Research Framework Research Articles

Narrative therapy focusing on bodily sensations: a case of enhancing treatment proactivity of adolescent anorexia nervosa

ABSTRACT Lack of treatment proactivity significantly affects the treatment outcomes for adolescent anorexia nervosa in China. This research illustrates a case where narrative therapy, focusing on bodily sensations, was employed for a Chinese adolescent with anorexia nervosa characterised by low treatment proactivity. The study analyses the case using a merged methodological frameworks of case study and narrative inquiry. This research delineates the client’s transformation through three primary themes: Detachment from Sensations of Dirtiness, Positive Development of Self-identity, and Enhancing Treatment Proactivity (two subthemes: Interpretation and Reversal of the ‘Dirtiness’ Bodily Sensations and Reconstruction of the Social Network). Finally, it analyses the relationships among various themes and constructs a process diagram to illustrate the entire transformation journey of the client. This study suggests that enhancing treatment proactivity could be linked to changes in understanding of bodily sensations and in self-narratives.

Service Oikos as a complex self-perpetuating system: a bibliometric study of service ecosystems

PurposeThis study aims to address the following research questions: (1) What are the theoretical frameworks and areas of study that influence the development of service ecosystems? and (2) To what extent does a service ecosystem align with the theoretical concepts presented in other research contexts within the study areas, thereby transforming the fundamental structure of the core concept?Design/methodology/approachWe conducted a bibliometric systematic literature review, analyzing 280 papers from a sample of 52 journals listed in the Association of Business Schools (ABS). The review covered the period between 2004 and 2022, and we utilized co-citation analysis, multi-dimensional scaling analysis and hierarchical cluster analysis (HCA) on a total of 2,614 citations.FindingsThis study employs co-citation analysis to identify the conceptual structure of the service ecosystem based on highly cited papers. Additionally, we utilize multidimensional scaling (MDS) to uncover key approaches driving service ecosystem research. Through HCA and network analysis, we examine the research scope and its development, emphasizing theory-driven approaches. By combining quantitative and qualitative analysis, we explore the interrelationships between scope, domain and evolution. This comprehensive analysis allows us to delve deeply into the study of service ecosystems. To broaden the research scope, we propose a conceptual framework for comparing the main components of a service ecosystem. The current paper clarifies the service ecosystem's intellectual structure, including service performance, humanistic approach, sustainable innovations and service reflexivity and reformation and proposes a prospective research framework for specialists and researchers by introducing a metaverse service ecosystem.Originality/valueFor the first time, the findings of this study shed light on processes that facilitate the flow of technologies, business models and markets through social structures, ultimately contributing to social change. In service-based systems, the development and application of a more humanistic approach within and surrounding social service ecosystems are crucial as they evolve. Therefore, adopting a dynamic and multifaceted approach offers valuable insights into the drivers of value creation.

Barriers and facilitators to evidence-based perioperative hypothermia management for orthopaedic patients: Asystematic review.

To assess barriers and facilitators to the implementation of guidelines for the prevention of inadvertent perioperative hypothermia in orthopaedic patients. Systematic review. Nine databases: PubMed, Embase, CINAHL, Cochrane CENTRAL, PsycINFO, ProQuest Dissertations and Theses, Scopus, Web of Science and Trip Clinical Evidence Database. Primary studies published in English between January 2008 to July 2022 were screened. Study selection, quality assessment, and data extraction were completed independently by researchers. Data were extracted using the Consolidated Framework for Implementation Research and mapped to the Expert Recommendations for Implementing Change strategies. Eighty-seven studies were included in the review. The most frequently reported barriers and facilitators related to evidence strength, relative advantage, and cost of implementing perioperative hypothermia prevention guidelines. The top four ERIC strategies were: Identify and prepare champions; Conduct educational meetings; Assess for readiness and identify barriers and facilitators; and Inform local opinion leaders. This review provides synthesized evidence regarding barriers and facilitators to perioperative hypothermia guidelines for patients undergoing orthopaedic surgery. Our work provides theory guided strategies to promote implementation of perioperative hypothermia prevention to assist nurses caring for patients undergoing orthopaedic surgery. Findings provide professionals caring for patients undergoing orthopaedic surgery with theory-informed strategies to improve perioperative hypothermia prevention. Reducing perioperative hypothermia will improve outcomes for patients undergoing orthopaedic surgery. The review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. Due to the study design, no patient or public consultation took place.

