Stakeholder Voices Research Articles

What about the negatives? An integrated framework for revealing diverse values of nature and its conservation

Abstract Taking into account the perspectives of local stakeholders is essential for just and effective biodiversity conservation. Plural valuation, making visible the diverse values people hold in relation to nature, has emerged as a key approach towards better inclusion of stakeholders' perspectives. So far, plural valuation has mainly focused on positive values, leaving equally important negative values underexposed. To address this, a concrete proposal has been presented to also consider ‘disvalues’. However, accessible frameworks to help practitioners apply this concept are arguably still lacking. To address this gap, we here propose the ‘Integrated Nature Futures Framework’ (I‐NFF), where ‘integrated’ indicates joint consideration of positive and negative values. The I‐NFF draws on the popular Nature Futures Framework (NFF) to develop disvalue thinking in a more accessible form. The I‐NFF considers three perspectives (‘nature’, ‘society’ and ‘culture’), based on which something can be placed on a spectrum from positive (‘for nature’, ‘for society’ and ‘as culture’) to negative (‘against nature’, ‘against society’ and ‘in conflict with culture’), and can be represented as two mirrored triangles. Using empirical data, we illustrate various purposes for which the I‐NFF can be used: to inventory nature‐related topics ‘at play’ in a given context, to depict how people frame their overall relationship with nature or to depict how people frame specific issues. This demonstrates how the I‐NFF helps reveal value pluralism and trade‐offs, capture the reciprocity of human–nature relationships and identify where perspectives differ and share common ground. We close by discussing how the I‐NFF can enhance the inclusion of stakeholder voices in biodiversity conservation, which is indispensable for a more nature‐ and people‐positive future. Read the free Plain Language Summary for this article on the Journal blog.

Two decades of stakeholder voices: Exploring engagement in Romania's FSC forest management certification

Stakeholders' engagement in forest management decision-making is a critical tool for enhancing the business acceptability of the forest sector, and the Forest Stewardship Certification (FSC) scheme proactively involves stakeholders in its implementation. Based on the stakeholder theory, this study examined stakeholder's engagement in the FSC forest management certification in Romania over the past two decades to identify the extent and inputs of their involvement in the process. Using in-depth content analysis and text mining techniques, we explored publicly available information from 209 public reports covering 45 forest management certificates. According to data available in 178 reports, the average number of stakeholders notified per audit was 50.7. However, response evidence was found in 128 reports, with an average of 1.2 responses per audit, suggesting a limited engagement in the process. Additional stakeholders' feedback was received as part of the on-site audits, with an average of 10.2 responses per audit. Given the inconsistencies in the reporting format between certification bodies, we set a structured framework to analyse the findings on stakeholders' engagement from different report sections. The employed analytical framework sheds light on stakeholder and legitimacy theories in forest certification. Our findings highlighted stakeholders' predominantly positive feedback tone, evenly distributed across all stakeholder types and the four analysis domains. Negative feedback accounted for only 9.4% of the findings, highlighting areas for improvement for certificate holders, companies in the timber supply chain and public authorities. This study's findings may assist FSC in refining its stakeholder engagement practices, contributing to enhanced participation and better risk mitigation of non-compliance with standard requirements.

Medical students in distress: a mixed methods approach to understanding the impact of debt on well-being

BackgroundNearly three in four U.S. medical students graduate with debt in six-figure dollar amounts which impairs students emotionally and academically and impacts their career choices and lives long after graduation. Schools have yet to develop systems-level solutions to address the impact of debt on students’ well-being. The objectives of this study were to identify students at highest risk for debt-related stress, define the impact on medical students’ well-being, and to identify opportunities for intervention.MethodsThis was a mixed methods, cross-sectional study that used quantitative survey analysis and human-centered design (HCD). We performed a secondary analysis on a national multi-institutional survey on medical student wellbeing, including univariate and multivariate logistic regression, a comparison of logistic regression models with interaction terms, and analysis of free text responses. We also conducted semi-structured interviews with a sample of medical student respondents and non-student stakeholders to develop insights and design opportunities.ResultsIndependent risk factors for high debt-related stress included pre-clinical year (OR 1.75), underrepresented minority (OR 1.40), debt $20–100 K (OR 4.85), debt >$100K (OR 13.22), private school (OR 1.45), West Coast region (OR 1.57), and consideration of a leave of absence for wellbeing (OR 1.48). Mental health resource utilization (p = 0.968) and counselors (p = 0.640) were not protective factors against debt-related stress. HCD analysis produced 6 key insights providing additional context to the quantitative findings, and associated opportunities for intervention.ConclusionsWe used an innovative combination of quantitative survey analysis and in-depth HCD exploration to develop a multi-dimensional understanding of debt-related stress among medical students. This approach allowed us to identify significant risk factors impacting medical students experiencing debt-related stress, while providing context through stakeholder voices to identify opportunities for system-level solutions.

