Involvement Of Key Stakeholders Research Articles

Maintaining Schools as Socio-Educational Environments for Teachers During the COVID-19 Pandemic

Objective: The objective of this study is to examine the impact of schools and key stakeholders in the socio-educational environment, particularly in assisting high school teachers during remote learning amid the COVID-19 pandemic. Method: This study employs a case study methodology with a qualitative approach, utilizing interview and observation tools for data mining. The research employed purposive sampling as a data mining method, and an interactive model was used for data analysis. Results and Discussion: The research findings indicate that teachers encountered social and educational challenges throughout the pandemic and the use of remote learning. Significant discoveries pertaining to this matter can be classified into two categories. Firstly, teachers saw profound disruptions due to the closure of schools during the pandemic. The rapidly evolving circumstances pose significant difficulties for teachers in the socio-educational domain, particularly due to the transition from in-person instruction to online learning and the substantial surge in technology-driven education. In this scenario, teachers find themselves facing a challenging predicament. They must simultaneously navigate the transition to digital learning while also effectively facilitating interactive learning with their students. The second discovery pertains to significant stakeholders inside schools and their respective roles in upholding the significance of educational institutions throughout the pandemic. The individuals encompassed in this group are teachers, principal, students, and parents. Research Implications: Despite the dire circumstances of the pandemic, the decision to close schools does not diminish their crucial function as institutions that are vital for ensuring the continuity of education and the involvement of key stakeholders. Originality/Value: This study offers a teacher's viewpoint on examining many factors that contribute to preserving the crucial function of schools during the pandemic. The topic of the COVID-19 pandemic, which encompasses environmental background, institutions, actors, education, and social factors, has not been extensively examined in scientific studies.

518 Improving Clinical Trial Activation Timelines through Parallel Processing and Key Stakeholder Involvement

OBJECTIVES/GOALS: A strategic initiative of Mayo Clinic is to decrease clinical trial activation timelines by 25% from 2022 levels. The team’s goal is to streamline activation via parallel processing, improved collaboration with business units, project manager facilitation, and early study coordinator involvement. METHODS/STUDY POPULATION: The workgroup targeted industry trials, focusing on key financial, regulatory, and operational elements. Current state process workflows and pain points were prepared and opportunities for concurrent activities or automation identified. The scope of the project manager role from the Office of Clinical Trials was extended to guide each activation team, who have varying levels of experience, to maintain timelines until the trial is opened. Coordinators responsible for study conduct engaged in key operational discussions earlier to ensure the trial will be run successfully. A Pilot program is utilizing the identified concurrent activities, project manager support, and earlier coordinator involvement to gauge effectiveness of the proposed solutions. RESULTS/ANTICIPATED RESULTS: The goal is for 120 industry clinical trials to join the Pilot program and to open enrollment in less than 30 weeks from being document ready. As of Q3 2023, 109 clinical trials across multiple Mayo sites have enrolled in the pilot. Thirty-five (85 percent) of 41 Pilot trials have opened to enrollment and have met the goal, with a median timeline of 24 weeks. Twenty-one (21) trials opened to enrollment in Q3 2023 with a median timeline of 23 weeks, representing 24% of all industry clinical trials opened that quarter. Opening trials and monitoring is ongoing and PI and study team feedback is positive. DISCUSSION/SIGNIFICANCE: Using a team-based approach, we identified key areas for optimization and parallel processing. The solution reduces trial activation timelines, increases patient access to experimental therapies, and has been positively received by study staff. Future projects will focus on enterprise implementation, optimization, and automation.

Fostering effective governance through intragovernmental networks: a case of a justice, crime prevention and security cluster network

South Africa’s crime challenge remains despite substantial public sector efforts. As wicked problems, including crime, often transcend the conventional capacities of public authorities to address them effectively, the primary aim of this research was to uncover the underlying dimensions that contribute to the effective functioning of an intragovernmental collaboration network. This research adopted a case study approach to delve into the structure and efficacy of the South African Justice, Crime Prevention, and Security Cluster. The chosen methodology and insider access to senior management produced rich descriptions not previously available to offer a conceptual understanding of balances and trade-offs required during a mandated and directed collaboration. Findings offer enhanced understanding, contributing to overcoming traditional barriers in public administration networks and reforming traditional hierarchical structures to offer meaningful governance alternatives or improvements to existing structures. Specifically, this study reveals gaps in the intragovernmental network and offers insights for governance and performance enhancements. Findings emphasize the importance of fostering a collaborative culture based on performance and accountability. The study underscores the need for more robust network directives, clarifying roles and responsibilities, and enhancing leadership attributes. It stresses the importance of efficient coordination, collaborative capability, and shared purpose. The study also suggests cluster-oriented budgeting and greater involvement of key stakeholders, including civil societies, research institutions, and academic establishments. These findings contribute to improving government-led networks in addressing complex challenges.

