Doctor interaction behavior, patient participation in value co-creation and patient satisfaction: cross-sectional survey in a tertiary-level hospital from Guangzhou, China.

Value co-creation can be defined as the joint benefit that is created by patients and medical service providers through the integration of their respective resources. Participation and interaction between doctors and patients can generate an outcome that benefits both sides. Relevant studies of value co-creation in the healthcare field are limited. This study established hypotheses to explore the association between doctor interaction behavior, patient participation in value co-creation, and patient satisfaction. A cross-sectional survey was conducted with 637 patients (outpatients and inpatients) at a tertiary-level hospital in Guangzhou, China. The analysis result indicated that doctor interaction behavior could stimulate patient participation in value co-creation then increase patient satisfaction. The standardized total effect, direct effect, and indirect effect were 0.641 (95%CI: 0.055 ~ 0.067), 0.546 (95%CI: 0.044 ~ 0.059), and 0.095 (95%CI: 0.032 ~ 0.166), respectively. Patient participation in value co-creation mediated the relationship between doctor interaction behavior and patient satisfaction. Among the different dimensions of doctor interaction behavior, access, risk assessment and transparency dimensions were associated with positive patient participation in value co-creation. During the treatment process, doctor interaction and patient participation can get satisfying results.

Protocol of a randomized controlled trial into guided internet-delivered cognitive behavioral therapy for insomnia in autistic adults (i-Sleep Autism).

BACKGROUND: Sleep problems, especially insomnia, are prevalent among autistic adults, affecting about 60 %, and significantly impact their quality of life. Internet-based cognitive behavioral therapy for insomnia (iCBT-I) could provide accessible and scalable treatment. Given the unique sensory- and information processing, and social challenges at play in autism, a tailored treatment approach may be essential to tackle sleep problems. Yet, interventions developed and tested specifically for autistic adults were scarce. Addressing this gap is crucial to meet the urgent need for effective insomnia treatments in this population. METHODS: With this two-arm, parallel, superiority randomized controlled trial, we will assess the effectiveness of a guided iCBT-I intervention for adults (N = 160) with autism and insomnia (i-Sleep Autism). In co-creation, i-Sleep Autism has been adjusted from an existing intervention (i-Sleep). Inclusion criteria are: age ≥ 18, an ASD diagnosis, and at least sub-threshold insomnia (Insomnia Severity Index ≥10). Participants are randomly assigned to either i-Sleep Autism or an information only waitlist control condition (online psychoeducation and sleep hygiene). After 6 weeks, the control group receives the intervention. Insomnia severity is the primary outcome. Secondary outcomes include pre-sleep arousal, general mental health, depression, anxiety, daily functioning, and quality of life. Assessments will occur at baseline, mid-intervention (3 weeks), post-intervention (6 weeks), and at 6-month follow-up (the intervention group). Linear mixed-effect regression models are employed to evaluate the effectiveness of i-Sleep Autism, alongside exploration of potential moderators and mediators. CONCLUSION: This trial can reveal whether autistic adults with insomnia benefit from a guided e-health intervention. TRIAL REGISTRATION: NL-OMON56692.

How doctors can lead the way in their communities: Co-creation, the Indian community and organ donation registration.

BACKGROUND AND AIMS: Transplant success rates can increase when organs and tissues are matched within ethnic communities, but how well are the processes around organ donation understood by discrete ethnic communities in Australia? We investigated this in relation to one ethnic group, the Australian-Indian community in Sydney. METHODS: A culturally appropriate survey and dissemination strategy was co-created with Indian community members through an Advisory Panel. Items were informed by a thematic analysis of cultural beliefs shared through the advisory panel discussions and measured awareness and practices associated with organ donation and transplantation and beliefs about organ donation and registration. Donation information was provided at the end. RESULTS: Two hundred and thirty-eight participants completed the survey. Hinduism along with Tamil and Gujarati were the most frequently identified religious and cultural backgrounds. The processes around organ donation were not well known, and Australian Organ Donor Register registration rates were below the national average. Principal component analysis revealed positive, social, medical trust, concerns, and cardiac and brain death belief factors. Doctors played a key role in generating trust in the donation system, decisions about organ donation were embedded in family and community, and family discussion was related to increased registration. Registered participants reported higher scores on medical trust beliefs, which also predicted family discussion. CONCLUSION: The information needed to understand the process of organ donation and registration in Australia is not embedded in this community, highlighting the need for programmes to be tailored to each culturally diverse community rather than culturally diverse communites in general. Doctors and the advisory panels are pivotal in this process.

