Initial Workshop Research Articles

Create to Collaborate: using creative activity and participatory performance in online workshops to build collaborative research relationships

BackgroundCreative methods/practices have been highlighted as helpful to develop more collaborative, equitable research partnerships between researchers and communities/public-participants. We asked artist partners to design four online workshops, one on each research priority area: school environments and mental health; wellbeing within the Somali community; air pollution; health data. We aimed to understand whether creative processes can enable public-participants and researcher- participants to meet in a neutral space to discuss a research theme and begin to build collaborative relationships through more equal engagement. Ideas could be taken forwards with seed funding, providing opportunity for collaboration to continue beyond initial workshops.MethodsDifferent artist partners designed and facilitated four workshops. Evaluation data was collected on each workshop using participatory observation and fieldnotes, alongside chatlog data, and one-to-one interviews with 21 workshop participants, providing a contextually rich, comparative evaluation across four diverse workshops. Analysis was thematically driven.ResultsArtist partners took different approaches to designing workshops. The workshops began with introductory games and activities, and there was less emphasis on introductions of people’s roles, with the intention to avoid hierarchical dynamics. Whilst public-participants enjoyed this, some researchers found it challenging and reported confusions over their workshop roles. Disrupting usual practice and challenging norms was not always an easy experience. There were examples where emergent, co-created knowledge was enabled. However, it was more challenging to facilitate longer-term collaborative research projects from the workshops due to different stakeholder priorities, and lack of staff time/ less sense of ownership for further work.ConclusionsCreative activities can influence and impact the types of conversations between public-participants and researchers in a way that changes and challenges power dynamics, shifting towards public-participant driven discussion. Whilst deconstructing hierarchies is important, supporting researchers is key so that any discomfort can be productive and experienced as a vital part of co-production. Longer term collaborative research projects were limited, highlighting a need for facilitation beyond initial workshops, and a sense of ownership from workshop participants to take things forwards. Workshops like these may lend themselves well to research prioritisation. However, taking community-led ideas forwards within research funding landscapes remains challenging.

PP149 Reengineering Of Processes For The Elaboration Of Health Technology Assessment Reports In Catalonia

IntroductionIn order to increase the value of its services and activities, the Agency for Health Quality and Assessment of Catalonia (AQuAS) has incorporated in its strategic plan the commitment to improve the processes, quality and people, while ensuring transparency, independence, rigor and efficiency following the guidelines of the European Foundation for Quality Management. We aim to present the standardization processes to improve the efficiency in elaborating health technology assessment (HTA) reports at AQuAS.MethodsProcess standardization has been developed in seven stages: (i) definition of scope, objectives and creation of working groups; (ii) mapping and analysis of all ongoing processes to determine whether they needed improvement or were already optimal; (iii) creation of new processes by evaluating the inclusion of automatic tools and their possible digitization; (iv) creation of the process map; (v) communication to the team for its implementation after training; (vi) dissemination on corporate website; (vii) monitoring and evaluation of their impact.ResultsThe creation of AQuAS’ HTA report development process map has involved 14 people over the past two years. After an initial two-day workshop, the team was organized in working groups of two to three people, with regular monitoring and the creation of a specific knowledge management unit led by the AQuAS’ evaluation manager. The process map was configured based on three axes. The strategic axis contains legal frameworks, ethical principles, good practices and methodological frameworks (29 specific for HTA reports). The key axis presents in an integrated way the process and methodology followed from the request of the HTA report to the final product’s dissemination. The support axis includes, among other, the management of 31 requests, information specialist processes (37 searches), training (51 courses) and 6 internal procedures with their corresponding 26 templates and 27 tools.ConclusionsWith a process reengineering approach, HTA reporting has become more efficient. We believe this approach can help other agencies improve their internal processes and subsequently improve team and customer satisfaction.

