Search results for: inclusive engagement

Authors: Marutani M, Kawajiri H, Usui C, Takai Y, Kawaguchi T

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Background: To build the inclusive society, the Japanese government provides “transition support for employment system” for Persons with Disabilities (PWDs). It is, however, difficult to provide appropriate accommodations due to their changeable health conditions. Mobile phone applications (App) are useful to monitor their health conditions and their environments, and effective to improve reasonable accommodations for PWDs. Purpose: This study aimed to develop an App that PWDs input their self-assessment and make their health conditions and environment conditions visible. To attain the goal, we investigated the items of the App for the first step. Methods: Qualitative and descriptive design was used for this study. Study participants were recruited by snowball sampling in July and August 2023. They had to have had minimum of five-years of experience to support PWDs’ employment. Semi-structured interviews were conducted on their assessment regarding PWDs’ conditions of daily activities, their health conditions, and living and working environment. Verbatim transcript was created from each interview content. We extracted the following items in tree groups from each verbatim transcript: daily activities, health conditions, and living and working. Results: Fourteen participants were involved (average years of experience: 10.6 years). Based on the interviews, tree item groups were enriched. The items of daily activities were divided into fifty-five. The example items were as follows: “have meals on one’s style” “feel like slept well” “wake-up time, bedtime, and mealtime are usually fixed.” “commute to the office and work without barriers.” Thirteen items of health conditions were obtained like “feel no anxiety” “relieve stress” “focus on work and training” “have no pain” “have the physical strength to work for one day.” The items of categories of living and working environments were divided into fifteen-two. The example items were as follows: “have no barrier in home” “have supportive family members” “have time to take medication on time while at work” “commute time is just right” “people at the work understand the symptoms” “room temperature and humidity are just right” “get along well with friends in my own way.” The participants also mentioned the styles to input self-assessment like that a face scale would be preferred to number scale. Conclusion: The items were enriched existent paper-based assessment items in terms of living and working environment because those were obtained from the perspective of PWDs. We have to create the app and examine its usefulness with PWDs toward inclusive society.

Keywords: occupational health, innovatiove tool, people with disability, employment

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Authors: Ni Komang Desy Arya Pinatih

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Transnational crime is a crime with 'unique' feature because the activities benefit the lack of state monitoring on the borders so dealing with it cannot be based on conventional engagement but also need joint operation with other countries. On the other hand with the flow of globalization and the growth of information technology and transportation, states become more vulnerable to transnational crime threats especially human trafficking. This paper would examine transnational crime activities, especially human trafficking in Indonesia. With the case study on the mapping of human trafficking crime in East Java province, Indonesia, this paper would try to analyze how the difference in human trafficking crime trends at the national and sub-national levels. The findings of this research were first, there is difference in human trafficking crime trends whereas at the national level the trend is rising, while at sub-national (province) level the trend is declining. Second, regarding the decline of human trafficking number, it’s interesting to see how the method to decrease human trafficking crime in East Jawa Province in order to reduce transnational crime accounts in the region. These things are hopefully becoming a model for transnational crimes engagement in other regions to reduce human trafficking numbers as much as possible.

Keywords: transnational crime, human trafficking, southeast Asia, anticipation model on transnational crimes

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Authors: Teresa Smith, Farrah Jacquez

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Health-risk behaviors (e.g., smoking, poor diet) directly increase the risk for chronic disease and morbidity. There is substantial evidence of a negative association between socioeconomic status (SES) and engagement in health-risk behaviors. However, due to the complexity of SES, researchers have suggested looking beyond this factor to fully understand the mechanisms that underlie engagement in health-risk behaviors. Stress is one plausible mechanism through which SES impacts health-risk behaviors. Currently, it remains unclear how stress occurring across the life course might impact health behaviors and explain the association between SES and these behaviors. To address the gaps in the literature, 172 adults between the ages of 18-49 were surveyed about their lifetime stress exposure, sociodemographic variables, and health-risk behaviors via an online recruitment portal, Prolific. Five major findings emerged from the current study. First, SES was negatively associated with engagement in health-risk behaviors and lifetime stress above and beyond current stress and other relevant demographics. Second, lifetime stress was significantly associated with health-risk behaviors above and beyond current stress and relevant demographic variables. Third, lifetime stress fully mediated the association between SES and health-risk behaviors above and beyond current stress and other demographics. Fourth, the severity of stress experienced emerged as the most significant lifetime stress variable that explains the relation between SES and health-risk behaviors. Fifth and finally, lower SES and experiencing financial and legal/crime stressors increased the likelihood of engaging in health-risk behaviors. The current study results align with previous research and suggest that stress occurring over the lifespan impacts the relation between SES and health-risk behaviors, which are in turn known to impact health outcomes. However, our findings move the current literature forward by providing a more nuanced understanding of the specific aspects of stress that influence this association. Specifically, the severity of stress experienced across the entire lifespan was the most important aspect of stress when examining the association between SES and health-risk behaviors. Further, individuals most at risk for engaging in health-risk behaviors are those of the lowest SES and experience financial and legal/crime stressors. These findings have the potential to inform interventions and policies aimed at addressing health-risk behaviors by providing a more sophisticated understanding of the impact of stress.

Keywords: stress, health behaviors, socioeconomic status, health

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Authors: Victor Oyewumi Ogunbiyi

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Food waste is a global sustainability issue that demands that multiple stakeholders participate in solving it. This article examines how different food system stakeholders are held responsible in the policy debate related to food waste reduction. The study adopts a qualitative approach, paying attention to the views of both public and private policymakers and constructing their views relating to opportunities and policy initiatives towards waste reduction. The data consists of a list of opportunities and food policy initiatives in the development process in Nigeria. The authors identify three emerging opportunities: sectoral growth, technological demands in food service, and sustainable collaborative behaviour. The findings also revealed key policy initiatives for development: law and regulations, multi-stakeholder collaboration, economic incentives, research, and new knowledge. The study extends the marketing literature on food sustainability by investigating several stakeholders’ roles beyond the practical management of the food services sector. Additionally, considering policy initiative development for food waste mitigation sheds light on how stakeholders’ policy initiatives can sustain the food service sector. Finally, the authors outline policy implications.

