Search Results (198)

Background: Family caregivers are a vital yet often under-recognized part of the healthcare system. They provide essential emotional, physical, and logistical support to individuals with illness, disability, or frailty, and their contributions improve continuity of care and reduce system strain. However, many healthcare and social service providers are not equipped to meaningfully engage caregivers as partners. In Alberta, stakeholders validated the Caregiver-Centered Care Competency Framework and identified the need for a three-tiered education model—Foundational, Advanced, and Champion—to help providers recognize, include, and support family caregivers across care settings. This paper focuses on the development and early evaluation of the Advanced Caregiver-Centered Care Education modules, designed to enhance the knowledge and skills of providers with more experience working with family caregivers. The modules emphasize how partnering with caregivers benefits not only the person receiving care but also improves provider effectiveness and supports better system outcomes. Methods: The modules were co-designed with a 154-member interdisciplinary team and grounded in the competency framework. Evaluation used the first three levels of the Kirkpatrick–Barr health workforce education model. We analyzed pre- and post-surveys from the first 50 learners in each module using paired t-tests and examined qualitative feedback and SMART goals through inductive content analysis. Results: Learners reported a high level of satisfaction with the education delivery and the knowledge and skill acquisition. Statistically significant improvements were observed in 53 of 54 pre-post items. SMART goals reflected intended practice changes across all six competency domains, indicating learners saw value in engaging caregivers as partners. Conclusions: The Advanced Caregiver-Centered Care education improved providers’ confidence, knowledge, and skills to work in partnership with family caregivers. Future research will explore whether these improvements translate into real-world practice changes and better caregiver experiences in care planning, communication, and navigation. Full article

As sustainable cultural heritage tourism increasingly demonstrates its unique value and appeal, effectively stimulating tourists’ emotional experiences and value co-creation behaviors has become a focal issue. This study investigates how multiple tourist motivations (self-enhancement, escapism, and social interaction) shape value co-creation through emotional mediators—namely aesthetic, nostalgic, and flow experiences. Data were collected from 470 valid responses from visitors to the UNESCO-listed Suzhou Classical Gardens in China and analyzed using partial least squares structural equation modeling (PLS-SEM). The results show that these emotional experiences significantly drive value co-creation behavior: self-enhancement motivation enhances all three experiences, escapism mainly promotes nostalgic and flow experiences, and social interaction primarily affects aesthetic experience. These findings clarify the psychological mechanisms through which tourists’ motivations and emotional experiences influence value co-creation behavior in cultural heritage tourism. This research advances our understanding of the motivation–experience–behavior framework and emphasizes that enhancing emotional engagement is key to fostering sustainable cultural heritage tourism practices. The study provides practical implications for designing experiences and strategies that balance visitor satisfaction with the long-term vitality of cultural heritage sites and local communities, thereby contributing to broader sustainable development goals. Full article

Background/Objectives: Early experiences can significantly influence brain development, particularly when they occur during specific time windows known as sensitive or critical periods. Therefore, the early promotion of neurodevelopmental functions is crucial in children at risk for neurodevelopmental disabilities, such as those with cerebral palsy. This article introduces AMIRA (A Multidimensional and Integrated Rehabilitation Approach), a rehabilitative framework designed for infants at risk of neurodevelopmental disabilities. Methods: AMIRA is intended to guide clinical–rehabilitation reasoning rather than prescribe a rigid sequence of predetermined activities for the child. The theoretical foundation and structure of AMIRA are presented by formalizing its criteria, objectives, tools, and intervention procedures. The framework comprises four distinct sections, each supported by adaptive strategies to facilitate access to materials and to promote play-based interactions among the child, their environment, and communication partners. Particular attention is given to optimizing both micro- and macro-environments for children with, or at risk of, co-occurring visual impairment. Each rehabilitative section includes three progressive phases: an initial observation phase, a facilitation phase to support the child’s engagement, and an active experimentation phase that gradually introduces more challenging tasks. Results: The intervention pathways in AMIRA are organized according to six core developmental domains: behavioral–emotional self-regulation, visual function, postural–motor skills, praxis, interaction and communication, and cognitive function. These are outlined in structured charts that serve as flexible guidelines rather than prescriptive protocols. Each chart presents activities of increasing complexity aligned with typical developmental milestones up to 24 months of age. For each specific ability, the corresponding habilitation goals, contextual recommendations (including environmental setup, objects, and tools), and suggested activities are provided. Conclusions: This study presents a detailed intervention approach, offering both a practical framework and a structured set of activities for use in rehabilitative settings. Further studies will explore the efficacy of the proposed standardized approach. Full article

