Three-round Delphi Technique Research Articles

Factors that contribute to extraordinary stress in farmers

This research aimed to identify the conditions leading to stress in farmers. Rural and agricultural communities face heightened stress levels due to multiple factors, with cumulative negative consequences, as proposed by the Cumulative Stress Model (CSM). This study engaged a panel of experts with lived and professional experiences in an intentional and iterative Delphi process to identify stressors in agricultural communities. Employing the three-round Delphi technique by Turoff and Linstone (1975), this study integrated diverse perspectives and expertise while minimizing biases arising from group discussions or face-to-face interactions. The findings indicate that most stressors, such as farm operating costs, commodity prices, weather, labor shortages, crop/livestock diseases, economic fluctuations, and work-related accidents, were beyond individual control. These stressors can lead to a sense of powerlessness, particularly challenging in communities valuing independence and self-reliance. Furthermore, farm operating costs, commodity prices, weather, labor shortages, and crop/livestock diseases ranked among the top stressors. Debts, loans, and work-related accidents also contributed to stress. Notably, farm operating costs, commodity prices, and weather emerged as the three most highly rated stressors across all categories—lack of control, sudden fluctuations, and farming-related stressors. Addressing these stressors is paramount for monitoring and improving the well-being of agricultural communities.

Assessment, Treatment, and Follow-Up of Phlebitis Related to Peripheral Venous Catheterisation: A Delphi Study in Spain

Background: Phlebitis related to peripheral venous catheters (PVCs) is a common complication in patients who require these devices and can have important consequences for the patients and the healthcare system. The management and control of the PVC-associated complications is related to nursing competency. The present study aims to determine, at the national level in Spain, the consensus on the assessment, treatment, and follow-up of PVC-related phlebitis and the importance of the actions taken. Method: A three-round Delphi technique was used with clinical care nurses who are experts in the field of in-hospital intravenous treatment in Spain. For this, an online questionnaire was developed with three open-ended questions on the dimensions of phlebitis assessment, treatment, and follow-up. For the statistical analysis of the results, frequencies and percentages were used to determine consensus, and the measures of central tendency (mean, standard deviation, and the coefficient of variation) were used to rank importance. The coefficient of variation was set as acceptable at ≤30%. Results: The final sample was 27 expert nurses. At the conclusion of round 3, actions were ranked according to their importance, with six items included in the PVC-related phlebitis assessment (symptomatology/observation, redness, the Maddox scale, induration, temperature, and pain), two in treatment (catheter removal, pentosan polysulphate sodium ointment + application of cold), and just one in follow-up (general monitoring + temperature control). Conclusions: There is a major disparity in relation to the PVC-related phlebitis assessment, treatment, and follow-up actions. More clinical studies are therefore needed to minimise the complications associated with the use of PVCs, given their impact on the quality of care and patient safety and their economic cost.

An Action Plan to Improve Postnatal Care in Ethiopia: A Mixed Methods Research

Despite the efforts made in Ethiopia to decrease maternal mortality by increasing postnatal care and other maternal health care services, neither significant reduction in maternal mortality nor an increase in postnatal care utilization. The objective of this study was to develop an action plan to improve postnatal care services in the Ethiopian context. Sequential mixed-methods research, was conducted over three phases. In the first phase of the study, background information on postnatal care services in Ethiopia was assessed and described. During the second phase of the study, an action plan for postnatal care improvement was developed, and the third phase concentrated on the validation of the developed action plan. For phase 1 one of the study 422 respondents were randomly selected and participated in the study from November 1 to 30, 2020. A self-administered structured questionnaire was used for quantitative data collection. The collected data were checked for completeness, cleaned, coded, and then entered into Statistical Package for Social Sciences (SPSS) software program version 21. For the thrird phase of the study a delphi technique was used to validate the developed action plan . For all phases of the study, the open-ended questions were open-coded and thematically analyzed. A validated action plan for the improvements of postnatal care was developed using the inputs from respondents during Phase 1, available literature as well as the three-round Delphi technique. The findings revealed that the developed action plan is applicable in the Ethiopian context and is crucial for improvement of postnatal care. The study revealed that the developed and validated action plan will improve postnatal care in Ethiopia. Follow-up studies to assess the limitations of the action plan can be conducted to adapt and improve the action plan. Further studies on possible challenges associated with the implementation can enhance the success of the implementation of the action plan.

