Strong Engagement Research Articles

Business model configurations for successful vertical farming

PurposeAs a response to global population growth and increasing demand for food, farmers have been complementing traditional agriculture practices with vertical farming (VF) and indoor hydroponic systems. To facilitate the growth of the VF industry, this paper aims to identify business model elements and their configurations that lead to high firm performance.Design/methodology/approachThe research goals were met by conducting literature reviews coupled with a fuzzy-set qualitative comparative analysis (fsQCA) on five business model elements, “superior” OR “strong” performance as two possible outcomes, and the top-ranked global VF growers listed in the Crunchbase Database.FindingsFrom the fsQCA results, it was observed that several business model configurations lead to strong firm performance. Vertical farms growing in urban settings and having strong customer engagement platforms, coupled with a presence of business-to-business (B2B) sales channels, are more consistently associated with superior performance. These results imply that the decision configuration of location, along with customer engagement activity and sales activity are differentiating factors between good firm performance and superior firm performance in the case of vertical farms.Originality/valueThis paper contributes to expanding the knowledge of business model theory, business model configurations and VF management, providing specific guidelines for vertical farm owners and investors related to decision-making for higher firm performance, as well as positive environmental, social and economic impact.

Exploring expectations and readiness for healthy lifestyle promotion in Swedish primary health care: a qualitative analysis of managers, facilitators, and professionals

Objective Prior to a multifaceted implementation strategy for a healthy lifestyle-promoting practice the expectations of primary health care managers, appointed internal facilitators and health care professionals on supporting change was explored. Design This study had an explorative qualitative design using data gathered from individual interviews and focus groups. Qualitative content analysis with a deductive category development was applied using the Consolidated Framework for Implementation Research. Setting and participants The study was conducted in a primary care setting in central Sweden as a part of the Act in Time research project. Prior to a multifaceted implementation strategy, we held 16 individual interviews with managers and appointed facilitators and five focus groups with 26 health care professionals. Results Managers, facilitators, and professionals held similar expectations, where their expressed need for support corresponded to three constructs: Readiness for implementation, Implementation climate, and Engaging. Our findings indicate the need for strong leadership engagement to focus on how the healthy lifestyle-promoting practice can be anchored among the professionals. Managers at all levels should communicate the vision and goals, enable facilitators and professionals to improve their competencies, build inter-professional teams, and jointly plan the new practice. Conclusion To change to a healthy lifestyle promoting practice professionals request support from their managers, who in turn need support from the middle and top managers. The requested support includes helping to prioritise health promotion and enabling the primary care centres to build competence and take ownership of the implementation. Trial registration ClinicalTrials.gov NCT04799860

The Living Well, Living Longer program: an integrated care strategy to improve the health of people living with severe mental illness.

Living Well, Living Longer (The Program) is an integrated care strategy to improve the physical health of people living with severe mental illness within a public mental health service. The significant life expectancy gap experienced by this cohort is largely attributed to higher rates of cardiovascular disease and modifiable risk factors. The Program addresses this by guiding people through the four stages of screening, detection, treatment initiation, and ongoing management of coexisting chronic health conditions. The Program adopted an integrated care approach to ensure the provision of appropriate and coordinated care across hospital and primary care services. Key care pathways include a cardiometabolic health assessment clinic, shared care with general practitioners, oral health services partnership and employment of peer support workers, dietitians, exercise physiologists, and smoking cessation to provide targeted community support and interventions. There has been strong engagement with the care pathways introduced since The Program's inception in 2013 and evaluation is currently underway to consider the impact on cardiometabolic health outcomes for participants. Critical to The Program's effectiveness has been engagement with lived experience expertise, multidisciplinary collaboration, and strong executive support. However, significant challenges persist amid an Australian public health crisis characterised by reducing rates of free primary healthcare access for people living with severe mental illness and enduring communication challenges between primary and secondary health services. With the implementation of MyMedicare and the imminent Single Digital Patient Record across NSW Health, we stand at a critical juncture. It is imperative to establish robust systems to enhance care for this vulnerable population.

Research on Online Education Teaching Mode of Colleges and Universities Based on Internet Technology

Abstract The steady growth of online education in Chinese higher education, despite its drawbacks, underscores an increasing interest in digital learning platforms. This study proposes enhancements to the Paragraph Vector, Stacking classifiers, and ZEN semantic coders to construct accurate learner profiles, facilitating personalized online education. By applying these improved models, universities can adapt their online courses more effectively, as demonstrated by case study analyses. Performance data for a sample of college students shows a concentration of scores between 80 and 90, with an average of 84.01, suggesting moderate academic achievement. Engagement metrics, particularly in educational experience richness, scored highest at 3.7854, with all engagement scores averaging above 3, indicating a strong engagement in the learning process.

