Interdisciplinary Team Collaboration Research Articles

Toward a multi-level approach to the study of the intergenerational transmission of trauma: Current findings and future directions.

A central goal in the field of developmental psychopathology is to evaluate the complex, dynamic transactions occurring among biological, psychological, and broader social-cultural contexts that predict adaptive and maladaptive outcomes across ontogeny. Here, I briefly review research on the effects of a history of childhood maltreatment on parental, child, and dyadic functioning, along with more recent studies on the intergenerational transmission of trauma. Because the experience and sequelae of child maltreatment and the intergenerational transmission of trauma are embedded in complex biopsychosocial contexts, this research is best conceptualized in a developmental psychopathology framework. Moreover, there is a pressing need for investigators in this area of study to adopt dynamic, multi-level perspectives as well as using developmentally guided, sophisticated research methods. Other directions for research in this field are suggested, including the implementation of collaborative interdisciplinary team science approaches, as well as community-based participatory research, to increase representation, inclusion, and equity of community stakeholders. A greater focus on cultural and global perspectives is also recommended.

AN INTERDISCIPLINARY APPROACH TO ADDRESSING HEARING LOSS IN THE INPATIENT SETTING TO IMPROVE COMMUNICATION

Abstract Nearly half of all adults over 60 years of age have hearing loss which is associated with decreased satisfaction with care, higher risk of readmission, and longer length of stay. These associations may be mediated by the barriers hearing loss places on patient-provider communication. There is a paucity of sustainable programs focused on addressing hearing loss among older adults in the inpatient. An interdisciplinary collaborative team comprising audiologists, geriatricians, and nurses developed and implemented a quality initiative to address hearing loss in the inpatient setting in two medical inpatient units at Johns Hopkins Bayview Medical Center that started with offering 16 training session slots to raise awareness of hearing loss and teach technologic, environmental, and communication considerations for adults with hearing loss. Over a 3-month period, 543 of 644 admitted patients were screened for hearing loss using a sustainable model built into the admission process. Those without hearing loss (52.6%) received no intervention, those with mild loss (31.3%) received signage in the room reminding providers of training, and those with moderate or greater loss (16.1%) received signage and an amplifier. At discharge, 79% and 81.6% of those with mild and moderate hearing loss indicated improved communication during their current stay relative to previous stays. Notably, a larger proportion of those without hearing loss (52.9%) also indicated improved communication. A post study survey among 18 nurses suggested themes of moderate (33%) desiring more training and overwhelming perceptions (94.4%) the program didn’t interfere with other duties and made communication with patients easier.

Eyes on the Prize: Decoding the Ophthalmic Product Regulations and Intricacies of the U.S. Food and Drug Administration Approval.

The dynamic and continuously evolving field of ophthalmology necessitates rigorous regulatory oversight in the United States. This review outlines the multifaceted Food and Drug Administration's (FDA) approval process for ophthalmic products, detailing the classifications, pathways, and regulatory compliance for devices, drugs, biologics, and combination products. Particular emphasis is placed on distinct frameworks for Class I, II, and III devices, as well as regulations for drugs, biologics, and combination products. The organizational structure of the FDA is detailed, with highlights on specific Ophthalmology oversight divisions, historical regulatory evolution, and initiatives such as Patient-Focused Drug Development. An in-depth examination of the regulatory journey, ranging from initial research to post-marketing surveillance, includes practical guidance through stages such as Pre-Investigational New Drug/Pre-Submission consultations, clinical trials, new drug application/biologics license application/premarket approval submissions, and FDA advisory committee interactions. The article underscores the importance of early interactions with the health authorities, interdisciplinary team collaboration, adherence to current standards, and the anticipation of policy changes to ensure patient safety. It concludes with an analysis of 4 key FDA-approved ophthalmic products, including Eylea®, Luxturna®, Alphagan P®, and the Raindrop® Near Vision Inlay, detailing their contributions to ophthalmic care and offering valuable insights into their respective clinical trials, regulatory pathways, and potential implications. These case studies are included to illustrate both successful and failed ophthalmic product launches, thereby highlighting the importance of alignment with regulatory compliance.

Prosthetic Management of Flap-Related Complications Following Glossectomy in Locally Advanced Tongue Cancer.

