Multidisciplinary Research Team Research Articles

(Opening Keynote) Heterogeneous Functional Materials: Their Present Science and Engineering, and Their Role in the Future of Our Society

Devices that convert and store energy are generally made from heterogeneous constituent materials that act and interact to selectively conduct, transport, and regulate mass, heat, and charge. Controlling these functional actions and interactions enables the technical breakthroughs that have made high efficiency fuel cells, batteries, and solid state membranes, for example, essential parts of our society and economy. In the biological sense, these materials are ‘vascular’ rather than primitive ‘cellular’ materials, so that the arrangements and configurations of the constituents play essential roles in their functional capabilities. Local interactions of the constituents create “emergent” properties and responses that are not part of the formal set of constituent characteristics, in much the same sense that society and culture is created by the group interactions of the people involved. The design of emergent properties is an open question in all formal science, but for energy materials the lack of this foundation science relegates development tasks to Edisonian trial and error, with anecdotal success and frequent costly failures. The present group has defined, for the first time, multi-scale heterogeneous functional materials with functional disordered and void phase regions as “HeteroFoaM,” and formed the first multidisciplinary research team (EFRC) to define and codify the foundation science of that material class. The primary goal of the HeteroFoaM Center was, and the continuing interest is, to create and establish the multi-scale fundamental knowledge and related methodology required for the rational and systematic multiphysics design of heterogeneous functional materials and their interfaces and surfaces for applications in energy transformation and storage. HeteroFoaM is a new atoms-to-systems paradigm that is intended to bring heterogeneous functional materials (for which the system is rarely simply the sum of the parts) into the modern age of computational materials to achieve the savings of time and cost associated with trial and error Edisonian design.The promise of this pursuit is to construct a Multi-Scale/Multi-Physics (M2SP) Design Science for Heterogeneous Functional Materials that is codified in models and codes that enable the design of material systems to convert fuels directly into electricity, store energy in easily transported forms, and separate strategic materials including nuclear waste.The HeteroFoaM paradigm is an approach that focuses on the “conformal science” that defines the local interactions that result from the arrangements and configurations of the constituents. The approach fully embraces the complexity of heterogeneous functional material systems including the uncertainty of predictions and observations, the creation of a formal structure for combining analysis, simulations, and experiments, and the creation of a science path to the prediction of emergent global response probabilities based on the local or meso-science of constituent interactions. However, since this concept was originated almost 10 years ago, a technical revolution has happened in our world society that makes progress in this field even more imperative. There has been an historic shift in our society to hydrogen as a preferred fuel, with industrial and governmental promises that it will be nearly an exclusive choice for society and industry in the next ten years or so. Therefore, our discussion will begin with the historic foundations of this field and end with a short summary of the remarkable and historic changes in society that have elevated this subject to a central and critical science and engineering subject for our world society today.

Strategies to mitigate the impact of the COVID-19 pandemic on child and youth well-being: a scoping review protocol

IntroductionChildren and youth are often more vulnerable than adults to emotional impacts of trauma. Wide-ranging negative effects (eg, social isolation, lack of physical activity) of the COVID-19 pandemic on children...

A Scientometric Visualization Analysis for Molecular Mechanisms of Substance Abuse and Its Neurotoxicity From 1997 to 2021.

Substance abuse has become a global problem due to drug-induced addiction and neurotoxicity, which causes a huge physical, social, and financial burden. Various kinds of drugs can hijack the users’/abusers’ behavior and associated neurocircuitry. To summarize recent scientific advances on drug abuse, we reviewed relevant publications to analyze research progress and such trends through bibliometric ways. Based on retrieval strategies, a total of 681 scientific records published from 1997 to 2021 were screened and included in the Web of Science (WoS) database. Further scientometric analysis revealed that annual publication output increased across this period, with the United States of America (USA) contributing a significant number of reasons. Research has focused on neurotransmitter, oxidative stress, mitochondrial system injury, and other neurotoxic mechanisms. Neuroimmune, neurotoxic targets, and new psychoactive substances have been hot topics in recent years, which deserve continued research in the future. Specific research on molecular mechanisms has progressed across this period, with an emphasis on the root cause of toxicity and molecular targets for therapy. Moreover, collaborations of international multi-disciplinary research teams have been efficient and need to be encouraged for addiction research and the development of appropriate therapeutic processes.

