Stakeholder Analysis Research Articles

Design of a Dyadic Digital Health Module for Chronic Disease Shared Care: Development Study.

The COVID-19 pandemic forced the spread of digital health tools to address limited clinical resources for chronic health management. It also illuminated a population of older patients requiring an informal caregiver (IC) to access this care due to accessibility, technological literacy, or English proficiency concerns. For patients with heart failure (HF), this rapid transition exacerbated the demand on ICs and pushed Canadians toward a dyadic care model where patients and ICs comanage care. Our previous work identified an opportunity to improve this dyadic HF experience through a shared model of dyadic digital health. We call this alternative model of care "Caretown for Medly," which empowers ICs to concurrently expand patients' self-care abilities while acknowledging ICs' eagerness to provide greater support. We present the systematic design and development of the Caretown for Medly dyadic management module. While HF is the outlined use case, we outline our design methodology and report on 6 core disease-invariant features applied to dyadic shared care for HF management. This work lays the foundation for future usability assessments of Caretown for Medly. We conducted a qualitative, human-centered design study based on 25 semistructured interviews with self-identified ICs of loved ones living with HF. Interviews underwent thematic content analysis by 2 coders independently for themes derived deductively (eg, based on the interview guide) and inductively refined. To build the Caretown for Medly model, we (1) leveraged the Knowledge to Action (KTA) framework to translate knowledge into action and (2) borrowed Google Sprint's ability to quickly "solve big problems and test new ideas," which has been effective in the medical and digital health spaces. Specifically, we blended these 2 concepts into a new framework called the "KTA Sprint." We identified 6 core disease-invariant features to support ICs in care dyads to provide more effective care while capitalizing on dyadic care's synergistic benefits. Features were designed for customizability to suit the patient's condition, informed by stakeholder analysis, corroborated with literature, and vetted through user needs assessments. These features include (1) live reports to enhance data sharing and facilitate appropriate IC support, (2) care cards to enhance guidance on the caregiving role, (3) direct messaging to dissolve the disconnect across the circle of care, (4) medication wallet to improve guidance on managing complex medication regimens, (5) medical events timeline to improve and consolidate management and organization, and (6) caregiver resources to provide disease-specific education and support their self-care. These disease-invariant features were designed to address ICs' needs in supporting their care partner. We anticipate that the implementation of these features will empower a shared model of care for chronic disease management through digital health and will improve outcomes for care dyads.

Analysis of Stakeholders' Perspectives on Barriers to Affordable Public Housing Implementation in Ghana

Analysis of Stakeholders' Perspectives on Barriers to Affordable Public Housing Implementation in Ghana

Gaps between Stakeholders` Concerns and Mitigation Measures in ESIA Reports of Geothermal Energy Projects: A Case Study of Geothermal Energy Projects in Djibouti, Ethiopia and Kenya

Geothermal energy serves as a viable alternative to fossil fuels in developing countries, catering to electricity needs, supporting socio-economic development, and striving towards sustainable development goals. It also poses potential negative impacts on the environment and society. This study conducted a comparative analysis of mitigation measures and stakeholders' concerns across eight environmental and social impact assessment reports (ESIA) for geothermal energy development projects in Djibouti, Ethiopia, and Kenya. Mitchell's mitigation hierarchy guideline (1997) was used to examine the purpose of 708 proposed mitigation measures for eight environmental and nine social criteria extracted from the literature and then a deductive qualitative content analysis were used to categorize these measures according to 18 criteria collected from the literature. Additionally, using an inductive qualitative content analysis, the study analysed 680 stakeholders' concerns sourced from public participation materials in the ESIA reports, identifying four main thematic categories and twenty-two subcategories. Stakeholders expressed concerns predominantly about socio-economic (52%) and development matters (20%), while ESIA reports offered fewer social mitigation measures (28.7%) compared to environmental ones (71.3%). Nonetheless, a strong correlation between the environmental and social mitigation measures proposed for our 17 criteria demonstrates a higher proportion of measures in power plant construction projects. Despite this, communities voiced apprehensions about new involuntary resettlement plans, economic opportunities, and unrealized corporate social responsibility (CSR) projects. Furthermore, the study revealed that local communities complained about the adverse effects of previous geothermal development projects, including air, water, and soil pollution, impacting their health, crop production, and livestock. This research highlights the discrepancy between stakeholders' concerns and mitigation measures in ESIA reports, attributed to possible inadequacies in the conduct of social impact assessment and public participation, leading to misunderstandings regarding project impacts and benefits among local communities. To address these issues, this paper recommends a more comprehensive understanding of social aspects, the consideration of cumulative impacts from other geothermal projects in the same area, and transparent communication to avoid unrealistic or costly promises during the realization of ESIA reports for geothermal energy projects

