REducing Delay through edUcation on eXacerbations (REDUX) shows promise in reducing exacerbation recognition and action delays for chronic lung diseases in the Netherlands. However, factors influencing its successful implementation in China remain unclear. To identify the perceived factors influencing nurse-led self-management implementation of REDUX in China, stakeholder analysis using qualitative and quantitative approaches was conducted. A qualitative approach assessed support for REDUX, perceived influencing factors, and referred intervention delivery mode among patients, healthcare professionals, and policymakers. A quantitative approach identified necessary conditions for developing and implementing a digital-version intervention, involving app developers and cyber-security officers. The study followed COREQ and stakeholder analysis guidelines. Thirty-five patients, healthcare professionals, and policymakers highly supported REDUX. Perceived influencing factors included facilitators (e.g., easy-to-use design, perceived benefits) and barriers (e.g., patients’ affordability, lack of policy support). Preferred intervention delivery modes varied among stakeholders. Eighty-seven app developers and cyber-security officers completed quantitative surveys. The quantitative data showed that the work process of developing the health apps and protecting the users’ security and privacy mostly aligned with the related international guideline recommendations. The study identified key interdependent factors that were perceived as crucial for REDUX implementation success. Healthcare policies should prioritize self-management intervention, and minor action plan adjustments are needed.
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Background: In implementation science, vast gaps exist between theoretical and practical knowledge. These gaps prevail in the process of getting from problem analysis to selecting implementation strategies while engaging stakeholders including care users. Objective: To describe a process of how to get from problem analysis to strategy selection, how to engage stakeholders, and to provide insights into stakeholders’ experiences. Design: A qualitative descriptive design. Setting and participants: The setting was a care organization providing long-term care to people with acquired brain injuries who are communication vulnerable. Fourteen stakeholders (care users, professionals and researchers) participated. Data were collected by a document review, five interviews and one focus group. Inductive content analysis and deductive framework analysis were applied. Intervention: Stakeholder engagement. Main outcome measures: A three-step process model and stakeholders experiences. Results and conclusion: We formulated a three-step process: (a) reaching consensus and prioritizing barriers; (b) categorizing the prioritized barriers and idealization; and (c) composing strategies. Two subthemes continuously played a role in how stakeholders were engaged during the process: communication supportive strategies and continuous contact. The experiences of stakeholder participation resulted in the following themes: stakeholders and their roles, use of co-creation methods and communication supportive strategies, building relationships, stimulus of stakeholders to engage, sharing power, empowerment of stakeholders, feeling a shared responsibility and learning from one another. We conclude that the inclusion of communicationvulnerable care users is possible if meetings are prepared, communication-friendly presentations and reports are used, and relationship building is prioritized.
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While sustainability of transport projects is of increasing importance, the concept of sustainability can be understood in many different ways by the stakeholders that are involved in or affected by mobility projects. In this paper, we compare the outcomes of the assessment of sustainability of projects through a multi-criteria analysis (MCA) and the appraisal of stakeholder preferences through the multi-actor multi-criteria analysis (MAMCA). Evaluating projects with both tools and comparing the outcomes can provide insight into the stakeholder support of sustainable solutions and the sustainability of alternatives preferred by stakeholders. The sustainability of projects is assessed through 16 criteria grouped under the three pillars of sustainability. They were selected by in-depth review of 16 case studies of mobility projects, 18 transport evaluation schemes and the ranking of potential criteria by 214 stakeholders in North-West Europe. These criteria were weighted by 93 representatives of decision makers in the mobility domain. Stakeholder preferences were appraised through the criteria identified for each stakeholder group. We illustrate the framework by evaluating alternative solutions to improve cycling connections between the towns of Tilburg and Waalwijk in the Netherlands. The results of the comparison show that stakeholder preferences are biased towards one or two of the sustainability pillars (economy, environment, society) in three ways: through the selection of the criteria by the stakeholders, the weights of each criterion by each stakeholder group and differences in the final ranking of alternatives between the stakeholder groups and the MCA.
