Cross-Sector Collaboration for a Healthy Living Environment-Which Strategies to Implement, Why, and in Which Context?

Global economic structure transition boosts PM2.5-related human health impact in Belt and Road Initiative

The Belt and Road Initiative (BRI) is an open platform for international cooperation proposed by China to promote common global development and prosperity. The BRI can promote the optimal allocation of resources and promote in-depth cooperation in international trade. Meanwhile, it can establish a green supply chain cooperation network to help BRI countries achieve green transformation. BRI has made a notable contribution to the rapid growth of cross-border trade. However, it has also brought environmental impacts. Given that little attention has been paid to the trade-embodied particulate matter 2.5 related human health impacts (PM2.5-HHI) throughout the BRI, this study accounts for and traces the embodied PM2.5-HHI flows between the BRI countries and non-Belt and Road Initiative (non-BRI) countries. Moreover, this study also uncovers the critical socioeconomic drivers of PM2.5-HHI changes in BRI countries during 1990-2015, based on the multi-regional input-output based structural decomposition analysis (MRIO-SDA). Results show that, firstly, BRI countries had significantly increased their economic added value by exporting products to the non-BRI countries. They also have brought PM2.5-HHI to themselves. Secondly, the final demand of BRI countries was the largest potential driving force of PM2.5-HHI of BRI countries. Thirdly, the emission intensity change of BRI is the key socioeconomic factor for reducing PM2.5-HHI. While per capita final demand level change of BRI and production structure change of non-BRI are the key socioeconomic factors for increasing PM2.5-HHI. The study's findings on the one hand can help reduce the PM2.5-HHI and impacts of environmental pollution of BRI countries from a global perspective by providing scientific support. On the other hand, they can help provide relevant policy recommendations for the green transformation of BRI and the construction of green BRI.

Collaboration for Developing and Sustaining Community Dementia-Friendly Initiatives: A Realist Evaluation

BACKGROUND

Dementia-friendly communities (DFCs) are seen as key to the inclusion and participation of people with dementia and carers. Dementia-friendly initiatives (DFIs) are important building blocks for the growth of DFCs. The collaboration between different stakeholders is a central aspect in developing and sustaining DFIs.

AIM

This study tests and refines an initial theory about collaborating for DFIs with special attention for the involvement of people with dementia and their carers during the collaboration for DFIs. The realist approach is used for deepening contextual aspects, mechanisms, outcomes, and its explanatory power.

METHODS

A participatory case study design using qualitative data (focus groups, observations, reflections, minutes from meetings, and exit interviews) was executed in four Dutch municipalities that have ambitions to become dementia- friendly communities.

RESULTS

The refined theory on the collaboration for DFIs incorporates contextual aspects such as diversity, shared insights, and clarity. It draws attention to the importance of mechanisms such as the recognition of efforts and progress, informal distributed leadership, interdependency, belonging, significance, and commitment. These mechanisms resonate with feeling useful and feeling collectively powerful in the collaboration. The outcomes of collaboration were activation, getting new ideas, and fun. Our findings address how stakeholders' routines and perspectives impact the involvement of people with dementia and their carers during collaboration.

CONCLUSION

This study provides detailed information about collaboration for DFIs. The collaboration for DFIs is largely influenced by feeling useful and collectively powerful. Further research is needed to understand how these mechanisms can be triggered with the involvement of people with dementia and their carers in the heart of the collaboration.

How to collaborate for health throughout the project timeline - a longitudinal study reflecting on implemented strategies in three projects for a healthy living environment

BACKGROUND

When improving the health of local and regional populations, cross-sector collaboration between different policy domains, non-governmental organisations and citizens themselves is needed. Previously, enabling factors and strategies have been identified to improve cross-sector collaboration for health. However, few longitudinal studies have been conducted to understand how the implementation of strategies for cross-sector collaboration changes throughout the collaboration process. The aim of this study is therefore to learn more about the different strategies that were implemented throughout three cross-sector collaboration projects for a healthy living environment.

METHODS

The realist evaluation approach was used to understand how the implemented strategies worked, in which context, why and with what outcomes. Project partners were asked to reflect on their implemented strategies at two different moments in the project timelines, and quarterly updates with project leaders were held. In addition two reference panels were organised for data triangulation.

RESULTS

Three key insights for successful cross-sector collaboration throughout projects for a healthy living environment were identified, namely 1. Investing in trust among the partners and faith in the project has a positive influence on continuing the collaboration throughout the project; 2. Making stakeholders actively participate throughout the project requires additional strategies after the onset of the project, and 3. Defining roles, tasks, and other prerequisites at the start of the project helps in pursuing the project over time, but needs re-examination throughout the project. These key insights were based on multiple examples of implemented strategies, linked to context, mechanisms and outcomes.

