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This paper describes an approach that we have evolved for developing successful digital interventions to help people manage their health or illness. We refer to this as the \"person-based\" approach to highlight the focus on understanding and accommodating the perspectives of the people who will use the intervention. While all intervention designers seek to elicit and incorporate the views of target users in a variety of ways, the person-based approach offers a distinctive and systematic means of addressing the user experience of intended behavior change techniques in particular and can enhance the use of theory-based and evidence-based approaches to intervention development. There are two key elements to the person-based approach. The first is a developmental process involving qualitative research with a wide range of people from the target user populations, carried out at every stage of intervention development, from planning to feasibility testing and implementation. This process goes beyond assessing acceptability, usability, and satisfaction, allowing the intervention designers to build a deep understanding of the psychosocial context of users and their views of the behavioral elements of the intervention. Insights from this process can be used to anticipate and interpret intervention usage and outcomes, and most importantly to modify the intervention to make it more persuasive, feasible, and relevant to users. The second element of the person-based approach is to identify \"guiding principles\" that can inspire and inform the intervention development by highlighting the distinctive ways that the intervention will address key context-specific behavioral issues. This paper describes how to implement the person-based approach, illustrating the process with examples of the insights gained from our experience of carrying out over a thousand interviews with users, while developing public health and illness management interventions that have proven effective in trials involving tens of thousands of users.

Push notifications offer a promising strategy for enhancing engagement with smartphone-based health interventions. Intelligent sensor-driven machine learning models may improve the timeliness of notifications by adapting delivery to a user's current context (e.g. location). This exploratory mixed-methods study examined the potential impact of timing and frequency on notification response and usage of Healthy Mind, a smartphone-based stress management intervention. 77 participants were randomised to use one of three versions of Healthy Mind that provided: intelligent notifications; daily notifications within pre-defined time frames; or occasional notifications within pre-defined time frames. Notification response and Healthy Mind usage were automatically recorded. Telephone interviews explored participants' experiences of using Healthy Mind. Participants in the intelligent and daily conditions viewed (d = .47, .44 respectively) and actioned (d = .50, .43 respectively) more notifications compared to the occasional group. Notification group had no meaningful effects on percentage of notifications viewed or usage of Healthy Mind. No meaningful differences were indicated between the intelligent and non-intelligent groups. Our findings suggest that frequent notifications may encourage greater exposure to intervention content without deterring engagement, but adaptive tailoring of notification timing does not always enhance their use. Hypotheses generated from this study require testing in future work. ISRCTN67177737.

PurposeUsing a dialogic approach to narrative analysis through the lens of fairytale, this paper explores the shared construction of corporate environmental stories. The analysis provided aims to reveal the narrative messaging which is implicit in corporate reporting, to contrast corporate and stakeholder narratives and to bring attention to the ubiquity of storytelling in corporate communications.Design/methodology/approachThis paper examines a series of events in which a single case company plays the central role. The environmental section of the case company's sustainability report is examined through the lens of fairytale analysis. Next, two counter accounts are constructed which foreground multiple stakeholder accounts and retold as fairytales.FindingsThe dialogic nature of accounts plays a critical role in how stakeholders understand the environmental impacts of a company. Storytelling mechanisms have been used to shape the perspective and sympathies of the report reader in favour of the company. We use these same mechanisms to create two collective counter accounts which display different sympathies.Research limitations/implicationsThis research reveals how the narrative nature of corporate reports may be used to fabricate a particular perspective through storytelling. By doing so, it challenges the authority of the version of events provided by the company and gives voice to collective counter accounts which are shared by and can be disseminated to other stakeholders.Originality/valueThis paper provides a unique perspective to understanding corporate environmental reporting and the stories shared by and with external stakeholders by drawing from a novel link between fairytale, storytelling and counter accounting.

