Search

Background: Community champions have been employed across various settings to disseminate evidence-based public health information. The Building Babies' Brains programme trains champions to work with parents in communities, equipping them with child development knowledge and parental engagement strategies. We explored what makes community champions effective in distributing information to parents, including how the champion–parent relationship and champions' personal characteristics affect information dissemination. Methods: Champions included both peers and professionals working with parents in target communities. We administered an online survey (n = 53) and follow-up interviews (n = 14) with champions, with representation from across all training cohorts. We conducted a realist-informed reflexive thematic analysis to generate themes in the data and highlight the contexts, mechanisms, and outcome patterns identified. Results: We observed 15 Context–Mechanism–Outcome configurations across five themes: information sharing opportunities, information relevance, the nature of the champion–parent relationship, interaction expectations, and champion confidence. Our programme theory for how the community champion approach works identified that peer champions focused more on building rapport, modelling behaviours, and being a trusted community resource than direct information transfer. Professional champions, in contrast, showed greater expertise and confidence in discussing parenting practices directly. For both groups, traits such as friendliness and the ability to establish a trusting relationship enhanced effectiveness. Conclusions: This research identifies the impacts of champion role, characteristics, and the champion–parent relationship on the effectiveness of knowledge mobilisation in this context, with implications for training and recruitment of champions. Those using a champion model in comparable settings should ensure that champions have the necessary knowledge, skills, and confidence to engage parents and share information effectively. [ABSTRACT FROM AUTHOR]

Abstract Background Champions play a critical role in implementing technology within healthcare services. While prior studies have explored the presence and characteristics of champions, this review delves into the experiences of healthcare personnel holding champion roles, as well as the experiences of healthcare personnel interacting with them. By synthesizing existing knowledge, this review aims to inform decisions regarding the inclusion of champions as a strategy in technology implementation and guide healthcare personnel in these roles. Methods A systematic mixed studies review, covering qualitative, quantitative, or mixed designs, was conducted from September 2022 to March 2023. The search spanned Medline, Embase, CINAHL, and Scopus, focusing on studies published from 2012 onwards. The review centered on health personnel serving as champions in technology implementation within healthcare services. Quality assessments utilized the Mixed Methods Appraisal Tool (MMAT). Results From 1629 screened studies, 23 were included. The champion role was often examined within the broader context of technology implementation. Limited studies explicitly explored experiences related to the champion role from both champions’ and health personnel’s perspectives. Champions emerged as promoters of technology, supporting its adoption. Success factors included anchoring and selection processes, champions’ expertise, and effective role performance. Discussion The specific tasks and responsibilities assigned to champions differed across reviewed studies, highlighting that the role of champion is a broad one, dependent on the technology being implemented and the site implementing it. Findings indicated a correlation between champion experiences and organizational characteristics. The role’s firm anchoring within the organization is crucial. Limited evidence suggests that volunteering, hiring newly graduated health personnel, and having multiple champions can facilitate technology implementation. Existing studies predominantly focused on client health records and hospitals, emphasizing the need for broader research across healthcare services. Conclusions With a clear mandate, dedicated time, and proper training, health personnel in champion roles can significantly contribute professional, technological, and personal competencies to facilitate technology adoption within healthcare services. The review finds that the concept of champions is a broad one and finds varied definitions of the champion role concept. This underscores the importance of describing organizational characteristics, and highlights areas for future research to enhance technology implementation strategies in different healthcare settings with support of a champion.

Abstract Background Implementation science researchers often cite clinical champions as critical to overcoming organizational resistance and other barriers to the implementation of evidence-based health services, yet relatively little is known about who champions are or how they effect change. To inform future efforts to identify and engage champions to support HPV vaccination, we sought to describe the key characteristics and strategies of vaccine champions working in adolescent primary care. Methods In 2022, we conducted a national survey with a web-based panel of 2527 primary care professionals (PCPs) with a role in adolescent HPV vaccination (57% response rate). Our sample consisted of pediatricians (26%), family medicine physicians (22%), advanced practice providers (24%), and nursing staff (28%). Our survey assessed PCPs’ experience with vaccine champions, defined as health care professionals “known for helping their colleagues improve vaccination rates.” Results Overall, 85% of PCPs reported currently working with one or more vaccine champions. Among these 2144 PCPs, most identified the champion with whom they worked most closely as being a physician (40%) or nurse (40%). Almost all identified champions worked to improve vaccination rates for vaccines in general (45%) or HPV vaccine specifically (49%). PCPs commonly reported that champion implementation strategies included sharing information (79%), encouragement (62%), and vaccination data (59%) with colleagues, but less than half reported that champions led quality improvement projects (39%). Most PCPs perceived their closest champion as being moderately to extremely effective at improving vaccination rates (91%). PCPs who did versus did not work with champions more often recommended HPV vaccination at the earliest opportunity of ages 9–10 rather than later ages (44% vs. 33%, p < 0.001). Conclusions Findings of our national study suggest that vaccine champions are common in adolescent primary care, but only a minority lead quality improvement projects. Interventionists seeking to identify champions to improve HPV vaccination rates can expect to find them among both physicians and nurses, but should be prepared to offer support to more fully engage them in implementing interventions.

