Stalking Research Articles (Page 1)

This research explores the collaborative development of ethical artificial intelligence (AI) tools with religious communities to enhance worship practices, inform moral decision-making, and support social cohesion. As AI technologies increasingly intersect with spiritual life—through applications such as automated liturgy generators and pastoral chatbots—there is an urgent need to ensure these systems uphold religious values and contribute positively to community well-being. While existing AI ethics frameworks are largely rooted in secular paradigms, few integrate religious epistemologies or position faith groups as active partners in design processes. Addressing this gap, the study investigates how religious communities and AI specialists can co-create systems that align with sacred values and promote communal resilience. Employing a participatory action methodology, the research engaged multi-faith dialogue groups, collaborative design sessions involving theologians and programmers, and case studies from Christian, Muslim, and Traditionalist communities in Nigeria. Findings indicate that effective integration of AI in religious contexts is contingent upon context-sensitive moral reflection, transparent data governance, and trust in institutions. The study argues that ethical AI for religious use must emerge from genuine collaboration rather than external imposition. It recommends the establishment of interfaith technology centers, the direct involvement of theologians in AI development teams, and the formulation of governance models informed by religious ethics and local priorities. These measures not only safeguard religious practices but also contribute to equitable and sustainable digital ecosystems aligned with global development objectives.

ABSTRACT While previous studies have explored reflective dialogues and their cognitive and affective impacts, limited attention has been given to the role of multimodal reflective dialogues in fostering empathy, metacognition, and collaborative problem-solving. This study examined how different dialogue formats—verbal versus multimodal—affect these outcomes among secondary school learners. Ninety Iranian Grade 12 female students (aged 17–18) were assigned to a Verbal Dialogue Group (VDG), a Multimodal Dialogue Group (MDG), or a Control Group (CG). The MDG engaged in reflective dialogues integrating text, visuals, and audio, the VDG used verbal-only communication, and the CG received conventional teacher-led instruction. Quantitative results showed that both MDG and VDG significantly outperformed the CG on all variables, with the MDG achieving the greatest gains. Post-hoc analysis indicated significant differences between MDG and VDG in empathy, but not in metacognition or problem-solving. Qualitative findings further revealed that multimodal resources enhanced learners’ ability to interpret peers’ emotions and engage in consultative reflection. Overall, the results underscore the value of incorporating multimodal elements into reflective dialogues to strengthen empathy, metacognitive awareness, and collaborative problem-solving in educational settings.

IntroductionA high discrepancy between a generally positive attitude and consent to donation has been observed in Italy, as in 2021 only 68.2% of registered individuals had provided consent. Understanding which variables may play a role in this decision-making process, considering the experiences of different groups, is essential to support the development and implementation of targeted policies. The aim of this study was to investigate the demographic and psychosocial variables associated with the decision to register consent for post-mortem organ donation in Italy, and to compare the experiences of different population groups to support the development of targeted policies.MethodsA quantitative study was conducted in 2021 in collaboration with the National Centre for Transplantation. A total of 353 participants–including healthcare professionals, citizens, opinion leaders and registry office employees–completed an ad-hoc questionnaire before and after participating in a focus group on organ donation. Descriptive statistics and regression analyses were conducted.ResultsOf the 353 participants, 93.8% reported a positive attitude toward post-mortem organ donation (score > 5 on a 7-point Likert scale). In the pre-focus group questionnaire, the mean attitude was 6.45 (SD = 1.05), which increased significantly to 6.56 (SD = 0.99) after the focus groups (Z = −4.06, p < 0.001). Regarding actual behavior, 50.4% had already registered their consent to donation. Significant associations emerged between positive attitude and gender (women reporting higher scores; U = 13,129, p = 0.045), level of education (r = 0.156, p = 0.004), familiarity with donation (e.g., knowing a donor or someone who registered consent; p < 0.001), and being registered with donation-related associations (p < 0.001). Intention to register was strongly predicted by attitude (p < 0.001), and actual consent registration was more likely among participants with higher education and those familiar with donation practices.ConclusionFindings highlight the role of demographic factors, familiarity, and personal values in shaping donation behavior, supporting the use of multivariable models to better explain consent registration. These insights underline the need to implement targeted awareness campaigns and policies aimed at promoting informed choices about organ donation.