Background/Objectives: BRIGHTLIGHT was the national evaluation of adolescent and young adult (AYA) cancer services in England. BRIGHTLIGHT results were not available when the most recent healthcare policy (NHSE service specifications for AYA Cancer) for AYA was drafted and therefore did not consider BRIGHTLIGHT findings and recommendations. We describe the co-development and delivery of a Policy Lab to expedite the implementation of the new service specification in the context of BRIGHTLIGHT results, examining the roles of multi-stakeholders to ensure service delivery is optimised to benefit AYA patients. We address the key question, “What is the roadmap for empowering different stakeholders to shape how the AYA service specifications are implemented?”. Methods: A 1-day face-to-face policy lab was facilitated, utilising a unique, user-centric engagement approach by bringing diverse AYA stakeholders together to co-design strategies to translate BRIGHTLIGHT evidence into policy and impact. This was accompanied by an online workshop and prioritisation survey, individual interviews, and an AYA patient workshop. Workshop outputs were analysed thematically and survey data quantitatively. Results: Eighteen professionals and five AYAs attended the face-to-face Policy Lab, 16 surveys were completed, 13 attended the online workshop, three professionals were interviewed, and three AYAs attended the patient workshop. The Policy Lab generated eight national and six local recommendations, which were prioritised into three national priorities: 1. Launching the service specification supported by compelling communication; 2. Harnessing the ideas of young people; and 3. Evaluation of AYA patient outcomes/experiences and establishing a national dashboard of AYA cancer network performance. An animation was created by AYAs to inform local hospitals what matters to them most in the service specification. Conclusions: Policy and research evidence are not always aligned, so when emerging evidence does not support current guidance, further exploration is required. We have shown through multi-stakeholder involvement including young people that it was possible to gain a different interpretation based on current knowledge and context. This additional insight enabled practical recommendations to be identified to support the implementation of the service specification. Full article

This study investigates the cybersecurity landscape of Aotearoa-New Zealand through a culturally grounded lens, focusing on the integration of Indigenous Māori values into cybersecurity frameworks. In response to escalating cyber threats, the research adopts a mixed-methods and interdisciplinary approach—combining surveys, focus groups, and case studies—to explore how cultural principles such as whanaungatanga (collective responsibility) and manaakitanga (care and respect) influence digital safety practices. The findings demonstrate that culturally informed strategies enhance trust, resilience, and community engagement, particularly in rural and underserved Māori communities. Quantitative analysis revealed that 63% of urban participants correctly identified phishing attempts compared to 38% of rural participants, highlighting a significant urban–rural awareness gap. Additionally, over 72% of Māori respondents indicated that cybersecurity messaging was more effective when delivered through familiar cultural channels, such as marae networks or iwi-led training programmes. Focus groups reinforced this, with participants noting stronger retention and behavioural change when cyber risks were communicated using Māori metaphors, language, or values-based analogies. The study also confirms that culturally grounded interventions—such as incorporating Māori motifs (e.g., koru, poutama) into secure interface design and using iwi structures to disseminate best practices—can align with international standards like NIST CSF and ISO 27001. This compatibility enhances stakeholder buy-in and demonstrates universal applicability in multicultural contexts. Key challenges identified include a cybersecurity talent shortage in remote areas, difficulties integrating Indigenous perspectives into mainstream policy, and persistent barriers from the digital divide. The research advocates for cross-sector collaboration among government, private industry, and Indigenous communities to co-develop inclusive, resilient cybersecurity ecosystems. Based on the UTAUT and New Zealand’s cybersecurity vision “Secure Together—Tō Tātou Korowai Manaaki 2023–2028,” this study provides a model for small nations and multicultural societies to create robust, inclusive cybersecurity frameworks. Full article

In 2022, the United Nations Global Biodiversity Framework set forth an ambitious target for “biodiversity-inclusive cities”, recognising the imperative to address biodiversity decline across all sectors, including the built environment. However, the application of this emerging concept remains limited, with few projects directly aligned with the framework’s objectives or timelines necessary for meaningful biodiversity outcomes. To address this limitation this research presents The Paddock, a 27-home regenerative development in southeastern Australia, designed to empower residents in ecological restoration and regeneration efforts. Engagement was initiated through citizen science surveys and a co-design workshop during 2015–2016. As a result, The Paddock seeks to support five focal species’ return via ecosystem-centred design principles. Utilising a mixed-methods approach, the paper documents the design process, ecological decision-making, and the evolving people–nature relationships within the community. Preliminary results indicate the anecdotal return of four targeted species alongside other local fauna. Feedback gathered from residents, combined with insights from the landowner and architect, illustrates that residing in a regenerative environment enhances ecological connections and stewardship tendencies. Ongoing long-term species monitoring will further evaluate the project’s ecological impact. This case study underscores the potential of biodiversity inclusive design (BID) in fostering biodiversity-positive and socially responsive housing developments. Full article