Can Entrepreneurial Marketing Provide an Economic Moat for Small and Emerging Firms?

This study explores the economic moat concept, which has become increasingly relevant to modern-day businesses seeking a sustainable competitive advantage. Drawing upon Porter's Five Forces Model, we investigate the potential for economic moats in small companies and emerging entrepreneurial firms. By analyzing examples of narrow economic moats in small firms, we provide insights into the strategies that may help these firms build and maintain a competitive advantage in their respective markets. Our findings suggest that entrepreneurial firms can leverage various sources of competitive advantages, such as customer loyalty, low-cost structures, and network effects, to create narrow economic moats that protect against competitive threats. Case studies of Andy’s Hobby Headquarters and Laura Farms illustrate how small firms can successfully cultivate narrow economic moats aligned with Porter’s Forces. Andy’s strategic evolution from a local hobby shop to a national and international destination, coupled with a strong online presence and community engagement, demonstrates how management actions can foster customer loyalty and differentiation. Similarly, Laura Farms leverages social media to project company values and create emotional ties with viewers, establishing a narrow economic moat. This paper offers practical insights for entrepreneurs and small business owners seeking long-term success in today's highly competitive business environment. Finally, it concludes that deliberate management strategies, particularly in marketing, can facilitate the development of economic moats within competitive environments and substitution pressures. By adjusting traditional definitions of economic moats to accommodate the rapid pace of entrepreneurship, it advocates for further research into the relationship between economic moats and sustained profitability among entrepreneurial ventures.

Forecasting a Summer of Extremes: Building Stakeholder Response Capacity to Marine Heatwaves

Forecasts of an El Niño in 2023/2024 raised concern among Australian marine stakeholders regarding its potential impacts on marine industries and systems. National level seafood-focused climate briefings were requested by the fisheries sector for the first time, driven by various state and regional level meetings and information requests. To respond to stakeholder needs, six virtual national marine climate briefings were undertaken through the austral 2023/2024 summer, underpinned by new subseasonal to seasonal marine heatwave forecast capabilities. These briefings were developed in collaboration with multiple science organizations and were targeted to industry and management authorities across the Australian seafood sector. As a result, targeted information products, additional regional and sector-specific briefings, and state response plans were developed. Collectively, these briefings were a catalyst for positive and rapid action in policy, management, industry, and research arenas. This experience showed that the combination of seasonal forecasting capability, inter-agency coordination, strong stakeholder engagement, and effective science communication plays a critical role in improving the understanding of, planning for, and responses to extreme events.

Fighting for menstrual equity through period product pantries.

Menstruators facing period poverty often struggle with menstrual hygiene and waste management, which can result in harmful short- and long-term health outcomes such as urinary tract infections, yeast infections, and vulvar contact dermatitis. Research indicates that 42% of menstruators in the United States have difficulty affording period products. Traditional methods of distributing period products through social services may unintentionally undermine menstruators' agency, leading to disempowerment and inefficient resource allocation. Period product pantries are a novel approach aimed at addressing period poverty, inequity, and inadequate menstrual health education in the United States. This paper aims to examine the development, organization, and implementation of two distinct period product pantry networks in Ohio and New York. It seeks to compare the advantages and challenges of grassroots versus nonprofit-led models and to provide practical insights for future pantry operators. The study examines two models of period product pantries: a grassroots effort led by three local residents in Ohio and an initiative spearheaded by a nonprofit organization in New York. The design includes a comparative analysis of both models' organization, funding methods, and operational structures. The authors gathered data on the construction, operation, and usage of two pantry networks, focusing on factors such as accessibility, community engagement, and sustainability. The study employed a combination of qualitative methods, including interviews with organizers, and a review of organizational documents to analyze the effectiveness and scalability of each model. Both pantry networks increased accessibility to period products in low socioeconomic neighborhoods, which are disproportionately affected by period poverty. The grassroots model, while resource-limited, fostered strong community ties and local engagement. The nonprofit-led model benefited from dedicated staff and a more stable funding structure but faced bureaucratic challenges. Despite their differences, both models demonstrated the potential to empower menstruators by preserving their dignity and autonomy. Period product pantries represent an innovative and equitable approach to addressing period poverty and inequity. The analysis of the two models offers valuable insights for organizations and individuals interested in establishing similar initiatives. While each model has its unique benefits and challenges, both are effective in empowering menstruators and providing accessible menstrual hygiene products to those in need. Not applicable.

