Persuasive games exist for a wide variety of objectives, from marketing, to healthcare and activism. Some of the more socially-aware ones cast players as members of disenfranchised minorities, such as migrants, prompting them to 'see what they see'. In parallel, a growing number of designers has recently started to leverage immersive technologies to enable the public to temporarily inhabit another person, to 'sense what they sense'. From these two converging perspectives, we hypothesize a still-uncharted space of opportunities at the crossroads of games, empathy, persuasion, and immersion. Following a Research through Design approach, we explored this space by designing A Breathtaking Journey, an embodied and multisensory mixed-reality game providing a first-person perspective of a refugee's journey. A qualitative study was conducted with a grounded theory/open coding methodology to tease out empathy-arousing characteristics, and to chart this novel game design space. As we elaborate on our analysis, we provide insights on empathic mixed-reality experiences, and conclude with offering three design opportunities: visceral engagement, reflective moments and affective appeals, to spur future research and design.
Abstract: Existing frailty models have enhanced research and practice; however, none of the models accounts for the perspective of older adults upon defining and operationalizing frailty. We aim to propose a mixed conceptual model that builds on the integral model while accounting for older adults’ perceptions and lived experiences of frailty. We conducted a traditional literature review to address frailty attributes, risk factors, consequences, perceptions, and lived experiences of older adults with frailty. Frailty attributes are vulnerability/susceptibility, aging, dynamic, complex, physical, psychological, and social. Frailty perceptions and lived experience themes/subthemes are refusing frailty labeling, being labeled “by others” as compared to “self-labeling”, from the perception of being frail towards acting as being frail, positive self-image, skepticism about frailty screening, communicating the term “frail”, and negative and positive impacts and experiences of frailty. Frailty risk factors are classified into socio-demographic, biological, physical, psychological/cognitive, behavioral, and situational/environmental factors. The consequences of frailty affect the individual, the caregiver/family, the healthcare sector, and society. The mixed conceptual model of frailty consists of interacting risk factors, interacting attributes surrounded by the older adult’s perception and lived experience, and interacting consequences at multiple levels. The mixed conceptual model provides a lens to qualify frailty in addition to quantifying it.
Aim: To evaluate healthcare professionals' performance and treatment fidelity in the Cardiac Care Bridge (CCB) nurse-coordinated transitional care intervention in older cardiac patients to understand and interpret the study results. Design: A mixed-methods process evaluation based on the Medical Research Council Process Evaluation framework. Methods: Quantitative data on intervention key elements were collected from 153 logbooks of all intervention patients. Qualitative data were collected using semi-structured interviews with 19 CCB professionals (cardiac nurses, community nurses and primary care physical therapists), from June 2017 until October 2018. Qualitative data-analysis is based on thematic analysis and integrated with quantitative key element outcomes. The analysis was blinded to trial outcomes. Fidelity was defined as the level of intervention adherence. Results: The overall intervention fidelity was 67%, ranging from severely low fidelity in the consultation of in-hospital geriatric teams (17%) to maximum fidelity in the comprehensive geriatric assessment (100%). Main themes of influence in the intervention performance that emerged from the interviews are interdisciplinary collaboration, organizational preconditions, confidence in the programme, time management and patient characteristics. In addition to practical issues, the patient's frailty status and limited motivation were barriers to the intervention. Conclusion: Although involved healthcare professionals expressed their confidence in the intervention, the fidelity rate was suboptimal. This could have influenced the non-significant effect of the CCB intervention on the primary composite outcome of readmission and mortality 6 months after randomization. Feasibility of intervention key elements should be reconsidered in relation to experienced barriers and the population. Impact: In addition to insight in effectiveness, insight in intervention fidelity and performance is necessary to understand the mechanism of impact. This study demonstrates that the suboptimal fidelity was subject to a complex interplay of organizational, professionals' and patients' issues. The results support intervention redesign and inform future development of transitional care interventions in older cardiac patients.