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The goal of a local energy community (LEC) is to create a more sustainable, resilient, and efficient energy system by reducing dependence on centralized power sources and enabling greater participation and control by local communities and individuals. LEC requires transformations in local energy systems, and strongly depends on the preferences and actions of the local actors involved. The necessity for extensive stakeholder involvement adds complexity to the energy transition, posing a significant challenge for all involved parties. The municipality of Leidschendam-Voorburg has committed to the national decision for energy transition. It has taken a strategic approach by proceeding De Heuvel/Amstelwijk as the pioneer in this initiative, leading the way for other neighborhoods to follow. It is crucial to devise strategies that effectively facilitate stakeholder engagement. To this end, a thorough stakeholder analysis is needed. Such an analysis can focus on the identification of key stakeholders, their interests, their influence, and their behavioral characteristics in relation to the energy transition. Additionally, it's crucial to uncover the challenges encountered by these stakeholders and finally develop appropriate strategies to address them hence enhance their engagement. This thesis begins with an introduction to the research background, including a presentation of the case study and a statement of the problem identified in the field, followed by the research questions underpinning the study. A thorough literature review ensues, providing a robust synthesis of existing research relating to stakeholder engagement in LECs, with a view to expediting energy transitions. The literature review not only forms the foundation for the research methods adopted in this study but also promotes in the construction of the conceptual model. Subsequent to the literature review, the research method is detailed. The filed research is conducted in five steps: Step 1 - identification of stakeholders, Step 2 - prioritization of stakeholders, Step 3 - interviewing, Step 4 - data analysis, including stakeholder profiling with mapping and addressing challenges, and finally, Step 5 - proposal of strategies for stakeholder engagement enhancement based on the expected and current levels of stakeholders engagement. This research collects necessary information to understand the profiles of stakeholders in De Heuvel/Amstelwijk, tackle challenges faced by different stakeholders, propose strategies to increase stakeholders engagement. It not only aims to enrich the depth of theoretical knowledge on the subject matter but also strives to aid in the development of a localized energy strategy that is optimally suited for the De Heuvel/Amstelwijk neighborhood as good example for other neighborhoods.
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Stakeholder engagement in Environmental Impact Assessment (EIA) and Health Impact Assessment (HIA) provides opportunities for inclusive environmental decision-making contributing to the attainment of agreement about the potential environmental and health impacts of a plan. A case evaluation of stakeholder engagement was carried out to assess its effect in terms of consensus-building. The case consisted in two health impact scoping workshops engaging 20 stakeholders: policy-makers, experts and residents. A Participatory Action Research approach was adopted. Methods included observation, semi-structured questionnaires and interviews. Analysis methods consisted of several coding rounds, in-depth reading and discussion of Atlas.ti output reports, as well as studying questionnaire results. Participants reported a broadening of perspectives on health in relation to the environment and attainment of shared perspectives. Still, meaningful differences remained, indicating that joint learning experiences, trust and mutual respect created a ‘sense of consensus’ rather than a joint view on the issues at stake. To avoid disappointment and conflict in later project development, explicit acknowledgment and acceptance of disagreements should be included as a ground rule in future stakeholder engagement processes.
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The first Stakeholder Network Meeting of the EU Horizon 2020-funded ONTOX project was held on 13-14 March 2023, in Brussels, Belgium. The discussion centred around identifying specific challenges, barriers and drivers in relation to the implementation of non-animal new approach methodologies (NAMs) and probabilistic risk assessment (PRA), in order to help address the issues and rank them according to their associated level of difficulty. ONTOX aims to advance the assessment of chemical risk to humans, without the use of animal testing, by developing non-animal NAMs and PRA in line with 21st century toxicity testing principles. Stakeholder groups (regulatory authorities, companies, academia, non-governmental organisations) were identified and invited to participate in a meeting and a survey, by which their current position in relation to the implementation of NAMs and PRA was ascertained, as well as specific challenges and drivers highlighted. The survey analysis revealed areas of agreement and disagreement among stakeholders on topics such as capacity building, sustainability, regulatory acceptance, validation of adverse outcome pathways, acceptance of artificial intelligence (AI) in risk assessment, and guaranteeing consumer safety. The stakeholder network meeting resulted in the identification of barriers, drivers and specific challenges that need to be addressed. Breakout groups discussed topics such as hazard versus risk assessment, future reliance on AI and machine learning, regulatory requirements for industry and sustainability of the ONTOX Hub platform. The outputs from these discussions provided insights for overcoming barriers and leveraging drivers for implementing NAMs and PRA. It was concluded that there is a continued need for stakeholder engagement, including the organisation of a 'hackathon' to tackle challenges, to ensure the successful implementation of NAMs and PRA in chemical risk assessment.
