Local Steering Committee Research Articles

Evolution of the Greater Manchester Nutrition and Hydration Programme.

Older adults in the community are at risk of malnutrition and dehydration. The present article aims to outline an intervention and a population-health approach to raise awareness of the importance of good nutrition and hydration in later life. This was addressed by developing strong partnership working, governance frameworks and local steering committees. Through the Greater Manchester Nutrition and Hydration Programme, 39 500 older people have been asked about appetite and weight loss and/or used the PaperWeight Armband to date. A total of 5586 people from this population were found to be at risk of malnutrition. All were provided resources, advice and signposting to address this issue. The gross fiscal return on investment over a 5-year period was 3.2-fold and the net present budget impact was £800 000. The long-term cashable fiscal return on investment was estimated at 2.69. This very promising approach has potential to enable older adults to extend their healthy life span and deliver cost savings to the health and care system.

Examining the implementation of the Healthy Kids Community Challenge

Introduction: The Healthy Kids Community Challenge (HKCC) was a community-based, multi-stakeholder obesity prevention program aimed at children and youth in Ontario, which was funded and coordinated by the Ministry of Health and Long-term Care from 2015-2018. This project contributed to the process evaluation of the HKCC, which is being carried out by Public Health Ontario. The objective of my research was to identify and understand the barriers and facilitators to implementation of the HKCC, from the perspective of members of the Local Steering Committees (LSCs), who were directly involved in implementation.
 Methods: 10 questions from the 2018 LSC Survey were coded and thematically analyzed, using NVivo 11.0 software, according to the themes presented within Durlak and Dupre’s Ecological Framework for Effective Implementation. Themes were summarized according to barriers, challenges, factors associated with implementation, strategies communities used to engage partners and reach vulnerable populations, as well as positive experiences. The findings were presented in a report which featured a rich, qualitative account, accompanied by direct quotations and code frequency charts.
 Results: A number of perceived barriers to implementation were identified, including program structure (i.e., tight timelines, short duration), low SES (i.e., barriers related to lack of time, transportation and access to childcare, as well as difficulty accessing HKCC information) and geography and transportation (i.e., to access programming). Some important perceived facilitators of implementation included: funding, partnerships, HKCC messaging, and an inclusive, accessible approach to planning events. Participants expressed interest in sustaining programs and partnerships beyond the HKCC funding period, although the loss of provincial funding was identified as a challenge. Participants also noted potential for sustainability, particularly related to increased cross-sectoral collaboration and increased capacity for community-based health promotion.
 Implications: The results could be used to improve implementation of future community-based, multi-stakeholder health promotion programs. They might also offer insight into how to tailor the implementation process of large-scale community-based health promotion programs to local contexts.

An early implementation assessment of Ontario\u2019s Healthy Kids Community Challenge: results from a survey of key stakeholders

BackgroundIn Ontario Canada, the Healthy Kids Community Challenge (HKCC) is a program intended to reduce the prevalence and prevent childhood overweight and obesity through community-based initiatives to improve health behaviours. Guided by the RE-AIM framework and Durlak and DuPre’s Ecological Framework for Understanding Effective Implementation, the evaluation focused on two objectives: 1) to describe the organization of the program at the community level; and, 2) to identify opportunities for improvement through an early assessment of factors contributing to implementation.MethodsParticipants (n = 320) – members of the HKCC local steering committee, including the local project manager – completed a cross-sectional survey using SurveyMonkey and descriptive statistics were calculated. A sample (20%) of qualitative open-ended responses was thematically analyzed.ResultsResults indicated strong respondent agreement that the HKCC enhanced individual knowledge of access to health-promoting programs (88.3%) and messaging regarding healthy behaviours for healthy kids, with less for its effectiveness in reducing weight (53.1%). There was a high-level of adherence to HKCC social marketing messages and overall program structure, with few Local Project Manager reports of adaptations to theme one (9.2%) and theme two messages (15.4%). Fewer Local Project Managers (50%) reported the existence of private partnerships. While most respondents agreed they had the appropriate information to complete mandatory reporting, the usefulness of the HKCC online networking platform was in question (only 47% of Local Project Managers agreed that it was useful). Results reveal sufficient funding from the province to support program implementation, with a moderate level of local political commitment (63% of respondents).ConclusionsResults indicate that the HKCC was considered beneficial for enhancing access to health promoting programs, could be feasibly implemented with adherence to centrally-developed social marketing messages, and was amendable to local adaptation. Despite this, few private partnerships were reported. Going forward, there is opportunity to further evaluate factors contributing to HKCC program implementation, particularly as it relates to buy-in from intervention providers, and strategies for forming private sector partnerships to support long-term program sustainability.