Keywords: multistakeholder engagement, food services, food waste, policy initiatives, Nigeria

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Authors: Violet Justine Mtonga, Cecilia Diaz

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this paper explores the prevalence of loyalty programs in the UK gambling industry and their association with unintended consequences and harm amongst program members. The use of loyalty programs within the UK gambling industry has risen significantly with over 40 million cards in circulation. Some research suggests that as of 2013-2014, nearly 95% of UK consumers have at least one loyalty card with 78% being members of two or more programs, and the average household possesses ‘22 loyalty programs’, nearly half of which tend to be used actively. The core design of loyalty programs is to create a relational ‘win-win’ approach where value is jointly created between the parties involved through repetitive engagement. However, main concern about the diffusion of gambling organisations’ loyalty programs amongst consumers, might be the use by the organisations within the gambling industry to over influence customer engagement and potentially cause unintended harm. To help understand the complex phenomena of the diffusions and adaptation of the use of loyalty programs in the gambling industry, and the potential unintended outcomes, this study is theoretically underpinned by the social exchange theory of relationships entrenched in the processes of social exchanges of resources, rewards, and costs for long-term interactions and mutual benefits. Qualitative data were collected via in-depth interviews from 14 customers and 12 employees within the UK land-based gambling firms. Data were analysed using a combination of thematic and clustering analysis to help reveal and discover the emerging themes regarding the use of loyalty cards for gambling companies and exploration of subgroups within the sample. The study’s results indicate that there are different unintended consequences and harm of loyalty program engagement and usage such as maladaptive gambling behaviours, risk of compulsiveness, and loyalty programs promoting gambling from home. Furthermore, there is a strong indication of a rite of passage among loyalty program members. There is also strong evidence to support other unfavorable behaviors such as amplified gambling habits and risk-taking practices. Additionally, in pursuit of rewards, loyalty program incentives effectuate overconsumption and heighten expenditure. Overall, the primary findings of this study show that loyalty programs in the gambling industry should be designed with an ethical perspective and practice.

Keywords: gambling, loyalty programs, social exchange theory, unintended harm

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Authors: Fredrick Forster, Gareth Ward, Matthew Tubby, Pamela Lithgow, Anne Nortcliffe

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This paper presents the results from a research study of random adult participants accessing one of four different commercially available Virtual Reality (VR) Head Mounted Displays (HMDs) and completing a post user experience reflection questionnaire. The research sort to understand how inclusive commercially available VR HMDs are and identify any associated barriers that could impact the widespread adoption of the devices, specifically in Higher Education (HE). In the UK, education providers are legally required under the Equality Act 2010 to ensure all education facilities are inclusive and reasonable adjustments can be applied appropriately. The research specifically aimed to identify the considerations that academics and learning technologists need to make when adopting the use of commercial VR HMDs in HE classrooms, namely cybersickness, user comfort, Interpupillary Distance, inclusiveness, and user perceptions of VR. The research approach was designed to build upon previously published research on user reflections on presence, usability, and overall HMD comfort, using quantitative and qualitative research methods by way of a questionnaire. The quantitative data included the recording of physical characteristics such as the distance between eye pupils, known as Interpupillary Distance (IPD). VR HMDs require each user’s IPD measurement to enable the focusing of the VR HMDs virtual camera output to the right position in front of the eyes of the user. In addition, the questionnaire captured users’ qualitative reflections and evaluations of the broader accessibility characteristics of the VR HMDs. The initial research activity was accomplished by enabling a random sample of visitors, staff, and students at Canterbury Christ Church University, Kent to use a VR HMD for a set period of time and asking them to complete the post user experience questionnaire. The study identified that there is little correlation between users who experience cyber sickness and car sickness. Also, users with a smaller IPD than average (typically associated with females) were able to use the VR HMDs successfully; however, users with a larger than average IPD reported an impeded experience. This indicates that there is reduced inclusiveness for the tested VR HMDs for users with a higher-than-average IPD which is typically associated with males of certain ethnicities. As action education research, these initial findings will be used to refine the research method and conduct further investigations with the aim to provide verification and validation of the accessibility of current commercial VR HMDs. The conference presentation will report on the research results of the initial study and subsequent follow up studies with a larger variety of adult volunteers.

Keywords: virtual reality, education technology, inclusive technology, higher education

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Authors: Ambeck Celyne Tebid, Harry S. Rampa

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The South African Education system recognises the need for all learners including those experiencing learning difficulties, to have access to a single unified system of education. For teachers to be pedagogically responsive to an increasingly diverse learner population without appropriate support has been proven to be unrealistic. As such, this has considerably hampered interest amongst teachers, especially those at the foundation phase to work within an Inclusive Education (IE) and training system. This qualitative study aimed at investigating foundation phase teachers’ experiences of school-based support teams (SBSTs) in two Full-Service (inclusive schools) and one Mainstream public primary school in the Gauteng province of South Africa; with particular emphasis on finding ways to supporting them, since teachers claimed they were not empowered in their initial training to teach learners experiencing learning difficulties. Hence, SBSTs were created at school levels to fill this gap thereby, supporting teaching and learning by identifying and addressing learners’, teachers’ and schools’ needs. With the notion that IE may be failing because of systemic reasons, this study uses Bronfenbrenner’s (1979) ecosystemic as well as Piaget’s (1980) maturational theory to examine the nature of support and experiences amongst teachers taking individual and systemic factors into consideration. Data was collected using in-depth, face-to-face interviews, document analysis and observation with 6 foundation phase teachers drawn from 3 different schools, 3 SBST coordinators, and 3 school principals. Data was analysed using the phenomenological data analysis method. Amongst the findings of the study is that South African full- service and mainstream schools have functional SBSTs which render formal and informal support to the teachers; this support varies in quality depending on the socio-economic status of the relevant community where the schools are situated. This paper, however, argues that what foundation phase teachers settled for as ‘support’ is flawed; as well as how they perceive the SBST and its role is problematic. The paper conclude by recommending that, the SBST should consider other approaches at foundation phase teacher support such as, empowering teachers with continuous practical experiences on how to deal with real classroom scenarios, as well as ensuring that all support, be it on academic or non-academic issues should be provided within a learning community framework where the teacher, family, SBST and where necessary, community organisations should harness their skills towards a common goal.

Keywords: foundation phase, full- service schools, inclusive education, learning difficulties, school-based support teams, teacher support

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Authors: Justyna Żywiołek, Marek Matulewski

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The article presents the results of a survey conducted among students from various European countries. The aim of the study was to understand how artificial intelligence (AI) affects educational processes in a digital environment. The survey covered a wide range of topics, including students' understanding and use of AI, its impact on motivation and engagement, interaction and support issues, accessibility and equity, and data security and privacy concerns. Most respondents admitted having difficulties comprehending the advanced functions of AI in educational tools. Many students believe that excessive use of AI in education can decrease their motivation for self-study and active participation in classes. Additionally, students reported that interaction with AI-based tools is often less satisfying compared to direct contact with teachers. Furthermore, the survey highlighted inequalities in access to advanced AI tools, which can widen the educational gap between students from different economic backgrounds. Students also expressed concerns about the security and privacy of their personal data collected and processed by AI systems. The findings suggest that while AI has the potential to support digital education, significant challenges need to be addressed to make these tools more effective and acceptable for students. Recommendations include increasing training for students and teachers on using AI, providing more interactive and engaging forms of education, and implementing stricter regulations on data protection.