Nursing Students' Learning Engagement Experiences During the COVID-19 Pandemic in Namibia: Implications for Nursing Education.

Ensuring strong student engagement in both traditional and virtual learning settings was essential for achieving positive educational results during the COVID-19 pandemic. However, fostering student engagement in both the traditional (face-to-face) and virtual learning environments has been accompanied by distinct challenges. There has been a lack of research specifically addressing the issue of nursing students' engagement within a blended learning setting in Namibia. To explore and describe nursing students' learning engagement experiences at a university campus in Namibia during the COVID-19 pandemic. A qualitative, descriptive, phenomenological study was employed to collect data from 10 purposively selected nursing students at a university campus in Namibia. Data from in-depth, face-to-face, individual interviews were collected using a semistructured interview guide. Data were analyzed using Colaizzi's seven-step method. The findings of the study describe students' learning engagement experiences under four distinct themes: (a) conditions and contexts of engagement; (b) student acts of engagement: positionality of teacher- and student-facilitated engagement; (c) consequences of engagement in a blended learning environment; and (d) student engagement dispositions: students' initiatives. The research findings revealed that despite mental health challenges, both teacher-facilitated and student-facilitated engagement were necessary for positive learning engagement in the blended learning environment. Student-facilitated engagement was significantly responsible for enabling students to maintain focus, adhere to guidelines, and adapt to the blended learning environment. These findings are useful in understanding the challenges faced by students during the COVID-19 pandemic. The findings thus provide valuable data for future studies seeking to address challenges associated with the blended learning environment.

Exploring the 'citizen organization': an evaluation of a regional Australian community-based palliative care service model.

Little Haven is a rural, community-based specialist palliative care service in Gympie, Australia. Its goals are to provide highest quality of care, support and education for those experiencing or anticipating serious illness and loss. Families and communities work alongside clinical services, with community engagement influencing compassionate care and support of dying people, their families and communities. Public Health Palliative Care promotes community engagement by community-based palliative care services and is grounded in equal partnerships between civic life, community members, patients and carers, and service providers. This takes many forms, including what we have termed the 'citizen organization'. This paper reports on an evaluation of Little Haven's model of care and explores the organization's place as a 'citizen' of the community it services. A co-designed evaluation approach utilizing mixed-method design is used. Multiple data sources obtained a broad perspective of the model of care including primary qualitative data from current patients, current carers, staff, volunteers and organizational stakeholders (interviews and focus groups); and secondary quantitative survey data from bereaved carers. Thematic analysis and descriptive statistics were generated. This model of care demonstrates common service elements including early access to holistic, patient/family-centred, specialized palliative care at little or no cost to users, with strong community engagement. These elements enable high-quality care for patients and carers who describe the support as 'over and above', enabling good quality of life and care at home. Staff and volunteers perceive the built-in flexibility of the model as critical to its outcomes; the interface between the service and the community is similarly stressed as a key service element. Organizational stakeholders observed the model as a product of local activism and accountability to the community. All participant groups agree the service model enables the delivery of excellent care. The construction of a community palliative care service as a citizen organization emerged as a new concept.

Podcasts as a tool for promoting health-related behaviours: A scoping review.