Total glossectomy defects resulting from postoncologic resection are commonly reconstructed with locoregional or free flaps. However, effectively managing complications that may arise after reconstruction can be a significant challenge. We present a unique case series describing prosthetic management of flap-related complications following glossectomy in patients treated for locally advanced tongue cancer. Three patients underwent total glossectomy, neck dissection, reconstruction using free flap, and tracheostomy. Two patients developed an intraoral fistula located in the anterior region of the floor of the mouth. The third patient developed a flap failure requiring a second procedure using a pectoralis major myocutaneous flap for correction of the orocutaneous fistula that ultimately did not heal. Mandibular obturator prostheses lined with a soft liner were fabricated for all the patients, which helped reduce salivary incontinence and improve swallowing and speech. This case series highlights that a collaborative interdisciplinary team approach is crucial for optimizing postoperative function and outcomes when managing complications from reconstructive procedures.

Facilitating oral COVID-19 therapy utilization through a pharmacy consult service

BackgroundTwo oral therapies, nirmatrelvir/ritonavir (Paxlovid) and molnupiravir (Lagevrio), are now available for the treatment of coronavirus disease 2019 (COVID-19). Treatment guidelines recommend using these agents for nonhospitalized adults with mild to moderate COVID-19 who are at high risk of disease progression. Despite guideline recommendations, therapy is frequently underutilized, resulting in lost opportunity to prevent severe outcomes including death. ObjectiveThis study aimed to describe the implementation of a pharmacy consult service for oral COVID-19 therapy within the ambulatory care setting. Practice descriptionUpon receipt of a positive COVID-19 test result, providers were encouraged to place a pharmacy consult for review. Information required within the consult submission served as a simple guide for determining eligibility for therapy. Once submitted, the pharmacist would identify which oral COVID-19 medication and dosage was most appropriate. In addition, for nirmatrelvir/ritonavir, the pharmacist would provide clear and concise instructions on how to manage any significant drug-drug interactions identified. Upon consult completion, the provider would order the appropriate therapy. Practice innovationWe depict an interdisciplinary approach to facilitate oral COVID-19 therapy utilization at a health care system level. EvaluationVeterans with a positive COVID-19 test from January 10, 2022, to July 10, 2022, were identified. A chart review was then used to collect relevant patient demographics and outcomes. The primary outcome was the eligibility for and subsequent prescribing of oral COVID-19 therapy. ResultsOf the 245 positive COVID-19 cases, 172 (70%) were eligible for oral COVID-19 therapy. Of those eligible, 118 (68.6%) were offered therapy and 95 (80.5%) accepted. Nirmatrelvir/ritonavir was the predominant agent used with 16% requiring renal dosage adjustment. Pharmacists identified 167 significant drug-drug interactions with nirmatrelvir/ritonavir encompassing 42 unique medications. Fourteen of the interactions warranted the utilization of molnupiravir. ConclusionThe utilization of a pharmacy consult service has facilitated interdisciplinary team collaboration and ultimately empowered the utilization of oral COVID-19 therapy.

A tuberculosis spondylitis patient with paraplegic manifestations

Background: Mycobacterium tuberculosis is the primary causative agent of tuberculous spondylitis (TB spondylitis), a chronic granulomatous inflammatory disease of the spine. Patients with TB spondylitis may have spinal lesions in up to 50% of cases, and 10-45% may also have neurological deficits. We reported a case of severe paraplegia manifesting TB spondylitis in a young adult patient. Case Presentation: A 28-year-old female Javanese Muslim was admitted to Dr. Soetomo General Academic Hospital in Surabaya, Indonesia with back pain, inability to move, and feeling stiff in both legs. During previous therapy, the patient was thought to have spondyloarthropathy. X-ray examination demonstrated T9 to T10 retrolisthesis and T10 corpus lipping. Thoracolumbosacral MRI with contrast revealed that the patient had TB spondylitis. A debridement and hemilaminectomy of T7-8 for fusion with bone segments at T7-8 were performed on the patient. The patient was treated with oral antituberculosis drugs for 10 months and could walk perfectly 8.5 months after the initial treatment. Conclusion: This case demonstrates the complexities of diagnosing TB spondylitis, which necessitates the use of multiple disciplines. Because the clinical manifestations of TB spondylitis differ, various methods, including thoracolumbosacral X-ray and MRI with contrast, are required to confirm the disease. As a result, an interdisciplinary collaborative team is required to achieve optimal patient outcomes and to prevent long-term sequalae.

Perioperative analgesia in the elderly.