Ongoing genesis of a novel glaciovolcanic cave system in the crater of Mount St. Helens, Washington, USA

Mount St. Helens, one of the highest-risk volcanoes in the Cascade Volcanic Arc, hosts a novel system of glaciovolcanic caves that has formed around the 2004−2008 lava dome. From 2014 to 2021 a multidisciplinary research team systematically explored and mapped these new caves to ascertain their characteristics. Air and fumarole temperatures, volume flow rates, and wind regimes were also monitored. More than 3.0 km of cave passages have formed in a semicircular pattern in the volcanic crater and provide an opportunity to (1) observe cave development over time, (2) identify low temperature fumaroles as the main driving force for cave formation, (3) verify the impact of seasonal snow accumulation on cave climate, and (4) assess heat distribution in subglacial and subaerial portions of the new lava dome. Glaciovolcanic cave systems on Mount St. Helens are comparatively young (<10 years) and the most dynamic in the Pacific Northwest. Observed cave expansion during the study suggests ongoing genesis and future formation of interconnected systems. However, further expansion may also be limited by increasing fumarole temperatures towards the upper parts of the lava dome, cave instability due to snow overload, or variable subglacial volcanic heat output. New glaciovolcanic cave system development provides a unique barometer of volcanic activity on glacier-mantled volcanoes and to study the subglacial environment. We present the results of eight years of initial study within this dynamic cave system, and discuss a pathway towards future longitudinal analyses.

Developing non-exercise activity thermogenesis (NEAT) through building design

PurposePhysical inactivity has a considerable negative impact on health. Physical activity has reduced partly due to workplace and lifestyle changes, causing people to spend more time in buildings and increasing sedentary behaviour. The purpose of this paper is to address a largely untapped opportunity for designers and managers to improve building users’ health by designing buildings that raise users’ Non-Exercise Activity Thermogenesis (NEAT) levels. In this research a conceptual model was developed to assess buildings’ performance in providing NEAT-promoting opportunities through building design features and management, in relation to building users’ propensity for NEAT behaviours.Design/methodology/approachThe conceptual model was developed by a multi-disciplinary team of researchers and data to populate the model was obtained through a survey of 75 buildings in Jakarta (Indonesia).FindingsThe presented proof-of-concept shows that the model’s “meso-scale” approach to study physical activity and building design can lead to potential improvements of NEAT levels and physical activity in buildings.Originality/valueThe review of precedent models shows that this subject has been researched at micro-scale (i.e. detailed monitoring of individuals’ movement) and macro-scale (i.e. epidemiological studies of populations’ health). The presented model is original, as it explores a “meso-scale”(i.e. building scale) that is unique.

Guidance to Support the Implementation of Specialized Adolescent and Young Adult Cancer Care: A Qualitative Analysis of Cancer Programs.

The nearly 90,000 adolescents and young adults (AYAs) diagnosed with cancer in the United States yearly have tended to occupy a no-man's land between medical and pediatric oncology, often reporting that existing models of care are misaligned with their needs and preferences. Although guidelines for optimal AYA cancer care are increasingly available, the implementation of such standards has been varied. This may be in part due to a lack of guidance for implementing specialized AYA care. In this study, we leveraged an implementation science framework to identify barriers and generate practical guidance to inform the implementation of specialized AYA cancer care. We conducted semistructured qualitative interviews, guided by the Consolidated Framework for Implementation Research, with AYA care stakeholders (N = 32 from 14 cancer programs). Our multidisciplinary research team analyzed interview transcriptions using a template analysis approach and gleaned from interviews practical guidance for implementing specialized AYA care. Participants reported barriers to implementing specialized AYA care across all five Consolidated Framework for Implementation Research domains: (1) intervention characteristics (eg, costs), (2) inner setting (eg, difficulties in collaborating between pediatric and medical oncology), (3) outer setting (eg, patient-level barriers to participating in AYA services), (4) individual characteristics (eg, attitudes about AYA oncology), and (5) process (eg, lack of metrics for program evaluation). They also shared practical guidance for addressing these barriers. Emerging guidance on the core elements of AYA cancer care must be matched with guidance to support the implementation of specialized AYA care. This study contributes to the body of evidence available to inform future implementation efforts.

