Equitable Impact Research Articles

The Denizen Designer Project: Practices, Relationships, and Principles of Activist-Led Design

Design activism is a way for designers and researchers to negotiate societal inequities and resulting implications for design practices. Within HCI and design, community-based methods are a common way to situate design engagements among those directly impacted by social inequities. Despite its potential for social impact, current approaches to design activism can be extractive and at odds with community-aligned advocacy. Drawing on interviews with 32 individuals who use design to address local, social inequities, we extend the current discourse around design activism by exploring 'activist-led design'. We outline four key considerations of this work: understanding activist-led design practices; relationality and community engagements; challenges of doing this work; and democratizing access to design. Our analysis highlights implications for academia's role in design activism. This paper interrogates design activism's role as a social and communal practice, and considers ways to support activist-led design. We propose considerations that contribute to the larger conversation of academic design having more equitable impact.

Who Does Design Research Serve? A Critical Evaluation of the Diversity of Samples Studied in Design Theory and Methods Research

Abstract Human subjects are often used in design theory and methods studies to understand how designers behave and link behaviors with design outcomes. We highlight that much of our past work and resultant knowledge in design theory and methodology (DTM) has used data from samples composed mainly of White men. We argue, therefore, that the tools, methods, and practices conceived through research intended for universal use may not be as generalizable as intended. We support this assertion through a quantitative assessment of past DTM literature. We definitively demonstrate a historic lack of diversity in human-subjects research in DTM through a critical review of 109 published works. Our findings suggest that age, gender, and race/ethnic background are underreported. This work is a call to action for researchers to reflect on who are the beneficiaries of design theory and methods research, how participant background might impact the findings, and what strategies can be employed to fulfill our promise of a more equitable design community and impact.

Health optimisation for patients with obesity before elective orthopaedic surgery: a qualitative study of professionals’ views on restrictive approaches and future practice

BackgroundPreoperative health optimisation for elective surgery entails supporting patients to improve their health in preparation for their treatment and recovery. While there is consensus that this process should address obesity, approaches vary across England. Despite guidance from the National Institute for Health and Care Excellence to the contrary, restrictive approaches with body mass index thresholds for referral to arthroplasty are in use. This qualitative study aimed to investigate the views of professionals on the current use and future implications of these policies.MethodsSemi-structured interviews were conducted with 20 professionals including clinicians, commissioners, policymakers, and health service managers, with experience of developing and/or implementing health optimisation policies for elective arthroplasty. Participants were sampled from areas in England with and without restrictive policies. We undertook thematic analysis of the interview data.ResultsParticipants described pre-surgical health optimisation as an important trigger for health improvement but identified current resourcing and inadequacies in provision of weight management support as significant barriers to success. Participants expressed concerns about the appropriateness and fairness of including obesity as a determinant to restrict access to surgery. They described short-term financial pressures underlying the use of restrictive body mass index thresholds and a lack of an evidence base, such that policies amounted to rationing and risked exacerbations of health inequalities. The study identified four priorities for improvements to future health optimisation practices: developing and implementing national guidance with flexibility for local variation, initiating patient engagement in primary care with onward integration across all services, improving resourcing to support effective equitable impact, and addressing wider determinants of obesity through societal change.ConclusionsOverall, participants had limited expectations of the impact of health optimisation policies on obesity without additional support, investment, and national guideline implementation. They raised strong concerns over current restrictive approaches. We conclude that addressing concerns around weight management support service availability and impacts on health inequalities is essential for shaping effective health optimisation policies. Future policy direction should support health optimisation to be offered early (ideally in primary care). Health optimisation interventions should be non-restrictive, inclusive, and well-monitored, particularly around equality impact.

