Multiple Stakeholder Perspectives Research Articles

Multiple Stakeholder Perspectives of Implementing Work-Related Cognitive Behavioral Therapy (WCBT) in Vocational Service Settings: A Qualitative Exploration of Intervention Acceptability and Sustainability.

Growing mental health treatment access disparities elevate the urgency for identifying and implementing innovative approaches for delivering evidence-supported interventions. Work-related cognitive behavioral therapy (WCBT), a technology-assisted CBT (t-CBT) designed to address social anxiety and employment outcomes among job seekers at vocational service centers and for delivery by vocational service professionals, offers a promising way to increase access to needed mental health care. This qualitative study, guided by the Organizational Transformation Model (OTM), explored factors related to WCBT's implementation at two Jewish Vocational Services (JVS) Human Service sites in Detroit, MI and Los Angeles County, CA. Twenty-seven staff-stakeholders across the two JVS sites completed in-depth, semi-structured interviews focused on their experiences with WCBT over the four-year study period. Thematic analysis identified five core codes that most broadly captured participants' perceptions of WCBT implementation and the factors influencing implementation, including: (1) Need, (2) Buy-in and engagement, (3) Communication, (4) Sustainability concerns, and (5) Implementation facilitators. Core codes aligned with OTM factors related to impetus to transform, improvement initiatives, integration across boundaries, alignment from top to bottom, and leadership. Findings identify implementation strategies likely to optimize uptake and sustainability of WCBT within JVS sites that can be tested in a larger, multi-site implementation trial.

Driving the zero-carbon construction strategy: key barriers and enablers

PurposeIn the fast-changing field of zero-carbon construction there is a gap in understanding how zero-carbon construction strategies are experienced in practice. This paper aims to identify the key barriers and enablers to driving a zero-carbon construction strategy by industry, policymakers and educators.Design/methodology/approachThe research was conducted in two stages. The first stage used a literature review to determine thematic areas from which to develop discussion points for the second stage of the research, which gathered insights into key barriers and enablers to driving a zero-carbon construction strategy from analysing recorded discussion with industry, policymakers and educators. This study adopts a qualitative research methodological design underpinned by dialectical approach of enquiries involving 31 participants. The philosophical standpoint aligns with a constructivist participatory worldview based on multiple stakeholder perspectives. Data involving virtual and face-to-face engagement held simultaneously in Australia and India were transcribed, coded and synthesised to identify the barriers and enablers to driving zero-carbon construction strategy.FindingsThe paper identified key barriers and enablers driving zero-carbon construction strategy. Barriers included limited awareness of industry dynamics; fixed mental models of professional practice; complexities in identifying appropriate skillsets; difficulties associated with reviewing education and training models and integrating sustainable strategies at early stages of projects. Enablers included: fostering education reform and supporting frameworks and procurement strategies for developers and clients; implementing efficient building designs, construction and operationalisation of zero-carbon buildings and; utilising an industry-led integrated approach. A framework was developed to provide an illustrative view of the linkage between the research projects’ focus areas and emergent themes.Originality/valueThe paper provides zero-carbon action priorities for four significant stakeholder groups in the build environment, developers, building occupiers, educators and government. As the priorities are derived in the research from examination of current literature and analysis of stakeholder viewpoints, this paper presents a unique, realistic and timely identification of barriers and key enablers driving zero-carbon construction strategies. Methodology applied in terms of data collection involved a public discourse and a unique technology-driven collaborative approach where participants simultaneously contributed across countries and time zones in a synchronous manner across key topics related to driving the zero-carbon construction strategy.

Exploring the Broader Benefits of Obesity Prevention Community-based Interventions From the Perspective of Multiple Stakeholders.