Abstract Health and well-being are understood as multidimensional, shaped by social, cultural, and emotional factors as well as healthcare services. In contexts marked by vulnerability, marginalisation, or structural exclusion, populations such as people in prison (PIP), refugees, and youth in under-resourced settings often face overlapping barriers to health equity and remain underrepresented in the design of health interventions. In this context, participatory methods that incorporate creative expression - such as storytelling, active techniques, photography, and collective future thinking - offer tools to engage individuals in articulating their experiences of distress, resilience, and well-being. These methods encourage individuals to express themselves, their needs and their experiences, which are essential to culturally sensitive, contextually relevant and responsive interventions for structurally marginalised populations. This workshop explores how these methods contribute to health, well-being and inclusion in diverse vulnerable settings. The objective is to share experiences, reflect on methodological and ethical considerations, and to discuss the potential of these approaches. The added value of this workshop lies in its focus on tools that facilitate the interpretation of participants’ own realities and inner worlds. These methodologies improve psychological well-being and support socio-emotional learning. They also uncover experiences of groups often excluded from standardised health interventions, enriching the understanding of health needs and broadening the scope of public health. The workshop presents four case studies applying participatory methodologies in contexts of structural vulnerability. The first explores the use of psychodrama with adolescents and young adults in Beira, Mozambique, through a project by Doctors with Africa-CUAMM. This approach uses collective enactment to foster emotional expression, build resilience, and strengthen group dynamics. The second draws on the Erasmus+ funded PARTNER project, which applies participatory futures thinking in prison settings. Through co-creative laboratories, PIP reimagine life trajectories and reflect critically on time, agency, and care. The third focuses on a photography project implemented by RedLab with adolescent refugees in Iraqi Kurdistan. The workshops facilitated self-narration and group dialogue, promoting emotional awareness and community connection. The fourth discusses participatory methods used in a project with Roma women in Greece to promote cervical and breast cancer screening and HPV vaccination, alongside health education. The session will conclude with a reflective exercise, inviting participants to respond to a shared prompt on applying expressive methods in their own contexts. This exchange will surface common challenges, tensions, and enablers, and support the co-development of insights for integrating participatory approaches into public health strategies. Key messages • Participatory methods amplify voices often excluded from public health and foster culturally responsive, equity-oriented interventions. • Creative expression strengthens mental well-being, collective reflection, and community-driven solutions in vulnerable contexts.

This study explores the use of photovoice as a reflective practice tool for early childhood student teachers in a teacher preparation program. Reflective practice is crucial for professional growth, yet traditional journaling often feels disconnected from real-world experiences for student teachers. Photovoice, which encourages participants to capture and reflect on meaningful classroom moments through photography, offers an engaging alternative. This research investigates the aspects of student teaching that candidates find reflective, how their images express satisfaction and dissatisfaction, and how group discussions develop shared understanding. Using a constructivist framework, seven student teachers participated in a semester-long photovoice project. Data were collected through over 350 images, descriptions, and four group discussions. Findings reveal four key reflective themes: instructional resources, student engagement, classroom environment, and relationships. While photovoice enhanced critical reflection and community building, participants were hesitant to openly discuss negative experiences, reflecting challenges in developing self-assessment. The study concludes that photovoice holds significant promise for enriching reflective practice in teacher education by integrating visual analysis and group dialogue and recommends its inclusion in teacher preparation curricula as a strategy for fostering critical reflection and community building. Received: 2 February 2025 | Revised: 3 June 2025 | Accepted: 12 September 2025 Conflicts of Interest The author declares that she has no conflicts of interest to this work. Data Availability Statement The data that support this work are available upon reasonable request to the corresponding author. Author Contribution Statement Amy Kelly: Conceptualization, Methodology, Investigation, Formal analysis, Writing – original draft, Writing – review &amp; editing, Supervision, Project administration.