Supporting ColoREctal Equitable Navigation (SCREEN): a protocol for a stepped-wedge cluster randomized trial for patient navigation in primary care

BackgroundBlack individuals in the United States (US) have a higher incidence of and mortality from colorectal cancer (CRC) compared to other racial groups, and CRC is the second leading cause of death among Hispanic/Latino populations in the US. Patient navigation is an evidence-based approach to narrow inequities in cancer screening among Black and Hispanic/Latino patients. Despite this, limited healthcare systems have implemented patient navigation for screening at scale.MethodsWe are conducting a stepped-wedge cluster randomized trial of 15 primary care clinics with six steps of six-month duration to scale a patient navigation program to improve screening rates among Black and Hispanic/Latino patients. After six months of baseline data collection with no intervention we will randomize clinics, whereby three clinics will join the intervention arm every six months until all clinics cross over to intervention. During the intervention roll out we will conduct training and education for clinics, change infrastructure in the electronic health record, create stakeholder relationships, assess readiness, and deliver iterative feedback. Framed by the Practical, Robust Implementation Sustainment Model (PRISM) we will focus on effectiveness, reach, provider adoption, and implementation. We will document adaptations to both the patient navigation intervention and to implementation strategies. To address health equity, we will engage multilevel stakeholder voices through interviews and a community advisory board to plan, deliver, adapt, measure, and disseminate study progress. Provider-level feedback will include updates on disparities in screening orders and completions.DiscussionPrimary care clinics are poised to close disparity gaps in CRC screening completion but may lack an understanding of the magnitude of these gaps and how to address them. We aim to understand how to tailor a patient navigation program for CRC screening to patients and providers across diverse clinics with wide variation in baseline screening rates, payor mix, proximity to specialty care, and patient volume. Findings from this study will inform other primary care practices and health systems on effective and sustainable strategies to deliver patient navigation for CRC screening among racial and ethnic minorities.Trial registrationNCT06401174

Inclusion and the availability of educational resources – capturing stakeholder voices

ABSTRACT Background Greater provision of inclusive education is an important goal for education systems internationally. Frequently identified barriers to progress include a lack of resources to support students with special educational needs (SEN) in mainstream education settings. Purpose This study from Spain sought to gain insight into the availability of educational resources to support students with SEN in mainstream schools in the region of Murcia, by exploring the perceptions of stakeholders. Methods Participants were 27 stakeholders involved in the development and operation of special classrooms in mainstream settings for students with SEN who require highly specialised attention. Perceptions were gathered from participants across 18 mainstream centres in the region, via semi-structured interviews and focus groups. Data were analysed qualitatively, according to an existing categorisation that distinguished between material, human and teaching space resources. Findings In-depth analysis suggested that, according to many stakeholders, an insufficiency of educational resources constituted one of the main barriers to achieving inclusive education. Participants believed that material resources in education centres should be increased to support students with SEN, reporting a lack of digital resources and the necessary teacher education for their application in the classroom. Limited availability of human resources was also highlighted, with participants desiring a more substantial presence of professionals in mainstream centres and a deeper commitment towards inclusion. They considered that there should be more space in the centres to conduct multisensory and motivating activities for students with SEN. Conclusions Catering to the diverse learning needs of all students is a key concern globally. This study underscores the significance of different types of resources in inclusive provision. It draws attention to the importance of increasing the availability of resources in mainstream educational settings to support students with SEN.