Community-based interventions (CBIs) show promise as effective and cost-effective obesity prevention initiatives. CBIs are typically complex interventions, including multiple settings, strategies and stakeholders. Cost-effectiveness evidence, however, generally only considers a narrow range of costs and benefits associated with anthropometric outcomes. While it is recognised that the complexity of CBIs may result in broader non-health societal and community benefits, the identification, measurement, and quantification of these outcomes is limited. This study aimed to understand the perspectives of stakeholders on the broader benefits of CBIs and their measurement, as well as perceptions of CBI cost-effectiveness. Purposive sampling was used to recruit participants from three stakeholder groups (lead researchers, funders, and community stakeholders of CBIs). Online semi-structured interviews were conducted, taking a constructivist approach. Coding, theme development and analysis were based on published guidance for thematic analysis. Twenty-six stakeholders participated in the interviews (12 lead researchers; 7 funders; 6 community stakeholders). Six key themes emerged; (1) Impacts of CBIs (health impacts and broader impacts); (2) Broader benefits were important to stakeholders; (3) Measurement of benefits are challenging; (4) CBIs were considered cost-effective; (5) Framing CBIs for community engagement (6) Making equitable impacts and sustaining changes-successes and challenges. Across all stakeholders, broader benefits, particularly the establishment of networks and partnerships within communities, were seen as important outcomes of CBIs. Participants viewed the CBI approach to obesity prevention as cost-effective, however, there were challenges in measuring, quantifying and valuing broader benefits. Development of tools to measure and quantify broader benefits would allow for more comprehensive evaluation of the cost-effectiveness of CBIs for obesity prevention.

From college to university: A practical exploration of tertiary vocational education at Shenzhen Polytechnic University

The emerging phenomenon of tertiary vocational education is a category of education positioned within vocational education. In China, tertiary vocational education has passed through the stages of "associate degree level" and "permitted establishment". Shenzhen Polytechnic University (SZPU), serving as an exemplary model of tertiary vocational education, plays a pivotal role in providing valuable insights for the transformation and development of other vocational institutions in China. This research aims to collect policy documents from SZPU and, through interviews from multiple stakeholder perspectives, gain an understanding of the perceptions and experiences of those involved in tertiary vocational education. It conducts an in-depth analysis of SZPU's motivations, trajectory, challenges, impacts, and countermeasures in initiating undergraduate vocational programs. On this basis, the study compares the educational practices of other institutions offering tertiary vocational education, synthesizes the pedagogical rationale and developmental directions of this type of education at a theoretical level, and proposes empirical and feasible developmental strategies at a practical level.

Stakeholder dynamics and territorial disputes in nature reserves management: A case of Cwebe community, Eastern Cape, South Africa

Nature reserves are important ideational spaces where global goals on environmental conservation can be achieved. However, their management is complex and challenging when multiple stakeholders claim ownership and control. This study was centered on this debate and explored stakeholder dynamics and territorial disputes around nature reserves, with a focus on Mhlanganisweni and eLalini Villages situated adjacent to Cwebe Nature Reserve (used interchangeably with 'the Nature Reserve') in South Africa. The aim was to understand the dynamics of the relationship between local communities and the Nature Reserve management, and to investigate how these factors contribute to territorial disputes and their consequences. Qualitative data was collected from women, youth, the elderly, and traditional authorities on one hand, and the management of the Nature Reserve on the other. The study found complex stakeholder relationships among stakeholders, with local communities frequently losing out in territorial disputes. This outcome is evident from the territorial disputes that arise over exclusion in decision-making, natural resource exploitation, and conservation policies within and around the Nature Reserve. The study recommends the implementation of a more inclusive conservation framework that acknowledges the perspectives of multiple stakeholders.

