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Benson J, Lakeberg M, Brand T. Exploring the perspectives and practices of humanitarian actors towards the Participation Revolution in humanitarian digital health responses: a qualitative study. Global Health 2024; 20:36. [PMID: 38671505 PMCID: PMC11055264 DOI: 10.1186/s12992-024-01042-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 04/22/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND As crises escalate worldwide, there is an increasing demand for innovative solutions to enhance humanitarian outcomes. Within this landscape, digital health tools have emerged as promising solutions to tackle certain health challenges. The integration of digital health tools within the international humanitarian system provides an opportunity to reflect upon the system's paternalistic tendencies, driven largely by Global North organisations, that perpetuate existing inequities in the Global South, where the majority of crises occur. The Participation Revolution, a fundamental pillar of the Localisation Agenda, seeks to address these inequities by advocating for greater participation from crisis-affected people in response efforts. Despite being widely accepted as a best practice; a gap remains between the rhetoric and practice of participation in humanitarian response efforts. This study explores the extent and nature of participatory action within contemporary humanitarian digital health projects, highlighting participatory barriers and tensions and offering potential solutions to bridge the participation gap to enhance transformative change in humanitarian response efforts. METHODS Sixteen qualitative interviews were conducted with humanitarian health practitioners and experts to retrospectively explored participatory practices within their digital health projects. The interviews were structured and analysed according to the Localisation Performance Measurement Framework's participation indicators and thematically, following the Framework Method. The study was guided by the COREQ checklist for quality reporting. RESULTS Varied participatory formats, including focus groups and interviews, demonstrated modest progress towards participation indicators. However, the extent of influence and power held by crisis-affected people during participation remained limited in terms of breadth and depth. Participatory barriers emerged under four key themes: project processes, health evidence, technology infrastructure and the crisis context. Lessons for leveraging participatory digital health humanitarian interventions were conducting thorough pre-project assessments and maintaining engagement with crisis-affected populations throughout and after humanitarian action. CONCLUSION The emerging barriers were instrumental in shaping the limited participatory reality and have implications: Failing to engage crisis-affected people risks perpetuating inequalities and causing harm. To advance the Participation Revolution for humanitarian digital health response efforts, the major participatory barriers should be addressed to improve humanitarian efficiency and digital health efficacy and uphold the rights of crisis-affected people.
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Affiliation(s)
- Jennifer Benson
- Health Sciences Bremen, University of Bremen, Bremen, Germany.
- Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
- Leibniz Science Campus Digital Public Health, Bremen, Germany.
| | - Meret Lakeberg
- Health Sciences Bremen, University of Bremen, Bremen, Germany
- Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Tilman Brand
- Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
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Pluchinotta I, Zhou K, Moore G, Salvia G, Belesova K, Mohajeri N, Hale J, Davies M, Zimmermann N. Co-producing knowledge on the use of urban natural space: Participatory system dynamics modelling to understand a complex urban system. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2024; 353:120110. [PMID: 38325277 PMCID: PMC11129192 DOI: 10.1016/j.jenvman.2024.120110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 02/09/2024]
Abstract
Decision-makers are increasingly asked to act differently in how they respond to complex urban challenges, recognising the value in bringing together and integrating cross-disciplinary, cross-sectoral knowledge to generate effective solutions. Participatory modelling allows to bring stakeholders together, enhance knowledge and understanding of a system, and identify the impacts of interventions to a given problem. This paper uses an interdisciplinary and systems approach to investigate a complex urban problem, using a participatory System Dynamics modelling process as an approach to facilitate learning and co-produce knowledge on the factors influencing the use of urban natural space. Stakeholders used a Systems Dynamics model and interface, as a tool to collectively identify pathways for improving the use of space and simulating their impacts. Under the lens of knowledge co-production, the paper reflects how such mechanisms can lead to the co-production of knowledge and social learning. The findings also contribute to identify ways of increasing the value of urban natural space focusing on urban areas undergoing physical and social transformation, such as the Thamesmead case study, London, UK.
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Affiliation(s)
- Irene Pluchinotta
- Institute for Environmental Design and Engineering, The Bartlett Faculty of the Built Environment, University College London, London, United Kingdom.