Providing palliative care for residents in LTC facilities: an analysis of routine data of LTC facilities in Lower Saxony, Germany

BackgroundDemographic trends show an increasing number of elderly people and thus a growing need for palliative care (PC). Such care is increasingly being provided by long-term care (LTC) facilities. The present study aimed at exploring PC indicators of residents at LTC facilities belonging to a non-profit provider in Lower Saxony, Germany, in order to identify potential improvements.MethodsA descriptive cross-sectional study was conducted, drawing on routine nursing chart data. Structural data from 16 participating LTC facilities and the care data of all residents who died in 2019 (N = 471) were collected anonymously between March and May 2020. Based on key literature on quality indicators of PC in LTC facilities in Germany, a structured survey was developed by a multidisciplinary research team. The descriptive, comparative and inferential data analysis was conducted using the SPSS software package.ResultsIn total, the complete records of 363 (77%) residents who died in the participating LTC facilities in 2019 were retrieved. The records reflected that 45% of the residents had been hospitalized at least once during the last 6 months of their lives, and 19% had died in hospital. Advance care planning (ACP) consultation was offered to 168 (46%) residents, and 64 (38%) declined this offer. A written advance directive was available for 47% of the residents. A specialized PC team and hospice service volunteers were involved in caring for 6% and 14% of the residents, respectively. Cancer patients received support from external services significantly more frequently (p < .001) than did non-cancer patients. Differences emerged in the distribution of PC indicators between LTC facilities. Facilities that have more PC trained staff offered more ACP, supported by more specialized PC teams and hospice services, and had fewer hospitalizations. In addition, more volunteer hospice services were offered in urban facilities.ConclusionsOverall, a rather positive picture of PC in participating LTC facilities in Germany emerged, although there were differences in the expression of certain indicators between facilities. ACP consultation, volunteer hospice services, and hospital admissions appeared to be superior in LTC facilities with more trained PC staff. Therefore, PC training for staff should be further promoted.

Influence of Professional Career Development and Teamwork on Employee Job Satisfaction: Evidence From Private Universities in Nigeria

The purpose of this study was to examine the influence of professional career development and teamwork on job satisfaction among lecturers in selected private universities in Nigeria. Social exchange theory was used to establish the theoretical framework of this study. The study adopted descriptive survey research design to establish the relationship between professional career development, teamwork and job satisfaction. Structured questionnaire was distributed to 428 respondents in six selected private universities in Nigeria. The reliability of the measuring instrument was tested using Cronbach Alpha. Hypothesis one was tested using correlation analysis and regression analysis were employed for testing of hypotheses two, three and four. The result of the analysis showed that there is a statistical influence between the three constructs professional career development, teamwork and job satisfaction of private university lecturers in Nigeria. The research concludes that professional career development and teamwork exert different levels of influence on private university lecturers’ job satisfaction and that teamwork exerts greater level of influence on lecturers’ job satisfaction. Hence it was suggested that management of private universities should promote the establishment of multidisciplinary and interdisciplinary research teams and centres in order to blend the experience of academics. Also, private universities should make annual plans to sponsor or subsidize conferences, seminars and workshop expenses of lecturers in order to encourage frequent participation in academic events so as to sustain the lecturer’s satisfaction and commitment on the job.

Abstract LB073: Improving early career faculty research programs: Underrepresented Biomedical Researcher Scholars Program

