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The purpose of this paper is to assess the relationship between elderly people's health literacy skills and those people's decision to make use of digital health service platforms. Despite the substantial influence of digitisation on the delivery of healthcare services, understanding how health intervention strategies might help empower elderly people's health literacy skills is critical.

This paper analyses the existing trends in research on the convergence of health literacy, health intervention programmes and digital health service platforms by reviewing 34 studies published between 2000 and 2020.

The findings of the review indicate three primary themes (health literacy skills, health management competency and attitude/confidence), which provide a summary of the current literature, and in all three the results show that health intervention programmes help to enhance health literacy skills of elderly people. Based on the review results and by organising the fragmented status quo of health intervention research, the authors develop a comprehensive research model and identify future research directions for research in this domain.

The findings will be useful to health professionals in two ways: (1) the findings provide practical information about the growing need to implement health literacy intervention programmes to satisfy elderly people's appetite for accessing health services due to cognitive and physiological impairments, and (2) the finding help them to understand that with digital health platforms, elderly people have quicker access to health services, improving the quality of care provided to them.

This paper presents a comprehensive research model for analysing the impact of health literacy skills on older people's ability and intention to access digital health information sources, considering various health intervention approaches.

To ensure that more people will benefit from integrated care initiatives, scaling-up of successful initiatives is the way forward. However, new challenges present themselves as knowledge on how to achieve successful large-scale implementation is scarce. The EU-funded project SCIROCCO uses a step-based scaling-up strategy to explore what to scale-up, and how to scale-up integrated care initiatives by matching the complementary strengths and weaknesses of five European regions involved in integrated care. The purpose of this paper is to describe a multi-method evaluation protocol designed to understand what factors influence the implementation of the SCIROCCO strategy to support the scaling-up of integrated care.

The first part of the protocol focuses on the assessment of the implementation fidelity of the SCIROCCO step-based strategy. The objective is to gain insight in whether the step-based strategy is implemented as it was designed to explore what works and does not work when implementing the scaling-up strategy. The second part concerns a realist evaluation to examine what it is about the SCIROCCO’s strategy that works for whom, why, how and in which circumstances when scaling-up integrated care.

The intended study will provide valuable information on the implementation of the scaling-up strategy which will help to explain for what specific reasons the implementation succeeds and will facilitate further improvement of project outcomes.

The expected insights could be useful to guide the development, implementation and evaluation of future scaling-up strategies to advance the change towards more sustainable health and care systems.

This study aims to elucidate the health care organization, management and policy barriers and facilitators associated with implementation of an evidence-based health promotion intervention in primary care centers in the Basque Country, Spain.

Seven focus groups were conducted with 49 health professionals from six primary care centers participating in the Prescribing Healthy Life program. Text was analyzed using the Consolidated Framework for Implementation Research (CFIR) focusing on those constructs related to health care organization, management and policy.

The health promotion intervention was found to be compatible with the values of primary care professionals. However, professionals at all centers reported barriers to implementation related to: (1) external policy and incentives, (2) compatibility with existing workflow and (3) available resources to carry out the program. Specific barriers in these areas related to lack of financial and political support, consultation time constraints and difficulty managing competing day-to-day demands. Other barriers and facilitators were related to the constructs networks and communication, culture, relative priority and leadership engagement. A set of six specific barrier-facilitator pairs emerged.

Implementation science and, specifically, the CFIR constructs were used as a guide. Barriers and facilitators related to the implementation of a health promotion program in primary care were identified. Healthcare managers and policy makers can modify these factors to foster a more propitious implementation environment. These factors should be appropriately monitored, both in pre-implementation phases and during the implementation process, in order to ensure effective integration of health promotion into the primary care setting.

A critical attribute of open educational practices (OEP) is the pursuit of open scholarship which comprises the release of educational resources under an open licence scheme that permits no-cost access, use, reuse, adaptation, retention and redistribution to others. The degree of openness in relation to this attribute will depend on the context and culture of the place and the people in it. When left to chance, the adoption and practice of open scholarship by educators is at best sketchy. For optimum impact, a design-based approach is essential. A central focus of such an approach will need to target educators’ belief systems and practices about their scholarship. Any such work will involve researchers collaborating with practitioners in real-life settings to improve educational practices through iterative analysis, design, development and implementation. The purpose of this paper is to report on how the development and use of such a design-based approach, implemented by the Open University of Sri Lanka, impacted the adoption and uptake of open scholarship among teachers in the Sri Lankan school system in terms of changes in their use of instructional resources, pedagogical thinking and pedagogical practices.

