Multi-stakeholder Perspective Research Articles

Multi-stakeholder perspectives on the implementation of a clinic-based food referral program for patients with chronic conditions: a qualitative examination.

Clinic-based food referral programs (FRPs) may help alleviate food insecurity and improve access to nutritious foods by systematically identifying and referring food-insecure primary care patients to community-based food resources. The purpose of this study was to examinethe barriers to and facilitators of implementation of an FRP offered to primary care patients who screen positive for food insecurity and have a qualifying chronic condition. we used a multi-stakeholder approach to conduct semi-structured interviews with healthcare providers and administrators from an academic medical center (AMC) (n = 20), representatives of a regional foodbank and its affiliated pantries (n = 11), and patients referred to the FRP (n = 20), during the initial phase of FRP implementation from April to September 2020. Interviews were audio-recorded, transcribed verbatim, and coded using a deductive dominant approach that allowed for the identification of emergent themes. Seven major themes emerged across the two domains of analysis: barriers to and facilitators of FRP implementation. Key barriers were (a) provider time constraints and competing demands; (b) inadequate physician feedback regarding patient use of the program; (c) patient transportation barriers; and (d) stigma associated with food pantry use. Key facilitators of implementation included (a) program champions; (b) screening and referral coordination; and (c) addressing food pantry-related stigma. This study identifies factors that deter and facilitate the implementation of an AMC-based FRP. Our findings highlight opportunities for healthcare and community-based organizations to refine and optimize FRP models toward the ultimate aim of advancing health equity for food-insecure patients.

Understanding the role of men in women's use of the vaginal ring and oral PrEP during pregnancy and breastfeeding: multi-stakeholder perspectives

We examined men’s influence on women’s interest in biomedical HIV prevention during pregnancy and breastfeeding through structured questionnaires and focus group discussions with currently or recently pregnant and breastfeeding (P/BF) women (n = 65), men with P/BF partners (n = 63) and mothers/mothers-in-law of P/BF women (n = 68) in eastern and southern Africa. Data were transcribed, coded and summarised into analytical memos. Men were depicted by most participants as joint decision-makers and influencers of women’s use of HIV prevention. Cultural and religious norms depicting men as heads, breadwinners and protectors of the family were cited to legitimise their involvement in decision-making. Male partner education and engagement were recommended to garner their support in women’s HIV prevention. This study elucidates how P/BF women’s ability to prevent HIV is shaped by traditional and contemporary gender norms in social settings and locations where the study was conducted. Findings may aid intervention design to engage men for P/BF women’s effective use of microbicide and oral PrEP.

The (in)congruence effect of leaders' narcissism identity and reputation on performance: A socioanalytic multistakeholder perspective.

Judgments about others' personal characteristics intertwine with social interactions in the workplace. The personality and social psychology literatures show forming impressions of what others are like is vitally important, in part, because it facilitates the forecasting and acceptance of others' behavior. Interestingly, very few studies consider others' (i.e., subordinates) judgments about their leaders' personality and whether correspondence between leaders' self-perceptions and these others' judgments is capable of providing meaningful and unique information. Using a socioanalytic perspective that considers multiple stakeholders, this study explores the (in)congruence effects between leaders' self-perception of narcissism (i.e., identity) and subordinates' perceptions of their leaders' narcissism (i.e., reputation) on two types of performance outcomes. Polynomial regression and response surface analysis indicate that congruence between leaders' narcissism identity and subordinates' aggregated ratings of leaders' narcissistic reputation related to group task and contextual performance via shared justice perceptions and collective effort in Study 1. Results of Study 2, which focused on leader-subordinate dyads, found leaders' narcissism identity-reputation congruence effects were related to individual subordinates' task and contextual performance via the subordinate's individual justice perceptions, but not by way of individual effort. These findings have important implications for leaders and organizations and suggest that to fully understand the implications of leaders' narcissism, one should consider the perspectives of interacting parties and how they converge or diverge when investigating relationships with aspects of performance. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A FUZZY MULTI-CRITERIA FRAMEWORK FOR THE DEVELOPMENT OF SUSTAINABLE COMMUNITY-BASED TOURISM IN MALAYSIA