Environmental and Socioeconomic Drivers Influencing Agriculture Development among Smallholder Farmers in Ecuador

Understanding smallholder farmers’ perceptions of climate change, technology, association involvement, and government policy, including its indicators, impacts, and impediments, is critical for promoting sustainable agriculture. Thus, this study aimed to evaluate the most significant social and environmental factors restricting the agricultural development of small farmers in terms of credit facilities and government subsidies. The agriculture area of Colon (Ecuador) was selected for a stakeholder analysis to identify and assess the priority, needs, goals and requirements of key people regarding agriculture and environmental management. Besides, a logistic regression model was applied to estimate the effect of social and environmental independent variables on credit facilities and government benefits. According to results, smallholder farmers face many challenges, but targeted policy development, supporting the perception of climate change, and enhancing access to markets can help them overcome these obstacles.

AN INTERGENERATIONAL TRAINING PROGRAM TO SUPPORT LATINE ELDERS: LESSONS LEARNED

Abstract Cultural adaptation and tailoring of caregiving interventions has garnered greater attention in part due to high levels of unmet need and poor intervention outcomes among dementia caregivers from racial and cultural groups. Additionally, there is a growing interest in understanding intervention mechanisms. We conducted a formative analysis of the process employed in the design of an intergenerational training program to support elders within the Latine community. A content analysis of memos and stakeholder listening sessions and document review guided this analysis. Framed within a discussion on the continuum of cultural adaptation, we report on lessons learned. Lessons include: 1) embracing community-led design, 2) demonstration of partnership commitment to facilitate trust-building, 3) consistent appreciative inquiry, and 4) demonstration of cultural centeredness within the partnership.

Assessing collaboration, knowledge exchange, and stakeholder agency in coastal governance to enhance climate resilience

Coastal governance plays a central role in building the capacities for adaptation and transformation towards climate resilience in coastal social-ecological systems (SES). However, enhancing climate resilience requires effective coordination between organisations involved in coastal governance. Therefore, more information about the role and agency of organisations and the relationships between them is needed. This paper aims to improve the understanding of collaboration, knowledge exchange, and stakeholder agency for enhancing climate resilience in coastal SES, using a case study in Algoa Bay, South Africa. We apply and combine stakeholder analysis and social network analysis, which is currently underrepresented in climate change adaptation research. Results suggest that different top-down and bottom-up processes are needed to improve knowledge exchange and enhance climate resilience in the coastal governance of the Algoa Bay SES. These include improved leadership, effective knowledge transfer, integration of climate information, support for bridging organisations, and inclusivity of marginalised stakeholders. These suggestions may also be more broadly applicable and transferable to similar coastal SES. Ultimately, the results of this study shed light on network structures in coastal governance facing climate change and advance research on combining stakeholder analysis and social network analysis in climate change adaptation and environmental governance research.

Stakeholder Analysis as a strategic tool in framing collaborative governance arenas for marine litter monitoring

Monitoring and assessment of marine litter requires multi-stakeholder involvement at national and subnational levels. Collaborative governance approaches are important, but often fail without adequate effort towards identifying and engaging stakeholders with appropriate profiles for the issue at stake. Stakeholder Analysis (SA) is increasingly used to ensure efficient governance arrangements. Our hypothesis is that SA contributes to collaborative governance processes for marine litter policies. We explored a pioneer participatory process in Brazil, where SA was applied to identify, categorize, and prioritize stakeholders, and analyze their power and interest, for the Strategic Plan for Monitoring and Assessing Marine Litter in the state of São Paulo. A top-down/bottom-up approach revealed that snowball sampling complemented the stakeholder assemblage identified by the consultation of experts. Prioritization of data-related stakeholders streamlined the participatory process. The interest-power matrix evaluated stakeholders' influences, guiding specific engagement strategies. We highlight the significance of SA in collaborative governance and mobilizing key stakeholders for effective marine litter monitoring initiatives, contributing to the global agenda to combat marine pollution.