Revolutionizing the Textile and Clothing Industry: Pioneering Sustainability and Resilience in a Post-COVID Era

The COVID-19 pandemic disrupted global supply chains, posing significant challenges to the textile and clothing industry. However, amidst these threats, there is a unique opportunity to rebuild a more sustainable and resilient fashion industry. This paper explores the shift from pre-COVID-19 business models and consumption values towards a renaissance characterized by real sustainability. By examining the transition from eco-efficiency to eco-effectiveness and from cradle-to-grave to cradle-to-cradle approaches, this study emphasizes the need for the active involvement of key stakeholders in co-creating value for all. Through a comprehensive analysis of the post-COVID era, this study aims to understand textile and clothing industry professionals’ perceptions and attitudes towards sustainable design practices and identify challenges in implementing such strategies. The findings contribute to the knowledge of sustainability in the post-COVID era and provide insights and strategies for textile and clothing industry players to thrive in a sustainable and transformed landscape.

PRACTICAL GUIDELINES FOR APPLYING THE RACI MODEL IN RECRUITMENT PRACTICES

This article provides practical guidelines for applying the RACI (Responsible, Accountable, Consulted, Informed) methodology in the context of recruitment. The RACI methodology offers a structured approach to defining roles and responsibilities within a project or process, improving clarity, communication, and accountability. The guidelines outline the steps involved in implementing the RACI methodology in the recruitment process. This includes defining roles and responsibilities, identifying accountable parties, determining consulted individuals, and ensuring informed stakeholders. Clear communication and transparency are emphasized throughout the process to keep stakeholders engaged and informed. The article also highlights the benefits of using the RACI methodology in recruitment, such as clearly defined roles, improved communication, streamlined decision-making, and enhanced collaboration. However, it acknowledges the challenges that organizations may encounter, including role ambiguity, resistance to change, limited stakeholder engagement, inadequate communication, and difficulty in defining accountability. To overcome these challenges, organizations are advised to invest in change management strategies, provide comprehensive training and support, foster open communication channels, and regularly evaluate and refine the implementation of the RACI methodology. By following these practical guidelines and addressing the challenges effectively, organizations can enhance their recruitment processes, ensure the involvement of key stakeholders, and make well-informed hiring decisions.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0611/a.php" alt="Hit counter" /></p>

PROVISION OF GLOBAL SUSTAINABLE DEVELOPMENT AS A FACTOR IN THE FORMATION OF LOCAL WELFARE

The subject of the article is the problem of ensuring the welfare of the population in the context of achieving the goals of sustainable development. The authors define the concepts of "sustainable development", "hromadas" (territorial communities), "welfare", and systematise the prerequisites for the formation of welfare at the local level. The paper aims at developing approaches to determining the priority tasks of territorial development in the system of sustainable development goals. It is noted that sustainable development is impossible without achieving a certain level of welfare. To achieve the research goal, the authors analyses and assesses the level of welfare of hromadas, and also considers a set of indicators for assessing welfare based on a combination of "hard" (objective) and "soft" (subjective) factors. The methodology for assessing the welfare of territories (on the example of Ukraine) and studying its impact on the level of sustainable development of the country is applied. The methodology is based on the construction of a non-linear regression model, which demonstrates the high significance of the factors "number of educational institutions" and "number of cultural and sports institutions". The publication also identifies the main reasons that, according to the respondents, impede the development of hromadas in the region under study: poor quality of education; insufficient public initiative and activity of residents; lack of opportunities for self-realisation and meaningful leisure; poor quality (lack of) road surfaces; unemployment; spread of crime, alcoholism, corruption; environmental pollution; drinking water pollution; deterioration of engineering networks; population ageing; lack of investment; lack of entrepreneurship of hromada residents; lack of hromada awareness; unfavourable conditions for business development. The conclusion of the research is that local and regional plans should provide a systematic vision of territorial development and define strategies based on an integrated and multidimensional approach to inclusive and sustainable development. They should be defined, implemented and monitored with the involvement of key territorial stakeholders in the governance process. Based on the analysis, recommendations will be made to identify territorial development priorities in the system of sustainable development goals at local and global levels. In particular, to establish local priorities, existing local and regional programmes should be reviewed to identify the main needs, priorities, gaps and cross-sectoral linkages of the territory and their relationship with the SDGs and national priorities.