Community-based tourism (CBT) is a growing niche market that has positively impacted many developing countries including Malaysia. CBT in Malaysia is recognised as the Malaysian Homestay Experience Programme (MHEP) which is under the coordination of the Ministry of Tourism, Arts and Culture. Previous studies have looked into stakeholders’ contributions and the roles they play in the MHEP. However, the sustainability criteria from the multi-stakeholder perspective should be understood. The collaboration between tourism stakeholders is pivotal in understanding their perspective by considering their diverse viewpoints on critical issues and bridging the current knowledge gap. This research aims to investigate how stakeholders could participate more efficiently in developing and employing a sustainable MHEP. This study applied a mixed-method approach and was divided into two phases. The first phase was the multistage qualitative research and the second phase involved a questionnaire survey with structured questions distributed to the multi-stakeholders. Academicians, government agencies, non-governmental organisations, businesses, host communities, homestay coordinators and tourists were involved in the data collection process. The study applied a two-stage methodology by integrating two multi- criteria decision-making techniques, Decision-Making Trial and Evaluation Laboratory and analytic network process to extend the existing evaluation criteria and weightage. The multi-criteria framework will provide stakeholders as decision-makers the ability to devise plans that are sustainable and compatible with conservation and rural development strategies. This study is decisive in helping stakeholders develop sustainable CBT and contribute to government policies, specifically in terms of MHEP development and management aligned with the Malaysia rural development policy. Sustainable CBT can be an efficient rural economic development tool to generate broader economic distribution and create a more comprehensive spatial development. Furthermore, this study also provides valuable insights for tourism policymakers in terms of efficient policy interventions related to CBT in accelerating sustainable development involving environmental, economic and socio-cultural growth.

Factors affecting unitized curtain wall system adoption for Hong Kong's high-rise residential buildings: a multi-stakeholder perspective

PurposeThe unitized curtain wall system (UCWS), one of the prefabricated technologies, is increasingly attracting attention in the Hong Kong construction industry. However, this innovative technology still lacks on-site implementation in high-rise residential buildings. To promote its development, this study aims at identifying the influential factors of UCWS adoption in Hong Kong's high-rise residential buildings from a multi-stakeholder perspective.Design/methodology/approachFactors were first selected through an in-depth literature review and a semi-structured interview. Then the factors were validated through a questionnaire survey using Cronbach's Alpha Reliability Test. Next, the factors were ranked regarding their importance using mean-score ranking and standard deviation. Meanwhile, different stakeholders were clustered using an experimental factor analysis (EFA) model to find the shared preferences (namely common factors).FindingsThe result shows that reduction of construction time (B1) and insufficient site storage area (C1) are the most important factors. The six stakeholder groups were clustered into two segments. B1 and improved quality control are the shared interests. While C1 and the need of specification change are the common concerns.Originality/valueThere are two major breakthroughs in this study. First is the novelty of research objects. UCWS, particularly its application preference in high-rise residential buildings, has rarely been studied, yet it is urgently required. Second is the novel research perspective. The influential factors were studied from a multi-stakeholder perspective. Not only the significant factors for six specific stakeholders but also the shared preference for stakeholder groups was identified. The findings contribute to promoting UCWS more targeted, efficient and comprehensive, as well as demonstrating the collaborative possibilities of multi-stakeholders.

Serengeti’s futures: Exploring land use and land cover change scenarios to craft pathways for meeting conservation and development goals

Rapid land use transformations and increased climatic uncertainties challenge potential sustainable development pathways for communities and wildlife in regions with strong economic reliance on natural resources. In response to the complex causes and consequences of land use change, participatory scenario development approaches have emerged as key tools for analyzing drivers of change to help chart the future of socio-ecological systems. We assess stakeholder perspectives of land use and land cover change (LULCC) and integrate co-produced scenarios of future land cover change with spatial modeling to evaluate how future LULCC in the wider Serengeti ecosystem might align or diverge with the United Nations’ Sustainable Development Goals and the African Union’s Agenda 2063. Across the wider Serengeti ecosystem, population growth, infrastructural development, agricultural economy, and political will in support of climate change management strategies were perceived to be the key drivers of future LULCC. Under eight scenarios, declines in forest area as a proportion of total land area ranged from 0.1% to 4% in 2030 and from 0.1% to 6% in 2063, with the preservation of forest cover linked to the level of protection provided. Futures with well-demarcated protected areas, sound land use plans, and stable governance were highly desired. In contrast, futures with severe climate change impacts and encroached and degazetted protected areas were considered undesirable. Insights gained from our study are important for guiding pathways toward achieving sustainability goals while recognizing societies’ relationship with nature. The results highlight the usefulness of multi-stakeholder engagement, perspective sharing, and consensus building toward shared socio-ecological goals.