Background: Champions play a critical role in implementing technology within healthcare services. While prior studies have explored the presence and characteristics of champions, this review delves into the experiences of healthcare personnel holding champion roles, as well as the experiences of healthcare personnel interacting with them. By synthesizing existing knowledge, this review aims to inform decisions regarding the inclusion of champions as a strategy in technology implementation and guide healthcare personnel in these roles. Methods: A systematic mixed studies review, covering qualitative, quantitative, or mixed designs, was conducted from September 2022 to March 2023. The search spanned Medline, Embase, CINAHL, and Scopus, focusing on studies published from 2012 onwards. The review centered on health personnel serving as champions in technology implementation within healthcare services. Quality assessments utilized the Mixed Methods Appraisal Tool (MMAT). Results: From 1629 screened studies, 23 were included. The champion role was often examined within the broader context of technology implementation. Limited studies explicitly explored experiences related to the champion role from both champions' and health personnel's perspectives. Champions emerged as promoters of technology, supporting its adoption. Success factors included anchoring and selection processes, champions' expertise, and effective role performance. Discussion: The specific tasks and responsibilities assigned to champions differed across reviewed studies, highlighting that the role of champion is a broad one, dependent on the technology being implemented and the site implementing it. Findings indicated a correlation between champion experiences and organizational characteristics. The role's firm anchoring within the organization is crucial. Limited evidence suggests that volunteering, hiring newly graduated health personnel, and having multiple champions can facilitate technology implementation. Existing studies predominantly focused on client health records and hospitals, emphasizing the need for broader research across healthcare services. Conclusions: With a clear mandate, dedicated time, and proper training, health personnel in champion roles can significantly contribute professional, technological, and personal competencies to facilitate technology adoption within healthcare services. The review finds that the concept of champions is a broad one and finds varied definitions of the champion role concept. This underscores the importance of describing organizational characteristics, and highlights areas for future research to enhance technology implementation strategies in different healthcare settings with support of a champion. [ABSTRACT FROM AUTHOR]

Issue Addressed: Strategies that support the implementation of the SunSmart program in primary schools are essential to optimising policy uptake. Evidence outlining the type of support required, however, is lacking. This project explored the usefulness of an implementation support approach to sun safe hat‐wearing in schools. Methods: Formative research was undertaken with 16 primary schools in Greater Western Sydney to explore current sun protection behaviours and practices, perceived barriers and motivators of sun safe hat‐wearing, and resource needs. Based on these insights, a resource toolkit was developed and tested in 14 demonstration sites. Follow‐up interviews evaluated the usefulness of the toolkit and implementation support approach. Results: Sun safe hat‐wearing practices varied among schools. Commonly reported motivators included school policies, role modelling, incentives and knowledge. Commonly reported barriers included negative social norms, forgetfulness, cost and lack of understanding. Formative insights informed the development of the 'Motivation, Access, Triggers' Model and a 23‐resource toolkit. Following toolkit rollout, champions reported that the ability to select resources according to local needs was useful, and most found that the toolkit supported their school with sun safe hat‐wearing. Conclusions: A toolkit with local champions and leadership buy‐in has the potential to improve policy implementation. The opportunity to prioritise resource selection enables schools to address their specific needs in line with their sun protection policy. So What?: The provision of policy implementation support can help schools overcome the challenges of transforming a written SunSmart policy into practice. [ABSTRACT FROM AUTHOR]

Background: Implementation science researchers often cite clinical champions as critical to overcoming organizational resistance and other barriers to the implementation of evidence-based health services, yet relatively little is known about who champions are or how they effect change. To inform future efforts to identify and engage champions to support HPV vaccination, we sought to describe the key characteristics and strategies of vaccine champions working in adolescent primary care. Methods: In 2022, we conducted a national survey with a web-based panel of 2527 primary care professionals (PCPs) with a role in adolescent HPV vaccination (57% response rate). Our sample consisted of pediatricians (26%), family medicine physicians (22%), advanced practice providers (24%), and nursing staff (28%). Our survey assessed PCPs' experience with vaccine champions, defined as health care professionals "known for helping their colleagues improve vaccination rates." Results: Overall, 85% of PCPs reported currently working with one or more vaccine champions. Among these 2144 PCPs, most identified the champion with whom they worked most closely as being a physician (40%) or nurse (40%). Almost all identified champions worked to improve vaccination rates for vaccines in general (45%) or HPV vaccine specifically (49%). PCPs commonly reported that champion implementation strategies included sharing information (79%), encouragement (62%), and vaccination data (59%) with colleagues, but less than half reported that champions led quality improvement projects (39%). Most PCPs perceived their closest champion as being moderately to extremely effective at improving vaccination rates (91%). PCPs who did versus did not work with champions more often recommended HPV vaccination at the earliest opportunity of ages 9–10 rather than later ages (44% vs. 33%, p < 0.001). Conclusions: Findings of our national study suggest that vaccine champions are common in adolescent primary care, but only a minority lead quality improvement projects. Interventionists seeking to identify champions to improve HPV vaccination rates can expect to find them among both physicians and nurses, but should be prepared to offer support to more fully engage them in implementing interventions. [ABSTRACT FROM AUTHOR]

The aim of this article is to explore the role of local school champions in the facilitation and implementation of "The School Health Program". This study is based on semi-structured interviews with 26 local school champions. The interviews focused on exploring key implementation responsibilities and barriers and facilitators to implement core program components. Champions identify coordination, promotion, and handling of support functions as key implementation tasks. The findings highlight organizational and structural factors that impact this type of implementation agent. Teachers functioning as champions can be central agents in the implementation of a whole-school program. Champions must, however, be supported by thorough organizational preparation, engaged leadership, and a well-defined distribution of roles. [ABSTRACT FROM AUTHOR]