Problematic Social Media Use Among Italian Midadolescents: Protocol and Rationale of the SMART Project.

BACKGROUND: Social media (SM) use constitutes a large portion of midadolescents' daily lives as a way of peer interaction. A significant percentage of adolescents experience intense or problematic social media use (PSMU), an etiologically complex behavior potentially associated with psychological distress. To date, studies longitudinally testing for risk or protective factors of PSMU, and collecting qualitative data are still scarce among midadolescents. Self-help interventions specifically targeting PSMU in this population and involving midadolescents in co-creation are needed. OBJECTIVE: The 2-year SMART multicenter project aims to (1) advance knowledge on PSMU; (2) co-design an unguided self-help app for promoting awareness and functional SM use; and (3) test feasibility and provide preliminary findings on its effectiveness to further improve and adapt the app. METHODS: The SMART project is organized in 3 phases: phase 1 will focus on knowledge advancement on PSMU and its risk and protective factors using a longitudinal design; phase 2 will explore adolescents perspectives using qualitative approach and will co-design an unguided self-help app for reducing PSMU, which will be evaluated and adapted in phase 3. Around 1500 midadolescents (aged 14-18 years) will be recruited in northern, central, and southern Italy to investigate the potential intra- and interpersonal psychological risk and protective factors for PSMU and define specific PSMU profiles and test for its association with psychological distress. Subjective (self-report) PSMU's psychosocial risk or protective factors will be assessed at 3 different time points and Ecological Momentary Assessment (EMA) will be used. Moreover, focus groups will be performed in a subsample of midadolescents to collect the adolescents' unique point of view on PSMU and experiences with SM. Those previous results will inform the self-help app, which will be co-designed through working groups with adolescents. Subsequently, the SMART app will be deployed and adapted, after testing its feasibility and potential effectiveness in a pilot study. RESULTS: The project is funded by the Italian Ministry of University and Research as part of a national grant (PRIN, "Progetti di Rilevante Interesse Nazionale"). The research team received an official notice of research funding approval in July 2023 (Project Code 2022LC4FT7). The project was preregistered on Open Science Framework, while the ethics approval was obtained in November 2023. We started the enrollments in December 2023, with the final follow-up data to be collected within May 2025. CONCLUSIONS: The innovative aspects of the SMART project will deepen the conceptualization of PSMU and of its biopsychosocial antecedents among midadolescents, with relevant scientific, technological, and socioeconomic impacts. The advancement of knowledge and the developed self-help app for PSMU will timely respond to midadolescents' increased loneliness and psychological burden due to COVID-19 pandemic and humanitarian crisis. TRIAL REGISTRATION: OSF Registries; https://osf.io/2ucnk/. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/58739.

The Googling Effect on patient co-creation in physiotherapy service exchange.

We study the process of value co-creation in physiotherapist-patient relationships and the underlying mechanisms of this process. We present the Googling Effect Model outlining the relationship between patients' pre-encounter online information search and their commitment to compliance in physiotherapy service exchange. We tested the model on a sample of physiotherapy service patients (n = 446) in the United States. We analyzed the collected responses using the partial least squares method, using SmartPLS 4.0. Our study contributes to the existing body of knowledge in several ways. We developed and tested the Googling Effect Model. Doing so adds to the healthcare literature on value co-creation in physiotherapy. The Googling Effect Model increases the predictive value of the Service-Dominant Logic as it outlines the mechanism underlying value co-creation in healthcare, including the role and importance of pre-encounter online information search in collaborative healthcare. Moreover, the findings illustrate how the underlying mechanism through which pre-encounter online information search affects commitment to compliance differs between men and women and different ethnic groups. These findings can be used to create an environment that increases service engagement and commitment to compliance by accounting for patients' gender and ethnicity.

Adult co-creators' emotional and psychological experiences of the co-creation process: a Health CASCADE scoping review protocol.

