Perspectives Of Key Stakeholders Research Articles

Informing a European guidance framework on electronic informed consent in clinical research: a qualitative study

BackgroundElectronic informed consent (eIC) may offer various advantages compared to paper-based informed consent. However, the regulatory and legal landscape related to eIC provides a diffuse image. By drawing from the perspectives of key stakeholders in the field, this study aims to inform the creation of a European guidance framework on eIC in clinical research.MethodsFocus group discussions and semi-structured interviews were conducted with 20 participants from six stakeholder groups. The stakeholder groups included representatives of ethics committees, data infrastructure organizations, patient organizations, and the pharmaceutical industry as well as investigators and regulators. All were involved in or knowledgeable about clinical research and were active in one of the European Union Member States or at a pan-European or global level. The framework method was used for data analysis.ResultsStakeholders underwrote the need for a multi-stakeholder guidance framework addressing practical elements related to eIC. According to the stakeholders, a European guidance framework should describe consistent requirements and procedures for implementing eIC on a pan-European level. Generally, stakeholders agreed with the definitions of eIC issued by the European Medicines Agency and the US Food and Drug Administration. Nevertheless, it was raised that, in a European guidance framework, it should be emphasized that eIC aims to support rather than replace the personal interaction between research participants and the research team. In addition, it was believed that a European guidance framework should include details on the legality of eIC across European Union Member States and the responsibilities of an ethics committee in the eIC assessment process. Although stakeholders supported the idea to include detailed information on the type of eIC-related materials to be submitted to an ethics committee, opinions varied on this regard.ConclusionThe creation of a European guidance framework is a much needed factor to advance eIC implementation in clinical research. By collecting the views of multiple stakeholder groups, this study advances recommendations that may facilitate the development of such a framework. Particular consideration should go to harmonizing requirements and providing practical details related to eIC implementation on a European Union-wide level.

A Helmet of Her Own?: A Qualitative Study of Key Stakeholder Perspectives on Headgear in Girls’ Lacrosse

Despite the high incidence rate of concussions in women's lacrosse, there is substantial push back against the use of helmets at the secondary educational and collegiate levels in the U.S. This study examines the social factors influencing the controversy surrounding the use of protective headgear and how the recent development of headgear specific to the women's game has shaped ongoing debates. Purposeful sampling was used to recruit interviewees with research knowledge or firsthand experience with injury and protective headgear in girls' lacrosse. Semistructured interviews were conducted and subsequently coded using qualitative research software to identify key themes and patterns. Sixteen respondents participated in this study; 4 players, 4 coaches, 3 researchers, and 5 administrators were represented in this sample. Overarching themes identified across these interviews included playing through pain, health consequences of concussions, concussion prevention strategies and the potential role of headgear, symbolism of headgear, gender dynamics, autonomy, and decision making. This qualitative study shows the importance of attention to the unique history of girls' lacrosse and current narratives surrounding headgear in the sport. There is a need for greater collaboration and consensus between all relevant groups to ensure that headgear best addresses the concerns of the people who will ultimately be using it. Future qualitative research should build on this preliminary study with a larger and more diverse sample to follow up on key themes and ultimately inform effective safety measures to protect athletes.

SARS-CoV-2 Pandemic's Impact on Domestic Violence Assistance: The Portuguese Stakeholders' Perspective

The SARS-CoV-2 pandemic has largely exposed pre-existing inequalities, deepening prevalent vulnerabilities and resulting in large and insidious impact on people's lives. Gender-based and domestic violence was configured within perverse and serious circumstances, as victims and aggressors were forced to remain in the same spaces, because of the confinements and mobility restriction, demanded by Governments worldwide to protect Global Public Health. In Portugal the situation was no different. A qualitative study was addressed to assess narratives and perspectives of key stakeholders and workers in the field. In-depth semistructured interviews were applied to six professionals with crucial roles both in terms of representation of the State and local structures, intervention, and response in the processes of domestic violence, as well as acting directly with victims. The results show important gaps in addressing domestic violence during the confinements. Nevertheless, our participants unanimously stated that social isolation associated to economic crisis intensified the occurrence of domestic violence and hinder victims' access to adequate care services. Additionally, the shortage of human resources in this area, and lack of adequate investment and financial resources contributed to impoverishment of health, protection, and guarantee of dignity and human rights for victims of gender-based and domestic violence.