The administration of analgesic drugs in elderly patients should take into account age-related physiological changes, loss of efficiency of homeostatic mechanisms, and pharmacological interactions with chronic therapies. Underestimation of pain in patients with impaired cognition is often linked to difficulties in pain assessment. In the preoperative phase, it is essential to assess the physical status, cognitive reserve, and previous chronic pain conditions to plan effective analgesia. Furthermore, an accurate pharmacological history of the patient must be collected to establish any possible interaction with the whole perioperative analgesic plan. The use of analgesic drugs with different mechanisms of action for pain relief in the intraoperative phase is a crucial step to achieve adequate postoperative pain control in older adults. The combined multimodal and opioid-sparing strategy is strongly recommended to reduce side effects. The use of various adjuvants is also preferable. Moreover, the implementation of non-pharmacological approaches may lead to faster recovery. High-quality postoperative analgesia in older patients can be achieved only with a collaborative interdisciplinary team. The aim of this review is to highlight the perioperative pain management strategies in the elderly with a special focus on intraoperative pharmacological interventions.

Education and Mentoring of Specialist Pediatric Palliative Care Medical and Nursing Trainees: The Quality of Care Collaborative Australia.

The Quality of Care Collaborative Australia (QuoCCA) builds capability in the generalist and specialist paediatric palliative care (PPC) workforce throughout Australia. It supports regional and community services to provide care close to families' homes, as well as building expertise in tertiary centers. Medical Fellows and Nurse Practitioner candidates (specialist trainees) were funded by QuoCCA at four tertiary hospitals throughout Australia supported by an education and mentoring framework. This study explored the activity and experiences of clinicians who had occupied these roles to evaluate their effectiveness to build PPC capability. Online surveys recorded the monthly activity of Medical Fellows, with a point in time check of knowledge, skills and confidence in 2019. Discovery Interview methodology was used to collect detailed experiences of 11 trainees employed between 2018 to 2022 in Queensland. A combination of mentoring and formal and informal education, peer support and practical experience was valuable for trainees. They found the support of the whole interdisciplinary team advantageous to learning. Shadowing experienced team members gave them the opportunity to learn practical skills, especially regarding communication with families. Practicing clinical skills was beneficial, through being on call, attending home visits, supporting families, prescribing medications and developing treatment plans in collaboration with the team.The trainee experience was optimised through learning from families, personal reflection, involvement in research projects and delivering QuoCCA education. The QuoCCA trainee roles for Medical Fellows and Nurse Practitioner candidates exhibit a valuable and effective education and mentorship framework that could be applied to other specialties. The service leadership and collaborative interdisciplinary team support various modes of education and mentoring. The roles not only develop the trainees' specialised PPC clinical skills, they also improve their general clinical practice, including communication, empathy and holistic care. A structured curriculum of education is recommended to protect these positive outcomes.

Interdisciplinary collaboration: Data scientists and radiologists.

Interdisciplinary collaboration has become sought after by most institutions and corporations over the past few decades. This type of collaboration has grown exponentially since the advent of the internet and the information age. With the wave of interest to develop machine learning for the interpretation of diagnostic images it has become necessary for data scientists and radiologists to communicate through interdisciplinary research and collaboration. Such communication requires careful navigation for productive and meaningful outcomes. This article seeks to offer an overview of some previous literature discussing the best practices when forming interdisciplinary collaborative teams, explore some of the communication similarities and differences between the radiologist and data scientist disciplines, share some examples where pitfalls have caused confusion or frustration and re-work, and also to convey that, through trust, listening skills and knowing one's limitations, much can be learned and accomplished when working together.

Pneumococcal Vaccination Practices in Patients With Multiple Sclerosis Receiving Anti-CD20 Monoclonal Antibodies After Pharmacy and Nursing Collaboration.

It is recommended that patients taking immunosuppressive anti-CD20 monoclonal antibodies (mAbs) receive pneumococcal vaccinations before their first dose to ensure optimal immune response. An initial medication use evaluation reviewed adherence to Centers for Disease Control and Prevention (CDC) pneumococcal immunization recommendations at the study site, and room for improvement was identified. The nursing team implemented workflow changes to increase nursing involvement in vaccination coordination, education, tracking, and administration. We sought to evaluate the impact of a nursing intervention on optimal pneumococcal vaccination administration rates in patients receiving anti-CD20 mAbs at a multiple sclerosis (MS) center. We performed a single-center, retrospective, pre/post medication use evaluation. Inclusion criteria were older than 18 years with a diagnosis of MS and received their first anti-CD20 mAb infusion at the study site during the preintervention or postintervention time frame. We included 406 and 73 patients in the preintervention and postintervention studies, respectively. The nursing intervention significantly improved the percentage of patients receiving optimal pneumococcal vaccination before their first infusion from 58% to 84% and significantly reduced the number with unknown vaccination status from 17% to 3%. Patients who received optimal follow-up vaccination with 23-valent pneumococcal polysaccharide vaccine after optimal 13-valent pneumococcal conjugate vaccine administration improved from 9% to 56%. A nursing team intervention improved adherence to CDC pneumococcal immunization recommendations for patients receiving anti-CD20 mAb therapy. This project highlights the value of interdisciplinary team collaboration between health system specialty pharmacies and specialized nursing teams in the care of patients with MS.