Implementing Ireland’s Food Vision 2030 within the Fresh Produce Sector: An Investigation of the Barriers and Enablers Using Systems Thinking Principles

The Irish Food Vision 2030 (IFV 2030) seeks to restructure Ireland’s agricultural food system to deliver long-term social, economic, and environmental sustainability in keeping with its commitment to the European Green Deal and the 2030 Sustainable Development Goals. This study investigates the effectiveness of the IFV 2030 in delivering on this commitment across the fresh produce supply chain in Ireland using a combination of data collected from stakeholders through a survey and systems thinking principles. A review of the literature and Foucault’s genealogical methods guided the development of the survey. Systems thinking principles were used to review the IFV 2030 and assess its capacity to deliver large-scale change for a sustainable Irish food system. Barriers to change were identified, including historical patterns of behaviour between EU and Irish policymakers that have repeatedly hindered progress towards large-scale change events. The results demonstrate that successful, long-term change will depend on the involvement and incentives of stakeholders within the supply chain. Continuous stakeholder engagement is required through a bottom-up organisational and supply chain approach to deliver long-term sustainability within the fresh produce sector. Using a systems thinking lens brings benefits through transdisciplinary collaboration and fosters the multiple stakeholder perspectives needed to deliver new ideas and solutions.

Building a sustainable career during the initial transition to work: a multiple-stakeholder perspective on proactive behaviors and contextual factors

PurposeThe initial transition into work has become less predictable. Therefore, emerging adults should take charge and be proactively engaged in their careers during the preparation stage of the school-to-work transition (STWT). We explored which behaviors emerging adults display during the STWT to foster their happiness, health, and productivity, how various contextual factors enable or hinder these behaviors, and to what extent these behaviors can be considered proactive.Design/methodology/approachTaking a qualitative approach, we conducted 44 semi-structured interviews with undergraduate students at an Applied Sciences University in the Netherlands six months before graduation. Additionally, we held nine focus groups (n = 55) and four interviews (n = 6) with contextual stakeholders (i.e. parents, faculty/staff, employers, the board of the university, higher education policymakers, and the Ministry of Education).FindingsThe students mentioned three main behaviors to foster their health, happiness, and productivity, namely, eating healthy food, maintaining social contacts, and reflecting on their motivations. Our analysis shows that, conceptually, none of these behaviors can be considered truly proactive. Moreover, the findings revealed multiple systemic underlying contextual hindrances to portray these behaviors, such as educational system characteristics, which make proactive behaviors less likely.Originality/valueAs the STWT is affected by multiple contexts, adopting a multi-stakeholder perspective is imperative when studying the phenomenon. We adopted the sustainable careers framework as a lens to uncover how emerging adults may build early career sustainability—additionally, we nuance current research on proactivity by concretizing the conceptualization of proactive behaviors.

Clinical Exercise Physiologists in the United Kingdom: Multi-stakeholder Perspectives

ABSTRACT Background In the UK Academy of Healthcare Science, registered clinical exercise physiologists (CEPs) receive specialist, master’s-level education and training in the knowledge and skills required to work with chronic and complex medical conditions based on a curriculum that was benchmarked against Australian standards. The aim of this study was to explore the perspectives of multiple stakeholders to identify the key knowledge and skills required for a registered CEP to work effectively in the United Kingdom and inform future iterations of the accredited curriculum. Methods Semistructured interviews of academics (n = 5), CEPs (n = 5) and service users (n = 5) explored perspectives of the key knowledge and skills required of a CEP in UK health care. Reflexive thematic analysis was performed to identify the key knowledge and skills of a UK-registered CEP that all the stakeholders deemed important. Results Six themes were identified from the interviews. The CEP-specific themes were identified as pathophysiology, physiological assessments, exercise prescription, exercise delivery, and behavior change and education. Clinical practice was recognized as the overarching concept that linked all the CEP-specific themes together. Conclusion This study provides the first understanding of the knowledge and skills required for a CEP to work effectively in the UK health care system, in addition to providing research evidence and insight to the next iterations of the Clinical Exercise Physiology UK (CEP-UK) curriculum framework. Future research should focus on establishing a more comprehensive, definitive list of the knowledge and skills of a UK CEP that will contribute to subsequent versions of the CEP-UK curriculum framework.