Scenarios of STR Development in the Logic of Socio-Political Changes (Based on the Materials of Stakeholders' Assessment)

The system of secondary vocational education is of strategic importance for the economy, since the quality of training determines the potential of its development. The speed of the emergence of new technologies requires flexibility and structural complexity of educational mechanisms, which is reflected in the decisions of the federal project "Professionalism". The new reality dictates the need for a conceptual understanding of the logic of the development of PDF, the potential and risk-taking of the steps taken and the viability of initiatives. The authors' contribution to the solution of this problem consists in identifying possible scenarios for the development of STR based on the expectations and readiness of stakeholders. The purpose of this article is to analyze possible scenarios for the development of SPE and their assessment from the perspective of key stakeholders – teachers and administrators of training institutions for SPE. Methodology, methods and techniques. The work consists of three main blocks: a theoretical analysis of research on the functioning of the SPO; an empirical part, presented by a description of the author's methodology and data from an expert survey; resulting conclusions containing formulations of basic scenarios for the development of the SPO. The scientific novelty of the research lies in the development of a methodology for analyzing the state and prospects of the development of SPO by a key stakeholder – training institutions for SPO. Practical significance. Conceptual constructions and the obtained practical data can be taken into account when developing educational strategies, individual results are useful for optimizing the educational process in universities that train personnel for vocational education. Conclusions. Changes in the value basis of vocational education, as well as an increase in the motivation of teachers and masters (not only material, but also at the level of understanding and acceptance of ideas) determine the effectiveness of decisions and initiatives.

A qualitative study of multiple voices to inform aftercare services for older persons following self-harm.

Self-harm and suicide are closely related in older adults, highlighting the opportunity for Aftercare interventions in targeted suicide prevention. The study aims were to explore strengths and shortfalls of current Aftercare services for older adults from the perspective of key stakeholders and researchers; and inform a set of guiding principles for older persons' Aftercare. Semi-structured interviews were undertaken with a convenience sampleof older people with lived experience of self-harm, clinicians and suicide researchers (n=22). Interviews were focussed on current practice (strengths and limitations), potential improvements, and identifying the core components of an acceptable Aftercare model. Interviews were audio-recorded, transcribed and subjected to a reflexive thematic analysis grounded in interpretive description. Current practice strengths included validation, a person-centred approach and optimising aftercare delivery. Limitations included ageism, practical limitations (lack of service awareness, fragmented service provision, barriers to access, and traumatising approaches), and limited services, funding and training. Overarching themes included anti-ageism; anti-stigma; empowerment and agency; conveying hope; patience and pace; accessible; and finding purpose: connections and meaningful activity. Older people who have self-harmed have complex, individualised needs. They sit within intersecting systems traversing healthcare, support services, family, and the social environment. Systemic, coordinated Aftercare founded upon core principles of anti-ageism, anti-stigma, partnership, empowerment, accessibility and provision of connections and meaning are needed.

Decision-Making Prepandemic: University Curtailment of Academic Operations Closure Processes During the Novel Coronavirus Disease 2019 (COVID-19) Outbreak.

Through in-depth interviews, this study aimed to understand perspectives of key stakeholders regarding the decision to curtail academic operations in the setting of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak before the declaration of a pandemic on March 11, 2020, and how such processes may be optimized in the future to best protect public health and safety. Virtual interviews with key stakeholders from 4 academic institutions were conducted from September to December 2020 using a standardized interview question template. The interviews lasted approximately 30-45 minutes and each interview was recorded with permission. The interviews were then transcribed and reviewed for qualitative analysis. The decision to curtail academic operations involved several common themes, such as discussing how institutions would control the outbreak and the process of transitioning to virtual learning and remote work. Universities were monitoring other universities' responses as well as evaluating the prevalence of cases nationally and globally. Risks and challenges identified included housing for international students, financial implications, and loss of academic productivity. The decision-making process may be optimized in the future by focusing on communication within a smaller committee, prioritizing epidemiology over fiscal implications, and embracing an openness to consider new strategies. Further research regarding this topic should be pursued to best protect public health and safety.

