Objective: To construct the underlying value structure of shared decision making (SDM) models. Method: We included previously identified SDM models (n = 40) and 15 additional ones. Using a thematic analysis, we coded the data using Schwartz’s value theory to define values in SDM and to investigate value relations. Results: We identified and defined eight values and developed three themes based on their relations: shared control, a safe and supportive environment, and decisions tailored to patients. We constructed a value structure based on the value relations and themes: the interplay of healthcare professionals’ (HCPs) and patients’ skills [Achievement], support for a patient [Benevolence], and a good relationship between HCP and patient [Security] all facilitate patients’ autonomy [Self-Direction]. These values enable a more balanced relationship between HCP and patient and tailored decision making [Universalism]. Conclusion: SDM can be realized by an interplay of values. The values Benevolence and Security deserve more explicit attention, and may especially increase vulnerable patients’ Self-Direction. Practice implications: This value structure enables a comparison of values underlying SDM with those of specific populations, facilitating the incorporation of patients’ values into treatment decision making. It may also inform the development of SDM measures, interventions, education programs, and HCPs when practicing.
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Introduction: Shared decision-making is considered to be a key aspect of woman-centered care and a strategy to improve communication, respect, and satisfaction. This scoping review identified studies that used a shared decision-making support strategy as the primary intervention in the context of perinatal care. Methods: A literature search of PubMed, CINAHL, Cochrane Library, PsycINFO, and SCOPUS databases was completed for English-language studies conducted from January 2000 through November 2019 that examined the impact of a shared decision-making support strategy on a perinatal decision (such as choice of mode of birth after prior cesarean birth). Studies that only examined the use of a decision aid were excluded. Nine studies met inclusion criteria and were examined for the nature of the shared decision-making intervention as well as outcome measures such as decisional evaluation, including decisional conflict, decisional regret, and certainty. Results: The 9 included studies were heterogeneous with regard to shared decision-making interventions and measured outcomes and were performed in different countries and in a variety of perinatal situations, such as women facing the choice of mode of birth after prior cesarean birth. The impact of a shared decision-making intervention on women’s perception of shared decision-making and on their experiences of the decision-making process were mixed. There may be a decrease in decisional conflict and regret related to feeling informed, but no change in decisional certainty. Discussion: Despite the call to increase the use of shared decision-making in perinatal care, there are few studies that have examined the effects of a shared decision-making support strategy. Further studies that include antepartum and intrapartum settings, which include common perinatal decisions such as induction of labor, are needed. In addition, clear guidance and strategies for successfully integrating shared decision-making and practice recommendations would help women and health care providers navigate these complex decisions.
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In the Interreg Smart Shared Green Mobility Hubs project, electric shared mobility is offered through eHUBs in the city. eHUBs are physical places inneighbourhoods where shared mobility is offered, with the intention of changing citizens’ travel behaviour by creating attractive alternatives to private car use.In this research, we aimed to gain insight into psychological factors that influence car owners’ intentions to try out shared electric vehicles from an eHUB in order to ascertain:1. The psychological factors that determine whether car owners are willing to try out shared electric modalities in the eHUBs and whether these factors are identical for cities with different mobility contexts.2. How these insights into psychological determinants can be applied to entice car owners to try out shared electric modalities in the eHUBs.Research was conducted in two cities: Amsterdam (the Netherlands) and Leuven (Belgium). An onlinesurvey was distributed to car owners in both cities inSeptember 2020 and, additionally, interviews wereheld with 12 car owners in each city.In general, car owners from Amsterdam and Leuven seem positive about the prospect of having eHUBs in their cities. However, they show less interest inusing the eHUBs themselves, as they are satisfied with their private car, which suits their mobility needs. Car owners mentioned the following reasons for notbeing interested in trying out the eHUBs: they simply do not see a need to do so, the costs involved with usage, the need to plan ahead, the expected hasslewith registration and ‘figuring out how it works’, having other travel needs, safety concerns, having to travel a distance to get to the vehicle, and a preferencefor ownership. Car owners who indicated that they felt neutral, or that they were likely to try out an eHUB, mentioned the following reasons for doing so:curiosity, attractive pricing, convenience, not owning a vehicle like those offered in an eHUB, environmental concerns, availability nearby, and necessity when theirown vehicle is unavailable.In both cities, the most important predictor determining car owners’ intention to try out an eHUB is the perceived usefulness of trying out an eHUB.In Amsterdam, experience with shared mobility and familiarity with the concept were the second and third factors determining car owners’ interest in tryingout shared mobility. In Leuven, pro-environmental attitude was the second factor determining car owners’ openness to trying out the eHUBs, and agewas the third factor, with older car owners being less likely to try one out.Having established that perceived usefulness was the most important determinant for car owners to try out shared electric vehicles from an eHUB, weconducted additional research, which showed that, in both cities, three factors contribute to perceived usefulness, in order of relevance: (1) injunctive norms(e.g., perceiving that society views trying out eHUBs as correct behaviour); (2) trust in shared electric mobility as a solution to problems in the city (e.g., expecting private car owners’ uptake of eHUBs to contributeto cleaner air, reduce traffic jams in city, and combat climate change); and (3) trust in the quality and safety of the vehicles, including the protection of users’privacy. In Amsterdam specifically, two additional factors contributed to perceived usefulness of eHUBs: drivers’ confidence in their capacity to try out anunfamiliar vehicle from the eHUB and experience of travelling in various modes of transport.Drawing on the relevant literature, the results of our research, and our behavioural expertise, we make the following recommendations to increase car users’ uptake of shared e-mobility:1. Address car owners’ attentional bias, which filters out messages on alternative transport modes.2. Emphasise benefits of (trying out) shared mobility from different perspectives so that multiple goals can be addressed.3. Change the environment and the infrastructure, as infrastructure determines choice of transport.4. For Leuven specifically: target younger car owners and car owners with high pro-environmental attitudes.5. For Amsterdam specifically: provide information on eHUBs and opportunities for trying out eHUBs.
