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Indigenous peoples' right to prior consultation and to informed consent represents the basis of the new global model shaping state-indigenous relations. Consultation processes promise to enable indigenous people to determine their own development and are especially promoted when extraction projects with significant socio-environmental impacts are planned on indigenous lands. In this article we draw on debates on participatory development in order to analyse the first state-led consultations in Bolivia's and Peru's hydrocarbon sectors (2007-14). The analysis shows that effective participation has been limited by (1) an absence of indigenous ownership of the processes; (2) indigenous groups' difficulties defending or even articulating their own visions and demands; and (3) limited or very general outcomes. The study identifies real-life challenges, such as power asymmetries, a 'communication hurdle' and appropriate timing - as well as simplistic assumptions underlying the consultation approach - that account for the unfulfilled promises of this new model.

The use of eHealth is more challenging for people with intellectual disabilities (IDs) than for the general population because the technologies often do not fit the complex needs and living circumstances of people with IDs. A translational gap exists between the developed technology and users' needs and capabilities. User involvement approaches have been developed to overcome this mismatch during the design, development, and implementation processes of the technology. The effectiveness and use of eHealth have received much scholarly attention, but little is known about user involvement approaches. In this scoping review, we aimed to identify the inclusive approaches currently used for the design, development, and implementation of eHealth for people with IDs. We reviewed how and in what phases people with IDs and other stakeholders were included in these processes. We used 9 domains identified from the Centre for eHealth Research and Disease management road map and the Nonadoption, Abandonment, and challenges to the Scale-up, Spread, and Sustainability framework to gain insight into these processes. We identified both scientific and gray literature through systematic searches in PubMed, Embase, PsycINFO, CINAHL, Cochrane, Web of Science, Google Scholar, and (websites of) relevant intermediate (health care) organizations. We included studies published since 1995 that showed the design, development, or implementation processes of eHealth for people with IDs. Data were analyzed along 9 domains: participatory development, iterative process, value specification, value proposition, technological development and design, organization, external context, implementation, and evaluation. The search strategy resulted in 10,639 studies, of which 17 (0.16%) met the inclusion criteria. Various approaches were used to guide user involvement (eg, human or user-centered design and participatory development), most of which applied an iterative process mainly during technological development. The involvement of stakeholders other than end users was described in less detail. The literature focused on the application of eHealth at an individual level and did not consider the organizational context. Inclusive approaches in the design and development phases were well described; however, the implementation phase remained underexposed. The participatory development, iterative process, and technological development and design domains showed inclusive approaches applied at the start of and during the development, whereas only a few approaches involved end users and iterative processes at the end of the process and during implementation. The literature focused primarily on the individual use of the technology, and the external, organizational, and financial contextual preconditions received less attention. However, members of this target group rely on their (social) environment for care and support. More attention is needed for these underrepresented domains, and key stakeholders should be included further on in the process to reduce the translational gap that exists between the developed technologies and user needs, capabilities, and context.

Social inclusion—the ability to participate fully in one’s social world—is gaining importance in policy and academic circles. Information systems research has shown how addressing digital divides and expanding individual capabilities could increase the inclusion of marginalized groups. Yet while these contributions are notable, much of early research often overlooked the deep-seated power relations embedded in social structures—organized patterns of relationships, norms, and institutions that perpetuate inequalities and hierarchies based on gender, race, ethnicity, and caste. However, the field has evolved to bring a more nuanced understanding of how social inclusion can be achieved during the implementation of digital projects. Building on these emerging insights, in this paper, we explore how a social infomediary—an intermediary addressing social issues through information provision to marginalized communities—uses a digitally enabled agriculture extension project to build social inclusion in communities. Drawing on a qualitative case study of a social intermediary in India, our research highlights the role of social context in facilitating and constraining social inclusion efforts. Based on our findings, we develop a 4R social inclusion framework for digital development projects that shows the importance of recognition, reposition, representation, and reciprocation in fostering social inclusion. We also identify corresponding processes: transformative narratives and dialogues, empathic scaffolding, structured discursive spaces, and innovative interdependence. We discuss the practical and theoretical implications of our research and provide future research directions.

Within agricultural innovation systems (AIS), various stakeholder groups inevitably interpret ‘innovation’ from their own vantage point of privilege and power. In rural developing areas where small-scale and subsistence farming systems support livelihoods, dominant policy actors often focus heavily on participatory modernization and commercialization initiatives to enhance productivity, access, and quality. However, existing social hierarchies may undermine the potential of such initiatives to promote inclusive and sustainable farmer-driven innovation. Focusing on the chronically food insecure smallholder agricultural systems operating in Yatta Sub-county, Eastern Kenya, this paper explores how power dynamics between stakeholders can influence, and can be influenced by, participatory agricultural innovation initiatives. Findings suggest that there are often significant disparities in access to, and control over, platform resources between smallholder farmers and other stakeholder groups, resulting in large asymmetries. We discuss how these power dynamics may increase the risk of agricultural intervention, further marginalizing already disempowered groups and reinforcing power hierarchies to the detriment of smallholders. This study highlights the need for a deeper understanding of the institutional contexts that facilitate and maintain relationships of power within agricultural innovation systems, as well as the complexities associated with promoting transformational agricultural innovation.

