Multi-stakeholder Initiatives Research Articles

A practical ‘How-To’ Guide to plain language summaries (PLS) of peer-reviewed scientific publications: results of a multi-stakeholder initiative utilizing co-creation methodology

BackgroundPeer-reviewed scientific publications and congress abstracts are typically written by scientists for specialist audiences; however, patients and other non-specialists are understandably interested in the potential implications of research and what they may mean for them. Plain language summaries (PLS)—summaries of scientific articles in easy-to-read language—are emerging as a valuable addition to traditional scientific publications. Co-creation of PLS with the intended audience is key to ensuring a successful outcome, but practical guidance on how to achieve this has been lacking.MethodsBuilding on the Patient Engagement (PE) Quality Guidance previously developed by Patient Focused Medicines Development (PFMD), a multi-stakeholder working group (WG) of individuals with patient engagement experience and/or expertise in PLS was established to develop further activity-specific guidance. PLS guidance was developed through a stepwise approach that included several rounds of co-creation, public consultation (two rounds), internal review and a final external review. The iterative development process incorporated input from a wide variety of stakeholders (patient representatives, industry members, publishers, researchers, medical communications agencies, and public officials involved in research bodies). Feedback from each step was consolidated by the WG and used for refining the draft guidance. The final draft was then validated through external consultation.ResultsThe WG comprised 14 stakeholders with relevant experience in PE and/or PLS. The WG developed a set of 15 ethical principles for PLS development. These include the necessity for objective reporting and the absence of any promotional intent, the need for balanced presentation, the importance of audience focus, the need to apply health literacy principles, and the importance of using inclusive and respectful language. The first public consultation yielded 29 responses comprising 478 comments or edits in the shared draft guidance. The second public consultation was an online survey of 14 questions which had 32 respondents. The final ‘How-To’ Guide reflects feedback received and provides a rational, stepwise breakdown of the development of PLS.ConclusionsThe resulting ‘How-To’ Guide is a standalone, practical, ready-to-use tool to support multi-stakeholder co-creation of PLS.

Plenty more fish in the sea? - is there a place for seafood within a healthier and more sustainable diet?

Fish and other seafood species play an important nutritional, economic and social role within current diets worldwide, providing significant amounts of protein and micronutrients for an estimated 3billion people. Advice to consume fish is a common feature of dietary guidelines globally, including in the UK. However, increased global demand for seafood has led to overfishing and environmental damage linked to aquaculture expansion; issues, which are exacerbated by climate change. This raises the question of whether future demand for seafood can be met sustainably. In this article, we provide professionals working in diet, nutrition and health with an insight into the challenges facing the seafood sector and offer advice on how consumers may include seafood within a healthier and more sustainable diet. While a complex and multi-faceted challenge, fisheries scientists estimate that successful implementation of better management practices (for farmed and wild-capture fisheries) can meet future demand, allow fish stocks to rebuild to sustainable levels, help mitigate environmental effects of aquaculture, and ensure profitable fisheries to support the ~60million people employed by the seafood sector globally. Those working within the UK food system, including nutrition and health professionals, and businesses, can support the transition towards a more sustainable future for seafood by: encouraging consumption of a wider variety of species by UK consumers; increasing awareness of and knowledge about 'ecolabel' certifications designed to help consumers identify more sustainable choices; and engaging with multi-stakeholder initiatives addressing sustainability challenges facing the seafood sector.

Who counts when health counts? A case-study of multi-stakeholder initiative to promote value-creation in Swedish healthcare.

A European initiative to design a "medical information framework" conceptualised how multiple stakeholders join in collaborative networks to create innovations. It conveyed the ways in which value is created and captured by stakeholders. We applied those insights to analyse a multi-stakeholder initiative to promote improvement of Swedish healthcare. Our longitudinal case study covered totally fifty stakeholders involved in a national project, aiming at designing a system to support value-based evaluation and reimbursement. During the project the focus changed from reimbursement to benchmarking. Sophisticated case-mix adjusting algorithms were designed to make outcome comparisons valid and incorporated in a software platform enabling detailed analysis of eight patient groups across seven regional health authorities. Those were deliverables demonstrating value created. However, the project was unable to transfer the system into routine use in the regions, a failed value-capture. The initial success was promoted by collaborative processes in diagnosis-specific working groups of well-informed and engaged professionals. The change of focus away from reimbursement decreased the involvement among health authorities, leaving no centrally placed persons to push for implementation. It highlights the importance of health professionals as the key stakeholder, who has both the know-how instrumental to creating an innovation, and the local involvement guaranteeing its implementation.

