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In 2011, community nursing services were reorganised in England in response to a national policy initiative, but little is known about the impact of these changes. A total of three dominant approaches emerged: (1) integration of community nursing services with an acute hospital provider, (2) integration with a mental health provider and (3) the establishment of a stand-alone organisation, i.e. without structural integration. The authors explored how these approaches influenced the trends in emergency hospital admissions and bed day use for older people.

The methodology was a longitudinal ecological study using panel data over a ten-year period from April 2006 to March 2016. This study’s outcome measures were (1) emergency hospital admissions and (2) emergency hospital bed use, for people aged 65+ years in 140 primary care trusts (PCTs) in England.

The authors found no statistically significant difference in the post-intervention trend in emergency hospital admissions between those PCTS that integrated community nursing services with an acute care provider and those integrated with a mental health provider (IRR 0.999, 95% CI 0.986–1.013) or those that did not structurally integrate services (IRR 0.996, 95% CI 0.982–1.010). The authors similarly found no difference in the trends for emergency hospital bed use.

PCTs were abolished in 2011 and replaced by clinical commissioning groups in 2013, but the functions remain.

The authors found no evidence that any one structural approach to the integration of community nursing services was superior in terms of reducing emergency hospital use in older people.

As far as the authors are aware, previous studies have not examined the impact of alternative approaches to integrating community nursing services on healthcare use.

Despite many calls to strengthen connections between health systems and communities as a way to improve primary healthcare, little is known about how new collaborations can effectively alter service provision. The purpose of this paper is to explore how a health authority, municipal leaders and physicians worked together in the process of transforming primary healthcare.

A longitudinal qualitative case study was conducted to explore the processes of change at the regional level and within seven communities across Northern British Columbia (BC), Canada. Over three years, 239 interviews were conducted with physicians, municipal leaders, health authority clinicians and leaders and other health and social service providers. Interviews and contextual documents were analyzed and interpreted to articulate how ongoing transformation has occurred.

Four overall strategies with nine approaches were apparent. The strategies were partnering for innovation, keeping the focus on people in communities, taking advantage of opportunities for change and encouraging experimentation while managing risk. The strategies have bumped the existing system out of the status quo and are achieving transformation. Key components have been a commitment to a clear end-in-view, a focus on patients, families, and communities, and acting together over time.

This study illuminates how partnering for primary healthcare transformation is messy and complicated but can create a foundation for whole system change.

The purpose of this article is the discussion of a service-learning experience in architecture pedagogy, based on two core courses at a private university in Mexico. The aim is to identify learning opportunities, challenges and implications arising from engaging with inhabitants of an informal urban settlement with limited digital resources in La Campana-Altamira in Monterrey, Mexico.

The methodology selected is a case study approach, chosen for its effectiveness in architectural pedagogy to create knowledge through exposure to a particular phenomenon, as well as highlight positive teaching practices to facilitate replicability. Case-study methodology was also beneficial in this case because its openness and flexibility allowed for research of a variety of phenomena simultaneously, in this case, both the effects in the informal settlement community and in the academic one.

Findings revealed that opportunities outweigh challenges, and meaningful service and learning are possible in an online context, even when the service aspects take longer than the course length if there are long-term relationships between communities and institutions.

The value of the article lies in the need for flexible and sensitive approaches that put communities in the center, a critical path to identifying and understanding their needs and improving their contexts. This holds especially true given the rapid pace of worldwide urbanization and the ubiquity of informal urban settlements. Implementing service-learning approaches in informal settings using online tools, while sanitary restrictions are in place shows that meaningful experiences can be achieved, even when courses are short and resources are limited.

The purpose of this paper is to develop a process model for the role transformation of vulnerable consumers through support services.

The study is based on four years of participant observation at a community-based support service and in-depth interviews with the consumers. Visual ethnography was used to document the process of the consumers' role transformation through service exchanges.

The main outcome of this study is a consumer transformation model, describing consumers' role transformation processes, from recipients to generic actors. The model demonstrates that vulnerable consumers will transform from recipients to quasi-actors before becoming generic actors.