The Importance of A Multistakeholder Perspective in Mapping Stakeholders' Roles Toward City Branding Implementation

This study aims to examine the perception of multi-stakeholder in implementing city branding programs and how they can collaborate across actors to support the implementation of city branding. The importance of stakeholders in implementing city branding has been widely discussed. However, the relationship between multi-stakeholder tourism is still under-explored. Therefore, this study emphasises the importance of multi-stakeholder perceptions in determining how each stakeholder can influence campaign implementation. This study uses a qualitative method by conducting in-depth interviews with relevant stakeholders: the government, the private sector, destination management staff, tourism associations, academics, and the general public. Using the Jakarta branding campaign, Enjoy Jakarta, this study finds that several crucial factors influence the Enjoy Jakarta campaign. These factors are stakeholder collaboration, departmental coordination, public management, attraction, promotion and accessibility. This study proposes stakeholders' role mapping in improving the implementation of Enjoy Jakarta programs.

Paediatric Inflammatory Bowel Disease: A Multi-Stakeholder Perspective to Improve Development of Drugs for Children and Adolescents.

Despite recent approvals for new drugs to treat adults with Crohn's disease or ulcerative colitis, there are only two approved advanced treatment options [infliximab and adalimumab] for children with inflammatory bowel disease [IBD]. There are many potential new therapies being developed for adult and paediatric IBD. Moreover, regulatory agencies in both the European Union and USA have processes in place to support the early planning and initiation of paediatric studies. Nevertheless, unacceptable delays in approvals for use of drugs in children persist, with an average 7-year gap, or longer, between authorization of new IBD drugs for adults and children. A 2-day virtual meeting was held during April 14-15, 2021 for multi-stakeholders [clinical academics, patient community, pharmaceutical companies and regulators] to discuss their perspectives on paediatric drug development for IBD. The multi-stakeholder group presented, discussed and proposed actions to achieve expediting the approval of new drugs in development for paediatric IBD. Collaborative action points for all stakeholders are required to make progress and facilitate new drug development for children with IBD.

What is needed to reform pharmacy education in Jordan: An exploratory study based on a multi-stakeholder perspective

Background: The Jordanian pharmacy profession is facing challenges related to pharmacy education and graduates' readiness to join the workforce. The Jordanian Accreditation and Quality Assurance Commission for Higher Education Institutions has led an initiative to revise undergraduate pharmacy academic programmes. Aim: This study aims to capture relevant stakeholders' perceptions of factors influencing pharmacy education in Jordan. Methods: In March 2021, three focus group discussions were conducted with relevant stakeholders. Focus groups were thematically analysed. The "systems model of performance improvement" by Richard A. Swanson was broadly followed to interpret discerned themes. Results: Thematic analysis resulted in three main themes. The discerned themes represented factors related to education input variables, teaching process variables, and environmental variables. Conclusion: Teaching and learning processes should be shifted from educator-centred to student-centred. The academic curriculum should reflect the local context of practice and society. Future interventions should follow a holistic and comprehensive approach to reforming Jordan's pharmacy education.