2078. Barriers and Facilitators to the HIV (PrEP) Care Continuum: Perspectives of Key Stakeholders and Formerly Incarcerated Individuals.

Abstract Background Recently incarcerated individuals are at increased risk for HIV acquisition during community re-entry but have poor access to HIV pre-exposure prophylaxis (PrEP). There is an opportunity to integrate PrEP into an existing Formerly Incarcerated Transition (FIT) program in North Carolina (NC). We aimed to explore potential barriers and facilitators to post release PrEP implementation within the existing FIT program from the perspectives of formerly incarcerated individuals (FIT clients) and community stakeholders (community health clinicians, community health workers). Methods We conducted 28 semi-structured in-depth interviews (14 FIT clients and 14 community stakeholders). We used a rapid assessment method to summarize interview transcripts based on the domains of the semi-structured interview guide and to characterize the contents of the summaries as potential barriers or facilitators to steps of the PrEP cascade. Results HIV stigma was mentioned as a potential barrier at each step of the PrEP cascade among both FIT clients and stakeholders. Both groups emphasized the importance of PrEP education for FIT clients, stakeholders, and the community to facilitate awareness and HIV risk perception. Stakeholders and FIT clients believed that competing priorities would be a significant barrier to PrEP uptake post-release. Linking incarcerated individuals to PrEP services during incarceration was mentioned as a facilitator to increase PrEP uptake. A lack of ongoing social support was seen as a critical barrier by FIT clients to achieve the necessary adherence to PrEP and retention to PrEP appointments. Both groups cited financial and logistical challenges such as the cost of PrEP services and transportation as potential barriers to PrEP adherence and retention. Conclusion Community stakeholders and FIT clients recommended several strategies that can be implemented to increase PrEP knowledge, uptake, and retention upon release. However, they also identified critical structural barriers that must be overcome before PrEP can be adopted among formerly incarcerated individuals in a non-Medicaid expansion state. Disclosures All Authors: No reported disclosures.

'We are doing damage control': Government stakeholder perspectives of educational and other services for children with autism spectrum disorder in South Africa.

Autism spectrum disorder is a growing public health concern in low- and middle-income countries like South Africa where there are no plans or policies in place for autism spectrum disorder management. Many children with autism spectrum disorder in South Africa are out of schools and waiting for school placement to become available. This study explored the perspectives of key government stakeholders on educational and other services for children with autism spectrum disorder in the Western Cape Province of South Africa and their suggestion for improving services for these children and their families. Semi-structured interviews were conducted with government stakeholders from the Western Cape Department of Education, Department of Health and the Department of Social development. The main theme that emerged was 'We are doing damage control'. Government stakeholders acknowledged that autism spectrum disorder services were being overlooked because of other demands on government resources. Finding from this study highlighted the need for government departments to work together to develop a strategy for autism spectrum disorder management. Engagement between government and civil society to break down barriers, strengthen systems and develop solutions to improving access to services for children with autism spectrum disorder and their families is recommended.

Perceptions of staff and leadership teams on implementation of telepresence robots in long‐term care: a qualitative descriptive study