Keywords: AI, digital education, education tools, motivation and engagement

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Authors: Julian Pigott

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This paper introduces the Language Learning as a Means of Drive Engagement (LLMDE) theory, derived from a grounded theory analysis of interviews with Japanese university students. According to LLMDE theory, language learning can be understood as a means of engaging one or more of four self-fulfillment drives: the drive to expand one’s horizons (perspective drive); the drive to make a success of oneself (status drive); the drive to engage in interaction with others (communication drive); and the drive to obtain intellectual and affective stimulation (entertainment drive). While many theories of learner psychology focus on conscious agency, LLMDE theory addresses the role of the unconscious. In addition, supplementary thematic analysis of the data revealed the role of context in mediating drive engagement. Unexpected memorable events, for example, play a key role in instigating and, indirectly, in regulating learning, as do institutional and cultural contexts. Given the apparent importance of such factors beyond the immediate control of the learner, and given the pervasive role of habit and drives, it is argued that the concept of motivation merits theoretical reappraisal. Rather than an underlying force determining language learning success or failure, it can be understood to emerge sporadically in consciousness to promote behavioral change, or to protect habitual behavior from disruption.

Keywords: drives, grounded theory, motivation, significant events

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Authors: Sheila Santharamohana, Susan Bennett

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Historically, the attrition rates in secondary schools of Indigenous people or Orang Asli of Malaysia have been a cause for nationwide concern. Efforts to increase student engagement focusing on curriculum re-design and aid have not had the targeted impact. The scope of the research explored a change model incorporating project-based learning and wrap-around support through school-community partnerships to increase Orang Asli engagement, student outcomes and improve cultural connectedness. The evaluation methodology was mixed-method comprising a student questionnaire, interviews, and document analysis. Data and evidence were gathered from school staff, community, the Orang Asli governmental authority (JAKOA) and external agencies. Findings from the year-long research suggests shared values and goals in school-community partnerships foster responsive leadership and is key to safeguarding vulnerable Orang Asli, resulting in improved student outcomes. The research highlighted the barriers to the recognition and distinct needs and unique values of the Orang Asli that impact their educational equity and outcomes.

Keywords: Indigenous Education, Cultural Connectedness, School-Community Partnership, Student Outcomes

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Authors: I. Tiahi

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The aim of the current paper is to explore educational practices in contemporary Algeria. Researches explain such practices bear traditional approach and the overlooks modern teaching methods such as mobile learning. That is why the research output of examining student engagement in respect of mobile learning was obtained from the following objectives: (1) To evaluate the current practice of English language teaching within Algerian higher education institutions, (2) To explore how social constructivism theory and m-learning help students’ engagement in the classroom and (3) To explore the feasibility and acceptability of m-learning amongst institutional leaders. The methodology underpins a case study and action research. For the case study, the researcher engaged with 6 teachers, 4 institutional leaders, and 30 students subjected for semi-structured interviews and classroom observations to explore the current teaching methods for English as a foreign language. For the action research, the researcher applied an intervention course to investigate the possibility and implications for future implementation of mobile learning in higher education institutions. The results were deployed using thematic analysis. The research outcome showed that the disengagement of students in English language learning has many aspects. As seen from the interviews from the teachers, the researcher found that they do not have enough resources except for using ppt for some teacher. According to them, the teaching method they are using is mostly communicative and competency-based approach. Teachers informed that students are disengaged because they have psychological barriers. In classroom setting, the students are conscious about social approval from the peer, and thus if they are to face negative reinforcement which would damage their image, it is seen as a preventive mechanism to be scared of committing mistakes. This was also very reflective in this finding. A lot of other arguments can be given for this claim; however, in Algerian setting, it is usual practice where teachers do not provide positive reinforcement which is open up students for possible learning. Thus, in order to overcome such a psychological barrier, proper measures can be taken. On a conclusive remark, it is evident that teachers, students, and institutional leaders provided positive feedback for using mobile learning. It is not only motivating but also engaging in learning processes. Apps such as Kahoot, Padlet and Slido were well received and thus can be taken further to examine its higher impact in Algerian context. Thus, in the future, it will be important to implement m-learning effectively in higher education to transform the current traditional practices into modern, innovative and active learning. Persuasion for this change for stakeholder may be challenging; however, its long-term benefits can be reflective from the current research paper.

Keywords: Algerian context, mobile learning, social constructivism, student engagement

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Authors: Kanika Sood, Sijie Shang

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A fundamental goal of education includes preparing students to become a part of the global workforce by making beneficial contributions to society. In this paper, we analyze student performance for multiple courses that involve different teaching pedagogies: a cooperative learning technique and an inquiry-based learning strategy. Student performance includes student engagement, grades, and attendance records. We perform this study in the Computer Science department for online and in-person courses for 450 students. We will perform correlation analysis to study the relationship between student scores and other parameters such as gender, mode of learning. We use natural language processing and machine learning to analyze student feedback data and performance data. We assess the learning outcomes of two teaching pedagogies for undergraduate and graduate courses to showcase the impact of pedagogical adoption and learning outcome as determinants of academic achievement. Early findings suggest that when using the specified pedagogies, students become experts on their topics and illustrate enhanced engagement with peers.

Keywords: bag-of-words, cooperative learning, education, inquiry-based learning, in-person learning, natural language processing, online learning, sentiment analysis, teaching pedagogy

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Authors: Fan Wei, Tang Yipeng

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The outbreak of COVID-19 in early 2020 has been raging around the world, which has severely affected people's work and life. In today's post-pandemic era, although the pandemic has been effectively controlled, people still need to maintain social distancing at all times to prevent the further spread of the virus. Based on this, social distancing in the context of the pandemic has aroused widespread attention from scholars. At present, most studies exploring the influencing factors of social distancing are studying the negative impact of social distancing on the physical and mental state of special groups from the inter-individual level, and their more focus on the forced complete social distancing during the severe period of the pandemic. Few studies have focused on the impact of social distancing on working groups in the post-pandemic era from the within-individual level. In order to explore this problem, this paper constructs a cross-level moderating model based on resource conservation theory from the perspective of psychological resources. A total of 81 subjects were recruited to fill in the three-stage questionnaires each day for 10 working days, and 661valid questionnaires were finally obtained. Through the empirical tests, the following conclusions were finally obtained: (1) At the within-individual level, daily social distancing is positively correlated with the second day’s recovery, and the individual’s low sociability regulates the relationship between social distancing and recovery. The indirect effect of daily social distancing through recovery has positive relationship employees’ work engagement and work-goal progress only when the individual has low sociability. For individuals with high sociability, none of these paths are significant. (2) At the within-individual level, there is a significant relationship between individual's recovery and work engagement and work-goal progress, indicating that the recovery of resources can produce positive work outcomes. According to the results, this study believes that in the post-pandemic era, social distancing can not only effectively prevent and control the pandemic but also have positive impacts. Employees can use the time and energy originally saved for social activities through social distancing to invest in things that can provide resources and help them recover.