Disclosure, content cues, emotions and behavioural engagement in social media influencer marketing: an exploratory multi-stakeholder perspective

ABSTRACT Influencer marketing involves multiple stakeholders. Research, however, has predominately explored key influencer marketing concepts, such as disclosure for native advertising from a consumer perspective. In addition, a review of the literature identifies other factors such as content cues and emotions, which may be important in providing a comprehensive understanding of influencer marketing. To address these gaps, this research adopted an exploratory research design using convergent interviews with the three key stakeholder groups consumers, influencers and brands. The findings reveal that beyond disclosure, other content cues within influencer marketing can contribute to advertising recognition. Further, from the perspective of brands, influencers are perceived to have unique credibility attributes relating to expertise on social media platforms and product categories. Emotional responses in influencer marketing are also shown to be predominately positive and directed towards influencers rather than brands, with potential for this to be transferred to the brand through emotional contagion.

Factors Influencing Postoperative Experiences in Adult Cochlear Implant Recipients: A Multistakeholder Perspective.

To explore factors influencing postoperative experiences of adult cochlear implant (CI) recipients, determine the impact of each factor, and conceptualize recipients' postoperative journey. Participatory mixed methods; concept mapping. Tertiary care (private and public). Ninety-three participated in the brainstorming activity. Eighty-nine completed the sorting tasks (96% retention rate): CI recipients (n = 44), significant others (n = 13), CI audiologists (n = 14) and surgeons (n = 5), CI clinics' administration staff (n = 5) and managers (n = 3), and CI manufactures' clinical support staff (n = 5). Rehabilitative (CIs). Statements were generated and rated by participants. Similarity of grouping of the statements informed the matrices used for cluster analysis to form concepts. Eighty-seven unique statements described the factors influencing adapting to, use, and maintenance of CIs after implantation. These were grouped, and five concepts were identified: financial considerations, complications, device usability and durability, device programming and adaptation, and patient motivation and supports. Although statements within the concepts financial considerations and complications were negatively rated, statements within the concepts device programming and adaptation, and patient motivation and supports were mostly rated as having positive influence in patients' postoperative journey. The concept device usability and durability contained both negatively and positively rated statements. Postoperative experience of adult CI recipients is a multifaceted journey with several challenges to address to improve services. Although support from and connection with family and clinicians, and simplicity of using a CI device facilitated the experience, medical and surgical complications, durability, and cost of maintaining the device challenged the postoperative experience.

Hospital-at-Home: Multistakeholder Considerations for Program Dissemination and Scale.

Policy Points Hospital-at-Home (HaH) is a home-based alternative for acute care that has expanded significantly under COVID-19 regulatory flexibilities. The post-pandemic policy agenda for HaH will require consideration of multistakeholder perspectives, including patient, caregiver, provider, clinical operations, technology, equity, legal, quality, and payer. Key policy challenges include reaching a consensus on program standards, clarifying caregivers' issues, creating sustainable reimbursement mechanisms, and mitigating potential equity concerns. Key policy prescriptions include creating a national surveillance system for quality and safety, clarifying legal standards for care in the home, and deploying payment reforms through value-based models.

O2-5 Mobilising People as Assets for community-based active ageing promotion: A multi-stakeholder perspective on peer volunteering initiatives

Abstract Background Citizens who contribute as volunteers and peer mentors within a community are important assets that can be mobilised to improve health and wellbeing. In order to optimise the contribution of peer-volunteers to active ageing initiatives, we need to understand their experiences and identify ways to support them in preparing for the role and overcoming potential challenges. Aim: This study synthesises the perspectives of a range of stakeholders involved in peer volunteering active ageing initiatives implemented in UK and provides an in-depth account of how such initiatives can effectively mobilise individuals as community assets. It draws on the experience of all actors involved in such initiatives, ranging from volunteers, recipients of volunteering actions, volunteer managers and volunteering service providers. Methods This evidence synthesis used qualitative data from (a) three studies focusing on the development (phase 1), feasibility trial evaluation (phase 2) and community roll-out (phase 3) of ACE (Active, Connected, Engaged), a peer volunteering active ageing intervention, alongside (b) the experiences of third sector organisations in providing peer volunteering programmes. Ten managers, 22 volunteers and 20 ACE participants were interviewed. Interviews were audio-recorded, transcribed verbatim and analysed using framework analysis. Results Seven main themes including 33 higher and 22 lower order themes were identified: Motives; Benefits; Characteristics of peer volunteers; Challenges; Training needs; Recruitment; Successful strategies for maintenance. Altruism, changes in life circumstances, opportunities to reconnect with the community and personal fulfilment were the main reasons for volunteering. Volunteering was described as being personally rewarding, an avenue to acquire new skills and knowledge, and increased social connections and physical activity. Effective volunteers are committed, reliable, have a good sense of humour, good interpersonal skills and are able to relate to the participants. When pairing volunteers with participants, clarity of role, level of time commitment, shared interests and geographical proximity are worth considering. Conclusions Successful implementation of peer-volunteering initiatives requires the use of appropriate recruitment routes, easy joining procedures, provision of ongoing support, good communication across all stakeholders, feedback and recognition of effort and a dedicated team to build resilience and provide volunteers with administrative support.