AbstractBackgroundCOVID‐19’s physical distancing mandates have increased the likelihood of experiencing social isolation and loneliness for residents in long‐term care (LTC), especially those living with dementia. Social isolation correlates with health risks, including depression and cognitive decline. Telepresence robots can be remotely driven and facilitate social interactions through videoconferencing. Researchers have begun to explore opportunities of using these robots in the healthcare field; however, there is a research gap on examining factors influencing their implementation in LTC from the perspectives of key stakeholders. This qualitative descriptive study focuses on exploring LTC staff and leadership teams’ perspectives on facilitators and barriers to implementing telepresence robots.MethodWe employed purposive and snowballing methods to recruit 22 participants from two LTC homes in British Columbia, Canada: operational and unit leaders, and interdisciplinary staff including nursing staff, care aides and allied health practitioners. Consolidated Framework for Implementation Research (CFIR) guided our data collection and analysis. Semi‐structured interviews were conducted by virtual meetings. Thematic analysis was performed to identify themes.ResultAnalysis of the data produced three themes: (a) perceived needs and values for family‐resident connections, (b) engagement through conversation and partnership, and (c) confidence with training and timely support. Based on the findings and CFIR guidance, we offer a preliminary conceptual tool “START”: Share benefits and successes; Tailor policies and plans with staff partners; Acknowledge and address staff concerns; Repeated training and demonstrations; and Timely technical support.ConclusionThis study offers pragmatic insights into staff and leadership teams’ perceptions of facilitators and barriers of implementing telepresence robots in LTC. The complexity of technology implementation will require executive and leadership teams to consider additional factors beyond the Plan‐Do‐Study‐Act (PDSA) cycle.

Early Supported Discharge for Older Adults Admitted to Hospital with Medical Complaints: A Qualitative Study Exploring the Views of Stakeholders.

Early supported discharge (ESD) is well established as a model of health service delivery for people with stroke. Emerging evidence indicates that ESD also reduces the length of stay for older medical inpatients. There is a dearth of evidence exploring the views of stakeholders on ESD as a model of care for older medical inpatients. The overall aim of this study is to explore the views and perceptions of older adults, family carers and healthcare professionals on the potential role of ESD for older adults admitted to hospital with medical complaints. Purposeful sampling was used to recruit older adults and family carers for interview. For Healthcare Professionals (HCPs), snowball purposeful sampling was used. Phone interviews took place following a semi-structured interview guide. Focus groups were moderated by A-MM. Braun and Clarke's approach to thematic analysis was used. Ethical approval was granted by the HSE Mid-Western Area Regional Ethics Committee in November 2021 (REC Ref. 096/2021). Fifteen HCPs took part across three focus groups, with six older adults and two family members participating in one-to-one interviews. Three themes were identified: 1. Pre-ESD experiences of providing and receiving older adult inpatient care, 2. Navigating discharge procedures from acute hospital services, 3. A vision for more integrated model of care and a medical ESD team. This study provided insight into the current discharge experiences of older adult care in the acute setting, the potential role for ESD in this population and the key factors that would need to be considered for the running of an ESD service for older adults admitted to hospital with medical complaints. This research highlights the barriers and facilitators to ESD for older medical inpatients from the perspectives of key stakeholders. Given the adverse outcomes associated with prolonged hospital stay, these findings will help inform the development of a feasibility trial, examining patient and process outcomes for older adults admitted to hospital with medical complaints who receive an ESD intervention.

Public health approaches to youth involvement in violence: Examining stakeholders’ perspectives in Australia and the United Kingdom

Australia and the United Kingdom (UK) have each witnessed a ‘punitive turn’ in relation to youth justice responses. A lack of contextualisation, such as the impact of trauma and adverse childhood experiences on young people, is often overlooked by media outlets, governments and policymakers, in favour of individual pathologisation of young people. In direct contrast to these punitive responses, the public health approach (PHA) has emerged particularly in the UK; and it identifies experiences of trauma as one of the leading causes of violence within communities. Drawing on the perspectives of those working with children and young people, we critically explore whether the implementation of a PHA could be an effective approach to addressing the underlying causes of young people's involvement in violence. The paper focuses specifically on a case study of the youth justice system in Victoria, Australia and draws on domestic and global perspectives of key stakeholders, to consider whether the introduction of a PHA in Victoria, Australia, would position young people's diverse needs at the centre of policy change in youth justice and better outcomes for young people and communities.

Pharmacogenomic Testing for Major Depression: A Qualitative Study of the Perceptions of People with Lived Experience and Professional Stakeholders.