Background Ethiopia alone carries 49% of the global burden of trachoma, associated with a lack of safe water, sanitation and hygiene (WASH) and poor health practices. The aim of this study was to examine whether gamification among schoolchildren and promotion of local ownership of school WASH is associated with healthy behaviors and WASH infrastructure improvements. Methods Application of the Accelerate gamification intervention for elimination of trachoma, with an emphasis on gamification among schoolchildren and community involvement in motivating face-washing, handwashing and functional use of latrines, was undertaken. Results The study was conducted over 9 mo in 223 rural schools from six districts within the intervention area, reaching 93 518 schoolchildren. At baseline, students were observed washing their hands after using latrines in 23 (10.3%) schools. This increased to 132 (59%) schools (p ≤ 0.001) at follow-up. The number of latrines increased from 585 at baseline to 594 at follow-up (p=0.031). The availability of handwashing stations in schools increased from 31 (13.9%) with water access (8%) and soap (5%) to 155 (69.5%) schools with handwashing stations with water access in 153 (98.7%) (p<0.001) and soap in 121 (78%) (p<0.001). Conclusions Motivational strategies such as gamification among schoolchildren and promotion of local ownership of school WASH may be associated with healthy behaviors and WASH infrastructure improvements. [ABSTRACT FROM AUTHOR]

Background: Community champions have been employed across various settings to disseminate evidence-based public health information. The Building Babies’ Brains programme trains champions to work with parents in communities, equipping them with child development knowledge and parental engagement strategies. We explored what makes community champions effective in distributing information to parents, including how the champion–parent relationship and champions’ personal characteristics affect information dissemination. Methods: Champions included both peers and professionals working with parents in target communities. We administered an online survey (n = 53) and follow-up interviews (n = 14) with champions, with representation from across all training cohorts. We conducted a realist-informed reflexive thematic analysis to generate themes in the data and highlight the contexts, mechanisms, and outcome patterns identified. Results: We observed 15 Context–Mechanism–Outcome configurations across five themes: information sharing opportunities, information relevance, the nature of the champion–parent relationship, interaction expectations, and champion confidence. Our programme theory for how the community champion approach works identified that peer champions focused more on building rapport, modelling behaviours, and being a trusted community resource than direct information transfer. Professional champions, in contrast, showed greater expertise and confidence in discussing parenting practices directly. For both groups, traits such as friendliness and the ability to establish a trusting relationship enhanced effectiveness. Conclusions: This research identifies the impacts of champion role, characteristics, and the champion–parent relationship on the effectiveness of knowledge mobilisation in this context, with implications for training and recruitment of champions. Those using a champion model in comparable settings should ensure that champions have the necessary knowledge, skills, and confidence to engage parents and share information effectively.

Universities face a critical crossroads, in need of swift, targeted, and efficient actions to address future challenges. This necessities a strategic approach to updating and assessing engineering design education. Efforts to improve teaching and learning require systematic change in many universities, yet research on structuring such change is scarce. Few studies have combined a systems perspective with a functional operational level. This research embeds design thinking to structure to isolated actions. Drawing from an extensive literature review of educational change frameworks and several illustrative cases, this article demonstrates the potential of design-driven change. It highlights how dynamic interrelations can facilitate educational transformations across diverse academic levels. By presenting an educational ecosystem as a framework for systematic educational change, design thinking functions as a catalyst for educational transformation. The article also presents case findings that strengthen supportive actions ingrained in existing change research frameworks connecting, them to a transparent approach for sustainable and careful decision-making.

Background: Globally, mental health disorders rank as the greatest cause of disability. Low and middle-income countries (LMICs) hold a disproportionate share of the mental health burden, especially as it pertains to depression. Depression is highly prevalent among those with non-communicable diseases (NCDs), creating a barrier to successful treatment. While some treatments have proven efficacy in LMIC settings, wide dissemination is challenged by multiple factors, leading researchers to call for implementation strategies to overcome barriers to care provision. However, implementation strategies are often not well defined or documented, challenging the interpretation of study results and the uptake and replication of strategies in practice settings. Assessing implementation strategy fidelity (ISF), or the extent to which a strategy was implemented as designed, overcomes these challenges. This study assessed fidelity of two implementation strategies (a ‘basic’ champion strategy and an ‘enhanced’ champion ​+ ​audit and feedback strategy) to improve the integration of a depression intervention, measurement based care (MBC), at 10 NCD clinics in Malawi. The primary goal of this study was to assess the relationship between the implementation strategies and MBC fidelity using a mixed methods approach. Methods: We developed a theory-informed mixed methods fidelity assessment that first combined an implementation strategy specification technique with a fidelity framework. We then created corresponding fidelity indicators to strategy components. Clinical process data and one-on-one in-depth interviews with 45 staff members at 6 clinics were utilized as data sources. Our final analysis used descriptive statistics, reflexive-thematic analysis (RTA), data merging, and triangulation to examine the relationship between ISF and MBC intervention fidelity. Results: Our mixed methods analysis revealed how ISF may moderate the relationship between the strategies and MBC fidelity. Leadership engagement and implementation climate were critical for clinics to overcome implementation barriers and preserve implementation strategy and MBC fidelity. Descriptive statistics determined champion strategy fidelity to range from 61 to 93% across the 10 clinics. Fidelity to the audit and feedback strategy ranged from 82 to 91% across the 5 clinics assigned to that condition. MBC fidelity ranged from 54 to 95% across all clinics. Although correlations between ISF and MBC fidelity were not statistically significant due to the sample of 10 clinics, associations were in the expected direction and of moderate effect size. A coefficient for shared depression screening among clinicians had greater face validity compared to depression screening coverage and functioned as a proximal indicator of implementation strategy success. Conclusion: Fidelity to the basic and enhanced strategies varied by site and were influenced by leadership engagement and implementation climate. Champion strategies may benefit from the addition of leadership strategies to help address implementation barriers outside the purview of champions. ISF may moderate the relationship between strategies and implementation outcomes.

