Foresight Exercise Research Articles

The future of public health in Europe

Abstract EuroHealthNet - in collaboration with the Copenhagen Institute for Futures Studies - has conducted a Foresight study to collect insights and identify risks and opportunities. The study investigates the role of public health by 2035 in achieving health equity through health promotion and prevention, in the context of the digital and green transition. The multi-round study ran from June to November 2023. It consisted of a workshop, a kick-off meeting, two rounds of surveys using the Delphi method, and a final back-casting expert panel. The Foresight exercise involved 35 experts across Europe and covered six themes: public health policy and governance; public health financing and spending; sustainability and the green transition; health promotion and disease prevention; equity and society; digitalisation in public health. The presentation will highlight some of the outcomes, recommendations as well as experiences from this Foresight exercise and how it can be applied in practice.

Envisioning telemedicine in the EU health systems: Insights from policy experts and cancer patients

Abstract Background Conducted as part of WP4 (Sustainability) of the eCAN Joint Action, the aim of this foresight exercise was to understand how telemedicine services in EU-Member States (MS) could be implemented in a patient-centric way to tackle cancer. Methods Based on a literature review, we identified factors that impact on the implementation of telemedicine in EU MS; these were integrated to an online survey. Health policy experts were invited to rank 34 factors using a 7-point Likert scale to better understand the barriers and facilitators of telemedicine services at the health system level, whilst patient associations ranked 28 other factors to capture end-users’ view. Next, survey respondents were invited to a foresight workshop to collect qualitative data and gain a forward-looking perspective. Results 20 health policy experts working in digital health across 14 EU MS, predominantly from Ministries of Health, and 8 cancer patient associations from 5 EU MS responded to the surveys. For a sustainable integration of telemedicine services in the EU, policy experts recommend developing a clear legal framework, embracing a hybrid healthcare model, and enhancing digital literacy. They stress the importance of telemedicine as a complementary tool, advocating for solid IT infrastructure, privacy safeguards, and the integration of health equity. Similarly, cancer patients emphasise the importance of being able to choose between telemedicine and in-person visits, focusing on personal interaction. They advocate for the involvement of patients in the design and testing of telemedicine services, ensuring solutions meet their preferences. Conclusions Policy experts and patients are in favour of hybrid models for cancer care. Recommended public health actions include: i) develop legal frameworks to complement in-person care with telemedicine; ii) boost digital literacy and IT infrastructure, ensuring privacy and health equity; and iii) involve patients in design for tailored services. Key messages • Both the EU Member States and cancer patients view telemedicine as a useful and complementary tool, however, not as a replacement for in-person healthcare services. • Both the EU Member States and cancer patients champion telemedicine with a focus on equity, privacy, digital literacy and a hybrid model of care that respects patient preferences for cancer treatment.

Navigating Tomorrow's Tide: Exploring the Future of Ocean Resources and Their Impact on Food and Feed Safety

Abstract In a context of global changes, a foresight study is helpful to look into the future, anticipate possible scenarios and take appropriate decisions to face emerging risks for food and feed safety. Considering that an increased use of the ocean is expected for the next decades, it is essential to explore its possible impact on the safety of food and feed from the oceans. A scoping study was carried out to analyse drivers of change that may impact/promote the future uses of the ocean and its resources. From bibliographic search, different ocean uses were identified: coastal and open‐sea mining, marine aquaculture, sea transport and trade, energy production and related infrastructures, fisheries, ocean crops, saline farming, desalination, extraction of bioresources, marine protected areas and conservation of the ocean. Through the information gathered in the scoping study and the input of several experts, three key ocean uses were prioritised to proceed to a participatory foresight exercise: (i) coastal and open‐sea mining; (ii) marine aquaculture; and (iii) sea transport and trade. The foresight exercise produced three possible scenarios for 2050 for each prioritised use of the ocean. On the basis of these scenarios, possible implications and potential emerging issues for the safety of food and feed from the oceans were identified and characterised through bibliographic data. This document also provides a description of the methodology followed in the scoping study and in the foresight exercise, and recommendations that could help EFSA to prepare to the challenges posed by the future exploitation of ocean resources.