De afgelopen twee decennia is er veel meer aandacht ontstaan bij onderzoekers en beleidsmakers voor het begrip co-creatie. Bijna altijd wordt de rol van co-creatie als positief en essentieel gezien in een proces waarin maatschappelijke of publieke uitdagingen worden onderzocht en opgelost (zogenaamde sociale innovatie). Het meeste onderzoek naar deze twee begrippen is kwalitatief van aard en gebaseerd op ‘case studies’.In zijn promotieonderzoek kijkt Peter Broekema naar de rol van co-creatie binnen sociale innovatie in Europese samenwerkingsprojecten. In zijn eerste artikel heeft hij de begrippen co-creatie en sociale innovatie tussen 1995 en 2018 binnen de EU geanalyseerd en geconcludeerd dat beide begrippen steeds breder gebruikt worden en samen met het begrip impact zijn getransformeerd tot een beleidsparadigma.In het tweede artikel keek Peter Broekema hoe beide begrippen doorwerken in specifieke subsidieoproepen en hoe consortia deze begrippen toepassen en samenwerken. Hierbij bleek dat er weliswaar verschillende typen consortia bestaan, maar dat zij geen specifieke co-creatiestrategie hadden.In zijn laatste twee artikelen zal hij gedetailleerd kijken naar een aantal EU projecten en vaststellen hoe de samenwerking is verlopen en hoe tevreden de verschillende partners zijn met het resultaat. Peter Broekema maakt hiervoor gebruik van projecten waarin hij zelf participeert (ACCOMPLISSH, INEDIT en SHIINE).EU beleidsparadigma van sociale innovatie in combinatie met co-creatie en impact. Co-creatie vindt vaak binnen eigen type stakehodlers plaatsAbstractSocial innovation and co-creation are both relatively new concepts, that have been studied by scholars for roughly twenty years and are still heavily contested. The former emerged as a response to the more technologically focused concept of innovation and the latter originally solely described the collaboration of end-users in the development of new products, processes or services. Between 2010-2015, both concepts have been adapted and started to be used more widely by for example EU policymakers in their effort to tackle so called ‘grand societal challenges’. Within this narrative – which could be called co-creation for social innovation, it is almost a prerequisite that partners – especially citizens - from different backgrounds and sectors actively work together towards specific societal challenges. Relevance and aimHowever, the exact contribution of co-creation to social innovation projects is still unclear. Most research on co-creation has been focussing on the involvement of end-users in the development of products, processes and services. In general, scholars conclude that the involvement of end-users is effective and leads to a higher level of customer satisfaction. Only recently, research into the involvement of citizens in social innovation projects has started to emerge. However, the majority of research on co-creation for social innovation has been focusing on collaborations between two types of partners in the quadruple helix (citizens, governments, enterprises and universities). Because of this, it is still unclear what co-creation in social innovation projects with more different type of partners entails exactly. More importantly however, is that most research has been based on national case studies in which partners from different sectors collaborate in a familiar ‘national’ setting. Normally institutional and/or cultural contexts influence co-creation (for example the ‘poldermodel’in the Netherlands or the more confrontational model in France), so by looking at projects in a central EU and different local contexts it becomes clear how context effects co-creation for social innovation.Therefore this project will analyse a number of international co-creation projects that aim for social innovation with different types of stakeholders in a European and multi-stakeholder setting.With this research we will find out what people in different contexts believe is co-creation and social innovation, how this process works in different contexts and how co-creation contributes to social innovation.Research question and - sub questionsThe project will answer the following question: “What is the added value of co-creation in European funded collaboration projects that aim for social innovation?” To answer the main question, the research has been subdivided into four sub questions:1) What is the assumed added value of co-creation for social innovation?2) How is the added value of co-creation for social innovation being expressed ex ante and ex post in EU projects that aim specifically for social innovation by co-creation?3) How do partners and stakeholders