Establishing sustainable collaborations in global pathology education.

Graduate-level pathology education is under-resourced in low/middle-income countries (LMIC) and provides a unique opportunity for building sustainable collaborations. By focusing on a bi-directional educational exchange through graduate medical training in Pathology and Laboratory Medicine (PALM), global collaborations can extend to research and scholarship efforts. There are few PALM-based graduate medical programs in high-income countries (HIC) that offer this type of global educational exchange, and the few that exist have been mitigated by pandemic-related travel restrictions. Nonetheless, re-investing in these types of exchanges will allow for new opportunity in global pathology education and research for the next generation of trainees. Drawing on the author's own experience in South Africa and Guatemala, five essential elements to establish a sustainable educational collaboration will be discussed: sustained effort and communication between partners of HIC and LMIC, involvement of key stakeholders, educational curriculum involving community engagement and cultural competency, bi-directional exchange between partners, and dedicated time and funding.

Key stakeholders' perspectives: A gap analysis of hospital-acquired pressure injuries.

Hospital-acquired pressure injuries (HAPIs) are a global high-stakes patient safety issue. Key stakeholder perspectives regarding their role and experiences with pressure injuries is critical as part of the solution to minimizing HAPI occurrence and attain sustainability. A qualitative, descriptive approach provided multiple perspectives of key stakeholders to support the complexity of HAPI care. The qualitative data are a part of a mixed method convergent research study examining pressure injury prevention and management practices. Nursing system theory, mixed method convergent design, and participatory action research methodologies were chosen to address both the gap analysis development and results, achieve collaborative comprehensiveness, and enable key stakeholder involvement throughout this HAPI prevention and management initiative. Participants were recruited and enrolled from a large Level I trauma hospital and the key stakeholders. Demographic information were collected prior to the individual interview. Focused interviews were conducted virtually using zoom technology. Qualitative data were analyzed using NVivo software and thematic analysis was confirmed across the co-investigators for congruence and applicability to the research questions. Qualitative interviews with 26 key stakeholders provided data to support and integrate a link with gap analysis results on the complex health issue of HAPIs. Specific barrier and recommendation themes identified interventions that could be prioritized. The 52 barrier and 52 recommendation themes/sub-theme(s) respectively were organized by Donabedian (structure, process, and outcome) with structure elements the majority. The top three structure barrier themes involved equipment and standards for use, staff prevention education, and specialized health professionals. The top three structure recommendation themes involved specialized health professionals, equipment and standards for use, and an educational plan for those at risk or with HAPIs. The article provides findings from the qualitative portion of a mixed method study related to HAPIs. The qualitative findings associated with the gap analysis quantitative results, achieved the goal of the participatory action research key stakeholders' input into HAPI care and can be replicated internationally. The benefit of key stakeholder's involvement in solving a clinical problem is sustainability. A quantitative approach and integrating qualitative stakeholders' perspectives provide an in-depth solution that will advance nursing capacity toward health care delivery and HAPI nursing science and policy development on a global level.

Co-creation of human papillomavirus self-sampling delivery strategies for cervical cancer screening in rural Zimbabwe: nominal group technique.