Podcasts are a popular medium for delivering health-related content, potentially influencing physical and mental health behaviours and outcomes. This scoping review evaluates the impact of health podcasts on such outcomes, engagement levels, and public perceptions. This scoping review followed the Arksey and O'Malley framework and PRISMA-ScR guidelines. Qualitative or quantitative articles published from 2004 onward were included. Eligibility criteria were developed using the Population, Exposure and Outcome framework. Included articles examined the use, engagement with, or perspectives towards health-related podcasts. Data were synthesised narratively. Fifty articles encompassing 38 studies were analysed. Significant improvements (p < 0.05) were observed in health monitoring, knowledge, behaviours, attitudes, chronic disease management, maternal health and behavioural improvements. Results were mixed for physical activity (n = 2 significantly improved, n = 2 no change), fruit and vegetable consumption (n = 1 significantly improved, n = 1 no change), and weight outcomes (n = 2 significantly improved, n = 2 no change). No significant changes were observed in depression and anxiety. Podcast engagement studies (n = 7) reported participation rates between 62% and 83% and an average weekly listening duration of 103-124 minutes. There was high satisfaction, trust and appreciation for podcasts that effectively blended personal anecdotes with reliable medical information. Sample sizes ranged from 7 to 722, with sample age ranging from under 18 to 73.2 ± 6.2 years. Studies included both male (n = 1), female (n = 6) and mixed samples (n = 24). Podcasts were used individually (n = 19), alongside other supportive technology such as apps and online material (n = 11) and retrospective podcast use was analysed in cross-sectional (n = 3) and a single (n = 1) audit. Duration of podcasts ranged from 30 seconds to 24 minutes. Podcasts show promise as effective tools for health promotion, achieving strong engagement and effects on knowledge and behaviours. Future research should explore content innovation and integration into health interventions, and long-term effectiveness.

Comparative analysis of food waste laws in Singapore and Japan: an examination of legal frameworks in hope of achieving Singapore’s zero-waste vision

This article compares food waste laws in Singapore and Japan and analyses similarities and differences in their legal approaches to minimizing food waste across the food supply chain. The research undertaken demonstrates that although there is broad alignment in many aspects of the two countries’ food waste recycling laws, the specific requirements differ significantly due to each country’s unique circumstances. This has given rise to implementation issues that hamper large-scale food waste recycling in Singapore. These issues encompass, inter alia, the law’s limited applicability to food-related establishments and the lack of clarity regarding acceptable output from food waste treatment processes. Moreover, Singapore does not have a separate law targeted at avoiding food loss, a potentially more effective approach that is aligned with the food waste hierarchy. However, Japan’s experience demonstrates that, even with a law in place, success in food waste prevention typically relies on voluntary efforts and strong public engagement. Based on these findings, the article concludes that Singapore’s existing food waste law can contribute to a certain extent the achievement of its ‘zero-waste’ vision.

On the Causes of the Lack of Rule of Law in the Western Balkans

The Western Balkan region continues to face significant challenges in establishing the rule of law. This paper examines the socio-legal factors contributing to the weakness of the rule of law in the Western Balkans. It identifies three key factors: inefficient and unaccountable state institutions, the rule of informal institutions and corruption networks, and impotent formalistic judiciary. These are traced back to underlying historical, sociological, and legal prerequisites in the region. The analysis finds that state institutions in the Western Balkans are often extractive and controlled by political elites, undermining checks and balances. Additionally, informal institutions like clan networks continue to thrive, promoting corruption and impunity. Finally, the judiciary retains vestiges of socialist legal formalism, hampering impartial adjudication. Recommendations focus on the need for substantive domestic ownership of reforms by local actors. Sustainable rule of law requires capable and accountable state institutions along with strong civic engagement. The EU and international donors must re-examine their technocratic approach and insist on tangible improvements.

A segmentation and characterization of consumers affected by rising food prices

The food price inflation in 2022 has put considerable pressure on some consumers, leading to changes in their food choice and consumption behavior. To gain a better understanding of consumers' responses to rising food prices, we conducted an online survey among 1000 consumers in Germany, in which they were asked to self-report the extent of their changes during a period from the beginning of 2022 to November 2022. A principal component analysis was conducted to summarize the queried items into three factors, which were subsequently used for a cluster analysis. The emerging clusters were characterized in terms of sociodemographic as well as psychographic variables, namely locus of control, life satisfaction, optimism, pessimism, human values, and food values. The segment that appears to be most affected by rising food prices consists of about 28% of the sample’s respondents and is characterized by a strong engagement in saving behaviors. These consumers are less satisfied with their lives and more pessimistic, corresponding to their lower incomes and lower likelihood to be fully employed. Communication and policy measures need to be designed in a way that these consumers regain stability and become more confident about the future.