The study adopted a design-based research (DBR) approach (Reeves, 2006), which involved researchers collaboratively working with practitioners in real-life settings to improve their educational practices along three aspects – instructional resource use, pedagogical perspectives and pedagogical practices. Based on the four stages of the DBR approach – analysis, solution, testing and refinement, and reflection, a professional development intervention programme was designed and implemented to support teachers on the integration of open educational resources (OER) and adoption of OEP in their teaching-learning process. Data collected throughout the process using multiple strategies such as questionnaire surveys, concept mapping, lesson plans, focus group interviews, self-reflections and “stories”, were analyzed using both qualitative and quantitative methods.

By the end of the intervention, significant changes were observed in teachers’ use of instructional resources, their pedagogical thinking and pedagogical practices. While resource usage has shifted from no or low usage of OER to reuse, revise, remix and creation of OER, the pedagogical thinking and practices of teachers moved from a content-centric and individualized patterns to more constructivist, context centric and collaborative ways. The diffusion of OEP was prominent along two dimensions – enhancements in the individual practices in innovative OER use as well as collaborative practices of sharing of resources, knowledge and good practices.

The systematic and flexible methodology adopted based on the DBR approach via a framework designed as a contextualized, process oriented and a self-reflective enquiry has been very useful to support changes in OEP among practitioners over time.

This iterative process allowed the researchers to function as “designers”, while investigating real-life issues in collaboration with the practitioners through reflective enquiry to further refine innovative practices towards OEP. This provides valuable insights for improved design solutions for future interventions in similar contexts.

Generally, food intake of older consumers is not in line with dietary guidelines. Insight into personal health-related motive orientations (HRMO) in this target group is useful for developing tailored interventions that support healthy food consumption, a better understanding is needed. The purpose of this paper is twofold: first, to identify older consumer groups based on HRMO; and second, to compare their consumption of different food groups and functionalities associated with a main meal.

An online survey was filled out by 459 Dutch adults aged 55–90 years (mean age=68.2 years), of the Sento network including 800 vital community-dwelling older consumers.

Analysis revealed five clusters of older adults with different HRMO profiles: appearance and achievement oriented, active oriented, altruistic oriented, achievement oriented and less health oriented. In addition, these segments differ in importance of functionalities associated with a main meal, i.e., physical, pleasure or rewarding, and in the consumption of specific food groups, i.e., unprocessed meat, meat replacers and unsalted nuts.

Recommendations for interventions and communication strategies to support healthy food consumption in the different HRMO segments are presented.

This exploration showed that different segments of Dutch older adults can be identified based on HRMO. Between these segments there are differences in consumption of protein-rich food groups and functionalities associated with a main meal.

This paper aims to identify the interaction of different intervention strategies implemented in Malaysia towards flattening the curve of COVID-19 cases. Since the outbreak of COVID-19, many approaches were adopted and implemented by the Malaysian government. Some strategies gained quick wins but with negative unintended consequences after execution, whereas other strategies were slow to take effect. Learning from the previous strategies is pivotal to avoid repeating mistakes.

This paper presents the cause, effect of and connection among the implemented COVID-19 intervention strategies using systems thinking through the development of a causal loop diagram. It enables the visualisation of how each implemented strategy interacted with each other and collectively decreased or increased the spread of COVID-19.

The results of this study suggested that it is not only essential to control the spread of COVID-19, but also to prevent the transmission of the virus. The Malaysian experience has demonstrated that both control and preventive strategies need to be in a state of equilibrium. Focusing only on one spectrum will throw off the balance, leaving COVID-19 infection to escalate rapidly.

The developed feedback loops provided policy makers with the understanding of the merits, pitfalls and dynamics of prior implemented intervention strategies before devising other effective intervention strategies to defuse the spread of COVID-19 and prepare the nation for recovery.

The purpose is to share strategies, rationales and lessons learnt from user involvement in a quality and safety improvement research project from the practice field in nursing homes and homecare services.

This is a viewpoint paper summarizing how researchers and co-researchers from the practice field of nursing homes and homecare services (nurse counsellors from different municipalities, patient ombudsman and next-of-kin representatives/and elderly care organization representant) experienced user involvement through all phases of the research project. The project included implementation of a leadership intervention.

Multiple strategies of user involvement were applied during the project including partnership in the consortium, employment of user representatives (co-researchers) and user-led research activities. The rationale was to ensure sound context adaptation of the intervention and development of tailor-made activities and tools based on equality and mutual trust in the collaboration. Both university-based researchers and Co-researchers experienced it as useful and necessary to involve or being involved in all phases of the research project, including the designing, planning, intervention implementation, evaluation and dissemination of results.

User involvement in research is a growing field. There is limited focus on this aspect in quality and safety interventions in nursing homes and homecare settings and in projects focussing on the leadership' role in improving quality and safety.