Human papillomavirus (HPV) self-sampling is recommended for cervical cancer screening, particularly among women who do not participate in or have access to current screening methods offered in Zimbabwe. Key stakeholder involvement is critical in co-creating acceptable delivery strategies for implementing HPV self-sampling to ensure demand and facilitate uptake by the target population. The main objective of this study was to engage key stakeholders in co-creating acceptable HPV self-sampling delivery strategies for cervical cancer screening in rural Zimbabwe. We invited key stakeholders and employed a nominal group technique (NGT) for data collection. We employed the NGT to (1) identify barriers to access and utilisation of available cervical cancer screening services and (2) co-create delivery strategies for HPV self-sampling. The workshop included 8 participants (women n = 4, health workers n = 2 and policymakers n = 2). Quantitative data was gathered by ranking ideas and qualitative data were collected from participant group discussions and analysed thematically. The results of the ranking exercise were fed back to the participants for comments. The most significant barriers to accessing and utilising current cervical cancer screening services by women were: Inadequate information and education on cervical cancer, lack of resources and funding for cervical cancer programmes, long distances to nearest health facilities, and low perceived personal risk of cervical cancer. Key stakeholders recommended enhanced education and awareness, results notification, linkage to care, community-based self-sampling, and the choice of sampling devices as potential HPV self-sampling delivery strategies. Our study demonstrated the utility of the NGT for reaching a consensus. Using the NGT, we established priority delivery strategies for HPV self-sampling cervical cancer screening. Adequate education and awareness, early results notification, choice of sampling device and community-based self-sampling were crucial to HPV self-sampling screening in rural Zimbabwe. The proposed delivery strategies can guide the development of guidelines for designing and implementing an HPV self-sampling intervention. We recommend a study to determine women's most preferred HPV self-sampling delivery strategies before implementing the intervention.

Implementation of pharmacy access to hormonal contraception

BackgroundStates throughout the country are enacting legislation to authorize pharmacist prescribing of hormonal contraception to decrease barriers to access. Little is known about the process of state implementation of pharmacist prescriptive authority for hormonal contraception. ObjectivesTo understand the state-level steps to enable pharmacist prescribing of hormonal contraception, including implementation challenges and facilitators. MethodsWe conducted a qualitative study of interviews with 18 key individuals, including pharmacists and other stakeholders, from ten states with laws permitting pharmacist-prescribed hormonal contraception from March 2021 to April 2022. We analyzed data using directed qualitative analysis principles and compared experiences across states. We organized the data using the Consolidated Framework for Implementation Research framework and evaluated relevant constructs in states’ implementation efforts. ResultsParticipants identified four key steps to implement pharmacist prescribing at the state level, including development of state rules and regulations, educational programs, reimbursement mechanisms, and expansion strategies to pharmacists and pharmacies. Participants identified early involvement of key stakeholders and a culture of support for clinical pharmacists as facilitators to implementation. Challenges included complexity and cost of billing mechanisms, lack of funding for implementation efforts, and competing priorities of pharmacies/pharmacists. ConclusionParticipants in states with pharmacist prescriptive authority for hormonal contraception identified development of reimbursement and billing mechanisms as the most critical state-level step in implementation. Focusing on facilitators of key steps can guide states in developing successful implementation strategies to improve contraceptive access.

AGING AND GERIATRIC CARE: A GLOBAL IMPERATIVE TOWARDS UNIVERSAL HEALTH COVERAGE

The global population of older people is projected to surpass the number of children under 5 years old and adolescents by 2050, with developing countries housing the majority of older individuals. This demographic shift necessitates adjustments in global health systems to cater to the increasing demand for age-appropriate care. Gerontology, as an interdisciplinary field, encompasses the study of biological, social, and medical aspects of aging. Anti-aging, a distinct discipline, focuses on understanding and combatting age-related ailments. This review provides insights into the distinctive aspects of anti-aging research, highlights current priority issues in health promotion and anti-aging measures, and explores implications of crises on aging research and healthcare. Furthermore, it emphasizes the need for collaboration among interdisciplinary research networks, integration of science and technology, and the involvement of key stakeholders to ensure universal health coverage. Future research should address the multidimensional aspects of healthy aging, reflect research priorities and preferences of older individuals, and promote health equity. This collective effort will contribute to the development of innovative solutions and facilitate cross-learning among countries to enhance the well-being of aging populations globally.

Development of the HT&Me intervention to support women with breast cancer to adhere to adjuvant endocrine therapy and improve quality of life.