Telemedicine in primary care of older adults: a qualitative study

BackgroundThe COVID-19 pandemic changed the healthcare system, leading to the rapid evolution and implementation of telemedicine (TM). TM has the potential to improve the quality of primary health care and increase accessibility for the population. However, its use may represent challenges for older people, as they may have distinct needs from the general population due to age-related changes in perceptual, motor, and cognitive capacities. We, thus, aimed to identify potential facilitators and barriers to TM use in primary care for older adults and develop recommendations accordingly.MethodsWe conducted a qualitative study to explore the challenges associated with TM use among older adults and healthcare professionals (HCPs) in primary care practice. Interviews were conducted with 29 older adults, and three focus groups involving HCPs from four McGill family medicine sites were organized. Employing a hybrid codebook thematic analysis, guided by the Consolidated Framework for Implementation Research (CFIR), we identified facilitators and barriers affecting the optimal use of TM by older adults and HCPs. We synthesized the results from semi-structured interviews and focus groups. These findings were then presented during a deliberative dialogue with eight participants, including family physicians, nurses, a social worker, and a government-level TM expert, to validate our results. The purpose was to gather feedback, identify and refine actionable recommendations. Subsequently, we utilized a thematic analysis using the same codebook to synthesize findings from the deliberative dialogue.ResultsParticipants agreed that TM contributed to maintaining the continuity of care and was particularly convenient when there was an existing or established patient-physician relationship or for addressing minor health issues. TM was found to be beneficial for people with limited mobility, reducing their exposure to potentially high-risk environments. However, participants expressed concerns about the lack of visual contact, causing essential details to be overlooked. Additionally, issues related to miscommunication due to language or hearing barriers were identified. HCPs perceived that most older adults did not consider phone consultations a medical act. Participants were open to a hybrid approach, combining in-person consultations and TM, based on their specific health conditions. Building upon these results, we formulated seven key recommendations.ConclusionsBoth older adults and HCPs consider TM a good alternative for accessing healthcare services. To improve the effective use of TM, it’s crucial to advocate for a hybrid approach that integrates both in-person and virtual methods. This approach should actively encourage and support individuals in becoming familiar with technological tools.

Understanding the multilevel factors influencing the implementation of digital health interventions for supportive care in Adolescents and Young Adult (AYA) cancer survivorship: determinants of adopting mindfulness-based mobile applications

BackgroundAdolescents and Young Adult (AYA) cancer survivors are at risk for psychological distress due to their unique developmental and medical needs. Healthcare providers can leverage the convenience and appeal of technology to provide supportive care for this vulnerable population. Using evidence-based mindfulness-based mobile interventions as a case example, the goal of this study was to identify key patient-, provider-, and organization-level barriers and facilitators to supportive care and implementing digital health interventions in AYA survivorship care.MethodsTwenty semi-structured interviews were conducted with stakeholders including AYA survivors (n = 10; between 18–29 years old) and clinical providers and administrators (n = 10). Interviews were transcribed and deductively mapped using the Consolidated Framework for Implementation Research (CFIR) and Theoretical Domains Framework (TDF) complementary frameworks.ResultsResults indicated that factors like cost and patients’ needs and resources were prevalent among both survivors and providers. There were key differences between providers and AYA survivors. Providers’ adoption and promotion of digital health interventions were influenced most strongly by contextual factors, including available resources (Inner Setting), culture (Outer Setting), and networks and communications (Outer Setting). On the other hand, survivors emphasized individual and intervention-related factors; they reported that social influence and knowledge influenced their adoption and use of digital health interventions, including meditation apps.ConclusionsThese results identified barriers and facilitators to the adoption of supportive care digital health interventions from multiple stakeholders. Results can be used to guide the development of implementation strategies to improve the uptake of digital health interventions in survivorship care, ultimately improving the psychosocial well-being of AYA cancer survivors.

