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Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower health literacy, rural healthcare systems also experience significant resource shortages, as well as issues with recruitment and retention of healthcare providers, particularly specialists. These factors combined result in complex change management-focused challenges for rural healthcare systems. Change management initiatives are often resource intensive, and in rural health organizations already strapped for resources, it may be particularly risky to embark on change initiatives. One way to address these change management concerns is by leveraging socio-technical simulation models to estimate techno-economic feasibility (e.g., is it technologically feasible, and is it economical?) as well as socio-utility feasibility (e.g., how will the changes be utilized?). We present a framework for how healthcare systems can integrate modeling and simulation techniques from systems engineering into a change management process. Modeling and simulation are particularly useful for investigating the amount of uncertainty about potential outcomes, guiding decision-making that considers different scenarios, and validating theories to determine if they accurately reflect real-life processes. The results of these simulations can be integrated into critical change management recommendations related to developing readiness for change and addressing resistance to change. As part of our integration, we present a case study showcasing how simulation modeling has been used to determine feasibility and potential resistance to change considerations for implementing a mobile radiation oncology unit. Recommendations and implications are discussed.

This study aims to contribute to the field of computer systems for sustainability research. It proposes a framework for sustainability awareness using online social networks (OSNs) by analyzing major research streams of the current state of knowledge and different bibliometric variables, and identifies a future research agenda in the field.

The preferred reporting items for systematic review and meta-analysis (PRISMA) methodology, content analysis and bibliometric tools were employed to identify, select, collect, synthesize, analyze and evaluate all research published on sustainability awareness using OSNs to provide complete insight into this research area.

This study proposed a framework comprising four categories for sustainability awareness using OSNs. These four categories are: the key factors to success, analysis of existing tools, proposal of new methods, approaches and theoretical frameworks, and case examples. In addition, this study synthesized the future research challenges for each category of the proposed framework.

Fostering sustainability awareness and sustainable behavior using OSNs is a growing area of research that seeks cultural change in society to achieve sustainable development. Through OSNs, people can discover and become aware of the consequences of unsustainable practices and habits in society, and learn how to develop sustainable behavior.

The peer review history for this article is available at https://publons.com/publon/10.1108/OIR