Breast cancer is the most common cancer in women worldwide. Approximately 80% of breast cancers are oestrogen receptor positive (ER+). Patients treated surgically are usually recommended adjuvant endocrine therapy (AET) for 5-10 years. AET significantly reduces recurrence, but up to 50% of women do not take it as prescribed. To co-design and develop an intervention to support AET adherence and improve health-related quality-of-life (QoL) in women with breast cancer. Design and development of the HT&Me intervention took a person-based approach and was guided by the Medical Research Council framework for complex interventions, based on evidence and underpinned by theory. Literature reviews, behavioural analysis, and extensive key stakeholder involvement informed 'guiding principles' and the intervention logic model. Using co-design principles, a prototype intervention was developed and refined. The blended tailored HT&Me intervention supports women to self-manage their AET. It comprises initial and follow-up consultations with a trained nurse, supported with an animation video, a web-app and ongoing motivational 'nudge' messages. It addresses perceptual (e.g. doubts about necessity, treatment concerns) and practical (e.g. forgetting) barriers to adherence and provides information, support and behaviour change techniques to improve QoL. Iterative patient feedback maximised feasibility, acceptability, and likelihood of maintaining adherence; health professional feedback maximised likelihood of scalability. HT&Me has been systematically and rigorously developed to promote AET adherence and improve QoL, and is complemented with a logic model documenting hypothesized mechanisms of action. An ongoing feasibility trial will inform a future randomised control trial of effectiveness and cost-effectiveness.

Collaboration and integration towards zero carbon refurbishment: A New Zealand case study

In light of climate change, zero carbon refurbishment for existing buildings is imperative for maximising carbon emission reductions. Due to the increasing complexity of reducing carbon emissions for existing buildings, there is a need for a more collaborative and integrative approach. Extensive research has shown the importance, benefits, and challenges of collaboration and integration in implementing sustainable buildings. However, little attention has been paid to investigating collaboration and integration in refurbishment projects that focus on reducing life cycle carbon emissions. This paper explores the collaboration and integration in the decision-making process towards zero carbon refurbishment by examining three real-life case studies in New Zealand. The findings resulted from an interactive cross-case analysis using replication logic within and among cases. Empirically, the study emphasises the importance of (1) organisational commitment and compatibility of team members, (2) the timely involvement of key stakeholders, (3) the highest level of integration in the design process, and (4) a centralised and integrated information system. The paper also divulges the current practices and challenges faced in the integration process, where lessons learnt are identified for future refurbishment projects. A collaboration and integration framework towards successfully delivering building projects towards zero carbon is proposed. The research implications may assist the real-world uptake of the zero‑carbon refurbishment approach by promoting effective collaboration and integration.

Understanding Smart City Practice in Urban China: A Governance Perspective

Through an evolution from an emerging marketing narrative to a geographical fact around the globe, smart city is increasingly understood as a city’s effort to make itself smart. There seems no single city in the world to be commonly recognized as a real smart city yet, albeit many cities have already tried hard in this missionary commitment. Yet some common features can still be seen and identified, particularly from the urban governance perspective. This article explores the practice of smart city construction in China through a lens of governance by observing the interactive involvement of key stakeholders in the process. By taking three cities (Hangzhou, Wuhan, and Shanghai) in China as study cases, a conceptual framework is established in which three sets of actors, i.e., ICT-related enterprises, government, and civil society, and, accordingly, three types of approaches, i.e., ICT-led, planning-led, and place-making-and-community-oriented, are identified. It is found that the evolution of smart city construction rather follows a nonlinear trajectory and is very dependent on whether or not the primary actors and related stakeholders can form an affirmative acting power in triggering the city’s implementation. In other words, there is no “one-size-fits-all” approach to smart city construction. Each city may have its specialization in smartness based on awareness of and respecting its unique existing setting. The empirical study also shows that smart city construction tends to be converged in recognition that the core of smart city is not the smartness of technology but the smartness of all institutions and people enabled to utilize smart tools properly and efficiently in pursuit of people’s well-being, institutional capacity building, and better spatial arrangement towards a sustainable, resilient, and inclusive city in and for the future. From a geographical perspective, that is how to build a smart urban space to make the city a better place to not just accommodate but facilitate and meet people’s increasing demand for a better life in their living places.

Best Practice Recommendations for Electronic Patient-Reported Outcome Dataset Structure and Standardization to Support Drug Development

