research can provide policy suggestions for the sustainable development of regional economy from an IC perspective.

A Study on the Verification of Competency Management Factors of College TAEKWONDO Athletes and Strategies for Improving Performance

Purpose: This study sought to conceptualize the components of the evaluation management for excellent college Taekwondo athletes and validate each component in detail. Furthermore, the purpose of this study is to, third, propose a strategy through the analysis of the importance of key management factors structuring the definition of the components. Method: To achieve the purpose of the study, literature review, in-depth interviews, the Delphi analysis, and the AHP analysis were sequentially carried out. Results: First, customized training and match strategies ought to be structured for each individual athlete. Furthermore, it is necessary to continuously share these with coaches, athletes, and parents, and create a flexible systematic training program which may be adjusted at any time according to the match performance. Second, it is necessary to introduce an active consulting program related to family life, school and team life, and interpersonal relationship, and also systematically introduce a program which enables the exchange of opin-ions by and between leaders, counselors, parents, and athletes. Third, after retiring as a college student, the basic academic and curriculum learning management, on top of the Taekwondo match skills, one ought to be able to operate a program which may be consulted by and between the advising professor and the Taekwondo coach so that one can organize life independently. Fourth, by classifying excellent athletes or athletes of high potential value, one needs to connect with the college headquarters to provide a sponsorship program to connect sponsors and sponsor organizations according to match skills and recent performance results, and also consider the career path for Taekwondo activities which can sustain match skills and athlete life as a matter of formal institutionalization. Conclusion: The athlete competency management evaluation scale developed with a focus on the college Taekwondo athletes may be utilized as the basic data for the college athletes to reach the national level of matching skills and also discover promising middle and high school students. Furthermore, academic and practi-cal effects may be expected in that they will provide useful information for the follow-up researchers in the study of the field of Taekwondo match.

New Approach for Managing Sustainability in Projects

Despite the work done to date, project sustainability management (PSM) is still at an embryonic stage. The existing literature considers sustainability as a transversal aspect to be incorporated into the traditional management functions (scope, time, cost, quality, etc.). This article proposes sustainability as a key aspect of project management, with three essential components: principles, processes and competences. Regarding principles, the principle of sustainable development should be added to those generally suggested. As for processes, seven are proposed for (1) planning sustainability management; (2) establishing a sustainability breakdown structure; (3) defining the sustainability objective; (4) identifying project alternatives to achieve it; (5) planning and (6) implementing the sustainability strategy; and (7) monitoring and control. The main interrelationships between these processes and those of project initiation, planning, implementation, control, and closure are also analysed. In addition, the competences that the project manager should have in this field are identified, as well as the main criteria to take into account in order to adapt PSM processes to the characteristics of the project and the organisation. Finally, the results of a Delphi analysis carried out to validate these proposals are presented.

The Development of a Video Intervention to Improve Senior Medical Students' Performance on Outpatient Telephone Encounters: a Delphi Analysis and Randomized Controlled Trial.

IntroductionPostgraduate trainees address outpatient telephone calls (OTCs) with little prior training. This study determines the skills necessary for OTCs and examines whether a video intervention improves medical students’ performance on simulated OTCs.Materials and MethodsWe utilized a Delphi technique to determine skills needed for OTCs and created a 9-min video teaching these skills. Senior medical students were randomized to Intervention (viewed video) and Control (did not view video) groups. Students were assessed pre-/post-intervention on simulated OTCs. The primary outcome was the between-group difference in improvement.ResultsThe Delphi yielded 34 important skills with the highest focus on communication (n = 13) and triage (n = 6). Seventy-two students completed assessments (Control, n = 41; Intervention, n = 31). The score (mean ± SD) improved 4.3% in the Control group (62.3 ± 14.3% to 66.6 ± 25.0%) and 12.2% in the Intervention group (60.7 ± 15.2% to 72.9 ± 20.4%, p = 0.15). The effect size measured by Cohen’s d was 0.55, considered effective (> 0.33) for an educational intervention.ConclusionsThis project fills a gap in OTC training. The use of the Delphi technique, intervention development based on the results, and evaluation of efficacy is a process that could be reproduced for other educational gaps.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40670-021-01331-w.