Issues in sustainability reporting assurance: evidence from interviews

Purpose This paper aims to examine the processes of sustainability reporting assurance (SRA) and the influence they have on shaping perception from disclosures. Given the evidence of inconsistencies and ambiguities in assurance processes, this paper examines how legitimacy is attained and maintained at different stages of SRA. Design/methodology/approach Evidence collected from 23 semi-structured interviews with assurance providers (APs), consultants, professionals and non-governmental organisations (NGOs) (non-APs) was used to conduct a thematic analysis from the perspectives of interviewees. Findings APs and non-APs are united in recognising the value of SRA, although, perspectives on transparency between the two groups differ. Experience and industry knowledge are essential to SRA delivery with non-APs preferring accounting APs. Nevertheless, non-APs are concerned about the role of companies in deciding assurance scope, as it can affect scrutiny. APs favour data accuracy (as opposed to data relevance) assurance due to team dynamics and internal review influences, with the latter also restricting assurance innovation. APs are interested in accessing better evidence and stakeholder engagement evaluations. Providing advisory services was not rejected by all APs. The perspectives of APs and non-APs demonstrate how progress in SRA has gained pragmatic legitimacy with noticeable gaps that serve to undermine attainment of moral legitimacy. Research limitations/implications SRA is a developing practice that will adopt changes as it continues to mature; some of these changes could impact findings in this research. General perspectives on SRA were sought from interviewees, this affected the ability for an in-depth focus on any of the range of interesting SRA issues that arose over the course of the research. Interviews were conducted with relevant parties in the SRA space that operate in the UK. Perspectives from parties outside the UK were not solicited. Practical implications Companies make an important decision to commission SRA. Findings in this research have highlighted specific non-APs issues of concern that can be useful in structuring operations and reporting regimes to facilitate assurance procedures. The findings will also be helpful to APs as they can direct more emphasis on stakeholder concerns towards demonstrating greater stakeholder accountability. Regulatory and standard setters can enact appropriate policies that can potentially drive the practice forward for assessment of cognitive legitimacy. Social implications The findings provide relevant account of stakeholder voices on the quality of corporate disclosures that has a direct effect on the wellbeing of communities and sustainability of societies. Collective stakeholder input on expectations can shape sustainability discourse. Originality/value This research demonstrates the applicability of financial audit quality indicators in SRA processes, extends the debate around the effectiveness of new audit fields and highlights the challenges of maintaining legitimacy with different audiences.

Exploring the concept of unmet need within sexual and reproductive health in England: A qualitative Delphi exercise

BackgroundUnmet need within sexual and reproductive health (SRH) is a concept that is difficult to define and measure. This qualitative Delphi exercise was used to ascertain the opinions of SRH professionals on the conceptualisation and measurement of unmet need within SRH. MethodsThis exercise was carried out in two rounds. In the first round, respondents responded narratively to three prompts, which were then used to create a series of statements. In the second round, participants responded narratively to the statements created in the first round. Responses from both rounds were then coded and analysed thematically. ResultsParticipants felt that an understanding of unmet need is an important part of SRH service design and provision, and believed that certain populations are often underrepresented within the datasets that are used to assess unmet need. Many respondents felt that a full understanding of unmet need within SRH would only come from involvement of relevant stakeholders in the process of investigating unmet need, and that qualitative methods may also have a role to play in gaining a more holistic understanding of unmet need within SRH. ConclusionsRespondents within this study felt that unmet need is complex concept that has a significant impact on service delivery and the outcomes and experiences of the most vulnerable populations. We need to improve our understanding of unmet need and prioritise stakeholder voices if we want to create interventions that address unmet need within SRH.

Community Participation in Village Development Planning

This study investigates community participation in planning physical development in Suko Village, Sidoarjo District, Indonesia. Employing descriptive qualitative research, the study utilizes interviews, observation, and documentation, with purposive sampling techniques. The results reveal a five-stage model of community involvement: (1) establishment of the Suko Village RPJM drafting team, (2) hamlet meetings, (3) community participation in village development planning, (4) preparation of plans and development plans for community involvement (BPD), and (5) establishment of the Village RPJM, represented by the BPD. This study contributes to the understanding of community participation in development planning and offers insights for enhancing community involvement in urban and rural settings. Highlight : Five-stage model: Identifies key stages for community involvement in physical development planning. Purposive sampling: Ensures diverse stakeholder voices are heard during planning process. BPD representation: Empowers village representatives to champion community needs in development plans. Keywords: community participation, physical development, Suko Village, Indonesia, qualitative research

Key stakeholder voices: Investigating student perceptions of teachers’ use of assessment for learning