Unraveling the post-adoptive hybrid learning experience: perspectives from information systems

Purpose Hybrid learning has become a reality due to the onslaught of the COVID-19 pandemic. Students world over had to switch to this new learning format. This study aims to analyze the impact of innovation attributes of the Unified Theory of Acceptance and User Technology (UTAUT2) model and community of inquiry (COI) framework on the hybrid learning experience and the continued intention for it. Design/methodology/approach Using a cross-sectional research design, the study has adapted a scale from past studies and collected data using purposive sampling from the student community. The research has used the structural equation modeling technique using SMART-PLS to study the hypothesized relationships. Findings The study’s findings are that performance expectancy, effort expectancy, facilitating conditions, hedonic motivation, teaching presence, cognitive presence and social presence influence hybrid learning experience and continued intention. Further hybrid learning experience mediates the continued intention. Practical implications This study has several academic and practical implications for improving the hybrid learning experience. Various stakeholders can get insights on improving the user’s desire to pursue learning in a hybrid environment. Originality/value Hybrid learner experience is an upcoming area of research and yet unexplored in India as well as in other countries. A new hybrid experience model was developed by extending the UTAUT2 to include the COI framework and learner experience frameworks.

Design of Co-Cured Multi-Component Thermosets with Enhanced Heat Resistance, Toughness, and Processability via a Machine Learning Approach.

Designing heat-resistant thermosets with excellent comprehensive performance has been a long-standing challenge. Co-curing of various high-performance thermosets is an effective strategy, however, the traditional trial-and-error experiments have long research cycles for discovering new materials. Herein, a two-step machine learning (ML) assisted approach is proposed to design heat-resistant co-cured resins composed of polyimide (PI) and silicon-containing arylacetylene (PSA), that is, poly(silicon-alkyne imide) (PSI). First, two ML prediction models are established to evaluate the processability of PIs and their compatibility with PSA. Then, another two ML models are developed to predict the thermal decomposition temperature and flexural strength of the co-cured PSI resins. The optimal molecular structures and compositions of PSI resins are high-throughput screened. The screened PSI resins are experimentally verified to exhibit enhanced heat resistance, toughness, and processability. The research framework established in this work can be generalized to the rational design of other advanced multi-component polymeric materials.

Exploring barriers and enabling factors for surgical task sharing with physician assistants in Liberia: a qualitative pre-implementation study.

This study explores potential barriers and enabling factors that may influence the acceptance of implementation of a surgical task-sharing initiative targeting physician assistants (PAs) in Liberia. A qualitative, pre-implementation study using semistructured interviews. Data was analysed in NVivo V.12 using deductive coding and the consolidated framework for implementation research as a guide. Liberia has few surgical providers and a poor surgical infrastructure resulting in a very low surgical volume. The research was conducted in the context of an already running surgical task-sharing programme for midwives. In 2019, a total of 30 key stakeholders in the field of surgery and the PAs training programme were interviewed. The majority of the stakeholders supported the idea of training PAs in surgery. The high unemployment rate among PAs and the need for career advancement of this cadre were important enabling factors. Resistance against surgical task sharing for mid-level clinicians is multifaceted. The Ministry of Health (MOH) did not share a common vision. Opponents within the MOH believed budgetary constraints within the MOH and the lack of surgical infrastructure is a more pressing problem compared with the surgically trained human resources. Another important group of opponents are medical officers (MOs) and their professional bodies. Many of their negative beliefs around surgical task sharing reflect lessons to be drawn from the current surgical training programme for midwives. Prior to deciding on implementation of a surgical training programme for PAs, wider support is needed. If surgical task sharing with PAs is to be considered, the intervention should focus on adapting the 'adaptable' periphery of the intervention to broaden the support of the MOH, MOs and their professional bodies. Failing to obtain such support should make the implementors consider alternative strategies to strengthen surgical human resources in rural Liberia.

CREdb: A comprehensive database of Cis-Regulatory Elements and their activity in human cells and tissues