Collaborative pathways

This extended abstract delineates a collaborative endeavor between the School of Communication & Design and the Learning Design team at RMIT Vietnam. The project’s core objective was to uplift and reimagine blended learning approaches across selected courses. In line with the growing body of research endorsing the role of academic-designer partnerships in fostering technology-enhanced learning (Ellis et al., 2016; Nihuka & Voogt, 2012; Huber & Jacka, 2022; McDonald & Mayes, 2005), this initiative thrived on the close collaboration between academics and learning designers. What sets our approach apart is the non-homogenized implementation of blended learning changes. Instead of uniformly transitioning courses from face-to-face to a blended format, changes were specifically tailored based on the needs and learning outcomes of each course. This bespoke approach, combined with our multifaceted support framework and adaptive project management strategies, ensured that the course design was both effective and reflective of individual course characteristics. The multifaceted support framework leveraged initial design workshops to establish core principles and a shared vision, codesign of initial proof of concept course modules, design templates, a central site providing blended learning exemplars and pedagogical resources and ongoing consultations. Embedded throughout these were foundational frameworks for online and blended learning including Backward Design and Community of Inquiry (Wiggins & McTighe, 2005, Garrison et al., 2001). New tools to support active, social, asynchronous learning were also integrated into the LMS. Adaptive project management strategies addressed challenges as they arose. The transformed courses showcase innovative blended learning approaches personalized to disciplinary contexts, leading to positive measurable impacts. Academics reported feeling empowered by new skills gained through the collaboration and this positive reception extended the reach of the program, providing a catalyst for academics not directly involved to implement the approaches and tools used in the program in their own course design. Despite its success, the initiative was not devoid of challenges. Different priorities necessitated compromise, and academics required additional support to adapt to new the new technologies and pedagogical strategies. The project’s collaborative nature proved instrumental in surmounting these hurdles, enabling learning designers to progressively build academic involvement whilst addressing issues central to blended learning implementation in a Vietnamese context such as lack of familiarity and experience with blended learning (Le et al., 2021). The outcomes of this collaboration underscore the value of leveraging complementary expertise of academics and designers. Beyond elevating technology-enhanced learning, the project fostered mutual understanding, leading to wider impacts than initially anticipated. Insights gained can inform effective collaboration strategies and highlight organizational enablers to nurture such relationships and promote the move to blended learning and uplifting of courses on a larger scale. This tailored approach not only represents a best practice example in the TEL context but also signifies a progressive step in the broader landscape of higher education, which is rapidly evolving towards online and blended modalities. While our experience is grounded in the Vietnamese context, the inherent flexibility and adaptability of our methods make it a model that can be replicated and customised for diverse tertiary educational settings globally. As higher education continues its evolutionary trajectory, academic-designer collaborations such as this one, rooted in blended learning enhancement, will grow in significance. The insights and methods presented here offer valuable pointers for those aiming to advance pedagogical innovation.

Implementation of guidelines on prevention of coercion and violence (PreVCo) in psychiatry: a multicentre randomised controlled trial

Interventions to prevent the use of coercion in psychiatric hospitals have been summarized in the 2018 German Association for Psychiatry, Psychotherapy, and Psychosomatic's comprehensive guidelines. Twelve recommendations for implementation of these guideline on psychiatric wards have been deducted and their feasibility has been tested in a pilot study, using external implementation consultants as facilitators. The objective of the PreVCo study was to test their effect in a randomised clinical trial. Fifty-four psychiatric wards in Germany treating voluntary and involuntary patients were randomly allocated to either an intervention or to a waiting list condition. The intervention consisted of the implementation of three out of 12 suggested recommendations as selected by the ward teams, supported by external study workers. As the primary outcome measure, the number of coercive measures used per bed and month in the final 3 months of the intervention period was determined. Secondary outcomes were the cumulative duration of coercive measures used per bed and months and assaults per bed and month. Achieved guideline adherence was measured by a fidelity scale developed for this purpose during a pilot study for the PreVCo Rating Tool. After a 3-month baseline collection period under routine conditions, randomisation was done after matching wards pairwise according to frequency of coercive measures used and scores on the PreVCo Rating Tool at baseline. The duration of the intervention period was 12 months; control wards received only an initial workshop presentation of the study and completed their PreVCo ratings. We used the Wilcoxon signed rank test and the paired t-test and conducted sensitivity analyses for different periods of observation. Neither the number of coercive measures used per month and bed nor their cumulative duration nor the number of assaults per bed and months differed significantly between the 27 intervention wards and the 27 control wards in the final 3 months of the intervention period. The median number of coercive measures used decreased by 45% (median 0.96 (IQR 1.34)-0.53 (IQR 0.59) from baseline until the end of the intervention period on the intervention wards and by 28% (median 0.98 (IQR 1.71)-0.71 (IQR 1.08) on waiting list wards. The PreVCo Rating Tool showed a significant improvement in intervention wards compared to control wards, indicating a successful implementation. The study demonstrated that guideline adherence could be significantly improved by the intervention. However, there was no evidence for an effect on the frequency or duration of coercive measures used. Spill-over effects and the impact of the COVID-19 pandemic on in-patient care might have limited the effect of the intervention. Further research from robust randomised controlled trials are necessary to identify effective interventions to reduce the use of coercion in psychiatric hospitals. The study was funded by the German Innovationsfonds beim Gemeinsamen Bundesausschuss (project no. 01VSF19037). The funder had no role in study design or data collection.