Collective health research assessment: developing a tool to measure the impact of multistakeholder research initiatives

BackgroundThe need to more collaboratively measure the impact of health research and to do so from multidimensional perspectives has been acknowledged. A scorecard was developed as part of the Collective Research Impact Framework (CRIF), to engage stakeholders in the assessment of the impacts of health research and innovations. The purpose of this study was to describe the developmental process of the MULTI-ACT Master Scorecard (MSC) and how it can be used as a workable tool for collectively assessing future responsible research and innovation measures.MethodsAn extensive review of the health research impact literature and of multistakeholder initiatives resulted in a database of 1556 impact indicators. The MSC was then cocreated by engaging key stakeholders and conducting semi-structured interviews of experts in the field.ResultsThe MSC consists of five accountability dimensions: excellence, efficacy, economic, social and patient-reported outcomes. The tool contains 125 potential indicators, classified into 53 impact measurement aspects that are considered the most relevant topics for multistakeholder research and innovation initiatives when assessing their impact on the basis of their mission and their stakeholders’ interests. The scorecard allows the strategic management of multistakeholder research initiatives to demonstrate their impact on people and society. The value of the tool is that it is comprehensive, customizable and easy to use.ConclusionsThe MSC is an example of how the views of society can be taken into account when research impacts are assessed in a more sustainable and balanced way. The engagement of patients and other stakeholders is an integral part of the CRIF, facilitating collaborative decision-making in the design of policies and research agendas. In policy making, the collective approach allows the evaluation perspective to be extended to the needs of society and towards responsible research and innovation. Multidimensionality makes research and innovations more responsive to systemic challenges, and developing more equitable and sustainable health services.

Same Same but Different? A Quantitative Exploration of Voluntary Sustainability Standards in Agriculture

Private governance by means of voluntary sustainability standards (VSS) has become ubiquitous, especially for the governance of sustainability issues along global value chains in agriculture. As VSS have multiplied and proliferated, their commonalities and differences are not always easily discernable to value chain participants and their stakeholders. Concurrently, extant research is ambiguous on the degree of harmonization or diversification of standards currently available. Two core aspects have received particular attention: the meaning of sustainability reflected in VSS and the degree of stakeholder inclusion in standard governance. It is the purpose of this study to compare VSS from different types of standard setting initiatives regarding these two core aspects by analyzing their purported sustainability worldview and the inclusiveness of their institutional design. The quantitative exploration covers exemplars offered by inter-governmental organizations, business initiatives, non-governmental organizations as well as multi-stakeholder initiatives. The analysis finds significant ambiguity of sustainability worldviews across the sample, as well as almost universal uptake of design characteristics to enhance inclusiveness irrespective of the type of standard setting initiative. However, there are also significant differences in the way sustainability is understood among VSS offered by different standard setting initiatives.

Diverse Organizational Adoption of Institutions in the Field of Corporate Social Responsibility

In the current literature, institutional adoption of Corporate Social Responsibility (CSR) governance standards is mainly understood in a binary sense (adoption versus no adoption), and existing research has hitherto focused on inducements as well as on barriers of related organizational change. However, little is known about often invisible internal adoption patterns relating to institutional entrepreneurship in the field of CSR. At the same time, additional information about these processes is relevant in order to systematically assess the outcomes of institutional entrepreneurship and to differentiate between substantive versus symbolic implementation. In this paper, we contribute a comparative intraorganizational differentiation of institutional adoption processes in the field of CSR, and we distinguish between broad and narrow organizational institutional adoption across different management functions relating to institutions of a similar type. Our study is based on a quantitative survey among members of the United Nations Global Compact Network Germany, as well as on qualitative interviews. We analyze different institutional adoption patterns and derive ten theoretical predictors of diverse institutional adoption choices and thereby inform the literatures on institutional entrepreneurship, CSR governance, and Multi-Stakeholder Initiatives. Besides our theoretical contributions, our findings serve as a source of information for practitioners engaged in CSR governance as they provide new insights into the managerial perception and assessment of different CSR standards and initiatives.