Ethics, design, and implementation criteria of digital assistive technologies for people with dementia from a multiple stakeholder perspective: a qualitative study

BackgroundDementia impairs the ability of people with dementia to be autonomous and independent. They need support from third parties, who should ideally respect their autonomy and independence as much as possible. Supporting people with dementia can be very burdensome for caregivers and numbers of patients increase while numbers of potential caregivers decline. Digital assistive technologies (DATs) that directly support patients or their caregivers may help bridging the increasing gap between need of support and available resources. DATs have the potential to preserve the autonomy and independence of people with dementia and promote their abilities, if they are properly designed in close interaction with future users. In our study, we focused on ethical concerns, technological requirements, and implementation criteria for DAT in general and specifically to support outdoor mobility of people with dementia.MethodsWe applied a qualitative approach and conducted a World Café (2 tables, n = 7) and an online focus group (n = 6) with people with dementia, relatives, healthcare professionals, scientists, ethics experts, and experts for digitally-assisted medical care. We descriptively analyzed the data using a content analysis approach.ResultsThe participants reported technological (e.g., lack of Wi-Fi), financial (e.g., expensive devices or lack of budget for DATs), political (e.g., legal hurdles such as the European Medical Device Law or data protection regulations) as well as user-related hurdles (e.g., lack of digital competence) for the implementation of DAT in dementia care. Among the issues discussed were the importance of autonomy, independence, safety, privacy, and questions of decision making capacity in DAT’s use. Participants identified opportunities and benefits in self-learning, situation-aware DATs and wished for dementia-friendly communities. They emphasized the value of personal interaction that should not be replaced, but rather supported by DAT.ConclusionThe results revealed multiple hurdles and ethical concerns for DAT use and provided recommendations for designing and implementing DATs. Further investigations are needed on the impact of DAT on personal interactions in caregiving and the role of DAT in dementia-friendly communities.

Exploring the varying agendas of principals, teachers, and a university related to mentorship

ABSTRACT Teachers are entering the field with a different set of teaching expectations than existing teachers were held to during their own training programs. As a result of shifts in teacher preparation practices and increasingly diverse student populations, existing teachers may not be equipped to mentor novice and student teachers, perpetuating cycles of inequity and frustration. Employing qualitative methods that examined the perspectives of multiple stakeholders, this study explores factors that inform existing teachers’ willingness and ability to mentor the next generation of teachers. Findings suggest that there needs to be more explicit guidance and coordination on the part of all stakeholders, each of whom presents unique perceptions and agendas regarding mentoring the next wave of teachers.

Consensus-building to improve implementation of NICE guidance on planning for end-of-life treatment and care: a mixed-methods study

BackgroundDespite the availability of guidance for the provision of good end-of-life care, there are significant variations across the UK in its delivery. This study sought to identify the influences on end-of-life treatment and care planning across several areas where deficiencies in evidence-based practice have been identified, and to develop consensus among healthcare providers and users for recommendations on how to address these deficits.MethodsAn online survey (106 responses), qualitative interviews (55 participants) and a consensus-building exercise (475 participants in the initial round) were undertaken. Participants included people approaching the end of life, people important to them, and health and care practitioners who help people plan for the end of life or provide end-of-life care. Recruitment was via online methods, including social media and online newsletters of relevant charities and professional organisations. Thematic analysis using the framework method was used to analyse qualitative data. Synthesis of qualitative and quantitative data led to the development of statements regarding recommendations for advancing implementation of good practice. A two-stage consensus-building exercise asked respondents first to rate these statements and then to rate and rank further sub-recommendations in three areas.ResultsResults from the consensus building exercise confirmed that end-of-life care planning conversations are to be welcomed and encouraged, and that the priority should be to have the conversation (which could be initiated by a range of professionals, or people planning end-of-life care themselves), rather than to wait for an ideal time to have it. Further rounds identified specific components of a standardised record of end-of-life treatment and care preferences that should be prioritised, specific health and care staff that should be empowered through training in advanced communication, and aspects of communication most important to include in training for healthcare professionals.ConclusionsOur study has identified opportunities for action to improve end-of-life treatment and care by combining multiple stakeholder perspectives and building consensus among them: the resulting recommendations have sufficient granularity to be implemented and evaluated. They are of relevance to policy makers, those who train healthcare professionals, and those looking after patients approaching the end of life.