BACKGROUND: There is a growing investment in the use of co-creation, reflected by an increase in co-created products, services, and interventions. At the same time, a growing recognition of the significance of co-creators' experience can be detected but there is a gap in the aggregation of the literature with regard to experience. Therefore, the purpose of this scoping review is to uncover the breadth of existing empirical research on co-creation experience, how it has been defined and assessed, and its key emotional and psychological characteristics in the context of co-created products, services, or interventions among adults. METHODS: The development of the search strategy was guided by the research question, Arksey, and O'Malley's scoping review methodology guidelines, and through collaboration with members of the Health CASCADE consortium. The results of the search and the study inclusion process will be reported in full and presented both narratively and by use of the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review (PRISMA-ScR) flow diagram. Comprehensive searches of relevant electronic databases (e.g. Scopus) will be conducted to identify relevant papers. Snowball searches to identify additional papers through included full-text papers will be done using the artificial intelligence tool, namely, Connected Papers. All review steps will involve at least two reviewers. Studies in English, Dutch, Chinese, Spanish, and French, published from the year 1970 onwards, will be considered. Microsoft Excel software will be used to record and chart extracted data. DISCUSSION: The resulting scoping review could provide useful insights into adult co-creators' experience of participating in the co-creation process. An increased understanding of the role of emotional and psychological experiences of participating in co-creation processes may help to inform the co-creation process and lead to potential benefits for the co-creators and co-created outcome. SYSTEMATIC REVIEW REGISTRATION: 10.5281/zenodo.7665851.

Feasibility, acceptability and preliminary evaluation of a user co-facilitated psychoeducational programme: a feasibility proof-of-concept randomised control trial.

BACKGROUND: Mental health settings are increasingly using co-facilitation of educational group interventions in collaboration with patient partners and service users. However, despite promising results, limited information is available regarding the feasibility and satisfaction levels of these programmes among adults newly diagnosed with attention-deficit hyperactivity/impulsivity disorder (ADHD). Hence, this study aimed to determine the feasibility, acceptability, and preliminary effects of a user co-facilitated psychoeducational group programme for adults diagnosed with ADHD. METHODS: This feasibility proof-of-concept randomised controlled trial recruited outpatients from a Norwegian community mental health centre. Outpatients randomised to the intervention group (IG) received a psychoeducational programme supplementing Treatment As Usual (TAU), while the control group received TAU. Feasibility was determined by the acceptance rate, adherence rate, and dropout rate. Acceptability was measured with the Client Satisfaction Questionnaire and a 3-item scale measuring satisfaction with the received information. To test the preliminary effects, self-efficacy, symptom severity, and quality of life were measured at baseline and pre- and post-intervention. RESULTS: Feasibility was demonstrated; most of the patients were willing to enrol, participants attended 82% of the psychoeducational programme, and only 13% dropped out of the study. The between-group analyses revealed that the IG reported significantly greater mean satisfaction than the CG. Moreover, the intervention group was more satisfied with the information they received during the psychoeducational programme. Concerning the preliminary effects, the linear mixed model showed improvement in quality of life (the subscale relationship); however, other patient-reported outcomes did not show improvements. CONCLUSIONS: This proof-of-concept randomised controlled trial supports the feasibility and acceptability of the user co-facilitated psychoeducational programme for patients newly diagnosed with ADHD in an outpatient setting. While preliminary findings indicate promise in enhancing patient-reported outcomes, a larger study is warranted to assess the intervention's effectiveness rigorously. TRIAL REGISTRATION: NCT03425, 09/11/2017.

Citizen involvement in research on technological innovations for health, care or well-being: a scoping review.

Citizen science can be a powerful approach to foster the successful implementation of technological innovations in health, care or well-being. Involving experience experts as co-researchers or co-designers of technological innovations facilitates mutual learning, community building, and empowerment. By utilizing the expert knowledge of the intended users, innovations have a better chance to get adopted and solve complex health-related problems. As citizen science is still a relatively new practice for health and well-being, little is known about effective methods and guidelines for successful collaboration. This scoping review aims to provide insight in (1) the levels of citizen involvement in current research on technological innovations for health, care or well-being, (2) the used participatory methodologies, and (3) lesson's learned by the researchers.A scoping review was conducted and reported in accordance with the PRISMA-ScR guidelines. The search was performed in SCOPUS in January 2021 and included peer-reviewed journal and conference papers published between 2016 and 2020. The final selection (N = 83) was limited to empirical studies that had a clear focus on technological innovations for health, care or well-being and involved citizens at the level of collaboration or higher. Our results show a growing interest in citizens science as an inclusive research approach. Citizens are predominantly involved in the design phase of innovations and less in the preparation, data-analyses or reporting phase. Eight records had citizens in the lead in one of the research phases.Researcher use different terms to describe their methodological approach including participatory design, co-design, community based participatory research, co-creation, public and patient involvement, partcipatory action research, user-centred design and citizen science. Our selection of cases shows that succesful citizen science projects develop a structural and longitudinal partnership with their collaborators, use a situated and adaptive research approach, and have researchers that are willing to abandon traditional power dynamics and engage in a mutual learning experience.