Technical agriculture skills teachers need to teach courses in the animal systems pathway

Fundamentally, agricultural teacher education programs and their faculty are tasked with preparing competent teachers capable of teaching students enrolled in public schools. As part of their design, an important facet of these programs is ensuring pre-service teachers are ready to provide educational opportunities in aspects of school-based agricultural education (SBAE), including teaching technical agriculture skills to students. We used a three-round Delphi technique to identify the technical agriculture skills SBAE teachers in Illinois and Iowa need to effectively teach courses in the Animal Systems pathway within the broader Agriculture, Food, and Natural Resources (AFNR) Career Cluster. Thirty-four SBAE teachers who were nominated by state-level SBAE leaders and other SBAE teachers in their states contributed data for our study. Twenty-two teachers participated in all three rounds. In total, we identified 35 technical agriculture skill items. To help ensure teachers are competent and prepared to teach courses in the Animal Systems pathway, we outline several approaches agricultural teacher educators should contemplate: (1) facilitating opportunities to foster technical agriculture skill development within agricultural teacher education programs, (2) collaborating with agricultural faculty who teach technical agriculture courses to pre-service teachers, and (3) using our list of 35 skills to facilitate future scholarly investigation on the topic. While not generalizable beyond the SBAE teachers in these two states, we do believe our findings have value for SBAE stakeholders. To overcome the limitation of generalizability and to delve deeper into teachers’ technical agriculture skill needs, we suggest that our study be replicated in other states.

Critical factors affecting Chinese construction expatriates’ living and working conditions in Thailand: a Delphi study

Expatriation management is a key concern in international construction projects, where the living and working conditions of expatriates can have a significant impact on project success. This study investigates the critical factors affecting Chinese construction expatriates’ living and working conditions in Thailand. Through a three-round Delphi technique involving twelve experts and in-depth semi-structured interviews with eight construction experts with extensive overseas experience to validate, six critical factors were identified for each living and working condition. Language and Covid-19-related (during the investigating period) factors were the most dominant factors affecting the living conditions, while technical standards, technology, and competition were critical factors for working conditions. The study categorizes the critical factors into five groups and provides suggestions for improvement. This research is the first to investigate the specific factors affecting Chinese construction expatriates in Thailand and offers insights and management directions for the expatriation process, particularly for the growing number of Chinese construction companies expanding internationally. The findings also serve as a valuable reference for future research on this topic.

Recommendations of the Netzwerk Kindersimulation for the Implementation of Simulation-Based Pediatric Team Trainings: A Delphi Process.

Serious or life-threatening pediatric emergencies are rare. Patient outcomes largely depend on excellent teamwork and require regular simulation-based team training. Recommendations for pediatric simulation-based education are scarce. We aimed to develop evidence-based guidelines to inform simulation educators and healthcare stakeholders. A modified three-round Delphi technique was used. The first guideline draft was formed through expert discussion and based on consensus (n = 10 Netzwerk Kindersimulation panelists). Delphi round 1 consisted of an individual and team revision of this version by the expert panelists. Delphi round 2 comprised an in-depth review by 12 external international expert reviewers and revision by the expert panel. Delphi round 3 involved a revisit of the guidelines by the external experts. Consensus was reached after three rounds. The final 23-page document was translated into English and adopted as international guidelines by the Swiss Society of Pediatrics (SGP/SSP), the German Society for Neonatology and Pediatric Intensive Care (GNPI), and the Austrian Society of Pediatrics. Our work constitutes comprehensive up-to-date guidelines for simulation-based team trainings and debriefings. High-quality simulation training provides standardized learning conditions for trainees. These guidelines will have a sustainable impact on standardized high-quality simulation-based education.

Barriers to Attracting Private Sector Investment in Public Road Infrastructure Projects in the Developing Country of Iran

Private sector investment, the mainstream financing method for procuring public road transport development projects, has encountered several profound difficulties and risks during execution, particularly in developing countries. However, there needs to be more extensive investigations on the major barriers facing road transport infrastructure projects in these countries. In this vein, the present study aims to identify and assess the perceived barriers inhibiting private sector investment in delivering public road transport infrastructure projects in the developing country of Iran. The research method adopted is based on a descriptive survey with a three-round Delphi technique with 35 experts from both the private and public sector in Iran. According to the research study results, four main groups of legal and organizational, political, economic, and operational barriers have been found to significantly impact the attraction of private sector investment in such projects. The three most significant obstacles for public road transport infrastructure projects in developing countries include: (i) a lack of financial and investment safety; (ii) a lack of proficient managers and policies of public organizations in order to facilitate the process of privatization; and (iii) corruption in the privatization process. The survey findings can help the government and policymakers to eliminate or alleviate the potential barriers towards private sector participation in future public road infrastructure projects, particularly in those developing countries such as Iran.