Attitude, Awareness, and Understanding of Artificial Intelligence AI among Medical and Dental Students in Jordan: A Cross-Sectional Study

BACKGROUND: The rapid growth of AI has transformed various sectors, including healthcare. AI aids medical diagnoses and treatment planning, but challenges such as privacy and ethical concerns exist. Understanding AI is crucial for medical and dental students in Jordan to enhance patient care. This study examines students' attitudes, awareness, and understanding of AI to inform effective education and better healthcare practices. METHODS: A cross-sectional study was conducted in Jordan among medical and dental students from Nov 2022 to Mar 2023. Data were analyzed using descriptive statistics, Mann-Whitney U test, Kruskal-Wallis tests, and Spearman's correlation. Ethical approval was obtained, and SPSS was used for analysis. RESULTS: The study involved 800 respondents, predominantly female (54.6%) and with an average age of 19.81 years. Most participants were medical students (64.6%), had a national diploma (75.0%), and were in their first or second year of education (73.1%). The majority were single (97.9%), and 75.1% resided in the central region. In terms of technology background, 38.8% had family members in the technology sector, and half used electronic devices for 3-6 hours daily. Over 75% used electronic devices for studying, while 44.1% had taken technology courses, with only 23.5% having specifically studied Artificial Intelligence (AI). Additionally, 46.0% had prior research experience, but only 18.0% had participated in AI-related research. Participants rated their overall technology knowledge at 2.91 ± 1.06 and AI knowledge at 2.43 ± 1.21. The main sources of AI information were social media (35.0%). Regarding AI applications, 28.0% believed it would enhance medical diagnosis, while 24.0% expressed concerns about hacking and cybersecurity. Only 10.0% planned to consistently incorporate AI into their future medical practice. Statistical tests revealed significant differences in awareness of AI based on study field (p-value = 0.034), income (p-value = 0.028), previous technology involvement (p-value = 0.004), ICDL course participation (p-value = 0.02), AI course participation (p-value &lt; 0.001), and programming language learning (p-value = 0.001). Similar variations were observed in understanding AI basic principles, with additional significance related to research course participation (p-value &lt; 0.001). Attitudes toward AI differed only among those with previous technology course involvement (p-value = 0.037). Spearman's correlation indicated a moderate positive association between awareness of AI in medicine and dentistry and understanding of AI basic principles (r: 0.491, p &lt; 0.001). CONCLUSION: The younger generation of medical and dental professionals’ views AI as a collaborator in their practice. Strong interest and active engagement in AI-related courses highlight the importance of integrating AI education into medical curricula for innovative healthcare practices.

From feeling like home to being at home: The negative outcomes of attachment to commercial places

This research illuminates the negative facets of attachment to commercial places. Prior research focusing on place attachment has emphasized that strong emotional bonds with a commercial place trigger behaviors that were valuable to both managers and customers. However, consumers' strong emotional engagement to places can lead them to move from feeling at home – where consumers experience a sense of comfort and familiarity – to being at home – where they see the place as part of their personal space –, which is likely to impact the place's commercial activities. Building on managers' and consumers interviews, our data emphasize the negative effects of attachment to commercial places, and also suggest that surprisingly, managers themselves play a role in the development of detrimental behaviors in the places they manage.

Impact of Firm Ownership Type on Organizational Commitment and Citizenship Behaviour

In today’s globalized scenario, where advancements in technologies have facilitated people to connect, communicate and collaborate, and where organizations are striving to create an ecosystem that develops sustainable competitive advantage, people issues become a key factor. Organizations, therefore, require an understanding of the business scenario, organizational context and employee characteristics that influence employee behaviour and their workplace relationships as well as their intentions to stay. Though all organizations expect their employees to act with a sense of trust and commitment, the business context of family- and non-family firms are unique and different. While family firms are characterized by the family’s value system and emotions in building strong employee engagement, non-family firms are transactional and driven by outcomes. The study explores differences in organizational commitment and organizational citizenship behaviour between family- and non-family firms, and it draws on the tenets from the Social Exchange theory. The data has been collected from 634 dyadic responses captured at two levels—employees’ self-reported commitment levels and their citizenship behaviour rated by their managers. Our results show that, in the Indian context, the employees of family firms demonstrate a higher affective, continuance and normative commitment as compared to those of non-family firms. However, the two groups did not differ significantly in their organization citizenship behaviour. It was also found that the relationship between organizational commitment and citizenship behaviour was stronger in employees of family firms than in employees of non-family firms.

A scoping review of physical activity-based interventions for obesity management in children and adolescents during the COVID-19 pandemic.