Current trends in addressing environmental and social risks in mining and mineral supply chains by regulatory and voluntary approaches

Mining activities have always raised environmental and social concerns due to their impact on natural resources and people. During the last decade, the stakeholder base expected to respond to these sustainability concerns has broadened from directly involved parties to a range of indirect stakeholders along the downstream mineral value chain. These stakeholders variably engage in reporting, supplier risk assessments, exercising supply chain due diligence, third party assurance, and corporate social responsibility measures. This trend reflects a combination of societal, investor, and regulatory pressure as well as industry self-regulation along the supply chain. The present article examines this development from the complementary perspectives of international regulations and voluntary industry and multi-stakeholder initiatives affecting the industrial and the artisanal mining sector as well as the associated mineral supply chains. To this end, we provide an introductory analysis on the global uptake, implementation challenges, and lessons learnt with regard to both regulatory developments and voluntary initiatives. Key challenges identified include a misalignment between local reforms and international efforts, heterogeneous downstream market requirements, and evasive strategies as well as gaps to report on and achieve positive local sustainability impacts, partly brought about by emphasising corporate risk management over local community priorities. Meaningful stakeholder dialogue and increased local ownership are key factors to overcome some of these challenges.

Hidden risks of deforestation in global supply chains: A study of natural rubber flows from Sri Lanka to the United States

Growing global demand for natural rubber is driving deforestation due to the expansion of rubber plantations, with consequences for biodiversity, carbon storage, and local communities. There has been little attention given to these issues in Sri Lanka, where rubber production is central to economic growth. Although private initiatives and government regulations aim to reduce deforestation associated with these plantations, it is unclear if these measures effectively protect forests or limit associated risks in the supply chains of companies purchasing Sri Lankan rubber. This paper uses the TRACAST methodological framework and remote sensing to track natural rubber supply chains from Sri Lanka to the U.S and to identify hidden deforestation risks resulting from this trade. We estimate 196 km2 of forest were converted into rubber plantations between 2006 and 2016, including protected forests located in an emerging rubber frontier in southeast Sri Lanka. Our analysis identifies rubber traders and multinational tire manufacturers as key actors that hinder the traceability of rubber back to the plantations. This opacity increases the potential for unsustainably produced rubber to enter global supply chains of transnational corporations such as Loadstar (Michelin) and Nike. Most of these corporations have sustainable procurement policies, but the effectiveness of these policies is compromised by the lack of supply chain transparency. Integrating public and private sector management through inclusive multi-stakeholder initiatives and multi-level land use governance can help overcome these hurdles, prevent future deforestation, and assist Sri Lanka in moving towards more sustainable rubber production.

Multistakeholder initiatives and their prospects for sustainability: the farmer perspective

AbstractTo promote sustainability, multistakeholder initiatives (MSIs) are an emerging form of private governance that brings together diverse stakeholders across the agrifood system to advance sustainable agriculture practices. Previous research on MSIs focuses on the organization and structure of various MSIs through coordinator and management perspectives. In this paper, we examine farmers' experiences of participating in a leading MSI metrics program for U.S. agriculture, Field to Market. Through survey and interview methodology, this paper examines farmers' motivations, perceived benefits and power dynamics within Field to Market's metrics program. We find that although being open to sharing sustainability metrics with buyers, farmers struggled to gain tangible benefits. The majority of farmers considered themselves ‘already sustainable’ in that they made economically efficient farming decisions. As such, participating in Field to Market resulted in little to no changes in farming practices. Because MSI metrics programs work to assist farmers in becoming aware of inefficiencies and encourage changes, the lack of utilizing data generated from the sustainability metrics highlights a significant shortfall of this MSI metrics program. Farmers also perceived buyers as the primary beneficiaries of sustainability metrics since the buyers could now make claims about the sustainability of their products. Additionally, our findings provide nuance related to economic benefits as farmers broadly conceptualized the primary economic benefits as continuing a relationship with buyers who were now asking farmers to join the metrics program and report data. Although the metrics program appears ‘voluntary,’ farmers perceived few other options when asked to report data since sharing data became an apparent baseline for doing business. This paper contributes an understanding of farmers' experiences of engaging with an MSI metrics program, which helps to illuminate the potential implications of these newly emerging approaches to promoting sustainability. Our findings demonstrate that proponents of this newly emerging approach to promoting sustainability may want to consider the distribution of benefits and the power dynamics embedded in these programs since these programs may carry unintended consequences as they are scaled up. Finally, we posit several additional avenues for future research to further elucidate the potential social implications of MSI metrics programs.