The digital scholarship department in Binghamton University's libraries was created in 2018 as part of a larger effort to bring digital humanities (DH) efforts to Binghamton. The initiative was largely spearheaded by one person who became one of the biggest digital scholarship (DS) champions on campus. They, along with the new DS librarian, founded a Digital Humanities Research Institute igniting the creation of smaller working groups and initiatives across campus. Our article discusses the role of DS champions on Binghamton's campus, including the types of advantages they were able to leverage, their interests and goals for a DS community, and what happens when they leave. Champions are a well-researched phenomenon in business and health sciences spaces, but there is sparse research on DS champions, despite the fact they often share characteristics with champions' roles in those areas. Understanding more about who champions are and what drives them would help DS communities plan for building sustainable and robust communities should their champions leave or no longer be able to participate in the communities they built. [ABSTRACT FROM AUTHOR]

India has an equal number of males and females overall. But women are viewed unfavorably in this complicated modern society as second-class citizens or as men's property. Women are still behind and have not advanced to the maximum degree of utilization. The majority of governments make particular allowances for women's advancement, and they work hard to maximize the potential of women's skills. The specific services and facilities that are offered to women in the corporate world have not been fully used. There is a dearth of successful female business owners. The moment has come to educate the female population about the chances available to them to pursue their passions and give back to the community, which may contribute to the nation's speedy growth. MSMEs (Micro, Small, and Medium-Sized Enterprises) are crucial to a nation's economic growth. The entire planet has power. Through its many programs, the Ministry of MSMEs is empowering female entrepreneurs by assisting them in igniting their creativity and creating their own identities. In our current society, women are required to carry out economic activities and support their families wherever the cost of living rises. Now that attitudes in society have evolved, working women are no longer despised. An effort was made to research the position of women entrepreneurs in this report. Current problems experienced by female entrepreneurs. Additionally, it covers the assistance offered by MSMEs to female entrepreneurs. [ABSTRACT FROM AUTHOR]

The construction industry is the primary focus for social procurement policies in many countries. However, there has been little research into the drivers of social procurement policy adoption in this industry. To help address this gap in research, this paper reports the results of semi-structured interviews with fifteen social procurement professionals who are implementing social procurement into the Australian construction industry. Results reveal interesting historical parallels with the implementation of environmental sustainability initiatives. However, social procurement has yet to become normalized. There appears to be a high level of homogeneity in industry practice and while there is considerable scope for innovation, this is constrained by the prescriptive and 'top-down' nature of social procurement policies in Australia which make it difficult for organizations to respond 'bottom-up' to actual community needs. It is concluded that the considerable untapped potential of social procurement policies to create social value currently depends on the intrapreneurial efforts of a small number of emerging social procurement professionals who are individually challenging the many institutional norms and practices which undermine the implementation of these policies into the construction industry. [ABSTRACT FROM AUTHOR]

This paper was presented in the 2021 Conference on Land Policy in Africa held in Kigali, Rwanda, in November 2021. It is based on a three-year study by the Land Development and Governance Institute (LDGI), in partnership with the International Development Research Centre (IDRC), Canada, to test the efficacy of the application of Kenya's new Community Land Act. The study sites are in Isiolo and Marsabit Counties, both in the Arid and Semi-Arid (ASAL) Northern Kenya. The study results demonstrate the importance of adequate sensitisation of the key actors (government, political and community) at county level and the grass root communities, the use of participatory and inclusive processes to establish the community governance organs and fulfil the statutory requirements provided under this new law. The study also highlights the importance of the use of community champions to ensure the continuous sensitisation of community members, and to to galvanise the communities in the registration and management of their land. Through the study, communities were supported to develop basic tools to guide them in land use planning and investor negotiations. The land use planning guide developed will help the communities to liase with the county government to prepare a land use development plan which is expected to enhance the sustainable use of the community land, while the investor negotiation guide developed will be helpful during negotiations with investors interested in partnering with the communities for investments on their land. The use of the investor guides is expected to inform the preparation of mutually beneficial investor agreements as anticipated under the Community Land Act. It is expected that the lessons from the study, which include: community empowerment, use of participatory inclusive processes, ensuring gender equity in the composition of governance organs and in decision making processes, embracing the youth, use of champions and avoiding the negative impacts of the adjudication of community land will be useful to state and non-state implementers of the new law, and may be used to inform the scaling up implementation countrywide. It is also expected that gaps identified in the new law, such as the management of the inheritance rights of children married outside the community, and those divorced, will inform law review.

The burden of health inequities borne by Indigenous peoples can be overwhelming, especially when mothers and newborns' lives are at stake and health services seem slow to invest in responsiveness. In Aotearoa (New Zealand), urgent action is required to eliminate persistent systemic inequities for Māori (Indigenous) whānau (family collectives that extend beyond the household). This Kaupapa Māori (by Māori, for Māori) qualitative study aimed to explore the views of health practitioners identified as champions by whānau of preterm Māori infants. Ten health practitioners were interviewed and asked about their involvement with the whānau, their role in explanations and communication, and their thoughts on whānau coping. Interview data were analysed using interpretative phenomenological analysis. Three superordinate themes were identified: working together in partnership, a problem shared is a problem halved, and sacred space. Collaboration between health practitioners and with whānau was important to the champions and central to their goal of enabling whānau autonomy. This was built on a foundation of connectivity, relationships, and a full appreciation that childbirth is a sacred time that is potentially disrupted when an infant is born prematurely. The values- and relationship-based practices of these champions protected and uplifted whānau. They showed that health practitioners have important roles in both the elimination of inequities and the sustaining of Māori self-determination. This championship is an exemplar of what culturally safe care looks like in day-to-day practice with Māori and is a standard that other health practitioners should be held to. [ABSTRACT FROM AUTHOR]