Keywords: social distancing, recovery, work engagement, work goal progress, sociability

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Authors: Sylvia Chan-Olmsted, Lisa-Charlotte Wolter

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With the continuous proliferation of media platforms, there have been tremendous changes in media consumption behaviors. From the perspective of sports sponsorship, while there is now a multitude of platforms to create brand associations, the changing media landscape and shift of message control also mean that sports sponsors will have to take into account the nature of and consumer responses toward these emerging digital media to devise effective marketing strategies. Utilizing the personal interview methodology, this study is qualitative and exploratory in nature. A total of 18 experts from European and American academics, sports marketing industry, and sports leagues/teams were interviewed to address three main research questions: 1) What are the major changes in digital technologies that are relevant to sports sponsorship; 2) How have digital media influenced the channels and platforms of sports sponsorship; and 3) How have these technologies affected the goals, strategies, and measurement of sports sponsorship. The study found that sports sponsorship has moved from consumer engagement, engagement measurement, and consequences of engagement on brand behaviors to micro-targeting one on one, engagement by context, time, and space, and activation and leveraging based on tracking and databases. From the perspective of platforms and channels, the use of mobile devices is prominent during sports content consumption. Increasing multiscreen media consumption means that sports sponsors need to optimize their investment decisions in leagues, teams, or game-related content sources, as they need to go where the fans are most engaged in. The study observed an imbalanced strategic leveraging of technology and digital infrastructure. While sports leagues have had less emphasis on brand value management via technology, sports sponsors have been much more active in utilizing technologies like mobile/LBS tools, big data/user info, real-time marketing and programmatic, and social media activation. Regardless of the new media/platforms, the study found that integration and contextualization are the two essential means of improving sports sponsorship effectiveness through technology. That is, how sponsors effectively integrate social media/mobile/second screen into their existing legacy media sponsorship plan so technology works for the experience/message instead of distracting fans. Additionally, technological advancement and attention economy amplify the importance of consumer data gathering, but sports consumer data does not mean loyalty or engagement. This study also affirms the benefit of digital media as they offer viral and pre-event activations through storytelling way before the actual event, which is critical for leveraging brand association before and after. That is, sponsors now have multiple opportunities and platforms to tell stories about their brands for longer time period. In summary, digital media facilitate fan experience, access to the brand message, multiplatform/channel presentations, storytelling, and content sharing. Nevertheless, rather than focusing on technology and media, today’s sponsors need to define what they want to focus on in terms of content themes that connect with their brands and then identify the channels/platforms. The big challenge for sponsors is to play to the venues/media’s specificity and its fit with the target audience and not uniformly deliver the same message in the same format on different platforms/channels.

Keywords: digital media, mobile media, social media, technology, sports sponsorship

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Authors: Kerrin Burnell

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In a world of increasingly technology-dependent students, the English language classroom should ideally keep up with developments to keep students engaged as much as possible. Unfortunately, as is the case in Oman, funding is not always adequate to ensure students have the most up to date technology, and most institutions are still reliant on paper-based textbooks. In order to try and bridge the gap between the technology available (smartphones) and textbooks, augmented reality (AR) technology can be utilized to enhance classroom, homework, and extracurricular activities. AR involves overlaying media (videos, images etc) over the top of physical objects (posters, book pages etc) and then sharing the media. This case study involved introducing students to a freely available entry level AR app called Aurasma. Students were asked to augment their English textbooks, word walls, research project posters, and extracurricular posters. Through surveys, interviews and an analysis of time spent accessing the different media, a determination of the appropriateness of the technology for the classroom was determined. Results indicate that the use of AR has positive effects on many aspects of the English classroom. Increased student engagement, total time spent on task, interaction, and motivation were evident, along with a decrease in technology-related anxiety. As it is proving very difficult to get tablets or even laptops in classrooms in Oman, these preliminary results indicate that many positive outcomes will come from introducing students to this innovative technology.

Keywords: augmented reality, classroom technology, classroom innovation, engagement

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Authors: Ehi E. Aimiuwu

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As of 2017, many researchers in educational journals are still wondering if students are effectively and efficiently engaged in active learning in the online learning environment. The goal of this qualitative single case study and narrative research is to explore if students are actively engaged in their online learning. Seven online students in the United States from LinkedIn and residencies were interviewed for this study. Eleven online learning techniques from research were used as a framework.  Data collection tools were used for the study that included a digital audiotape, observation sheet, interview protocol, transcription, and NVivo 12 Plus qualitative software.  Data analysis process, member checking, and key themes were used to reach saturation. About 85.7% of students preferred individual grading. About 71.4% of students valued professor’s interacting 2-3 times weekly, participating through posts and responses, having good internet access, and using email.  Also, about 57.1% said students log in 2-3 times weekly to daily, professor’s social presence helps, regular punctuality in work submission, and prefer assessments style of research, essay, and case study.  About 42.9% appreciated syllabus usefulness and professor’s expertise.

Keywords: class facilitation, course management, online teaching, online education, student engagement

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Authors: Teresa Carlone, Matteo Mannocchi

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In the last decade, a growing number of International Organizations are pushing toward green solutions for adaptation to climate change. This is particularly true in the field of Disaster Risk Reduction (DRR) and land planning, where Nature-Based Solutions (NBS) had been sponsored through funding programs and planning tools. Stakeholder engagement and co-creation of NBS is growing as a practice and research field in environmental projects, fostering the consolidation of a multidisciplinary socio-ecological approach in addressing hydro-meteorological risk. Even thou research and financial interests are constantly spread, the NBS mainstreaming process is still at an early stage as innovative concepts and practices make it difficult to be fully accepted and adopted by a multitude of different actors to produce wide scale societal change. The monitoring and impact evaluation of stakeholders’ participation in these processes represent a crucial aspect and should be seen as a continuous and integral element of the co-creation approach. However, setting up a fit for purpose-monitoring strategy for different contexts is not an easy task, and multiple challenges emerge. In this scenario, the Horizon 2020 OPERANDUM project, designed to address the major hydro-meteorological risks that negatively affect European rural and natural territories through the co-design, co-deployment, and assessment of Nature-based Solution, represents a valid case study to test a monitoring strategy from which set a broader, general and scalable monitoring framework. Applying a participative monitoring methodology, based on selected indicators list that combines quantitative and qualitative data developed within the activity of the project, the paper proposes an experimental in-depth analysis of the stakeholder engagement impact in the co-creation process of NBS. The main focus will be to spot and analyze which factors increase knowledge, social acceptance, and mainstreaming of NBS, promoting also a base-experience guideline to could be integrated with the stakeholder engagement strategy in current and future similar strongly collaborative approach-based environmental projects, such as OPERANDUM. Measurement will be carried out through survey submitted at a different timescale to the same sample (stakeholder: policy makers, business, researchers, interest groups). Changes will be recorded and analyzed through focus groups in order to highlight causal explanation and to assess the proposed list of indicators to steer the conduction of similar activities in other projects and/or contexts. The idea of the paper is to contribute to the construction of a more structured and shared corpus of indicators that can support the evaluation of the activities of involvement and participation of various levels of stakeholders in the co-production, planning, and implementation of NBS to address climate change challenges.