Building an Ideational and Institutional Architecture for Africa’s Agricultural Transformation

AbstractOver the past two decades, transnationally networked actors have promoted a vision of transforming African agriculture from an object of poverty-alleviating development assistance to a motor of economic growth by integrating smallholders into markets and promoting agribusiness through multi-stakeholder initiatives. Munro and Schurman analyze the networking and communicative labor that key policy actors have performed to advance this vision. An institutional and ideational architecture for this project is created by defining agricultural challenges in specific ways, imbuing particular ideas with authority and establishing strategic institutional connections. This architecture constitutes an emerging governance regime for African agriculture, but its long-term prospects remain uncertain.

Introduction of Subcutaneous Infliximab CT-P13 and Vedolizumab in Clinical Practice: A Multi-Stakeholder Position Statement Highlighting the Need for Post-Marketing Studies.

Although subcutaneous formulations of infliximab CT-P13 and vedolizumab are registered for treating moderate-to-severe inflammatory bowel disease [IBD], many questions on their use remain unanswered. We set up a multi-stakeholder initiative resulting in a position statement. Based on publicly available data, statements on subcutaneous infliximab and vedolizumab were developed and reviewed by 45 Belgian IBD physicians in a three-round modified Delphi process. During a consensus meeting, input from 16 IBD patients, nine IBD nurses and two clinical pharmacologists was provided and statements were further discussed, modified and scored. Statements achieving agreement by at least 70% of the IBD physicians were accepted. The Delphi process resulted in 79 agreed statements. In patients initiating intravenous therapy, IBD physicians would only consider switching to subcutaneous formulations in patients achieving both clinical and biological response [for Crohn's disease] or both clinical and endoscopic response [for ulcerative colitis]. For patients under maintenance therapy, switching to subcutaneous formulations was only considered in those achieving both clinical and endoscopic response while receiving standard dosing of infliximab or vedolizumab. While awaiting more scientific data, IBD physicians should consider weekly subcutaneous injections or switching back to an intravenous formulation in case of loss of response. Finally, switching to a subcutaneous formulation should always be a shared decision. All stakeholders welcomed subcutaneous infliximab and vedolizumab. However, more scientific data are needed to select the right patients and timing for switching to these newer formulations, and to explore the optimal strategy in case of loss of response.

Power Relations in Multi Stakeholder Initiatives: Insights from the Government-Instituted Indonesian National Forestry Council

Power Relations in Multi Stakeholder Initiatives: Insights from the Government-Instituted Indonesian National Forestry Council

Compliance and cooperation in global value chains: The effects of the better cotton initiative in Pakistan and India

The Better Cotton Imitative (BCI), the world's largest multi-stakeholder initiative (MSI) for sustainable cotton production, is a prime example of a hybrid “cooperation-compliance” model used by some MSIs to engage farmers and on-farm workers in the global South. Using a mixed methods approach, we investigate the impacts of this hybrid model on economic, environmental, and labor conditions of farmers and on-farm workers on irrigated cotton farms in Pakistan and India. In one of few cross-national comparisons of BCI impacts, we find evidence that farmers participating in BCI's “cooperation-compliance” model report (a) higher gross incomes and (b) lower input costs than comparison farmers. However, (c) BCI had no positive impacts upon labor conditions on cotton farms, as compared to conventional peers. Finally, (d) BCI's impacts are mediated by institutional and geographic differences across the study sites. We conclude that effects of MSIs are hard to generalize but can most meaningfully be understood within particular institutional designs, value chains, specific time periods, and institutional contexts.