From 2020 to 2022 Australia supressed community transmission of SARS-CoV-2 by imposing a range of population-level measures. This limited mortality and created time to achieve high levels of vaccination, but also caused indirect harms. Our study aimed to capture lay perspectives on the implications of using lockdowns, masking mandates, and school and border closures to supress transmission in future pandemics. We report on 9 dialogue groups (n = 53) with residents of Sydney, Melbourne and Adelaide. Each location had different epidemiological conditions and health policy settings during the pandemic. Dialogue group methods allow data collection on questions in applied ethics. We found that mandating masking indoors was broadly accepted in all group discussions, but attitudes to other measures varied depending on participants' past experiences. All groups accepted lockdowns and school closures might be necessary but wanted greater flexibility in policy implementation based on a broader range of health and social risks. Groups from cities that experienced the tightest public health controls during COVID-19 tended to have greater tolerance of future use of stringent measures (with conditions). Public compliance during future infectious disease emergencies likely depends on trust in institutions and expertise, and perceptions of the necessity, effectiveness and fairness of interventions. Rather than assuming public acquiescence, defiance or disinterest, in preparing for the next pandemic it is important to devote resources to understanding the public acceptability and perceived legitimacy of implementing any or all these measures.

Background: Obsessive relational intrusion (ORI) refers to unwanted and repeated behaviors aimed at initiating or rekindling a relationship with someone who does not reciprocate the same level of interest. The Obsessive Relational Intrusion-Victim Short Form (ORI-VSF) is designed to assess such intrusive experiences from the victim’s perspective. Objectives: The present study aimed to validate the Persian version of the ORI-VSF in an Iranian sample by examining its psychometric properties and measurement invariance across gender. Methods: A cross-sectional study was conducted between January and August 2024 in Zanjan, Iran. A total of 773 Iranian adults (68% female; mean age = 26.45 ± 8.06) were recruited through online posters via local social networks using convenience sampling. Participants completed the ORI-VSF, Relational Rumination Questionnaire (RelRQ), Obsessive Relational Intrusion and Celebrity Stalking Scale (ORI&amp;CS), Depression, Anxiety, and Stress Scales (DASS-21), and the Satisfaction with Life Scale (SWLS). Results: Confirmatory factor analysis (CFA) supported the original two-factor structure of the ORI-VSF after the removal of items 1, 2, and 3 due to low factor loadings, yielding a final 20-item version with excellent fit indices [χ2 = 417.04, df = 142, P &lt; 0.001; Goodness of Fit Index (GFI) = 0.950, Comparative Fit Index (CFI) = 0.960, Tucker-Lewis Index (TLI) = 0.946, root mean square error of approximation (RMSEA) = 0.050]. The Persian ORI-VSF demonstrated strong internal consistency (Cronbach’s alpha = 0.919 for the total scale; 0.845 for the pursuit subscale; 0.894 for the aggression subscale). Convergent and discriminant validity were supported through significant correlations with relational rumination (R = 0.275), psychological distress (R = 0.234), and life satisfaction (R = -0.149). Measurement invariance analyses confirmed configural, metric, and scalar invariance across gender (ΔCFI ≤ 0.006, ΔRMSEA ≤ 0.001). Conclusions: The Persian version of the ORI-VSF is a psychometrically sound instrument for assessing ORI victimization among Iranian adults. Its robust reliability, validity, and gender-based measurement equivalence make it suitable for use in both clinical and research contexts in Persian-speaking populations.