Governance of Clinical AI applications to facilitate safe and equitable deployment in a large health system: Key elements and early successes.

One of the key challenges in successful deployment and meaningful adoption of AI in healthcare is health system-level governance of AI applications. Such governance is critical not only for patient safety and accountability by a health system, but to foster clinician trust to improve adoption and facilitate meaningful health outcomes. In this case study, we describe the development of such a governance structure at University of Wisconsin Health (UWH) that provides oversight of AI applications from assessment of validity and user acceptability through safe deployment with continuous monitoring for effectiveness. Our structure leverages a multi-disciplinary steering committee along with project specific sub-committees. Members of the committee formulate a multi-stakeholder perspective spanning informatics, data science, clinical operations, ethics, and equity. Our structure includes guiding principles that provide tangible parameters for endorsement of both initial deployment and ongoing usage of AI applications. The committee is tasked with ensuring principles of interpretability, accuracy, and fairness across all applications. To operationalize these principles, we provide a value stream to apply the principles of AI governance at different stages of clinical implementation. This structure has enabled effective clinical adoption of AI applications. Effective governance has provided several outcomes: (1) a clear and institutional structure for oversight and endorsement; (2) a path towards successful deployment that encompasses technologic, clinical, and operational, considerations; (3) a process for ongoing monitoring to ensure the solution remains acceptable as clinical practice and disease prevalence evolve; (4) incorporation of guidelines for the ethical and equitable use of AI applications.

Meeting the Need for a Discussion of Unmet Medical Need

As Europe and the world continue to battle against COVID, the customary complacency of society over future threats is clearly on display. Just 30 months ago, such a massive disruption to global lives, livelihoods and quality of life seemed unimaginable. Some remedial European Union action is now emerging, and more is proposed, including in relation to tackling “unmet medical need” (UMN). This initiative—directing attention to the future of treating disease and contemplating incentives to stimulate research and development—is welcome in principle. But the current approach being considered by EU officials merits further discussion, because it may prove counter-productive, impeding rather than promoting innovation. This paper aims to feed into these ongoing policy discussions, and rather than presenting research in the classical sense, it discusses the key elements from a multistakeholder perspective. Its central concern is over the risk that the envisaged support will fail to generate valuable new treatments if the legislation is phrased in a rigidly linear manner that does not reflect the serpentine realities of the innovation process, or if the definition placed on unmet medical need is too restrictive. It cautions that such an approach presumes that “unmet need” can be precisely and comprehensively defined in advance on the basis of the past. It cautions that such an approach can reinforce the comfortable delusion that the future is totally predictable—the delusion that left the world as easy prey to COVID. Instead, the paper urges reflection on how the legislation that will shortly enter the pipeline can be phrased so as to allow for the flourishing of a culture capable of rapid adaptation to the unexpected.

From Ampesie to French fries: systematising the characteristics, drivers and impacts of diet change in rapidly urbanising Accra.

