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As part of a national plan to govern professional and organizational development in Norwegian specialist healthcare, the country’s hospital clinics are tasked with constructing development plans. Using the development plan as a case, the paper analyzes how managers navigate and legitimize the planning process among central actors and deals with the contingency of decisions in such strategy work.

This study applies a qualitative research design using a case study method. The material consists of public documents, observations and single interviews, covering the process of constructing a development plan at the clinical level.

The findings suggest that the development plan was shaped through a multilevel translation process consisting of different contending rationalities. At the clinical level, the management had difficulties in legitimizing the process. The underlying tension between top-down and bottom-up steering challenged involvement and made it difficult to manage the contingency of decisions.

The findings are relevant to public sector managers working on strategy documents and policymakers identifying challenges that might hinder the fulfillment of political intentions.

This paper draws on a case from Norway; however, the findings are of general interest. The study contributes to the academic discussion on how to consider both the health authorities’ perspective and the organizational perspective to understand the manager’s role in handling the contingency of decisions and managing paradoxes in the decision-making process.

The main aim of this article is to broaden the notion of strategic intent in public relations. It also develops an understanding of the social value of what can be defined as the first modern health communication campaign in Europe based on strategic intents and the development of modernity.

The study is based on both historical research and empirical material from the Norwegian tuberculosis campaign from 1889 up to 1913, when Norwegian women achieved suffrage. The campaign is analysed in the framework of modernity and social theory. The literature on lobbying and social movements is also used to develop a theoretical framework for the notion of strategic intent.

The study shows that strategic intent can be divided into two layers: (1) the implicit strategic intent is the real purpose behind the communication efforts, whereas (2) the explicit intent is found directly in the communication efforts. The explicit intent may be presented as a solution for the good of society at the right political moment, giving an organisation the possibility to mobilise for long-term social changes, in which could be the implicit intent.

The distinction between explicit and implicit strategic intent broadens our understanding on how to make long-term social changes as well as how social and political changes occur in modern societies. The article also gives a historical account of what is here defined as the first modern health communication campaign in Europe and its social value.

This study aims to examine how the theory of planned behaviour and technology acceptance theory can be used to understand the adoption of non-pharmaceutical interventions (NPIs). The relationships between attitudes, behavioural intentions towards using NPIs, actual use of NPIs and word-of-mouth (WOM) were examined and compared between early and late adopters.

A survey was conducted to test the hypotheses with partial least squares structural equation modelling (n = 278).

The results indicate that relationships between attitudes, intentions and behavioural intentions were positive and significant in the whole data set – and that there were differences between the early and late adopters. WOM had no substantial relationship with actual usage and early adopters’ behavioural intentions.

This research gives a better sense of how WOM impacts attitudes, behavioural intentions and actual usage among early and late adopters of NPIs and highlights the effectiveness of WOM, especially among late adopters of NPIs. Furthermore, using the TAM allows us to make specific recommendations regarding encouraging the use of NPIs. A new three-stage communications model is introduced that uses early adopters as influencers to reduce the NPI adoption time by late adopters.

Nurse leaders are challenged by ethical issues in today’s complex health-care settings. The purpose of this study was to describe and analyze key elements of moral distress identified by nurse leaders from health-care systems in the USA, Germany, Austria and Switzerland. The aim was to develop an understanding of distressing ethical issues nurse leaders face in the USA and three German-speaking European countries.

This descriptive cross-sectional study surveyed a convenience sample of nurse leaders in the USA, Germany, Austria and Switzerland. The voluntary, anonymous survey also included qualitative questions and was distributed using the Qualtrics® platform. A thematic analysis of the qualitative data in each country was carried out and a comparative analysis identified similarities and differences between the groups of nurse leaders comparing the US data to that from three German-speaking European countries.