The adolescent years are pivotal in reproductive and sexual development and maturation, yet the experience of migration can severely disrupt this period, inhibiting young immigrants’ knowledge, access, and engagement with sexual and reproductive health (SRH) services. Further, young immigrants and minority populations often face persistent intersectional barriers, including language difficulties, cultural stigma, and systemic exclusion, that result in adverse SRH outcomes. Recent advances in SRH care, particularly in digital health and community-based interventions, show promise in improving access to culturally appropriate SRH services and information. Co-designing SRH programs with families and young immigrants to adequately acknowledge the unique cultural norms and barriers in SRH is essential in ensuring a high outreach of interventions. Shifts in traditional health policies are needed to ensure that immigrant and minority adolescents are not overlooked and that SRH programs incorporate culturally relevant content that is easily and widely accessible. Despite positive shifts, several barriers remain: limited disaggregated data on diverse populations, inadequate policy attention, and the insufficient scalability and funding of promising interventions. Future research and promotional efforts must prioritise the co-creation of SRH interventions with stakeholders and affected communities, ensuring that services are sustainable, culturally appropriate, and accessible to all adolescents. Full article

This study addresses the performance of digital platforms in enhancing ocean governance by improving communication and collaboration among stakeholders. It analyses several platforms based on their collaborative initiatives, digital tools, and ability to function as networks of knowledge. The findings show that these platforms bridge gaps between regional, national, and non-governmental organisations, promoting informed decision making. Their online presence enhances transparency and engagement, especially post-COVID-19. This study highlights the need for hybrid platforms combining informative and interactive elements to better serve both experts and the public. From this analysis, some recommendations are drawn to provide rules and design for the cooperation and co-design of a platform to foster better communication, collaboration, and sustainable ocean management practices. Full article

Introduction: Social prescribing is an innovative approach that connects individuals to community-based activities to promote well-being. This study explores the barriers and facilitators influencing older adults’ engagement in social prescribing programmes in Portugal. Methodology: A qualitative study was carried out in October 2024, in Portugal, with 16 participants aged 65 and over. Data was collected through two focus groups, each with eight participants. Data were analysed using the COM-B model (Capability, Opportunity, Motivation) to identify key factors affecting adherence. Results: The main barriers identified were physical limitations, digital exclusion, transport inaccessibility, and the urban-centric location of services. Facilitators comprised tailored activities, digital support and education, accessible venues and transport, and personalised interventions. Ongoing feedback mechanisms and familiar community settings were essential for sustained participation. Conclusions: These findings suggest that co-designed, inclusive, and locally accessible programmes can significantly enhance the involvement and well-being of older adults. Full article

The Language, Culture, and Knowledge-building through Science (LaCuKnoS) project tests and refines a model of science teaching and learning that brings together current research on the role of language in science communication, the role of cultural and community connections in science engagement, and the ways people apply science knowledge to their daily decision making. One key component of the model brings families together as co-learners and co-teachers through family learning experiences. We describe our work to promote more robust family conversations about science in our lives within an existing research practice partnership, using a two-tiered qualitative conversational analysis to compare the family conversations that result from three family engagement models: (a) family science festivals; (b) family science workshops; and (c) family science home learning. More specifically, this paper addresses the question: How do families describe and evaluate science in their lives and communities during family conversations that occur during each of these three engagement models? Discourse analysis using the appraisal dimension of systemic functional linguistics highlights the affective components of families evaluating science in their lives, as well as how each model provided unique affordances for different communicative goals. These findings are used to propose a set of design principles to guide the continued exploration of community-sustaining and family-centric models of family engagement as a key strategy for broadening science participation. Full article

Living Labs are collaborative, real-world environments for co-creating sustainable innovations that rely on trust-based engagement with local communities. However, while many studies emphasise scaling up or out of such innovations, the potential for achieving qualitative transformations in relation to local values (“scaling deep”) remains underexplored. In response, we adopted a design ethnographic approach that blended immersive, reflexive ethnographic methods with the participatory co-design characteristics of Living Labs. This approach involved closely partnering with a local community champion through participant observation and co-creation workshops embedded in the community’s daily life. Our findings show that community champions acted as co-creators and mediators, building trust and aligning Living Lab activities with local values through a relational ethic of care. By immersing the research team in day-to-day community life via shared activities and open dialogue, champions enabled situated learning about local needs, thereby facilitating “scaling deep” through mutual trust and understanding. Overall, the study demonstrates that scaling deep in Living Labs hinges on embodied researcher–community partnerships in mutual care and shared responsibility. The study contributes to the Living Lab literature by illustrating how community champions can bridge understanding about sustainable transformations through relational engagement. Full article

