Live Long and Educate

Using the lenses of Vygotskian constructivism, situated cognition, the antecedents of flow, and a pedagogy interwoven with the multiliteracy framework, the authors present a COVID-19 simulation game. The game has multiple levels, challenges, disrupters, and allows for student player groups to work together (i.e., collaborate within and across player groups) to achieve the strategic objectives of the game. The player groups have an overall goal to minimize loss of life, while other parameters need to be optimized, depending on the stakeholder group that the player group is role-playing. While the game can be digitized, it is presented in a manner that allows instructors to implement the game simulation right away in their classrooms. Assessment rubrics, decision matrix templates, and debriefing notes are provided to allow for student learners to reflect on their decisions (based on course concepts) both individually and as a player group.

Integrating palliative care and heart failure: a protocol for a realist synthesis (PalliatHeartSynthesis)

IntroductionHeart failure affects over 26 million people worldwide with prevalence expected to grow due to an ageing global population. Palliative care can address the holistic needs of patients with heart failure, and integrated palliative care in heart failure management has been indicated to improve outcomes for patients. Despite known benefits for integrated palliative care in heart failure management, implementation is poor across the majority of global health services. Recent systematic reviews have identified the benefits of integrating palliative care into heart failure management and highlighted barriers to implementation. However, there was heterogeneity in terms of countries, healthcare settings, delivery by differing staff across multidisciplinary teams, modes of delivery and different intervention components.Methods and analysisThe aim of this study is to identify how integrated palliative care and heart failure interventions produce desired outcomes, in which contexts, and for which patients. We will undertake a realist synthesis to identify this, using Pawson’s five iterative steps. We will recruit an international stakeholder group comprised of healthcare providers and patients with heart failure to advise and provide feedback throughout the review. Our initial realist programme theory sets out the necessary steps needed to accomplish the final intended outcome(s) from the implementation of integrated palliative care and heart failure. This initial programme theory will be shaped through an iterative process of testing and refinement.Ethics and disseminationEthical approval is not required for this study. With our stakeholder group, we will coproduce a user guide that outlines practical advice to optimise, tailor and implement interventions designed to integrate palliative care and heart failure, taking into consideration local context, alongside user-friendly summaries of the synthesis findings using short animations to convey complex findings. We will draw on the expertise within the stakeholder group to identify key stakeholders for disseminating to relevant audiences, ensuring outputs are tailored for their respective needs.PROSPERO registration numberCRD42021240185.

A Review of Digital Health Design Approaches: Challenges Towards Real World Implementation (Preprint)

BACKGROUND Digital health represents an important strategy in the future of healthcare delivery. Over the past decade, mHealth has accelerated the agency of healthcare users. Despite prevailing excitement about the potential of digital health, questions remain on efficacy, uptake, usability and patience outcome. This challenge is confounded by two industries, DIGITAL and HEALTH, that have vastly different approaches to research, design, testing and implementation. In this regard, there is a need to examine prevailing design approaches, to weigh their benefits and challenges towards implementation, and to recommend a path forward that synthesises the needs of this complex stakeholder group. OBJECTIVE This review studies prominent digital health intervention (DHI) design approaches mediating the digital health space. In doing so, we seek to examine each methodology’s: origins, perceived benefits, contrasting nuances, challenges, and typical use-case scenarios. METHODS A narrative synthesis approach to literature review was employed to review existing evidence. We searched indexed scientific literature using keywords relative to different digital health intervention designs. Papers selected after screening were those that discussed the design and implementation of digital health design approaches. RESULTS 120 papers on intervention design were selected for full-text review. We selected the 20 most prominent papers on each design approach, synthesizing findings under the categories of origins, advantages, disadvantages, challenges and cases. CONCLUSIONS Digital health is experiencing the growing pains of rapid expansion. Currently, numerous design approaches are being implemented in order to harmonise the needs of a complex stakeholder group. Whether the primary stakeholder is positioned as the end-user/person/human/patient, the challenge to synthesise the constraints and affordances of both digital design and healthcare, built equally around user satisfaction and clinically efficacy remains paramount. Further research that works towards a transdisciplinarity in digital health may help to break down friction in this field. Until digital health is viewed as a hybridised industry with unique requirements rather than competing interests, the nuances that each design approach posits will be difficult to realise in a real world context. We encourage the collaboration of digital and health experts within hybrid design teams, through all stages of intervention design, in order to create a better digital health culture and design ethos.

Understanding Resident, Family, and Staff Safety Priorities to Guide Development of an Engagement Toolkit

Resident and family engagement (the desire, ability, and activation as a partner in care) is a necessary component of keeping assisted living (AL) residents safe. Barriers to engagement include differing priorities between the resident/family and staff. This presentation outlines the results of a content analysis of qualitative interviews with 105 AL staff, residents, and family members, in which we examined AL stakeholder priorities for safety. Qualitative interviews were analyzed to first identify safety priorities by stakeholder type (staff, resident, and families), and then compared across stakeholder group. Stakeholder-specific safety priorities were identified, including infection management (COVID-19 and others), medications errors, falls, elopement, lack of AL resources/staffing, conflict, adverse events, nutrition, physical hazards, building security, chemical agents, fire/natural disasters, and abuse/neglect – the importance of these priorities vary by stakeholder type. Presentation discussion will include implications for future intervention to address the top safety problems in AL.