Many schools aim to implement Assessment for Learning (AfL) to stimulate students to take more ownership of their learning and develop self-regulatory skills. This survey-based study is among the few in the field showing how students experience the extent of implementation of AfL, here in English language and mathematics classes in 12 Dutch secondary schools. Analysis showed no differences between the subjects. Students (N = 685) experienced activities to clarify the learning intentions and success criteria and eliciting evidence on their learning progress regularly (between 50–74% of the lessons). Students hardly ever experienced activities aimed at peer- and self-assessment (less than 25% of the lessons). However, cluster analysis revealed three distinct clusters related to the extent of AfL strategy use students experienced. Overall, we can conclude that AfL is not yet fully integrated into teaching practices. Teachers’ skills, knowledge and attitudes required to increase student engagement in AfL practices and strengthen students’ self-regulated learning need more attention in future teacher professional development trajectories.

Co-Design of a website for women with pelvic organ prolapse: A study protocol

Background Despite high reported prevalence of pelvic organ prolapse (POP), women report difficulties accessing evidence-based and reliable information about the condition. Many rely on social media and other popular and highly visible internet platforms which have been found to contain poor quality information that is difficult for the average patient to understand. The aim of the study is to co-design an information website for premenopausal women with POP. The website design will be based on the Website Developmental Model for the Healthcare Consumer (WDMHC) framework. Methods A four phase process will be utilised as per the WDMHC framework: 1) User, task and environmental analysis; 2) Functional and representational analysis; 3) Cognitive walkthrough, keystroke level model, heuristic testing; 4) Content based testing, expert testing and user-based testing. Ethics approval has been obtained (LS-23-19-Carroll-Ful). Two groups of stakeholders will be recruited (i) patient group (ii) healthcare professional (HCP) group. Patient participants will be recruited from an online pelvic floor dysfunction (PFD) support group (n=950 members). A website designer and HCP stakeholders involved in the multidisciplinary team caring for women with POP will be invited to participate. Both groups will participate in separate co-design online workshops. Focus group workshops will be video-recorded, transcribed and imported into NVivo. Themes and subthemes will be developed. The website will be designed and disseminated to all participants for feedback. Cognitive walkthrough and heuristic testing will be undertaken. Following this, necessary modifications will be made to the website. Participants will then complete a modified System Usability Scale (SUS) and the eHealth Impact Questionnaire, while five HCPs will complete the DISCERN instrument. Conclusion This study will inform the design and testing of an information website for women with POP. The website design and content will be informed by patient and HCP stakeholder voices and the health literacy literature.

Stakeholders' Voices of Lung Cancer Screening in Hong Kong: Study Protocol for a Mixed Methods Study.

Introduction: This study aims to (1) explore physicians' perceptions and experiences of lung cancer screening in Hong Kong, (2) evaluate physicians' readiness of implementing lung cancer screening in Hong Kong, (3) explore high-risk smokers' health beliefs of lung cancer and screening, (4) identify barriers and facilitators for high-risk Hong Kong smokers to screening for lung cancer, and (5) validate the Chinese Lung Cancer Screening Health Belief Scale in relation to high-risk smokers in Hong Kong. Methods and analysis: A mixed methods design will be used in this study. Individual qualitative interviews will be conducted with physicians who have experience with high-risk smokers. Physicians' perceptions and experiences of lung cancer screening, and their readiness to accept lung cancer screening in Hong Kong, will be gathered through the qualitative interviews. A semi-structured interview guide will be used in the qualitative interviews. In addition, a quantitative survey with qualitative questions will be conducted on high-risk smokers to investigate their health beliefs of lung cancer and screening and barriers and facilitators for them to screening lung cancer. A lung cancer screening health belief scale, sociodemographic questionnaire, smoking and lung cancer screening history questionnaire, lung cancer and screening knowledge questionnaire, lung cancer stigma scale, generalized anxiety disorder scale, patient health questionnaire-9, patients' medical trust scale and preferred lung cancer screening intervention delivery questionnaire will be conducted in the quantitative survey. Constant comparison and content analysis will be used to analyze the qualitative data. Descriptive data analysis, validity and reliability analysis, one-way analysis of variance and post hoc analyses will be used to analyze quantitative data. Discussions: This study explores physicians' and high-risk smokers' perceptions and experiences toward lung cancer screening in Hong Kong. Findings from this study can help healthcare providers and policy makers become aware of the stakeholder's voices. In addition, these findings can help to inform the design of future interventional lung cancer screening programs and provide a tool to measure Chinese high-risk smokers' health beliefs toward lung cancer screening. A major limitation of this mixed methods study is the amount of time taken to complete the overall study. Also, its complexity requires more collaboration and networking among researchers. Ethics and dissemination: This study has minimal risk to the participants. It will be submitted to the university IRB for ethical approval. Findings related to physicians' perceptions and experiences of lung cancer screening in Hong Kong, physicians' readiness of implementing lung cancer screening, high-risk smokers' health beliefs of lung cancer and screening, barriers, and facilitators for high-risk Hong Kong smokers to screening lung cancer will be disseminated in journals and conferences. The reliability and validity of the Chinese lung cancer screening health belief scale will be reported in methodological research journals.