Implementing injury prevention training in youth handball (I-PROTECT) in Sweden: study protocol for a cluster randomised trial

IntroductionEfficacy trials show that evidence-based injury prevention training reduces injuries in youth athletes but effectiveness, that is, outside the controlled setting, is lower and, consequently this training has had limited...

Definitions and assessments of recovery from gambling disorder: A scoping review.

While the concept of recovery is receiving increasing attention in the context of gambling disorder (GD), no consensus has yet been reached regarding its definition. This scoping review aims to map the literature on GD recovery, identify gaps, and provide insights for a more holistic and patient-centred perspective. A systematic search of three databases was conducted (PubMed, PsycINFO, and ScienceDirect). Based on the method by which the results of these studies were produced, the studies included were sorted into four categories (quantitative, instrument validation, qualitative, and mixed studies) and subsequently examined using conceptual analysis. One hundred thirteen articles were included in this research after the screening process. In the quantitative and instrument validation studies, recovery was defined or operationalized in terms of abstinence, the absence of a GD diagnosis, or mild GD severity, or by reference to treatment outcomes or controlled gambling. A meta-synthesis of the results of the qualitative studies revealed four core features of recovery (insight, empowerment and commitment, wellbeing enhancement, and reconsideration of the issue of relapse). Discrepancies in definitions, outcomes, and variables used were evident across studies. Additionally, the quantitative and standardized approaches employed in most studies exhibited severe limitations with regard to defining recovery from the subjective and multidimensional perspectives of people recovering from GD. This lack of definitional clarity emphasizes thenecessity for further qualitative research. This research should encompass multiple stakeholder perspectives to develop a working definition promoting recovery from a holistic, patient-centred, and tailored approach.

The role of artificial intelligence in the supply chain finance innovation process

AbstractLeveraging on ten case studies, the paper examines the Supply Chain Finance (SCF) innovation process through a multiple stakeholder perspective (buyers, suppliers, and SCF providers). The aim is to identify the phases of the process impacted by Artificial Intelligence (AI), as well as its benefits and challenges. AI affects several activities in the Initiation phase of the innovation process, supporting the SCF provider’s commercial activities and contributing to assessing the buyer’s creditworthiness, detecting fraud, or proposing the right SCF solution. In the Implementation phase, AI supports assessing the supplier’s credit rating, categorizing and onboarding suppliers, and fastening the administrative tasks. Formulating 9 propositions, this study supports the theory related to the SCF by providing empirical evidence about the role of AI in the SCF innovation process and also identifying the resulting benefits and challenges for all the actors involved.

Advancing Transthyretin Amyloidosis Drug Development in an Evolving Treatment Landscape: Amyloidosis Forum Meeting Proceedings.