BackgroundCis-regulatory elements (CREs) play a pivotal role in gene expression regulation, allowing cells to serve diverse functions and respond to external stimuli. Understanding CREs is essential for personalized medicine and disease research, as an increasing number of genetic variants associated with phenotypes and diseases overlap with CREs. However, existing databases often focus on subsets of regulatory elements and present each identified instance of element individually, confounding the effort to obtain a comprehensive view. To address this gap, we have created CREdb, a comprehensive database with over 10 million human regulatory elements across 1,058 cell types and 315 tissues harmonized from different data sources. We curated and aligned the cell types and tissues to standard ontologies for efficient data query.ResultsData from 11 sources were curated and mapped to standard ontological terms. 11,223,434 combined elements are present in the final database, and these were merged into 5,666,240 consensus elements representing the combined ranges of the individual elements informed by their overlap. Each consensus element contains curated metadata including the number of elements supporting it and a hash linking to the source databases. The inferred activity of each consensus element in various cell-type and tissue context is also provided. Examples presented here show the potential utility of CREdb in annotating non-coding genetic variants and informing chromatin accessibility profiling analysis.ConclusionsWe developed CREdb, a comprehensive database of CREs, to simplify the analysis of CREs by providing a unified framework for researchers. CREdb compiles consensus ranges for each element by integrating the information from all instances identified across various source databases. This unified database facilitates the functional annotation of non-coding genetic variants and complements chromatin accessibility profiling analysis. CREdb will serve as an important resource in expanding our knowledge of the epigenome and its role in human diseases.

Core competencies for digital leadership development: a perspective from the lens of paradox theory

Purpose In an era marked by artificial intelligence (AI), virtual reality (VR) and augmented reality (AR), this study presents a research paradigm centered on nurturing fundamental skills crucial for effective digital leadership in a paradoxical age where leaders are ambitious as well as skeptical for the adoption of such technologies. This study offers a strategic framework to seamlessly integrate diverse technologies into leadership development; the objective is to bridge the divide between theoretical understanding and practical implementation, especially through the lens of paradox theory. Design/methodology/approach This conceptual study delineates essential attributes that digital leaders must cultivate, drawing insights from the corpus of literature encompassing leadership, technology and organizational advancement. Synthesizing theoretical perspectives, the study proposes a comprehensive research framework that provides a systematic approach to harnessing the potential of AI, VR and AR to enhance leadership competencies. This conceptual study significantly contributes to paradox theory through method of “theory adaptation” as elaborated in the literature. Findings The study unveils a spectrum of foundational proficiencies, including technological acumen, adaptability, strategic acumen, effective communication, collaborative aptitude and ethical acumen, among others. These competencies underscore the multifaceted skill set required of digital leaders. To adeptly traverse the intricate digital terrain, foster innovation and align technological advancements with organizational objectives, these proficiencies are imperative for digital leaders to possess. Originality/value The distinctiveness of this study lies in its all-encompassing approach to digital leadership development by offering a paradoxical perspective and hence making a contribution to the body of knowledge for paradox theory. By amalgamating AI, VR and AR into a cohesive framework, the study enhances the comprehension of how these technologies collaboratively nurture leaders capable of cultivating organizational triumph in the digital age. This proposed paradigm serves as a bridge between cutting-edge digital technology usage and leadership proficiency paradox, furnishing pragmatic insights to benefit both academic researchers and industry practitioners.

Perception and adaptation of receptive prosody in autistic adolescents

A fundamental aspect of language processing is inferring others’ minds from subtle variations in speech. The same word or sentence can often convey different meanings depending on its tempo, timing, and intonation–features often referred to as prosody. Although autistic children and adults are known to experience difficulty in making such inferences, the science remains unclear as to why. We hypothesize that detail-oriented perception in autism may interfere with the inference process if it lacks the adaptivity required to cope with the variability ubiquitous in human speech. Using a novel prosodic continuum that shifts the sentence meaning gradiently from a statement (e.g., “It’s raining”) to a question (e.g., “It’s raining?”), we have investigated the perception and adaptation of receptive prosody in autistic adolescents and two groups of non-autistic controls. Autistic adolescents showed attenuated adaptivity in categorizing prosody, whereas they were equivalent to controls in terms of discrimination accuracy. Combined with recent findings in segmental (e.g., phoneme) recognition, the current results provide the basis for an emerging research framework for attenuated flexibility and reduced influence of contextual feedback as a possible source of deficits that hinder linguistic and social communication in autism.

