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The study aims to explore how segmentation as a methodology can be adapted to the healthcare context to provide a more nuanced understanding of the served population and to facilitate the design of patient-centric services.

The study was based on a collaborative project with a national healthcare organization following the principles of action design research. The study describes the quantitative segmentation performed during the project, followed by a qualitative interview study of how segments correspond with patient behaviors in an actual healthcare setting, and service design workshops facilitated by segments. A number of design principles are outlined based on the learnings of the project.

The segmentation approach increased understanding of patient variability within the service provider organization and was considered an effective foundation for modular service design. Patient characteristics and life circumstances were related to specific patterns of health behaviors, such as avoidance or passivity, or a persistent proactivity. These patterns influenced the patients' preferred value co-creation role and what type of support patients sought from the care provider.

The proposed segmentation approach is immediately generalizable to further healthcare contexts and similar services: improved understanding of patients, vulnerable patients in particular, improves the fit and inclusivity of services.

The segmentation approach to service design was demonstrated to be effective in a large-scale context. The approach allows service providers to design service options that improve the fit with individual patients' needs for support and autonomy. The results illuminate how patient characteristics influence health and value co-creation behaviors.

This paper intends to verify the extent to which Clean Development Mechanism (CDM) projects intend to contribute to sustainable development (SD) in Brazil, one of the top three leading countries in terms of the number of CDM projects. The authors assess the impact of CDMs not only in environmental aspects, but also social and economic ones.

The authors define a set of qualitative sustainability indicators and scrutinize documents regarding a sample of almost half of all the projects registered in Brazil between 2004 and 2020 (219 projects).

The findings of this study contradict many previous studies finding very limited evidence of SD in CDMs in many different countries: most projects in Brazil intend to contribute to some extent with SD, with 91% and 75% claiming to improve social and economic aspects, respectively.

The authors derive lessons from Brazil that can be used in other researches.

The authors derive lessons from Brazil and propose paths for public policy toward encouraging sustainable development.

The empirical data set relies on data collected directly from each of the projects in Brazil (roughly half of all of them) between 2004 and 2020. This is not only up to date, but pushes further the analytical scope of previous works.