Can clinical coordination be improved through Participatory Action Research (PAR) interventions?

Abstract Background Despite the effectiveness of Participatory Action Research (PAR) in reducing the gap between evidence and practice, its use to improve care integration is rare. The aim is to analyze the factors influencing the implementation of PAR interventions to improve clinical coordination in public health services networks of Brazil, Chile, Colombia, Mexico and Uruguay. Methods A qualitative, descriptive-interpretative study was conducted in participating healthcare networks of each country. Focus groups and individual semi-structured interviews were conducted to a criteria sample of participants: members of Local Steering Committee (LSC)(29), professionals’ platform (PP)(28), other professionals (49) and managers(28). Thematic content analysis was performed, segmented by country and themes. Results Findings reveal that contextual factors, the PAR process and interventions’ content were determinants in the implementation, interacting over time, and differing among experiences. On the one hand, institutional support (providing the necessary resources) together with the interest of professionals and managers in participating, emerged as influencing factors influenced by other factors related to: the system (alignment with policies; electoral cycle), networks (lack of time due to work overload; precarious employment conditions) and individuals (limited mutual knowledge and mistrust). On the other, some characteristics of the PAR process facilitated institutional support and motivation: professionals’ participation in all activities, design flexibility and shared decision-making - also present when interventions were based on mutual adjustment - the LSC’s leadership and the facilitating role of the research team. Conclusions Evidence is provided that when some contextual elements converge the implementation of interventions through PAR processes can turn into a factor of motivation and cohesion, determinant for the adoption of clinical coordination interventions. Key messages Contributes to fill the knowledge gap in factors influencing the implementation of PAR interventions in healthcare. Provides a framework for analysis and recommendations for their implementation.

Dossier : La fabrique de la compensation écologique : controverses et pratiques – Regards d’écologues sur le premier site naturel de compensation français

Le premier site naturel de compensation français a été inauguré le 11 mai 2009 sur le site d’un verger abandonné dans la plaine de Crau (Bouches-du-Rhône, France). Cette opération avait notamment pour objectif d’expérimenter le premier mécanisme d’offre de compensation français via la réhabilitation d’une végétation herbacée permettant le retour des oiseaux steppiques emblématiques de cet espace. Impliqués dans le comité local de pilotage, des écologues ont conseillé les techniques de réhabilitation et expertisé leurs effets sur la biodiversité tout en réalisant des recherches expérimentales pour étendre la restauration à la végétation et à certains groupes d’insectes. Après 7 années de suivis, les résultats montrent que la réhabilitation a bien permis la création d’une végétation favorable au retour de l’avifaune steppique mais le succès des expérimentations de restauration ne peut pas encore être définitivement prédit sur le long terme. Ces résultats soulignent les difficultés scientifiques et techniques de la restauration et limitent donc le mécanisme de compensation à la réhabilitation de certaines composantes ou fonctions.

New York State's Inland Geographic Response Plans

Geographic Response Plans (GRPs) are location-specific plans developed to provide guidance for oil spill responses throughout the United States. Until recently, the majority of crude oil transportation in the United States has occurred via waterways on oil tankers and barges, therefore, most existing GRPs focus on the protection of sensitive biological resources and socio-economic features in near shore environments. The recent development of crude oil extraction from the Bakken formation has resulted in a significant increase in the volume of crude oil being transported via railroads and pipelines and has highlighted the need for inland response planning. Rail cars transporting the volatile and flammable Bakken crude oil now traverse more than 850 miles of New York State on two major Class 1 Railroads. In response, Executive Order 125 was issued by the governor directing state agencies to strengthen the state's preparedness for incidents involving crude oil transportation. New York State's (NYS) Department of Environmental Conservation (DEC), in collaboration with the Department of Homeland Security & Emergency Services and Department of Health, are leading a multi-stakeholder effort to develop Inland GRPs for the 21 NYS counties currently impacted by crude-by-rail transportation. County steering committees were established consisting primarily of local first response agencies, as well as their state and federal partners. Utilizing Sensitive Resource Maps developed by DEC, coupled with the local steering committee input, location-specific response plans were drafted, reviewed, and set as final working “evergreen” documents, which are open for update/refinement at any time in the future. The NYSDEC GRPs are similar to typical GRPs in that they are map-based, location-specific contingency plans that outline response strategies for the protection of sensitive resources. However, the NYSDEC GRPs differ from traditional GRPs in several ways. They extend contingency planning to cover spills on land, in addition to surface water-based spills. Due to the flammability of Bakken crude oil, much more emphasis is placed on the fire risks associated with a train derailment. This is done by mapping sensitive human receptors (e.g., schools, daycare centers, assisted living centers, etc.), critical infrastructure, and identifying fire (and vapor) suppression assets. The NYSDEC GRPs also place more emphasis on the initial response options available to local first responders, options that can be implemented before other response assets may arrive on-scene (State, Federal, and RP). This presentation will discuss the development, structure, proposed implementation, training and exercises associated with this ongoing program.