Keywords: co-creation and collaborative planning, monitoring, nature-based solution, participation & inclusion, stakeholder engagement

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Authors: Muwaffaq Usman Adam, Isaac Quaye, Jim Anbazu, Yetimoni Kpeebi, Michael Osei-Assibey

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Urban informality, characterized by spontaneous and self-organized practices, plays a significant but often overlooked role in shaping the development of cities, particularly in the context of mixed-use and compact urban environments. This paper aims to explore the invisible planning processes inherent in informal practices and their influence on the urban form of Ghanaian cities. By examining the dynamic interplay between informality and formal planning, the study will discuss the ways in which informal actors shape and plan for mixed-use and compact development. Drawing on the synthesis of relevant secondary data, the research will begin by defining urban informality and identifying the factors that contribute to its prevalence in Ghanaian cities. It will delve into the concept of mixed-use and compact development, highlighting its benefits and importance in urban areas. Drawing on case studies, the paper will uncover the hidden planning processes that occur within informal settlements, showcasing their impact on the physical layout, land use, and spatial arrangements of Ghanaian cities. The study will also uncover the challenges and opportunities associated with informal planning. It examines the constraints faced by informal planners (actors) while also exploring the potential benefits and opportunities that emerge when informality is integrated into formal planning frameworks. By understanding the invisible planner, the research will offer valuable insights into how informal practices can contribute to sustainable and inclusive urban development. Based on the findings, the paper will present policy implications and recommendations. It highlights the need to bridge the policy gaps and calls for the recognition of informal planning practices within formal systems. Strategies are proposed to integrate informality into planning frameworks, fostering collaboration between formal and informal actors to achieve compact and mixed-use development in Ghanaian cities. This research underscores the importance of recognizing and leveraging the invisible planner in Ghanaian cities. By embracing informal planning practices, cities can achieve more sustainable, inclusive, and vibrant urban environments that meet the diverse needs of their residents. This research will also contribute to a deeper understanding of the complex dynamics between informality and planning, advocating for inclusive and collaborative approaches that harness the strengths of both formal and informal actors. The findings will likewise contribute to advancing our understanding of informality's role as an invisible yet influential planner, shedding light on its spatial planning implications on Ghanaian cities.

Keywords: informality, mixed-uses, compact development, land use, ghana

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Authors: Rachel S. E. Lim, Winnie L. C. Tan

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Visual literacy is about making meaning through the interaction of images, words, and sounds. Graphic communication students typically develop visual literacy through critique and production of studio-based projects for their portfolios. However, the abrupt switch to online learning during the COVID-19 pandemic has made it necessary to consider new strategies of visualization and planning to scaffold teaching and learning. This study, therefore, investigated how MIRO, a cloud-based visual collaboration platform, could be used to develop the visual literacy confidence of 30 diploma in graphic communication students attending a graphic design course at a Singapore arts institution. Due to COVID-19, the course was taught fully online throughout a 16-week semester. Guided by Kolb’s Experiential Learning Cycle, the two lecturers developed students’ engagement with visual literacy concepts through different activities that facilitated concrete experiences, reflective observation, abstract conceptualization, and active experimentation. Throughout the semester, students create, collaborate, and centralize communication in MIRO with infinite canvas, smart frameworks, a robust set of widgets (i.e., sticky notes, freeform pen, shapes, arrows, smart drawing, emoticons, etc.), and powerful platform capabilities that enable asynchronous and synchronous feedback and interaction. Students then drew upon these multimodal experiences to brainstorm, research, and develop their motion design project. A survey was used to examine students’ perceptions of engagement (E), confidence (C), learning strategies (LS). Using multiple regression, it¬ was found that the use of MIRO helped students develop confidence (C) with visual literacy, which predicted performance score (PS) that was measured against their application of visual literacy to the creation of their motion design project. While students’ learning strategies (LS) with MIRO did not directly predict confidence (C) or performance score (PS), it fostered positive perceptions of engagement (E) which in turn predicted confidence (C). Content analysis of students’ open-ended survey responses about their learning strategies (LS) showed that MIRO provides organization and structure in documenting learning progress, in tandem with establishing standards and expectations as a preparatory ground for generating feedback. With the clarity and sequence of the mentioned conditions set in place, these prerequisites then lead to the next level of personal action for self-reflection, self-directed learning, and time management. The study results show that the affordances of MIRO can develop visual literacy and make up for the potential pitfalls of student isolation, communication, and engagement during online learning. The context of how MIRO could be used by lecturers to orientate students for learning in visual literacy and studio-based projects for future development are discussed.

Keywords: design education, graphic communication, online learning, visual literacy

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Authors: Arti Singh, Carolyn Jenkins, Oyedunni S. Arulogun, Mayowa O. Owolabi, Fred S. Sarfo, Bruce Ovbiagele, Enzinne Sylvia