A questionnaire development to assess the social representation of nurses in the Basque Country: a psychometric assessment.

BackgroundOnly a few Spanish studies have explored how nurses are seen by society and no validated tools exist for this purpose in the scientific literature.ObjectivesThe aim was create and evaluate the psychometric characteristics of a questionnaire that explored the social representation of nursing in social and health care.MethodsQualitative and quantitative methods were used to develop the questionnaire and the first version was created based on existing studies. A three-round Delphi technique was used that involved nurses, doctors, journalists and a politician. The pilot questionnaire was then tested and retested with 23 journalism students, with an interval of 10–14 days between the two phases. After further modifications, the questionnaire was sent to all the third and fourth year journalism students at the University of the Basque Country. Principal component factor analysis was used to identify the key components for the questionnaire.ResultsA total of 141 third and fourth year journalism students took part in the study. The internal consistency of the 43-item perception section of the questionnaire had a Cronbach’s alpha value of 0.90. The 42.7% agreed or strongly agreed that nursing was an eminently scientific profession and 26.3% agreed or strongly agreed with the statement that nurses were presented in the media as health educators and disseminators. Just under a fifth (19.9%) agreed with the statement that society was aware of the competencies that nurses required.ConclusionsThe questionnaire provided the first validated tool that allowed researchers to assess how nursing, and all of its areas of professional development, were perceived by society. This could enable studies to assess the evolution of the profession over time and between different socio-cultural contexts.

Recommendations to support the mental wellbeing of nurses and midwives in the United Kingdom: A Delphi study.

To use the Delphi technique to identify and prioritize recommendations for research and practice to improve the mental wellbeing of nurses and midwives in the United Kingdom (UK). Although there is evidence that self-reported mental wellbeing among nurses and midwives in the UK is poor, interventions have not adequately considered the wider context in which they work. The wide range of individual, organizational, occupational and wider sector-level factors that can influence wellbeing requires the involvement of different stakeholders to identify the most pressing actions required. A three-round Delphi technique was conducted in 2019. In the first round, 16 subject matter experts generated, reviewed and discussed recommendations from a review of the research evidence with potential to support the mental wellbeing of nurses. A second group with 23 stakeholder representatives then rated and provided feedback on the developed recommendations through two additional rounds. Recommendations that received an 'essential' or 'important' rating from at least 80% of participants were retained and prioritized. In total, 45 recommendations met the consensus agreement and were retained. More than half (57%) involved action at the organizational level, 27% to public policy and 13% to research. Only one recommendation is related to the individual. Collectively, these recommendations highlight the importance of taking direct action to tackle poor mental wellbeing among the workforce and initiating change at the policy and organizational level. Our findings emphasize the need to take a systemic approach to improving the mental health of nurses and midwives in the UK with input from different stakeholders. There is a clear consensus that action is needed at the organization and policy levels, rather than at the individual level as is current practice. This study provides a framework, alongside a set of practical recommendations, that provides a starting point for different stakeholders to understand, address and support the mental wellbeing of nurses and midwives. Although UK-focused, it has relevance to healthcare workforces internationally.

Risk Factors in Various Climates of Wheat Production in Western Iran: Experts’ Opinions

Agriculture is the origin of existence and survival in any society. However, this sector is always associated with risk and uncertainty, and farmers are faced with many challenges. Therefore, the main aim of this research was to explore the (production) risk factors of irrigated wheat production systems among farmers in Kermanshah province, Iran. The exploratory nature of this study on the one hand and the need for expert judgment on the other hand necessitated a Delphi research design. Thus, this study utilized a three-round Delphi technique. The population comprised of 10 subject-matter experts (SME) and 32 agricultural extension experts in two climates (warm and semi-arid and cold and moderate) in seven counties in Kermanshah province. A purposeful (complete) sample of 42 experts in the agricultural field participated in this study. Data were collected using a questionnaire designed on the basis of the Delphi technique. The findings indicated that, after three rounds of Delphi technique, the panel members reached a consensus on 75 factors which were categorized into biological, natural, managerial, and technological-structural groups for production risk. The results of this research provide useful insights for researchers, extension agents, and farmers.

