An action research approach to facilitating the adoption of a foot health assessment tool in India

Background: India has a diabetes population that is growing and alongside this, the incidence of limb threatening foot problems is increasing. Foot health care provision does not yet meet this demand. In one locality in India, clinicians had an unstructured approach to foot health assessments resulting in poor adoption of evidence based guidelines from the West and a persistence of serious foot complications. There was the perception that existing assessment tools did not take into account the local cultural, organizational and professional needs and there was a lack of ownership of any potential solution to the problem. Therefore, the aim of this work was to facilitate the ownership and development of a foot health assessment tool for use in the Indian context. In order to achieve this an action research approach was chosen. Methods: Participants were facilitated through the action and implementation phases of the action research cycle by the researchers. The action phase included generating a list of potential items for inclusion in the tool from a review of the literature to provide an evidence based foundation for the foot health assessment tool. A modified Delphi method was used to further refine the contents of the tool. Members of the Delphi Panel (n=8) were experts in their field of medicine and experts in delivering health care within services in India. Results: The outcome of the study was the adoption of a locally developed foot health assessment tool (Salford Indian Foot Health Assessment Tool, SIFT). It contains thirteen sections, which reflect the risk factors identified for assessing foot health agreed by the participants to fit the Indian context. The SIFT is supported with evidence based guidelines from the West and a training program was delivered by the researchers in order to support its implementation into clinical practice. Conclusion: An action research approach has facilitated the development and implementation of a locally created and owned foot health assessment tool. This in turn has resulted in the integration of evidence-based guidelines from the West with consideration to local cultural, organizational and professional needs and ultimately the needs of their patients. Further work is underway evaluating the outcomes of the SIFT in practice. Keywords: Diabetes; Action research; Foot health assessment

A 'soft' approach to TLM requirements capture to support through-life management

Loughborough University and BAE Systems are sponsoring a research programme to develop an enterprise Knowledge Management system for Through Life Management (TLM) in support of Through Life Capability Management (TLCM). This paper summarises the finding of a requirements analysis case study which captured, analysed and synthesised the key stakeholder requirements for this Knowledge Management research within the aerospace and defence industry. This study consists of two approaches; (1) an Interactive Management (IM) workshop and (2) semi-structured interviews with the Subject Matter Experts (SMEs). Three of the group methodologies used in the Interactive Management workshop were Idea-Writing, Nominal Group Technique and Interpretive Structural Modelling. Soft systems rich pictures were also constructed by the SMEs to provide a diagrammatic representation of the systematic but non-judgmental understanding of the problem situation. The difficulties and benefits of adopting this ’soft’ approach and future research plans are also discussed here