The field of implementation science has emerged as a response to the challenges experienced in translating evidence-based practice and research findings to healthcare settings. Whilst the field has grown considerably in recent years, comparatively, there is a conspicuous lack of attention paid to the work of pre-implementation, that is, how we effectively engage with organisations to support the translation of research into practice. Securing the engagement and commitment of healthcare organisations and staff is key in quality improvement and organisational research. In this paper the authors draw attention to the pre-implementation phase, that is, the development of an amenable context to support implementation research.

Drawing from examples across an interdisciplinary group of health systems researchers working across a range of healthcare organisations, the authors present a reflective narrative viewpoint. They identify the principal challenges experienced during the course of their work, describe strategies deployed to effectively mitigate these challenges and offer a series of recommendations to researchers based on their collective experiences of engaging in collaborations with healthcare organisations for research and implementation. This reflective piece will contribute to the narrative evidence base by documenting the challenges, experiences and learning emerging from the authors’ work as university researchers seeking to engage and collaborate with healthcare organisations.

The RELATE model is presented to guide researchers through six key steps and sample strategies in working to secure organisational buy-in and creating a context amenable to implementation and research. The six stages of the RELATE model are: (1) Recognising and navigating the organisation's complexity; (2) Enhancing understanding of organisational priorities and aligning intervention; (3) Leveraging common values and communicating to key individuals the value of implementation research; (4) Aligning and positioning intervention to illustrate synergies with other initiatives; (5) Building and maintaining credibility and trust in the research team; and (6) Evolving the intervention through listening and learning.

The authors hope this guidance will stimulate thinking and planning and indeed that it will encourage other research teams to reflect and share their experiences and strategies for successful engagement of organisations, thus developing a knowledge base to strengthen implementation efforts and increase efficacy in this important enterprise.

Researchers must relate to the world’s everyday reality of the healthcare managers and administrators and enable them to relate to the potential of the research world in enhancing practice if we are to succeed in bringing the evidence to practice in a timely and efficient manner. Climates receptive to implementation must be developed incrementally over time and require actors to navigate messy and potentially unfamiliar organisational contexts. In this paper, the often invisible and lamentably underreported work of how we begin to work with healthcare organisations has been addressed. The authors hope this guidance will stimulate thinking and planning and indeed that it will encourage other research teams to reflect and share their experiences and strategies for successful engagement of organisations, thus developing a knowledge base to strengthen implementation efforts and increase efficacy in this important enterprise.

The purpose of this paper is twofold: first, to take stock of the current state of knowledge about inclusive value-chain development (VCD) in the context of international agricultural research; and second, to draw out the implications for future research and action.

This paper is based on a review of recent research papers authored by professionals affiliated with international agricultural research centers and their partners in Africa, Asia, and Latin America.

The studies reviewed in the paper identify the opportunities emerging from new and expanding markets for agricultural products and challenges to smallholder participation in these markets. It identifies key attributes of successful value-chain interventions, emphasizing the importance of combining value-chain approaches with other approaches, including those emerging from innovation systems and rural livelihoods frameworks. Methods are offered for evaluating complex value-chain interventions.

The paper summarizes the state of knowledge as of early 2016 in a dynamic field. Important contributions to knowledge may have been made since then.

The paper summarizes the state of knowledge in the field, and identifies emerging issues and policy implications, knowledge gaps, and priorities for future applied research.

Implementing change in healthcare is difficult to accomplish due to the unpredictability associated with challenging the status quo. Adapting the intervention/practice/program being implemented to better fit the complex context is an important aspect of implementation success. Despite the acknowledged influence of context, the concept continues to receive insufficient attention at the team-level within implementation research. Using two heterogeneous multidisciplinary healthcare teams as implementation case studies, this study evaluates the interplay between context and implementation and highlights the ways in which context influences the introduction of a collective leadership intervention in routine practice.

The multiple case study design adopted, employed a triangulation of qualitative research methods which involved observation (Case A = 16 h, Case B = 15 h) and interview data (Case A = 13 participants, Case B = 12 participants). Using an inductive approach, an in-depth thematic analysis of the data outlined the relationship between team-level contextual factors and implementation success.

Themes are presented under the headings: (1) adapting to the everyday realities, a key determinant for implementation success and (2) implementation stimulating change in context. The findings demonstrate a dynamic relationship between context and implementation. The challenges of engaging busy healthcare professionals emphasised that mapping the contextual complexity of a site and adapting implementation accordingly is essential to enhance the likelihood of successful implementation. However, implementation also altered the surrounding context, stimulating changes within both teams.

By exposing the reciprocal relationship between team-level contextual factors and implementation, this research supports the improved design of implementation strategies through better understanding the interplay and mutual evolution of evidence-based healthcare interventions within different contexts.