Abstract According to the U.S. Department of Education in Fall 2018, full-time faculty in degree-granting postsecondary institutions were ~40% White males; 35% White females; 7% Asian/Pacific Islander males; 5% Asian/Pacific Islander females; and 3% each Black males, Black females, Hispanic males, and Hispanic females.1 Under-representation is one of the barriers to success for African American and Hispanic faculty. Barriers to women’s career advancement from underrepresented groups in academic medicine, science, and engineering and obtaining external research funding support for African American faculty do not occur in a vacuum and co-exist with barriers to research productivity overall.2 This data establishes the necessity of increasing representation, creating more accessible research opportunities, building networks, mentoring relationships in STEM-related fields, obtaining a diverse scientific workforce, and ensuring the success of all underrepresented in biomedical research (UBR) trainees and early career faculty. The All of Us Evenings with Genetics (AoUEwG) Research Program provides training to support Early Career Faculty and Senior Postdoctoral fellowship in cancer research. This engagement program includes Evenings With Genetics seminars, where regional and national campus audiences will be introduced to research opportunities available through the All of Us research hub; the Underrepresented Biomedical Researcher Faculty Summit UBRFS), where summit attendees will take part in using the All of Us research hub and receive data science training and professional development; and the UBRFS Scholars Program, where conference participants will receive yearlong support after the summit, including monthly multidisciplinary research team meetings, quarterly meetings, and mentor support. The AoUEwG Research Program aims to increase research productivity among UBR early career faculty and support their promotion to the next career level. Citation Format: Debra Murray, Susan Fernbach. Improving early career faculty research programs: Underrepresented Biomedical Researcher Scholars Program [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr LB073.

Research Ready Grant Program (RRGP) protocol: a model for collaborative multidisciplinary practice–research partnerships

BackgroundLittle attention has been given to the process of implementing or evaluating a structured academic–clinician (university–health service) research capacity-building (RCB) model within healthcare settings. We have developed a model for collaborative multidisciplinary practice–research partnerships called the Research Ready Grant Program (RRGP). The RRGP is informed by Cooke’s (BMC Fam Pract 6:44, 2005) RCB framework and principles. The aim of the study outlined in this protocol is to conduct a process and outcome evaluation of the programme. We will explore how the RRGP's structured mentor model contributes to RCB of clinician-led multidisciplinary research teams. We will identify key factors at the organization, team and individual levels that affect research capacity of health professionals working in one regional health service district. This protocol describes the RRGP design and outlines the methods we will employ to evaluate an RCB programme, the RRGP, delivered in a regional health service in Australia.MethodsThe study will adopt an exploratory concurrent mixed-methods approach designed to evaluate the process of implementing an RCB model across one regional hospital and health service. Both quantitative and qualitative data collection methods over a 12-month period will be implemented. Data triangulation will be applied to capture the complex issues associated with implementing collaborative multidisciplinary practice–research partnerships.DiscussionThe RRGP is an innovative RCB model for clinicians in their workplace. It is expected that the programme will facilitate a culture of collaborative multidisciplinary research and strengthen hospital–university partnerships.

Networks for Science-Informed Innovation in the Arctic: Insights on the Structure and Evolution of a Canadian Research Network

In remote peripheral regions like the Arctic, research networks have been identified as an important mechanism for nurturing science-informed innovation. Given that relatively little is known about the network structures that support Arctic innovation processes, we employ social network analysis techniques to examine the structural organization and evolution of ArcticNet, a large Canadian Arctic scientific research network over a 13-year period (2004 – 17). ArcticNet funded 152 multidisciplinary research teams, connecting multiple types of science-based innovation actors, not including students (301 organizations and 1659 individuals). The research network grew without reaching saturation (increasing size, decreasing density), suggesting that ArcticNet was successful in recruiting new actors over the 13-year period. ArcticNet was centralized around non-local, public-sector actors (mainly Canadian academics). The emergence of collaborations across several boundaries (sectoral, geographic, thematic) suggests that non-local Canadian academic actors played an important boundary-spanning role, particularly in the early stages of the network. Participation by local northern actors doubled from Phase 1 to Phase 4, and with time, local northern actors had an increasing propensity for carrying out boundary-spanning roles and addressing structural holes. This study presents new insights into the networked nature of Arctic scientific research with potential implications for future research and innovation policy.

