van Woezik Anne F G, Braakman-Jansen Louise M A, Kulyk Olga, Siemons Liseth, van Gemert-Pijnen Julia E W C
Center for eHealth and Wellbeing Research; Department of Psychology, Health and Technology. Faculty of Behavioral, Management and Social Sciences, University of Twente, Enschede, Netherlands.
Center for eHealth and Wellbeing Research; Department of Psychology, Health and Technology. Faculty of Behavioral, Management and Social Sciences, University of Twente, Enschede, Netherlands ; Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
Antimicrob Resist Infect Control. 2016 May 21;5:20. doi: 10.1186/s13756-016-0119-2. eCollection 2016.
Infection prevention and control can be seen as a wicked public health problem as there is no consensus regarding problem definition and solution, multiple stakeholders with different needs and values are involved, and there is no clear end-point of the problem-solving process. Co-creation with stakeholders has been proposed as a suitable strategy to tackle wicked problems, yet little information and no clear step-by-step guide exist on how to do this. The objectives of this study were to develop a guideline to assist developers in tackling wicked problems using co-creation with stakeholders, and to apply this guideline to practice with an example case in the field of infection prevention and control.
A mixed-method approach consisting of the integration of both quantitative and qualitative research was used. Relevant stakeholders from the veterinary, human health, and public health sectors were identified using a literature scan, expert recommendations, and snowball sampling. The stakeholder salience approach was used to select key stakeholders based on 3 attributes: power, legitimacy, and urgency. Key values of stakeholders (N = 20) were derived by qualitative semi-structured interviews and quantitatively weighted and prioritized using an online survey.
Our method showed that stakeholder identification and analysis are prerequisites for understanding the complex stakeholder network that characterizes wicked problems. A total of 73 stakeholders were identified of which 36 were selected as potential key stakeholders, and only one was seen as a definite stakeholder. In addition, deriving key stakeholder values is a necessity to gain insights into different problem definitions, solutions and needs stakeholders have regarding the wicked problem. Based on the methods used, we developed a step-by-step guideline for co-creation with stakeholders when tackling wicked problems.
The mixed-methods guideline presented here provides a systematic, transparent method to identify, analyze, and co-create with stakeholders, and to recognize and prioritize their values, problem definitions, and solutions in the context of wicked problems. This guideline consists of a general framework and although it was applied in an eHealth context, may be relevant outside of eHealth as well.
感染预防与控制可被视为一个棘手的公共卫生问题，因为在问题定义和解决方案方面尚未达成共识，涉及多个具有不同需求和价值观的利益相关者，并且解决问题的过程没有明确的终点。与利益相关者共同创造已被提议作为解决棘手问题的合适策略，但关于如何做到这一点的信息很少，也没有明确的分步指南。本研究的目的是制定一项指南，以帮助开发者通过与利益相关者共同创造来解决棘手问题，并将该指南应用于感染预防与控制领域的一个实例。
采用了一种混合方法，包括定量研究和定性研究的整合。通过文献扫描、专家推荐和滚雪球抽样确定了兽医、人类健康和公共卫生部门的相关利益者。利益相关者显著性方法用于根据权力、合法性和紧迫性这三个属性选择关键利益相关者。通过定性半结构化访谈得出利益相关者（N = 20）的关键价值观，并使用在线调查进行定量加权和排序。
我们的方法表明，利益相关者识别和分析是理解表征棘手问题的复杂利益相关者网络的先决条件。总共识别出73个利益相关者，其中36个被选为潜在关键利益相关者，只有一个被视为确定的利益相关者。此外，得出关键利益相关者价值观对于深入了解利益相关者对棘手问题的不同问题定义、解决方案和需求是必要的。基于所使用的方法，我们制定了在解决棘手问题时与利益相关者共同创造的分步指南。
这里提出的混合方法指南提供了一种系统、透明的方法，用于识别、分析利益相关者并与之共同创造，以及在棘手问题的背景下识别他们的价值观、问题定义和解决方案并确定其优先级。该指南由一个通用框架组成，尽管它应用于电子健康背景，但在电子健康之外可能也相关。
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