| | - Ke Zhou
- Institute for Environmental Design and Engineering, The Bartlett Faculty of the Built Environment, University College London, London, United Kingdom
| | - Gemma Moore
- Institute for Environmental Design and Engineering, The Bartlett Faculty of the Built Environment, University College London, London, United Kingdom
| | - Giuseppe Salvia
- Institute for Environmental Design and Engineering, The Bartlett Faculty of the Built Environment, University College London, London, United Kingdom
| | - Kristine Belesova
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Nahid Mohajeri
- Institute for Environmental Design and Engineering, The Bartlett Faculty of the Built Environment, University College London, London, United Kingdom
| | - Joanna Hale
- UCL Centre for Behaviour Change, University College London, London, United Kingdom
| | - Michael Davies
- Institute for Environmental Design and Engineering, The Bartlett Faculty of the Built Environment, University College London, London, United Kingdom
| | - Nici Zimmermann
- Institute for Environmental Design and Engineering, The Bartlett Faculty of the Built Environment, University College London, London, United Kingdom
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Akinluyi EA, Greenough A, Ison K, Clarkson PJ. Applying a participatory systems and value approach in a transdisciplinary exercise: on assessing the impact of training and education initiatives. Health Syst (Basingstoke) 2023; 12:446-460. [PMID: 38235305 PMCID: PMC10791087 DOI: 10.1080/20476965.2023.2230632] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 06/16/2023] [Indexed: 01/19/2024] Open
Abstract
Participatory systems approaches are readily used in multi- and inter-disciplinary exploration of shared processes, but are less-commonly applied in trans-disciplinary efforts eliciting principles that generalise across contexts. The authors were charged with developing a transdisciplinary framework for prospectively or retrospectively assessing initiatives to improve education and training within a multifaceted organisation. A common System Impact Model (SIM) was developed in a series of workshops involving thirty participants from different disciplines, clinical specialisms, and organisations. The model provided a greater understanding of the interrelationships between factors influencing the benefits of education and training and development as seen from various stakeholder perspectives. It was used to create a system for assessing the impact of initiatives on service-users/patients, trainees, and organisations. It was shown to enable a range of participants to connect on common challenges, to maximise cross-, multi-, and inter-disciplinary learning, and to uncover new strategies for delivering value, as system designers.
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Affiliation(s)
- Emmanuel A Akinluyi
- Medical Physics Department, Guy’s & St Thomas’ NHS Foundation Trust, London, UK
| | - Anne Greenough
- Women and Children’s Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, UK
- Asthma UK Centre for Allergic Mechanisms in Asthma, King’s College London, London, UK
- NIHR Biomedical Research Centre Based at Guy’s and St Thomas’ Hospitals and King’s College London, London, UK
| | - Keith Ison
- Medical Physics Department, Guy’s & St Thomas’ NHS Foundation Trust, London, UK
| | - P John Clarkson
- Engineering Design Centre, Department of Engineering, University of Cambridge, Cambridge, UK
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Hale J, Jofeh C, Chadwick P. Decarbonising existing homes in Wales: a participatory behavioural systems mapping approach. UCL OPEN ENVIRONMENT 2022; 4:e047. [PMID: 37228458 PMCID: PMC10208331 DOI: 10.14324/111.444/ucloe.000047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 09/01/2022] [Indexed: 05/27/2023]
Abstract
To reduce carbon emissions, urgent change is needed to high-carbon human behaviours including home energy use. Previous policy failures point to insufficient integration of systemic and behavioural approaches which are too often seen as alternative and incompatible approaches to bring about change. A novel behavioural systems mapping approach was used to inform national policy recommendations for energy-saving retrofit of homes in Wales. Three participatory workshops were held with the independent Welsh residential decarbonisation advisory group ('the Advisory Group') to: (1) map relationships between actors, behaviours and influences on behaviour within the home retrofit system; (2) provide training in the Behaviour Change Wheel (BCW) framework and (3) use these to develop policy recommendations for interventions. Recommendations were analysed using the capability, opportunity and motivation (COM-B) model of behaviour to assess whether they addressed these factors. Two behavioural systems maps (BSMs) were produced, representing privately rented and owner-occupied housing tenures. The main causal pathways and feedback loops in each map are described. Necessary interventions to achieve national-scale retrofit included: government-led investment, campaigns and awareness-building, financial-sector funding mechanisms, enforcement of regulations and creating more streamlined and trusted supply chain services. Of 27 final policy recommendations, six addressed capability, 24 opportunity and 12 motivation. Participatory behavioural systems mapping can be used in conjunction with behaviour change frameworks to develop policy recommendations that address the behavioural determinants of complex environmental problems in a systemic way. Research is underway to refine and extend the approach through application to other sustainability challenges and methods of constructing systems maps.