Dare scholars look to the future? Academia and strategic foresight for the European Union's foreign policy

AbstractDrawing on examples of foresight projects situated at the interface between academia and foreign policy practice, this article reflects on the role of academics in informing the practice of foreign policy‐making in the EU. The study explores why academics have rarely engaged in foresight over the past two decades and why this has changed in recent years. It argues that this shift is triggered, on the one hand, by the strategic blunders of the last decade and, on the other hand, by the conceptual developments within the disciplines of political science or international relations. After demonstrating the growing trend of scholarly engagement in foresight with a series of illustrative examples, the article discusses the added value and limitations of academic‐generated foresight for EU foreign policy. Taking these into account, the analysis indicates best practice solutions, such as foresight exercises, with the joint involvement of researchers and policymakers.

Foresight in public health: a tutorial on application and insights on challenges from the PHIRI foresight exercise.

The application of foresight to the field of public health is limited. There is growing need to anticipate uncertain future trends and to plan for them. Foresight provides tools to experts and policymakers to discuss and plan for possible futures. Hence, the aim of this study is to illustrate how the foresight six-step approach can be applied in public health, and to provide recommendations on dealing with challenges, drawn from the Population Health Information Research Infrastructure (PHIRI) foresight exercise. In this tutorial, we describe the six-step approach as part of foresight methodology and give examples of possible challenges. Step 1 comprises the formulation of study objectives. Step 2 focuses on developing a conceptual model and applying the Demographic Economic Sociocultural Technological Ecological and Political-Institutional (DESTEP) framework to identify and prioritize driving forces for the topic of interest. In Step 3, a time horizon and spatial level are defined. Step 4 discusses scenario logics. Steps 5 and 6 discuss different types of scenarios and associated tools for analyses. Possible challenges encountered whilst applying the foresight methodology at each of the steps, were drawn from experiences during PHIRI foresight exercise. Challenges associated with applying the foresight six-step approach included: formulating concise objectives, developing a conceptual model, understanding driving forces and uncertainty and difficulties in building scenarios. Understanding concepts used in the six-step approach and how they relate to each other remained difficult. Support from foresight experts, conducting more foresight exercises, tutorials and guidelines can enhance understanding and support building capacity.

Transactional distance theory in distance learning: Past, current, and future research trends

The accelerated adoption of distance learning in post-pandemic times has resulted in increasing research publications and review studies in a short time. This necessitates the exploration of a large corpus of academic publications for effective distance learning and learning strategies. As distance learning stakeholders have assimilated the transactional approach to understanding distance learning, transactional distance theory (TDT) is relevant to understand ways to reduce the distance between learners and educators for maximum effectiveness of distance learning. Our study applies TDT to review distance learning from a supply perspective and as a tool to ensure the improved quality of distance learning. This paper has two key contributions: we have presented evidence synthesis and conducted a foresight exercise. Following preferred reporting items for systematic reviews and meta-analyses guidelines, 275 documents published between 1994 and 2022 were identified for review. Our analysis revealed patterns, relationships, and trends in the application of TDT in various distance learning contexts. Most TDT research is conducted in social sciences (83.7%), with computer science accounting for 42.6% of the studies. The course materials’ structure and design have also received considerable attention, with around 40.0% of the research focused on this area. For distance learning, studies revolve around factors such as student engagement, satisfaction, and TDT, which examine the distance between learners and instructors in various learning environments. Through systematic review and meta-analysis, we identify the three thematic areas in TDT research on distance learning. We have chartered themes on the effect of alternate design distance learning platforms on learner success, pushing the development boundaries in distance learning success through TDT, and the practical processes for designing successful distance learning courses via TDT-based pedagogical frameworks. In doing so, we streamline research in TDT and distance learning thematically and provide insight into further work. In addition, this study analyzed the relationships between sustainable development goal (SDG) and TDT literature. The co-citation analysis suggested that the strongest links were observed between education and innovation (SDG 4 and SDG 9), followed by education and gender equality (SDG 4 and SDG 5).