Perioperative management of patient with late rheumatoid arthritis and post-bone tuberculosis with genu contracture undergoing tenotomy

Background: Rheumatoid arthritis (RA) is an autoimmune and inflammatory disease that potentially attacks all parts of the human body. Despite the use of disease-modifying anti-rheumatic drugs (DMARDs), the rate of total knee arthroplasty (TKA) remains high. Critical complications such as infection, dislocation, and readmission following TKA are also reportedly high and therefore, appropriate management during perioperative period is critical. We reported the perioperative management of a patient with late RA and genu contracture underwent tenotomy. Case Presentation: A 22-year-old male was referred to Dr. Soetomo General Hospital with a chief complaint of pain in the right and left groin. He also complained of immobilization and stiffness in both knees. He had been diagnosed with bone tuberculosis in 2014 and underwent a total knee replacement of both knees in 2015 due to stiffness and inability to walk. Radiography examination indicated erosion and loss of joint spaces in the joints of the hip, fingers, and toes. Laboratory investigation showed positive anti-mutated citrullinated vimentin (anti-MCV), confirming RA. The patient underwent tenotomy surgery and was treated with methylprednisolone 4 mg peroral daily, chloroquine 250 mg peroral daily, and natrium diclofenac peroral to reduce pain. Tenotomy was performed. Considering the disease activity, conventional DMARDs (chloroquine 250 mg peroral and low dose steroid, methylprednisolone 1x4mg peroral) were prescribed. Conclusion: The case highlights the complexity of perioperative management of late RA and genu contracture underwent tenotomy that required multiple disciplines. Therefore, interdisciplinary collaborative team is critical to be able to achieve optimal results of the patient.

The Impact of Design Thinking PBL Robot Course on College Students’ Learning Motivation and Creative Thinking

<i>Contribution:</i> Prior studies have shown that project-based learning (PBL) is an effective approach on engineering education. This study further identifies the impact of a design thinking (DT) integrated PBL approach on the college students&#x2019; learning motivation and creativity. <i>Background:</i> A well-developed robot and its project often require interdisciplinary knowledge, such as design and technology, and interdisciplinary team collaboration to optimize the requirements of desirability and viability for developing products. The current study systematically embeds the elements of DT and PBL on a robot design course. <i>Intended Outcomes:</i> The DT PBL approach can improve the student&#x2019;s learning motivation and creativity in developing robots for engineering students. <i>Application Design:</i> A quasi-experimental design was used. Eighteen participants were assigned to the experimental group, whereas 23 participants were assigned to the comparison group. While the elements of DT and PBL were embedded into and delivered for the experimental group, the comparison group used a PBL-only approach. <i>Findings:</i> Evidence collected from quantitative survey/tests and qualitative interviews indicates that: 1) the experimental group outperformed the comparison group in overall learning motivation, and its subscales (task value and self-efficacy). The project enabled them to reflect on the insufficiency of required expertise and skills, which also helped them to learn more effectively and efficiently and 2) the experimental group outperformed the comparison group in overall creativity and its subscales (fluency, originality, and flexibility). The experimental group students can think faster, consider the problem through multiple perspectives, and come out with more creative ideas.

Bridging Allied Health Professional Roles to Improve Patient Outcomes in Rural and Remote Australia: A Descriptive Qualitative Study.