This study aimed to examine how allied healthcare professionals as informal leaders can lead reforms to improve patient care on an interprofessional team. With 284 interprofessional team members working in 59 geriatric facilities, our findings demonstrated that informal leaders exhibiting more championship behaviors gained higher innovation success scores. In addition, the champion's professional tenure and institutional size were both negatively associated with innovation success. We discuss important implications for this understudied issue in interprofessional team research: how a low-status informal leader can direct reform aimed at improving patient care within a healthcare organization. [ABSTRACT FROM AUTHOR]

The aim of this article is to explore the role of local school champions in the facilitation and implementation of “The School Health Program”. This study is based on semi-structured interviews with 26 local school champions. The interviews focused on exploring key implementation responsibilities and barriers and facilitators to implement core program components. Champions identify coordination, promotion, and handling of support functions as key implementation tasks. The findings highlight organizational and structural factors that impact this type of implementation agent. Teachers functioning as champions can be central agents in the implementation of a whole-school program. Champions must, however, be supported by thorough organizational preparation, engaged leadership, and a well-defined distribution of roles.

Abstract Background Champions have been documented in the literature as an important strategy for implementation, yet their effectiveness has not been well synthesized in the health care literature. The aim of this systematic review was to determine whether champions, tested in isolation from other implementation strategies, are effective at improving innovation use or outcomes in health care. Methods The JBI systematic review method guided this study. A peer-reviewed search strategy was applied to eight electronic databases to identify relevant articles. We included all published articles and unpublished theses and dissertations that used a quantitative study design to evaluate the effectiveness of champions in implementing innovations within health care settings. Two researchers independently completed study selection, data extraction, and quality appraisal. We used content analysis and vote counting to synthesize our data. Results After screening 7566 records titles and abstracts and 2090 full text articles, we included 35 studies in our review. Most of the studies (71.4%) operationalized the champion strategy by the presence or absence of a champion. In a subset of seven studies, five studies found associations between exposure to champions and increased use of best practices, programs, or technological innovations at an organizational level. In other subsets, the evidence pertaining to use of champions and innovation use by patients or providers, or at improving outcomes was either mixed or scarce. Conclusions We identified a small body of literature reporting an association between use of champions and increased instrumental use of innovations by organizations. However, more research is needed to determine causal relationship between champions and innovation use and outcomes. Even though there are no reported adverse effects in using champions, opportunity costs may be associated with their use. Until more evidence becomes available about the effectiveness of champions at increasing innovation use and outcomes, the decision to deploy champions should consider the needs and resources of the organization and include an evaluation plan. To further our understanding of champions’ effectiveness, future studies should (1) use experimental study designs in conjunction with process evaluations, (2) describe champions and their activities and (3) rigorously evaluate the effectiveness of champions’ activities. Registration Open Science Framework ( https://osf.io/ba3d2 ). Registered on November 15, 2020.

Between 1998 and 2021, the Open Society Foundations (OSF) network invested around US$50 million in supporting the emerging field of palliative care worldwide, funding different approaches and interventions to advance its objective of putting palliative care on the global public health agenda. To describe six approaches that were instrumental to the successes of Open Society Foundations' support in building the global field of palliative care. A robust discussion of lessons learnt is unfortunately not possible because Open Society Foundations did not commission a rigorous evaluation of the impacts of its investments. This article describes these six approaches: Investing in versatile palliative care leaders at national and regional level; investing in palliative care champions within the OSF network; proactively engaging the World Health Organization (WHO) in efforts to promote palliative care; developing tools and skills to improve palliative care financing; using a human rights-based approach; and supporting self-advocacy by people with palliative care needs. Deep, long-term investments in national and regional champions from the palliative care community and OSF's own network built palliative care leaders with well-rounded skills, knowledge and opportunities to develop their own networks. The active engagement and involvement of the WHO in efforts to advance palliative care enhanced the credibility of palliative care as a discipline as well its champions, whereas the human rights approach resulted in more diverse strategies to overcome barriers to palliative care. The focus on palliative care financing and self-advocacy showed significant promise for impact. The approaches and strategies described helped a nascent palliative care field develop into a health service that is increasingly integrated into public health systems. Other funders and national governments can build on OSF's long term support for the palliative care field and support further integration of palliative care within public health to increase access. [ABSTRACT FROM AUTHOR]

Abstract Background The clinical Pandemic Practice Champion (PPC) role was created in a large tertiary pediatric hospital as a knowledge translation (KT) strategy for implementing COVID-19 evidence-based knowledge. We aimed to describe the core components of the PPC role, the process of implementing the role, and the factors that hindered or facilitated role implementation. Methods An exploratory case study was undertaken. Semi-structured interviews were conducted virtually with stakeholders including PPC, managers, and front-line health care professionals (HCP). A directed approach to qualitative content analysis consistent with the Consolidated Framework for Implementation Research (CFIR) guided the analytic process. Inductive analyses and three stages of thematic synthesis were also conducted. Results Four PPC, 3 managers, and 6 HCP were interviewed. The core components of the PPC role consisted of (a) acting as knowledge experts and educators, (b) problem-solving for complex patient care issues, (c) conducting crisis management, and (d) acting as a resource to management, HCP, and families. Facilitators for successful implementation included access to external information, a supportive organizational context and culture, dedicated time and resources, and leadership support. Lack of clarity of role definition, insufficient time, pandemic uncertainty and fatigue, inability to change infrastructure, and access to external information hindered implementation. Conclusion The PPC role was successfully implemented within a crisis context. Key barriers (role clarity, time, resources) and facilitators (organizational and leadership support) need to be considered when implementing the PPC role in practice. Future studies are needed to determine the intervention effectiveness of the champion role in changing HCP behavior and health outcomes and further examine implementation processes and mechanisms.