A stakeholder analysis of the road transport system in Tanzania using a STAMP control structure

The way the road transport system is developed in a country affects safety. This study aims to identify the roles and relationships of road transport stakeholders and to explore the understanding of control and feedback mechanisms and associated gaps influencing road safety. A System-Theoretic Accident Model and Processes (STAMP) model was applied to document and interview data (n = 30). Participants emphasised the hindrance of overlapping mandates among stakeholders on the road transport system’s operations and underlined the roles of coalitions for road safety as system enablers. Further, the withdrawal of some controls by international agencies can increase system vulnerability. Most importantly, critical control and feedback gaps were shown to increase risks for safety within the road transport system. The findings underscore the complexity of the road transport system and add to the discussion on a system’s approach to road safety. Practitioner summary: Using a STAMP methodology, we extensively studied the road transport system in Tanzania. Road transport stakeholders were identified through the review of documents, interviews were conducted, and the main findings were discussed. Control and feedback mechanisms and associated gaps were critically presented, recommendations were proposed, and policy implications were suggested.

Apollo 24/7 – A chink in Apollo Hospitals’ armour?

Learning outcomes This case study is designed to enable students to analyze the competitive landscape of a business impacted by technological disruption; evaluate the viability of an organic growth strategy using stakeholder analysis; evaluate the revenue and cost structure of Apollo 24/7 and decide on the future investment strategy; and analyze funding strategies of traditional hospitals versus pure digital players. Case overview/synopsis To extend its reach, Apollo Hospitals Enterprise (Apollo Hospitals), a leading private sector brick-and-mortar hospital chain in India known for using state-of-the-art technology, launched a unified virtual mobile platform Apollo 24/7 in February 2020, 45 days into the COVID-19 pandemic. The management believed that the digital platform had a unique ecosystem that could not be replicated. The analysts were optimistic about the impact of the decision on the future performance of Apollo Hospitals, as it was expected to lead to higher penetration and increased revenue. They also anticipated the unlocking of value, as and when the venture capitalist (VC) would invest in Apollo Hospitals. However, with increasing operating expenses on account of burgeoning technological and marketing expenses, things did not seem to go going as planned. Three years later, in February 2022 after the Q3 of financial year 2023 results. Suneeta Reddy, the company’s managing director found herself pondering whether the digital platform could boost Apollo Hospitals’ profitability in addition to expanding its reach and increasing affordability when the company missed the analyst estimates. In India, which was then the second most populous country, “incremental access” and “affordability” were what mattered to the patients, However, for the investors and analysts, it was quarter-on-quarter performance. The change in the macroeconomic environment stalled the company’s plan of raising money from VCs. Furthermore, the financing dilemma also plagued Reddy. She knew there was a difference between financing for conventional businesses that for digital businesses. She also had to take decide between short-term profitability with which investors were obsessed versus long-term sustainability, which involved taking care of stakeholders’ interests. Complexity academic level This case study is basically aimed at postgraduate courses and executive management courses. Supplementary materials Teaching notes are available for educators only. Subject Code CSS11: Strategy.

Developing a Policy for Healthy Schools Food: A Plan of Action

Background and Objectives: Childhood obesity is a pressing global health concern, particularly in low- and middle-income countries like Palestine. This study aims to address the prevalence of childhood obesity in Palestine and its association with the school food environment. The objective is to propose and advocate for the implementation of a "healthy schools' food policy" to promote the consumption of nutritious food while prohibiting the sale of unhealthy items. Methods: A comprehensive analysis of the sociocultural, economic, political, ethical, and legal contexts surrounding childhood obesity in Palestine was conducted. This included a review of existing studies, stakeholder analyses, and an evaluation of policy alternatives. A legislative strategy was developed to guide the implementation of the proposed policy. Results: The study identified the widespread prevalence of childhood obesity in Palestine, with contributing factors rooted in sociocultural, economic, and political contexts. The analysis of policy alternatives revealed that establishing and enforcing a written protocol for "Food and Beverage Services" in schools emerged as the most effective option. This policy approach received the highest score in terms of effectiveness, access and fairness, cost-effectiveness, and administrative and political feasibility. Conclusion: The findings highlight the urgent need for policy interventions to address childhood obesity in Palestine. The proposed "healthy schools' food policy" offers a promising avenue to promote nutritious food consumption while curbing the availability of unhealthy options. Collaborative efforts involving stakeholders, including schools, the Ministry of Education, healthcare professionals, parents, and the community, are crucial for successful policy implementation. Regular evaluations and community feedback will be essential to monitor the policy's impact and make necessary adjustments. This study underscores the significance of prioritizing children's health within the broader context of societal well-being.