Integrated safety, health and environmental management in the construction industry: key organisational capability attributes

PurposeFor construction organisations to be effective at implementing an integrated safety, health and environmental (SHE) management system, they require the right level of organisational capability. This capability includes the policies, systems and resources of the organisation. However, within the academic literature, it is unclear which organisational attributes of construction companies are important for implementing integrated SHE management. This study aims to explore the organisational attributes that determine integrated SHE management capability and their relative priorities.Design/methodology/approachThe study used a literature review supported by expert verification and a subsequent three-round expert Delphi technique accompanied by applying the voting analytical hierarchy process.FindingsThe study identified 20 attributes grouped under five main thematic categories. These are strategy (the organisation’s vision and top management commitment); process (the organisation’s procedures and processes for SHE management); people (organisation’s human resources, their competence, roles, responsibilities and involvement in SHE management); resources (organisation’s physical and financial resources for SHE management) and information (SHE related documents, data, records and their communication across an organisation). While these thematic categories and the attributes within carry different weights of importance, the strategy-related attributes are the most important, followed by the people-related attributes.Originality/valueThe results of this study should enable construction companies and key industry stakeholders to understand construction companies’ capability to successfully implement an integrated SHE management system. Furthermore, construction companies should be able to prioritise efforts or investments to enhance their SHE management capability.

Exploring barriers and possible actions suggested in rural libraries for information society: Perspectives from library practitioners in Malaysia

This study aims to explore the barriers when developing information societies and to suggest possible actions for rural libraries to participate in information societies, tailored to the needs of Malaysian rural libraries. This study employed a three-round Delphi technique; including a face-to- face interview in the first round, followed by two rounds of close-ended survey questions presented in a Likert-type scale format distributed to a selected group of leaders with experience in rural library planning and strategies. It reveals how funding, library infrastructures, information communication technology, local content resources, and human resources adversely affected rural libraries in the development of an information society. Based on the recommendation elicited for the five categories, this study suggests possible actions that provide practical guidance on the actions to be taken by the rural libraries in developing an information society.

A Regional Study of the Agricultural Mechanics Knowledge and Skills Needed by School-based Agricultural Education Teachers

A priority of agricultural teacher education programs is to develop technically competent, prepared school-based agricultural education (SBAE) teachers. SBAE teachers should be knowledgeable in various agricultural subject matter, such as agricultural mechanics. Using Roberts and Ball’s (2009) Content-based Model for Teaching Agriculture as the conceptual framework for our study, we used a three-round Delphi technique to identify the agricultural mechanics knowledge and skills SBAE teachers in Arkansas, Louisiana, Oklahoma, and Texas need to successfully teach agricultural mechanics courses. Spread across all four states, a panel of 47 SBAE teachers with expertise in agricultural mechanics contributed data for our study. Thirty-five teachers participated in all three rounds. After all three rounds were completed, 71 technical agricultural mechanics knowledge and skill items (e.g., circular saw use, computer numerical control [CNC] systems use, etc.) and 49 agricultural mechanics “teacher skill” / laboratory management knowledge and skill items (e.g., budget management, developing a student traffic control system, etc.) were identified. We recommend various efforts to help expand teachers’ competence in these items should be undertaken within these states, including: (1) establishing and expanding partnerships with agricultural industry stakeholders to provide professional development opportunities for SBAE teachers, (2) realigning agricultural teacher education courses and experiences to better reflect teachers’ agricultural mechanics knowledge and skill needs, and (3) facilitating opportunities for teachers to develop competence in agricultural mechanics through SBAE teacher-led training. To help provide systematic, consistent examination of teacher competence needs in agricultural mechanics, replication of our study should occur at regular intervals.

Characteristics of a technology-based intervention for young drivers' hazard perception: A Delphi study

IntroductionRoad traffic injuries remain the leading cause of death for youth ages 15 to 29. Poor hazard perception skills are a contributor to collision risk in this population. This Delphi study sought stakeholder consensus on the characteristics that should be prioritized in the development of technology-based hazard perception interventions for young drivers. MethodsA three-round Delphi technique was used to reach consensus among eighteen experts in the fields of driver education and road safety. Three rounds of successive questionnaires were distributed, progressively integrating feedback and prioritizing intervention characteristics. Consensus was measured via interquartile ranking, interquartile ranking deviation, and percentage frequencies. ResultsIn round 1, participants achieved consensus on all but two of the proposed 18 characteristics. In round 2, all statements but one reached consensus. In round 3, participants ranked the characteristics in order of priority, achieving consensus on what and to what extent should specific aspects of a technology-based intervention be attended to, in design and implementation. ConclusionsThis study provides a guideline for the development, evaluation, and implementation of interventions to address hazard perceptions skills in young drivers. As such, our findings contribute to the development of suitable and acceptable interventions among youth, aiming to curtail this public health emergency.