Overweight and obesity have emerged as global health issues among children and adolescents. Restrictions related to the COVID-19 pandemic have aggravated the threat of paediatric obesity due to the prevalent reduction in physical activity (PA) in children and adolescents. However, this has also created an opportunity for healthcare professionals to explore new strategies to address this persistent problem. A systematically conducted scoping review was performed on 15 online databases to summarise and analyse the design, efficacy, and feasibility of PA-based weight management interventions for children and adolescents during the pandemic. Finally, we reviewed 23 eligible studies that were published between 2021 and 2023. The included interventions were presented to 1938 children and adolescents and 355 parents using a virtual or virtually blended face-to-face approach during the pandemic. The intervention design included a basic PA programme with three optional components (nutritional education, sociopsychological counselling, and medication consultations). Implementation generally resulted in favourable changes in body mass index (BMI) and/or body size or composition (primary outcomes), as well as health behaviours, physical health or fitness, and individual well-being (secondary outcomes). A longer duration of exposure to the intervention, female sex, and older age were associated with a higher efficacy of the included interventions. Moreover, the interventions showed high feasibility, with medium-high participant attendance, high acceptance/satisfaction in both children and adolescents and their parents and teachers, and strong participant engagement. This may be related to the high accessibility of health information, timely social support, and enhanced self-efficacy. In conclusion, both the virtual and blended delivery of well-planned weight management interventions during the pandemic show promise for the treatment and control of paediatric obesity. The lessons learned from the pandemic may help improve the design of future interventions and inform the proper integration of new technologies that have emerged in the post-pandemic world.

Risk of Stunting in Children: Links to Internal and Social Family Interactions in Central Buton District (a Case Study)

With a high prevalence of stunting in children in the Central Buton District. This study aims to explore the relationship between internal family dynamics and external social relationships affecting children's nutrition. The study was based on the hypothesis that more frequent and qualitative family interactions and involvement in social activities would correlate with a lower risk of stunting. This study used a cross-sectional study design. Analyzing secondary data from the 2021 Family Data Collection (PK21). The study included 6,586 target families as a sample, the analysis included family dynamics as an exposure variable and used the family happiness index formula to identify family interaction and social interaction. The study used logistic regression from Scikit-learn to evaluate the data in the final stage. Data analysis revealed that internal family interactions, although important, showed no statistically significant association with stunting risk (p=0.3699). However, social interaction had a highly significant association with reduced risk of stunting, with a regression coefficient of -1.9934 and Odds Ratio (AOR) of 0.1362 (95% CI: 0.0739 - 0.2510, p&lt;0.0001) in logistic regression analysis. These findings confirm that strong social engagement and community support are key factors in reducing the prevalence of stunting among children in the Mawasangka sub-district. This study concludes that engagement in community social activities has a significant impact on reducing the risk of stunting in children. The findings suggest that interventions aimed at reducing stunting should go beyond intra-family interventions and include increased social interaction and community support to achieve optimal outcomes in stunting prevention.

Abstract A052: Perspectives of African immigrants on community health needs and clinical trials

Abstract INTRODUCTION In the past decade, Jacksonville, Florida has seen an increase in African immigrants. However, little is known about their health needs and perspectives related to community health and clinical trials. The Mayo Clinic Comprehensive Cancer Center (MCCCC) Community Outreach and Engagement (COE) Office and Programs partnered with multiple community-based organizations as part of the FL Community Engagement Alliance Against COVID-19 to hold a series of focus groups with African immigrants to better understand their perspectives surroudning these determinants. METHODS This was a qualitative study with African immigrants residing in Jacksonville, Florida. Data was collected by community partner, Jocelyn Turner Consulting, who has led multiple community-based studies in Florida. Recruitment was in partnership with African businesses and churches. Using a guide developed by MCCCC COE, three focus groups were held to explore African immigrants’ 1) general experiences, 2) access to social services, 3) perspective of community health and diseases, 4) access and use of healthcare services, 5) knowledge and participation in clinical trials, and 6) appropriate strategies for providing community education and enhancing participation in research studies. RESULTS 24 participants participated in the focus groups. 83% had recently immigrated from Africa (Democratic of the Congo, Benin, Ghana, Sudan, Mali, Nigeria, Ethiopia, and Nigeria). The remaining 17% recently immigrated from Haiti or came to the US as a baby. Participants reported suprise to the proliferation of chronic diseases, such as increased cancer diagnoses of those who immigrated to the United States. Most participants associated this with the Western sedentary lifestyle, dietary habits, and lack of access to fresh food. Participants connected to refugee organizations reported knowledge of the ability to access health education resources and mental/physical care services, but those not connected with similar organizations expressed limited knowledge about access. Similarly, participants with no connection to refugee organizations reported not knowing where to access healthcare services and not seeking services until home remedies had failed. Only 33% of participants reported knowledge of clinical trials and all reported mistrust of research. Many of the participants expressed a need for health-related information upon arrival in the United States. CONCLUSION There is currently little infrastructure in place to support African immigrants in Jacksonville, Florida, which can contribute to cancer health disparities in this population. Strong community engagement is needed to partner with African immigrant communities to address culturally specific needs identified of this underrepresented population. The needs expressed by participants include information on physical activity, nutrition, and healthcare/clinical trials. A strong partnership with African immigrant communities has the potential to address cancer disparities and increase both trust and participation in clinical trials. Citation Format: Jocelyn Turner, Laureen Husband, Jessica Otero, Opeyemi Bolajoko, Parisa Fathi, Jennifer Crook, Folakemi Odedina. Perspectives of African immigrants on community health needs and clinical trials [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 A052.