PurposeAustralia’s rural and remote populations experience inequality of access to healthcare, with demand exceeding capacity for delivery of health services, often due to a maldistribution of the health workforce. A strategy which may overcome barriers to accessing adequate healthcare includes implementation of interdisciplinary collaborative teams, identified as a successful method of healthcare delivery. This study thus aimed to explore interdisciplinary allied health collaborative practice in a rural community.MethodsRole theory, as a philosophical perspective, was used to explore role perceptions and the potential for interdisciplinary collaboration between pharmacists and allied health professionals including dieticians/public health nutritionists, speech pathologists, occupational therapists, and physiotherapists, by conducting 29 interviews in a rural community. All interviews were transcribed verbatim, coded, and categorised into emerging themes.ResultsFive constructs of role theory were used to describe the data: role identity, role overload, role sufficiency, role conflict, and role ambiguity. Participants identified as rural generalists and health promoters, who work within innovative and adaptive healthcare settings. Role overload was reported as considerable due to high demand for services and a lack of resources in rural and remote regions, resulting in poor role sufficiency. Overall, there was a low level of role conflict, and participants were highly in favor of interprofessional collaboration; however, uncertainty of the pharmacist’s role (role ambiguity) was a major barrier identified. Health professionals with more years in practice provided few examples of how they would utilise a pharmacist in their practice, although these gave valuable insight into the potential integration of a pharmacist into an interdisciplinary health team, with allied health professionals.ConclusionThis study has applied role theory providing a greater understanding of the enablers and barriers of pharmacists working within interdisciplinary allied health teams and highlighting opportunities to bridge interprofessional roles to improve patient outcomes, especially in rural and remote communities.

Measuring the processes of interdisciplinary team collaboration: Creating valid measures using a many-facet Rasch model approach.

The science of team science (SciTS) is an emerging research area that studies the processes and outcomes of team-based research. A well-established conceptual framework and appropriate methodology for examining the effectiveness of team science are critically important for promoting and advancing collaborative and interdisciplinary research. Although many instruments have been developed and used in the SciTS field, psychometric evidence has not been routinely assessed or reported for these scales. In addition, commonly used psychometric methods were mainly limited to internal consistency and factor analysis. To fill the gaps, this study introduces a framework based on Rasch measurement theory for creating and evaluating measures for team sciences. We illustrate the application of Rasch measurement theory through the creation of valid measures to evaluate the processes of interdisciplinary scientific teams. Data were collected from 16 interdisciplinary teams through a university-wide initiative for promoting interdisciplinary team collaboration. Psychometric evidence based on a many-facet Rasch model was obtained for assessing the quality of the measures. The interdisciplinary teams differed in their clarity measures. Significant differences were also found between gender groups, racial groups, and academic ranks. We reported the reliability of measures and identified items that do not fit the model and may present potential threat to validity and fairness of SciTS measures. This study shows the great potential of using Rasch measurement theory for developing and evaluating SciTS measures. Applying Rasch measurement theory produces objective measures that are comparable across individuals, interdisciplinary teams, institutions, time, and various demographic groups.

Integrating the GSA KAER Toolkit Into Practical Training for Primary Care Clinics

Education is central to driving change in clinical practice. First, primary care providers and their clinic team members need to understand why detecting cognitive impairment is important, how it can be done efficiently, and what the next steps in referral and management are. To engage primary care clinics in this change process, we developed a continuing education intervention, based on the KAER Model, using a live video format. Four evidence-based, 45-minute training modules presented core knowledge skills, including how to have difficult conversations, which are essential to diagnosing cognitive impairment. To overcome the obstacles to doing so in primary care, our team relied on a deep understanding of busy primary care practice. With a combined 35 years of direct experience in primary care, our collaborative interdisciplinary team was able to use the KAER Model to develop a highly acceptable intervention for primary care.

The medical and surgical management of gastroschisis

Gastroschisis (GS) is a full-thickness abdominal wall defect in which fetal intestine herniates alongside the umbilical cord into the intrauterine cavity, resulting in an intestinal injury of variable severity. An increased prevalence of gastroschisis has been observed across several continents and is a focus of epidemiologic study. Prenatal diagnosis of GS is common and allows for delivery planning and treatment in neonatal intensive care units (NICUs) by collaborative interdisciplinary teams (neonatology, neonatal nursing and pediatric surgery). Postnatal treatment focuses on closure of the defect, optimized nutrition, complication avoidance and a timely transition to enteral feeding. Babies born with complex GS are more vulnerable to complications, have longer and more resource intensive hospital stays and benefit from standardized care pathways provided by teams with expertise in managing infants with intestinal failure.This article will review the current state of knowledge related to the medical and surgical management and outcomes of gastroschisis with a special focus on the role of the neonatologist in supporting integrated team-based care.

Psychosocial factors associated with conflicts among health professionals in the operating room in a Greek sample.