envision the co-creation process beforehand and continuously shape this process in EU projects to maximise social innovation?4) How do partners and stakeholders regard the added value of co-creation for social innovation in EU projects that that aim for social innovation?Key conceptsThe research will focus on the interplay between the two main concepts a) co-creation and b) social innovation. For now, we are using the following working definitions:a) co-creation is a non-linear process that involves multiple actors and stakeholders in the ideation, implementation and assessment of products, services, policies and systems with the aim of improving their efficiency and effectiveness, and the satisfaction of those who take part in the process.b) social innovation is the invention, development and implementation of new ideas with the purpose to (immediately) relieve and (eventually) solve social problems, which are in the long run directed at the social inclusion of individuals, groups or communities.It is clear that both definitions are quite opaque, but also distinguish roughly the same phases (ideation/invention, development, implementation and assessment) and also distinguish different levels (products/services, policies and systems). Both concepts will be studied within the policy framework of the EU, in which a specific value to both concepts has been attributed, mostly because policymakers regard co-creation with universities and end-users almost as a prerequisite for social innovation. Based on preliminary research, EU policies seem to define social innovation in close reation with ‘societal impact’, which could defined as: “the long lasting effect of an activity on society, because it is aimed at solving social problems”, and therefore in this specific context social innovation seems to encompasses societal impact. For now, I will use this working definition of social innovation and will closely look at the entanglement with impact in the first outlined paper.MethodologyIn general, I will use a qualitative mixed method approach and grounded theory to answer the main research question (mRQ). In order to better understand the added value of co-creation for social innovation in an EU policy setting, the research will:SubRQ1) start with an analysis of academic literature on co-creation and social impact. This analysis will be followed by and confronted with an analysis of EU policy documents. SubRQ2) use a qualitative data analysis at nineteen EU funded projects to understand how co-creation is envisoned within social innovation projects by using the quintuple helix approach (knowledge flows between partners and stakeholders in an EU setting) and the proposed social innovation journey model. By contrasting the findings from the QDA phase of the project with other research on social innovation we will be able to find arachetypes of social innovation in relation with the (perceived) added value of co-creation within social innovation. SubRQ3) These archetypes will be used to understand the process of co-creation for social innovation by looking closely at behavioural interactions within two social innovation projects. This close examination will be carried out by carrying out interviews with key stakeholders and partners and participant observation.SubRQ4) The archetypes will also be used to understand the perceived added value by looking closely at behavioural interactions within two social innovation projects. This close examination will be carried out by carrying out interviews with key stakeholders and partners and participant observation.ImpactThe project will contribute to a better understanding of the relationship between co-creation and social innovation on different levels:a) Theoretical: the research will analyse the concepts of co-creation and social innovation in relation to each other by looking at the origins of the concepts, the adaptation in different fields and the uptake within EU policies;b) Methodological: a model will be developed to study and understand the non-lineair process of co-creation within social innovation, by focusing on social innovation pathways and social innovation strategies within a quintuple helix setting (i) academia, ii) enterprises and iii) governments that work together to improve iv) society in an v) EU setting);c) Empirical: the project will (for the first time) collect data on behavioural interactions and the satisfaction levels of these interactions between stakeholders and partners in an EU project.d) Societal: the results of the research could be used to optimize the support for social innovation projects and also for the development of specific funding calls.