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Affiliation(s)
- Joanna Hale
- Centre for Behaviour Change, University College London, London, UK
| | - Christopher Jofeh
- Welsh Government’s Independent Advisory Group on Residential Decarbonisation
| | - Paul Chadwick
- Centre for Behaviour Change, University College London, London, UK
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de Salas K, Scott JL, Schüz B, Norris K. The super wicked problem of ocean health: a socio-ecological and behavioural perspective. Philos Trans R Soc Lond B Biol Sci 2022; 377:20210271. [PMID: 35574852 DOI: 10.1098/rstb.2021.0271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
We are dependent on our oceans for economic, health and social benefits; however, demands on our oceans are escalating, and the state of the oceans is deteriorating. Only 2% of countries are on track to achieve the desired outcomes for the sustainable development goal (SDG 14) for the oceans by 2030, and the changes needed to prevent further degradation, or limit the impact of existing degradation, are not being undertaken fast enough. This paper uses a socio-ecological lens to explore the nature of actors and behaviours for change at the local, community, state, national and international levels, and introduces the need for technology, information- and knowledge-sharing, and policy as interconnected mediators, that work both in concert, and independently, to address the 'super wicked' problem of ocean health and to promote resilience. We recommend the need to develop transformational teams and leaders, as well as transformative policies within a holistic and integrated system to ensure ocean health initiatives are greater than the sum of their parts and are actual, realistic, achievable and evidence-informed pathways to change. This article is part of the theme issue 'Nurturing resilient marine ecosystems'.
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Goodess C, Berk S, Ratna SB, Brousse O, Davies M, Heaviside C, Moore G, Pineo H. Climate change projections for sustainable and healthy cities. BUILDINGS & CITIES 2021; 2:812-836. [PMID: 34704037 PMCID: PMC7611885 DOI: 10.5334/bc.111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The ambition to develop sustainable and healthy cities requires city-specific policy and practice founded on a multidisciplinary evidence base, including projections of human-induced climate change. A cascade of climate models of increasing complexity and resolution is reviewed, which provides the basis for constructing climate projections-from global climate models with a typical horizontal resolution of a few hundred kilometres, through regional climate models at 12-50 km to convection-permitting models at 1 km resolution that permit the representation of urban induced climates. Different approaches to modelling the urban heat island (UHI) are also reviewed-focusing on how climate model outputs can be adjusted and coupled with urban canopy models to better represent UHI intensity, its impacts and variability. The latter can be due to changes induced by urbanisation or to climate change itself. City interventions such as greater use of green infrastructure also have an effect on the UHI and can help to reduce adverse health impacts such as heat stress and the mortality associated with increasing heat. Examples for the Complex Urban Systems for Sustainability and Health (CUSSH) partner cities of London, Rennes, Kisumu, Nairobi, Beijing and Ningbo illustrate how cities could potentially make use of more detailed models and projections to develop and evaluate policies and practices targeted at their specific environmental and health priorities. PRACTICE RELEVANCE Large-scale climate projections for the coming decades show robust trends in rising air temperatures, including more warm days and nights, and longer/more intense warm spells and heatwaves. This paper describes how more complex and higher resolution regional climate and urban canopy models can be combined with the aim of better understanding and quantifying how these larger scale patterns of change may be modified at the city or finer scale. These modifications may arise due to urbanisation and effects such as the UHI, as well as city interventions such as the greater use of grey and green infrastructures.There is potential danger in generalising from one city to another-under certain conditions some cities may experience an urban cool island, or little future intensification of the UHI, for example. City-specific, tailored climate projections combined with tailored health impact models contribute to an evidence base that supports built environment professionals, urban planners and policymakers to ensure designs for buildings and urban areas are fit for future climates.
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Affiliation(s)
- Clare Goodess
- Climatic Research Unit, School of Environmental Sciences, University of East Anglia, Norwich, UK
| | - Sarah Berk
- Climatic Research Unit, School of Environmental Sciences, University of East Anglia, Norwich, UK Satyaban Bishoyi Ratna
| | - Satyaban Bishoyi Ratna
- Climatic Research Unit, School of Environmental Sciences, University of East Anglia, Norwich, UK
| | - Oscar Brousse
- The Bartlett School of Environment, Energy and Resources, Faculty of the Built Environment, University College London, London, UK
| | - Mike Davies
- The Bartlett School of Environment, Energy and Resources, Faculty of the Built Environment, University College London, London, UK
| | - Clare Heaviside
- The Bartlett School of Environment, Energy and Resources, Faculty of the Built Environment, University College London, London, UK
| | - Gemma Moore
- The Bartlett School of Environment, Energy and Resources, Faculty of the Built Environment, University College London, London, UK
| | - Helen Pineo
- The Bartlett School of Environment, Energy and Resources, Faculty of the Built Environment, University College London, London, UK
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Deloly C, Gall ARL, Moore G, Bretelle L, Milner J, Mohajeri N, Osrin D, Salvia G, Symonds P, Tsoulou I, Zimmermann N, Wilkinson P, Davies M. Relationship-building around a policy decision-support tool for urban health. BUILDINGS & CITIES 2021; 2:717-733. [PMID: 34704038 PMCID: PMC7611888 DOI: 10.5334/bc.110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Contemporary challenges linked to public health and climate change demand more effective decision-making and urban planning practices, in particular by taking greater account of evidence. In order to do this, trust-building relationships between scientists and urban practitioners through collaborative research programmes is required. Based on a policy-relevant research project, Complex Urban Systems for Sustainability and Health (CUSSH), this project aims to support the transformation of cities to meet environmental imperatives and to improve health with a quantitative health impact assessment. A case study in Rennes, France, focuses on the role of a policy decision-support tool in the production and use of knowledge to support evidence-informed decision-making. Although the primary objective of informing decision-making through evidence-based science is not fulfilled, the use of a decision-making support tool can lay the foundations for relationship-building. It can serve as a support for boundary-spanning activities, which are recognised for their effectiveness in linking science to action. This case study illustrates that the path of knowledge transfer from science to policy can be challenging, and the usefulness of using models may not be where it was thought to have been.