Patient-Centered Quality Measures for Dialysis Care: A Report of a Kidney Disease Outcomes Quality Initiative (KDOQI) Scientific Workshop Sponsored by the National Kidney Foundation

Providing high-quality patient-centered care is the central mission of dialysis facilities. Assessing quality and patient-centeredness of dialysis care is necessary for continuous dialysis facility improvement. Based predominantly on readily measured items, current quality measures in dialysis care emphasize biochemical and utilization outcomes, with very few patient-reported items. Additionally, current metrics often do not account for patient preferences and may compromise patient-centered care by limiting the ability of providers to individualize care targets, such as dialysis adequacy, based on patient priorities rather than a fixed numerical target. Developing, implementing, and maintaining a quality program using readily quantifiable data while also allowing for individualization of care targets that emphasize the goals of patients and their care partners provided the motivation for a September 2022 Kidney Disease Outcomes Quality Initiative (KDOQI) Workshop on Patient-Centered Quality Measures for Dialysis Care. Workshop participants focused on 4 questions: (1) What are the outcomes that are most important to patients and their care partners? (2) How can social determinants of health be accounted for in quality measures? (3) How can individualized care be effectively addressed in population-level quality programs? (4) What are the optimal means for collecting valid and robust patient-reported outcome data? Workshop participants identified numerous gaps within the current quality system and favored a conceptually broader, but not larger, quality system that stresses highly meaningful and adaptive measures that incorporate patient-centered principles, individual life goals, and social risk factors. Workshop participants also identified a need for new, low-burden tools to assess patient goals and priorities.

It Takes A Village; Involvement of Village Health Teams to Develop Tools and Resources to Communicate about Antiretroviral Use in Pregnancy and Breastfeeding at Community Level in Uganda.

Research findings must be communicated to the populations who will benefit from them, in a manner that is accessible and understandable. We recently generated novel data on medication use in breastfeeding. A Faculty of Health and Life Sciences (Liverpool) grant enabled work with a team of Village Health Teams (VHTs) in Hoima, rural Uganda, to co-create related communication materials for use in their house-to-house visitation and health education. After an initial workshop from 24th to 26th March 2021, training and review of draft materials, 10 VHT pairs visited 50 households in Hoima district. Basic demographic data were collected alongside preferred communication methods. VHTs provided feedback and re-design of materials commenced. This included dramatization of scenarios and photography. A second round of house-to-house visitation informed final adjustments. We conducted focused group discussions and a dissemination workshop attended by VHTs, local healthcare leaders and journalists was hosted on 16th - 17th June 2022. Most households (74%) had a breastfeeding baby. Majority could read and had access to radios (60%), but not to smartphones (58%) or television (86%). Most preferred verbal and visual aids for health education, and requested images of "people who look like us".Final co-created materials included posters in English and Runyoro and laminated 'job aids' in both languages . These continue to be in active use. VHTs and community members requested future projects of this nature. Healthcare communication to communities must be accessible and clear. Representation of images that the public can identify with is important. Co-creation workshops were successful in rural Uganda, and pave the way for future collaborative, participatory research.

Fostering belonging: an interdisciplinary journal club

This session explored the evolution of an interdisciplinary journal club open to undergraduate and Master’s students, the challenges faced, and how we plan to develop the project going forward.
 The aim of the club is to empower students through an initial staff-led workshop, followed by student-led peer-to-peer discussion sessions, developing their confidence in group working (and indirectly meeting new people), critical reading and analysis. The club also provides the opportunity to analyse and interpret statistical data, an area that can be daunting for students (Mezgebe, Chesson and Thurston, 2019). Articles for discussion in the club are chosen to be accessible to students from all disciplines, with a focus where possible on aspects of equity, diversity, and inclusion. Collaboration between different facets of our learning development team allow our Librarian, Writing, and Maths and Statistics advisers to bring their specific expertise to the initiative, resulting in a holistic approach additionally underpinned by students’ increased ownership.
 Impact is measured through pre- and post-participation surveys* with mostly positive comments, touching on benefits beyond obvious ‘skills development’, most notably participation being seen to instil a sense of connection and belonging with fellow students, contributing to students’ sense of wellbeing and the appreciation of having a space to explore learning outside of the core assessed curriculum.
 We hoped to tap into delegates’ experiences of any similar initiatives and explore possibilities for further developing our initiative, which could include embedding subject-specific clubs within course programmes (i.e., empowering academic staff to facilitate these), with the aim of further enhancing a sense of belonging across the institution. Equally, the model we have developed is adaptable to different contexts, so we would encourage delegates to consider the potential for adaptation to their institutional contexts.
 *Ethical approval has been obtained to use survey responses for research.