Exploring the supply chain ambidexterity: a multilevel micro-foundational perspective

Purpose This study aims to introduce a multilevel micro-foundational perspective on supply chain (SC) ambidexterity, grounded in organizational learning and adaptation research. It investigates the interplay of contextual factors, strategic orientation and a bundle of supply chain management practices to foster ambidextrous performance. Design/methodology/approach Leveraging a blend of perceptual and objective data and measures, this study explores the intricacies of macro and micro factors at multiple levels, offering empirical support for the research framework. The interrelationships among these factors are scrutinized through three analytical approaches: selection, interaction and system forms of interdependence analysis. Findings First, the authors offer empirical support for their conceptual model, illustrating that ambidexterity behavior and outcomes in the SC emanate from intricate interactions between macro and micro factors across various levels. Second, the authors present robust empirical evidence endorsing a system/gestalt form of interdependence analysis in capturing SC ambidexterity and performance. This analytical approach effectively captures the complementarity and contradictory interdependence among the opposing poles of efficiency and responsiveness. Originality/value The organizational and SC activity configuration faces numerous paradoxical tensions, such as profitability versus sustainability. This study offers valuable insights into establishing an ambidextrous system capable of navigating and addressing these paradoxical situations.

Women's Economic Transformation: A Literature Review on Empowerment through Entrepreneurship and Financial Inclusion in Pekalongan, Indonesia

This systematic literature review (SLR) explores factors influencing women's empowerment through entrepreneurship and financial inclusion in Pekalongan. Key elements supporting or hindering women entrepreneurs include access to capital, entrepreneurship education, training, and robust support networks. Financial inclusion, encompassing banking services, microcredit, and financial education, is crucial for enhancing women's economic capacity and independence. The research employs a structured SLR methodology, using databases like Scopus to identify relevant studies from the past decade. The data collection involves keyword identification, literature search, screening, full-text review, and data extraction, followed by thematic analysis and coding. The findings reveal that well-designed government and NGO programs significantly impact women's economic and social well-being, with success dependent on local context and sustained support. Policy recommendations for Pekalongan include increasing access to financial services through microcredit and entrepreneurship training, expanding financial education programs, strengthening support networks via women's business groups and mentoring, and addressing socio-cultural barriers. Tailored policies and programs that consider the local context are essential for effective implementation. This study's comprehensive approach, combining women's entrepreneurship and financial inclusion within Pekalongan's context, provides practical recommendations for policymakers and enriches existing literature, offering a framework for future research and policy development in similar socio-economic settings.

Implementation Determinants of Problem-Solving Therapy Delivered by Near-Peer Lay Counselors for Youth Living with HIV in Botswana: Lay Counsellor Perspectives

AbstractAn evidence-based psychological intervention, known as Friendship Bench, for depression and anxiety was adapted among adolescents living with HIV (ALHIV) in Gaborone, Botswana, and renamed Safe Haven. The purpose of this study was to qualitatively describe the barriers and facilitators that influence the implementation of Safe Haven from the perspective of peer counselors delivering the intervention in Gaborone, Botswana. We conducted a secondary analysis using qualitative data from a pilot study to evaluate Safe Haven. Eight peer counselors participated in semi-structured interviews to describe their experiences with implementing Safe Haven during the pilot. We analyzed the interview data thematically using the Consolidated Framework for Implementation Research to guide theme development. We identified six barriers and two facilitators of Safe Haven implementation. The barriers were 1) client reticence and confidentiality concerns, 2) parent disapproval, 3) client accessibility, 4) counselor psychological wellbeing, 5) scheduling conflicts 6) limited financial resources for counselors. The facilitators were 1) peer delivery of counseling was deemed more acceptable among adolescents than counseling delivered by older adults, and 2) the counselors placed high value on the intervention. We found that parental disapproval and shared trauma among counselors and clients are key barriers that may negatively impact implementation outcomes such as sustainability and penetration. To improve accessibility of the intervention, peer counselors recommended implementation in school settings and to educate parents on mental health. Overall, the barriers and facilitators identified in our study can guide larger scale implementation of Safe Haven among ALHIV in resource-poor settings.

Moving from idea to reality: The barriers and enablers to implementing Child and Family Hubs policy into practice in NSW, Australia