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The origins of SWOT analysis have been enigmatic, until now. With archival research, interviews with experts and a review of the available literature, this paper reconstructs the original SOFT/SWOT approach, and draws potential implications. During a firm's planning process, all managers are asked to write down 8 to 10 key planning issues faced by their units. Each manager grades, with evidence, these issues as either safeguarding the Satisfactory; opening Opportunities; fixing Faults; or thwarting Threats: hence SOFT (which is later merely relabeled to Strengths, Weaknesses, Opportunities and Threats, or SWOT). Subgroups of managers have several dialogues about these issues with the instruction to include the needs and expectations of all the firm's stakeholders. Their developed resolutions or proposals become input for the executive planning committee to articulate corporate purpose(s) and strategies. SWOT's originator, Robert Franklin Stewart, emphasized the crucial role that creativity plays in the planning process. The SOFT/SWOT approach curbs mere top-down strategy making to the benefit of strategy alignment and implementation; Introducing digital means to parts of SWOT's original participative, long-range planning process, as suggested herein, could boost the effectiveness of organizational strategizing, communication and learning. Archival research into the deployment of SOFT/SWOT in practice is needed.
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Electric vehicles have penetrated the Dutch market, which increases the potential for decreased local emissions, the use and storage of sustainable energy, and the roll-out and use of electric car-sharing business models. This development also raises new potential issues such as increased electricity demand, a lack of social acceptance, and infrastructural challenges in the built environment. Relevant stakeholders, such as policymakers and service providers, need to align their values and prioritize these aspects. Our study investigates the prioritization of 11 Dutch decision-makers in the field of public electric vehicle charging. These decision-makers prioritized different indicators related to measurements (e.g., EV adoption rates or charge point profitability), organization (such as fast- or smart-charging), and developments (e.g., the development of mobility-service markets) using the best-worst method. The indicators within these categories were prioritized for three different scenario's in time. The results reveal that priorities will shift from EV adoption and roll-out of infrastructure to managing peak demand, using more sustainable charging techniques (such as V2G), and using sustainable energy towards 2030. Technological advancements and autonomous charging techniques will become more relevant in a later time period, around 2040. Environmental indicators (e.g., local emissions) were consistently valued low, whereas mobility indicators were valued differently across participants, indicating a lack of consensus. Smart charging was consistently valued higher than other charging techniques, independent of time period. The results also revealed that there are some distinct differences between the priorities of policymakers and service providers. Having a systematic overview of what aspects matter supports the policy discussion around EVs in the built environment.
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Cities’ sustainability strategies seem to aim at the reduction of the negative impacts of urban freight transport. In the past decades, many public and private initiatives have struggled to gain broad stakeholder support and thus remain viable. Researchers and practitioners have only recently recognised stakeholder acceptance of urban freight solutions as a challenge. A first step in achieving convergence is to understand stakeholder needs, preferences and viewpoints. This paper proposes and applies an approach to identify the main stakeholder perspectives in the domain of urban freight transport. We use Q-methodology, which originates from social sciences and psychology, to record subjective positions and identify the dominant ones. We explain the approach, operationalise the method for the domain of urban freight transport and apply it to stakeholder groups in the Netherlands. We find four dominant perspectives, reflecting how stakeholders normally take positions in the urban freight dialogue. Important findings concern disparities between industry associations and some of their membership, divergent views about the expected role of public administration, and the observation that the behaviour of shippers and Logistics Service Providers (LSP) appears to be inconsistent with their beliefs. All these factors together can act as a barrier to the implementation of urban freight consolidation concepts. The Q-methodology is valuable for eliciting perspectives in urban freight and is a promising tool to facilitate stakeholder dialogue and, eventually, convergence.
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Insider ethnographic analysis is used to analyze change processes in an engineering department. Distributed leadership theory is used as conceptual framework.
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