Anticipating return migration to Ukraine: participatory foresight with Ukrainians displaced to Spain

Abstract In the context of the ongoing Russian invasion and the uncertainties surrounding the potential return migration of millions of displaced Ukrainians, this study explores the future of (return) migration through an innovative and inclusive participatory foresight approach, engaging 20 displaced Ukrainians residing in Valencia, Spain, from May to December 2023. The foresight process included workshops, discussions via online messaging groups, interviews, participatory observations, and culminated in an open art exhibition. Through this process, we conducted a collective horizon scanning, identifying weak signals and emerging trends, followed by an examination of critical uncertainties, which led to the development of four distinct scenarios: Exhaustion Return, Energetic Return, Virtual Return, and Disconnection. The insights derived from this foresight exercise hold practical relevance for both Ukrainian and EU migration policymakers, emphasizing the importance of lived experiences in shaping anticipatory migration policies. This study also offers theoretical contributions by applying participatory foresight to the field of return migration, challenging established knowledge paradigms, and fostering a more inclusive and nuanced understanding of migration dynamics and their broader implications.

Actions to strengthen the contribution of small farms and small food businesses to food security in Europe

This study stems from a participatory foresight exercise conducted in nine Mediterranean, Baltic, Nordic and Eastern European regions, aiming to strengthen the role of small farms and small food businesses in ensuring food security. A wide range of stakeholders participated by attending workshops. They represented farmers’ organisations, food businesses, consumers’ organisations, NGOs, researchers, extension services, professional groups, and administration and public bodies. The actions proposed by participants are scanned and categorised around six broad objectives, stakeholders’ priorities and their underlying beliefs and preconceptions are discussed around the current debates of the literature, and the drivers that influence the feasibility of the proposed actions are discussed. Furthermore, the alignment of stakeholders’ -driven objectives with the European Strategies on food, agriculture, and rural areas is examined, with a focus on: (i) the EU Farm to Fork Strategy, (ii) the Rural Action Plan contained in the Long-Term Vision of Rural Areas developed by the EU Commission, and (iii) the Common Agricultural Policy in force since January 2023.

Exploring the benefits of applying indigenous knowledge (IK) into foresight process

PurposeIndigenous knowledge is an essential element for unveiling the evolutionary journey of socio-culture phenomena. One of the key challenges in foresight exercises is to incorporate social-culture issues such as culture, lifestyle and behavior (referred as indigenous knowledge) into the study. However, the statistical trends of those factors tend to be either not available or limited unlike the population or economic related factors. The purpose of this study is to present the use of valuable data from indigenous knowledge to enhance the foresight exercise through the better understanding of social dynamics and changes.Design/methodology/approachThe fragmented form of indigenous knowledge is analyzed and converted into a structured data format and then interpreted to unveil the evolutionary journey of socio-cultural phenomena. This study applies a scenario development method to visualize the results of foresight by comparing before and after the integration of indigenous knowledge. Finally, an assessment was conducted to reflect the value enhancement resulting from the integration of indigenous knowledge into the foresight process.FindingsWith the proposed approach, the foresight study on the future development of Thai food was demonstrated. The findings of this study show that the use of indigenous knowledge on eating behavior, cooking style and food flavor helps improve the alternative scenarios for the future development of Thai foods.Practical implicationsIndigenous knowledge can be applied to develop plausible scenarios and future images in foresight exercises. However, by nature, indigenous knowledge is not well-structured and, therefore, needs to be analyzed and turned into structured data so that it can be interpreted before integrating into the foresight process.Originality/valueThis study is one of few studies addressing the opportunities for integrating indigenous knowledge into foresight process. Indigenous knowledge can unveil the evolution of socio-cultural changes to improve the results of foresight study, especially the cases where statistical data and trends may not be sufficient to foresee future development.

4.F. Workshop: Supporting present policy making to address future challenges: foresight and public health policies