The use of artificial intelligence (AI) and robotics is widely expected to revolutionise agriculture. Although an emerging literature is bringing into conversation AI and agricultural ethics, there has been little attention paid to public attitudes regarding such technological change. Using data collected in 12 dialogue groups conducted across rural and metropolitan Australia, this paper examines public perceptions of the social and ethical impacts of AI and robotics in agriculture. We identify and map a diversity of views regarding the possible risks and benefits of AI and robotics, and the value of agriculture in the context of a future of ‘farmerless farming.’ Our results add depth and nuance to the existing, mostly quantitative, literature on public attitudes towards agricultural robotics and AI and constitute a valuable resource for policymakers, or other stakeholders who want to engage with public opinion regarding these technologies.

Efficacy of non-pyrethroid indoor residual spraying or intensive behaviour change communication in combination with long-lasting insecticidal nets for malaria control in west Africa: a pragmatic, cluster-randomised, controlled trial.

In this article, we explore how knowledge is co-constructed in a participatory grief research project. The empirical data comprise audio recordings of nine three-hour meetings, summaries of meetings, and the project outcome, i.e., an expanded version of the Dual Process Model of Coping with Bereavement (DPM). The aim of this article is to examine how dialogical dynamics shaped knowledge production in a participatory grief research project and to contribute to the development of participatory methods in bereavement research. Through a dialogical approach to participatory knowledge production as the analytical lens, we identified moments of tension and relational engagement in the group dialogues and examined how certain grief experiences came to be included as outcomes while others did not. We present two examples to illustrate how different dialogical processes either facilitated or hindered the recognition and inclusion of diverse grief experiences in the expanded DPM. Our findings underscore the importance of relational engagement, openness to diverse perspectives, and willingness to revisit silenced contributions. We reflect on how these processes may shape participatory knowledge production and suggest ways to support even more inclusive and reflexive dialogues in participatory grief research.

Theme 2: Community-enabled population health and wellbeing2 Pillars: Shared values and vision, People as partners in health and care. The "Recovery and Renewal of Participation in Healthcare" project aimed to strengthen co-design capacity and resilience within the healthcare sector. It explored and investigated co-design experiences and adaptations that build capacity to enhance community engagement with a specific focus on equity, diversity, and inclusion (EDI).Keywords: Co-design, Equity, Diversity, and Inclusion (EDI), Capacity building, empowerment, realist synthesis. Audience: 20 participants including health design practitioners, health researchers, policymakers, community members, and members of equity-seeking groups. Approach: The goal of the workshop is to share learnings and build capacity in co-design strategies and techniques that can be used to develop advanced co-design practice. This will include practical recommendations and strategies to enhance co-design for healthcare change. The workshop will be anchored around findings from a realist synthesis process on diverse outcomes and mechanisms experienced in co-design practices across different contexts during the pandemic. The workshop will discuss and share ways to enhance community engagement through co-design using an EDI framework. Structure of the session:0 min. Introduction: Two Facilitators will briefly describe the Co-Design beyond Pandemics project including background to the Recovery and Renewal research and community of practice resources. This will include the realist synthesis results relating to the 9 pillars of integrated care and the incorporation of the EDI Framework.5 min. presentation of different case studies / contexts: Two facilitators will present three case studies from the Recovery and Renewal of Participation in Healthcare project aligning three major themes. Example case studies include:- Community Context and Proxy: D-DEC (Integrating marginalized groups in public health communication design at emergency dept. discharge)2- Safety: Challenging Stigma Through Storytelling, Supporting the Stillbirth Journey3- Collaborative Making: Aging and Mental Health, Addictions Don Discriminate. Fostering Local Community Engagement in St. Louis30 min. Small group dialogue: In breakout groups of five, each group will discuss strategies for engaging communities in their work and/or case studies. Case study details will be available in poster format at tables. Example prompts: What characteristics of communities did the case studies engage with that relate to the three themes? How might these strategies or techniques enhance context specific community engagement for health equity? What are some of the strategies or techniques that could enhance safety in community engagement? What are some of the strategies or techniques that could enhance collective making within community engagement? What were some of the challenges? How might we address these challenges?30 min. Large group discussion: The groups will summarize their dialogue and then open the discussion including a re-reflection on the EDI framework to allow for additional themes. 5 min. closing. Outcomes: Findings from this workshop will be summarized in three blog posts on Co-design Beyond Pandemics community of practice . This collaborative platform is a space for design researchers and practitioners from diverse geographies and equity seeking groups to access resources and share practices and build connections. There are currently 70 members within this group.