The Role of Logistics Management in Supporting Goods Management for Equitable Distribution and Impact on Regional Economic Growth

The purpose of this study is expected to be able to build a hypothesis regarding the influence between variables that can later be used for further research in the scope of logistics management. The article on the role of logistics management in supporting the management of goods for equitable distribution and having an impact on regional economic growth is a scientific literature article in the scope of logistics management. The approach or method used in this literature review research is descriptive qualitative. The data collection technique is to use literature studies or conduct a review of relevant previous articles. The data used in this descriptive qualitative approach comes from previous research that is relevant to this research and is sourced from academic online media such as the Thomson Reuters Journal, Springer, Taylor & Francis, Scopus Emerald, Sage, WoS, Sinta Journal, DOAJ, EBSCO, Google Scholar and digital reference books. In previous studies, 1 relevant previous article was used to review each independent variable. The results of this literature review article are: 1) Logistics Management plays a role in Equitable Distribution; and 2) Logistics Management plays a role in Regional Economic Growth.

Challenges with measures used for assessing research impact in higher education institutions

Internationally, there has been a push for the prioritisation of research impact beyond its scholarly contribution. Traditionally, research impact assessments have focused on academic impact and quantitative measures, at the expense of researchers for whom research impact cannot be quantified. Bibliometric indicators and other quantitative measures are still the most widely used method for evaluating research impact because these measures are easy to use and provide a quick solution for evaluators. Conversely, metric indicators fail to capture important dimensions of high-quality research. Hence, in this study, we explored challenges with metric indicators. We adopted a case study of the University of Cape Town and used document analysis, a questionnaire survey to collect data from academics and researchers, as well as semi-structured interviews with a sample of academic and research staff. The findings highlight common challenges with quantitative measures, such as bias and discipline coverage, and the ability of measures to drive researchers’ behaviour in another direction. We propose the adoption of responsible research metrics and assessment in South African higher education institutions for more inclusive and equitable research impact assessments.

Caregiver recruitment strategies for interventions designed to optimize transitions from hospital to home: lessons from a randomized trial

Challenges to recruitment of family caregivers exist and are amplified when consent must occur in the context of chaotic healthcare circumstances, such as the transition from hospital to home. The onset of the COVID-19 pandemic during our randomized controlled trial provided an opportunity for a natural experiment exploring and examining different consent processes for caregiver recruitment. The purpose of this publication is to describe different recruitment processes (in-person versus virtual) and compare diversity in recruitment rates in the context of a care recipient’s hospitalization. We found rates of family caregiver recruitment for in-person versus virtual were 28% and 23%, respectively (p = 0.01). Differences existed across groups with family caregivers recruited virtually being more likely to be younger, white, have greater than high school education, and not be a spouse or significant other to the care recipient, such as a child. Future work is still needed to identify the modality and timing of family caregiver recruitment to maximize rates and enhance the representativeness of the population for equitable impact.

Allocation of Funds in Bilevel Subsidy Welfare Programs

Problem definition: Most subsidy welfare programs operate in a bilevel hierarchical structure, wherein a funding agency allocates funds to multiple service organizations. These service organizations invest in activities within their areas to generate societal impact for beneficiaries by enhancing the quantity and quality of services at local providers. The funds allocation decisions in such programs are complicated by the funding agency’s equity consideration, intricate relationships among contextual factors in societal impact generation, and information asymmetry between different entities about availability of additional funds for an agency. Methodology/results: We propose a model to analyze how the funding agency should allocate funds to generate the most societal impact equitably across areas. We show that the funding agency should direct more funds toward an area with a relatively balanced mix of subsidy-accepting and nonaccepting providers, or with fewer nonaccepting providers, and outreach activity is more likely to yield a higher investment return. Further, comparing the inequity levels and total societal impact under the proposed equity-ensuring method with those under other methods, we find that an efficiency-focused method enhances total societal impact, but can result in greater inequity, especially when there is a large across-area disparity in the size of beneficiaries. A simple formula-based method could achieve greater total societal impact, while not severely sacrificing equity in certain situations. Conversely, the equity-ensuring method always eliminates inequity by not severely sacrificing the total societal impact under a wide range of parameter values. Managerial implications: Given the growing impetus to consider equity within their operations, our equity-ensuring method helps the funding agencies adjust their allocation strategies to generate the greatest equitable impact. Finally, using a case study based on Massachusetts’ child care subsidy program, we illustrate that the proposed method achieves equity while enhancing the overall societal impact by approximately 3% versus the current formula-based method. Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2022.0474 .