Burden of COVID-19 on Italian Internal Medicine Wards: Delphi, SWOT, and Performance Analysis after Two Pandemic Waves in the Local Health Authority "Roma 6" Hospital Structures.

Background: COVID-19 causes major changes in day-to-day hospital activity due to its epidemiological characteristics and the clinical challenges it poses, especially in internal medicine wards. Therefore, it is necessary to understand and manage all of the implicated factors in order to maintain a high standard of care, even in sub-par circumstances. Methods: This was a three-phase, mixed-design study. Initially, the Delphi method allowed us to analyze the causes of poor outcomes in a cohort of an aggregate of Italian COVID-19 wards via an Ishikawa diagram. Then, for each retrieved item, a score was assigned according to a pros/cons, opportunities/threats system. Scores were also assigned according to potential value/perceived risk. Finally, the performances of MCs (Medicine-COVID-19 wards) and MCFs (Medicine-COVID-19-free: Internal Medicine wards) units were represented via a Barber’s nomogram. Results: MCFs hospitalized 790 patients (−23.90% compared to 2019 Internal Medicine admissions). The main risk factors for mortality were patients admitted from local facilities (+7%) and the presence of comorbidities (>3: 100%, ≥5: 24.7%). A total of 197 (25%) patients were treated with non-invasive ventilation (NIV). The most deaths (57.14%) occurred in patients admitted from local facilities. Conclusions: Medicine-COVID-19 wards show higher complexity and demand compared to non-COVID-19 ones and they are comparable to sub-intensive therapy wards. It is necessary to promote the use of NIV in such settings.

Cardiovascular Risk Management Recommendations for Patients with Chronic Myeloid Leukaemia who are Candidates for Ponatinib: Multidisciplinary Delphi Analysis

Progress in the treatment of Chronic Myeloid Leukaemia (CML) has significantly improved the survival rates and prognosis of these patients. As a result, there is a growing awareness of the adverse effects that the treatments used can have on the Cardiovascular (CV) system. A high percentage of patients develop sequential resistance to CML treatments and, in these cases, ponatinib represents a good therapeutic option that has been associated with cardiovascular events. This required the development of recommendations for its management. A Delphi analysis conducted by a multidisciplinary panel of experts developed and agreed on clinical practice recommendations to optimize cardiovascular risk control in CML patients requiring ponatinib treatment.

Calibrating a chief complaint list for low resource settings: a methodologic case study

BackgroundThe chief or presenting complaint is the reason for seeking health care, often in the patient’s own words. In limited resource settings, a diagnosis-based approach to quantifying burden of disease is not possible, partly due to limited availability of an established lexicon or coding system. Our group worked with colleagues from the African Federation of Emergency Medicine building on the existing literature to create a pilot symptom list representing an attempt to standardize undifferentiated chief complaints in emergency and acute care settings. An ideal list for any setting is one that strikes a balance between ease of use and length, while covering the vast majority of diseases with enough detail to permit epidemiologic surveillance and make informed decisions about resource needs.MethodsThis study was incorporated as a part of a larger prospective observational study on human immunodeficiency virus testing in Emergency Departments in South Africa. The pilot symptom list was used for chief complaint coding in three Emergency Departments. Data was collected on 3357 patients using paper case report forms. Chief complaint terms were reviewed by two study team members to determine the frequency of concordance between the coded chief complaint term and the selected symptom(s) from the pilot symptom list.ResultsOverall, 3537 patients’ chief complaints were reviewed, of which 640 were identified as ‘potential mismatches.’ When considering the 191 confirmed mismatches (29.8%), the Delphi process identified 6 (3.1%) false mismatches and 185 (96.9%) true mismatches. Significant chief-complaint clustering was identified with 9 sets of complaints frequently selected together for the same patient. “Pain” was used 2076 times for 58.7% of all patients. A combination of user feedback and expert-panel modified Delphi analysis of mismatched complaints and clustered complaints resulted in several substantial changes to the pilot symptom list.ConclusionsThis study presented a systematic methodology for calibrating a chief complaint list for the local context. Our revised list removed/reworded symptoms that frequently clustered together or were misinterpreted by health professionals. Recommendations for additions, modifications, and/or deletions from the pilot chief complaint list we believe will improve the functionality of the list in low resource environments.