Analysis of Stakeholders in Social Entrepreneurship Development

Stakeholders have an essential role in the development of social entrepreneurship (SE), so it is necessary to understand the role and contribution of stakeholders. Stakeholders referred to in the development of SE are parties involved and interested in the success and sustainability of SE. This research was conducted with women social entrepreneurs in the Greater Jakarta and Central Java Provinces. This study aims to discover the role of actors in developing SE in the Greater Jakarta and Central Java Provinces. The MACTOR analysis method is used in this study; this method includes determining system actors, setting goals, describing power relations, and assessing attitudes and the importance of dreams for actors. The analysis results are presented through graphs and figure, providing insight into actor competitiveness, alliance patterns, possible conflicts, and actor support for developing SE in the Greater Jakarta and Central Java Provinces. The study results show that policy is the central government; in this case, KEMENKOP UKM (MINISTRY OF COOPERATIVES AND SMES), UKM (Ministry of Cooperatives and SMEs), and KEMENSOS (MINISTRY OF SOCIAL AFFAIRS) (Ministry of Social Affairs) are vital in setting special SE regulations. The existence of rules issued by the central government will help social entrepreneurs get various social supports that are useful for developing SE.

Abstract C014: Strengthening transdisciplinary teams through developmental evaluation: Learnings from a multi-year, multi-project initiative

Abstract Cancer disparities are complex problems which require a deep understanding and strong collaboration from a broad set of perspectives across the academic and non-academic spectrum (community members, community-based organizations, policymakers) to identify sustainable solutions. The Community and Cancer Science Network (CCSN) initiative of the Medical College of Wisconsin Cancer Center is a transdisciplinary network focused on addressing statewide cancer disparities. CCSN grounds its approach in the principles of deep equity, systems-change, and the integration of biology to policy. CCSN currently includes multiple projects and more than 140 community and academic partners. Diverse transdisciplinary collaborations do not occur organically, often need facilitation and benefit from on-going assessment and support. To continually evaluate ways in which we can build and sustain strong teams and solutions, we utilize a developmental evaluation process leveraging the expertise of an external evaluation firm. Developmental evaluation supports social innovations by working with program leaders to focuses on learning and adaption. As CCSN has grown, developmental evaluation has allowed us to continually adapt how we build and guide our transdisciplinary teams. External developmental evaluators work with each project team as a cooperative partner and help guide the team leaders through understanding data needs, data collection, data analysis, and data interpretation. Our developmental evaluation began with journey mapping to understand the process and elements for successful leadership of a transdisciplinary team. This approach provided data allowing us to understand a pattern of certain pain points in collaborations and ways in which to prepare for and mitigate expected challenges. As the network has grown, we have utilized developmental evaluation to refine an annual partner survey and employ intermediate surveys (i.e., Right Now surveys) to assess team progress and openness to collaboration. Network mapping and stakeholder analysis have contributed to team formation helping team leaders consider new voices and perspectives. Further tools including Before/After Action reviews, Situational Analyses, and a readiness assessment were used to shape our understanding of successful transdisciplinary teams. We will show evidence of how these tools have positively impacted our ability to engage community and academic partners in authentic transdisciplinary collaborations over a four-year, and multi-project effort. Transdisciplinary Collaboration involving community and academic partners offer great promise for innovative approaches to cancer disparities. These unique collaborations may need additional support and guidance. Developmental evaluation provides tools to allow leaders to adapt to the needs and changes within complex teams. Citation Format: Laura Pinsoneault, Tobi Cawthra, Alexis Krause, Kristen Gardner-Volle, Jenelle Elza, Kim Kinner, Melinda Stolley. Strengthening transdisciplinary teams through developmental evaluation: Learnings from a multi-year, multi-project initiative [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C014.