Abstract The COVID-19 pandemic and its impact on health showed that we were not prepared for uncertain health events and its uncertain consequences and impact in society. To be prepared for the uncertainty of the future, foresight provides a systematic, participatory, and vision-building process that explores the future to anticipate trends and support present-day actions. Foresight explores possible futures and their impact on society and population health. Foresight can enable better informed present-day decision-making and thereby better short-term and long-term preparedness in European Union (EU) Member States (MS) and the European region for possible future health crises. With foresight, experts and policy makers can explore long-term decisions that need to be made in the present to be prepared for the future. Using foresight to formulate long-term decisions can allow setting priorities, planning budgets and spending to address health threats and challenges, and learning how to cope with challenges while keeping resilient and sustainable health systems. In this workshop, we will focus on how foresight can be integrated into the policy cycle to support policy makers to be prepared for the future. It will provide an outlook on how a foresight exercise can provide insights into future challenges to provide recommendations and explore policy implications. The workshop will start with an interactive Mentimeter session to get a better view on how the audience is familiar with foresight in the policy cycle. Then, a brief presentation is given as introduction to foresight and its role in policy making. This is followed by a presentation of a Foresight study that provides recommendations for policy makers to address present and future challenges related to mental health. The second foresight study provides an example on how digitalization in primary healthcare can address present and future challenges. The last presentation gives an overview on the role that foresight can play in the policy cycle at different stages of the foresight exercise when discussing the use of personalized medicine in cancer prevention. The workshop will be concluded by a discussion with the four presenters on the lessons learned regarding foresight and policy making. Key messages • Foresight provides a systematic and participatory process to support policy making towards sustainable and resilient health systems. • Foresight can enable better informed present-day decision-making towards better short- and long-term preparedness in the European region and its Member States for possible future health challenges.

Foresight in public health: application and challenges

Abstract Background Foresight studies in the field of public health are limited. However, in the context of increasing uncertainty and complexity, such as with the COVID-19 pandemic, there is growing need to anticipate future trends and to plan for them. Foresight provides the tools to explore possible futures and develop policy strategies. Despite its value, foresight is an underused methodology. Hence, the aim of this study is to illustrate how foresight can be applied in public health, and how to deal with the associated challenges. Methods We describe the six-steps that are part of foresight methodology. In step 1 we discuss how to formulate study objectives. We illustrate in step 2, the application of the conceptual model and the DESTEP tool to identify and rank driving forces. We then discuss time horizon and spatial distribution, in step 3. In step 4, we discuss scenario logics. Finally in steps 5 and 6, we discuss the types of scenarios and tools for analyses. Possible challenges encountered when applying foresight methodology are drawn from the experiences and lessons learnt from the PHIRI project. Results Challenges during application of the foresight six-steps approach included difficulties in formulating research objectives, developing a conceptual model, identifying most important future trends, developing systematic, consistent and plausible scenarios with clear messages for policy makers. Understanding the concept of uncertainty was especially difficult, both in formulating scenarios and policy messages. Conclusions Understanding of foresight concepts and their relation to each other is difficult. Support from foresight experts, conducting foresight exercises and publication of tutorial papers on foresight can enhance understanding. Key messages • Foresight methodology is a valuable tool to explore possible futures with a diverse group of stakeholders. • Foresight promotes the development of policies that are appropriate and robust in their implementation in changing times.

A pandemic's impact on Mental Health

Abstract Background A small topic-specific foresight exercise that shows how monitoring the current and country-specific state of people's mental health has been done in Austria. Since the consequences of the Covid-19 pandemic cannot be precisely quantified with just one or two indicators, a different approach is needed. Methods A comprehensive overview of different mental health indicators is a good approach to identify general trends in the psychosocial health of the population. In the absence of survey data, it was decided to focus on available routine data. A specific country context can be understood through comparisons between countries, as was done in use case D of the PHIRI project. Results Even though the pandemic (or other crises) affected practically everyone's life, some population groups are showing significant psychological suffering, e.g., young people (especially girls and young women), people with pre-existing mental health conditions, and elderly. Conclusions Hence, interventions need to be taken at various levels of a society-wide approach. This means that despite specialized psychosocial support, interventions on “lower levels” dealing with matters of social security, community support etc. are necessary. The Austrian example was used to describe insights to future developments that are applicable to the impact of the COVID-19 pandemic to mental health of the population in several European countries.

Assistive technology for people with visual disability: Future prospects through a technology foresight exercise

BACKGROUND: In recent years, with ever-improving technology, considerable progress has been made in the approaches available to develop mobility assistive technology systems. OBJECTIVE: This paper aims to anticipate the future of assistive technologies of navigation and mobility for people with severe visual disabilities in the next twenty years (2021–2041). METHODS: We conducted a technology foresight exercise by identifying promising technologies and invited over 20,000 researchers worldwide to share their views on the future of assistive technologies for people with visual impairment. The technologies and respondents were identified from specialized journals indexed on Web of Science. RESULTS: Most respondents believe computer vision will be the most important assistive technology group for mobility and navigation for visually impaired people, especially with haptic feedback. They also believe that voice and vibrotactile are the most relevant feedback and that glasses and smartphones will be the most important tools for visual impairment support. CONCLUSIONS: While costs and lack of user training may hamper the development and use of these new technologies, they represent the future of assistive technology for people with visual impairments.