Strengthening the role of hospital leadership in infection control (LEAD-IC) – a multimodal educational intervention in German acute care hospitals

BackgroundThe effect of leadership support for adherence to infection control and prevention (IPC) measures has been demonstrated. To expand this support, a target group-specific educational study for chief medical officers (CMO) was implemented and its influence on IPC indicators was investigated.MethodsA controlled cohort study was conducted between 2018 and 2019. The intervention based on an initial workshop, an e-learning course, and a final meeting. Participants’ activities involving IPC management were surveyed. Consumption of alcohol hand rub (AHR) and incidence density of hospital-associated (HA) Clostridioides difficile-associated infections (CDI) were analyzed.ResultsEight percent of 360 CMOs invited participated in the initial workshop; 70% of those participants registered for the online course. Overall, 43% completed the post-intervention questionnaire, in which 85% of respondents reported increased collaboration with relevant stakeholders. The pre-intervention median AHR consumption was higher in the intervention group than in the control group. Both groups showed an increase (38.6 (interquartile range (IQR) 33.6; 45.0) to 41.9 ml/patient day (PD) (IQR 35.0; 56.6) and 33.4 (IQR 28.3; 40.8) to 35.8 ml/ PD (IQR 31.6; 43.2), respectively). Pre-intervention median HA CDI cases were lower in the intervention group than in the control group. Both groups reported a decrease (0.22 (IQR 0.17; 0.33) to 0.19 cases/1000 PD (IQR 0.15; 0.26) and 0.32 (IQR 0.2; 0.48) to 0.22 cases/1000 PD (IQR 0.11; 0.33), respectively).ConclusionMultimodal IPC training of CMOs is worthwhile and can lead to changes in IPC-relevant cooperation in hospitals. IPC training of hospital management should be further intensified.

Proceedings of the 2023 Second Annual ASTCT-NMDP ACCESS Initiative Workshop

Here the proceedings from the Second Annual American Society for Transplantation and Cellular Therapy (ASTCT) and National Marrow Donor Program (NMDP) ACCESS Initiative are reviewed to inform the hematopoietic cell transplantation (HCT) and cellular therapy (CT) ecosystem about progress and direction of the collaborative. Highlights from the meeting, including updates on the progress of projects from the Awareness, Poverty, and Racial Inequity Committees, are presented. The ACCESS Initiative continues to evolve and will remain dependent on the HCT/CT ecosystem's continued dedication to reduce barriers and improve outcome disparities for all patients in need of HCT/CT.

Co-designing an online treatment decision aid for men with low-risk prostate cancer: Navigate.

To develop an online treatment decision aid (OTDA) to assist patients with low-risk prostate cancer (LRPC) and their partners in making treatment decisions. Navigate, an OTDA for LRPC, was rigorously co-designed by patients with a confirmed diagnosis or at risk of LRPC and their partners, clinicians, researchers and website designers/developers. A theoretical model guided the development process. A mixed methods approach was used incorporating (1) evidence for essential design elements for OTDAs; (2) evidence for treatment options for LRPC; (3) an iterative co-design process involving stakeholder workshops and prototype review; and (4) expert rating using the International Patient Decision Aid Standards (IPDAS). Three co-design workshops with potential users (n= 12) and research and web-design team members (n= 10) were conducted. Results from each workshop informed OTDA modifications to the OTDA for testing in the subsequent workshop. Clinician (n= 6) and consumer (n= 9) feedback on usability and content on the penultimate version was collected. The initial workshops identified key content and design features that were incorporated into the draft OTDA, re-workshopped and incorporated into the penultimate OTDA. Expert feedback on usability and content was also incorporated into the final OTDA. The final OTDA was deemed comprehensive, clear and appropriate and met all IPDAS criteria. Navigate is an interactive and acceptable OTDA for Australian men with LRPC designed by men for men using a co-design methodology. The effectiveness of Navigate in assisting patient decision-making is currently being assessed in a randomised controlled trial with patients with LRPC and their partners.

Development of the PSYCHS: Positive SYmptoms and Diagnostic Criteria for the CAARMS Harmonized with the SIPS.