Co-creating a yoga program for women diagnosed with gynecologic cancer: a consensus study.

PURPOSE: Yoga may be uniquely suited to address bio-psycho-social concerns among adults with gynecologic cancer because it can be tailored to individuals' needs and can help shift focus inward towards self-reflection, body appreciation, and gratitude. This study describes the collaborative process guided by the Knowledge-to-Action framework used to develop a yoga program for adults diagnosed with gynecologic cancer and inform a feasibility trial. METHODS: In 3 collaborative phases, yoga instructors and women diagnosed with gynecologic cancer formulated recommendations for a yoga program and evaluated the co-created program. RESULTS: The program proposed is 12 weeks in length and offers two 60-min group-based Hatha yoga classes/week to five to seven participants/class, online or in person, with optional supplemental features. Overall, participants deemed the co-created program and instructor guidebook to be reflective of their needs and preferences, though they provided feedback to refine the compatibility, performability, accessibility, risk precautions, and value of the program as well as the instructor guidebook. CONCLUSION: The feasibility, acceptability, and benefits of the program are being assessed in an ongoing feasibility trial. If deemed feasible and acceptable, and the potential for enhancing patient-reported outcomes is observed, further investigation will focus on larger-scale trials to determine its value for broader implementation.

Challenges and Facilitation Approaches for the Participatory Design of AI-Based Clinical Decision Support Systems: Protocol for a Scoping Review.

BACKGROUND: In the last few years, there has been an increasing interest in the development of artificial intelligence (AI)-based clinical decision support systems (CDSS). However, there are barriers to the successful implementation of such systems in practice, including the lack of acceptance of these systems. Participatory approaches aim to involve future users in designing applications such as CDSS to be more acceptable, feasible, and fundamentally more relevant for practice. The development of technologies based on AI, however, challenges the process of user involvement and related methods. OBJECTIVE: The aim of this review is to summarize and present the main approaches, methods, practices, and specific challenges for participatory research and development of AI-based decision support systems involving clinicians. METHODS: This scoping review will follow the Joanna Briggs Institute approach to scoping reviews. The search for eligible studies was conducted in the databases MEDLINE via PubMed; ACM Digital Library; Cumulative Index to Nursing and Allied Health; and PsycInfo. The following search filters, adapted to each database, were used: Period January 01, 2012, to October 31, 2023, English and German studies only, abstract available. The scoping review will include studies that involve the development, piloting, implementation, and evaluation of AI-based CDSS (hybrid and data-driven AI approaches). Clinical staff must be involved in a participatory manner. Data retrieval will be accompanied by a manual gray literature search. Potential publications will then be exported into reference management software, and duplicates will be removed. Afterward, the obtained set of papers will be transferred into a systematic review management tool. All publications will be screened, extracted, and analyzed: title and abstract screening will be carried out by 2 independent reviewers. Disagreements will be resolved by involving a third reviewer. Data will be extracted using a data extraction tool prepared for the study. RESULTS: This scoping review protocol was registered on March 11, 2023, at the Open Science Framework. The full-text screening had already started at that time. Of the 3,118 studies screened by title and abstract, 31 were included in the full-text screening. Data collection and analysis as well as manuscript preparation are planned for the second and third quarter of 2024. The manuscript should be submitted towards the end of 2024. CONCLUSIONS: This review will describe the current state of knowledge on participatory development of AI-based decision support systems. The aim is to identify knowledge gaps and provide research impetus. It also aims to provide relevant information for policy makers and practitioners. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/58185.

Understanding the influences on hospital discharge decision-making from patient, carer and staff perspectives.