BackgroundAdverse childhood experiences can impact physical and mental health throughout the lifespan. To support families experiencing adversity and improve child health and developmental equity, an integrated, multi-sector response is required. Child and Family Hubs (Hubs) are a feasible and acceptable approach to providing such a response. In the Australian context, a number of federal and New South Wales (NSW) state policies support an integrated, multi-sector response using Hubs to support families experiencing adversity. This study examined NSW policy stakeholder and health service manager perspectives on the barriers and enablers to translating policy into practice in the implementation of Child and Family Hubs.MethodsSemi-structured interviews were conducted with 11 NSW government policy stakeholders and 13 community health service managers working in child and family policy and planning or child and family community-based services. Interviews were of 30–60 min duration and explored stakeholder knowledge, perspectives and experiences around childhood adversity, and barriers and enablers to operationalizing policies supporting Hubs. Analysis of barriers and facilitators to implementation of Hub models of care was undertaken using the Consolidated Framework for Implementation Research (CFIR).ResultsKey barriers that emerged included short-term and inconsistent funding, lack of resourcing for a Hub co-ordinator, limited support for evaluation and insufficient time to plan for Hub implementation. Key enablers included flexibility and adaptability of Hub models to meet local needs, formal change management processes, strong governance structures and engagement among Hub practitioners. Key insights included the importance of targeted strategies to support sustained individual practice change and the need for organization-wide commitment to enable the successful adoption and maintenance of the Hub model of care.ConclusionsThis study provides valuable insights and contributes evidence around what is needed to strengthen and support the operationalization and scalability of the Hub model of care. Key recommendations for Hub practitioners include the importance of formal change management processes and establishment of strong governance structures, while key recommendations for policymakers include the need for sustainable Hub funding and a standardized, evidence-based framework to support Hub implementation and evaluation.

Transforming E-Commerce Logistics: Sustainable Practices through Autonomous Maritime and Last-Mile Transportation Solutions

The logistics landscape in e-commerce is undergoing a profound transformation toward sustainability and autonomy. This paper explores the implementation of autonomous maritime and last-mile transportation solutions to optimize the entire logistics chain from factory to customer. Building on the lessons learned from the maritime industry’s digital transformation, the study identifies key features and proposes a forward-looking autonomous maritime and last-mile transportation system. Emphasizing the role of geospatial technologies, the proposed system employs GIS-based electronic route optimization for efficient goods delivery, integrating onboard and ashore GIS-based sensors for enhanced location precision. A case study was built to analyze the implementation of autonomous means of transport along the route of a product from factory to customer. The integration of autonomous systems shows substantial improvements in logistics performance. Synchromodal logistics and smart steaming techniques can be utilized to optimize transportation routes, resulting in reduced fuel consumption and emissions. The findings reveal that autonomous maritime and last-mile transport systems can significantly enhance the efficiency, flexibility and sustainability of e-commerce logistics. The study emphasizes the need for advanced technological integration and provides a comprehensive framework for future research and practical applications in the logistics industry.

Barriers and facilitators of improved nutritional support for patients newly diagnosed with cancer: a pre-implementation study

BackgroundDisease-related malnutrition affects a significant number of patients with cancer and poses a major social problem worldwide. Despite both global and national guidelines to prevent and treat malnutrition, the prevalence is high, ranging from 20 to 70% in all patients with cancer. This study aimed to explore the current practice of nutritional support for patients with cancer at a large university hospital in Norway and to explore potential barriers and facilitators of the intervention in the Green Approach to Improved Nutritional support for patients with cancer (GAIN), prior to implementation in a clinical setting.MethodsThe study used individual interviews and a focus group discussion to collect data. Study participants included different healthcare professionals and patients with cancer treated at a nutrition outpatient clinic. The Consolidated Framework for Implementation Research (CFIR) was used to guide the thematic data analysis.ResultsBarriers connected to the current nutritional support were limited resources and undefined roles concerning responsibility for providing nutritional support among healthcare professionals. Facilitators included a desire for change regarding the current nutritional practice. The GAIN intervention was perceived as feasible for patients and healthcare professionals. Potential barriers included limited knowledge of technology, lack of motivation among patients, and a potential added burden experienced by the participating patients.ConclusionsThe identification of the potential barriers and facilitators of the current nutritional support to patients with cancer will be used to plan the implementation of improved nutritional support in a randomized controlled trial for patients with cancer prior to clinical implementation. The current findings may be of value to others trying to implement either or both nutritional support and digital application tools in a clinical healthcare setting.Trial registrationThe study was registered in the National Institutes of Health Clinical trials 08/09/22. The identification code is NCT05544318.