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Affiliation(s)
- Clément Deloly
- Department of Environmental and Occupational Health, School of Public Health (EHESP), Rennes, France
| | - Anne Roué-Le Gall
- Department of Environmental and Occupational Health, School of Public Health (EHESP), Rennes, France; UMR CNRS Arènes, Université de Rennes, Rennes, France
| | - Gemma Moore
- Institute for Environmental Design and Engineering, Bartlett School of Environment, Energy and Resources, University College London, London, UK
| | | | - James Milner
- Centre on Climate Change and Planetary Health, Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine (LSHTM), London, UK
| | - Nahid Mohajeri
- Institute for Environmental Design and Engineering, Bartlett School of Environment, Energy & Resources, University College London, London, UK
| | - David Osrin
- Institute for Global Health, University College London, London, UK
| | - Giuseppe Salvia
- Institute for Environmental Design and Engineering, Bartlett School of Environment, Energy and Resources, University College London, London, UK
| | - Phil Symonds
- Institute for Environmental Design and Engineering, Bartlett School of Environment, Energy and Resources, University College London, London, UK
| | - Ioanna Tsoulou
- Institute for Environmental Design and Engineering, Bartlett School of Environment, Energy and Resources, University College London, London, UK
| | - Nici Zimmermann
- Institute for Environmental Design and Engineering, Bartlett School of Environment, Energy and Resources, University College London, London, UK
| | - Paul Wilkinson
- Centre on Climate Change and Planetary Health & Department of Public Health, Environments & Society, London School of Hygiene & Tropical Medicine (LSHTM), London, UK
| | - Michael Davies
- Institute for Environmental Design and Engineering, Bartlett School of Environment, Energy and Resources, University College London, London, UK
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Pineo H, Zhou K, Niu Y, Hale J, Willan C, Crane M, Zimmermann N, Michie S, Liu Q, Davies M. Evidence-informed urban health and sustainability governance in two Chinese cities. BUILDINGS & CITIES 2021; 2:550-567. [PMID: 34853832 PMCID: PMC7612054 DOI: 10.5334/bc.90] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Sustainable development is best supported by intersectoral policies informed by a range of evidence and knowledge types (e.g. scientific and lay). Given China's rapid urbanisation, scale and global importance in climate mitigation, this study investigates how evidence is perceived and used to inform urban health and sustainability policies at central and local levels. Well-informed senior professionals in government/scientific agencies (12 in Beijing and 11 in Ningbo) were interviewed. A thematic analysis is presented using deductive and inductive coding. Government agency participants described formal remits and processes determining the scope and use of evidence by different tiers of government. Academic evidence was influential when commissioned by government departments. Public opinion and economic priorities were two factors that also influenced the use or weight of evidence in policymaking. This study shows that scientific evidence produced or commissioned by government was routinely used to inform urban health and sustainability policy. Extensive and routine data collection is regularly used to inform cyclical policy processes, which improves adaptive capacity. This study contributes to knowledge on the 'cultures of evidence use'. Environmental governance can be further improved through increased data-sharing and use of diverse knowledge types.
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Affiliation(s)
- Helen Pineo
- UCL Institute for Environmental Design and Engineering, The Bartlett School of Environment Energy and Resources, University College London (UCL), London, UK
| | - Ke Zhou
- UCL Institute for Environmental Design and Engineering, The Bartlett School of Environment Energy and Resources, University College London (UCL), London, UK
| | - Yanlin Niu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Joanna Hale
- Centre for Behaviour Change, University College London (UCL), London, UK
| | - Catherine Willan
- Bartlett Faculty of the Built Environment, University College London (UCL), London, UK
| | - Melanie Crane
- The Australian Prevention Partnership Centre, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Nici Zimmermann
- UCL Institute for Environmental Design and Engineering, The Bartlett School of Environment Energy and Resources, University College London (UCL), London, UK
| | - Susan Michie
- Department of Clinical, Educational and Health Psychology, University College London (UCL), London, UK
| | - Qiyong Liu
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Michael Davies
- UCL Institute for Environmental Design and Engineering, The Bartlett School of Environment Energy and Resources, University College London (UCL), London, UK
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