BACKGROUND: Gaps in discharge planning are experienced by 41% of hospital patients in Australia. There is an established body of knowledge regarding the features of the discharge process that need to be improved to avoid subsequent hospital readmission and enhance the discharge experience. However, many of these studies have focused solely on factors related to unplanned hospital readmissions and there has been limited success in operationalising improvements to the discharge process. The aim of this study was to explore and describe the factors that influence the decision to discharge adult medical patients from hospital, from patient, carer and staff perspectives. METHODS: A qualitative descriptive study was conducted in one acute medical ward in Melbourne, Australia. The study data were collected by observations of clinical practice and semi-structured interviews with patients, carers and staff. Participants were: i) English-speaking adults identified for discharge home, ii) patient carers, and iii) staff involved in the discharge process. Observation data were analysed using content analysis and interviews data were analysed using thematic analysis. RESULTS: Twenty-one discharges were observed, and 65 participants were interviewed: 21 patients, two carers, and 42 staff. Most patients (76%) were identified as being ready for discharge during morning medical rounds, and 90% of discharge decisions were made collaboratively by the medical team and the patient. Carers were observed to be notified in 15 discharges by the patient (n = 8), doctors (n = 4), or nursing staff (n = 3). Five themes were constructed from thematic analysis of interviews: Readiness for Home, Fragmented Collaboration, Health Literacy, Unrealistic Expectations, and Care beyond Discharge. A collaborative team and supportive carers were considered to enhance risk assessment and discharge planning, however fragmented communication between clinicians, and between clinicians and patients/carers was a barrier to discharge decision-making. CONCLUSIONS: Our study highlights the need for a more coordinated approach to discharge decision-making that optimises communication with patients and carers and multidisciplinary workflows and reduces fragmentation. The importance of patient-centred care and a personalised approach to care are well established. However, there is a need to design systems to customise the entirety of the patient journey, including the approach to discharge decision making.

Co-creation in healthcare and research to improve service delivery for young people with chronic pain.

Introduction: The process of co-creation can enable more effective, agile and integrated healthcare solutions achieving outcomes that effectively translate to healthcare delivery. Collaborative knowledge generation is particularly important in fields such as pediatric chronic pain where there is a complex interplay between biological, social, environmental, emotional, familial and school factors. The co-creation initiative described here was designed to amplify the voices of youth with chronic pain and their families and a variety of key stakeholders and generate novel approaches to the management of chronic pediatric pain in the setting of the South Australian Pediatric Chronic Pain Service. Methods: Stakeholders who were identified as influential in this ecosystem were allocated to 6 groups. A skilled facilitator co-prepared and delivered the workshop, engaging participants in three structured activities. Firstly, the challenges to service delivery were outlined, followed by the groups discussing what is currently working. The second activity involved lateral thinking without restrictions on time, resources or system to generate solutions to the key challenges presented. Finally, stakeholders were asked to agree on a generated solution from Activity 2 and build a case for actionable implementation of this solution. Data were summarised by the workshop facilitator and reflexive thematic analysis was used for coding and generating themes. Results: From Activity 1, six themes collectively demonstrated that stakeholders valued many of the existing strengths of the service delivery, but some areas such as pain education was undervalued. Activity 2 generated solutions from high-level ideas to more day-to- day management strategies. Each of six groups generated unique solutions to an identified challenge for Activity 3. Discussion: Engaging a wide variety of stakeholders in collaborative knowledge generation successfully provided the South Australian Pediatric Chronic Pain Service with a variety of novel, scalable solution across the healthcare continuum. Equally important is that this initiative helped to raise awareness about the complex issues faced in pediatric chronic pain care and helped to establish new partnerships that have led to enhanced service delivery.

The Tale of Designing a Clinical-Cases Manual for Rotations and Mixed Methods Analysis of Students' Participatory Experience in Co-Creation.