A Patient-Centric Approach to Sickle Cell Disease Clinical Trials: Integrating Patient Perspectives in the RISE UP Phase 2/3 Trial of Mitapivat for Informed Protocol Design and Associated Patient Community Benefit

Background: Sickle cell disease (SCD) is a genetic blood disorder that affects millions of people worldwide. There are currently limited treatment options and a high unmet need; new therapies - and therefore new trials - are essential. Although there is evidence of growing patient (pt) participation in the drug development processes, there is a lingering suspicion among the community that they are not treated as equal partners and too frequently regarded as mere data sources. Involving pts in planning and execution of clinical trials is essential to improve participation and meet the real needs of the patient community. Mitapivat is a first-in-class, oral, allosteric activator of pyruvate kinase (PK), approved by the United States Food and Drug Administration for the treatment of hemolytic anemia in adults with PK deficiency, by the European Union European Medicines Agency, and the Medicines and Healthcare products Regulatory Agency in Great Britain for the treatment of PK deficiency in adults. The RISE UP phase 2/3 trial (NCT05031780) of mitapivat in pts with SCD was therefore devised to use a new approach to clinical trial design and recruitment that considered pt preferences wherever possible. Objective: Using the RISE UP Phase 2/3 trial, redefine best practices in clinical trial design by asking pts with SCD to describe what matters most to them in a trial setting and by involving them in decision making processes and trial awareness communications. Methods: Nine SCD pts and advocates (five from the US, one from Bahrain, one from France and two from the UK) took part in a series of clinical trial design workshops. Four remote advisory board interviews were held with pts (&amp;gt;16 years of age) and advocates to consult on the RISE UP Phase 2/3 clinical trial design. The insights gained from these consultations were incorporated into the proposed trial protocol design that was subsequently shared with Health Authorities (HAs) for their comment from a regulatory perspective. Once finalized, feedback from HAs was presented to the steering committee to determine whether changes requested by HAs met the needs and barriers-to-uptake expressed during partner consultations. In addition, a group of seven patients were involved in the development of the RISE UP phase 2/3 clinical trial awareness campaign, which sought to educate the community about the RISE UP clinical trial and value of pt participation. Results: Pt contributions to the protocol design included modified inclusion/exclusion criteria and the addition of pain (beyond pain crises) and fatigue as study outcomes. An overview of the community feedback is shown in Table 1. In response to pt input, monthly study visits were implemented for seven months, followed by visits every three months. An open label extension period was also added with visits on the second, fourth, eighth, and twelfth weeks of the extension period, followed by every 3 months up to 1.5 years and every six months thereafter. Taking additional pt input into account, the trial was adjusted to include a recommendation for tailored management of SCD pain crises using a daily diary. Additionally, following patient recommendations, the trial approved reimbursement for study-related travel, lodging, and specific non-study assessments. The RISE UP communications campaign was effective, with heightened interest in clinical trial participation generated within the community. Strong social media engagement and digital efforts resulted in increased trial website views, and community education and awareness efforts resulted in increased clinicaltrials.gov views to an average of 2-3 clicks per day. Approximately 278,000 users visited the RISE UP website and the campaign's YouTube video, which launched on World Sickle Cell Day has attracted 3 million views since Q4 2022. Conclusion: To meet the needs of the SCD pt and caregiver community and advance clinical trial research, we implemented a patient-centered approach to clinical trial protocol design and trial recruitment. Overall, this patient-centric approach could be useful in improving community engagement, designing trials that better reflect the needs and concerns of the pt population, and ultimately improving pt participation and diverse representation in clinical trials.