Vulnerable consumers' participation in value cocreation can be promoted by providing social support according to their dynamic roles. By enabling consumers to participate in value cocreation, social support provision can become sustainable and inclusive, especially in rural areas affected by aging and depopulation. Transforming recipients into generic actors should be a critical aim of service provision in the global challenge of aging societies.

Beyond identifying service factors, the research findings describe the mechanism of consumers' role transformation process as a service mechanics study. Furthermore, this study contributes to transformative service research by applying social exchange theory and broadening service-dominant logic by describing the process of consumer growth for individual and community well-being.

The purpose of this study is to operationalise and measure the effects of negative customer engagement (CE) in conjunction with positive CE. Both valences are explored through affective, cognitive and behaviour dimensions, and, in relation to the antecedent of involvement and outcome of word-of-mouth (WOM). It also explores the moderating influence of service context by examining engagement within a social service versus a social networking site (SNS). Engagement with the dual focal objects of a service brand and a service community are also examined.

Structural equation modelling is used to analyse 625 survey responses.

Involvement is a strong driver of positive CE, and positive CE has a strong effect on WOM. These findings are consistent across the “brand” and “community” object, suggesting positive CE is mutually reinforced by different objects in a relationship. Positive CE is also found to operate consistently across the service types. Involvement is a moderately negative driver of negative CE, and negative CE is a positive driver of WOM. These relationships operate differently across the objects and service types. Involvement has a stronger inverse effect on negative CE for the social service, diverging from assumptions that negative CE is reflective of highly involved customers. Interestingly, negative CE has a stronger effect on WOM in the social service, highlighting the active and vocal nature of customers within this service context.

To the best of the authors’ knowledge, this is the first paper to quantitatively measure positive and negative valences of engagement concurrently, and examine the moderating effect of dual objects across contrasting service types.

Collaborative consumption, such as car sharing, specifically implicates customer-to-customer interaction, which must be regulated by service providers (companies, peers and self-regulating communities), comprising different challenges for business organizations. While in conventional business relations, consumers are protected from undesirable customer behavior by laws, regulations (power) in the context of collaborative consumption are rare, so that trust becomes more relevant. It is the purpose of the study to investigate possible mechanisms to prevent undesirable customers in collaborative consumption.

In between subject designs, samples of 186 and 328 consumers filled in experimental online questionnaires with vignettes. Analyses were made of differences among car sharing companies, private persons and car sharing communities in terms of the power of providers, trust in providers and trust in other users of the shared goods, undesirable customer behavior and consumer–provider relations.

Companies, private persons and self-regulating communities differ in terms of perceived power and trust. Participants specifically perceive mainly coercive power with the car sharing company, but with the private person and the community, reason-based trust in other users is perceived as prevalent. Nevertheless, undesirable customer behavior varies only marginally over the models.

The present study is the first to investigate measures to prevent undesirable customer behavior over different collaborative consumption models. This enables appropriate identification of market segments and tailoring of services. The study identifies opportunities for companies in contrast to private persons and self-regulating communities and, in doing so, provides important stimulation for marketing strategy and theory development.

The COVID-19 pandemic has brought about disruption in the way health-care professionals carry out their day-to-day practices across communities. The purpose of this research paper is to explore the professional experiences of occupational therapists working in community and rehabilitation mental health settings during a period of the COVID-19 pandemic and to help gain an understanding of how their day-to-day work practices have been affected.

A qualitative phenomenological research study explored the lived experiences of ten occupational therapists working within Health Service Executive community and rehabilitation mental health services during the COVID-19 pandemic. Participants included eight community mental health occupational therapists and two rehabilitative mental health occupational therapists. Data was collected through semi-structured interviews and analysed using reflexive thematic analysis.

Three themes were identified: holding on to what we do; technology: friend and foe; and COVID as a catalyst to clarify the occupational therapy role. These themes capture the community changes, challenges and frustrations experienced by the occupational therapists while striving to provide quality mental health occupational therapy services during the pandemic.

The findings demonstrate the adaptive nature of the profession, the importance of traditional observation methods of community-based care, the experiences with telehealth approaches and an opportunity to clarify misconceptions of aspects of the profession’s role in relation to employment-related issues and occupational therapy group work within such mental health settings.