Due to the lack of research at the intersection of IT and behavioral health economics we investigate results-based incentives for health promotion in organizations by questioning (1) whether and why employees accept them, (2) which functional affordances of IT enable their implementation and, finally, (3) whether they have positive effects on the health promotion behavior of employees. The current presentation addresses the first two research questions and describes a first build-and-evaluate cycle according to design-science research methodology. For that purpose, the delay of gratification framework is used as justificatory knowledge to inform the design of results-based incentive models for health promotion in organizations (RIMHPO) and their enabling IT artifacts. In a second step, an empirical study was conducted to assess one particular RIMHPO-based program and to gather further feedback on the design principles. The expected results of the current work are finally discussed with regard to policy implications.

Background: The complex, multidimensional nature of healthcare quality makes provider and treatment decisions based on quality difficult. Patient-reported outcome (PRO) measures can enhance patient centricity and involvement. The proliferation of PRO measures, however, requires a simplification to improve comprehensibility. Composite measures can simplify complex data without sacrificing the underlying information. Objective and methods: We propose a five-step development approach to combine different PRO into one composite measure (PRO-CM): (i) theoretical framework and metric selection, (ii) initial data analysis, (iii) rescaling, (iv) weighting and aggregation, and (v) sensitivity and uncertainty analysis. We evaluate different rescaling, weighting, and aggregation methods by utilizing data of 3145 hip and 2605 knee replacement patients, to identify the most advantageous development approach for a PRO-CM that reflects quality variations from a patient perspective. Results: The comparison of different methods within steps (iii) and (iv) reveals the following methods as most advantageous: (iii) rescaling via z-score standardization and (iv) applying differential weights and additive aggregation. The resulting PROCM is most sensitive to variations in physical health. Changing weighting schemes impacts the PRO-CM most directly, while it proves more robust towards different rescaling and aggregation approaches. Conclusion: Combining multiple PRO provides a holistic picture of patients’ health improvement. The PRO-CM can enhance patient understanding and simplify reporting and monitoring of PRO. However, the development methodology of a PROCM needs to be justified and transparent to ensure that it is comprehensible and replicable. This is essential to address the well-known problems associated with composites, such as misinterpretation and lack of trust.

Background: Primary headaches, including migraine and tension-type headaches (TTH), are widespread and have a social, physical, mental, and economic impact. They occur mainly during productive years (ie, between ages of 25 and 55). One of the key components of treatment are behavior interventions such as lifestyle modification. Scalable conversational agents (CAs) offer the potential to deliver behavior interventions at low threshold. To our knowledge, there is no evidence on behavioral interventions delivered by CAs for the treatment of headaches. Objective: This study aimed (1) to develop and test a smartphone-based coaching intervention (BalanceUP) for people suffering from frequent headaches, delivered by a conversational agent (CA), and designed to improve mental well-being by various behavior change techniques, and (2) to evaluate the effectiveness by comparing the intervention and control group, and to assess the engagement and acceptance of participants using BalanceUP. Methods: In a randomized controlled trial, adults with frequent headaches were recruited from a non-clinical setting and allocated to either a CA intervention (BalanceUP) or control condition. The effect of the treatment on changes on primary outcome mental well-being (PHQ ADS), and secondary outcomes (psychosomatic symptoms, stress, headache-related self-efficacy, intention to change behavior, presentism and absenteeism, pain coping) were assessed using Linear Mixed Models and Cohen d. Primary and secondary outcomes were assessed pre- and post-intervention, engagement during and acceptance post-intervention. Results: A total of 198 participants (mean age 38.7, SD 12.14; 86.9% women) were recruited online and in collaboration with experts and allocated to the intervention (n=110), and control group (n=88). Post-intervention, the intention to threat (ITT) analysis revealed very strong evidence for improved well-being (treatment: est/beta –3.28, 95% CI –5.07 to –1.48) with moderate between-group effects (Cohen d=–0.66, 95% CI –0.99 to –0.33) in favor of the intervention group. We also found strong evidence for reduced somatic symptoms, perceived stress, absenteeism/presentism, as well as improved headache management self-efficacy, application of behavior change techniques, and pain coping skills, with effects ranging from medium to large (d=0.43 to d=1.05). 65% of participants used the coaching as intended by engaging throughout the coaching and completing the outro. Conclusions: BalanceUP was well accepted, results suggest that a coaching delivered by a CA can be effective in reducing headache sufferers’ burden by improving their well-being. Clinical Trial: German Clinical Trials Register DRKS00017422; https://trialsearch.who.int/Trial2.aspx?TrialID=DRKS00017422, Swiss Ethics BASEC-Nr. Req-2021-01365

self-assessment; self-evaluation - As one part of the Sino-Swiss Management Training Program, the province of Sichuan was included in an action learning program. The objective was to increase the administrative capacity of the provincial government to master the further development of the province. Topics were: 1. Sustainable development of eco-tourism 2. Water Environmental Management in the Minjiang and Tuojiang River Drainage Areas 3. Construction of Ecological Shelterbelt in the Upper Reaches of the Yangtze River This report demonstrates some of the outcomes of the project, using both figures and narratives as illustrations.

In contrast to many other European countries, ambulatory services in Germany are traditionally mostly provided outside of hospitals. This is evident in international comparisons when looking at the share of expenditures for outpatient care provided by hospitals (in Germany 2.8%, in Portugal 39.8%), the share of physicians working at hospitals, the share of day cases or the organisation of secondary care provision. However, in the context of emergency care services, patients’ expectations of receiving more convenient and better accessible care for non-urgent or minor problems have led to increasingly crowded emergency departments. International experience suggests that different activities aiming at a better coordination of care, such as integrated call centers, extending out-of-hours services and offering ambulatory services within or nearby hospitals, can help to steer patients to the most appropriate provider. However, innovative and integrated health care service models are in conflict with the fragmented payment and planning structures in Germany.

This article illuminates the relationship between the increased importance management has gained in public institutions, and political reality in everyday work lives. It attempts to gauge the rationalities behind the managerial and the political system and derives a heuristic structure from them. On the basis of this discussion, an analysis is conducted of the origins of new public management, using Switzerland as an example. It is concluded that NPM reforms started as managerial reforms of public institutions, but that they developed into de facto political reforms. Thus the managerial background of project managers, consultants and public management scholars is a necessary but not sufficient precondition for a successful implementation of NPM in the politico-administrative system. The contribution which public management is able to make to the governance debate must not be underestimated. Not least, it leads to a clarification of the sources of legitimacy of government action. The rationality model introduced in this article is designed to make systemic differences between management and politics visible - and to improve communication between politicians and public managers.