To harmonize two ascertainment and severity rating instruments commonly used for the clinical high risk syndrome for psychosis (CHR-P): the Structured Interview for Psychosis-risk Syndromes (SIPS) and the Comprehensive Assessment of At-Risk Mental States (CAARMS). The initial workshop is described in the companion report from Addington et al. After the workshop, lead experts for each instrument continued harmonizing attenuated positive symptoms and criteria for psychosis and CHR-P through an intensive series of joint videoconferences. Full harmonization was achieved for attenuated positive symptom ratings and psychosis criteria, and modest harmonization for CHR-P criteria. The semi-structured interview, named Positive SYmptoms and Diagnostic Criteria for the CAARMS Harmonized with the SIPS (PSYCHS), generates CHR-P criteria and severity scores for both CAARMS and SIPS. Using the PSYCHS for CHR-P ascertainment, conversion determination, and attenuated positive symptom severity rating will help in comparing findings across studies and in meta-analyses.

Priority setting to support a public health research agenda: a modified Delphi study with public health stakeholders in Germany

BackgroundResearch priority setting (RPS) studies are necessary to close the significant gap between the scientific evidence produced and the evidence stakeholders need. Their findings can make resource allocation in research more efficient. However, no general framework for conducting an RPS study among public health stakeholders exists. RPS studies in public health are rare and no such study has been previously conducted and published in Germany. Therefore, we aimed to investigate which research topics in public health are prioritised by relevant stakeholders in Germany.MethodsOur RPS study consisted of a scoping stage and a Delphi stage each split into two rounds. Firstly, we invited members of the German Public Health Association to gather expert insights during two initial workshops. Next, we defined the relevant stakeholder groups and recruited respondents. Thereafter, we collected research topics and assessment criteria with the respondents in the first Delphi round and aggregated the responses through content analysis. Finally, we asked the respondents to rate the research topics with the assessment criteria in the second Delphi round.ResultsIn total, 94 out of the 140 invited public health organisations nominated 230 respondents for the Delphi study of whom almost 90% participated in both Delphi rounds. We compiled a comprehensive list of 76 research topics that were rated and ranked by several assessment criteria. We split the research topics into two types, substantive research topics and methodological-theoretical research topics respectively, to ensure the comparability among the research topics. In both types of research topics—substantive research topics and methodological-theoretical research topics—the respective top five ranked research topics hardly differed between public health researchers and public health practitioners. However, clear differences exist in the priority ranking of many (non-top priority) research topics between the stakeholder groups.ConclusionsThis research demonstrates that it is possible, with limited resources, to prioritise research topics for public health at the national level involving a wide range of pertinent stakeholders. The results can be used by research funding institutions to initiate calls for research projects with an increased relevance for health and/or scientific progress.

Advancing cane-quality management in the South African smallholder-farmer sector through participatory on-farm demonstration and knowledge exchange

Cane-quality management involving chemical ripening is an important component of profitable sugarcane production by large-scale commercial farmers in South Africa. For smallholder farmers (SHFs), however, sugarcane field size and adjacent alternative land-uses render conventional aerial crop-spraying methods unsuitable. The recent availability of spraying drones has created opportunities for chemical ripening to be introduced to the smallholder farmer sector. A network of demonstration trials based on strong partnerships of researchers, extension specialists and smallholder farmers, and participation by various industry stakeholders was established in 11 smallholder farmer regions. Knowledge exchange in each region involved an initial stakeholder engagement workshop, a series of practical field days during the execution of the trial, and post-trial information sharing events. The initial workshops were aimed at creating project awareness, defining the relative advantage that ripening with drones could deliver, identifying negative perceptions and potential barriers that might hinder adoption, and reaching consensus on trial methodology. Field days were focused on demonstrating the processes of maturity assessment to establish the need for chemical ripening and applying a ripener with a drone to parts of the fields. At the same time, control portions were left untreated, and assessing the efficacy of ripening benefits and harvest readiness. These demonstrations illustrated the judicious use of agrochemicals by only spraying fields suited to ripening. In-field estimates of cane yield and cane quality in the ripened and control treatments shortly before harvest, and in some cases, field production data from the sugar factories, revealed a range of improvements in recoverable crystal (ERC) due to ripening that was influenced by location and sugarcane cultivar. Although the SHFs expressed genuine interest in chemically ripening their crops with spraying drones, industry challenges will need to be addressed prior to wider adoption.