The purpose of this study is to investigate conflicts and identify the factors that cause the creation of conflicts in the operating room as well as coping strategies for conflict resolution. The operating room is a special and changeable working environment, which is constantly evolving, and requires interdisciplinary team collaboration. Therefore, it is an environment that may cause conflict among employees. The study was conducted at three Public Hospitals of Athens, during the period from 1 April 2018, to 15 June 2018. The research tool used to conduct the research was the questionnaire of Kontogianni et al. (2011). The questionnaire consisted of four sections dealing with conflict issues and their management. The sample consisted of 185 nurses and medical staff. The level of statistical significance was set equal to .05. The questions were analysed through the statistical package SPSS 20. Τhe majority of participants had conflicts with colleagues (79%), with doctors (69.5%) and with nurses (43.7%). Τhe majority of the sample was unaware of conflict management strategies (60%). One of the important factors that intensify the conflicts is the burdensome workload in combination with the unsatisfactory salary. Avoidance is the preferred conflict management strategy (64.7%), followed by mutual benefit trading (55.4%.) Acceptance is the least appropriate strategy (10.9%). In order to deal with conflicts in the operating room effectively, it is necessary for nurses and physicians to be trained in conflict management. Nursing managers should support the training of nurses in conflict management in order to create a climate of cooperation and reduce conflicts.

Feature‐driven systems engineering procedure for standardized product‐line development

AbstractNumerous systems engineering (SE) methods for the model‐based and textual specification of systems focus on managing complexity solely by partitioning the system based on physical structures or by defining different views of the system and therefore reach their limits in agile development. The increasing demand for an agile system development requires an agile systems engineering procedure for the model‐based and textual top‐down specification of systems. Although function‐based development, variant management, and product line development are well established in software engineering, previous work has failed to introduce methods for the agile specification of systems by combining established methods from systems and software engineering. For that purpose, this paper demonstrates a new SE methodology, which for the first time combines conventional SE methods with the agile development procedure of feature‐driven development. The methodology is systematically developed based on theoretical analyses and its suitability for the application‐specific definition of feature‐driven development processes is demonstrated using the example of reference architectures for XiL simulation models of electric vehicles. By applying feature‐driven development, the resulting CUBE methodology enhances collaboration in interdisciplinary development teams and enables companies to adapt development processes to a more agile top‐down specification of systems.

Implementation Science Meets Software Development to Create eHealth Components for an Integrated Care Model for Allogeneic Stem Cell Transplantation Facilitated by eHealth: The SMILe Study as an Example.

To describe a process of creating eHealth components for an integrated care model using an agile software development approach, user-centered design and, via the Behavior Change Wheel, behavior theory-guided content development. Following the principles of implementation science and using the SMILe project (integrated care model for allogeneic stem cell transplantation facilitated by eHealth) as an example, this study demonstrates how to narrow the research-to-practice gap often encountered in eHealth projects. We followed a four-step process: (a) formation of an interdisciplinary team; (b) a contextual analysis to drive the development process via behavioral theory; (c) transfer of content to software following agile software development principles; and (d) frequent stakeholder and end user involvement following user-centered design principles. Our newly developed comprehensive development approach allowed us to create a running eHealth component and embed it in an integrated care model. An interdisciplinary team's collaboration at specified interaction points supported clear, timely communication and interactions between the specialists. Because behavioral theory drove the content development process, we formulated user stories to define the software features, which were prioritized and iteratively developed using agile software development principles. A prototype intervention module has now been developed and received high ratings on the System Usability Scale after two rounds of usability testing. Following an agile software development process, structured collaboration between nursing scientists and software specialists allowed our interdisciplinary team to develop meaningful, theory-based eHealth components adapted to context-specific needs. The creation of high-quality, accurately fitting eHealth components specifically to be embedded in integrated care models should increase the chances of uptake, adoption, and sustainable implementation in clinical practice.

Formalising theories of human decision-making for agent-based modelling of social-ecological systems: practical lessons learned and ways forward

Incorporating representations of human decision-making that are based on social science theories into social-ecological models is considered increasingly important – yet choosing and formalising a theory for a particular modelling context remains challenging. Here, we reflect on our experiences of selecting, formalising and documenting psychological and economic theories of human decision-making for inclusion in different agent-based models (ABMs) of natural resource use. We discuss the challenges related to four critical tasks: How to select a theory? How to formalise a theory and how to translate it into code? How to document the formalisation? In this way, we present a systematic overview of the choices researchers face when including theories of human decision-making in their ABMs, reflect on the choices we made in our own modelling projects and provide guidance for those new to the field. Also, we highlight further challenges regarding the parameterisation and analysis of such ABMs and suggest that a systematic overview of how to tackle these challenges contributes to an effective collaboration in interdisciplinary teams addressing socio-ecological dynamics using models.