Understanding Clinical Ethics Consultation: What Stories Reveal.

This commentary reflects on twelve stories of participants in clinical ethics consultations from the perspective of family members, some of whom are ethics consultants, and healthcare professionals. Together they reveal expectations of ethics consultations and suggest descriptions of the service. Some common themes emerge, including the role of the clinical ethics consultant in navigating complex situations, assuring all stake-holder voices are heard, attending to moral distress, addressing issues that seem beyond medical practice, and being accessible. They are almost uniformly positive about the experience, with criticism primarily about lack of access to the service.

Enabling pupils to flourish: six evidence-based principles of whole-school wellbeing promotion.

Schools have become increasingly important as health promotion settings, seeking to improve pupils' health and wellbeing through adopting a whole-school approach. A strong evidence-base highlights that focusing on the social, emotional and psychological aspects of pupils' wellbeing enables them to flourish, enjoy life and be better equipped to overcome challenges. However, it is acknowledged that further evidence is required regarding: (1) what happens in primary schools, (2) the impact of the English education system, (3) complexity and context, and (4) capturing children's voices. This article, therefore, addresses these gaps by asking the question: How do schools use whole-school wellbeing promotion to enable pupils to flourish? Taking an exploratory approach the study used a three-phase, mixed methods design to address the research problem by undertaking a systematic literature review, a secondary data analysis and a case study to capture multiple stakeholder voices including pupils. As appropriate for this research design, the findings from each phase were integrated into an overarching analysis which is presented in this article. Six broad principles formed consistent threads across the findings: (1) enabling children to flourish, (2) integrating wellbeing with key school goals, (3) promoting wellbeing and building capital, (4) building on virtuous cycles, (5) managing complexity and context, and (6) evaluating wellbeing promotion through listening to different voices. As well as presenting new knowledge addressing the identified research gaps, this study has demonstrated that schools can avoid 'reinventing the wheel' by adopting existing practices and resources and adapting them to their own setting. It is, therefore, hoped the six evidence-based principles of this study are equally transferable to schools within the English education system and more broadly. In addition, the paper highlights recognized challenges to staffing and resourcing and raises the question over whether schools receive sufficient funding to deliver the whole-school initiatives that government recommends. This article provides readers with an exploration of what has been achieved in schools and it is outside its scope to address specific issues about funding and other practical logistics for implementing whole-school wellbeing promotion, therefore further research is recommended.

A revised digital media–arena framework guiding strategic communication in digital environments

PurposeThis paper refines the Digital Media–Arena (DMA) framework to address the diversity of stakeholders contributing to the production, (re)appropriation and (re)distribution of organisational messages in digital environments. It also presents a case analysis for the purpose of demonstrating the applicability of the revised conceptual framework to a critical situation.Design/methodology/approachGrounded in key public relations, corporate communication and strategic communication research, this study first extends the DMA framework by introducing six new forms of media-arenas. Next, the study takes a public sector perspective to analyse the revised framework against a critical situation involving the Finnish prime minister in summer 2022.FindingsThe application of the revised DMA framework to analyse the critical situation shows the importance of mapping and understanding diverse discourses across multi-arenas and their communication role in a rapidly unfolding scandal surrounding the prime minister of Finland. Findings also reveal the diversity of stakeholder voices forming their own versions of organisational messages and sometimes converging organisational messages within and across DMAs.Practical implicationsThe DMA framework can offer practical suggestions to guide communicators to make strategic choices in what, where, how and with whom they can communicate.Originality/valueThe revised DMA framework contributes expanding the field's knowledge of the strategic communicative use of the digital environment in typically highly volatile and multi-vocal situations by offering instrumental understanding of the conflicting challenge between subjugating and liberating organisational messages across the digital spectrum.