AI and Aphasia in the Digital Age: A Critical Review.

Aphasiology has a long and rich tradition of contributing to understanding how culture, language, and social environment contribute to brain development and function. Recent breakthroughs in AI can transform the role of aphasiology in the digital age by leveraging speech data in all languages to model how damage to specific brain regions impacts linguistic universals such as grammar. These tools, including generative AI (ChatGPT) and natural language processing (NLP) models, could also inform practitioners working with clinical populations in the assessment and treatment of aphasia using AI-based interventions such as personalized therapy and adaptive platforms. Although these possibilities have generated enthusiasm in aphasiology, a rigorous interrogation of their limitations is necessary before AI is integrated into practice. We explain the history and first principles of reciprocity between AI and aphasiology, highlighting how lesioning neural networks opened the black box of cognitive neurolinguistic processing. We then argue that when more data from aphasia across languages become digitized and available online, deep learning will reveal hitherto unreported patterns of language processing of theoretical interest for aphasiologists. We also anticipate some problems using AI, including language biases, cultural, ethical, and scientific limitations, a misrepresentation of marginalized languages, and a lack of rigorous validation of tools. However, as these challenges are met with better governance, AI could have an equitable impact.

Machine learning for healthcare that matters: Reorienting from technical novelty to equitable impact.

Despite significant technical advances in machine learning (ML) over the past several years, the tangible impact of this technology in healthcare has been limited. This is due not only to the particular complexities of healthcare, but also due to structural issues in the machine learning for healthcare (MLHC) community which broadly reward technical novelty over tangible, equitable impact. We structure our work as a healthcare-focused echo of the 2012 paper "Machine Learning that Matters", which highlighted such structural issues in the ML community at large, and offered a series of clearly defined "Impact Challenges" to which the field should orient itself. Drawing on the expertise of a diverse and international group of authors, we engage in a narrative review and examine issues in the research background environment, training processes, evaluation metrics, and deployment protocols which act to limit the real-world applicability of MLHC. Broadly, we seek to distinguish between machine learning ON healthcare data and machine learning FOR healthcare-the former of which sees healthcare as merely a source of interesting technical challenges, and the latter of which regards ML as a tool in service of meeting tangible clinical needs. We offer specific recommendations for a series of stakeholders in the field, from ML researchers and clinicians, to the institutions in which they work, and the governments which regulate their data access.

Engagement With Remote Delivery Channels in a Physical Activity Intervention for Senior Women in the US.

Identify the effects of engagement with different intervention delivery channels on physical activity (PA), and the participant subgroups engaging with the different channels, among Women's Health Initiative Strong and Healthy (WHISH) PA trial participants. Secondary analysis of data from WHISH, a pragmatic trial that used passive randomized consent. United States (remote intervention in all 50 states). 18,080 U.S. women, aged 68-99 years, assigned to the WHISH PA intervention arm. 6 dichotomous variables operationalized engagement: Engagement with Targeted Inserts, Email (opened), Email (clicked links), Website (logging in), Website (tracking), Interactive Voice Response (IVR). PA was measured using the CHAMPS PA questionnaire. Linear regressions evaluated effects of engagement on PA. Conditional Inference Trees identified subgroups of participants engaging with different channels based on demographic and psychosocial variables. Engagement with each channel, except IVR, was associated with significantly more hours/week of PA (square root coefficients .29 - .13, P values <.001). Consistently across channels, features that identified subgroups of participants with higher engagement included younger age, and higher levels of PA and physical function. Subgroups with the highest engagement differed from those with the lowest in most participant characteristics. For equitable population-level impact via large-scale remotely-delivered PA programs, it may be necessary to identify strategies to engage and target harder to reach subgroups more precisely. The WHISH trial is registered at ClinicalTrials.gov (No. NCT02425345).