The objective of this mixed-methods study was to improve the emotional competences of Tanzanian secondary school adolescents by examining and identifying successful social-emotional learning practices. Questionnaires and focus group talks were completed by 244 teenagers, ages 13 to 17. Students and teachers reported through surveys and interviews, respectively, the benefits of social emotional skills and social emotion regulation techniques. Perception of emotions was found to have a positive effect on students' interest in learning (β=.144, t(4, 239)= 2.141, p=.033). A student's participation, communication, cooperation, assertion, responsibility, empathy, and self-control were statistically shown to enhance social and emotional competences (the model summary's impact size was 54%). This research investigates how students manage their learning and develops their emotional competences by looking at their social-emotional skills. This study offers methods for fostering emotional competences as well as the impact of social emotional abilities on students' ability to cope with learning. The Ministry of Education, Science, and Technology should therefore provide curricula and a framework for the efficient control of teenage students' social and emotional behaviour.

Self-administered screening questionnaires are one of the key strategies to shorten diagnostic delay among patients with autoimmune rheumatic diseases (ARDs). However, most existing screening questionnaires for ARDs were developed to screen for one or a limited number of ARDs, and thus have limited utility when the goal is to screen for common ARDs. We aimed to develop a list of ARDs for population screening, and based on this, a list of manifestations to be assessed in a screening questionnaire for ARDs. This study comprised two phases: Phase 1 involved the development of a list of ARDs through a modified Delphi study with accredited rheumatologists and Phase 2 involved the development of a list of manifestations through a modified nominal group technique with accredited rheumatologists, other healthcare professionals caring for patients with ARDs, and patients with ARDs. In Phase 1, 14 candidate ARDs were identified using a multipronged approach, ten of which were deemed necessary to be screened for in the general population, through three rounds of Delphi exercise. In Phase 2, 80 candidate manifestations of these ten ARDs were identified from a literature review. Of these, 59 manifestations were deemed necessary to be assessed in a screening questionnaire through one round of prenominal group dialogue and two rounds of nominal group discussion. Consensus-based lists of ARDs and their manifestations were developed in this study. They provide a basis for developing new ARD screening questionnaires to facilitate early diagnosis of ARDs in the general population.

This study explores the transformative impact of the Tahsin Program on advancing Qur’anic literacy by integrating culturally responsive pedagogy with contextually grounded instructional design. Addressing the gap in inclusive, community-rooted religious education, the program aims to foster both linguistic proficiency and cultural identity. A qualitative case study approach was employed at a community-based learning center in Cimahi, Indonesia. Data were gathered through semi-structured interviews, focus group discussions, direct classroom observations, and document analysis. This multi-method strategy ensured a comprehensive understanding of the program’s design and outcomes. Findings revealed that over 80% of learners improved their Tajweed proficiency within three months. The program’s unique integration of modular curriculum progression, localized content, intergenerational mentorship, and embedded formative feedback contributed significantly to learner success. Culturally embedded practices—particularly the inclusion of elders—enhanced communal learning and reinforced cultural identity. Peer mentoring and dialogic group discussions fostered interpretive depth and active engagement, while ongoing feedback supported differentiated instruction and learner autonomy. The Tahsin Program exemplifies how pedagogical models that blend tradition with innovation can enhance religious education. By grounding the curriculum in social constructivist theory, the program accommodates diverse learner profiles and promotes sustainable community involvement. This study highlights the effectiveness of context-sensitive, culturally grounded Qur’anic education. Future research should explore how digital tools can scale such models for broader urban and online application.