In the Eye of the Beholder: The Impact of Intergenerational Programs from the Perspectives of Their Different Stakeholders

Since most evaluations of intergenerational programs (IGPs) focus on the perspective of a single stakeholder group concerning the benefit for themselves, we compared perceptions of multiple stakeholders: older adults, younger adults, and IGP organizers concerning the impact of IGPs on older and young participants. Using a mixed-methods approach, we collected data from thirteen community-based IGPs. The quantitative analyses included a comparison of the different stakeholder groups via ANOVAs and chi-square analyses. In order to identify the reasons for different attribution ratings among stakeholders, we conducted a qualitative analysis of the stakeholders’ comments and responses to open-ended questions using a thematic analysis approach. Overall, participants rated benefits to themselves lower than attributed to them by their counterparts. Differences in ratings may be explained by differences in expectations and needs, cognitive dissonance, as well as a lack of awareness about other participants’ experiences. Given the discrepancies in perception of impact, it is vital to seek input from all stakeholders in order to understand their respective needs and expectations, construct a balanced evaluation, and improve IGP processes and outcomes. Studying a single stakeholder group for project evaluation is likely to provide only one perspective, whereas including all points of view provides a more complete picture.

Stakeholder Involvement in Evaluation: Does it Affect Observers’ Perceptions of an Evaluation? And Which Stakeholder Group(s) Do People Think Should to Participate?

Background Stakeholders are often involved in evaluation, such as in the selection of specific research questions and the interpretation of results. Except for the topic of whether stakeholder involvement increases use, a paucity of research exists to guide practice regarding stakeholders. Objectives We address two questions: (1) If a third-party observer knows stakeholders were involved in an evaluation, does that affect the perceived credibility, fairness, and relevance of the evaluation? (2) Among individuals with a possible stake in an evaluation, which stakeholder group(s) do they want to see participate; in particular, do they prefer that multiple stakeholder groups, rather than a single group, participate? Research Design Six studies are reported. All studies address the former question, while Studies 3 to 5 also focus on the latter question. To study effects of stakeholder involvement on third-party views, participants read summaries of ostensible evaluations, with stakeholder involvement noted or not. To examine a priori preferences among potential stakeholders, participants completed a survey about alternative stakeholder group involvement in an evaluation in which they would likely have an interest. Results and Conclusions Across studies, effects of reported stakeholder participation on third-parties’ views were not robust; however, small effects on perceived fairness sometimes, but not always, occurred after stakeholder involvement and its rationales had been made salient. All surveys showed a large preference for the involvement of multiple, rather than single stakeholder groups. We discuss implications for research and practice regarding stakeholder involvement, and for research on evaluation more generally.

Re-thinking Women's Sport Research: Looking in the Mirror and Reflecting Forward

Despite decades of research and advocacy—women's professional sports continue to be considered second class to men's sports. The goal of this paper is to rethink how we state, present, and solve problems in women's sport. To affect true change, the wisdom of a broad stakeholder group was embraced such that varied perspectives could be considered. A three-question survey was developed to examine what key constituents believe is working in women's sports, what they believe the salient challenges are for women's sport, and how they would prioritize the next steps forward in the post-pandemic sport landscape. Results indicated siloed differences of opinion based upon the age and role of the stakeholder in the women's sport ecosystem. We discuss the implications and offer recommendations as to how we as scholars might recalibrate our approach to women's sport scholarship to maximize the impact of our research and affect change.

“Through their eyes, I can work” – rural physicians' perceptions about mobile phone use among community health workers – a qualitative analysis

PurposePhysicians who are primary care providers in rural communities form an essential stakeholder group in rural mobile health (mHealth) delivery. This study was exploratory in nature and was conducted in Udupi district of Karnataka, India. The purpose of this study is to examine the perceptions of rural medical officers (MOs) (rural physicians) regarding the benefits and challenges of mobile phone use by community health workers (CHWs).Design/methodology/approachIn-depth interviews were conducted among 15 MOs belonging to different primary health centers of the district. Only MOs with a minimum five years of experience were recruited in the study using purposive and snowball sampling. This was followed by thematic analysis of the data collected.FindingsThe perceptions of MOs regarding the CHWs' use of mobile phones were largely positive. However, they reported the existence of some challenges that limits the potential of its full use. The findings were categorized under four themes namely, benefits of mobile phone use to CHWs, benefits of mobile phone-equipped CHWs, current mobile phone use by CHWs and barriers to CHWs' mobile phone use. The significant barriers reported in the CHWs' mobile phone use were poor mobile network coverage, technical illiteracy, lack of consistent technical training and call and data expense of the CHWs. The participants recommend an increased number of mobile towers, frequent training in mobile phone use and basic English language for the CHWs as possible solutions to the barriers.Originality/valueStudies examining the perceptions of doctors who are a primary stakeholder group in mHealth as well as in the public health system scenario are limited. To the authors’ knowledge, this is one of the first studies to examine the perception of rural doctors regarding CHWs' mobile phone use for work in India.

IEEE P7001: A Proposed Standard on Transparency

This paper describes IEEE P7001, a new draft standard on transparency of autonomous systems1. In the paper, we outline the development and structure of the draft standard. We present the rationale for transparency as a measurable, testable property. We outline five stakeholder groups: users, the general public and bystanders, safety certification agencies, incident/accident investigators and lawyers/expert witnesses, and explain the thinking behind the normative definitions of “levels” of transparency for each stakeholder group in P7001. The paper illustrates the application of P7001 through worked examples of both specification and assessment of fictional autonomous systems.