Context and background: This paper presents a study based on a three-year study by the Land Development and Governance Institute (LDGI), in partnership with the International Development Research Centre (IDRC), Canada, to test the efficacy of the application of Kenya's new Community Land Act. The study sites are in Isiolo and Marsabit Counties, both in the Arid and Semi-Arid (ASAL) Northern Kenya. Goal and objectives: The paper has the objective to demonstrate the importance of adequate sensitisation of the key actors (government, political and community) at county level and the grass root communities, the use of participatory and inclusive processes to establish the community governance organs and fulfil the statutory requirements provided under this new law. The study also highlights the importance of the use of community champions to ensure the continuous sensitisation of community members, and to to galvanise the communities in the registration and management of their land. Methodology: Through the study, communities were supported to develop basic tools to guide them in land use planning and investor negotiations. The land use planning guide developed will help the communities to liase with the county government to prepare a land use development plan which is expected to enhance the sustainable use of the community land, while the investor negotiation guide developed will be helpful during negotiations with investors interested in partnering with the communities for investments on their land. The use of the investor guides is expected to inform the preparation of mutually beneficial investor agreements as anticipated under the Community Land Act. Results: It is expected that the lessons from the study, which include: community empowerment, use of participatory inclusive processes, ensuring gender equity in the composition of governance organs and in decision making processes, embracing the youth, use of champions and avoiding the negative impacts of the adjudication of community land will be useful to state and non-state implementers of the new law, and may be used to inform the scaling up implementation countrywide. It is also expected that gaps identified in the new law, such as the management of the inheritance rights of children married outside the community, and those divorced, will inform law review. [ABSTRACT FROM AUTHOR]

Implementation science research identifies clinical champions as instrumental in aligning healthcare professionals' (HCPs) behavior with practice guidelines for delivering health services, including vaccinations. However, we know relatively little about identifying or supporting champions. To characterize who vaccine champions are, what they do, and how to support their work in pediatric primary care. In 2022, we interviewed a purposive sample of peer-nominated or self-identified vaccine champions (n=20) and HCPs who worked with vaccine champions (n=4). We thematically analyzed qualitative data. Vaccine champions' defining characteristics were firsthand primary care experience, whether as providers or nursing staff, and a strong belief in vaccinations as uniquely effective tools for primary prevention. Participants noted these beliefs were "part of the DNA" of specialties like pediatrics and infectious disease, where they perceived champions as especially common. Being "insatiable in their quest for knowledge," champions primarily conceptualized their role as understanding and sharing complex information and performance metric data related to vaccine administration. Champions' role in leading other implementation strategies, such as communication training, was more peripheral. Champions reported that dedicated time and staff support helped them "go above and beyond" to improve vaccination rates. Our findings suggest that vaccine champions can be found among providers and nursing staff with deep clinical experience and commitment to primary prevention through vaccination, including through providing vaccine education to colleagues. Healthcare systems can allocate resources to support champions as educators, while exploring opportunities to extend their role in other implementation strategies to improve vaccination rates., (© Society of Behavioral Medicine 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Social procurement is re-emerging as an innovative collaborative policy tool for governments around the world to leverage their construction supply chains to help them address intransigent social problems such as long-term unemployment. Such policies challenge deeply rooted institutional norms and structures in the construction industry and research shows that they are being championed by a small and largely undefined group of social procurement professionals who suffer significant role conflict and ambiguity. Contributing new insights to this nascent research, this paper traces etymological definitions of champion roles, merging them with organisational theory to present a new typology of social procurement champions in the construction industry. Drawing on a thematic analysis of snowballed interviews with fifteen recognised champions of social procurement in the Australian construction industry, findings highlight four distinct types of social procurement champion: champions of organisations; champions of the concept; champions of people; and champions of a solution. It is found that there is no one pure type of social procurement champion. Rather, champions have to adapt their social procurement roles to the highly dynamic and varied organisation contexts in which they operate. These findings advance the emerging social procurement debate within and outside construction by highlighting the many different roles which are needed to implement social innovations like social procurement into a project-based industry like construction. It is concluded that organisations which see this as one person's responsibility are likely to fail in implementing these new policy reforms. [ABSTRACT FROM AUTHOR]

Background: Physically Active Children in Education (PACE) is composed of eight implementation strategies that improves schools' implementation of a government physical activity policy. A greater understanding of each discrete implementation strategy could inform improvements to PACE for delivery at-scale. This study aimed to: (A) measure the dose delivered, fidelity, adoption and acceptability of each strategy using quantitative data; (B) identify implementation barriers and facilitators using qualitative data; and (C) explore the importance of each strategy by integrating both data sets (mixed methods). Methods: This study used data from a cluster randomised noninferiority trial comparing PACE with an adapted version (Adapted PACE) that was delivered with reduced in-person external support to reduce costs and increase scalability. Data were collected from both trials arms for between-group comparison. Descriptive statistics were produced using surveys of principals, in-school champions and teachers; and project records maintained by PACE project officers (objective A). Thematic analysis was performed using in-school champion and project officer interviews (objective B). Both data sets were integrated via a triangulation protocol and findings synthesized in the form of meta-inferences (objective C). Results: Eleven in-school champions and six project officers completed interviews; 33 principals, 51 in-school champions and 260 teachers completed surveys. Regardless of group allocation, implementation indicators were high for at least one component of each strategy: dose delivered =100%, fidelity ≥95%, adoption ≥83%, acceptability ≥50%; and several implementation barriers and facilitators were identified within three broad categories: external policy landscape, inner organizational structure/context of schools, and intervention characteristics and processes. All strategies were considered important as use varied by school, however support from a school executive and in-school champions' interest were suggested as especially important for optimal implementation. Conclusion: This study highlights the importance of both executive support and in-school champions for successful implementation of school physical activity policies. In particular, identifying and supporting an in-school champion to have high power and high interest is recommended for future implementation strategies. This may reduce the need for intensive external support, thus improving intervention scalability. [ABSTRACT FROM AUTHOR]

The American Association of Colleges of Pharmacy has long emphasized the value of strategic engagement, recognizing that it is critical to the success of pharmacy education, contributing to the expansion of pharmacy and public health practice, the fulfillment of institutional missions, and the meeting of programmatic needs. The 2023-2024 Strategic Engagement Committee was charged with operationalizing advocacy champions, creating an advocacy resource guide to support advocacy champions in their engagement with diverse public and private stakeholders, offering formal training to advocacy champions in the form of a new connect community and webinar series, and conducting focus groups at the 2024 Annual Meeting to determine strengths of the advocacy guide and opportunities to support advocacy champions further., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 American Association of Colleges of Pharmacy. Published by Elsevier Inc. All rights reserved.)