ABSTRACT Self-ageism remains largely overlooked in the global campaign against ageism. While educational and learning interventions against ageism are considered promising, their effectiveness is not fully understood, and tailored approaches addressing specific manifestations of ageism like sexual (self-)ageism are lacking. In this study, we explore how a tailored Participatory Action Research (PAR) approach can foster transformative learning among older people to combat sexual self-ageism as part of the broader structural movement against ageism. We engaged 53 older adults in a 15-month PAR process involving dialogue groups on sexuality in later life. We analyzed the transformative impacts of the process through the lens of Transformative Learning (TL) theory. PAR fostered change across multiple levels. On the personal level, open dialogue helped older adults overcome social isolation. Interpersonally, group engagement facilitated critical self-reflection through exposure to diverse perspectives. Collaborative learning enabled shifts in discourse, relationships, and practices around later-life sexuality, extending the impact to the community level. The co-creation of a public video series marked a collective effort to challenge sexual ageism at the societal level. PAR can catalyze transformative learning processes that address sexual (self-)ageism at personal, interpersonal and community levels, with potential for broader societal impact. These findings underscore the value of participatory, tailored learning approaches in confronting self-ageism as an integral part of the global campaign against ageism, tackling ageism from within and from the bottom-up.

This study reports on anxiety, enjoyment, and breakdown fluency of L2 English learners under the monologue and dialogue conditions using an idiodynamic approach. Eight Mandarin-speaking undergraduates from a top university in China voluntarily participated in the study, with half completing in a monologue condition and the other half in a dialogue condition. The results showed that both monologue and dialogue groups exhibited a significant positive correlation between anxiety and breakdown fluency, and a significant negative correlation between enjoyment and breakdown fluency. However, these correlations were more pronounced in the dialogue group. The study also revealed that the monologue group experienced significantly less anxiety (p &lt; 0.05) and more enjoyment (p &lt; 0.001) in L2 speaking than the dialogue group. Nevertheless, there was no significant difference in breakdown fluency between the two groups (p = 0.152). Last but not least, the study found that learners’ emotional fluctuations could be subject to cognitive, task implementation, task design, and interpersonal factors.

This study presents a methodological approach for assessing the educational impact of philosophical dialogues. Drawing upon the Q-U model, this research develops a framework designed to evaluate group dynamics. The framework was implemented in philosophical dialogue at a junior high school in Gifu Prefecture, Japan, to examine its practical applicability. Existing evaluation methods predominantly emphasize individual assessment. However, philosophical dialogues operate within a community, where collective transformations take place. The proposed framework assesses both individual and communal transformations through a structured self-assessment questionnaire, measuring participants’ critical and caring thinking. The findings indicate that philosophical dialogues contribute to the maturation of dialogue groups, as evidenced by changes in students’ critical and caring thinking abilities over time. Results from the exploratory study suggest that philosophical dialogues can foster gradual improvements in participants’ cognitive and social abilities. The feasibility of assessing community transformation through student self-assessments was examined and found to be viable. These findings suggest that this study contributes to the ongoing discourse on evaluating philosophical dialogues by advocating for assessment methodologies that capture their dynamic and interactive nature. Future research should incorporate teacher and peer evaluations to complement self-reported data. Furthermore, expanding the sample size and introducing control groups would enhance the validity of the proposed framework.

Background: Government actions are crucial in influencing employment possibilities and tackling youth unemployment, which has considerable effects on economic stability and social cohesion. However, these policies do not reflect the actual needs of the youth labor market, as there is a noticeable gap between the skills imparted through these programs and the skills required by the evolving job market. Objective: This study therefore assessed the role of government policies in fostering youth employment on the Plateau. The role of government policies in fostering youth employment in Plateau State was deemed pivotal, given the persistent challenge of unemployment within Nigeria. Plateau State grappled with high levels of youth unemployment, a situation exacerbated by the overall economic challenges and socio-political dynamics of the country. Methods: This study employed methodological approaches such as desk review, focus group talks, and key informant interviews. To accomplish the goals of the study, both primary and secondary data were utilized. Eighty key informant interviews and eighteen focus groups were held in all. Results: The study discovered that the government had rolled out numerous policies designed to address youth unemployment in Plateau State, but there were several shortcomings in their design and implementation. Key Contribution to Knowledge: This study is crucial for policymakers, as it will help them adopt a more holistic approach that integrates various aspects of youth empowerment into a cohesive strategy. Recommendations: The study thus recommended that a central coordinating body should be established to oversee all youth employment initiatives in Plateau State.