Assessment of research, development and innovation in occupational health and safety in Spain

The evolution of the Spanish Occupational Health and Safety Strategy, within the EU Strategic Framework on Health and Safety at Work 2007–2012 and 2013–2020, highlights the strategic interest in increasing the success rate of research, development and innovation (RDI) projects in this area. This study aims to assess RDI on occupational health and safety being conducted in Spain.To achieve this objective, a Delphi analysis was conducted with eight experts in research and occupational health and safety. The conclusion was that there was insufficient promotion of and support for RDI in occupational health and safety, compared to similar areas such as the environment and quality, and that it must become a research priority to promote new programmes that boost and fund innovative projects in this area. The panel also highlighted that developing these projects in coordination would increase the prospect of obtaining more funding and achieving more ambitious goals.Considering the results obtained, future lines of research that might improve RDI in occupational health and safety are proposed.

A Proposed Legislative System for Internet of Things in Kingdom of Saudi Arabia: A Prospective Study

This study presents a proposed system for organizing Internet of Things (IoT) in Saudi Arabia. First, an initial list of the proposed legislative system for IoT systems in Saudi Arabia is developed based on articles of laws, legislations, and guidelines of related existing systems of IoT applied in other countries. This study then uses content analysis approach to prepare a preliminary list of the basic aspects of IoT, and lastly Delphi technique is adopted as a basic approach to develop final list of the proposed legislative system for IoT systems in Saudi Arabia. This study identifies five aspects as major requirements for IoT systems. These aspects are ordered according to their importance from perspective of experts as following: Infrastructure, IoT Security, Transparency and IoT Data Quality, and Privacy. This study shows in both rounds of Delphi analysis the consensus of all phrases in all aspects with ratio equal or greater than 80%. The study concludes with number of recommendations including the encouragement of future research to study separately each identified aspect from legal and informational side; and the importance of having implementing regulation or guidelines for the use of IoT and its services in the governmental, private, and third sectors.

A Validated Grading Scale for Downturned Oral Commisure in Asian Faces.

Downturned oral commissures develop gradually with aging. Tools have been developed to evaluate the marionette line or the lower face. However, there is no validated and reproducible tool to evaluate the progress after oral commissure treatment in clinical practice. The authors aimed to develop a scoring system to evaluate therapeutic interventions for downturned oral commissures and to verify its reliability, reproducibility, and clinical significance. In the Scale Development Group, the Delphi method was used to establish a 5-graded scoring system to evaluate oral commissure position. The scoring system was applied to 50 participants. The authors recorded and compared the intrarater agreement, interrater agreement, and significance of the grade-dependent scale. Delphi analysis of the scoring system verified the grade description adequacy. Intrarater agreement showed almost perfect agreement, and the intraclass correlation coefficient of the interrater agreement had a significantly higher agreement rate. The differences between the clinical grades were significant. The Hugel Downturned Oral Commissure Scale is precise, reproducible, and reflective of the clinical differences for downturned oral commissure. Its novelty lies in the use of specific angles and ratio. This scale has clinical trial potential owing to its standardized and quantitative assessment.

Using foresight to explore the impacts of flooding in Houston on health, poverty, and equity out to 2050

This paper presents a research study that is a valuable first project in setting the stage for bringing a foresight perspective to the impacts of severe flooding on health, poverty, and equity in Houston, out to the year 2050. Drawing on qualitative and quantitative research gathered from methodologies such as the Delphi and Cross-Impact Analysis combined with insights gained from interviews with subject-matter experts, it explores four alternative, plausible scenarios for Houston’s long-term future. Exploring scenarios that feature the continuation of present-day trends, a system collapse, a system balanced by a new equilibrium, and a system transformation provides an opportunity for stakeholders and policymakers to work together to create a more inclusive future for all city residents.