Daily use of chlorhexidine gluconate (CHG) has been shown to reduce risk of healthcare-associated infections. We aimed to assess moving CHG bathing into routine practice using a human factors approach. We evaluated implementation in non-intensive care unit (ICU) settings in the Veterans Health Administration. Our multiple case study approach included non-ICU units from 4 Veterans Health Administration settings. Guided by the Systems Engineering Initiative for Patient Safety, we conducted focus groups and interviews to capture barriers and facilitators to daily CHG bathing. We measured compliance using observations and skin CHG concentrations. Barriers to daily CHG include time, concern of increasing antibiotic resistance, workflow and product concerns. Facilitators include engagement of champions and unit shared responsibility. We found shortfalls in patient education, hand hygiene and CHG use on tubes and drains. CHG skin concentration levels were highest among patients from spinal cord injury units. These units applied antiseptic using 2% CHG impregnated wipes vs 4% CHG solution/soap. Non-ICUs implementing CHG bathing must consider human factors and work system barriers to ensure uptake and sustained practice change. Well-planned rollouts and a unit culture promoting shared responsibility are key to compliance with daily CHG bathing. Successful implementation requires attention to staff education and measurement of compliance. [ABSTRACT FROM AUTHOR]

This paper presents the outcomes of a community-based information communications technology (ICT) and basic adult education (BAE) nutrition training intervention for out-ofschool young mothers (YMs) in a resource-limited rural village in eastern Limpopo Province, South Africa. YMs have been identified as a vulnerable and priority group for human development. Out-of-school YMs are often trapped in a cycle of poverty because they lack the resources and qualifications to compete outside their village environment. Implementation of the project's objectives to improve the nutritional and vocational skills education of the YMs was tracked to observe its empowering effect and the effectiveness of the community-based participatory action research (CBPAR) methodology in the implementation of the BAE. Voluntary sampling was used to purposively focus on seven of the 20 selected unemployed YMs between the ages of 18-30 years from this community. The findings revealed that the collaborative CBPAR approach enabled YMs to be empowered in their local community through active participation in the planning, trialling implementation, reflection, observation, and evaluation of the ICT and BAE nutrition course as an out-of-school adult learning experience. During these stages, some YMs displayed what may be considered "champion" behaviours such as higher levels of motivation in class, inviting others to the class, helping peers, regular attendance, and willingness to volunteer locally to access and assist with the facilitation of future courses. This study points to champions acting as catalysts to enable YMs and their older women mentors to fill different roles in the development and delivery of community-based BAE. [ABSTRACT FROM AUTHOR]

Human papillomavirus (HPV) vaccination prevents 6 HPV-related cancers in men and women. Yet, rates of HPV vaccination among adolescents in the United States lag behind other developed nations, revealing a significant public health issue. This feasibility study tested a collaborative online learning environment to cultivate HPV vaccination champions. A 3-month training program recruited parents to serve as proponents and social media influencers to identify solutions to overcome barriers to HPV vaccination. A mixed methods study design included a pretest survey, three online asynchronous focus groups, a posttest survey, as well as a longitudinal follow-up survey at 6 months. Participants included 22 parents who self-identified as female (95.4%) and white (90.9%). Overall, there was a statistically significant difference in knowledge of HPV and HPV vaccination between pretest and posttest (p = 0.0042). This technology-mediated intervention increased parents' confidence and motivated them to speak more freely about HPV vaccination in-person and online with others in their social networks. Participants identified prevalent misinformation about HPV vaccination and learned how to effectively craft messages to address concerns related to safety and side effects, gender, understanding of risk, and sexual activity. Objective measures and qualitative open-ended assessment showed high intervention engagement and treatment satisfaction. All participants (100%) indicated that they enjoyed participating in the intervention. The effectiveness of this feasibility study suggests that social media is an appropriate platform to empower parents to counter vaccine hesitancy and misinformation through HPV vaccination information that is simple and shareable in-person and online.

A social accountability mandate for Canadian medical schools formally emerged in Canada with changes to accreditation standards in 2015. However, how social accountability is defined and operationalized within medical schools has transpired independently. Key enablers of social accountability in Canadian medical schools have been largely unexplored. This paper is the first of a two part series that seeks to explore drivers of social accountability in a sample of Canadian medical schools. Nine key drivers of social accountability emerged from the data including a unified vision, committed leadership, accreditation standards, champions of social accountability, authentic community engagement, community-based learning opportunities, a supportive organizational and governance structure, diversity within medical schools, and measurement of progress and outcomes. This is the first study of its kind to examine what is driving social accountability across Canadian medical schools. An appreciative inquiry approach highlights areas of progress for future work to focus and build upon. This paper presents the findings from part one of the study – exploring the themes emerging from key informant interviews with senior leaders. A second paper will dive into the broader perspectives of faculty, staff and students, to explore more fully the varying perspectives of social accountability within colleges. [ABSTRACT FROM AUTHOR]