A System Thinkingbased Framework for Sustainable Governance in Healthcare

This study emphasises the importance of thinking beyond the constrictive perspective of shareholder profit maximisation and putting stakeholder value maximisation front and centre in healthcare. This study uses system thinking approaches to understand the pitfall of the narrow approach of shareholder profit maximisation in healthcare organisations. The study further performs stakeholder analysis to identify each stakeholder’s interests, needs, expectations, and level of influence and power over the health systems and policy. The study used multi-criteria decision analysis approach to identify the priority of the stakeholder organisations. The criteria used for the prioritisation are levels of interest, influence, and impact. Contrary to belief pharmaceutical companies were found to be the most significant player in driving the outcomes of the healthcare system. The study also emphasises the role of government and regulators in the achievement of the same. Stakeholder analysis done in the study also concurs with these findings. Finally, the study uses the grounded theory approach to suggest a framework for the achievement of objectives and providing sustainable governance. This study concludes that by thinking beyond shareholder profit maximisation, healthcare organisations can prioritise patient-centred care, social responsibility, and innovation, ultimately leading to better outcomes for patients and society.

Bibliometric mapping of research developments on the topic of fishing port management using VOSviewer

The study aims to determine position of the research to be analysed regarding the management of fishing ports with the stakeholder analysis approach that plays a role in management. Ports are one of the industries that have social consequences for stakeholders, necessitating a greater awareness of their social responsibilities. However, the literature has not yet assigned equal weight to the social components of ports because they have economic and environmental dimensions. Fishing ports can produce waste as a source of pollution. Thus, stakeholders must play an important role in managing fishing ports. The results showed a network of visualizations, overlay of visualizations, and density of visualizations. Research on the management of fishing ports with an evaluation approach to the role of stakeholders has not been widely conducted; thus, further research can be conducted.

Existing evidence on the use of participatory scenarios in ecological restoration: a systematic map

Background and contextThe scale of land degradation worldwide has led to nearly one billion hectares committed to restoration globally. However, achieving such restoration targets will necessitate complex trade-offs against limited time, competing knowledge, costs, resources and varying stakeholder and societal preferences. Participatory scenarios allow a way to identify collaborative solutions for restoration planning and implementation best suited for the local cultures and societies they are tied to. They can be used to navigate uncertainties surrounding future trajectories of restored areas by evaluating trade-offs in outcomes. This research aims to systematically map the evidence on the use of participatory scenarios in restoration planning. We use the following research question: What evidence exists on the use of participatory scenarios in ecological restoration? This is answered by examining the characteristics of the evidence base, types of study design, types of outcomes, trade-offs in outcomes, and the role of participants.MethodsA comprehensive and reproducible search strategy was followed using bibliographic databases, web-based searches, and targeted searching. Search results underwent a two-step screening process according to eligibility criteria. Metadata on key areas of interest were extracted from included texts and were narratively synthesised alongside data visualisations to answer the research questions.Review findings18,612 records were initially identified, and 106 articles were included in the final map. Most studies were conducted in Europe and North America, focusing on restoring agricultural land or forests. Most texts used mixed methods and explored multiple outcome types, but environmental outcomes were the most assessed. Within environmental outcomes, indicators for ecological function were assessed more frequently than structural or compositional indicators. The most common reason for choosing outcomes and indicators was stakeholder interest. Trade-offs in social, ecological, and economic outcomes were mainly examined across space using mapping techniques, while far fewer studies looked at trade-offs across stakeholders and time. Participants were mostly included in the scenario creation step and were usually chosen purposefully by the research team.ConclusionsIt is difficult to understand how useful scenarios are for restoration planning because few texts reported how scenarios fed into the process. Despite this, the range of outcomes used and different method types adopted suggests participatory scenarios allow for integrating different knowledge and approaches, alongside facilitating the use of qualitative or semi-quantitative data when this is more appropriate or quantitative data is not widely available. To better use participatory scenarios as a tool for ecological restoration planning, decision-makers can push for greater levels and definitions of participation from the offset of restoration projects with specified, regular, and structured communication and participation channels. We also recommend more systematic methods of participant selection, such as stakeholder analysis. Further research is needed to understand the effectiveness of participatory scenarios in restoration planning and whether the participation of stakeholders was successful in meeting objectives. To improve the evidence base, future studies should clearly evaluate their effectiveness in the restoration planning process and their success in meeting their participatory objectives.