Global nutrition challenges: A public health review of dietary risks and interventions

This public health review addresses the intricate challenges posed by global nutrition and examines the impact of dietary risks on the well-being of populations worldwide. In an era marked by diverse dietary patterns, the prevalence of both undernutrition and overnutrition presents a complex public health landscape. This paper encapsulates the key aspects explored in the comprehensive analysis, emphasizing the urgent need for targeted interventions. The review delves into the multifaceted nature of global nutrition challenges, considering factors such as food insecurity, inadequate dietary diversity, and the rising prevalence of diet-related non-communicable diseases. Highlighting the interconnectedness of nutrition and public health, the document scrutinizes the disparities in nutritional outcomes across different regions, socioeconomic groups, and age categories. Moreover, the paper outlines evidence-based interventions aimed at addressing these challenges. These interventions encompass policy initiatives, community-based programs, and educational campaigns designed to promote healthier dietary choices. Special emphasis is placed on the role of stakeholders, including governments, non-governmental organizations, and the food industry, in fostering a supportive environment for improved nutrition. The paper concludes by emphasizing the urgency of a concerted global effort to tackle nutrition challenges comprehensively. It underscores the significance of adopting a multifaceted approach that integrates preventive measures, policy changes, and community engagement to foster a sustainable and equitable impact on global nutrition. The insights presented in this review serve as a call to action for policymakers, healthcare professionals, and public health advocates to collaborate in mitigating the adverse effects of dietary risks and building a healthier, more resilient global population.

Equitable differential privacy.

Differential privacy (DP) has been in the public spotlight since the announcement of its use in the 2020 U.S. Census. While DP algorithms have substantially improved the confidentiality protections provided to Census respondents, concerns have been raised about the accuracy of the DP-protected Census data. The extent to which the use of DP distorts the ability to draw inferences that drive policy about small-populations, especially marginalized communities, has been of particular concern to researchers and policy makers. After all, inaccurate information about marginalized populations can often engender policies that exacerbate rather than ameliorate social inequities. Consequently, computer science experts have focused on developing mechanisms that help achieve equitable privacy, i.e., mechanisms that mitigate the data distortions introduced by privacy protections to ensure equitable outcomes and benefits for all groups, particularly marginalized groups. Our paper extends the conversation on equitable privacy by highlighting the importance of inclusive communication in ensuring equitable outcomes for all social groups through all the stages of deploying a differentially private system. We conceptualize Equitable DP as the design, communication, and implementation of DP algorithms that ensure equitable outcomes. Thus, in addition to adopting computer scientists' recommendations of incorporating equity parameters within DP algorithms, we suggest that it is critical for an organization to also facilitate inclusive communication throughout the design, development, and implementation stages of a DP algorithm to ensure it has an equitable impact on social groups and does not hinder the redressal of social inequities. To demonstrate the importance of communication for Equitable DP, we undertake a case study of the process through which DP was adopted as the newest disclosure avoidance system for the 2020 U.S. Census. Drawing on the Inclusive Science Communication (ISC) framework, we examine the extent to which the Census Bureau's communication strategies encouraged engagement across the diverse groups of users that employ the decennial Census data for research and policy making. Our analysis provides lessons that can be used by other government organizations interested in incorporating the Equitable DP approach in their data collection practices.

Digital zakat management, transparency in zakat reporting, and the zakat payroll system toward zakat management accountability and its implications on zakat growth acceleration

This study examines the impact of Digital Zakat Management, Transparency in Zakat Reporting, and the Zakat Payroll System on Zakat Growth Acceleration, with Zakat Management Accountability as the mediating factor. Data from muzakki and Zakat institutions were collected through surveys and questionnaires, and regression and correlation analyses were used to assess the relationships between variables. The findings reveal that digital Zakat management positively impacts Zakat management accountability and Zakat growth acceleration. Transparency in Zakat reporting also has a positive effect on Zakat management accountability. However, the Zakat payroll system does not significantly influence Zakat management accountability or Zakat growth acceleration through mediation. The study underscores the importance of accountability as a mediator between digitalization, transparency, and Zakat growth, offering insights for Zakat institutions to optimize their practices and promote equitable social impact. Future research should consider qualitative methods and comprehensive variables to understand Zakat dynamics better.