Fostering employability among youth at-risk in a multi-cultural context: Insights from a pilot intervention program

Recent studies indicate that the transition from school to work is a critical juncture in shaping the professional future of youth at risk. This period may thus serve as a window of opportunities for fostering employability among these youths and, thereby, for promoting their social mobility. However, systematic evaluations of intervention programs aimed at fostering employability among at-risk adolescents—and especially in a multi-cultural context—are relatively few. The current study describes the strengths and weaknesses of a pilot, nation-wide, multi-cultural, holistic intervention program, aimed at fostering employability among at-risk adolescents before they actually enter the labor market. The program integrated efforts in three main domains: cultivating work-related skills, fostering personal and interpersonal skills, and providing a supportive personal and group climate. During the years 2011–2013, the program was operated in 40 localities in Israel and in three culturally different sectors: The Jewish-Israeli majority sector in the periphery, the Ultra-Orthodox Jewish minority sector, and the Israeli-Arab (Muslim) minority sector. The current study describes the results of an evaluation study that accompanied the implementation of the program in nine representative localities (117 adolescents, ages 14–19) during 2012.Overall, the functioning of the adolescents (as evaluated by the professional program instructors) improved in all examined work-related domains: personal-emotional functioning, work-related functioning, CV writing ability, and future education prospects. Regression analyses highlighted several factors as predictive of improvement in the different employability-related domains, most notably, having a working father, being active in group meetings, having no Internet connection at home, helping other participants in the program, and being involved in selecting the topics of a professional course. Importantly, this improvement was linked with the cultural affiliation of the participants, and participants from the different sectors indicated different factors as contributing to their advancement.The results of this evaluation study suggest that intervention programs for promoting employability among at-risk adolescents should integrate a holistic and flexible national model with adaptations by local steering committees, whose members are from the same cultural group as the participating adolescents. Such a strategy will enable each unique community to tailor the local operation of the program to the culturespecific needs of—and to maximally utilize the resources available for—the different sectors in a multi-cultural society, while establishing a dialogue and reciprocal learning in national forums. A dilemma has been identified, however, with respect to increasing the local involvement of the national committee to provide the local committees with different viewpoints.

Climate change adaptation strategies for transportation infrastructure in Prince George, Canada

Transport infrastructure is particularly vulnerable to climate impacts as it is designed for long operational lives, and both episodic and seasonal conditions contribute to deterioration, disruption and unsafe incidents. There are some examples of adaptation in transportation design, but many communities do not have the capacity to incorporate climate change considerations into infrastructure planning and management. Researchers worked closely with the City of Prince George, in Central British Columbia, Canada, to build on existing work and explore how the City could plan, design, and maintain roads and other structures to account for climate change. A local steering committee was formed, and created and evaluated 23 potential research topics. Two focus areas were selected for further investigation and explored during a workshop with practitioners, researchers, consultants and other representatives. The workshop precipitated an investigation of projected impacts of climate change on road maintenance and road safety, and plans to explore alternative paving techniques. Outcomes of the case study provide insights regarding climate change and local transportation infrastructure, including: how researchers can engage with local experts to explore adaptation; issues local governments perceive as important; and barriers communities face as they attempt to address vulnerabilities.

Evaluating the effectiveness of care integration strategies in different healthcare systems in Latin America: the EQUITY-LA II quasi-experimental study protocol.