The survey was completed by 316 nurse leaders: Germany, Austria, and Switzerland (n = 225) and the USA (n = 91). Similar themes identified as causing all nurse leaders moral distress included a lack of individual and organizational integrity, hierarchical and interprofessional issues, lack of nursing professionalism, patient care/patient safety concerns, finances negatively impacting care and issues around social justice. Within these six themes, there were also differences between the USA and the three German-speaking European countries.

Understanding the experiences associated with distressing ethical situations can allow nurse leaders and organizations to focus on solutions and develop resilience to reduce moral distress in the USA and three German-speaking European countries.

Although governments have used social media platforms to interact with the public in an attempt to minimize anxiety and provide a forum for public discussion during the pandemic, governments require sufficient crisis communication skills to engage citizens in taking appropriate action effectively. This study aims to examine how the National Health Commission of China (NHCC) has used TikTok, the leading short video–based platform, to facilitate public engagement during COVID-19.

Building upon dual process theories, this study integrates the activation of information exposure, prosocial interaction theory and social sharing of emotion theory to explore how public engagement is related to message sensation value (MSV), media character, content theme and emotional valence. A total of 354 TikTok videos posted by NHCC were collected during the pandemic to explore the determinants of public engagement in crises.

The findings demonstrate that MSV negatively predicts public engagement with government TikTok, but that instructional information increases engagement. The presence of celebrities and health-care professionals negatively affects public engagement with government TikTok accounts. In addition, emotional valence serves a moderating role between MSV, media characters and public engagement.

Government agencies must be fully aware of the different combinations of MSV and emotion use in the video title when releasing crisis-related videos. Government agencies can also leverage media characters – health professionals in particular – to enhance public engagement. Government agencies are encouraged to solicit public demand for the specific content of instructing information through data mining techniques.

The purpose of this study is shed light on the underlying forces behind entrepreneurship within a regional innovation system (RIS) in a remote rural region. The authors examine the following questions: Which are the main underlying forces behind the entrepreneurial process in a rural RIS characterized by traditionally low-tech, small-scale businesses? How can the development of a low-tech regional innovation system be conceptualized?

The design of the study is based on entrepreneurship theory. Data analysis followed practices used in phenomenography, a research approach used to analyse and identify commonalities and variations in populations' perceptions of a certain phenomenon. Data are composed using semi-structured interviews and a database composed of company information of all firms in the population.

A proactive mobilization of regional stakeholders and resources can be an important driving force behind the entrepreneurial process and generation of a rural RIS. Innovation can be generated within low-tech industries turning the rural context into an asset. An RIS in a remote rural context can be initiated and orchestrated by regional authorities, but knowledge brokering and orchestration can also be managed by networks of small-scale businesses brought together by mutual benefit and common interests.

Regional innovation systems theory is most often used to study high-tech industries. But by combining regional innovation systems with rural entrepreneurship and entrepreneurship context theory is a fruitful avenue to understand the role of rural entrepreneurship in regional development, even in remote and peripheral regions. Innovation does not need to entail high-tech international environments; it can appear as the result of efforts in low-tech industries in rural and remote environments. The authors’ findings need to be scrutinized; therefore, the authors call for more research on regional innovation systems in rural environments.

It is possible for regional authorities to orchestrate a development process through the actions of a strong regional agent but also by supporting the creation of networks of small businesses that are built on trust and common interests.

This study contributes to the literature with a new perspective to the study of entrepreneurship and of regional innovation systems. Entrepreneurship research with focus on rural contexts most often highlight limits to entrepreneurship and see entrepreneurship as “just running a business”. A perspective that starts from innovation and innovative behaviour, despite the rural context and embedded resources, helps to generate new knowledge that can enrich the understanding of entrepreneurship and also be the foundation for more precise business development policies in rural settings.

Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide insights into patients' perceptions of satisfaction, experience and self-reported outcomes. However, little attention has been devoted to questions about factors fostering the use of patient-reported information to create value at the system level.

Action research design is carried out to elicit possible triggers using the case of patient-reported experience and outcome data for breast cancer women along their clinical pathway in the clinical breast network of Tuscany (Italy).