Unveiling complexity of hydrogen integration: A multi-faceted exploration of challenges in the Dutch context

As the transition to sustainable energy intensifies, hydrogen emerges as a pivotal medium in mitigating climate change and improving energy security. While its applicability across various sectors is undeniable, its integration into established energy systems presents multifaceted challenges. This study investigates the complexities of integrating hydrogen into the Netherlands' energy systems. Beyond technological advancements, the successful design and rollout of a hydrogen supply chain require coordination and collaboration among a myriad of stakeholders. Through a mixed-methods approach, this study combines findings from a broad literature review, policy document analyses, evaluation of 59 field projects, and engaging dialogues with 33 key stakeholders from different sectors. This investigation led to the identification and categorization of key players in the Dutch hydrogen sector, revealing their interconnected roles and the challenges encountered in the hydrogen integration process. The study further categorized the identified challenges faced by stakeholders into five core domains: technical, infrastructural (including supply chain), socioeconomic, environmental, and institutional, with associated factors. Prominent challenges include transportation infrastructure upgrades, high initial costs and scalability, effective storage methods, safety and cybersecurity measures, storage and distribution infrastructure, security of supply, and public acceptance. This study contributes to the hydrogen integration discourse, offering insights for academics, industry, and policymakers. Its detailed stakeholder analysis, holistic categorization of challenges across five domains, and a stakeholder-centric approach grounded in real-world dialogues offer applicable frameworks beyond its primary context. In this vein, it guides future research and decisions, and its approach is adaptable for different regions or sectors, emphasizing comprehensive transition strategies.

Unveiling the Digital Landscape of CAR-T Therapies in Multiple Myeloma Using Social Media Insights

Introduction: The rapid evolution of novel chimeric antigen receptor T-cell (CAR-T) therapies, including Carvykti (ciltacabtagene autoleucel) and Abecma (idecabtagene vicleucel), have revolutionized the treatment landscape for multiple myeloma (MM) patients. These cutting-edge therapies have demonstrated remarkable efficacy in clinical trials, representing a significant advancement in the field. However, their real-world impact on patient and physician experiences, and perceptions remain important topics of ongoing investigation. In recent years, social media platforms have emerged as valuable sources of real-time data and patient perspectives, providing an unprecedented opportunity for researchers to gain insights into physician and patient perceptions around these emerging CAR-T therapies. This study aims to perform a comprehensive digital analysis to measure sentiment expression by different health care stakeholders and to identify health information needs related to MM CAR-T therapies. Methods: This digital analysis utilized publicly available data related to CAR-T therapies approved for the treatment of relapsed or refractory MM from various online sources related to CAR-T therapies. The data was captured using the web indexing tool Talkwalker. The analysis covered the time period from May 21, 2021 to May 21, 2023. Quantitative analysis involved applying filters and Boolean search terms to segment the data and generate figures such as share of voice, language and media type distribution, and treatment and MM mentions over time. Additionally, a qualitative assessment was conducted by reviewing posts related to the key topics of interest. Individuals who self-identify as healthcare professionals (HCPs) based on their bio, social media name, byline in news articles, or other indications were included in stakeholder analysis. Results: Out of the 471.5K MM posts generated over the 2-year study period, 47,909 posts (10%) were about CAR-T therapy, and 13,117 posts specifically commented on either Carvykti (55%) or Abecma (45%). In terms of specialty, hematologists were the primary contributors (47%), followed by oncologists (16%) and pharmacists (6%). CAR-T therapy was most referenced in posts discussing efficacy, safety, duration, and time to cytokine release syndrome (CRS), with a higher number of posts mentioning Carvykti (57%) compared to Abecma (43%). The most prominent key themes of pressing challenges and needs mentioned among CAR-T therapy posts were cost (60.5%), post-CAR-T care (38.6%), access (37.5%), education (6.7%), and quality of life (6.4%). Both Carvykti and Abecma were frequently mentioned alongside access and cost, although access (60%) was more prominent with Carvykti and cost (61%) with Abecma. Among HCPs, the most significant key theme of pressing challenges and needs was post-CAR-T infusion care considerations (58.6%), such as extended hospital stays to manage immune-mediated toxicities such as CRS and neurotoxicity, the risk of cytopenia and infections, and strategies to mitigate these risks. Management strategies mentioned included earlier and more aggressive supportive care, the use of cytokine-targeting therapies such as tocilizumab for any grade CRS, steroids such as dexamethasone for immune effector cell-associated neurotoxicity syndrome, and prophylactic antiseizure medications for all patients regardless of neurotoxicity. In the category of Diversity, Equity, & Inclusion, both Carvykti and Abecma were mentioned similarly on various topics, including access to CAR-T therapies (87% vs. 74%), diversity in clinical trials (19% vs. 17%), geographic location implications (9% vs. 15%), and racial disparities (3% vs. 4%). Conclusions: The study findings highlight the importance of demystifying cost perceptions against the added value to patients, HCPs and payers, and implementing comprehensive post-CAR-T care protocols aligned with the concerns expressed in social media discussions for improvement in CAR-T therapies for multiple myeloma. By leveraging the power of social media data, this study offers valuable real-world insights that can inform clinical decision-making, enhance patient-centered care, and contribute to the development of strategies to overcome challenges associated with CAR-T therapies in multiple myeloma.