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-Chatbots are being used at an increasing rate, for instance, for simple Q&A conversations, flight reservations, online shopping and news aggregation. However, users expect to be served as effective and reliable as they were with human-based systems and are unforgiving once the system fails to understand them, engage them or show them human empathy. This problem is more prominent when the technology is used in domains such as health care, where empathy and the ability to give emotional support are most essential during interaction with the person. Empathy, however, is a unique human skill, and conversational agents such as chatbots cannot yet express empathy in nuanced ways to account for its complex nature and quality. This project focuses on designing emotionally supportive conversational agents within the mental health domain. We take a user-centered co-creation approach to focus on the mental health problems of sexual assault victims. This group is chosen specifically, because of the high rate of the sexual assault incidents and its lifetime destructive effects on the victim and the fact that although early intervention and treatment is necessary to prevent future mental health problems, these incidents largely go unreported due to the stigma attached to sexual assault. On the other hand, research shows that people feel more comfortable talking to chatbots about intimate topics since they feel no fear of judgment. We think an emotionally supportive and empathic chatbot specifically designed to encourage self-disclosure among sexual assault victims could help those who remain silent in fear of negative evaluation and empower them to process their experience better and take the necessary steps towards treatment early on.
Designing with the Sun is a KIEM-GoCI explorative research project on the theme Energy Transition and Sustainability. The project is aimed at network and agenda building and design research that explores new (cultural) practices of renewable energy consumption, based on a shift from ‘energy blindness’ to ‘energy awareness’. Up until now the solar industry has been propelled forward by technical innovations, offering mostly pragmatic, economic benefits to consumers. Innovation in this field mostly concerns making solar panels more efficient and less costly. However, to succeed, the energy transition also needs new cultural practices. These practices should reflect the ways renewables are different from fossil fuels. For solar, this means using more direct solar energy, when the sun is there, and being able to adapt to periods of low energy. Currently, consumers are mostly ‘blind’ to the infrastructure behind fossil-based energy. However, for energy sources such as solar and wind ‘awareness’ of their availability becomes more important. What could such an awareness look or feel like? How can it be enacted? And how can a change in practice that is more attuned to availability be experienced positively? Solar companies see opportunities in using design to help build motivating practices and narratives within the solar field, enabling awareness through personal relationships between consumer and solar energy. However, the knowledge of how to get there is lacking. In a research-through-design trajectory, and together with partners from the Creative Industries, Designing with the Sun aims to explore new ways of relating citizens to solar energy. Ultimately, these insights should enable the newly emerging field of solar design to contribute to the emergence of more sustainable and rewarding energy awareness and practices.
DISTENDER will provide integrated strategies by building a methodological framework that guide the integration of climate change(CC) adaptation and mitigation strategies through participatory approaches in ways that respond to the impacts and risks of climatechange (CC), supported by quantitative and qualitative analysis that facilitates the understanding of interactions, synergies and tradeoffs.Holistic approaches to mitigation and adaptation must be tailored to the context-specific situation and this requires a flexibleand participatory planning process to ensure legitimate and salient action, carried out by all important stakeholders. DISTENDER willdevelop a set of multi-driver qualitative and quantitative socio-economic-climate scenarios through a facilitated participatory processthat integrates bottom-up knowledge and locally-relevant drivers with top-down information from the global European SharedSocioeconomic Pathways (SSPs) and downscaled Representative Concentration Pathways (RCPs) from IPCC. A cross-sectorial andmulti-scale impact assessment modelling toolkit will be developed to analyse the complex interactions over multiple sectors,including an economic evaluation framework. The economic impact of the different efforts will be analyse, including damage claimsettlement and how do sectoral activity patterns change under various scenarios considering indirect and cascading effects. It is aninnovative project combining three key concepts: cross-scale, integration/harmonization and robustness checking. DISTENDER willfollow a pragmatic approach applying methodologies and toolkits across a range of European case studies (six core case studies andfive followers) that reflect a cross-section of the challenges posed by CC adaptation and mitigation. The knowledge generated byDISTENDER will be offered by a Decision Support System (DSS) which will include guidelines, manuals, easy-to-use tools andexperiences from the application of the cases studies.