Groundwater Quality Evaluation of the Dawu Water Source Area Based on Water Quality Index (WQI): Comparison between Delphi Method and Multivariate Statistical Analysis Method

Water quality in the Dawu water source area is primarily studied through the traditional water quality assessment method that measures the chemical parameters of water against the existing standards, which is simple but cannot accurately describe the water quality. Although the water quality index (WQI) proposed by Horton is widely used for comprehensive water quality evaluation, parameter selection and weight determination are primarily based on the Delphi method, which is subjective and random. Moreover, in groundwater evaluation, the focus is primarily laid on general chemical parameters, such as Total Dissolved Solids, hydrogen ion concentration, Electrical Conductivity, and heavy metals, such as Hydrargyrum, Arsenic, and Chromium, with limited consideration for organic pollutants. In this study, WQI technology in combination with the entropy weight method was used to evaluate the groundwater environmental quality of the Dawu water source area, and the scientific results were analyzed by comparing the full index, Delphi, and multivariate statistical analysis methods. The results showed that the groundwater in the Dawu water source area generally had good quality and was potable and that the application of multivariate statistical analysis method was more suitable than the Delphi method in the index selection process.

ANALISIS KEBIJAKAN PENGENDALIAN URBANISASI KOTA BERASTAGI KABUPATEN KARO SUMUT

ABSTRAK
 This study aims at analyzing the factors driving and pulling the occurrence of urbanization in Berastagi and the efforts made by the Karo district government to control it. The method used is descriptive qualitative with primary data sources from interviews and field observations, while secondary data is from literary studies, social media and documentation. The data analysis used is the Delphi analysis to equalize the perceptions of the informants, the analysis of pull and support factors as well as policy analysis on efforts to control urbanization in the City of Berastagi.The conclusion from the results of this study is that the main driving factor for urbanites from their hometowns for those who are not married is shy to live in the village, while for those who are already married are limited employment opportunities in the village. The main draw factor for urbanites from the destination area is for those who do not have family, invite friends who are already in the city while those who are already married are looking for a new job. Efforts made by the Government in the Origin Region are Encouraging and Facilitating: Soft Loans, MSME Empowerment Program Assistance (especially Micro Enterprises) and Building Village Facilities through APBD. Efforts made by the Government in the urbanization destination of Berastagi City are to make a new settlement plan consisting of a. Agricultural Zone on Jl. Air (Column Monument towards Simpang Empat District); b. Office Zone On Jl. Djamin Ginting (from Tugu Kol to Kec. Kaban Jahe); . and c. Tourism Zone Jl. Djamin Ginting starting from the monument mejuah Juah towards Tahura).

ANALISIS KEBIJAKAN PENGENDALIAN URBANISASI KOTA BERASTAGI KABUPATEN KARO SUMUT

ABSTRAK
 This study aims at analyzing the factors driving and pulling the occurrence of urbanization in Berastagi and the efforts made by the Karo district government to control it. The method used is descriptive qualitative with primary data sources from interviews and field observations, while secondary data is from literary studies, social media and documentation. The data analysis used is the Delphi analysis to equalize the perceptions of the informants, the analysis of pull and support factors as well as policy analysis on efforts to control urbanization in the City of Berastagi.The conclusion from the results of this study is that the main driving factor for urbanites from their hometowns for those who are not married is shy to live in the village, while for those who are already married are limited employment opportunities in the village. The main draw factor for urbanites from the destination area is for those who do not have family, invite friends who are already in the city while those who are already married are looking for a new job. Efforts made by the Government in the Origin Region are Encouraging and Facilitating: Soft Loans, MSME Empowerment Program Assistance (especially Micro Enterprises) and Building Village Facilities through APBD. Efforts made by the Government in the urbanization destination of Berastagi City are to make a new settlement plan consisting of a. Agricultural Zone on Jl. Air (Column Monument towards Simpang Empat District); b. Office Zone On Jl. Djamin Ginting (from Tugu Kol to Kec. Kaban Jahe); . and c. Tourism Zone Jl. Djamin Ginting starting from the monument mejuah Juah towards Tahura).