Evaluating blinatumomab implementation in low- and middle-income countries: a study protocol

BackgroundThe recent implementation of novel therapies has accelerated progress in pediatric cancer care. Despite the significantly poorer survival of patients in low- and middle-income countries (LMICs), administation complexities and other significant resource barriers have limited the translation of these novel therapies in these regions. This study aims to develop a model that can be used to support the implementation of novel therapies, such as blinatumomab (bispecific antibody therapy for B-cell acute lymphoblastic leukemia [B-ALL]) in LMIC centers, with the long-term goal of developing an implementation framework for similar future efforts.MethodsIn this study, mixed methods will be applied to understand the key contextual considerations that can be accounted for through a training program and prospectively designed implementation activities. The Consolidated Framework for Implementation Research will guide the activities related to implementation evaluation in parallel with a drug donation program. A multidisciplinary research team comprising high- and low-middle income healthcare professionals, industry, and implementation scientists has been assembled with the common goal of improving safe access to blinatumomab. To assess the factors affecting blinatumomab administration, semi-structured interviews with diverse collaborators and quantitative assessments of organizational characteristics will be conducted, together with quantitative and qualitative assessments of feasibility, acceptability, appropriateness, and cost of blinatumomab implementation. A quantitative assessment of stakeholder perceptions of different implementation strategies used as part of the multifaceted approach will also be performed. Finally, we will examine the key domains and processes used and construct the implementation roadmap for translation of novel therapies.DiscussionThis study will rigorously develop an implementation roadmap for translation of novel therapies in low-resource settings. The knowledge gained in the formative assessment will reveal the priority areas and key implementation strategies. Thereby, the resultant roadmap will facilitate future scale-out strategies for novel therapies in LMICs, thus increasing access, building capacity for management, and ultimately improving the care for children in LMICs.

Promoting new and expanded roles for librarians and information specialists.

This chapter describes how the U.S. National Library of Medicine (NLM), under the leadership of Donald A.B. Lindberg M.D., promoted new and expanded roles for librarians and information specialists in response to advances in technology and public policy. These advances brought information services directly to all potential users, including health professionals and the public and stimulated NLM to expand its programs, policies, and services to serve all. Dr. Lindberg included librarians and information specialists in all of NLM’s new endeavors, helping both to recognize and establish new or expanded roles. The involvement of librarians and information specialists in multidisciplinary healthcare research teams, in underserved communities, and in research data management and compliance has helped to redefine the health sciences information profession for the 21st century.

The Surveillance of Physical Activity, Sedentary Behavior, and Sleep: Protocol for the Development and Feasibility Evaluation of a Novel Measurement System.

BackgroundThere is increasing recognition of the need for more comprehensive surveillance data, including information on physical activity of all intensities, sedentary behavior, and sleep. However, meeting this need poses significant challenges for current surveillance systems, which are mainly reliant on self-report.ObjectiveThe primary objective of this project is to develop and evaluate the feasibility of a sensor-based system for use in the surveillance of physical activity, sedentary behavior, and sleep (SurPASS) at a national level in Denmark.MethodsThe SurPASS project involves an international, multidisciplinary team of researchers collaborating with an industrial partner. The SurPASS system consists of (1) a thigh-worn accelerometer with Bluetooth connectivity, (2) a smartphone app, (3) an integrated back end, facilitating the automated upload, analysis, storage, and provision of individualized feedback in a manner compliant with European Union regulations on data privacy, and (4) an administrator web interface (web application) to monitor progress. The system development and evaluation will be performed in 3 phases. These phases will include gathering user input and specifications (phase 1), the iterative development, evaluation, and refinement of the system (phase 2), and the feasibility evaluation (phase 3).ResultsThe project started in September 2020 and completed phase 2 in February 2022. Phase 3 began in March 2022 and results will be made available in 2023.ConclusionsIf feasible, the SurPASS system could be a catalyst toward large-scale, sensor-based surveillance of physical activity, sedentary behavior, and sleep. It could also be adapted for cohort and interventional research, thus contributing to the generation of evidence for both interventions and public health policies and recommendations.International Registered Report Identifier (IRRID)DERR1-10.2196/35697

Resilience of Cyber-Physical Systems: Role of AI, Digital Twins, and Edge Computing

Cyber-physical systems encompass multiple system domains (i.e., water, energy, networking) with heterogeneous goals and complexity of interactions. Existing technologies do not address the disparate time and spatial scales across the many system domains, especially with the latest threats and challenge spaces. New methods to manage resilience of systems, including integrating new computing and sensing strategies, machine learning and artificial intelligence, as well as advanced resilience analytics and prediction, are required to ensure that cyber-physical systems can withstand adverse events. This article summarizes the results of the December 2021 Society for Risk Analysis “Workshop on Resilience Analytics: Methodology and Applications to Cyber-Energy Systems” in which a multidisciplinary team of researchers, policymakers, military, and industry professionals met to identify priorities for research.