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Background: Stroke, the leading cause of adult-onset disability and the second leading cause of death, is a major public health concern particularly pertinent in Sub-Saharan Africa (SSA), where nearly 80% of all global stroke mortalities occur. The Stroke Investigative Research and Education Network (SIREN) seeks to comprehensively characterize the genomic, sociocultural, economic, and behavioral risk factors for stroke and to build effective teams for research to address and decrease the burden of stroke and other non communicable diseases in SSA. One of the first steps to address this goal was to effectively engage the communities that suffer the high burden of disease in SSA. This study describes how the SIREN project engaged six sites in Ghana and Nigeria over the past three years, describing the community engagement activities that have arisen since inception. Aim: The aim of community engagement (CE) within SIREN is to elucidate information about knowledge, attitudes, beliefs, and practices (KABP) about stroke and its risk factors from individuals of African ancestry in SSA, and to educate the community about stroke and ways to decrease disabilities and deaths from stroke using socioculturally appropriate messaging and messengers. Methods: Community Advisory Board (CABs), Focus Group Discussions (FGDs) and community outreach programs. Results: 27 FGDs with 168 participants including community heads, religious leaders, health professionals and individuals with stroke among others, were conducted, and over 60 CE outreaches have been conducted within the SIREN performance sites. Over 5,900 individuals have received education on cardiovascular risk factors and about 5,000 have been screened for cardiovascular risk factors during the outreaches. FGDs and outreach programs indicate that knowledge of stroke, as well as risk factors and follow-up evidence-based care is limited and often late. Other findings include: 1) Most recognize hypertension as a major risk factor for stroke. 2) About 50% report that stroke is hereditary and about 20% do not know organs affected by stroke. 3) More than 95% willing to participate in genetic testing research and about 85% willing to pay for testing and recommend the test to others. 4) Almost all indicated that genetic testing could help health providers better treat stroke and help scientists better understand the causes of stroke. The CABs provided stakeholder input into SIREN activities and facilitated collaborations among investigators, community members and stakeholders. Conclusion: The CE core within SIREN is a first-of-its kind public outreach engagement initiative to evaluate and address perceptions about stroke and genomics by patients, caregivers, and local leaders in SSA and has implications as a model for assessment in other high-stroke risk populations. SIREN’s CE program uses best practices to build capacity for community-engaged research, accelerate integration of research findings into practice and strengthen dynamic community-academic partnerships within our communities. CE has had several major successes over the past three years including our multi-site collaboration examining the KABP about stroke (symptoms, risk factors, burden) and genetic testing across SSA.

Keywords: community advisory board, community engagement, focus groups, outreach, SSA, stroke

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Authors: Dina Ziadlou, Anthony Sunjaya, Joyzen Cortez Ramos, Romario Muñoz Ramos, Richard Dasselaar

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This study aimed to evaluate the opinions of users using digital health technologies to prevent, promote, and maintain their health and well-being with or without the support of a healthcare provider to delineate an overview of the future patient journey while considering the strategic initiatives in the digital transformation era. This research collected the opinions of healthcare clients through a structural questionnaire to collect user accessibility, user knowledge, user experience, user engagement, and personalized medicine to investigate the mindset of the users and illustrate their opinions, expectations, needs, and voices about digital self-care expansion. In the realm of digital transformation, the accessibility of users to the internet, digital health platforms, tools, and mobile health applications have revolutionized the healthcare ecosystem toward nurturing informed and empowered patients who are tech-savvy and can take the initiative to be in charge of their health, involved in medical decision-making, and seek digital health innovations to prevent diseases and promote their healthy lifestyles. Therefore, the future of the patient journey is digital self-care intervention in a healthcare ecosystem where the partnership of patients in healthcare services is tied to their health information and action ownership.

Keywords: digital health, patient engagement, self-care intervention, digital self-care intervention, digital transformation

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Authors: Alexander David Natanson

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This paper focuses on the effect of Sanctuary and Immigration and Customs Enforcement (ICE) policies on local economies. "Sanctuary cities" refers to municipal jurisdictions that limit their cooperation with the federal government's efforts to enforce immigration. Using county-level data from the American Community Survey and ICE data on economic indicators from 2006 to 2018, this study isolates the effects of local immigration policies on U.S. counties. The investigation is accomplished by simultaneously studying the policies' effects in counties where immigrants' families are persecuted via collaboration with Immigration and Customs Enforcement (ICE), in contrast to counties that provide protections. The analysis includes a difference-in-difference & two-way fixed effect model. Results are robust to nearest-neighbor matching, after the random assignment of treatment, after running estimations using different cutoffs for immigration policies, and with a regression discontinuity model comparing bordering counties with opposite policies. Results are also robust after restricting the data to a single-year policy adoption, using the Sun and Abraham estimator, and with event-study estimation to deal with the staggered treatment issue. In addition, the study reverses the estimation to understand what drives the decision to choose policies to detect the presence of reverse causality biases in the estimated policy impact on economic factors. The evidence demonstrates that providing protections to undocumented immigrants increases economic activity. The estimates show gains in per capita income ranging from 3.1 to 7.2, median wages between 1.7 to 2.6, and GDP between 2.4 to 4.1 percent. Regarding labor, sanctuary counties saw increases in total employment between 2.3 to 4 percent, and the unemployment rate declined from 12 to 17 percent. The data further shows that ICE policies have no statistically significant effects on income, median wages, or GDP but adverse effects on total employment, with declines from 1 to 2 percent, mostly in rural counties, and an increase in unemployment of around 7 percent in urban counties. In addition, results show a decline in the foreign-born population in ICE counties but no changes in sanctuary counties. The study also finds similar results for sanctuary counties when separating the data between urban, rural, educational attainment, gender, ethnic groups, economic quintiles, and the number of business establishments. The takeaway from this study is that institutional inclusion creates the dynamic nature of an economy, as inclusion allows for economic expansion due to the extension of fundamental freedoms to newcomers. Inclusive policies show positive effects on economic outcomes with no evident increase in population. To make sense of these results, the hypothesis and theoretical model propose that inclusive immigration policies play an essential role in conditioning the effect of immigration by decreasing uncertainties and constraints for immigrants' interaction in their communities, decreasing the cost from fear of deportation or the constant fear of criminalization and optimize their human capital.

Keywords: inclusive and exclusive institutions, post matching, fixed effect, time trend, regression discontinuity, difference-in-difference, randomization inference and sun, Abraham estimator

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Authors: Jessica Federman

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The current research offers a longitudinal and qualitative study design to examine how reciprocity improves relations between the homeless and various stakeholders within a community. The study examines a homeless shelter that sought to establish a facility within a community of Los Angeles, that was initially met with strong resistance and opposition from a variety of organizations due to deeply entrenched views about the negative impact of having homeless individuals within the community. The project tested an intervention model that targets the reduction of stigmatization of homeless individuals and promotes synergistic exchanges between conflicted organizational entities in communities. Years later, the data show that there has been a remarkable reversal in the perception of the agency by the very forces that initially prevented it from being established. This reversal was achieved by a few key strategic decisions. Community engagement was the first step toward changing people’s minds and demonstrating how the homeless shelter was helping to alleviate the problem of homelessness instead of contributing to it. Central to the non-profit’s success was the agency’s pioneering formulation of a treatment model known as, Reciprocal Community Engagement Model (RCEM). The model works by reintegrating the homeless back into society through relationship building within a network of programs that foster positive human connections. This approach aims to draw the homeless out of the debilitating isolation of their situation, reintegrate them through purposeful roles in the community while simultaneously providing a reciprocal benefit to the community at large. Through multilevel, simultaneous social interaction, RCEM has a direct impact not only on the homeless shelter’s clients but also for the community as well. The agency’s approach of RCEM led to their homeless clients getting out of the shelter and getting to work in the community directly alongside other community volunteers and for the benefit of other city and community organizations. This led to several opportunities for community members and residents to interact in meaningful ways. Through each successive exposure, the resident and community members’ distrust in one another was gradually eased and a mutually supportive relationship restored. In this process, the community member becomes the locus of change as much as the residents of the shelter. Measurements of community trust and resilience increased while negative perceptions of homeless people decreased.