With increasing evidence for the clinical utility of pharmacogenomic (PGx) testing for depression, there is a growing need to consider issues related to the clinical implementation of this testing. The perspectives of key stakeholders (both people with lived experience [PWLE] and providers) are critical, but not frequently explored. The purpose of this study was to understand how PWLE and healthcare providers/policy experts (P/HCPs) perceive PGx testing for depression, to inform the consideration of clinical implementation within the healthcare system in British Columbia (BC), Canada. We recruited two cohorts of participants to complete individual 1-h, semi-structured interviews: (a) PWLE, recruited from patient and research engagement networks and organizations and (b) P/HCPs, recruited via targeted invitation. Interviews were audiotaped, transcribed verbatim, de-identified, and analysed using interpretive description. Seventeen interviews were completed with PWLE (7 with experience of PGx testing for depression; 10 without); 15 interviews were completed with P/HCPs (family physicians, psychiatrists, nurses, pharmacists, genetic counsellors, medical geneticists, lab technologists, program directors, and insurers). Visual models of PWLE's and P/HCP's perceptions of and attitudes towards PGx testing were developed separately, but both were heavily influenced by participants' prior professional and/or personal experiences with depression and/or PGx testing. Both groups expressed a need for evidence and numerous considerations for the implementation of PGx testing in BC, including the requirement for conclusive economic analyses, patient and provider education, technological and clinical support, local testing facilities, and measures to ensure equitable access to testing. While hopeful about the potential for therapeutic benefit from PGx testing, PWLE and P/HCPs see the need for robust evidence of utility, and BC-wide infrastructure and policies to ensure equitable and effective access to PGx testing. Further research into the accessibility, effectiveness, and cost-effectiveness of various implementation strategies is needed to inform PGx testing use in BC.

“So, if she wasn’t aware of it, then how would everybody else out there be aware of it?”—Key Stakeholder Perspectives on the Initial Implementation of Self-Collection in Australia’s Cervical Screening Program: A Qualitative Study

In December 2017, the Australian National Cervical Screening Program transitioned from 2-yearly cytology-based to 5-yearly human papillomavirus (HPV)-based cervical screening, including a vaginal self-collection option. Until July 2022, this option was restricted to under- or never-screened people aged 30 years and older who refused a speculum exam. We investigated the perspectives and experiences of stakeholders involved in, or affected by, the initial implementation of the restricted self-collection pathway. Semi-structured interviews were conducted with 49 stakeholders as part of the STakeholder Opinions of Renewal Implementation and Experiences Study. All interviews were audio recorded and transcribed. Data were thematically analysed and coded to the Conceptual Framework for Implementation Outcomes. Stakeholders viewed the introduction of self-collection as an exciting opportunity to provide under-screened people with an alternative to a speculum examination. Adoption in clinical practice, however, was impacted by a lack of clear communication and promotion to providers, and the limited number of laboratories accredited to process self-collected samples. Primary care providers tasked with communicating and offering self-collection described confusion about the availability, participant eligibility, pathology processes, and clinical management processes for self-collection. Regulatory delay in developing an agreed protocol to approve laboratory processing of self-collected swabs, and consequently initially having one laboratory nationally accredited to process samples, led to missed opportunities and misinformation regarding the pathway's availability. Whilst the introduction of self-collection was welcomed, clear communication from Government regarding setbacks in implementation and how to overcome these in practice were needed. As Australia moves to a policy of providing everyone eligible for screening the choice of self-collection, wider promotion to providers and eligible people, clarity around pathology processes and the scaling up of test availability, as well as timely education and communication of clinical management practice guidelines, are needed to ensure smoother program delivery in the future. Other countries implementing self-collection policies can learn from the implementation challenges faced by Australia.

Sexual and Reproductive Health Advocacy Successes, Failures, and Needs in the United States: Perspectives From Key Stakeholders.