Collaborative research as boundary work: learning between rice growers and conservation professionals to support habitat conservation on private lands

Multi-stakeholder initiatives for biodiversity conservation on working landscapes often necessitate strategies to facilitate learning in order to foster successful collaboration. To investigate the learning processes that both undergird and result from collaborative efforts, this case study employs the concept of boundary work as a lens to examine learning between rice growers and conservation professionals in California’s Central Valley, who were engaged in a collaborative research project focused on migratory bird conservation. Through analysis of workshop observations, project documents, and interviews with rice growers and conservation professionals, we identified five distinct factors of the collaborative research process that influenced learning amongst these two groups: having mutually beneficial goals, sharing ownership of the collaborative research process, building trust, integrating knowledge, and institutional alignment. We also examined and identified learning outcomes for both rice growers and conservation professionals, which included new knowledge of the social-ecological system, new practices around farming and collaboration, and shifting identities. Our findings suggest that applying these factors and outcomes for learning when structuring collaborative research, and other multi-stakeholder initiatives, can foster learning amongst diverse stakeholder groups to support new approaches for balancing resource use and adaptive management.

Credibility of Soft Law for Artificial Intelligence—Planning and Stakeholder Considerations

<bold xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Seeing the CEOs</b> of four of the world’s largest tech companies appear before the U.S. Congress in July 2020 reinforced the idea that regulatory action for these tech giants is coming <xref ref-type="bibr" rid="ref1" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">[1]</xref> . But a different subtext was also clear—specific regulation for future technologies that these and other companies have in research and development is likely a long way off, in no small part because these are fundamental platform technologies that easily cross geographic boundaries with uses, value, and risks that can be hard to predict. Work in Europe and China to regulate artificial intelligence (AI) may be further along, but will face similar challenges and limitations <xref ref-type="bibr" rid="ref2" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">[2]</xref> , <xref ref-type="bibr" rid="ref3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">[3]</xref> . Companies, civil society, courts, and even governments will need to turn elsewhere for guidance and safeguards on the governance of AI, and society will need to turn elsewhere for effective safeguards. Most likely, these will come in the form of the array of multistakeholder initiatives, standards, codes of conduct, and the like that fall under the broad umbrella of “soft law”—mechanisms that “include various types of instruments that set forth substantive expectations but are not directly enforceable by government” <xref ref-type="bibr" rid="ref4" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">[4]</xref> – <xref ref-type="bibr" rid="ref5" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"/> <xref ref-type="bibr" rid="ref6" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">[6]</xref> . The trust that society places in AI itself will depend on the credibility of the rules that guide its development and use, including those based on soft law. This is a tall order for rules built without state authority.

Requalifying markets of basic food commodities? An examination of the Round Table on Responsible Soy's implementation in Córdoba, Argentina

The Round Table on Responsible Soy (RTRS) is an international multi-stakeholder initiative whose certification scheme seeks to promote more economically, socially and environmentally sustainable practices in the soy sector. This paper offers an in-depth case study of Argentina's soy producing province of Córdoba in order examine RTRS′ attempt to requalify soy, a basic food commodity for which discussions around quality have traditionally tended to be marginal. Guided by a regulationist analytical framework, the empirical analysis shows that RTRS aims at producing some modest transformations in the production practices of the soy sector. However, due to this initiative's unsuccessful attempt to guarantee demand and significant price premiums for producers, the possibility of achieving such modest transformations becomes compromised. As a consequence, the case of RTRS makes visible some of the challenges and difficulties that emerge when markets of basic food commodities attempt to adopt the logic of quality markets.

Core outcome set for preventive intervention trials in chronic and episodic migraine (COSMIG): an international, consensus-derived and multistakeholder initiative

ObjectiveTypically, migraine prevention trials focus on reducing migraine days. This narrow focus may not capture all that is important to people with migraine. Inconsistency in outcome selection across trials limits...