Keywords: stigma, homelessness, reciprocity, identity

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Authors: Claire P. Griffin

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The education provision for students with special educational needs, including students with Autism Spectrum Disorder (ASD), has undergone significant national and international changes in recent years. In particular, an increase in resource-based provision has occurred across educational settings in an effort to support inclusive practices. This paper seeks to explore the role of the Special Needs Assistant (SNA) in supporting children with ASD in Irish schools. This research stems from the second national evaluation of ‘Education Provision for Students with Autism Spectrum Disorder in Ireland’ (NCSE, 2016). This research was commissioned by the National Council for Special Education (NCSE) in Ireland and conducted by a team of researchers from Mary Immaculate College, Limerick from February to July 2014. This study involved a multiple case study research strategy across 24 educational sites, as selected through a stratified sampling process. Research strategies included semi-structured interviews, classroom observations, documentary review and child conversations. Data analysis was conducted electronically using Nvivo software, with use of an additional quantitative recording mechanism based on scaled weighting criteria for collected data. Based on such information, key findings from the NCSE national evaluation will be presented and critically reviewed, with particular reference to the role of the SNA in supporting pupils with ASD. Examples of positive practice inherent within the SNA role will be outlined and contrasted with discrete areas for development. Based on such findings, recommendations for the evolving role of the SNA will be presented, with the aim of informing both policy and best practice within the field.

Keywords: autism spectrum disorder, inclusive education , paraprofessional, special needs assistant

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Authors: Bin Zhou, Tongli Lu, Jianwu Zhang, Hongtao Hao

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Dual clutch transmissions (DCT) offer a high comfort performance in terms of the gearshift. Hydraulic multi-disk clutches are the key components of DCT, its engagement determines the shifting comfort. The prefill of the clutches requests an initial engagement which the clutches just contact against each other but not transmit substantial torque from the engine, this initial clutch engagement point is called the touch point. Open-loop control is typically implemented for the clutch prefill, a lot of uncertainties, such as oil temperature and clutch wear, significantly affects the prefill, probably resulting in an inappropriate touch point. Underfill causes the engine flaring in gearshift while overfill arises clutch tying up, both deteriorating the shifting comfort of DCT. Therefore, it is important to enable an adaptive capacity for the clutch prefills regarding the uncertainties. In this paper, a dynamic model of the hydraulic actuator system is presented, including the variable force solenoid and clutch piston, and validated by a test. Subsequently, the open-loop clutch prefill is simulated based on the proposed model. Two control parameters of the prefill, fast fill time and stable fill pressure is analyzed with regard to the impact on the prefill. The former has great effects on the pressure transients, the latter directly influences the touch point. Finally, an adaptive method is proposed for the clutch prefill during gear shifting, in which clutch fill control parameters are adjusted adaptively and continually. The adaptive strategy is changing the stable fill pressure according to the current clutch slip during a gearshift, improving the next prefill process. The stable fill pressure is increased by means of the clutch slip while underfill and decreased with a constant value for overfill. The entire strategy is designed in the Simulink/Stateflow, and implemented in the transmission control unit with optimization. Road vehicle test results have shown the strategy realized its adaptive capability and proven it improves the shifting comfort.

Keywords: clutch prefill, clutch slip, dual clutch transmission, touch point, variable force solenoid

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Authors: Joanne Danker, Iva Strnadová, Therese Cumming

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As a consequence of the increased evidence of the bi-directional relationship between student well-being and positive educational outcomes, there has been a surge in the number of research studies dedicated to understanding the notion of student well-being and the ways to enhance it. In spite of these efforts, the concept of student well-being remains elusive. Additionally, studies on student well-being mainly consulted adults' perspectives and failed to take into account students' views, which if considered, could contribute to a clearer understanding of the complex concept of student well-being. Furthermore, there is a lack of studies focusing on the well-being of students with autism spectrum disorder (ASD), and these students continue to fare worse in post-school outcomes as compared to students without disabilities, indicating a significant gap in the current research literature. Findings from research conducted on students without disabilities may not be applicable to students with ASD as their educational experiences may differ due to the characteristics associated with ASD. Thus, the purpose of this study was to explore how students with ASD, their parents, and teachers conceptualise student well-being. It also aims to identify the barriers and assets of the well-being of these students. To collect data, 19 teachers and 11 parents participated in interviews while 16 high school students with ASD were involved in a photovoice project regarding their well-being in school. Grounded theory approaches such as open and axial coding, memo-writing, diagramming, and making constant comparisons were adopted to analyse the data. All three groups of participants conceptualised student well-being as a multidimensional construct consisting of several domains. These domains were relationships, engagement, positive/negative emotions, and accomplishment. Three categories of barriers were identified. These were environmental, attitudes and behaviours of others, and impact of characteristics associated with ASD. The identified internal assets that could contribute to student well-being were acceptance, resilience, self-regulation, and ability to work with others. External assets were knowledgeable and inclusive school community, and having access to various school programs and resources. It is crucial that schools and policymakers provide ample resources and programs to adequately support the development of each identified domain of student well-being. This could in turn enhance student well-being and lead to more successful educational outcomes for students with ASD.

Keywords: autism spectrum disorder, grounded theory approach, school experiences, student well-being

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Authors: Rajkumar Ghosh, Shyama Pada Gorai

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Access to safe drinking water is a fundamental human right; however, regions like Purulia, Bankura, Birbhum, Malda, Dinajpur in West Bengal, India, face formidable challenges due to heightened fluoride levels. This paper delves into the hurdles of fresh drinking water production, presenting comprehensive solutions derived from literature reviews, field surveys, and scientific analyses. Encompassing fluoride-affected areas in Purulia, Bankura, Birbhum, Malda, North-South Dinajpur, and South 24 Parganas, the study emphasizes an integrated and sustainable approach. Employing a multidisciplinary methodology, combining scientific analysis and community engagement, the study identifies key factors influencing water quality and proposes sustainable strategies. Elevated fluoride concentrations exceeding international health standards (Purulia: 0.126 – 8.16 mg/L, Bankura: 0.1 – 12.2 mg/L, Malda: 0.1 – 4.54 mg/L, Birbhum: 0.023 – 18 mg/L) necessitate urgent intervention. Infrastructure deficiencies impede water treatment and distribution, while limited awareness obstructs community participation. The proposed solutions embrace advanced water treatment technologies, infrastructure development, community education, and sustainable water management practices. This comprehensive effort aims to provide clean drinking water, safeguarding the health of affected populations. Building on these foundations, the study explores the potential of rooftop rainwater harvesting as an effective and sustainable strategy to mitigate challenges in fresh drinking water production. By addressing fluoride contamination concerns and promoting community involvement, this approach presents a holistic solution to water quality issues in affected regions. The findings underscore the importance of integrating sustainable practices with community engagement to achieve long-term water security in Purulia, Bankura, Birbhum, Malda, North-South Dinajpur, and South 24 Parganas. This study serves as a cornerstone for further research and policy development, addressing fluoride contamination's impact on public health in affected areas. Recommendations include the establishment of long-term monitoring programs to assess the effectiveness of implemented solutions and conducting health impact studies to understand the long-term effects of fluoride contamination on the local population.