Physician advocates for sexual and reproductive health (SRH) care have been active in the United States for decades. Despite such activism, access to SRH services has been fraught with persistent restrictions, particularly for abortion care. We sought the perspectives of key stakeholders on what makes for an effective SRH physician advocate and thoughts about the successes, failures, and needs of the abortion advocacy movement. We interviewed 15 SRH key informants (KIs) in sectors with expertise in organizational policy and advocacy (n = 6); clinical leadership and education (n = 3), media (n = 3), and reproductive justice (n = 3). The analytic team coded repeating ideas and conducted a thematic analysis, organizing findings within KI perspectives on the role of physician advocates in the field of abortion and contraception; successes, failures, and needs in abortion and contraception advocacy; and recommendations on the composition and components of an ideal clinician advocacy training program. KIs relayed that skill building related to communication, developing relationships with changemakers, and understanding political systems was critical for effective advocacy. They felt clinician advocacy training programs should include providers other than physicians and be designed for trainees to build relationships with one another over time. KI perspectives can be valuable in informing advocacy training programs and for contributing strategic approaches to increasing equitable and widespread access to SRH services.

P094Sexual and reproductive health advocacy successes, failures, and needs in the US: Perspectives from key stakeholders

<h3>Objectives</h3> Despite active advocacy for access to sexual and reproductive health (SRH) services in the US, persistent restrictions have created barriers to care. We sought the perspectives of key stakeholders on what makes for an effective SRH physician advocate and thoughts about the successes, failures, and needs of the abortion advocacy movement. <h3>Methods</h3> We interviewed 15 SRH key informants (KIs) in sectors with expertise in organizational policy and advocacy (n=6); clinical leadership and education (n=3); media (n=3); and reproductive justice (n=3) as part of a mixed-methods evaluation of a physician advocacy training program. The analytic team coded repeating ideas and conducted a thematic analysis, organizing findings within KI perspectives on the role of physician advocates; successes, failures, and needs in SRH advocacy; and recommendations on the composition and components of an ideal advocacy training program. <h3>Results</h3> KIs felt successes included mandated access to contraception under the Affordable Care Act and the application of reproductive justice and storytelling to abortion advocacy. Failures included misplaced political focus and increased abortion bans. Participants highlighted the importance of building community across disciplines and diminishing silos. Skill-building related to communication, developing relationships with changemakers, and understanding political systems was thought to be critical for effective advocacy. They felt clinician advocacy training programs should include providers other than physicians and be designed for trainees to build relationships with one another over time. <h3>Conclusions</h3> KI perspectives can be valuable in informing advocacy training programs and for contributing strategic approaches to increasing equitable and widespread access to SRH services.

Climate Change and the Caribbean: Challenges and Vulnerabilities in Building Resilience to Tropical Cyclones

Caribbean Small Island Developing States (SIDS) is one of the most vulnerable regions in the world to the impacts of climate change. The region has prioritized adaptation to climate change and has implemented many adaptation actions over the past 20 years. However, the region is becoming increasingly vulnerable to the impacts of tropical cyclones (TC). This paper analyses the impacts of TC on the region between 1980 to 2019. It aims to examine the economic loss and damage sustained by the region, identify the sectors most impacted, and ascertain the perspectives of key stakeholders on the factors that hinder building resilience. Statistical analysis techniques and semi-structured interviews were to unpack and understand the dataset. The paper finds that economic loss and damage has gradually increasing between 1980 to 2009 with a drastic increase between 2010 to 2019. The paper highlights the agriculture, housing, transport, and utility sectors as the most impacted. The findings also call to attention the need for increased access to adaptation financing for SIDS, the disadvantages of the income status that hinders building resilience, and the need for increased Early Warning Systems. The paper recommends revising the per capita national income as an eligibility criterion for accessing concessional development finance assistance, a comprehensive EWS for the countries in the region, and consideration of debt relief for countries affected by TC.

The role of intimate partner relationships on suicide risk among men in the construction sector in New Zealand (NZ): Understanding the interplay between work, family, and employee mental health