PurposeThis paper aims to interrogate the accountabilities of the foreign companies which have directly invested in the Iraqi oil and gas industry.Design/methodology/approachUsing both qualitative and quantitative methodologies, the authors first map the stakeholder accountabilities (qualitative) of foreign oil and gas companies and second, the authors seek to demonstrate quantitatively – through structural break tests and publicly available sustainability reports – whether these companies have accounted for their environmental and social impacts both to Iraqi people and to the global community.FindingsThe authors find that the Western democratic values embedded in stakeholder theory, in terms of sustainability, do not hold the same meaning in cultural contexts where conceptions and application of Western democratic values are deeply problematic. This paper identifies a crucial problem in the global oil supply chain and problematises the application of traditional theoretical approaches in the context of the Iraqi oil and gas industry.Practical implicationsImplications of this study include the refocus of attention onto the local and global environmental impacts of the Iraqi oil and gas industry by foreign direct investments. Such a refocus highlights the reasons and ways that decision makers should accommodate these less salient stakeholders.Originality/valueThe primary contribution is the critique of the lack of environmental accountability of foreign direct investment companies in the Iraqi oil and gas industry. The authors also make theoretical and methodological contributions via the problematisation of the cultural bias inherent in traditional stakeholder theories, and by introducing a quantitative method to evaluate the accountabilities of companies.

Background Social relationships are important for self‐management and outcomes of multiple long‐term conditions (MLTC). Previous research indicates MLTC negatively impacts social relationships and people living with MLTC do not feel adequately supported to manage their health. However, there is limited understanding of the processes and contextual factors that influence social relationships in the context of MLTC. This study explored experiences of social relationships for adults living with MLTC to improve understanding of their social relationship needs. Methods Semi‐structured telephone interviews were conducted with 22 people living with MLTC in Southern England. Participants were recruited through charity networks and GP practices. Eligibility criteria were: individuals aged ≥ 45 years living with MLTC within the community. Participants were purposively sampled to include diverse characteristics in terms of age, gender, and residential area deprivation. Transcribed interview data were analysed using reflexive thematic analysis. Results Four themes were developed. ‘There is no single route to meaningful social connection’ reflected how participants achieved, valued, and maintained meaning in relationships in diverse ways. ‘Change in sense of self’ captured the mental load, nostalgia, low mood and depressive symptoms experienced because of MLTC, which was reported to negatively impact their relationships with others. ‘A need to be seen and understood’ described how participants valued social relationships that enabled them to talk about their conditions with others who have shared experiences. Participants experienced a sense of abandonment when they felt unable to share their needs and experiences with family and close friends. Some participants experienced distress around the need to self‐manage their health, which was reinforced by limited health and care services. ‘Altered interaction’ reflected how MLTC required participants to find new ways to maintain social connection. Conclusion Meaningful connection may be achieved through diverse social relationships, including acquaintances and support groups. Further efforts to connect people to these forms of relationships could improve self‐management of MLTC, though strategies may vary for adults with different characteristics and health needs. Interventions that target mental burden, nostalgia, low mood and depressive symptoms experienced because of MLTC could support appropriate and meaningful social connection. Further research is needed to test these relationships. Patient and Public Contribution Three public contributors shaped the design of this study by sharing their experiences and views of key issues people who lack adequate social support may experience and how this might impact management of their health. They noted the importance of speaking to a range of people to understand social relationship needs of people living with MLTC, as experiences will vary. Two public contributors reviewed and helped refine the interview topic guide and commented on the importance of tone when conducting interviews, to encourage participants to share their experiences. One public contributor supported analysis of the transcripts through coding, discussion, and manuscript review. They highlighted the abandonment expressed by participants and how participants appeared to want to be seen as independent despite wanting and needing more support. Trial Registration None.