The equitable impact of sugary drink taxation structures on sugary drink consumption among Canadians: a modelling study using the 2015 Canadian Community Health Survey-Nutrition.

Estimate the impact of 20 % flat-rate and tiered sugary drink tax structures on the consumption of sugary drinks, sugar-sweetened beverages and 100 % juice by age, sex and socio-economic position. We modelled the impact of price changes - for each tax structure - on the demand for sugary drinks by applying own- and cross-price elasticities to self-report sugary drink consumption measured using single-day 24-h dietary recalls from the cross-sectional, nationally representative 2015 Canadian Community Health Survey-Nutrition. For both 20 % flat-rate and tiered sugary drink tax scenarios, we used linear regression to estimate differences in mean energy intake and proportion of energy intake from sugary drinks by age, sex, education, food security and income. Canada. 19 742 respondents aged 2 and over. In the 20 % flat-rate scenario, we estimated mean energy intake and proportion of daily energy intake from sugary drinks on a given day would be reduced by 29 kcal/d (95 % UI: 18, 41) and 1·3 % (95 % UI: 0·8, 1·8), respectively. Similarly, in the tiered tax scenario, additional small, but meaningful reductions were estimated in mean energy intake (40 kcal/d, 95 % UI: 24, 55) and proportion of daily energy intake (1·8 %, 95 % UI: 1·1, 2·5). Both tax structures reduced, but did not eliminate, inequities in mean energy intake from sugary drinks despite larger consumption reductions in children/adolescents, males and individuals with lower education, food security and income. Sugary drink taxation, including the additional benefit of taxing 100 % juice, could reduce overall and inequities in mean energy intake from sugary drinks in Canada.

Integrating asset-based community development and community-based research for social change: A beginning

&#x0D; &#x0D; &#x0D; This themed volume is grounded in a set of diverse case studies that bring community and university partners together using two aligned methodologies: community-based research (CBR), which evolved from higher education, and asset-based community development (ABCD), which evolved from community practice. The volume places these methodologies in dialogue with each other, to examine and begin to answer the question that guided the volume’s call for articles: can CBR and ABCD be compatible agents in equitable and sustainable change? From the case studies emerge five themes that we explore in this guest editorial: (1) the benefits of community-university partnerships; (2) the risks of community-university partnerships; (3) notions of community expertise and ‘community partner’; (4) the centrality of relationship-based methodologies in partner-building; and (5) explorations of power, equity and justice. The editorial opens and closes with discussion on the important systemic question of power imbalances between universities and communities, which has to be addressed for these methodologies to be effective, whether used on their own or in combination within community-university partnerships. It concludes with a discussion of the ‘deep, wide and connected’ community engagement that the articles as a whole suggest is necessary to have equitable and sustainable impact.&#x0D; &#x0D; &#x0D;

AGE-FRIENDLY CITIES AND COMMUNITIES: RESEARCH ON LOCAL PRACTICE TO STRENGTHEN THE MOVEMENT’S FUTURE

Abstract The age-friendly cities and communities (AFCC) movement has accelerated a major paradigmatic shift for the field of aging in the 21st century. Launched and spurred by high-profile government agencies and organizations across the globe, this ambitious movement highlights the transformative potential of deliberate, cross-sectoral efforts to improve built, social, and service environments of localities in response to population aging. This presentation will provide a brief overview of the development of a global program of policy and practice on AFCCs, with an emphasis on its emergence in the United States. It will then present insights regarding challenges and opportunities for the future based on findings from an ongoing, longitudinal study of a regional network of AFCC initiatives. The study, designed as a developmental evaluation, explores the perspectives of on-the-ground AFCC leaders on their practice as part of a private philanthropic grantmaking initiative to spur AFCCs in New Jersey. Reflecting on our years of engaged research with this network, the presentation will highlight issues concerning multi-level systems alignment, the promises and pitfalls of public sector leadership, the need for additional practice theories, and greater incorporation of considerations of aging equity and racial justice. The presentation will demonstrate the importance of continuing to leverage the strengths of community-engaged research to better ensure the movement’s relevance, reach, and equitable impact across diverse community, organizational, and broader systems contexts.