Strategic routes for wastewater treatment plant upgrades to reduce micropollutants in European surface water bodies

The European Union is determined to address the problem of contaminants of emerging concern (CEC) occurrence in natural water bodies. However, if a broad range of possible advanced treatment technological solutions exists as well as a variety of possible future conditions, then emission and consequently strategies for wastewater treatment plan (WWTP) upgrade and operation are not easy to anticipate. Here, a strategic foresight exercise was carried out to support decision-making matching anticipated future conditions toward the goal of finding suitable treatment upgrades to control CECs release in the environment. As a result, a roadmap and strategic routes were developed based on the interpretation of drivers for the EU region in the context of Shared Socioeconomic Pathways (SSPs) global change narratives. Screening and ranking of WWTP tertiary and advanced treatment technology upgrades were performed. Analysis of the resulting envisioned strategic routes allowed identifying and confronting core challenges such as the CEC removal agenda, technologies’ performance, requirements for CEC removal and water scarcity. The results also underline opportunities to shape WWTP technological upgrade planning such as: enhancing circular economy solutions in WWTP, water reclamation, and accelerated increase of the technology readiness level of hybrid and nature-based solutions.

The Results of a Foresight Exercise: Future Threats and Trends in Crisis Management

Introduction:The challenges that the health systems face in the last years increased exponentially. No matter if we are talking about the impact of the COVID-19 pandemic or the Russian military action in Ukraine, the European health ecosystem is facing new problems. In the light of these uncertainties, we assessed which could be the next trends that can impact the healthcare systems, in order to better prepare and adapt to the new contexts.Method:Using two foresights exercises (FSE), one in 2018 and the second one in 2022, we identified the most important trends in the political, economic, social, technological, security, environmental and medical sectors that could have an impact on health.Results:53 people participated in the first FSE and 40 in the second one. The respondents identified cyber security, an increased reliance on digital technologies for communications, CBRNE management of the patients, centrally coordinated attacks, demographic aging, reduced economic resources, violence against emergency medical staff and the increased need and demand for psychosocial support as the most important trends. Moreover, they considered that wars, hybrid threats, the fake news, pandemics and the influence of artificial intelligence could impact the healthcare systems.Conclusion:Many of the trends identified in 2018 as having a possible impact on the health system proved to be relevant four years later. Therefore, we consider the FSE a relevant tool in foreseeing the main areas that could have an impact on health and its results could guide the preparedness for the future.

Strengthening Global Systems to Prevent and Respond to High-Consequence Biological Threats

Introduction:The world is facing the devastating impact a biological event can have on human health, economies, and political stability. COVID-19 has revealed that national governments and the international community are woefully unprepared to respond to pandemics—underscoring our shared vulnerability to future catastrophic biological threats that could meet or exceed the severe consequences of the current pandemic. This study examines potential threats related to deliberate Russian military use and misuse of the tools of modern biology or an accident caused by a CBRN event evolving rapidly in the highly volatile political environment in and around Ukraine and other conflicts.Method:A participatory foresight, co-creative, future and transformation-oriented methodology was used to structure a transformative model for a disciplined exploration of scenarios to confront complex challenges and facilitate improved outcomes. Foresight helps to evaluate current policy priorities and potential new policy directions; see how the impact of possible policy decisions may combine with other developments; inform, support and link policy-making in and across a range of sectors; identify future directions, emerging technologies, new societal demands and challenges; and anticipate future developments, disruptive events, risks and opportunities.Results:The study found that the “mitigation scenarios” are based on the “Confront, Regulate, Overcome” metamodel combined with the “Security, Rescue, Care” response modalities. These require the cooperation/coordination of law enforcement forces along with military forces, fire departments and civil security resources, hospital and first-line responder teams, in order to appropriately address populations, assets and territories issues elicited by the identified threat, which drives key decision makers’ tasks at the strategic level.Conclusion:The participatory foresight exercise demonstrated gaps in national and international biosecurity and pandemic preparedness architectures highlighted by the challenges of the Ukraine war—exploring opportunities for better cooperation to improve prevention and response capabilities for high-consequence biological events, and generate actionable recommendations for the international community.