Purpose Environmental philosophies have guided cultures throughout history and continue to do so. This paper uses a framework of environmental philosophies drawn from history and the present, to analyse contemporary corporate environmental reporting. The purpose of this paper is to interrogate the philosophical underpinnings of corporate reporting allows for a nuanced understanding of the relationship between corporate activities and nature, and in so doing demonstrates the moral practices of accounting for nature. Design/methodology/approach Three themes are extracted from a historical review of western environmental philosophy: dualism, transcendence and interconnectivity. These themes are applied to a sample of corporate environmental reports through discourse analysis, enabling the illustration of otherwise obscured moral characteristics of the corporate relationship with the natural environment. Findings This paper uses environmental philosophies to better understand some of the implicit messaging of corporate environmental reporting. Evidence of each of the three themes is found in a sample of environmental reports, predominantly dualism and interconnectivity. Research limitations/implications Understanding that accounting is not just a technical, but also a social and moral practice expands the way the authors can interpret the outcomes of accounting. By presenting an exemplar of how accounting practice such as the corporate sustainability report can be analysed through a moral lens, this paper offers new insights intentioned to inform a more meaningful approach to environmental reporting. Originality/value A novel framework to explore the corporate sector’s relationship with the natural environment is presented. In light of current and predicted environmental changes, much of which has been attributed to the impact of corporate activities, the importance of a detailed explication of this relationship – such as the one proposed here – becomes imperative.

PurposeThis paper aims to examine the role numbers play in corporate environmental reporting. To deeply examine the ontological meanings of enumeration in the context of nature, the histories of number and accounting are explored. Some key tropes emerge from these histories, namely, distancing and control.Design/methodology/approachTo explore some of the implications of quantifying nature, three years of environmental reports of ten companies from the ASX200 are analysed through a Barthsian lens. Examples of enumerating nature are highlighted and explored in terms of what this means for the corporate relationship with nature. This study has focussed on some specific aspects of nature that are commonly counted in corporate environmental reporting: carbon, energy, water, biodiversity and waste. This study explores how monetisation and obfuscation are used and how this informs the myth that nature is controllable.FindingsThis study finds that quantifying nature constructs a metaphorical distance between the company and the natural world which erodes the sense of connection associated with an authentic care for nature. These findings are critical in light of the detrimental impact of corporate activity on the natural world. The reports themselves, while promoted as a tool to help mitigate damage to the natural environment, are implicitly perpetuating its harm.Research limitations/implicationsGiven the extent to which companies are responsible for environmental damage and the potential capacity embedded in corporate communications, better understanding the implications of quantifying nature could powerfully instigate a new but necessary approach to nature.Originality/valueThe insights of this paper are relevant to those aiming to improve the underpinning approaches used in corporate environmental reporting. This paper provides new understandings of the ways quantitative expression of environmental values constructs the myth that nature is controllable.

Purpose The purpose of this paper is to elucidate the moral dimensions of accounting by examining the case of Gross National Happiness (GNH) in Bhutan, and to propose a new approach to accounting that is grounded in the Buddhist principle of the Middle Path. This approach aims to promote well-being and happiness, contrasting with traditional accounting practices. Design/methodology/approach The paper outlines the core concepts of the Middle Path theory and GNH. The authors first problematise the role of traditional accounting in the well-being and happiness project. The authors explore accountability from the Middle Path perspective, which is a key aspect of Buddhist philosophy. Using the concept of Middle Path accountability and GNH in practice, the authors then examine accounting in terms of the four “immeasurable moral virtues” (tshad med bzhi) of the Middle Path. The authors conclude by highlighting the value of the Middle Path for conceptualising accountability and emancipating contemporary accounting from its ethical and theoretical constraints. Findings This paper compares the application of traditional accounting and accountability with the Middle Path and GNH practices. The authors find that ethical discourses in traditional accounting and accountability are not compatible with the values of the Middle Path, thereby limiting the scope of accounting and accountability. This constraint is overcome by introducing four “immeasurable moral virtues” (tshad med bzhi) of Buddhism, which promote spiritual development (wisdom) to replace the existing ethical strands of traditional accounting and accountability to support the well-being and happiness project. Research limitations/implications The study is limited to the review of concepts in GNH and Buddhist philosophy. More empirical studies in different contextual settings could increase understanding of how the practice of Middle Path and GNH could drive the project of well-being and happiness through accounting. Practical implications The paper seeks to contribute to the operationalisation of GNH in organisation by framing social and well-being accounting grounded in the Middle Path theory. The authors also seek to clarify the role of accounting as a social and moral practice. Social implications Situated within the fields of social and moral accounting, the paper seeks to elevate the potential role of accounting in the promotion of well-being and happiness of people and other sentient beings. By applying four moral virtues of love, compassion, appreciative joy and equanimity in accounting, the authors seek to enhance the role of accounting that could potentially reduce poverty, social inequity, corruption and promote harmony and cultural well-being. Originality/value This study undertakes a conceptual integration of the GNH and Middle Path philosophy to understand the theoretical and ethical implications of traditional accounting and accountability. This contribution to the literature expands the possibilities of accounting and accountability on social and well-being accounting by introducing the Middle Path and GNH concepts.