Implementing proven methods in a community-based health system to improve breast cancer screening rates during the COVID-19 pandemic.

6565 Background: There are reduced screening rates across the United States secondary to the COVID-19 pandemic; the additional anticipated deaths from breast and colorectal cancer, secondary to reduced screening, is approximated at 10,000 people. A study of thirty-two health systems in Georgia noted an 8% decrease in screening mammography compared to pre-pandemic rates. To help reverse the decline, Northeast Georgia Medical Center (NGMC) participated in the "Return to Screening" initiative, in conjunction with the American Cancer Society (ACS). A quality improvement project was performed at the community-based hospital system to increase breast cancer screening rates, using a multidisciplinary approach with a focus on health care disparities. Methods: The initial goal was to increase screening mammograms by 10% (n = 14,364) from June 1st to December 1st 2021. Interventions were selected by a multidisciplinary team of NGMC researchers, clinical providers, and oncology administrators. Interventions varied in category, encompassing unique patient and provider-specific approaches. The evidence-based interventions were tailored to address health care disparities in the local population. This included identification and quantification of cultural groups in the community to ensure quality patient access. Integrative collaboration consisted of intermittent meetings to certify consistent communication, project reflection and identification of barriers. The selected interventions were executed monthly, with simultaneous data tracking of mammography rates. Results: From June 1st to December 1st 2021, a total of forty evidence-based interventions were successfully implemented. Analysis of screening rates demonstrated a 15% increase across the allotted time period, corresponding to an average of 1,302 mammograms monthly (n = 15,284). This exceeded the initial anticipated goal of increasing screening by 10% (n = 14,364). Analysis of mammography results identified 331 new cases of breast cancer diagnosed within the allotted period, a 7% mean diagnosis rate increase. Certain planned interventions were unable to be conducted and required modification due to limitation of the ongoing pandemic; however, this solidified the use of social media and virtual participation as effective methods of community outreach. Conclusions: We identified key methods to engage the local community and successfully increased rates of screening mammography. Interventions were tailored to the local population, ensuring patient-centered tools and a personalized approach to medicine. The multidisciplinary, consistent collaboration with stakeholders ensured quality of care for the local patient population. This project demonstrates the importance of local community engagement to impact national cancer screening rates, and thus, ensure earlier detection of breast cancer.

Understanding and addressing food waste from confusion in date labeling using a stakeholders’ survey

Food waste is a significant global challenge for the humanity and environment. Different agencies world-wide are trying to reduce food waste in several ways. Of the reasons behind food waste, consumer level waste is significant, often hard to track, but can be a very critical contributor to food security if prevented. Food waste due to confusion in date labeling is one such way that consumers waste food. Currently, there are about 50 different types of date labels in use in the United States of America (USA) and they are not regulated. Due to the complex nature of consumer level food waste, our multi-disciplinary team of researchers conducted a stakeholder needs assessment survey (n = 123) to better understand the existing confusion over date labels. Our survey results indicate that majority of the stakeholders (75% of responses received in this category) are confused about the date labeling and associate it with food safety and feel unsafe to consume foods beyond the date indicated on the labels. The stakeholders think that better understanding the science behind such date labels and potential application of modern technology such as a mobile phone app, targeted community outreach education, social media, and print materials may help reduce food waste, which in turn would positively contribute to global food security. • A stakeholders' survey was conducted in the farm-to-fork continuum. • Respondents confuse date labels with food safety. • A multi-disciplinary approach, novel use-inspired technology, and community level intervention are key to reduce food waste.

Equity in Global North–South research partnerships: interrogating UK funding models

This article considers the degree to which achieving equity in Global North–South research partnerships is possible under current UK funding models. While there has been significant discussion with respect to the decolonisation of research, it will be argued that there is some distance between the language of equity articulated currently by UK funding bodies, and the realities of working as a project partner in the Global South. The article draws on the prior and ongoing experiences of a multidisciplinary team of researchers brought together by a UK-funded research project. In the interests of moving towards more equitable systems of knowledge production and dissemination, it explores the power asymmetries that can be inherent in Global North–South research partnerships, and the extent to which issues of coloniality continue to shape aspects of research agenda setting, project framing, impact, academic publishing and the division of labour within partnerships.