Sir David Allan (Dai) Rees. 28 April 1936—10 June 2021

Dai Rees was a carbohydrate chemist, who made major contributions to our understanding of the structure and function of naturally occurring polysaccharides. During his time at the University of Edinburgh he was the first to identify the self-association of polysaccharides from red algae such as agarose and the carrageenans into ordered double helical structures. This understanding of polysaccharide structure and functionality achieved in Edinburgh was of interest to carbohydrate chemists and the industries where these materials are widely used, such as foods and pharmaceuticals. Throughout the 1970s, Dai worked in the Unilever Colworth House laboratory as principal scientist. He continued his studies of polysaccharide structure and function, but also led fundamental research in emerging sciences of corporate interest to Unilever's long-term business future. Dai believed that high quality science was the source of uniqueness in innovation and technology. He identified that problems in research require a multidisciplinary approach, and at Colworth House he organized smaller projects into research themes, allowing faster development of both understanding and application. This philosophy was practised throughout his management career. He became director of the National Institute for Medical Research in 1982, and from 1987 to 1996 was the chief executive of the Medical Research Council. At the same time, he was a senior advisor to the UK National Technology Foresight exercise and president of the European Science Foundation. After retirement, he was instrumental in establishing the Centre for Novel Agricultural Products at the University of York, funded by the Garfield Weston Foundation.

Exploring future research and innovation directions for a sustainable blue economy

The blue economy integrates commercial, research and innovation activities across diverse industrial sectors. Achieving a sustainable blue economy requires unlocking the potential of science and innovation to develop innovative ocean sustainability solutions. This study explores the role of foresight in co-creating alternative, preferred futures for a sustainable blue economy looking towards 2030 and in establishing an interdisciplinary dialogue about research and innovation opportunities to achieve these futures. To this end, a foresight exercise is conducted with marine scientists and researchers in 6 countries in Europe. The exercise is designed in three stages: scanning, scenario-building and strategic orientation, and uses a combination of foresight methods to encourage creative thinking and exploration. The scenarios developed in the study describe alternative future worlds built on the establishment of self-sustaining communities and engaged societies; the diffusion of digitalisation and growth of blue biotechnologies; booming ecosystem services and open and collaborative research infrastructures that impact different sectors of the blue economy. A portfolio of research and innovation areas is developed that aims to inspire new research directions in four domains: (i) integrated ocean management tools; (ii) closed loop, circular polyculture systems; (iii) co-creation of innovation and transdisciplinary research; and (iv) open access and collaborative databases supporting ecosystem services. The study highlights the role of foresight in bridging across disciplinary perspectives and industry sectors. Foresight can be used to complement Decision-Support Systems and other quantitative approaches for research agenda-setting and for decision-making on policies addressing sustainability in the marine sciences. The process contributes to futures skills-building at institutional level and helps establish a futures mindset for strategic planning.

The results of a Foresight exercise: Outcome from a NO-FEAR internal evaluation

The results of a Foresight exercise: Outcome from a NO-FEAR internal evaluation

Towards purposeful business schools: Deepening and broadening external engagement

Building on recent suggestions that business schools’ instrumental (outcomes-focussed) strategies should be replaced by the pursuit of their purpose to enhance the public good, this paper answers the special edition’s call to consider business school futures by presenting a foresight exercise that first conceives, and then illustrates, ways that purpose-driven business schools can extend (deepen and broaden) their external engagement activity. From our review of previous research, we present a new typology of business school engagement approaches that has two dimensions: (a) strategic focus (instrumental-purposeful), and (b) engagement management (organic-co-ordinated). From our scan of the business school environment in the United Kingdom (UK) and France, we illustrate, with empirical examples, the two purposeful engagement approaches in our typology (organic and co-ordinated). These findings indicate a variety of ways that business schools of the future can better enhance the public good through extended engagement.