“Phonics Monkeys” and “Real Life Reading”: Heteroglossic Views of a State Reading Initiative

ABSTRACT Framed by Bakhtinian theories of authoritative discourse and heteroglossia, this study examines perceptions of a Science-of-Reading-based state reading initiative five years into implementation. Using interview transcripts, researchers engaged in polyphonic analysis to bring the voices of teachers, reading interventionists, parents, administrators, and state department of education officials into created dialogue. Findings from this qualitative study suggest there were contrasting perspectives about reading and the SRI, that many participants felt the initiative narrowed reading instruction and constrained teachers’ agency, and that, overall, there have been limited opportunities for dialogue about the initiative. Findings demonstrate that a narrow view of reading research may silence and delegitimize some stakeholder voices. This state’s goal of sharpening the focus of reading instruction led to instruction that was perceived by some stakeholders as narrow, boring, and meaningless, unlikely to create the statewide culture of reading that was targeted. Implications for this and future state reading initiatives point to the value of dialogue among varied stakeholders, which might allow for the idiosyncrasies of the teaching and learning of reading and writing to be addressed.

Stakeholder-Driven Intervention Development for Dialysis Trials Using a Design Sprint Methodology

Stigma contributes to ineffective treatment for pain among individuals with kidney failure on dialysis, particularly with buprenorphine pain treatment. To address stigma, we adapted a Design Sprint, an industry-developed structured exercise where an interdisciplinary group works over 5 days to clarify the problem, identify and choose a solution, and build and test a prototype. Adapted Design Sprint which clarified the problem to be solved, proposed solutions, and created a blueprint for the selected solution. Five individuals with pain and kidney disease receiving dialysis, 5 physicians (nephrology, palliative care, and addiction medicine) and 4 large dialysis organization leaders recruited for specific expertise or experience. Conducted through online platform (Zoom) and virtual white board (Miro board). Descriptions of the Design Sprint adaptations and processes. To facilitate patient comfort, a patient-only phase included four 90-minute sessions over 2-weeks, during which patient participants used a mapping process to define the critical problem and sketch out solutions. In a physician-only phase, consisting of two 120-minute sessions, participants accomplished the same tasks. Duringa combined phase of two 120-minute sessions, patients, physicians, and large dialysis organization representatives vetted and developed solutions from earlier phases, leading to an intervention blueprint. Videoconferencing technology allowed for geographically diverse representation and facilitated participation from patients experiencing medical illness. The electronic whiteboard permitted interactive written contributions and voting on priorities instead of only verbal discussion, which may privilege physician participants. A skilled qualitative researcher facilitated the sessions. Challenges included the time commitment of the sessions, absences owing to illness or emergencies, and technical difficulties. An adapted Design Sprint is a novel method of efficiently and rapidly incorporating multiple stakeholders to develop solutions for clinical challenges in kidney disease. Stigma contributes to ineffective treatment for pain among individuals with kidney failure on dialysis, particularly when using buprenorphine, an opioid pain medicine with a lower risk of sedation used to treat addiction. To develop a stigma intervention, we adapted a Design Sprint, an industry-developed structured exercise where an interdisciplinary group works over 5 days to clarify the problem, identify and choose a solution, and build and test a prototype. We conducted 3 sprints with (1) patients alone, (2) physicians alone, and (3) combined patients, physicians, and dialysis organization representatives. This paper describes the adaptations and products of sprints as a method for gathering diverse stakeholder voices to create an intervention blueprint efficiently and rapidly.

Co-Design of a website for women with pelvic organ prolapse: A study protocol.