Deliberation Without Democracy in Multi-stakeholder Initiatives: A Pragmatic Way Forward

Political CSR scholars argue that multi-stakeholder initiatives (MSIs) should be designed to facilitate deliberation among corporations, civil society groups, and others affected by corporate conduct for their decisions to be considered democratically legitimate. However, critics argue that decisions reached within deliberative MSIs will lack democratic legitimacy so long as corporations are granted a role in helping to make them. If the critics are correct, it leads to a paradox. Corporations must be excluded from holding decision-making authority within MSIs if they are to function as democratically legitimate regulatory institutions at a global level. However, this risks severely diminishing the incentive of corporations to support and participate within MSIs, which often depend heavily for their success on the visibility provided them by corporate participants. In this paper, I argue that this apparent paradox should be considered irrelevant to the future study of MSIs since it is both unnecessary and impractical for researchers to focus on establishing democratically legitimate systems of governance within them. Instead, I recommend an approach informed by three touchstones of pragmatic philosophy to guide their future study—a criterion of usefulness, wariness of category disputes and commitment to experimentalism. I conclude by drawing on research in political science and social psychology that demonstrates an important practical role for deliberation within such organizations, arguing that researchers must zero in on the role that inclusive deliberation can play in bolstering their effectiveness as regulatory instruments.

The use of Real-World Data (RWD) by Health Technology Assessment (HTA) agencies

Abstract Issue There are divergent views between HTA bodies and pharmaceutical industry on the potential for RWD to inform determination of added benefit or value for money of new medicines. However, exploration of use of RWD is now essential as more high-cost innovative therapies come to market with short-term uncontrolled trials. Description of problem Payers are increasingly seeing use of RWD to fill evidence gaps in clinical development programmes, including external control arms or collection of RWD after initial assessment to determine real-life effectiveness or duration of benefit. An international multi-stakeholder initiative, RWE4Decisions, led by the Belgian Payer - RIZIV/INAMI - has explored these issues over the past few years. They have proposed that all stakeholders including industry, clinicians, regulators, patients and methodologists need to be involved to determine what questions can be answered by RWD and ensuring data is of sufficient quality to generate robust real-world evidence (RWE). Alongside this, the IMPACT HTA Project has reviewed use of RWD in specific rare disease case studies. Results Several HTA/Payers have implemented RWD collection schemes, but few have been successful in delivering sufficient evidence to enable re-assessment of treatment value. Italy is an exception, with a national web-based registry system. Other countries prefer to rely on secondary use of health system data and links to clinical registries, but curating and analysing these data can be complex. The case studies show how more recently some countries are overcoming these challenges by entering into more formal agreements with stakeholders to ensure purposive data collection. Lessons There is a need to publish protocols and reports related to RWD collection in an international portal. If possible, dialogues among bodies should happen in advance to align RWD collection requirements and facilitate data analysis.

Stakeholder Influence on Sustainable Supply Chain Management: A Case Study of a German Apparel Frontrunner

Although interest in green and sustainable supply chains has been growing for over a decade in the academic discourse, the textile industry still embraces numerous examples of non-sustainable behavior (i.e., environmental damage, poor working conditions, or modern slavery). While there is a general agreement that stakeholder pressure can lead to more sustainable SCs, a lot remains for a more differentiated stakeholder perspective in sustainable supply chain management (SSCM). Thus, this study aims for theory elaboration by structuring relationships between SSCM and stakeholder constructs through an exploratory single case study design on the Otto Group, a German apparel frontrunner. It enables an in-depth investigation of the complexity of both stakeholder engagement/relationships and SSCM. As key results, sustainability managers and employees are important facilitators to realize win-win situations. Further, most progress is nowadays made in participating in multi-stakeholder-initiatives (MSI) and with standards to tackle sustainability issues in SCs. Furthermore, this study shows the importance of a shift from the perspective of sustainable products toward sustainable values, and it outlines best practices regarding the integration of stakeholders' expectations in SSCM.