Purpose: Current yoga programs for cancer survivors do not meet participants’ needs and are rarely implemented in community-based settings, despite reported benefits. The aim of the current study was to implement a co-created 12-week bi-modal Hatha-based yoga program for adults diagnosed with gynecologic cancer in the community and assess the feasibility and acceptability of the program and study methods. Methods: Using a mixed methods series N-of-1 A₁BA₂ research design, participants were recruited from The Ottawa Hospital. Participants self-selected a morning or evening program, completed surveys 9 to 11 times and were interviewed post-program. The yoga instructor was interviewed post-program about her experience delivering the program. Quantitative feasibility outcomes were tracked throughout the study. Qualitative acceptability outcomes were explored during post-program semi-structured interviews. Audio and video recordings of the yoga classes and data from the instructor interview were used to assess fidelity outcomes to determine whether the protocol could be adhered to consistently. Results: Forty-one individuals were screened for eligibility and 20 consented (48.7%). Seventeen participants (85.0%) completed the final survey. Participants attended 83.1% (19.9/24) of classes with varied engagement with optional features. The instructor was 61.3% adherent to the prescribed protocol, using recommended behaviors 44.6% of the time. Participants shared barriers and facilitators that influenced the success of the trial methods and program. Conclusions: The program was well-received and trial methods were moderately successful, but refinements are warranted before a large-scale trial. Community-based yoga programs could be feasible and acceptable for women with gynecologic cancer. Full article

This study examines how climate citizens’ assemblies (CCAs) influence youth engagement, both in practice and in shaping perceptions of political “voice”, drawing on Albert O. Hirschman’s “Exit, Voice, and Loyalty” framework. Through qualitative analysis of 71 interviews, participatory workshops, and observational data across four cities—Barcelona, Bologna, Geneva, and Paris—it explores whether CCAs address youth climate activists’ demands, enable meaningful participation, and yield policy outcomes aligned with their claims. Findings reveal divergent perceptions: in Bologna, co-design with activists tended to foster trust, while Barcelona saw disillusionment due to unmet expectations. Geneva’s embedded deliberative processes strengthened institutional loyalty, whereas Paris faced skepticism as activists turned to civil disobedience. Overall, CCAs’ effectiveness hinges on inclusivity, follow-through, and communication; when perceived as tokenistic, they risk reinforcing disengagement (“exit”). The study underscores the need for embedded, responsive democratic innovations to sustain youth participation amid climate crises. Full article

The latest research highlights the need for circularity in modern industrial supply chains, which is reflected in the decisions of European and global policymakers, as well as in the strategies of major stakeholders. Digital Twins are considered a principal catalyst in the transition to circularity, while real-world, accurate and timely data is a key factor in these supply chains. This emphasis on data highlights the central role of data analytics in extracting key insights and utilizing machine learning to propose sustainability initiatives in decentralized production ecosystems. In consequence, commercial solutions are being developed; however, a single solution might not address all requirements. In this work we present a comprehensive modular, scalable and secure analytics architecture, designed to expand the available components in commercial solutions by providing an intelligent layer to Digital Twins. Our approach integrates with the latest standards for international data spaces, interoperability and process models in distributed environments where multiple actors engage in co-opetition. The proposed architecture is implemented in a market-ready solution and demonstrated in two case studies, in Spain and in Greece. Validation results confirm that the analytics service delivers accurate, timely and actionable insights, while following open communication standards and sustainability guidelines. Our research indicates that companies implementing digital twin solutions using standardized connectors for interoperability can benefit by customizing the proposed solution and avoiding complex developments from scratch. Full article

This conceptual paper presents a framework for supporting multilingual students’ mathematical discourse through teacher professional development grounded in design-based research (DBR). Drawing on sociocultural learning theory, the Integrated Language and Mathematics Project (ILMP) was co-developed with elementary educators to promote integrated instruction that simultaneously advances students’ mathematical understanding, language development, and cultural identity. The ILMP framework centers around three instructional pillars: attention to language, attention to mathematical thinking, and cultural responsiveness. Through collaborative inquiry cycles, educators engaged as learners, contributors, and designers of practice, iteratively enacting and reflecting on instructional strategies rooted in students’ linguistic and cultural assets. Teachers implemented discussion-rich mathematical tasks, supported by language scaffolds and culturally relevant contexts, to foster students’ mathematical reasoning and communication. This approach was particularly impactful for multilingual learners, whose language use and problem-solving strategies were both valued and elevated. This paper also discusses the opportunities and challenges of DBR and research–practice partnerships, including flexibility in implementation and navigating district-level priorities. Insights underscore the importance of practitioner agency, asset-based pedagogy, and the co-construction of professional learning. The ILMP framework offers a scalable, equity-oriented model for improving integrated language and mathematics instruction in diverse elementary classrooms and beyond. Full article