To ensure that an eHealth technology fits with its intended users, other stakeholders, and the context within which it will be used, thorough development, implementation, and evaluation processes are necessary. The CeHRes (Centre for eHealth and Wellbeing Research) Roadmap is a framework that can help shape these processes. While it has been successfully used in research and practice, new developments and insights have arisen since the Roadmap’s first publication in 2011, not only within the domain of eHealth but also within the different disciplines in which the Roadmap is grounded. Because of these new developments and insights, a revision of the Roadmap was imperative. This paper aims to present the updated pillars and phases of the CeHRes Roadmap 2.0. The Roadmap was updated based on four types of sources: (1) experiences with its application in research; (2) literature reviews on eHealth development, implementation, and evaluation; (3) discussions with eHealth researchers; and (4) new insights and updates from relevant frameworks and theories. The updated pillars state that eHealth development, implementation, and evaluation (1) are ongoing and intertwined processes; (2) have a holistic approach in which context, people, and technology are intertwined; (3) consist of continuous evaluation cycles; (4) require active stakeholder involvement from the start; and (5) are based on interdisciplinary collaboration. The CeHRes Roadmap 2.0 consists of 5 interrelated phases, of which the first is the contextual inquiry, in which an overview of the involved stakeholders, the current situation, and points of improvement is created. The findings from the contextual inquiry are specified in the value specification, in which the foundation for the to-be-developed eHealth technology is created by formulating values and requirements, preliminarily selecting behavior change techniques and persuasive features, and initiating a business model. In the Design phase, the requirements are translated into several lo-fi and hi-fi prototypes that are iteratively tested with end users and other stakeholders. A version of the technology is rolled out in the Operationalization phase, using the business model and an implementation plan. In the Summative Evaluation phase, the impact, uptake, and working mechanisms are evaluated using a multimethod approach. All phases are interrelated by continuous formative evaluation cycles that ensure coherence between outcomes of phases and alignment with stakeholder needs. While the CeHRes Roadmap 2.0 consists of the same phases as the first version, the objectives and pillars have been updated and adapted, reflecting the increased emphasis on behavior change, implementation, and evaluation as a process. There is a need for more empirical studies that apply and reflect on the CeHRes Roadmap 2.0 to provide points of improvement because just as with any eHealth technology, the Roadmap has to be constantly improved based on the input of its users.

Digital assistive technologies have the potential to address the pressing need for adequate therapy options for patients with long COVID (also known as post-COVID-19 condition) by enabling the implementation of individual and independent rehabilitation programs. However, the involvement of the target patient group is necessary to develop digital devices that are closely aligned to the needs of this particular patient group. Participatory design approaches, such as cocreation, may be a solution for achieving usability and user acceptance. However, there are currently no set methods for implementing cocreative development processes incorporating patients. This study addresses the following research questions: what are the tasks and challenges associated with the involvement of patient groups? What lessons can be learned regarding the adequate involvement of patients with long COVID? First, a literature review based on a 3-stage snowball process was conducted to identify the tasks and challenges emerging in the context of the cocreation of digital assistive devices and services with patient groups. Second, a qualitative analysis was conducted in an attempt to extract relevant findings and criteria from the identified studies. Third, using the method of theory adaptation, this paper presents recommendations for the further development of the existing concepts of cocreation in relation to patients with long COVID. The challenges of an active involvement of patients in cocreative development in health care include hierarchical barriers and differences in the levels of specific knowledge between professionals and patients. In the case of long COVID, patients themselves are still inexperienced in dealing with their symptoms and are hardly organized into established groups. This amplifies general hurdles and leads to questions of group identity, power structure, and knowledge creation, which are not sufficiently addressed by the current methods of cocreation. The adaptation of transdisciplinary methods to cocreative development approaches focusing on collaborative and inclusive communication can address the recurring challenges of actively integrating patients with long COVID into development processes.