Despite high reported prevalence of pelvic organ prolapse (POP), women report difficulties accessing evidence-based and reliable information about the condition. Many rely on social media and other popular and highly visible internet platforms which have been found to contain poor quality information that is difficult for the average patient to understand. The aim of the study is to co-design an information website for premenopausal women with POP. The website design will be based on the Website Developmental Model for the Healthcare Consumer (WDMHC) framework. A four phase process will be utilised as per the WDMHC framework: 1) User, task and environmental analysis; 2) Functional and representational analysis; 3) Cognitive walkthrough, keystroke level model, heuristic testing; 4) Content based testing, expert testing and user-based testing.Ethics approval has been obtained (LS-23-19-Carroll-Ful). Two groups of stakeholders will be recruited (i) patient group (ii) healthcare professional (HCP) group. Patient participants will be recruited from an online pelvic floor dysfunction (PFD) support group (n=950 members). A website designer and HCP stakeholders involved in the multidisciplinary team caring for women with POP will be invited to participate.Both groups will participate in separate co-design online workshops. Focus group workshops will be video-recorded, transcribed and imported into NVivo. Themes and subthemes will be developed.The website will be designed and disseminated to all participants for feedback. Cognitive walkthrough and heuristic testing will be undertaken. Following this, necessary modifications will be made to the website. Participants will then complete a modified System Usability Scale (SUS) and the eHealth Impact Questionnaire, while five HCPs will complete the DISCERN instrument. This study will inform the design and testing of an information website for women with POP. The website design and content will be informed by patient and HCP stakeholder voices and the health literacy literature.

Co-Design of a website for women with pelvic organ prolapse: A study protocol

Background: Despite high reported prevalence of pelvic organ prolapse (POP), women report difficulties accessing evidence-based and reliable information about the condition. Many rely on social media and other popular and highly visible internet platforms which have been found to contain poor quality information that is difficult for the average patient to understand. The aim of the study is to co-design an information website for women with POP. The website design will be based on the Website Developmental Model for the Healthcare Consumer (WDMHC) framework. Methods: A four phase process will be utilised as per the WDMHC framework: 1) User, task and environmental analysis; 2) Functional and representational analysis; 3) Cognitive walkthrough, keystroke level model, heuristic testing; 4) Content based testing, expert testing and user-based testing. Ethics approval has been obtained (LS-23-19-Carroll-Ful). Two groups of stakeholders will be recruited (i) patient group (ii) healthcare professional (HCP) group. Patient participants will be recruited from an online pelvic floor dysfunction (PFD) support group (n=950 members). A website designer and HCP stakeholders involved in the multidisciplinary team caring for women with POP will be invited to participate. Both groups will participate in separate co-design online workshops. Focus group workshops will be video-recorded, transcribed and imported into NVivo. Themes and subthemes will be developed. The website will be designed and disseminated to all participants for feedback. Cognitive walkthrough and heuristic testing will be undertaken. Following this, necessary modifications will be made to the website. Participants will then complete a modified System Usability Scale (SUS) and the eHealth Impact Questionnaire, while five HCPs will complete the DISCERN instrument. Conclusion: This study will inform the design and testing of an information website for women with POP. The website design and content will be informed by patient and HCP stakeholder voices and the health literacy literature.

Strategy Making as Polyphony: How Managers Leverage Multiple Voices in Pursuing Agility

Although agility is often associated with rapid speed and flexibility, having processes for “deep reflection” is also crucial. This includes the need for collective dialogs across and outside organizations to build greater awareness of, and attention to, strategic issues. How do managers involve a wider range of stakeholder voices in strategy as they pursue agility? This article identifies three practices that synergistically contribute to agility and conceptualizes them in a framework for managers called the “Strategy Making as Polyphony Wheel.” The work outlines several implications for managerial practice and research.

Amplifying Student and Administrator Perspectives on Equity and Bias in Learning Analytics

When higher education institutions (HEIs) have the potential to collect large amounts of learner data, it is important to consider the spectrum of stakeholders involved with and impacted by the use of learning analytics. This qualitative research study aims to understand the degree of concern with issues of bias and equity in the uses of learner data as perceived by students, diversity and inclusion leaders, and senior administrative leaders in HEIs. An interview study was designed to investigate stakeholder voices that generate, collect, and utilize learning analytics from eight HEIs in the United States. A phased inductive coding analysis revealed similarities and differences in the three stakeholder groups regarding concerns about bias and equity in the uses of learner data. The study findings suggest that stakeholders have varying degrees of data literacy, thus creating conditions of inequality and bias in learning data. By centring the values of these critical stakeholder groups and acknowledging that intersections and hierarchies of power are critical to authentic inclusion, this study provides additional insight into proactive measures that institutions could take to improve equity, transparency, and accountability in their responsible learning analytics efforts.