CONCLUSIONS

This study shows the different strategies that can be employed as the collaboration in projects for a healthy living environment progresses. We found that 'trust' does not merely include the relationships built between the partners, but at the onset of projects can also be based on faith in the project itself. In addition, as it can be difficult to foresee the right investments and strategies at the onset of the project, frequent reflection moments to choose fitting strategies might benefit regional partners in their cross-sector collaboration for health.

Working with parents of children with complex mental health issues to improve care: A qualitative inquiry

The study objective was to explore the experiences of parents of children (6-17 years) with complex mental healthcare needs in accessing healthcare services in Alberta, Canada. Parents were interviewed using a semi-structured guide with open-ended and probing questions. Interviews were audio recorded and transcribed verbatim. Thematic analysis revealed three main themes: (1) Fragmented healthcare services profoundly impacted participants' experience of mental health care due to (a) a lack of a collaborative approach across disciplines in the healthcare system; (b) unavailability of information related to mental health care and (c) a lack of patient-centred care. (2) Navigating the complex healthcare system was difficult due to fragmented services and was hindered by gaps in accessing and receiving care, lack of continuity of care and lack of resources. (3) Distressed parents discussed the emotional challenges, financial burdens, self-advocacy and stigma they experienced in navigating the system. Parents offered insights into potential solutions to these gaps. Parents recommended the creation of a one-stop shop service with a team approach led by a navigator to facilitate and support navigations across healthcare services that work collaboratively across disciplines among healthcare services and across sectors inclusive of social services, education, policing and community programmes.

Promoting Strategies for Healthy Environments in University Halls of Residence under Regular Epidemic Prevention and Control: An Importance-Performance Analysis from Zhejiang, China

In the post-epidemic era, regular epidemic prevention and control is a daunting and ongoing task for nations all around the world. University halls of residence have been important spaces where university students balance their studies, work, and personal lives after COVID-19. Therefore, a healthy physical living environment deserves more attention. This paper compares situations before and after COVID-19 in an effort to evaluate the impact of indoor environments in university halls of residence on students. The study proposed eight vital dimensions for creating a healthy university hall of residence environment and, from 14 September to 4 October 2022, used an online questionnaire to collect data from 301 university students studying in Zhejiang, China. The key quality of service characteristics for fostering a healthy environment in university halls of residence were discovered using descriptive statistical analysis and revised importance-performance analysis (IPA). We found that an improved indoor physical environment and efficient arrangement of indoor space were crucial for the health of university students. The quality of educational services could be improved, and indoor exercise should be utilized effectively, both of which can contribute significantly to a healthy indoor environment. This study aims to contribute to the development of future initiatives to support healthy physical living environments in university halls of residence.

Examining Intersectoral Action as an Approach to Implementing Multistakeholder Collaborations to Achieve the Sustainable Development Goals

Objectives: The Sustainable Development Goals (SDGs) re-orient action towards improving the social and ecological determinants of health and equity. SDG 17 calls for enhanced policy and institutional coherence and strong multi-stakeholder partnerships. Intersectoral action (IA) has a promising history in public health, including health promotion and global health. Some experts see IA as crucial to the SDGs. Yet less is known about how IA is conceptualized and what promising models exist with relevance to the SDGs. We sought to investigate how IA is understood conceptually and empirically.

Methods: We conducted a narrative review of global public health and political science literatures and grey literature on the SDGs to identify theoretical models, case studies and reviews of IA research.

Results: Multiple competing conceptualizations of IA exist. Research has focused on case studies in high-income countries. More conceptual clarity, analyses of applications in LMICs, and explorations of political and institutional factors affecting IA are needed, as is attention to power dynamics between sectors.

Conclusion: IA is required to collaborate on the SDGs and address equity. New models for successful implementation merit exploration.

Coping Strategies Used by Older Adults to Deal with Contact Isolation in the Hospital during the COVID-19 Pandemic

Due to the COVID-19 pandemic, many older adults have experienced contact isolation in a hospital setting which leads to separation from relatives, loss of freedom, and uncertainty regarding disease status. The objective of this study was to explore how older adults (55+) cope with contact isolation in a hospital setting during the COVID-19 pandemic in order to improve their physical and psychological wellbeing. The realist evaluation approach was used to formulate initial program theories on coping strategies used by (older) adults in an isolation setting. Twenty-one semi-structured interviews with older patients (n = 21) were analysed. This study revealed that both emotion-focused coping strategies as well as problem-focused coping strategies were used by older adults during contact isolation. The study also uncovered some new specific coping strategies. The results have useful implications for hospital staff seeking to improve the wellbeing of older adults in contact isolation in hospitals. Problem-focused coping strategies could be stimulated through staff performing care in a person-centred way. Trust in staff, as part of emotion-focused coping strategies, could be stimulated by improving the relationship between patients and staff.