This project aims to develop a measurement tool to assess the inclusivity of experiences for people with varying challenges and capabilities on the auditory spectrum. In doing so, we performed an in-depth exploration of scientific literature and findings from previous projects by Joint Projects. Based on this, we developed an initial conceptual model that focuses on sensory perception, emotion, cognition, and e[ort in relation to hearing and fatigue. Within, this model a visitor attraction is seen as an “experienscape” with four key elements: content, medium, context, and individual. In co-creative interviews with experts by experience with varying challenges on the auditory spectrum, they provided valuable insights that led to a significant expansion of this initial model. This was a relevant step, as in the scientific and professional literature, little is known about the leisure experiences of people with troubled hearing. For example, personal factors such as a person’s attitude toward their own hearing loss and the social dynamics within their group turned out to greatly influence the experience. The revised model was then applied in a case study at Apenheul, focusing on studying differences in experience of their gorilla presentation amongst people with varying challenges on the auditory spectrum.Societal issueThe Netherlands is one of the countries in Europe with the highest density of visitor attractions. Despite this abundance, many visitor attractions are not fully accessible to everyone, particularly to visitors with disabilities who sometimes are not eligible to ride due to safety concerns, yet when eligible generally still encounter numerous barriers. Accessibility of visitor attractions can be approached in various ways. However, because the focus often lies on operational and technical aspects (e.g., reducing stimuli at certain times of the day by turning o[ music, o[ering alternative wheelchair entrances), strategic and community-focused approaches are often overlooked. More importantly, there is also a lack of attention to the experience of visitors with disabilities. This becomes apparent from several studies from Joint Projects, where visitor attractions are being visited together with experts by experience with various disabilities. Nevertheless, experience is often being regarded as the 'core product' of the leisure sector. The right to meet, discover, develop, relax and thus enjoy this core product is hindered for many people with disabilities due to a lack of knowledge, inaccessibility (physical, digital, social, communicative as well as financial) and discrimination in society. Additionally, recreation entrepreneurs still face a significant gap in reaching the potential market of guests with disabilities and their networks. Thus, despite the numerous initiatives in the leisure sector aimed at improving accessibility on technical and operational fronts, often people with disabilities are still not being able to experience the same kind of enjoyment as those without. These observations form the pressing impetus for initiating the current research project, tapping into the numerous opportunities for learning, development and growth on making leisure offer more inclusive.Benefit to societyIn total, the current project approach comes with a number of enrichments in terms of both knowledge and methodology: a mixed-methods approach that allows for comparing data from different sources to obtain a more complete picture of the experience; a methodological co-design process that honours the 'nothing about us without us' principle; and benchmarking for a group (i.e., people with challenges on the auditory spectrum) that despite the size of its population has thus far mostly been overlooked.
communicative participation, language disordersOBJECTIVE(S)/RESEARCH QUESTION(S) Speech and language therapists (SLTs) are the primary care professionals to treat language and communication disorders. Their treatment is informed by a variety of outcome measures. At present, diagnosis, monitoring of progress and evaluation are often based on performance-based and clinician-reported outcomes such as results of standardized speech, language, voice, or communication tests. These tests typically aim to capture how well the person can produce or understand language in a controlled situation, and therefore only provide limited insight in the person’s challenges in life. Performance measures do not incorporate the unobservable feelings such as a patient's effort, social embarrassment, difficulty, or confidence in communication. Nor do they address language and communication difficulties experienced by the person themselves, the impact on daily life or allow patients to set goals related to their own needs and wishes. The aim of our study is give our patients a voice and empower SLTs to incorporate their patient's perspective in planning therapy. We will Aangemaakt door ProjectNet / Generated by ProjectNet: 08-12-2020 12:072Subsidieaanvraag_digitaal / Grant Application_digitaalDossier nummer / Dossier number: 80-86900-98-041DEFINITIEFdevelop a valid and reliable patient-reported outcome measure that provides information on communicative participation of people with communication disorders and integrate this item bank in patient specific goal setting in speech and language therapy. Both the item bank and the goal setting method will be adapted in cocreation with patients to enable access for people with communication difficulties.STUDY DESIGN Mixed methods research design following the MRC guidance for process evaluation of complex interventions, using PROMIS methodology including psychometric evaluation and an iterative user-centered design with qualitative co-creation methods to develop accessible items and the goal setting method.RESEARCH POPULATION Children, adolescents and adults with speech, language, hearing, and voice disorders.OUTCOME MEASURES An online patient-reported outcome measure on communicative participation, the Communicative Participation Item Bank (CPIB), CPIB items that are accessible for people with language understanding difficulties, a communicative-participation person-specific goal setting method developed with speech and language therapists and patients and tested on usability and feasibility in clinical practice, and a course for SLTs explaining the use of the goal-setting method in their clinical reasoning process.RELEVANCE This study answers one of the prioritized questions in the call for SLTs to systematically and reliably incorporate the clients’ perspective in their daily practice to improve the quality of SLT services. At present patient reported outcomes play only a small role in speech and language therapy because 1) measures (PROMS) are often invalid, not implemented and unsuitable for clinical practice and 2) there is a knowledge gap in how to capture and interpret outcomes from persons with language disorders.