Climate change perception and adaptation among farmers in coastal communities of Bayelsa State, Nigeria: a photovoice study

PurposeThere is an increasing need for greater awareness and understanding of the risks climate change poses to farming communities so as to inform appropriate adaptive responses. The purpose of this study is to investigate farmers’ climate change impacts, awareness, risk perception and current adaptation strategies adopted to deal with the impacts of climate change on their livelihood.Design/methodology/approachThis research was undertaken with 67 farmers in Bayelsa State, Nigeria. This study used a combination of focus group discussion and quantitative survey to obtain data. Surveyed farmers were invited to an initial workshop and asked to take photos of climate change impacts on their land and the adaptation strategies being adopted. The photos were analysed and discussed with the farmers in a second workshop. Then, in a third workshop, farmers and other stakeholders came together to rank the most important consequences of climate change and shared knowledge on adaptation strategies. The survey and photovoice data were analysed using descriptive and inferential statistics.FindingsThe results of this study showed that a majority of the farmers were knowledgeable of climate change, mostly got climate information through media. Floods and high temperatures were perceived as the most occurring climate change-related disaster risks. Majority of the farmers perceived climate change as high risk and have taken up multiple adaptation strategies in response to it, including changing planting times, mulching their land and digging irrigation pits. Farmers’ responses indicated that they want to do more but are restricted by financial resources.Practical implicationsThis study outcomes provide evidence for a need to consider stakeholders’ participation in planning climate change responses to effectively address the challenges posed by climate change, particularly in coastal agricultural communities. Government and relevant agencies as recommended need to support farmers to undertake needed adaptive strategies to adapt with future flooding, high temperature and drought, providing them with necessary facilities to enhance their adaptive capacities.Originality/valueTo the best of the authors’ knowledge, this was one of the first studies to use photovoice to investigate climate change awareness, impacts and adaptations strategies with majority female farmers in west Africa. This study highlights the importance of participatory approaches to capture grassroots climate adaptation approaches.

213-OR: ADA Presidents' Select Abstract: EMBARK—A Randomized, Controlled Trial Comparing Three Approaches to Reducing Diabetes Distress in Adults with Type 1 Diabetes

Diabetes distress (DD) refers to the fears, worries and burdens associated with the diabetes experience. DD is common, distinct from depression, and associated with glycemic and disease management. EMBARK is a randomized, controlled clinical trial comparing three interventions to reduce DD among adults with type 1 diabetes (T1D). Following baseline assessment, participants were randomly assigned to either: (1) Streamline, an educator-led education and management program, (2) TunedIn, a psychologist-led program focused exclusively on reducing DD, or (3) FixIt, an integration of StreamLine and TunedIn. All interventions were group-based (8 to 12 members) and virtual, including initial workshop(s), 1:1 phone calls, and follow-up meetings over a 4-month period. Recruitment occurred through clinics and community organizations in the U.S. Inclusion criteria were: T1D diagnosis, elevated DD (≥ 2.0 T1-DDS score), age ≥ 21 years, HbA1c ≥ 7.5% (58 mmol/mol), and English speaking. Regression analyses recorded change in DD from baseline to immediate post-intervention. A total of 300 adults with T1D participated (M±SD 46±15 years of age, 79% female, HbA1c 8.3%±0.9 (67 mmol/mol), T1-DDS score 2.8±0.8). Large and clinically meaningful reductions in total DD score occurred for each of the three study arms at follow-up (p < .001). The greatest DD reductions occurred in the FixIt intervention (Δ .88±.80), followed by TunedIn (Δ .59±.70), and then Streamline (Δ .48±.71); with DD reductions significantly greater in FixIt compared to Streamline (p = .005). The same pattern of results was evident in comparisons for the DD sources of Powerlessness (p < .001), Management (p = .06), Hypoglycemia (p = .009), and Physician Distress (p = .01). These preliminary findings highlight the benefit of focusing directly on the emotional side of diabetes to reduce DD and indicate that DD reductions are greatest when education and emotional DD-targeted interventions are integrated. Disclosure D.M.Hessler: Consultant; Lilly. A.Ahmann: Advisory Panel; Medtronic. U.Masharani: Research Support; Clementia Pharmaceuticals. L.Fisher: Consultant; Abbott Diabetes, Eli Lilly and Company, Research Support; Ascensia Diabetes Care. L.A.Strycker: None. W.H.Polonsky: Consultant; Abbott Diabetes, Boehringer Ingelheim and Eli Lilly Alliance, Eli Lilly and Company, Insulet Corporation, Intuity Medical, Inc., MannKind Corporation, Provention Bio, Inc., Sanofi-Aventis U.S., Vertex Pharmaceuticals Incorporated. S.Guzman: Consultant; Abbott Diabetes. G.Aleppo: Advisory Panel; Medscape, Consultant; Bayer Inc., Insulet Corporation, Research Support; Dexcom, Inc., Eli Lilly and Company, Emmes, Insulet Corporation, Fractyl Health, Inc., WellDoc, Speaker's Bureau; Dexcom, Inc. E.Stephens: None. S.Kim: None. N.B.Argento: Advisory Panel; Dexcom, Inc., Eli Lilly and Company, ConvaTec Inc., Diabeloop SA, Senseonics, Speaker's Bureau; Dexcom, Inc., Boehringer Ingelheim and Eli Lilly Alliance, Novo Nordisk, MannKind Corporation, Zealand Pharma A/S, Xeris Pharmaceuticals, Inc., Eli Lilly and Company. Funding National Institutes of Health (5R01DK121241)