BackgroundAdolescents with cerebral palsy (CP) classified at levels IV and V of the gross motor function classification system (GMFCS) face significant restrictions in participating in leisure activities. Involving the public in the development of interventions is a recommended practice. Tools such as the Involvement Matrix (IM) can facilitate collaborative research. The aim of this study was to co-design an intervention to improve leisure activity participation in adolescents with CP at GMFCS levels IV and V, in collaboration with the adolescents, their families, and healthcare professionals.MethodsThis study employed a participatory action research (PAR) approach, involving five adolescents with CP at GMFCS levels IV and V, their mothers, three physiotherapists, and two occupational therapists. Different dialogue groups were formed to facilitate the co-creation of the intervention. The IM guided participant engagement, while the participation and environment measure—children and youth (PEM—CY) was used to assess the adolescents' community participation. Through the dialogue groups, discussions were conducted to identify barriers to participation and collaboratively design an intervention that reflected the preferences of the target audience.ResultsThe "Leisure on Wheels" intervention was developed to address the participation barriers identified in the dialogue groups. The results focused on the development process, emphasizing collaborative discussions and adjustments to meet the target audience's needs. The intervention components were tailored to the participants' preferences. To ensure clarity and replicability, the intervention was described using the template for intervention description and replication (TIDieR) checklist. The goal attainment scaling (GAS) was used to define individualized objectives based on the participants' preferences and needs. Feedback from an external group, including two adolescents with CP and their mothers, validated the intervention's relevance and acceptability. The intervention was planned for a four-week period, including weekly 60-min in-person sessions at a selected leisure location and 20-min remote consultations to monitor progress and adjust strategies.ConclusionsThis study highlighted the perceived effectiveness of the co-design model and participatory approach, which facilitated the adaptation of the intervention to the specific needs of adolescents and their families, enhancing its relevance and acceptability.Trial registration: Ethics Committee of the Federal University of Rio Grande do Norte/Trairi Health Sciences School (UFRN/FACISA) (Opinion Number: 51319321.1.0000.5568).

Studies show that breast screening participants are open to artificial intelligence (AI) in breast screening, but hold concerns about AI performance, governance, equitable access, and dependence on technology. Little is known of consumers’ views on how AI should be used in breast screening practice. Our study aims to determine what matters most to women regarding AI use in the workflow of publicly funded breast screening programs, and how women choose between workflow options. We recruited forty women of screening age to learn about AI, the Australian breast screening program, and four possible workflows that include AI – one where AI works alone, and three different combinations of humans and AI. Participants then joined one of eight 90-minute dialogue groups to discuss their normative judgements on workflow options. Women proposed four conditions on AI deployment: preserving human control, evidence to assure AI performance, time to become familiar with AI, and clearly justifying the need for implementation. These informed women’s unified rejection of AI working alone, and divided preferences across the other three workflows, as they traded off workflow attributes. Current evidence on AI performance convinced some women, but not others. Most women believed humans mitigate risk the best, so workflows should continue to be designed around them. Public breast screening services are trusted and valued by women, so significant changes require careful attention to outcomes relevant to women. Our results – women’s detailed judgements on workflow design options – are new to the research literature. We conclude that women expect that AI only be deployed to do tasks it can do well, only where necessary, and only to fill gaps that radiologists cannot meet. Advancements in AI accuracy alone are unlikely to influence all women to accept AI making final decisions, if clinicians are available to perform the same task.