Design for Sustainable Behaviour: a conceptual model and intervention selection model for changing behaviour through design.

This thesis is based in the research area of Design for Sustainable Behaviour (DfSB), a field which seeks to reduce the social and environmental impact of products in the use phase of their life cycle. There has been significant theoretical development in this area in recent years, leading to a proliferation of intervention strategies and design methodologies. However, there has been a recognised lack of a reliable means of selecting which intervention strategy to use in a given situation, and a lack of real world intervention case studies generating measurable medium-to-long term reductions in energy consumption. Addressing these gaps was a central focus of this research. This thesis documents four distinct research phases; an extensive literature review, an in-depth user study of existing energy consuming behaviours and motivations, the development and trialling of design interventions, and the evaluation of the generated theories as a tool for designers. Literature on domestic energy consumption, human behaviour, and approaches to changing behaviour was reviewed to establish the current level of thinking and to identify opportunities for further research. This guided the undertaking of the user study with a number of families in the East Midlands of the UK, which illuminated the relevant motivational goals, and highly routinized nature, displayed in many energy consuming behaviours. Over the course of this phase of the research journey a new conceptual model of behaviour in context was developed, and refined to create the Behavioural Intervention Selection Axis (BISA). These theoretical developments were then applied to the generation of DfSB intervention concepts, one of which was selected and developed to a functional prototype stage. These prototypes were trialled in situ in family homes for an extended period, and achieved a significant change in behaviour and related energy consumption. Further evaluation of the BISA as a tool to guide designers was performed through a series of workshops with design students, which ascertained its usefulness in this respect. Both the intervention development and trialling and the design workshops showed the conceptual model and BISA to be successful in providing designers with a reliable and useful means of selecting appropriate intervention strategies to change behaviour. In addition the intervention trial provided a wealth of qualitative insight into the way in which DfSB can effect behaviour, and the range of new motivational goals it can engender

Research methods from human-centered design: Potential applications in pharmacy and health services research

Challenges faced by health systems have become increasingly complex, and expanding the range of methodological options available via interdisciplinary collaboration is important to enable researchers to address them. As complexity increases, it can be more difficult to ensure solutions remain patient-centered. Human-centered design is an approach that focuses on engaging with and understanding the needs of all services users while retaining a systems perspective. Therefore, design professionals skilled in these approaches are increasingly collaborating within health systems in pharmacy and health research teams. This methodological paper considers the potential contribution of human-centered design approaches to optimising development, implementation, and sustainability of patient-centered interventions in pharmacy and health services research. It provides an overview of human-centered design principles and their application, and outlines the emerging roles of design professionals in pharmacy and health services research. It focuses on three key human-centered design methods that can most readily be used by pharmacy and health services researchers. Journey mapping, prototyping, and user testing are discussed in detail. Journey mapping enables holistic visualisation of patient experience from practical and emotional perspectives. It may be used to visualize current practice or model potential future services, and can be informed by quantitative and qualitative data derived from both primary and secondary research. Prototyping facilitates exploration of interventions such as new services quickly and at low-cost. Health services researchers can utilize prototypes for services, processes, experiences, physical objects, environments, spaces, or digital tools for example. Formative evaluation and user testing supports rapid iteration of prototypes to ensure that they meet patient and healthcare professional needs. Finally, challenges with interdisciplinary collaboration and strategies to maximize the potential of using human-centered design approaches in pharmacy and health services research to address complex challenges, enhance practice and deliver benefits for service users, patients, and health systems are discussed

LEEDR: what are the results? Participant feedback for H99

The LEEDR project was a four-year study that explored energy consumption in family homes. 20 households took part, being involved for about three years. Insights were fed back to the participants at the end of the project in the form of a unique, tailored book for each family. This book represents the style, formatting and information content of those books. This version has been called ‘H99’ and it is an amalgam of chapters from multiple homes, and therefore should not be used as a source of data or analysis: please refer to publications. The information contained here has been released generally in the hope that it might inspire and inform the development of feedback from other similar projects

Medication safety incidents associated with the remote delivery of primary care: a rapid review

Background The COVID-19 pandemic triggered rapid, fundamental changes in how healthcare is delivered in communities, notably increased remote delivery of primary care. While the impact of these changes on medication safety are not yet fully understood, research conducted before the pandemic may provide evidence for possible consequences. This rapid review examines the published literature on medication safety incidents associated with the remote delivery of primary care. Objective(s) To examine the published literature on medication safety incidents associated with the remote delivery of primary care, with a focus on telemedicine and electronic prescribing. Methods A rapid review was conducted according to the Cochrane Rapid Reviews Methods Group guidance. An electronic search was carried out on Embase and Medline (via PubMed) using key search terms “medication error”, “electronic prescribing”, “telemedicine” and “primary care”. Identified studies were synthesised narratively; reported medication safety incidents were categorised according to the WHO Conceptual Framework for the International Classification for Patient Safety. Results Fifteen studies were deemed eligible for inclusion in this review. All fifteen studies reported medication incidents associated with electronic prescribing; no studies were identified that reported medication safety incidents associated with telemedicine. The most commonly reported medication safety incidents were ‘wrong label/instruction’ and ‘wrong dose/strength/frequency’. The frequency of medication safety incidents ranged from 0.89 to 81.98 incidents per 100 electronic prescriptions analysed. Conclusions To our knowledge, this is the first review to examine the literature on medication safety incidents associated with the remote delivery of primary care. Common incident types associated with electronic prescriptions were identified. There was wide variation in reported frequencies of medication safety incidents associated with electronic prescriptions. A gap in the literature was identified regarding medication safety incidents associated with telemedicine. Further research is required to determine the impact of the COVID-19 pandemic on medication safety in primary care.</p

Medication safety incidents associated with the remote delivery of primary care: a rapid review

Objectives: The COVID-19 pandemic triggered rapid, fundamental changes, notably increased remote delivery of primary care. While the impact of these changes on medication safety is not yet fully understood, research conducted before the pandemic may provide evidence for possible consequences. To examine the published literature on medication safety incidents associated with the remote delivery of primary care, with a focus on telemedicine and electronic prescribing. Methods: A rapid review was conducted according to the Cochrane Rapid Reviews Methods Group guidance. An electronic search was carried out on Embase and Medline (via PubMed) using key search terms 'medication error', 'electronic prescribing', 'telemedicine' and 'primary care'. Identified studies were synthesised narratively; reported medication safety incidents were categorised according to the WHO Conceptual Framework for the International Classification for Patient Safety. Key findings: Fifteen studies were deemed eligible for inclusion. All 15 studies reported medication incidents associated with electronic prescribing; no studies were identified that reported medication safety incidents associated with telemedicine. The most commonly reported medication safety incidents were 'wrong label/instruction' and 'wrong dose/strength/frequency'. The frequency of medication safety incidents ranged from 0.89 to 81.98 incidents per 100 electronic prescriptions analysed. Summary: This review of medication safety incidents associated with the remote delivery of primary care identified common incident types associated with electronic prescriptions. There was a wide variation in reported frequencies of medication safety incidents associated with electronic prescriptions. Further research is required to determine the impact of the COVID-19 pandemic on medication safety in primary care, particularly the increased use of telemedicine.</p