Creation of a Faculty Development Curriculum to Reduce the Impact of Racial/Ethnic Bias on Medical Students (P5-2.003)

<h3>Objective:</h3> To design, implement, and evaluate a curriculum for faculty to reduce the impact of racial/ethnic bias on neurology clerkship students. <h3>Background:</h3> Bias in medical education leads to inequity in student grading for those who identify with a marginalized racial/ethnic group. Although numerous studies document this problem, strategies to counteract bias remain a topic of active inquiry. <h3>Design/Methods:</h3> Students who rotated on the Neurology clerkship between 2018–2020 completed an anonymous needs assessment survey focused on race/ethnicity, clerkship grade, and experiences of bias and/or stereotype threat. Using Kern’s framework of curricular development, we designed a 90-minute faculty workshop, dedicating 30 minutes to educating with descriptive statistics and exemplar quotes from student survey results and 60 minutes to discussion exercises. Effectiveness of the workshop was evaluated through (1) student surveys administered during the 2020–2022 academic years in tandem with curriculum rollout, and (2) a post-session faculty survey assessing participant knowledge and awareness. <h3>Results:</h3> 55 students (response rate = 28%) completed our needs assessment survey, and our follow-up survey was completed by 108 students (response rate = 50%). 23.6% of students in the initial survey reported they felt their evaluation was “moderately” or “considerably” influenced by bias versus 6.5% in the follow-up survey. In the initial survey, 46.2% of individuals who identified with a race/ethnic background marginalized in medicine reported experiencing “moderate” or “considerable” stereotype threat that impacted their clerkship performance, versus 15% in the follow-up survey. 35 of 58 faculty responded to our survey after the initial workshop (response rate = 60%). 40% “never” or “rarely” considered the impact of bias on clerkship students, and 74% could not recall any witnessed specific examples of bias over the last year. <h3>Conclusions:</h3> We successfully created and implemented a workshop to educate faculty on the impact of racial/ethnic bias on clerkship students, and have seen early success on student perception. <b>Disclosure:</b> Dr. Thompson-Stone has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Conway Homer PC. Dr. Jay has nothing to disclose. Mrs. Sampath has nothing to disclose. Racquel Whyte has nothing to disclose. Dr. Braun has nothing to disclose.

166 Community Driven Research Day: Addressing Community Needs in Rural Pennsylvania

OBJECTIVES/GOALS: Describe the community of Norther Dauphin County, PA and increase awareness of this community’s health related needs. Establish partnerships between Penn State faculty and Northern Dauphin County community-based organizations to develop an optimal approach to address identified health related needs. METHODS/STUDY POPULATION: Northern Dauphin is located in the rural Northern Tier of Dauphin County, PA and has roughly 30,000 residents within 272 square miles. Of those residents, approximately 1 in 4 families live below the poverty level. Although over 6,000 residents receive Medical Assistance (MA), only one local provider accepts MA covered patients. Residents have limited access to health care due to the rurality of the area when paired with a lack of public transportation. The Penn State Clinical and Translational Science Institute (CTSI) Community Engaged Research Core (CERC) has partnered with Northern Dauphin County community- based organizations to explore the needs of community members and how partnerships with Penn State Faculty could help to address the community needs. RESULTS/ANTICIPATED RESULTS: A Community Advisory Board (CAB) of leaders (e.g., school officials, business owners) was created to identify community needs. After an initial workshop with the CAB, an assessment was created and distributed to the larger community to identify the top community health needs. Details from the assessment were then used to prioritize the themes for the Community Driven Research Day (CDRD). The CERC team identified Penn State University faculty with research interests related to these prioritized themes. The faculty identified and community leaders were then invited to the CDRD. The agenda for the event included an introduction to Community Engaged Research, a presentation from a researcher and community partner working together, round table discussions based on the themes selected, and an overview of pilot grants. DISCUSSION/SIGNIFICANCE: The CDRD will facilitate partnerships between the Penn State faculty and local community leaders to help effectively move forward addressing the community’s health needs. The PSU CTSI will offer pilot grants to formalize and strengthen these partnerships and conduct community engaged research initiatives to discover optimal ways to address them.