Sub-Saharan Africa (SSA) is urbanising rapidly. One of the most visible outcomes of this urbanisation process is the change in the diets of urban residents. However, diet change in the context of rapid urbanisation is a complex and multi-dimensional phenomenon that encompasses multiple intersecting historical, environmental, socioeconomic, and political aspects. This study aims to unravel and systematise the characteristics, drivers and impacts of diet changes in Accra, through the interviews of multiple stakeholders and Causal Loop Diagrams. Diet change is characterised by the increased consumption of certain foodstuff such as rice, chicken, fish, vegetable oil, sugar, and ultra-processed food (UPF), and the decreased consumption of traditional foodstuff such as roots, tubers, and some cereals such as millet. These changes are driven by multiple factors, including among others, changes in income, sociocultural practices, energy access, and policy and trade regimes, as well as the proliferation of supermarkets and food vendors. Collectively, these diet changes have a series of environmental, socioeconomic, and health/nutrition-related impacts. Our results highlight the need to understand in a comprehensive manner the complex processes shaping diet change in the context of urbanisation, as a means of identifying effective interventions to promote healthy and sustainable urban diets in SSA. The development of such intervention should embrace a multi-stakeholder perspective, considering that the relevant urban actors have radically different perspectives and interests at this interface of urbanisation and diet change. Supplementary InformationThe online version contains supplementary material available at 10.1007/s11625-022-01195-y.

Synergy or Antagonism? How Corporate Political and Social Strategies Influence Firm Innovation

Although the increasing research interest on non-market strategy, the relationship between non-market strategy and firm innovation as well as the combinative impact of engagement in CPA and CSR are not well researched or understood. In this study, we integrate institutional perspective and multi-stakeholder perspective to analyze how the CPA and CSR independently and interdependently affect a firm’s innovation performance. With 3938 firm-year observations of China’s A-shared listed private firms between 2014 and 2018, we find support for the predictions that CPA strategy and CSR strategy both can exert a positive effect on firm innovation performance. We further develop competing hypotheses for the interactive effect of CPA and CSR on firm innovation from synergistic versus antagonistic view, and the findings are consistent with the antagonistic view. This study not only enriches our knowledge regarding the independent and joint influence of non-market strategies on firm innovation performance, but also highlights the necessary to pay attention to the heterogeneity of non-market stakeholders when integrating non-market political and social strategies.

Application of learning organization 2.0: a case study of Ricoh Ena Forest Japan

PurposeThis paper aims to offer an empirical application of the concept of learning organization (LO) 2.0.Design/methodology/approachBased on fieldwork study, a case of Ricoh Ena Forest Project is presented to illustrate the contextualized and multi-stakeholder perspective of LO 2.0 in running an environmental sustainability project.FindingsThe case demonstrated the value of incorporating multiple stakeholders to develop a multi-party learning entity for sustainability pursuit. The findings also highlighted the importance of forfeiting managerial dominance and the creation of a shared commitment in implementing the concept of LO 2.0.Originality/valueThe study adds empirical evidence to the literature on how LO 2.0 can be implemented and provides guidance on tackling some of the potential challenges.

Assessing Safety Risk Management Performance in Chinese Subway Construction Projects: A Multistakeholder Perspective

The rapid development of subway projects in China presents significant safety risks to those involved. Building on the previous empirical research that identified and classified the safety risks of these projects, the aim of this paper is to assess the safety risk management performance in Chinese subway construction projects from a multistakeholder perspective. Questionnaire surveys and semistructured interviews were conducted with three hundred and ninety-nine and eight construction professionals, respectively, who worked on subway construction projects in southeast China. The results indicate that the top five areas of safety risk management performance are related to construction plan development, management of high-risk construction works, hazard identification and communication, government-related factors, and client-related factors. In contrast, the bottom five areas of safety risk management performance are related to engineering consultant-related factors, the site’s natural environment and weather conditions, regular tests, machine calibration and maintenance, site construction schedule, and construction preparedness. The relationship between this safety risk management performance and the perceived importance of each risk factor is also reported, identifying priority areas for improvements on these projects. These findings contribute new conceptual insights to the paucity of research on the safety risk management performance of Chinese subway construction projects from a multistakeholder perspective. The results also provide new practical insights for policymakers and project managers to help them develop more effective and focused strategies to further improve the safety performance of these major projects.

HTA23 Value from a Multi-Stakeholder Perspective: A Framework to Assess Digital Health Solutions for Improving Chronic Disease Management

Innovative digital health technologies (DHTs) present aspects of value that are not appropriately accounted for in current health technology assessments. This research aims to understand where value lies in DHTs from a multi-stakeholder perspective.