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The study aims to address a critical gap in existing healthcare payment schemes and care service pricing by recognizing the influential role of patients' decisions on self-management efforts. These decisions not only impact health outcomes but also shape the demand for care, subsequently influencing care costs. Despite the significance of this interplay, current payment schemes often overlook these dynamics. The research focuses on investigating the implications of a novel behavior-based payment scheme, designed to align incentives and establish a direct connection between patients' decisions and care costs. The primary objective is to comprehensively understand whether and how this innovative payment scheme structure influences key stakeholders, including patients, care providers, insurers and overall social welfare.

In this paper, we propose a game-theoretical model to incorporate the performance of self-management with the demand for healthcare service, compare the patient's effort decision for self-management and provider's price decision for healthcare service under a behavior-based scheme with that under two implemented widely payment schemes, that is, co-payment scheme and co-insurance scheme.

Our findings confirm that the behavior-based scheme incentives patient self-management more than current schemes while reducing their possibility of seeking healthcare service, which indirectly induces the provider to lower the price of the service. The stakeholders' utility under various payment schemes is sensitive to the cost of treatment and the perceived health utility of patients. Especially, patient health awareness is not always benefited provider profit, as it motivates patient self-management while diminishing the demand for care.

We provide a novel framework for characterizing behavior-based payment schemes. Our results confirm the need for modification of the current payment scheme to incentivize patient self-management.

The authors describe an original unit plan that draws from local and national concerns for truthful history education about the history of racial violence in the United States. The unit plan contextualizes one impetus for truth and reconciliation in a community with a history of anti-Black violence.

The participants partnered with the Equal Justice Initiative to pilot the unit in their district’s new African American History course. The unit drew on historical research and cultural memory to situate local history within a broader context of racism and violence.

The teachers identified eight goals for the unit so that students could understand racialized violence, acknowledge racism as the lived experience of many of their students, and participate in a collaborative learning environment with productive discussions. Speaking from their own experiences with racism, and creating opportunities for students to do the same, the teachers aided the community in voicing long-silenced memories.

Besides bridging some of the gaps between local, regional, and national histories, more research is needed to further examine historical trauma and its implications for both the past and present, in order to amplify and humanize experiences of racism. Additional research is a critical step in developing more thoughtful, empathic and holistic discussions of history and racism at the local level.

In the wake of the recent past, the authors have learned that teaching about the history of racial violence can be enhanced and empowered by reference to relevant current events. The resurgence of racially charged language and violence over the past few years makes this goal more urgent than ever. This unit gives practical guidance to teachers who face this challenge.

The sociopolitical reality of historical trauma and racism must be confronted, and proximity to key events is important in conveying the urgency of racial violence and the need for history education that addresses it. Teachers are making difficult decisions about their options for teaching about race, and they are understandably concerned about any perceived missteps. Nonetheless, inclusive, truthful history education is an appropriate and essential response to narratives of exclusion and silence as the authors help students to develop deliberative skills concerning difficult topics such as racial violence. Teachers and students, together, can do the crucial work of remembering.

The stripping away of narrative agency, identity and history can cover up stories about the stripping away of life and dignity. In the unit plan, the authors recognize truth and reconciliation—especially in the education of people who have relatively little exposure to topics of race and racism—as elemental to a restorative stance against racism.

Parental advocacy is an emerging area of research and policy interest in Wales and across the UK. Although there is little research in the UK context to date, international research has indicated that parental advocacy can improve the relationship between parent and professional in the field of child protection social work. This paper aims to ascertain how the implementation of a parental advocacy programme supports parents to play a meaningful role in decision-making when children’s services are working with them and their families.

This study used interviews, surveys and focus groups to obtain qualitative data from 18 parents, seven parent advocates, two advocacy managers and four social workers, to explore the potential impact of parental advocacy on decision-making. The study identified challenges in implementing parental advocacy, particularly relating to awareness of the service. Participants also discussed experiences of the child protection system and how parents are supported by advocates.

Despite challenges surrounding implementation, initial findings were encouraging, and generated examples of how parental advocacy services have helped parents to understand children’s services and develop relationships of trust with social care professionals. In doing so, this study identified potential mechanisms that may be useful to support future service delivery.

This paper and research is novel as it explores parental advocacy within the Welsh context. Although there has been research conducted into parental advocacy, this has largely come from the USA. This research comes from the evaluation of an innovative and promising parental advocacy scheme in Wales.