Introduction: The post-pandemic era ignited the concepts of virtual learning, enhancing a strong need for a specific clinical case manual of commonly encountered scenarios in internal medicine. In this article, we describe the process for creating a clinical cases manual which can be followed for any other clinical science. Further, we report the participatory experience of students in the co-creation of manual. Methods: The hand-written notes of the teacher during the rotation of internal medicine were improvised, and created into a digital version. The editorial team which included mainly student volunteers participated in digitization and reviewing the content, diagrams and flowcharts. We describe the process of designing the clinical-cases manual for rotations in internal medicine, which includes handwritten notes, review of the notes, formation of editorial team, digitization of text and artwork, editing and book release. It can be replicated for any other clinical sciences in rotations. In addition, the online survey with both quantitative and qualitative type of questions was used to assess the students' participatory experiences in co-creating manual. Results: The clinical-cases manual for rotations in internal medicine was released and received well. The online survey responses revealed that the participating students benefited in terms of professional and personal development. There was an inter-item statistical difference implying that all the participants were agreeing or strongly agreeing to survey questions. All participants agreed on the usefulness of the manual. The main themes identified through qualitative analysis were technical skills acquisition, lifelong learning and teaching, self-assessment, discipline, time management, teamwork and communication skills. Conclusion: The creation of a clinical case manual for rotation, specific to the local needs can be done through a systematic process, that can be enriched by involving students. Encouraging the participation of students in co-creation is an important academic exercise that contributes to professional and personal development.

A project co-created with the community to mitigate loneliness in midlife women.

This paper describes how a team of researchers, policy stakeholders and community members came together to co-create prevention-oriented and community-informed solutions to address loneliness in women-The Loneliness Project. Our aim is to encourage community partnerships and collective effort to address public health approaches to loneliness by developing a shared understanding of the issue from multiple perspectives and through the co-creation process, highlighting the key factors for co-creating a funding application for a community demonstration project.

Public attitudes towards personal health data sharing in long-term epidemiological research: a Citizen Science approach in the KORA study.

BACKGROUND: Loss to follow-up in long-term epidemiological studies is well-known and often substantial. Consequently, there is a risk of bias to the results. The motivation to take part in an epidemiological study can change over time, but the ways to minimize loss to follow-up are not well studied. The Citizen Science approach offers researchers to engage in direct discussions with study participants and to integrate their opinions and requirements into cohort management. METHODS: Guided group discussions were conducted with study participants from the KORA cohort in the Augsburg Region in Germany, established 40 years ago, as well as a group of independently selected citizens. The aim was to look at the relevant aspects of health studies with a focus on long-term participation. A two-sided questionnaire was developed subsequently in a co-creation process and presented to 500 KORA participants and 2,400 employees of the research facility Helmholtz Munich. RESULTS: The discussions revealed that altruistic motivations, (i.e. supporting research and public health), personal benefits (i.e. a health check-up during a study examination), data protection, and information about research results in layman's terms were crucial to ensure interest and long-term study participation. The results of the questionnaire confirmed these aspects and showed that exclusively digital information channels may be an obstacle for older and less educated people. Thus, paper-based media such as newsletters are still important. CONCLUSIONS: The findings shed light on cohort management and long-term engagement with study participants. A long-term health study needs to benefit public and individual health; the institution needs to be trustworthy; and the results and their impact need to be disseminated in widely understandable terms and by the right means of communication back to the participants.

Establishing the importance of co-creation and self-efficacy in creative collaboration with artificial intelligence.

The emergence of generative AI technologies has led to an increasing number of people collaborating with AI to produce creative works. Across two experimental studies, in which we carefully designed and programmed state-of-the-art human-AI interfaces, we examine how the design of generative AI systems influences human creativity (poetry writing). First, we find that people were most creative when writing a poem on their own, compared to first receiving a poem generated by an AI system and using sophisticated tools to edit it (Study 1). Following this, we demonstrate that this creativity deficit dissipates when people co-create with-not edit-AI and establish creative self-efficacy as an important mechanism in this process (Study 2). Thus, our findings indicate that people must occupy the role of a co-creator, not an editor, to reap the benefits of generative AI in the production of creative works.

From Streets to Tables: Bottom-Up Co-creation Case Studies for Healthier Food Environments in Vietnam and Nigeria.