The electronic patient-reported outcome (ePRO) Dataset Structure and Standardization Project is a multistakeholder initiative formed by Critical Path Institute’s PRO Consortium and Electronic Clinical Outcome Assessment (eCOA) Consortium to address issues related to ePRO dataset structure and standardization and to provide best practice recommendations for clinical trial sponsors and eCOA providers. Given the many benefits of utilizing electronic modes to capture PRO data, clinical trials are increasingly using these methods, yet there are challenges to using data generated by eCOA systems. Clinical Data Interchange Standards Consortium (CDISC) standards are used in clinical trials to ensure consistency in data collection, tabulation, and analysis and to facilitate regulatory submission. Currently, ePRO data are not required to follow a standard model, and the data models used often vary by eCOA provider and sponsor. This lack of consistency creates risks for programming and analysis and difficulties for analytics functions generating the required analysis and submission datasets. There is a disconnect between data standards used for study data submission and those used for data collection via case report forms and ePRO forms, which would be mitigated through the application of CDISC standards for ePRO data capture and transfer. The project was formed to collate and examine the issues arising from the lack of adoption of standardized approaches and this paper details recommendations to address those issues.Recommendations to address issues with ePRO dataset structure and standardization include adopting CDISC standards in the ePRO data platform, timely involvement of key stakeholders, ensuring ePRO controls are implemented, addressing issues of missing data early in development, ensuring quality control and validation of ePRO datasets, and use of read-only datasets.

Designing and evaluating a smartphone app to increase underserved communities’ data representation in transportation policy and planning

The current global focus on transportation equity, as well as a move towards smart mobility, highlights the need for more representative transportation data to inform transportation planning. In this case study, an interdisciplinary research team describes the process of refining and evaluating the utility of a transportation daily diary mobile-phone-based app. The process is framed through transportation equity and diverse key stakeholder engagement. The team custom-designed the app, MyAmble, to capture successful transportation behaviors, as well as latent demand, defined as travel not taken but desired, among underserved populations. Stakeholder focus groups with subject matter expert (n = 30) and end users (n = 19) were conducted prior to pilot testing the app, and post-pilot test focus groups (n = 18) and usability surveys (n = 76) were conducted to evaluate the app’s usability. Pre-pilot focus groups indicated that transportation planners desired more questions about safety and other transit modes. End users identified missing destinations, such as temporary housing locations. Post-pilot focus group members reported that using MyAmble required minimal training or technological assistance and that they had sustained confidence throughout usage. Further refinements include reducing length of daily use and resolving Broadband or data plan obstacles for end users. Designing transportation apps to collect data about transportation behaviors among underserved population members is critical to equitable transportation planning. Moreover, key stakeholder involvement in the design may produce more successful apps and those which include more relevant information for planners, as well as more inclusive travel behaviors.

Barriers and facilitators to the implementation of workplace health promotion programs: Employers' perceptions.

Workplace health promotion programs (WHPPs) can benefit the lifestyle and health of employees. However, not all WHPPs have been successful in their implementation, and thus their effectiveness. This study aimed to identify the barriers and facilitators to implementing an integrated WHPP, which targets multiple lifestyle factors at different levels (individual and organizational), from an employer's perspective. Data were collected by two online focus groups among 18 representatives of eight different organizations. Data from the focus group discussions were transcribed verbatim and analyzed using thematic analysis. Data were coded both inductively and deductively, using the Consolidated Framework for Implementation Research (CFIR) consisting of the following five domains: (1) intervention characteristics, (2) outer setting, (3) inner setting, (4) characteristics of individuals, and (5) process. Ratings were performed to indicate the positive or negative influence and strength of a construct regarding the implementation of WHPPs. Barriers and facilitators in all domains of the CFIR were found. Regarding characteristics of the WHPP, complexity and costs hindered implementation, while high adaptability facilitated it. An organization that met the needs of employees (the outer setting) facilitated implementation. Available resources, access to knowledge, leadership involvement, and continuity of communication were facilitators within the inner setting. Barriers were different approaches to implementation within one organization and the perceived interference with employees' lives. For the implementation process, the involvement of key stakeholders, including employees, was identified as an important facilitator. Various barriers and facilitators in different domains play a role in the implementation of integrated WHPPs, according to employers. Strategies that tackle the identified barriers and incorporate the facilitators will likely contribute to the successful implementation of integrated WHPPs.

A New Strategy for Rejuvenating Primary Healthcare: The Government-Society Partnership Model.

Primary healthcare systems worldwide are under stress as increased demands during pandemic surges have exposed deficiencies in the system. Primary healthcare centers have significant responsibilities but are often underfunded and understaffed. Recent events, including the COVID-19 pandemic, have highlighted the importance of a strong primary health center network to promote community health and save lives. Most governments have multiple competing financial needs for scarce resources, ultimately limiting the advancement of government primary healthcare systems. Hence, various models involving collaboration and outsourcing have been evaluated and employed to improve primary health services. We propose and describe a sustainable and scalable government-society partnership model to bridge the gulf and rejuvenate primary healthcare with a focus on the Indian healthcare system. The involvement of key stakeholders, including society, non-government organizations, and corporate sponsors, is essential to rebuild the network.