Hereditary transthyretin amyloidosis (ATTRv, also referred to as hATTR; ORPHA 271861) and wild-type ATTR amyloidosis (ATTRwt; ORPHA 330001) are rare, progressive, systemic protein misfolding disorders with heterogeneous clinical presentations. ATTRv and ATTRwt amyloidosis are characterized by the deposition of amyloid fibrils in multiple organs including the heart, nerves, eyes, and soft tissues. The management of ATTR amyloidosis is complex because of its multisystemic nature and progression despite available treatment options. Morbidity is high and there are many unmet medical needs for patients. While contemporary ATTR amyloidosis cohorts are diagnosed earlier, have lower risk disease and lower mortality compared with the previous era, these advances coupled with the emergence of effective disease-modifying therapies have confounded the design of future prospective clinical trials and interpretation of historical control data. The Amyloidosis Forum is a public-private partnership between the US Food and Drug Administration Center for Drug Evaluation and Research and the nonprofit Amyloidosis Research Consortium ( www.arci.org ). This article summarizes proceedings from the 21 June 2023 Amyloidosis Forum on advancing drug development in ATTR amyloidosis in an evolving treatment landscape. The Forum focused on elements of clinical trial design to address these challenges and discussed their strengths and weaknesses from multiple stakeholder perspectives (i.e., patient, sponsor, statistician, clinician, and regulatory authorities). Given rapid evolution of natural history in ATTR amyloidosis, the utility of historical control data is limited. Leveraging contemporary real-world data is essential for clinical trial design. Evidence generation from clinical trials should address clinically relevant questions. Key factors in successful trial design must be informed by up-to-date data on natural history, prognostic factors, clinically meaningful thresholds, and sharing available clinical trial data. The Amyloidosis Forum includes the community of patients with ATTR amyloidosis, the physicians who treat them, and the sponsors and regulators who collectively stand ready to support further studies in order to develop novel effective therapies.

Evaluating the inhibitors in the growth of high-speed railway in India: A multi-stakeholder perspective

The expansion of the high speed railway (HSR) network has made vital contributions in improving intercity travel around the globe. Despite being promoted by governments across the globe, multiplicity of barriers has prevented the penetration of HSR services in developing economies apart from China. Many studies have emphasized on the advantages of HSR services but have failed to highlight the challenges in developing an efficient HSR network. This study aims to identify and develop interrelationships between the major inhibitors in the growth of HSR in a developing economy such as India considering the perspective of multiple stakeholders. The stakeholders considered for the present study are academic researchers, Indian railway officials and ancillary companies involved in the construction of HSR. Thirteen major inhibitors are identified after consulting all the stakeholders and a blended methodology consisting of Fuzzy theory as well as decision-making trial and evaluation laboratory method (Fuzzy-DEMATEL) is used to develop the inter-relationships. All stakeholders highlighted some common inhibitors such as financial viability of the HSR project, financial health of Indian Railways and the existing infrastructure as the major challenges in growth of HSR in India. Furthermore, strategies have been identified to mitigate these inhibitors to help the policy makers. Strategies have been proposed and a relationship (inhibitor-strategy) matrix has been developed to understand the acceptability of these strategies. The major contribution of the present study is that no study has considered different stakeholder's perspectives in identifying the inhibitors. Furthermore, the policy makers can directly use the findings of this study for HSR growth in developing economies.

Codesigning Online Continuing Medical Education on Social Health Integration and Social Risk-Informed Care for Primary Care Providers.

Adapting clinical care decisions for patient-reported social risks is essential to social health integration and patient-centered care. Most research in this area focuses on awareness and assistance (social-needs-targeted care), such as screening and referral to food, financial, and other resources. Limited evidence for adjustment strategies (social risk-informed care) or adapting care for social risks made it difficult for Kaiser Permanente to implement new initiatives. This article describes a codesign process to build a novel, adjustment-focused continuing medical education course. The authors codeveloped the online continuing medical education course with patients and clinicians using user-centered design. Transcripts from codesign activities were coded and analyzed by thematic analysis to identify major themes, including perceptions of social risk-informed care and barriers to care adjustment. Practical hurdles for implementing social risk-informed care emerged, including clinicians' concerns about the ethics of adjustment as substandard care, particularly without robust assistance activities. However, patients expressed a desire for their care to be adapted to their social circumstances, to allow for more realistic care plans. Implementation barriers identified from the codesign were addressed through an interactive, case-study approach. Existing evidence on contextualized care and shared decision making informed a general framework for primary care providers to engage in awareness and adjustment activities, paired with 3 interactive case studies based on real-world, clinician-supplied scenarios. The authors recommend that multiple stakeholder perspectives be incorporated during the development of social health integration initiatives, particularly adjustment. Education complemented by active, nuanced, flexible implementation strategies may be necessary for the successful uptake of care-delivery-based social health integration activities.