IntroductionAlthough fragmentation in the provision of healthcare is considered an important obstacle to effective care, there is scant evidence on best practices in care coordination in Latin America. The aim is to evaluate the effectiveness of a participatory shared care strategy in improving coordination across care levels and related care quality, in health services networks in six different healthcare systems of Latin America.Methods and analysisA controlled before and after quasi-experimental study taking a participatory action research approach. In each country, two comparable healthcare networks were selected—intervention and control. The study contains four phases: (1) A baseline study to establish network performance in care coordination and continuity across care levels, using (A) qualitative methods: semi-structured interviews and focus groups with a criterion sample of health managers, professionals and users; and (B) quantitative methods: two questionnaire surveys with samples of 174 primary and secondary care physicians and 392 users with chronic conditions per network. Sample size was calculated to detect a proportion difference of 15% and 10%, before and after intervention (α=0.05; β=0.2 in a two-sided test); (2) a bottom-up participatory design and implementation of shared care strategies involving micro-level care coordination interventions to improve the adequacy of patient referral and information transfer. Strategies are selected through a participatory process by the local steering committee (local policymakers, health care network professionals, managers, users and researchers), supported by appropriate training; (3) Evaluation of the effectiveness of interventions by measuring changes in levels of care coordination and continuity 18 months after implementation, applying the same design as in the baseline study; (4) Cross-country comparative analysis.Ethics and disseminationThis study complies with international and national legal stipulations on ethics. Conditions of the study procedure were approved by each country's ethical committee. A variety of dissemination activities are implemented addressing the main stakeholders. Registration No.257 Clinical Research Register of the Santa Fe Health Department, Argentina.

Being useful: achieving indigenous youth involvement in a community-based participatory research project in Alaska

Objectives: To report on a participatory research process in southwest Alaska focusing on youth involvement as a means to facilitate health promotion. We propose youth-guided community-based participatory research (CBPR) as way to involve young people in health promotion and prevention strategizing as part of translational science practice at the community-level.Study design: We utilized a CBPR approach that allowed youth to contribute at all stages.Methods: Implementation of the CBPR approach involved the advancement of three key strategies including: (a) the local steering committee made up of youth, tribal leaders, and elders, (b) youth-researcher partnerships, and (c) youth action-groups to translate findings.Results: The addition of a local youth-action and translation group to the CBPR process in the southwest Alaska site represents an innovative strategy for disseminating findings to youth from a research project that focuses on youth resilience and wellbeing. This strategy drew from two community-based action activities: (a) being useful by helping elders and (b) being proud of our village.Conclusions: In our study, youth informed the research process at every stage, but most significantly youth guided the translation and application of the research findings at the community level. Findings from the research project were translated by youth into serviceable action in the community where they live. The research created an experience for youth to spend time engaged in activities that, from their perspectives, are important and contribute to their wellbeing and healthy living. Youth-guided CBPR meant involving youth in the process of not only understanding the research process but living through it as well.

EPODE approach for childhood obesity prevention: methods, progress and international development

SummaryChildhood obesity is a complex issue and needs multistakeholder involvement at all levels to foster healthier lifestyles in a sustainable way. ‘Ensemble Prévenons l'ObésitéDes Enfants’ (EPODE, Together Let's Prevent Childhood Obesity) is a large-scale, coordinated, capacity-building approach for communities to implement effective and sustainable strategies to prevent childhood obesity. This paper describes EPODE methodology and its objective of preventing childhood obesity.At a central level, a coordination team, using social marketing and organizational techniques, trains and coaches a local project manager nominated in each EPODE community by the local authorities. The local project manager is also provided with tools to mobilize local stakeholders through a local steering committee and local networks. The added value of the methodology is to mobilize stakeholders at all levels across the public and the private sectors. Its critical components include political commitment, sustainable resources, support services and a strong scientific input – drawing on the evidence-base – together with evaluation of the programme.Since 2004, EPODE methodology has been implemented in more than 500 communities in six countries. Community-based interventions are integral to childhood obesity prevention. EPODE provides a valuable model to address this challenge.