Current food systems fail to provide equity, sustainability, and positive health outcomes, thus underscoring the critical need for their transformation. Intervening in food environments holds substantial promise for contributing to this much-needed transformation. Despite scholars and practitioners often recognizing the necessity for bottom-up approaches, there is a dearth of empirical investigations evaluating the potential of these approaches to contribute to food system transformations in low- and middle-income countries (LMICs). Our study aimed to address this research gap, providing a unique perspective in this regard. Drawing on evidence from two co-creation case studies conducted with small-scale informal fruit and vegetable vendors and poor consumers in Vietnam and Nigeria from January 2020 to December 2021, we explored the relevance of bottom-up community-engaged co-creation processes in intervening within LMICs' food retail environments. Employing a mixed-methods approach that includes quantitative surveys, qualitative interviews, participatory workshops, and focus group discussions, we demonstrated that bottom-up co-creation processes involving marginalized socioeconomic groups can generate retail-level innovations that are tailored to informal retail contexts, whereas remaining aligned with established top-down theories and literature pertaining to food environments and healthy diets. We provided empirical evidence highlighting how both vendors and consumers respond positively to the co-created innovations. Expanding upon our results, we offered methodological insights applicable to interventions targeted at food environments in LMICs, and considerations for future research or development initiatives in this domain. Our findings revealed the capacity of vulnerable stakeholders to actively engage in public health initiatives and contribute to developing innovative solutions that are context-specific and conducive to the adoption of healthier dietary practices. These results confirm the potential of bottom-up, co-creation, real-world interventions within informal settings to contribute toward fostering inclusive transformation of food systems.

Synergizing stakeholder collaboration for value co-creation in China's prefabricated decoration diffusion: A tripartite evolutionary game perspective.

The emerging prefabricated decoration (PD) sector in China offers a compelling avenue for revolutionizing the construction industry, aligning with the imperatives of sustainability and industrialization. However, the outlook for the diffusion of PD in China's construction industry is less than promising. The development of PD is closely related to its value creation and the intricate interplay of stakeholder strategies and their ramifications on PD's value co-creation necessitates thorough exploration. Based on evolutionary game theory, this study elucidates the dynamic interactions among local governments, developers, and decoration contractors in China's evolving PD landscape. A tripartite evolutionary game model was established, investigating the evolutionary stable equilibriums and the corresponding strategies. Then, an empirical analysis in Chongqing City validates the game models and primary conclusions. Scrutinizing subsidy thresholds, local subsidy biases, PD proportion in prefabrication, and binary innovation allocation, the research unveils nuanced insights pertinent to boosting PD's value co-creation. Findings advocate an assembly rate threshold of subsidy (65%-70 %) and a shift towards incentivizing decoration contractors to catalyze PD adoption. Additionally, excessive PD proportion and immature product investments may hinder industry development, prompting stakeholders to recalibrate strategies dynamically. These findings characterize the mechanisms of stakeholder value co-creation during the PD diffusion, enriching the implications of value co-creation theory in the emerging industry of the construction sector. They also furnish stakeholders committed to promoting the diffusion of PD in the domestic and international construction sectors with practical strategic guidance, particularly tailored for cities in the early stages of PD development.

Asserting the visibility of social work in science.

Scientific evidence has shown that Social Work has frequently been considered a second-level discipline in the traditional sexist hierarchy, because pioneers and most social workers are women. The twofold objective of this article is to analyze the dynamics that overcome this consideration and to put forward actions to go further in the near future. The factors that limit these actions and those that make them possible are studied. This article exposes the dynamics of the current transformation of Social Work, namely, the increase in the importance of social impact in social research, the increase in interdisciplinarity, and the impact of interdisciplinary research.

Digital age: The path choice of government-citizen value co-creation.

This study explores the relationship between government and citizen in the digital age and proposes a specific path to realize the value co-creation of government and citizen in the digital age. Quantitative analysis of 40 policy texts on "digital government construction" of 30 provincial and municipal governments in China before November 2022 was conducted using NVivo12. The case of Minsheng Cloud revealed that provincial and municipal government departments have not paid sufficient attention to citizen participation. Furthermore, citizens' participation ability and enthusiasm are not high. The study found that in the process of strengthening the construction of digital government, "government optimisation", "citizen participation", "governance guarantee", "data governance" and "government digitization" are the key elements. We discuss the feasibility, necessity and coupling of the value co-creation theory to establish the benign interaction between government and citizens and realize co-creation. We find that the "DART" model can be co-created based on value, and that the continuous Improving the four aspects of "dialogue", "access", "transparency" and "risk assessment" will undoubtedly help realize the value co-creation of government and citizens in the digital era, and form a governance pattern of co-construction and sharing. It is therefore of great significance to promote the government's digital construction and digital governance capability to accelerate the construction of digital China and promote the modernisation of the national governance system and governance capability.