Workshop dan Pendampingan Bidang Pajak dan Akuntansi bagi Amal Usaha Muhammadiyah (AUM) Se-Kabupaten Tuban

Persyarikatan Muhammadiyah already has a large number of business charities. As an organization that echoes the spirit of progress, Muhammadiyah continues to improve in organizational management to realize good organizational governance. This service is part of efforts to realize good governance, especially in the field of financial management. This dedication partner is Muhammdiyah's charitable efforts in the fields of Education and Health in Tuban district. The form of activity is workshops and assistance in the field of tax and accounting. The initial workshop and mentoring activities were carried out by controlling business charity status (AUM) for the purpose of issuing Business Identification Numbers (NIB). Assistance is carried out after AUM has a NPWP, Financial Statements and NIB.

A roadmap to the Co-production of a decision support tool for coastal ecosystems

Coastal ecosystems are complex and often support a broad spectrum of functions with competing objectives. In addition to their ecological value, they offer socio-economic benefits (i.e., ecosystem services) to coastal communities. One potential way to help address this complexity is to use decision support systems to help natural resources managers understand system dynamics and evaluate strategies to maintain the health and integrity of these ecosystems. This paper presents a roadmap and detailed application of co-production strategies where managers and researchers are fully engaged in a collaborative manner in the design of a decision support tool for coastal ecosystems. It also emphasizes the importance of capturing end-users’ (i.e., natural resource managers) priorities to refine the conceptual design of the decision support tool, while maintaining a sound scientific and modeling framework. The case study presented here centers on the Northern Gulf of Mexico, but the concept can be exported globally to other systems. This effort highlights foundational co-production strategies, including transdisciplinary team assembly, a knowledge sharing workshop, Toolbox Dialogue Initiative workshops to facilitate working across disciplines, core team and focus group meetings, and design charrettes. Further, this paper articulates the benefits and difficulties of executing a co-production process through virtual collaborations.

Understanding school food systems to support the development and implementation of food based policies and interventions

BackgroundSchools provide opportunities to improve the quality of children's diet, whilst reducing inequalities in childhood diet and health. Evidence supports whole school approaches, including consistency in food quality, eating culture and food education. However, such approaches are often poorly implemented due to the highly complex environments in which schools operate. We aimed to develop a school food systems map using a systems thinking approach to help identify the key factors influencing primary school children’s dietary choice.MethodsEight workshops were conducted with 80 children (from schools from varying locations (region of England/UK; urban/rural), deprivation levels and prioritisation of school food policies)) and 11 workshops were held with 82 adult stakeholders across the UK (principals, teachers, caterers, school governors, parents, and local and voluntary sector organisations) to identify factors that influence food choice in children across a school day and their inter-relationships. Initial exploratory workshops started with a ‘blank canvas’ using a group model building approach. Later workshops consolidated findings and supported a wider discussion of factors, relationships and influences within the systems map. Strengths of the relationship between factors/nodes were agreed by stakeholders and individually depicted on the map. We facilitated an additional eight interactive, in-person workshops with children to map their activities across a whole school day to enable the production of a journey map which was shared with stakeholders in workshops to facilitate discussion.ResultsThe final ‘CONNECTS-Food’ systems map included 202 factors that were grouped into 27 nodes. Thematic analysis identified four key themes: leadership and curriculum; child food preference; home environment; and school food environment. Network analysis highlighted key factors that influence child diet across a school day, which were largely in keeping with the thematic analysis; including: 'available funds/resources', 'awareness of initiatives and resources', 'child food preference and intake', 'eligibility of free school meals', 'family circumstances and eating behaviours', 'peer/social norms', 'priorities of head teachers and senior leaders'.ConclusionsOur systems map demonstrates the need to consider factors external to schools and their food environments. The map supports the identification of potential actions, interventions and policies to facilitate a systems-wide positive impact on children’s diets.