The case shows that communication and engagement of multi-stakeholder representation are needed for making information actionable in a multi-level, multispecialty care pathway organized in a clinical network; moreover, political and managerial support from higher level governance is a stimulus for legitimizing the use for quality improvement. At the organizational level, an external facilitator disclosing and discussing real-world uses of collected data is a trigger to link measures to action. Also, clinical champion(s) and clear goals are key success factors. Nonetheless, resource munificent and dedicated information support tools together with education and learning routines are enabling factors.

Current literature focuses on key factors that impact performance information use often considering unidimensional performance and internal sources of information. The use of patient/user-reported information is not yet well-studied especially in supporting quality improvement in multi-stakeholder governance. The work appears relevant for the implications it carries, especially for policymakers and public sector managers when confronting the gap in patient-reported measures for quality improvement.

This paper aims to examine the health technology use in health information seeking, communication and personal health information management, as well as in the effects they may have on his relationship with the physician and on the consumption of medical resources.

An online survey was conducted. The questionnaires were distributed via online health discussion forums using Google's survey software with a summary presentation of the study’s objective. The final selection of 362 individuals was made using social media, direct email and collaboration with community groups. The empirical validation of the causal model was conducted using the partial least square approach.

The results show that the use of e-health strengthens the quality of the patient–physician relationship and patient empowerment while increasing the consumption of medical resources.

The results of this research indicate that the internet has transformed the relationship of patients to health, to their doctors and to the health-care system. In this new context, a reconsideration of the status of the patient must be considered by health service providers.

During the 1990s, Italian healthcare organisations (HOs) underwent a process of corporatisation, and the most innovative HOs introduced the balanced scorecard (BSC) to address the need for broader accountability. Currently, there is a limited understanding of the dynamics and outcomes of such a process. Therefore, this study aims to explore whether the BSC is still considered an effective performance management tool and analyse the factors driving and hindering its evolution and endurance in public and non-profit HOs.

We conducted a retrospective longitudinal analysis of two pioneering cases in the adoption of the BSC: one in a public hospital and the other in a non-profit hospital. Data collection relied on accessing institutional documents and reports from the early 2000s to the present, as well as conducting semi-structured interviews with the internal sponsors of the BSC.

We found evidence of three main categories of factors that trigger or hinder the adoption and development of the BSC: (1) the role of the internal sponsor and professionals’ commitment; (2) information technology and the controller’s technological skills; and (3) the relationship between the management and professionalism logics during the implementation process. At the same time, there is no evidence to suggest that specific technical features of the BSC influence its endurance.

The paper contributes to the debate on the key factors for implementing and sustaining multidimensional control systems in professional organisations. It emphasises the importance of knowledge-based assets and distinctive internal capabilities for the success of the business. The implications of the BSC legacy are discussed, along with future developments of multidimensional control tools aimed at supporting strategy execution.

The psychological foundations of consumers’ reasons for product choices are analyzed in the field of marketing. The purpose of this research is to identify the implicit reasons for white meat consumption in the UK and Turkey.

In the scope of the means-end chain theory, in-depth interviews were conducted with individuals, and the reasons for consumers’ product preferences were revealed by moving from concrete to abstract.

It has been determined that the white meat consumption of Muslims in the UK is primarily shaped by their religious approach. In Turkey, on the contrary, both consumption patterns and reasons for preference are changing. It has been found that white meat consumption is associated with values such as security needs, satisfaction with life, self-fulfillment and happiness.

This research has contributed to the marketing literature by examining consumers’ implicit consumption reasons for white meat in the context of religion and culture.

Marketing strategies should focus on building trust in halal certification, particularly in the UK. Brands should associate their promotion strategies with feelings of security and happiness, which are associated in the minds of consumers.

This study is a new study in terms of revealing the connotations of consumers about consuming chicken and fish and showing the implicit needs that the brands can emotionally associate with.