Background Meaningful involvement of underserved communities in health research requires consideration of structural, cultural and linguistic diversity. Games offer promising ways to foster engagement with complex topics and create shared language. However, there is limited evidence on the effectiveness of games for enabling meaningful Public Involvement in health research and minimal methodological guidance on how to facilitate games‐based co‐design with underserved groups. This paper evaluated a combined participatory Listening Café and games‐based approach to public involvement, aimed at supporting meaningful conversations about health with community members, reflecting on the process and lessons learned to establish a replicable methodological model for inclusive public involvement in health research. Design We collaborated with community partners from two Family Hubs in Southern England to plan and deliver co‐design sessions. Initial meetings addressed preferred ways of working, event locations, accessibility, ownership of the final product and budgeting. The sessions took place in the community and adopted the Listening Café model, which is a participatory approach for public involvement that builds trust through shared food and informal conversations. The process included three co‐design sessions and a follow‐up 3 months later. Evaluation methods included feedback forms, verbal check‐ins and written reflections from researchers, community partners and community members. Results Through a series of Listening Cafés, we co‐designed the card game, ‘Me: Inside and Out’, to encourage conversations about the challenges of living with health conditions with underserved groups. The game facilitated rich, meaningful conversations, fostered empathy and enabled community members to share their lived experiences. Community members reported feeling heard, valued and more connected from being involved in the co‐design process, playing the game and understanding more about each other. Conclusion A combined participatory Listening Café and games‐based co‐design approach for public involvement can effectively involve underserved communities in health research. Cultural sensitivity, shared ownership and relationship‐building are crucial processes for fostering inclusion. The Listening Café model proved effective in creating safe, informal spaces for dialogue. Researchers can adopt this methodological approach for public involvement to address perceived barriers to involving underserved communities, co‐producing outcomes that reflect the voices of those it aims to serve. Patient or Public Contribution Community partners (Sarah and Julie) supported planning the sessions. Community members attended and contributed to co‐design sessions.

Background Pandemic influenza poses a future health threat against which infection control behaviours may be an important defence. However, there is little qualitative research examining perceptions of infection control measures in the context of pandemic influenza. Methods Eight focus groups and one interview were conducted with a purposive sample of 31 participants. Participants were invited to discuss their perceptions of infection transmission and likely adherence to infection control measures in both non-pandemic and pandemic contexts. Infection control measures discussed included handwashing, social distancing and cough hygiene (e.g. covering mouth, disposing of tissues immediately etc.). Results Thematic analysis revealed that although participants were knowledgeable about infection transmission, most expressed unfavourable attitudes toward control behaviours in non-pandemic situations. However, with the provision of adequate education about control measures and appropriate practical support (e.g. memory aids, access to facilities), most individuals report that they are likely to adhere to infection control protocols in the event of a pandemic. Of the behaviours likely to influence infection transmission, handwashing was regarded by our participants as more feasible than cough and sneeze hygiene and more acceptable than social distancing. Conclusion Handwashing could prove a useful target for health promotion, but interventions to promote infection control may need to address a number of factors identified within this study as potential barriers to carrying out infection control behaviours.