Global health economics: The Equitable Impact Sensitive Tool (EQUIST) – development, validation, implementation and evaluation of impact (2011 to 2022)

Global health economics: The Equitable Impact Sensitive Tool (EQUIST) – development, validation, implementation and evaluation of impact (2011 to 2022)

Raising global citizens at home: Exploring a methodological approach

Views on how to balance the needs of humans and the environment differ widely. Global citizenship supports the transition to a sustainable society as the substantial and complex challenges facing the world transcend national borders. Global citizenship is a key response in contemporary higher education which aims to prepare students to address present and future challenges. We outline the design, international virtual collaboration, for an undergraduate course to develop students' global citizenship competencies. International virtual collaboration works as an open-source instrument that provides an inclusive, equitable and low environmental impact solution to the internationalization of university students at home. We explain an iterative Participatory Action Research methodology to develop and enhance the present and anticipated positive societal impact of the course. The positive societal impacts include reduced environmental impact (by reduced need to travel), improved partnerships (by better understanding of cultural differences that may make working together across borders difficult), quality education (by improved educational design and approach), equality and diversity (by improved access, lower cost, for education that develops global citizenship competencies).

Enhancing Impact: A Call to Action for Equitable Implementation Science

Despite investments in evidence-based interventions and Implementation Science, most evidence-based interventions are not widely or routinely adopted, delivered, or sustained in many real-world community and healthcare settings. This gap is even greater in settings and populations experiencing numerous social and structural barriers to health, with important implications for persistent patterns in health inequities. In this Viewpoint, as part of a Special Issue on Advancing the Adaptability of Chronic Disease Prevention and Management through Implementation Science, we outline seven calls to action for the field of Implementation Science, with the goal of encouraging researchers, practitioners, and funders to be more intentional and accountable in applying Implementation Science to have greater impact on promoting health equity. Calls to action include (1) enhance public health, community, and multi-sectoral partnerships to promote health equity and equitable implementation; (2) revisit and build the evidence base needed to promote health equity and impact at multiple levels; (3) prioritize focus on policy development, dissemination, and implementation; (4) be agile and responsive in application of Implementation Science frameworks, processes, and methods; (5) identify and redefine meaningful metrics for equity and impact; (6) disseminate scientific evidence and research to a diverse range of partners and potential beneficiaries; and (7) extend focus on de-implementation, mis-implementation, and sustainability which are central to enhancing health equity. Additionally, we outline why a focus on prevention and public health is essential to making progress towards health equity in Implementation Science, summarize important advancements that the field has made towards making equity more foundational, and pose important research questions to enhance equitable impact of work in this area.

In Conversation with Equity: Qualitatively Engaging Quantitative Data for Equitable Social Impact

Making meaningful progress towards achieving racial equity in public serving institutions requires making equity-informed decisions, which itself requires the use of equity-oriented data. Public and nonprofit organizations, however, are at varying degrees of readiness to use this data and to make equity-focused decisions. We draw on qualitative research to examine how children’s hospitals use equity-focused neighborhood data to understand racial/ethnic inequities in the populations they serve and eventually to make decisions that can help correct these inequities. The interactions between data producers and users involve not only technical exchanges, but also the adoption of shared analytic frameworks that center equity, as well as “nervous” conversations. Our analysis indicates that qualitative interrogations of the use of quantitative data within organizations may help to overcome knowledge, organization, and equity readiness barriers to equitable outcomes. Using equity-focused data for data-driven decision-making is relational, so qualitative research methods can facilitate the reflexivity and critical mindsets needed to change organizational practices to improve racial equity. Employing qualitative methods can help data producers make their construction and dissemination of data more rigorous. Facilitating equity conversations can also help improve relationships with data users, which is necessary for data collaborations to promote racial equity.