Development of a clinical pathway for behavioural and psychological symptoms of dementia care: A tool to improve resident outcomes

ObjectivesClinical pathways are used to improve the quality of care, reduce variation and maximise health or treatment outcomes in selected populations. The aim of this study was to develop a draft clinical pathway based on the best practice evidence for use in the management of behavioural and psychological symptoms of dementia (BPSD) in residential aged care facilities (RACFs).MethodsThe pathway was developed using the best practice evidence from clinical practice guidelines, operational guides and a systematic literature review. A multidisciplinary team of health professionals and researchers worked in an iterative process to contextualise the proposed pathway to local needs and context, and improve its clarity and user‐friendliness. The pathway was then re‐assessed for accuracy and adherence to the evidence.ResultsThe draft pathway outlines processes for BPSD prevention, watchful waiting for mild‐to‐moderate BPSD, and specific interventions for severe BPSD. Ongoing risk assessment is required throughout, and non‐pharmacological options are first‐line interventions. Person‐centred care was found to be an important care component across all three phases. An instruction guide with colour‐coded flow charts was developed to assist staff with determining the best care and treatment for each person living with dementia. Feasibility testing is underway.ConclusionsA draft clinical pathway based on clinical practice guidelines was developed to enhance the translation of evidence into practice for the management of BPSD, by nursing and clinical leaders in RACFs.

Combining Persuasive System Design Principles and Behavior Change Techniques in Digital Interventions Supporting Long-term Weight Loss Maintenance: Design and Development of eCHANGE.

BackgroundLong-term weight maintenance after weight loss is challenging, and innovative solutions are required. Digital technologies can support behavior change and, therefore, have the potential to be an effective tool for weight loss maintenance. However, to create meaningful and effective digital behavior change interventions that support end user values and needs, a combination of persuasive system design (PSD) principles and behavior change techniques (BCTs) might be needed.ObjectiveThis study aimed to investigate how an evidence-informed digital behavior change intervention can be designed and developed by combining PSD principles and BCTs into design features to support end user values and needs for long-term weight loss maintenance.MethodsThis study presents a concept for how PSD principles and BCTs can be translated into design features by combining design thinking and Agile methods to develop and deliver an evidence-informed digital behavior change intervention aimed at supporting weight maintenance. Overall, 45 stakeholders participated in the systematic and iterative development process comprising co-design workshops, prototyping, Agile development, and usability testing. This included prospective end users (n=17, 38%; ie, people with obesity who had lost ≥8% of their weight), health care providers (n=9, 20%), healthy volunteers (n=4, 9%), a service designer (n=1, 2%), and stakeholders from the multidisciplinary research and development team (n=14, 31%; ie, software developers; digital designers; and eHealth, behavior change, and obesity experts). Stakeholder input on how to operationalize the design features and optimize the technology was examined through formative evaluation and qualitative analyses using rapid and in-depth analysis approaches.ResultsA total of 17 design features combining PSD principles and BCTs were identified as important to support end user values and needs based on stakeholder input during the design and development of eCHANGE, a digital intervention to support long-term weight loss maintenance. The design features were combined into 4 main intervention components: Week Plan, My Overview, Knowledge and Skills, and Virtual Coach and Smart Feedback System. To support a healthy lifestyle and continued behavior change to maintain weight, PSD principles such as tailoring, personalization, self-monitoring, reminders, rewards, rehearsal, praise, and suggestions were combined and implemented into the design features together with BCTs from the clusters of goals and planning, feedback and monitoring, social support, repetition and substitution, shaping knowledge, natural consequences, associations, antecedents, identity, and self-belief.ConclusionsCombining and implementing PSD principles and BCTs in digital interventions aimed at supporting sustainable behavior change may contribute to the design of engaging and motivating interventions in line with end user values and needs. As such, the design and development of the eCHANGE intervention can provide valuable input for future design and tailoring of evidence-informed digital interventions, even beyond digital interventions in support of health behavior change and long-term weight loss maintenance.Trial RegistrationClinicalTrials.gov NCT04537988; https://clinicaltrials.gov/ct2/show/NCT04537988