Background: Successful implementation of multifactorial fall prevention interventions (FPIs) is essential to reduce increasing fall rates in communitydwelling older adults. However, implementation often fails due to the complex context of the community involving multiple stakeholders within and across settings, sectors, and organizations. As there is a need for a better understanding of the occurring context-related challenges, the current scoping review purposes to identify what contextual determinants (i.e., barriers and facilitators) influence the implementation of FPIs in the community. Methods: A scoping reviewwas performed using the Arksey andO’Malley framework. First, electronic databases (Pubmed, CINAHL, SPORTDiscus, PsycINFO) were searched. Studies that identified contextual determinants that influence the implementation of FPIs in the community were included. Second, to both validate the findings from the literature and identify complementary determinants, health and social care professionals were consulted during consensus meetings (CMs) in four districts in the region of Utrecht, the Netherlands. Data were analyzed following a directed qualitative content analysis approach, according to the 39 constructs of the Consolidated Framework for Implementation Research. Results: Fourteen relevant studies were included and 35 health and social care professionals (such as general practitioners, practice nurses, and physical therapists) were consulted during four CMs. Directed qualitative content analysis of the included studies yielded determinants within 35 unique constructs operating as barriers and/or facilitators. The majority of the constructs (n = 21) were identified in both the studies and CMs, such as “networks and communications”, “formally appointed internal implementation leaders”, “available resources” and “patient needs and resources”. The other constructs (n = 14) were identified only in the . Discussion: Findings in this review show that awide array of contextual determinants are essential in achieving successful implementation of FPIs in the community. However, some determinants are considered important to address, regardless of the context where the implementation occurs. Such as accounting for time constraints and financial limitations, and considering the needs of older adults. Also, broad cross-sector collaboration and coordination are required in multifactorial FPIs. Additional context analysis is always an essential part of implementation efforts, as contexts may differ greatly, requiring a locally tailored approach.
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This chapter provides insights into the complex and adaptive nature of systems and illustrates key characteristics of such systems. These contribute to an understanding of the challenges in health promotion and imply a need for more context-specific research to evaluate the health promotion interventions. CARA can address this need as it can be used to evaluate and support change in complex adaptive systems. To support and inspire other health promotion researchers who want to adopt CARA as their research approach, we have discussed our experiences and provided some guiding principles. Overall, complexity thinking can help to understand the challenges in health promotion, whereby CARA provides a possible strategy for health promotion researchers when dealing with the challenges of evaluating health promotion interventions in complex adaptive systems.
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The aim of the paper is a contextual analysis of universities in the Netherlands: an analysis of the key issues and external developments, and how they affect the academic organization, the organization of academic work and the characteristics and preferences of scientists. Subsequently, we will discuss effects of these developments on the HRM system and policy (and in specific the management of talent or excellence). We will use multiple theoretical frameworks and perspectives grounded in organizational theory to describe Dutch universities and their context: structural frame, professional frame, cultural frame and political frame. Most literature discusses one aspect of the academic organization: education or research aspect, HRM aspect, financial aspect et cetera. Seldom the different aspects have been presented as one integrated entity. We want to show that using multiple frames or lenses will lead to an integrated, enriched and more balanced view of a situation.
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The pace of technology advancements continues to accelerate, and impacts the nature of systems solutions along with significant effects on involved stakeholders and society. Design and engineering practices with tools and perspectives, need therefore to evolve in accordance to the developments that complex, sociotechnical innovation challenges pose. There is a need for engineers and designers that can utilize fitting methods and tools to fulfill the role of a changemaker. Recognized successful practices include interdisciplinary methods that allow for effective and better contextualized participatory design approaches. However, preliminary research identified challenges in understanding what makes a specific method effective and successfully contextualized in practice, and what key competences are needed for involved designers and engineers to understand and adopt these interdisciplinary methods. In this proposal, case study research is proposed with practitioners to gain insight into what are the key enabling factors for effective interdisciplinary participatory design methods and tools in the specific context of sociotechnical innovation. The involved companies are operating at the intersection between design, technology and societal impact, employing experts who can be considered changemakers, since they are in the lead of creative processes that bring together diverse groups of stakeholders in the process of sociotechnical innovation. A methodology will be developed to capture best practices and understand what makes the deployed methods effective. This methodology and a set of design guidelines for effective interdisciplinary participatory design will be delivered. In turn this will serve as a starting point for a larger design science research project, in which an educational toolkit for effective participatory design for socio-technical innovation will be designed.
The tourism strategy of the municipality of Amsterdam and the Destination Management Organisation stress the importance of increasing liveabilty and enhancing a sense of unity through, also by connecting with residents. An important area in which they would like to achieve this, is Amsterdam Noord, a neighbourhood that was historically on the fringe of the city but is now appointed as one of the (to be further developed) multi-cores of the city. As such it is facing a rapid transformation on a social, cultural, economic and infrastructural level with an increasing leisure and tourism offer. The idea is to apply principles of regenerative tourism and community capacity building to ensure a sustainable tourism development, although it remains unclear how to do this in in practice. The current PD addresses this issue by investigating possible regenerative urban tourism principles and practices (here: collaborative interventions) that can be designed to increase local community building capacities, using a living lab setting in Amsterdam-Noord. It follows a participatory action research approach where the researcher is part of a living lab team and local eco system. By participating in local meet-ups as well as desk research and (group)interviews a further contextual understanding of how regenerative tourism can be conceptualised in an urban context is gained. Next, workshops, experiments and design-based interventions with local stakeholders will be done to construct different stories of place and new ways of performing tourism. The PD will contribute to knowledge development creating a conceptual framework for regenerative urban tourism. It will also provide academic and practical insights on with regards to stimulating capacity building and how to measure this within a tourism context (also in relation to co-creation and placemaking practices), what potentials can be tapped into and how small-scall collaborative interventions can influence wider system change.