Development and Validation of Enterprise Architecture (EA) Readiness Assessment Model

Enterprise architecture (EA) proves to be a holistic strategy in aligning business and information technology. An increasing number of organizations, especially in the public sector, have adopted EA in order to take advantage of the opportunities that it offers. Through EA, the efficiency of the organization is improved, with the optimization of resources and the elimination of duplication and redundancy. However, the successful establishment of EA relies on the organization’s readiness and ability to adopt EA practices because without proper readiness, the practices will probably fail. EA readiness refers to the assessment of how ready an organization is to adopt and to establish EA practices. EA readiness helps the organization to measure their stage of readiness, to identify any gaps, and then to redesign its strategy in order to adopt EA practices. EA is a merger between business and IT. Thus, the important elements of EA readiness should comprise of people, process, technology, and catalyst enabler. There is a lack of readiness for an assessment model that shapes these four elements towards EA; hence, a clear gap has been identified. Therefore, the objective of this study is to validate the EA Readiness Assessment Model (EARAM) by performing the Delphi technique. The study adopts a three-round Delphi Technique to verify the identified elements and factors and this is followed by developing and validating the proposed model. Results from the Delphi analysis have validated four (4) major elements of EARAM, namely people, process, technology, and catalyst enabler. The number of factors that contributes towards the readiness of the EA establishment is fourteen (14). It is anticipated that this model (EARAM) can help the Malaysian Public Sector (MPS) organization to identify and understand the elements and factors that must be considered when assessing the readiness to practice EA.

Expanding evaluator competency research: Exploring competencies for program evaluation using the context of non-formal education

The overlap of competencies between general program evaluation and specific contexts or content will always be reality because evaluators may need unique competencies to answer evaluation questions for particular contexts or content areas. Limited research exists that explores the essential competencies required by professionals who use evaluation as one part of their job portfolio, which leaves unanswered questions regarding the applicability of current evaluator competency models in such settings. We used a modified three-round Delphi technique to identify evaluator competencies for non-formal educators in Cooperative Extension (CE). Our panelists identified 36 competencies in the non-formal educational programming context for CE educators that they considered important to be included in evaluation capacity building efforts. We categorized our 36 identified competencies from the Delphi study into the five competency domains proposed by the American Evaluation Association. Our findings provide information to help guide professional development among non-formal educators related to program evaluation.

Development of key performance indicators to capture in measuring the impact of pharmacists in caring for patients with epilepsy in primary healthcare: A Delphi consensual study

ObjectiveThis study was conducted to develop and achieve formal consensus on a core set of key performance indicators (KPIs) that can be captured in measuring the impact of pharmacists in caring for patients with epilepsy (PWE) visiting epilepsy clinics as outpatients in primary healthcare practice. MethodsIn this study, a comprehensive literature search and review was conducted to extract candidate KPIs. Interviews with key contacts (6 pharmacists, 2 neurologists, 3 nurses, and 3 PWE) were also conducted to supplement the inventory set of KPI candidates. A three-round Delphi technique was followed among a panel of 40 members to achieve formal consensus on a core list of KPIs. Consensual KPIs were ranked by the ratings of the panelists. ResultsThe final consensual core set contained 8 KPIs in the thematic activity areas of pharmaceutical care, medication reconciliation and best possible medication history, patient education/counseling, interprofessional patient care, competence, and performance efficiency/patient satisfaction. The KPIs related to therapy problems identified and resolved by pharmacist and provision of proactive comprehensive direct patient care by a pharmacist received significantly higher (p-value: 0.0001) scores compared to the KPI related to complaints about pharmacists received. ConclusionEight consensual KPIs to capture in measuring the impact of pharmacists in caring for PWE visiting epilepsy clinics as outpatients in primary healthcare practice were developed using the Delphi technique. If successfully adopted, implemented, captured, and analyzed, these consensual KPIs might help advance pharmaceutical care of PWE in primary healthcare practice.