The Hong Kong Chemical Society

The Hong Kong Chemical Society

An integrated coastal zone management initiative for sensitive coastal wetland on either sides of The Moulouya Estuary in Morocco

Abstract The project, funded under SMAPIII program (Small and Middle Action Plan) of the European Union, encompasses over 40-km coast on either sides of the Moulouya estuary in Morocco. The site shelter important biodiversity features, and is classified as protected areas. The project aims at integrating the conservation of these sensitive areas with local, sustainable development by encouraging dialogue and planning at local, regional and national levels. The projects create a space for dialogue and planning through the animation of working groups and a local steering committee for the relevant stakeholders (e.g. local communities, local non-governmental organisations, private businesses, and administration). The outcome of these working groups will be formalized with a signed moral contract called “Contrat de l’Espace Littoral” by all the relevant stakeholders. The contract will summarize a common vision for their territory and make recommendations for coastal management. Alternative economical micro-actions, aiming at improving community livelihoods, are also developed in the site. Additionally, the project has provided training and technical assistance to monitor changes in the coastal zone, setting up social, economical and ecological indicators. Additional studies were implemented to determine the causes and consequences of the key risks. The studies contribute to creation of future scenarios that will be necessary for the “Moral Contract” and Management Plan. Interdisciplinary working groups were formed around key themes including: pollution, natural resources, income generating activities, etc. Using the information from the studies, the working groups laid out a management framework for each theme. Training and experience sharing is an important element of this project. The different local, regional and national stakeholders have taken part in trainings on conflict resolution, sustainable tourism, income generating activities, monitoring and indicators, and Geographic information Systems. Awareness campaigns have also been carried out at all levels promoting the sustainable development of the coast. The moral Contract is the primary of the project and the key for the projects sustainability. Il creates a real engagement from the relevant stakeholders to ensure the implementation of management plan.

Accountability of experts in the Danish national park process

In 2002 the Danish Minister of Environment initiated a process to investigate the possibilities of establishing national parks in Denmark. For this purpose experts were mobilised to investigate the status and potentials of the areas in question. The national park process was extensive in scope and complex, and in theory such complexity is assumed to make it difficult for non-experts to understand all the relevant aspects of policy. This exclusion of non-experts may lead to scientification of politics. Furthermore politicisation of science might occur as experts might advocate political interests disguised as objective science, and policy-makers might select results that further their own interests. As a result policy-makers risk losing a source of legitimacy, scientists risk losing credibility and the citizens risk losing the possibility to hold policy-makers accountable for their decisions, which puts democracy at risk. This paper examines the accountability relationships that experts were a part of in the national park process. These include accountability towards the employer, towards the buyer and towards the general public. The purpose is to determine if these relationships were adequate to circumvent the problems associated with scientification of politics and to discuss how accountability relationships and thereby democracy could be strengthened. The empirical analysis shows that in the national park process experts were mainly accountable towards the National Forest and Nature Agency. There were formal accountability relationships between the experts and the local steering committees and the national advisory group, but these relationships were less significant. Moreover, despite the fact that the process was deemed unusually open to the public by the participants, the relationship between experts and the public cannot be characterised as an accountability relationship and could have been improved by including experts in the deliberative fora of the process.

A longitudinal assessment of inter-sectoral participation in a community-based diabetes prevention programme

To understand the development of inter-sectoral participation in the three intervention municipalities of Stockholm Diabetes Prevention Programme (SDPP) case studies with a longitudinal assessment were conducted using the spidergram method, document analysis and group discussions. At three time points, the members of the local steering committees assessed the extent of participation from narrow to wide inter-sectoral participation in five key areas: planning, resources, leadership, network and implementation. Wide participation of various interest groups was recognised in planning and implementing activities whereas local resources, the representation of the leadership and the extent of the network were perceived as more restricted. Expert involvement varied during the programme period but was not regarded as exerting control over the local programmes. Participation within the local steering committees decreased, with a stronger focus on the project co-ordinator and other local partners in latter years. The extent of partner engagement increased due to focusing on activities approaching multi-sector collaboration and institutionalisation. Overall, communication and shared responsibility appeared critical in influencing both the development and perception of participation. In conclusion, to understand the dynamic process of participation at different times, areas and levels, the development and use of evaluation designs combining different methods and information sources throughout the lifespan of a project are recommended.

Qualitätsmessung zwischen Illusion und Realität - Ist Qualität in der Medizin messbar?