Aims: To develop and test the relationship between nurse champions' personal social networks and innovation success in terms of spread. Design: A cross sectional. Method(s): Data were collected on 94 nurse champions at three medium‐large tertiary medical centres from 2015–2016. Data from champions on their personal network were assessed via a standardized and acceptable three‐step network survey. Success in terms of innovation spread was assessed via perceived extent of spread. Network structural and relational characteristics were depicted by level of spread. Multivariate linear regression was used to assess the relationship between network characteristics and innovation spread. Findings: Above and beyond various project and network control variables, network density was significantly and positively related to project spread, tie‐strength diversity was significantly and negatively related to project spread and difference in ethnic origin between champions and alters was significantly and positively related to project spread. Maximum age of network members was marginally significantly related to project spread. Conclusion(s): Our findings show that high‐density personal social networks; networks where tie strength among network members is similar, thus, creating liking and trust among members; having at least one older network member who might have close access to professional and organizational resources acquired throughout their career; and having ties with network members from different ethnic groups to prevent knowledge stickiness, all promote innovation spread. Champions should be carefully nominated based on their ability to engage network members and to build ties with various network members inside and outside the nursing unit; once selected, champions should be aware of their social networks. Impact: The current study explored champions' personal‐network structure, composition and variance measures and their implications for innovation project spread. The findings demonstrated that nursing champions' personal social networks matter for innovation spread. This finding has implications for the nominating and the coaching of champions. [ABSTRACT FROM AUTHOR]

The article examines the process of restoration and development of the physical culture and sports movement in the USSR in the 40s (postwar) - 50s of the XX century. The conditions for the transformation of physical education and sports into a national movement in specified years demanded the encouragement of all types of mass sports and physical culture. Sport has also created a new cultural environment, since sports facilities - stadiums, sports palaces, arenas, playgrounds, tracks, swimming pools - have not only become important architectural objects but have also had a significant impact on the entire organization and conduct of leisure activities of the population. Practical work on physical culture and sports at enterprises, institutions, universities, schools was carried out by physical education teams or sports organizations. During this period, sports days were annually held in local physical culture groups, in districts and cities, spartakiads of voluntary sports societies, universities, schools were organized. Numerous athletes took part in them, the strongest of whom took part in the All-Russian and All-Union Spartakiads. [ABSTRACT FROM AUTHOR]

Abstract Background Studies investigating associations between ACTN3 R577X and ACE I/D genotypes and endurance athletic status have been limited by small sample sizes from mixed sport disciplines and lack quantitative measures of performance. Aim: To examine the association between ACTN3 R577X and ACE I/D genotypes and best personal running times in a large homogeneous cohort of endurance runners. Methods We collected a total of 1064 personal best 1500, 3000, 5000 m and marathon running times of 698 male and female Caucasian endurance athletes from six countries (Australia, Greece, Italy, Poland, Russia and UK). Athletes were genotyped for ACTN3 R577X and ACE ID variants. Results There was no association between ACTN3 R577X or ACE I/D genotype and running performance at any distance in men or women. Mean (SD) marathon times (in s) were for men: ACTN3 RR 9149 (593), RX 9221 (582), XX 9129 (582) p = 0.94; ACE DD 9182 (665), ID 9214 (549), II 9155 (492) p = 0.85; for women: ACTN3 RR 10796 (818), RX 10667 (695), XX 10675 (553) p = 0.36; ACE DD 10604 (561), ID 10766 (740), II 10771 (708) p = 0.21. Furthermore, there were no associations between these variants and running time for any distance in a sub-analysis of athletes with personal records within 20% of world records. Conclusions Thus, consistent with most case-control studies, this multi-cohort quantitative analysis demonstrates it is unlikely that ACTN3 XX genotype provides an advantage in competitive endurance running performance. For ACE II genotype, some prior studies show an association but others do not. Our data indicate it is also unlikely that ACE II genotype provides an advantage in endurance running.

There has been a recent proliferation of social procurement policies in Australia that target the construction industry. This is mirrored in many other countries, and the nascent research in this area shows that these policies are being implemented by an emerging group of largely undefined professionals who are often forced to create their own roles in institutional vacuums with little organisational legitimacy and support. By mobilising theories of how organisational champions diffuse innovations in other fields of practice, this paper contributes new insights into the evolving nature of these newly emerging roles and the motivations which drive these professionals to overcome the institutional inertia they invariably face. The results of semi-structured interviews, with fifteen social procurement champions working in the Australian construction industry, indicate that social procurement champions come from a wide range of professional backgrounds and bring diverse social capital to their roles. Linked by a shared sense of social consciousness, these champions challenge traditional institutional norms, practices, supply chain relationships, and traditional narratives about the concepts of value in construction. We conclude that, until normative standards develop around social procurement in the construction industry, its successful implementation will depend on external institutional pressures and the practical demonstration of what is possible in practice within the performative constraints of traditional project objectives.

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This study looks at the role of champions in the early stages of the product development process, when employees try to secure initial funding for project proposals. Project proposals that fail to receive funding never become part of the firm's project pipeline; hence, it is critical to understand the champion's role early on. Existing research on corporate champions is mostly focused on the later stages of the new product development process and has generally identified corporate champions as key to projects likely to face organisational resistance. However, several recent studies suggest that champions may prefer projects less likely to face organisational resistance. Using data from project proposals of executive MBA students across 78 large organisations, we find that champion support for the team is weaker for project proposals likely to evoke resistance and that such lower champion support further reduces the likelihood of high-resistance early-stage proposals to receive initial funding. [ABSTRACT FROM AUTHOR]

Copyright of Papeles del CEIC is the property of Centro de Estudios sobra la Identidad Colectiva, Facultas de Ciencias Sociales and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)