Design for occupational safety and health: key attributes for organisational capability

PurposeAgainst the backdrop of the contribution of design to the occurrence of occupational injuries and illnesses in construction, design for occupational safety and health (DfOSH) is increasingly becoming prominent in the construction sector. To ensure that design interventions are safe for construction workers to build and maintain, design firms need to have the appropriate organisational capability in respect of DfOSH. However, empirical insight regarding the attributes that constitute DfOSH organisational capability is lacking. The purpose of this paper, which trailblases the subject of DfOSH organisational capability in construction, is to address two key questions: what organisational attributes determine DfOSH capability? What is the relative priority of the capability attributes?Design/methodology/approachThe study employed three iterations of expert focus group discussion and a subsequent three-round Delphi technique accompanied by the application of voting analytic hierarchy process.FindingsThe study revealed 18 capability attributes nested within six categories, namely: competence (the competence of organisation’s design staff); strategy (the consideration of DfOSH in organisation’s vision as well as the top management commitment); corporate experience (organisation’s experience in implementing DfOSH on projects); systems (systems, processes and procedures required for implementing DfOSH); infrastructure (physical, and information and communication technology resources); and collaboration (inter- and intra-organisational collaboration to implement DfOSH on projects). Whilst these categories and their nested attributes carry varying weights of importance, collectively, the competence-related attributes are the most important, followed by strategy.Originality/valueThe findings should enable design firms and other key industry stakeholders (such as the clients who appoint them) to understand designers’ DfOSH capability better. Additionally, design firms should be able to prioritise efforts/investment to enhance their DfOSH capability.

What Courses Do I Need to Teach in Order to Address Food Insecurity in Sub Saharan Africa? A Delphi Study

Sub Saharan Africa is a region that has been struggling with food insecurity for decades. Though the percentage of undernourished people in the region has decreased over the last 25 years, the actual number of undernourished people increased by more than forty million. Combatting food insecurity in the region requires an arsenal of skills, knowledge, and abilities across a broad range of disciplines. One way to target food insecurity is through education and capacity building. The purpose of this study was to identify the courses and topics that should be included in a food security (FS) graduate certificate focused on Sub Saharan Africa. Identification of the topics and courses came from faculty and professionals working in the FS field in Sub Saharan Africa. A three-round Delphi technique was conducted to accomplish the purpose of the study with a total of 63 experts. Of the original 101 topics that the expert panel proposed in Round One, 80 reached the level of agreement. Researchers grouped the topics into 28 courses. The final result of the study was 24 courses that reached the level of agreement for determining the main topics and courses that should be included in a graduate certificate focused on FS for Sub Saharan Africa

Successful recruitment and retention strategies for women health volunteers: viewpoints of the volunteers' supervisors and relevant researchers.

BackgroundWomen health volunteers (WHVs) are a link between people and healthcare workers. Despite their key role in promoting community health, strategies are rarely designed to keep them volunteering. The aim of this research was to find successful strategies to overcome barriers to recruitment and retention of the volunteers in assigned activities.Subjects and methodsA three-round online national Delphi technique was used to ask the opinions of Iranian health volunteers’ supervisors and the relevant researchers. At the first round, the participants were asked ten open-ended questions across four barriers: inadequate capability of the volunteers and trainers, inadequate acceptance of the volunteers, restrictive social norms, and organizational problems. At the second round, with the questionnaire consisting of closed-ended questions, the experts were asked to rank the feasibility of each strategy using a seven-point Likert scale. Items along with the feedback received from the second round were included in the third-round questionnaire. Strategies with a median of 6 or higher and with an interquartile range ≤1 were regarded to be feasible.ResultsConsensus was obtained on 100 of the 133 strategies. A mixture of improving group work, implementing motivation tactics, assessing the needs of people/WHVs, reforming policy, monitoring and evaluation of WHVs/trainers, mobilizing the community, empowering WHVs/trainers, rationalizing WHVs/trainers/people, improving intersectional collaboration, implementing problem-based approaches, allocating proper resources, appropriate recruitment of WHVs, using social networks, and information dissemination were found to be the effective strategies to overcome the barriers to active participation.ConclusionThe highest consensuses among experts were on implementing motivation tactics and mobilizing the community. It seems that community mobilization, incentives, and logistical supplies such as providing prizes and transportation facilities for volunteers are mechanisms that can help retain WHVs and also overcome barriers to their active participation.