Keywords: fluoride mitigation, rainwater harvesting, water quality, sustainable water management, community engagement

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Authors: Kristin Prentice, Carri Hand

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As the Canadian population ages and chronic health conditions continue to escalate, older adults will require various types of housing, such as long term care or retirement homes. Moving to a new home may require a change in leisure activities and social networks, which could be challenging to maintain identity and create a sense of home. Leisure has been known to help older adults maintain or increase their quality of life and life satisfaction and may help older adults in moving to new homes. Sense of home and identity within older adults' transitions to new homes are concepts that may also relate to leisure engagement. Literature is scant regarding the role of leisure in older adults moving to new homes and how the sense of home and identity inter-relate. This study aims to explore how leisure may play a role in older adults' transitioning to new homes, including how sense of home and identity inter-relate. An ethnographic approach will be used to understand the culture of older adults transitioning to new homes. This study will involve older adults who have recently relocated to a mid-sized city in Ontario, Canada. The study will focus on the older adult’s interactions with and connections to their home environment through leisure. Data collection will take place via video-conferencing and will include a narrative interview and two other interviews to discuss an activity diary of leisure engagement pre and post move and mental maps to capture spaces where participants engaged in leisure. Participants will be encouraged to share photographs of leisure engagement taken inside and outside their home to help understand the social spaces the participants refer to in their activity diaries and mental maps. Older adults attempt to adjust to their new homes by maintaining their identity, developing a sense of home through creating attachment to place, and maintaining social networks, all of which have been linked to engaging in leisure. This research will provide insight into the role of leisure in this transition process and the extent that the home and community can contribute to aiding their transition to the new home. This research will contribute to existing literature on the inter-relationships of leisure, sense of home, and identity and how they relate to older adults moving to new homes. This research also has potential for influencing policy and practice for meeting the housing needs of older adults.

Keywords: leisure, older adults, transition, identity

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Authors: Robin Lok-Wang Ma

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The Center/Unit for Industry Engagement and Collaboration, as well as Internship, play a significant role at university. In general, the Center serves as the official interface between the industry and the School or Department to cultivate students’ early exposure to professional experience. The missions of the Center are not limited to provide a communication channel and collaborative platform for the industries and the university but also to assist students to build up their career paths early while still in the university. In recent years, a cooperative education experience (commonly known as a co-op) has been strongly advocated for students to make the school-to-work transition. The nature of the co-op program is not only consistent with the internships/final year design projects, but it is also more industrial-oriented with academic support from faculty at the university. The purpose of this paper is to describe an approach to how cooperative education experience can be integrated into Engineering Curriculum. It provides a mutual understanding and exchange of ideas for the approach between the university and the industry. A suggested format in terms of timeline, duration, selection of candidates, students, and companies’ expectations for the co-op program is described. Also, feedbacks from employers/industries show that a longer-term co-op program is well suited for students compared with a short-term internship. To this end, it provides a new insight into collaboration and/or partnership between the university and the industries to prepare professional work-ready graduates.

Keywords: cooperative education, industry, engagement, collaboration

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Authors: Bonnie R. Brammall, Rhonda M. Garad, Helena J. Teede, Cheryce L. Harrison

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Introduction: Reproductive aged women are at high-risk for accelerated weight gain and obesity development, with pregnancy recognised as a critical contributory life phase. Healthy lifestyle interventions during the preconception and antenatal period improve maternal and infant health outcomes. Yet, interventions from preconception through to postpartum and translation and implementation into real-world healthcare settings remain limited. OptimalMe is a randomised, hybrid implementation effectiveness study of evidence-based healthy lifestyle intervention. Here, we report engagement, acceptability of the intervention during preconception, and self-reported behaviour change outcomes as a result of the preconception phase of the intervention. Methods: Reproductive aged women who upgraded their private health insurance to include pregnancy and birth cover, signalling a pregnancy intention, were invited to participate. Women received access to an online portal with preconception health and lifestyle modules, goal-setting and behaviour change tools, monthly SMS messages, and two coaching sessions (randomised to video or phone) prior to pregnancy. Results: Overall n=527 expressed interest in participating. Of these, n=33 did not meet inclusion criteria, n=8 were not contactable for eligibility screening, and n=177 failed to engage after the screening, leaving n=309 who were enrolled in OptimalMe and randomised to intervention delivery method. Engagement with coaching sessions dropped by 25% for session two, with no difference between intervention groups. Women had a mean (SD) age of 31.7 (4.3) years and, at baseline, a self-reported mean BMI of 25.7 (6.1) kg/m², with 55.8% (n=172) of a healthy BMI. Behaviour was sub-optimal with infrequent self-weighing (38.1%), alcohol consumption prevalent (57.1%), sub-optimal pre-pregnancy supplementation (61.5%), and incomplete medical screening. Post-intervention 73.2% of women reported engagement with a GP for preconception care and improved lifestyle behaviour (85.5%), since starting OptimalMe. Direct pre-and-post comparison of individual participant data showed that of 322 points of potential change (up-to-date cervical screening, elimination of high-risk behaviours [alcohol, drugs, smoking], uptake of preconception supplements and improved weighing habits) 158 (49.1%) points of change were achieved. Health coaching sessions were found to improve accountability and confidence, yet further personalisation and support were desired. Engagement with video and phone sessions was comparable, having similar impacts on behaviour change, and both methods were well accepted and increased women's accountability. Conclusion: A low-intensity digital health and lifestyle program with embedded health coaching can improve the uptake of preconception care and lead to self-reported behaviour change. This is the first program of its kind to reach an otherwise healthy population of women planning a pregnancy. Women who were otherwise healthy showed divergence from preconception health and lifestyle objectives and benefited from the intervention. OptimalMe shows promising results for population-based behaviour change interventions that can improve preconception lifestyle habits and increase engagement with clinical health care for pregnancy preparation.

Keywords: preconception, pregnancy, preventative health, weight gain prevention, self-management, behaviour change, digital health, telehealth, intervention, women's health

Procedia PDF Downloads 80