This oral presentation aims to illustrate a comprehensive literature review and methodology used in my study. The main purpose of this study is to explore the role of intimate partner relationships on suicide risk among men in the construction sector in NZ. The focus of my research is on relationship breakdown which is a predominant theme preceding suicide by men in the industry (Bryson et al., 2019). Several studies have investigated specific elements of intimate partner relationships associated with suicidality, including intimate partner violence and abuse (Devries et al., 2013; McLaughlin et al., 2012). There is currently no research within NZ that has explored the interplay between men’s work, family, and mental health. The underlying theoretical paradigms for this study will be interpretivism and critical theory. For this study, I will use qualitative research methodology because I seek to capture the experiences, perceptions and perspectives of construction workers, their spouses, and key stakeholders. My data collection for Study 1 will comprise of semi-structured face-to-face interviews with key stakeholders in the construction sector. Study 2 will comprise of semi-structured face-to-face interviews with construction workers across a range of occupations and their intimate partners. Recruitment of participants for Study 1 will be based on each participant having direct and current connection to the construction sector in NZ. Study 2 recruitment will be through the MATES in Construction Programme where participants will be selected from across a range of occupations within the sector. Furthermore, their partners will be invited to participate in the research. Thematic analysis will be used to analyze the transcripts from the interviews. NVivo software will be used for data analysis to deduce the main themes and subthemes in the data coding. Currently, I am finalizing my confirmation of candidature; after which I intend to apply for ethical approval and plan to conduct fieldwork in NZ once this is received.

Current issues and future considerations for the wider implementation of robotic-assisted surgery: a qualitative study

ObjectivesThe effective implementation of a fast-changing healthcare delivery innovation, such as robotic-assisted surgery (RAS), into a healthcare system, can be affected (both positively and negatively) by external contextual factors. As...

Accounting Undergraduates’ Action Plans in Designing their First Career

This paper aims to examine the accounting undergraduates’ action plan in designing their first career to increase their chances to be employed immediately after they graduate. This is essential given that the growing unemployment rate were reported in the nation. Using a qualitative research design, semi-structured interviews were conducted involving five final-year students and five work supervisors/managers in Melaka, Malaysia. The study discovered that undergraduates’ initial decision about which career path to pursue will influence their internship placement. To guarantee post-graduation employment, undergraduates should be prepared for real-world challenges, equipped with computer skills, soft skills, interpersonal skills, good time management, and be able to integrate internship experiences with academic knowledge. Employers expect undergraduates to comprehend accounting standards and guidelines like MFRS, MPERS, and MPSAS and possess good attitudes and interpersonal skills. Hence, discovering undergraduates’ action plan may provide opportunities to explore areas for improvement in internship practices from the perspectives of key stakeholders including university department leaders, work supervisors/managers, lecturers as well as final year students. It is vital as work-based experiences have become increasingly important in education prior to beginning a career as it allows students to develop skills and competencies that determine their employability. Future research should include more public and private universities as it will provide more generalizability of insights into Malaysian accountancy undergraduates’ action plans in designing their first career as well as involving more participants.

Implementing a smoking cessation training for lower socioeconomic groups into local policy in Amsterdam, the Netherlands: Identifying preconditions and barriers among multiple stakeholder groups

Abstract Background Socioeconomic inequalities in smoking prevalence are high, partly because smoking cessation programs are insufficiently accessible and suitable for smokers with a lower socioeconomic position (SEP). To make it easier for this target group to access suitable smoking cessation programs, it is necessary to structurally implement such programs into local policies. The study aims to identify preconditions and barriers for the implementation of smoking cessation programs for people with low SEP from the perspective of key stakeholders. Methods The Feel Free! Smoking cessation rolling group training has been previously developed for people from lower socio-economic groups and was implemented in Amsterdam Noord. Semi-structured interviews were held with 25 stakeholders consisting of participants, trainers, professionals in the neighbourhood and stakeholders of the municipality. The interviews were audio-recorded, transcribed verbatim and analysed using a thematic approach. The Implementation Framework of Fleuren will be used to structure the presentation. Results The main preconditions found are effective recruitment of participants by local professionals, having a central coordinator for implementation within the neighbourhood network, and offering a smoking cessation program with a clear added value for participants. The main barriers found are challenges in setting up a sustainable financial structure, allocation of organizational tasks, and high participant absences and dropout. More results will be presented in detail. Conclusions This study shows that action is required from various stakeholders to facilitate the implementation process. These findings can inform policy makers and implementers to choose strategies to implement suitable smoking cessation programs into local policy.