A protocol for the formative evaluation of the implementation of patient-reported outcome measures in child and adolescent mental health services as part of a learning health system

BackgroundMental health conditions affect one in seven young people and research suggests that current mental health services are not meeting the needs of most children and youth. Learning health systems are an approach to enhancing services through rapid, routinized cycles of continuous learning and improvement. Patient-reported outcome measures provide a key data source for learning health systems. They have also been shown to improve outcomes for patients when integrated into routine clinical care. However, implementing these measures into health systems is a challenging process. This paper describes a protocol for a formative evaluation of the implementation of patient-reported measures in a newly operational child and adolescent mental health centre in Calgary, Canada. The purpose is to optimize the collection and use of patient-reported outcome measures. Our specific objectives are to assess the implementation progress, identify barriers and facilitators to implementation, and explore patient, caregivers and clinician experiences of using these measures in routine clinical care.MethodsThis study is a mixed-methods, formative evaluation using the Consolidated Framework for Implementation Research. Participants include patients and caregivers who have used the centre’s services, as well as leadership, clinical and support staff at the centre. Focus groups and semi-structured interviews will be conducted to assess barriers and facilitators to the implementation and sustainability of the use of patient-reported outcome measures, as well as individuals’ experiences with using these measures within clinical care. The data generated by the patient-reported measures over the first five months of the centre’s operation will be analyzed to understand implementation progress, as well as validity of the chosen measures for the centres’ population.DiscussionThe findings of this evaluation will help to identify and address the factors that are affecting the successful implementation of patient-reported measures at the centre. They will inform the co-design of strategies to improve implementation with key stakeholders, which include patients, clinical staff, and leadership at the centre. To our knowledge, this is the first study of the implementation of patient-reported outcome measures in child and adolescent mental health services and our findings can be used to enhance future implementation efforts in similar settings.

The Influence of Social Commerce Dynamics on Sustainable Hotel Brand Image, Customer Engagement, and Booking Intentions

Social commerce plays a significant role in various aspects of the hotel industry. By using social commerce platforms such as Facebook, Instagram, and hotel booking websites, hotels can enhance their brand visibility, engage more effectively with guests, and stimulate hotel bookings. Nonetheless, prior research reported a lack of studies in this area, namely social commerce in the context of domestic tourism. Drawing on Stimuli–Organism–Response (SOR) theory as being a well-established framework in social commerce research, this study seeks to examine the impact of social commerce on hotel booking intentions, both directly and indirectly, by considering the mediating effects of both brand image and customer engagement. This research used an online survey questionnaire as a tool for collecting primary data from domestic tourists in Egypt during the period from January to April 2024. The study sample encompassed 315 participants who were recruited using the convenience sampling technique. Using Smart PLS 4.0 software, Structural Equation Modeling was performed to examine the proposed model and hypotheses. The results highlighted the significant impact of social commerce on both hotel brand image and customer engagement, which in turn encouraged booking intentions among potential domestic guests. The results also supported the significant mediating effect of hotel brand image and customer engagement in the relationship between social commerce and hotel booking intentions. This study provides some theoretical contributions to the literature of hospitality management by addressing notable gaps in knowledge. This study also suggests some practical implications for industry executives that support their social commerce techniques and boost booking intentions and behavior among domestic tourists such as creating visually attractive content, sponsoring virtual mega events, actively interacting with social media followers, and incorporating booking functionalities in social media platforms. In so doing, hotels can boost their sustainable marketing practices to target a promising market segment by exploiting Web 2.0 capabilities.

Belonging in remote higher education classrooms: The dynamic interaction of intensive modes of learning and arts-based pedagogies

In this paper, the authors explore the conditions that support belonging in remote VU Block Model® teaching. They examine the role of arts-based, embodied pedagogy in promoting engagement in learning, connection between students, and between students and teachers, and in an environment in which vulnerability and risk-taking in learning is valued. A discussion of belonging in higher education and the practice of embodied learning is followed by the reflections of seven participants. These participants were students in a remotely taught, arts-based higher education block unit, which had been mindfully adapted to retain the embodied nature of delivery during the COVID-19 pandemic. After students’ participation in focus group interviews, the lead author constructed found poetry from their comments and reflections. This found poetry forms the dataset through which the questions of belonging are explored. The researchers found that when explored through the lens of the Community of Inquiry Framework, embodied and arts-based practices provided opportunities for students to develop a sense of belonging, deepen understanding of lived experiences, and realise higher education and career goals. This study elevates the voices of students, providing opportunities for higher education teachers to consider the importance of belonging for student success in remote, intensive, and on-campus modes of delivery.