Визначення сутності корпоративної інтеграції у векторі розвитку корпоративного управління

The study is dedicated to determining the essence of corporate integration in the vector of corporate governance development, in particular, foreign and domestic research on the essence and processes of corporate integration in the vector of corporate governance development was thoroughly summarized and the basic principles of corporate integration process management were substantiated. In our research, we came to the view that integration can be represented in dynamics as a process, and in statics as a state, the result of a process. For all the multitude of types of integration, we came to the conclusion that they come down to two options depending on the subject composition of the participants: territorial (interstate, interregional) integration; production integration. The conducted research made it possible to identify within the currents and schools of economic theory different directions for the study of integration activity, which is explained by the complexity, multi-component and interdependence of the components of the phenomenon under study. Also, our analysis of literary sources revealed the absence of a universal approach both to the phenomenon of corporate integration and to its typology. Therefore, its essence and process were considered within the framework of the neoclassical direction, institutional economic theory, from the standpoint of the structural-functional approach and the global economic approach. Today, there is an approach that examines integration processes in two areas: international economic relations and organizational and economic relations at the level of individual organizations. Depending on the direction of corporate integration, the main types of merger and acquisition agreements were highlighted. In the study, according to the level of centralization of functions, two main organizational and economic forms of a corporate association were highlighted and schematically presented: an international corporation and an international strategic alliance. We also considered the management characteristics of the classification of integration associations from several different aspects: level of integration; goals of integration; form of ownership; field of activity; geographic coverage. We have described in detail the forms of international corporations, such as national associations, syndicates, trusts, concerns, and conglomerates, since these forms are a rigid and long-term type of association of companies. It was determined that each of the considered organizational and economic forms can be formed by various methods, which we presented in the author's classification of methods of formation of organizational and economic forms of international corporate integration. It was determined that management of corporate integration processes requires justification, adoption and implementation of management decisions. These decisions are determined by various factors: strategic orientation; new competitive advantages and competencies; interaction with other subjects of economic relations. These parameters affect the development and implementation of management solutions in the field of corporate integration. The article identifies several widely used methods of managing corporate integration processes that help ensure a successful merger or acquisition of companies: strategic planning; project management; involvement of key stakeholders; cultural integration; effective communication. Therefore, the choice of necessary and effective management methods depends on specific circumstances, strategic goals and features of corporate integration. It is recommended to choose those methods that are best suited to achieve successful integration of companies, in particular, they can be combined.

578: DEVELOPING A COMMUNICATION TOOL FOR FAMILIES IN THE PEDIATRIC INTENSIVE CARE UNIT: A DELPHI STUDY

Introduction: Effective communication is essential to delivering quality care in the pediatric intensive care unit (PICU). There is a growing body of literature supporting the use of communication tools in the adult ICU, neonatal ICU, and palliative care setting. There is no easily scalable tool that has been described to support families in communication in the PICU. We propose that engaging key stakeholders in the development of a PICU family communication tool via a Delphi study will result in consensus about pertinent items to include, resulting in a useful tool for families. Methods: The Delphi method was used to inform a five-part process: (1) drafting of potential items for the tool based on literature review, (2) focus group of experts in critical illness communication to refine and condense items to be included in a survey, (3) survey of key stakeholders including parents of children with previous PICU admission and PICU healthcare providers, (4) additional rounds of the survey via the Delphi method until consensus is reached, (5) final review of the tool by critical illness communication experts. The survey queries stakeholders using a 5-point Likert scale and qualitative feedback for each item. Items with a score of 4 or 5 by >70% of stakeholders are included in the next round of the Delphi with incorporation of qualitative feedback. Results: There were ten participants in the initial focus group consisting of nurses, physicians, and researchers, mostly practicing in an academic setting (50%), with most participants having greater than 10 years of experience in their specialty (80%). Twenty-six specific items were drafted for inclusion in the Delphi method survey under six major themes: questions about medical information, questions about the provision of care, questions about communication, questions about decision-making, discussing family and patient needs with the medical team, and discussing more information about their child with the medical team. Conclusions: The Delphi method provides a useful stepwise approach for the involvement of key stakeholders in the creation of a tool that supports families in communication with their healthcare providers in the PICU. Future research should trial efficacy of this tool.