Enhancing resilience in transnational E-commerce supply chains: Critical factors, perspectives and strategic action plan

This study develops a hybrid model to investigate the factors affecting transnational e-commerce supply chain resilience (TNSCRE) by integrating the Entropy Weight Method (EWM), Simple Additive Weighting (SAW), and Interpretive Structural Modeling (ISM). The study identifies 36 critical factors categorized under supply chain adaptability, supply chain efficiency, and supply chain evolution, and five criteria are used to rank these factors. The EWM is used to calculate the relative weights of the criteria, and the SAW method is used to rank the factors based on their weighted scores. The ISM is then used to evaluate the interrelationships among the key factors. The research highlights the significance of several factors, such as the speed of supply chain disruption recovery, interactive collaboration, and response time to supply chain disruption. Sensitivity analysis was performed to assess the robustness of the findings. Finally, a SWOT analysis is conducted to develop a strategic action plan for addressing these significant factors. The study provides a comprehensive understanding of the factors that impact TNSCRE from the perspective of multiple stakeholders. The findings can help e-commerce business owners improve their existing supply chain resilience and achieve sustainable growth in the context of globalization.

Stakeholder perspectives following implementation of Vietnam’s first speech-language pathology degrees: recommendations for future curriculum development

Purpose To investigate perspectives of multiple stakeholders involved in development and delivery of Vietnam’s first speech-language pathology degrees and derive recommendations for future degrees in Vietnam and other Majority World countries. Methods An exploratory-descriptive qualitative research design using focus groups and individual semi-structured interviews in the preferred language (English or Vietnamese) was used, with 70 participants from five stakeholder groups: project managers, students, academic educators, placement supervisors and interpreters. Transcriptions were analysed using thematic network analysis. Results Analysis identified five organising themes: (1) People enjoyed working with/learning from others; (2) Benefits from/to stakeholders; (3) The pandemic impacted program delivery and learning; (4) Practical challenges; (5) Preparation with flexibility required for success and sustainability. From the five organising themes, one synthesising global theme was developed, conveying that satisfying international collaborations require preparation, support, high quality interpreting, and management of challenges. Conclusions Recommendations highlight the need for preparation, collaboration, support to manage challenges, flexibility, recognition for placement supervisors and high-quality interpreting. The recommendations are of relevance to other organisations engaged in development of professional degrees in Majority World countries. Future research would benefit from a critical investigation of the diverse perspectives of stakeholders involved in the development and implementation of international curricula.

Attachment and adjustment in expatriate reactions to the 2011 Tohoku disasters

PurposeThis study aims to develop an extended social attachment model for expatriates, integrating a multiple stakeholder perspective, to understand evacuation decisions during disasters.Design/methodology/approachThrough interviews with 12 Tokyo-based expatriates who experienced the 2011 Tohoku earthquake, tsunami and nuclear disasters, this study collects the lived experiences of a diverse set of expatriates. This data is analyzed abductively to map relevant evacuation factors and to propose a reaction typology.FindingsWhile the 2011 Tohoku disasters caused regional destruction and fears of nuclear fallout, Tokyo remained largely unscathed. Still, many expatriates based in Tokyo chose to leave the country. Evacuation decisions were shaped by an interplay of threat assessment, location of attachment figures and cross-cultural adjustment. The study also discusses the influence of expatriate types.Practical implicationsDisaster planning is often overlooked or designed primarily with host country nationals in mind. Expatriates often lack the disaster experience and readiness of host country nationals in disaster-prone regions in Asia and beyond, and thus might need special attention when disaster strikes. This study provides advice for how to do so.Originality/valueBy unpacking the under-researched and complex phenomenon of expatriate reactions to disasters, this study contributes to the fields of international human resource and disaster management. Specifically, seven proposition on casual links leading to expatriate evacuation are suggested, paving the way for future research.