Background A healthy lifestyle may improve mental health. It is yet not known whether and how a mobile intervention can be of help in achieving this in adolescents. This study investigated the effectiveness and perceived underlying mechanisms of the mobile health (mHealth) intervention #LIFEGOALS to promote healthy lifestyles and mental health. #LIFEGOALS is an evidence-based app with activity tracker, including self-regulation techniques, gamification elements, a support chatbot, and health narrative videos. Methods A quasi-randomized controlled trial ( N  = 279) with 12-week intervention period and process evaluation interviews ( n  = 13) took place during the COVID-19 pandemic. Adolescents (12-15y) from the general population were allocated at school-level to the intervention ( n  = 184) or to a no-intervention group ( n  = 95). Health-related quality of life (HRQoL), psychological well-being, mood, self-perception, peer support, resilience, depressed feelings, sleep quality and breakfast frequency were assessed via a web-based survey; physical activity, sedentary time, and sleep routine via Axivity accelerometers. Multilevel generalized linear models were fitted to investigate intervention effects and moderation by pandemic-related measures. Interviews were coded using thematic analysis. Results Non-usage attrition was high: 18% of the participants in the intervention group never used the app. An additional 30% stopped usage by the second week. Beneficial intervention effects were found for physical activity ( χ 2 1  = 4.36, P  = .04), sedentary behavior ( χ 2 1  = 6.44, P  = .01), sleep quality ( χ 2 1  = 6.11, P  = .01), and mood ( χ 2 1  = 2.30, P  = .02). However, effects on activity-related behavior were only present for adolescents having normal sports access, and effects on mood only for adolescents with full in-school education. HRQoL ( χ 2 2  = 14.72, P  < .001), mood ( χ 2 1  = 6.03, P  = .01), and peer support ( χ 2 1  = 13.69, P  < .001) worsened in adolescents with pandemic-induced remote-education. Interviewees reported that the reward system, self-regulation guidance, and increased health awareness had contributed to their behavior change. They also pointed to the importance of social factors, quality of technology and autonomy for mHealth effectiveness. Conclusions #LIFEGOALS showed mixed results on health behaviors and mental health. The findings highlight the role of contextual factors for mHealth promotion in adolescence, and provide suggestions to optimize support by a chatbot and narrative episodes. Trial registration ClinicalTrials.gov [NCT04719858], registered on 22/01/2021.

Participatory development became a new development orthodoxy during the early 1990s. However, many researchers have criticised that its implementation often fails to live up to its original transformative roots. This article analyses the participatory research methods promoted by the UNDP, its epistemological foundations and the knowledge–power dynamics within them. The inquiry finds that the local experts hired by the UNDP play a central role in articulating the top-down authority of the UNDP with the bottom-up legitimacy of the local perspectives. Rather than promoting ‘development by the people, for the people’, the UNDP promotes ‘development by the experts, for the people’.

Background The escalating global prevalence of type 2 diabetes and prediabetes presents a major public health challenge. Physical activity plays a critical role in managing (pre)diabetes; however, adherence to physical activity recommendations remains low. The ENERGISED trial was designed to address these challenges by integrating mHealth tools into the routine practice of general practitioners, aiming for a significant, scalable impact in (pre)diabetes patient care through increased physical activity and reduced sedentary behaviour. Methods The mHealth intervention for the ENERGISED trial was developed according to the mHealth development and evaluation framework, which includes the active participation of (pre)diabetes patients. This iterative process encompasses four sequential phases: (a) conceptualisation to identify key aspects of the intervention; (b) formative research including two focus groups with (pre)diabetes patients ( n  = 14) to tailor the intervention to the needs and preferences of the target population; (c) pre-testing using think-aloud patient interviews ( n  = 7) to optimise the intervention components; and (d) piloting ( n  = 10) to refine the intervention to its final form. Results The final intervention comprises six types of text messages, each embodying different behaviour change techniques. Some of the messages, such as those providing interim reviews of the patients’ weekly step goal or feedback on their weekly performance, are delivered at fixed times of the week. Others are triggered just in time by specific physical behaviour events as detected by the Fitbit activity tracker: for example, prompts to increase walking pace are triggered after 5 min of continuous walking; and prompts to interrupt sitting following 30 min of uninterrupted sitting. For patients without a smartphone or reliable internet connection, the intervention is adapted to ensure inclusivity. Patients receive on average three to six messages per week for 12 months. During the first six months, the text messaging is supplemented with monthly phone counselling to enable personalisation of the intervention, assistance with technical issues, and enhancement of adherence. Conclusions The participatory development of the ENERGISED mHealth intervention, incorporating just-in-time prompts, has the potential to significantly enhance the capacity of general practitioners for personalised behavioural counselling on physical activity in (pre)diabetes patients, with implications for broader applications in primary care.

The lack of strategic planning has increased urban pressure and accumulated traffic in cities. Smart Cities are replacing the short-time perspective with a long-term approach. The objectives align with city strategic goals, and citizens play an essential role in the decision-making process. High-level guidelines have emerged over the years to guide smart Cities’ vision and implementation. However, the lack of a tool that combines top-down and bottom-up approaches to help local policymakers plan and assess cities is still notorious. Moreover, this paper provides a methodology that allows the definition of structural priorities and contextual preferences while comparing policymakers’ statements and citizens’ opinions. Furthermore, this paper designs an approach to fill the existing gap and give policymakers a framework to monitor and measure their performance based on standard Key Performance indicators and select relevant initiatives toward meeting the defined goals. This way, policymakers possess a tool that allows on the one hand, the standard comparison between cities and, on the other hand, the personalized comparison of their territory over time. Finally, a test case with the premise of improving city logistics is described to practically detail the guidelines of the proposed tool.