Gridlock in compromise, or is multi-objective optimisation possible in renewable energy planning? A stakeholder analysis using scenario-MCDA

ABSTRACT The energy and climate crises are driving renewable energy, but it is currently facing obstacles in leading countries. Balancing environmental, social and economic interests has become complex at the regional level due to spatial trade-offs in a contested space. To investigate stakeholder willingness to compromise on a joint ranking on wind and solar energy sites, multi-criteria decision analysis (MCDA) planning support was explored. Using a two-part stakeholder survey, four groups were identified: ‘advocates’ who were satisfied with the site ranking (66%), ‘realists’ who were willing to compromise despite previous disagreement (13%), ‘dissenters’ not accepting (35%), and ‘dogmatists’ not engaging. Planning decisions and stakeholder engagement are underpinned by distinct attitudes towards the role of (democratic) planning and sustainable development. The use of trade-off analysis can ensure transparency and trace back stakeholder interests in making planning decisions. However, decision quality factors also need to be considered to ensure a thorough planning reflection.

Shared perceived causes of suicide among young men and violence against young women offer potential for co-designed solutions: intervention soft-modelling with fuzzy cognitive mapping

ABSTRACT Violence against young women (VAW) and suicide among young men are serious concerns in Botswana and elsewhere. We examined the overlap in locally perceived causes of these two forms of violence in Botswana using the results from separate studies that used fuzzy cognitive mapping (FCM) to explore perceived causes of the two outcomes. FCM depicts perceived causes of an outcome and their links to the outcome and each other, with weights denoting the perceived strength of each link. The two studies engaged groups of young women, young men, older women, and older men in rural communities. We grouped related concepts into broader categories, then combined category maps for each outcome into a single map including both forms of violence. Based on social network analysis, we calculated the out-degree centrality of each category indicating its influence within the network. Intervention soft-modelling explored the effects of removing individual categories on suicide and VAW. Of 24 causal categories in the combined map, six were shared between both outcomes, 10 were for suicide only, and seven were for VAW only. The six shared categories accounted for 60% of cumulative influence of all categories in the combined map. The three most influential shared categories were financial difficulties, conflict in relationships, and parenting and family issues. Based on local perceptions, avoiding conflict in relationships could reduce suicide by 4.8% and VAW by 18.5%. Eliminating parenting and family issues could reduce suicide by 3% and VAW by 5.4%. Preventing financial difficulties could reduce suicide by 9.3% and VAW by 2.9%. The findings support the idea that some interventions might reduce both personal and interpersonal violence among youth. Analysis of stakeholder perceived causes and soft-modelling of potential interventions could inform community-led co-design of strategies to reduce youth suicide and violence against young women in Botswana.

Addressing Challenges in Delivering Sustainable Rural Water Provision Using Solar Water Pumping in Malawi: A Stakeholder Analysis

Addressing Challenges in Delivering Sustainable Rural Water Provision Using Solar Water Pumping in Malawi: A Stakeholder Analysis