The current implementation of external quality assurance focuses on identical, albeit simple univariate procedures. This approach proves to be inefficient, exhibiting low specificity. Definitions of performance indicators were classified by the local steering committee and applied to Bavarian obstetric data augmented with multivariate and confidence interval analyses as well as statistical simulations. A highly selected group of units with multivariate extreme values was audited. Blind application of federal regimes without further in-depth analysis of concomitant data is inefficient and may lead to wrong conclusions. Exclusive univariate analyses of performance indicators are not enough. Multivariate analyses have a higher specificity. Classification reveals an imbalance in the indicator set with respect to varying degrees of coverage as well as a bias towards outcome. Deficiencies in the organisational processes crucial for quality of care are often only revealed by dedicated cause and effect analyses within the hospital, thus constituting an essential prerequisite for desired changes in health care policies. It is unlikely that mere publication of performance indicators in the impending quality report will generate lucidity in spite of abundant structure. The installation of standardised programmes with identical computation rules may appear convincing as long as no doubt is cast upon the efficacy of the performance indicators in respect to their intended usage as well as upon the expected feedback effects. The experience so far however teaches us that these elements may be essential yet although not sufficient.

New Directions for Families

SUMMARY In conjunction with the SAMHSA-funded Women with Co-Occurring Disorders and Violence Study, Arapahoe House refined and evaluated an intervention integrating treatment for substance dependence, mental illness, and trauma for women and their dependent children. The New Directions for Families program combines comprehensive residential and outpatient treatment with parenting and self-sufficiency skills development. The program provides gender-specific, culturally sensitive, and strengths-oriented services for families in a two-phase program over eight months. Services include treatment for individual recovery in each of the three problem areasmental health, alcohol and other drug abuse, trauma; basic needs of the family including employment; and social and family support systems. Consumers are involved in all aspects of the project-in designing and implementing the intervention and evaluation and in governing the project through participation on the project's local and national steering committees.

Planning of a community-based approach to injury control and safety promotion in a rural community.

This paper describes the planning of a community-based approach to injury control and safety promotion, the Kolan Injury Prevention Program. The process involved the establishment of a local steering committee, 11 months of injury surveillance, a critical review of the evidence base, community consultations and assessment of community resources. There were 412 recorded injury cases during the surveillance period, with higher rates among men, manual workers, those aged 15-34 years, sport/leisure activities and around the home and farm. Salient issues for residents included a lack of access to safety information and skills, particularly with regard to first aid and bush fire for isolated residents and rurally inexperienced new residents. While injury prevention was identified as an important issue for the community, the rapidly changing size and nature of the community and its infrastructure made this a particularly challenging issue. Challenges included limited availability of volunteers from key sectors, lack of formal data collection systems, difficulties in mobilising support for a broad issue like injury, limited communication networks and the negative impact of distance and role uncertainty on community ownership of the program. This case study illustrates the steps involved in an effective community-based needs assessment addressing injury prevention. Such an approach, if carried out systematically, will help ensure that the strategies and programs developed will be both appropriate and likely to obtain the support of the local community.

Survey of paramedic skills in the United Kingdom and Channel Islands

A national training programme for paramedics was adopted in 1984 on government recommendation.1 Regional training programmes were established under the auspices of local steering committees, and paramedics throughout Britain were trained in endotracheal intubation, intravenous cannulation, cardiac monitoring and defibrillation, and the use of selected parenteral drugs. Further skills could be introduced on the basis of local need. We believed that regional variation could not be explained by demographic and infrastructural differences alone. We therefore undertook a national survey of the extended skills currently practised by ambulance paramedics. In April 1995 we sent questionnaires to the chief executives of the 47 ambulance trusts in the United Kingdom and Channel Islands and followed up by telephone calls. The respondents were asked to identify which of 108 extended skills were currently being taught and which were expected to be taught by the …

“Job 1” at Ford: Employee Co‐operation

The Ford Motor Company is undergoing an evolutionary change in its corporate culture and operating procedures, hoping to transform itself into a twenty‐first century organisation capable of competing around the globe with other world‐class producers. Beset with simultaneous strategic, financial and design crises it has become obvious that revitalisation of the company is dependent on recasting the labour‐management relationship, and that cost increases must be offset by productivity. The 1979 negotiations between Ford and the Union of Automobile Workers (UAW) resulted in the creation of the National Joint Committee on Employee Involvement (NJCEI) specifically considering quality circles and team building; while 1982 negotiations outlined specific functions of local steering committees, career counselling and guidance, targeted vocational retraining projects and introduced the Employee Development and Training Programme. Through the use of joint governing boards, local steering committees and the National Joint Committee, Ford and union officials meet frequently to discuss topics of mutual concern. With eleven major product re‐configurations either in progress or recently completed, it appears that the company has made a major gamble on the future. The UAW‐Ford NJCEI has been successful in achieving its aims of improved employee satisfaction, labour‐management co‐operation and improved product quality.