Background
Parents feel a responsibility to provide a healthy start for their young children, but struggle to realise this. Especially in disadvantaged neighbourhoods, parents face challenges such as financial strain, stress, and isolation. Facing these challenges can contribute to tensions between parents’ values, such as balancing family harmony with healthy food choices. Such value tensions may negatively affect the nutrition decisions parents make for their children. Nutrition interventions often fail to address these value tensions, which contributes to their relatively low uptake and impact. By understanding the tensions parents face between their values, the present research offers recommendations for future nutrition interventions to encourage healthy nutrition decisions in disadvantaged situations.

Methods
We conducted a qualitative interview study using semi-structured interviews with 20 parents of children aged zero to four years, living in disadvantaged neighbourhoods. Transcripts were analysed inductively to identify value tensions, stressors that trigger them, and protective factors that mitigate their impact.

Results
Six key value tensions parents experienced regarding nutrition were identified, which emerged in situations involving, for example, stress, low income, or limited social support. The three most common tensions included balancing the value of the dietary health of the child with the values of enjoyment of the child, convenience for the parent, and well-being of the parent. Our analyses showed that the value tensions were triggered by specific stressors, such as challenging child behaviour, unhealthy food provided by friends or family, and lack of me-time for the parent. The participants reported relief from stressors and the resulting value tensions by relying on protective factors such as social and material support, including informal household support and access to healthy, convenient foods.

Conclusions
This study provides insights into how value tensions, stressors, and protective factors influence parents’ nutrition decisions for their children. By addressing these value tensions, alongside other influences such as structural barriers, nutrition interventions may become more fitting and motivating for parents within their specific contexts. In addition to general recommendations on value-based intervention design, our findings offer specific guidance for developing tailored nutrition interventions for families in disadvantaged neighbourhoods.

Actors involved in programs that promote sustainability transitions project how future value can be created and protected within the constraints of existing institutions and fields. There is a need to better understand this projecting among versatile organizational actors to support the successful advancement of sustainability transitions. Drawing upon the joint value creation employed in five circular economy programs, we identify three modes of projecting for promoting sustainability transitions: distributing, dispersing, and activating. The modes of projecting relate strongly to how programs are configured. We contribute to the sustainability transitions literature by examining niche-regime interactions through the lens of joint value creation, offering novel insights into programs’ unique ways of promoting sustainability transitions. Another contribution is to the literature on value creation in interorganizational projects and programs by revealing different approaches for joint value creation in different modes of projecting.

Despite the growing potential of artificial intelligence (AI) in improving clinical decision making, patients' perspectives on the use of AI for their care decision making are underexplored. In this paper, we investigate patients' preferences towards the autonomy of AI in assisting healthcare decision making. We conducted interviews and an online survey using an interactive narrative and speculative AI prototypes to elicit participants' preferred choices of using AI in a pregnancy care context. The analysis of the interviews and in-story responses reveals that patients' preferences for AI autonomy vary per person and context, and may change over time. This finding suggests the need for involving patients in defining and reassessing the appropriate level of AI assistance for healthcare decision making. Departing from these varied preferences for AI autonomy, we discuss implications for incorporating patient-centeredness in designing AI-powered healthcare decision making.

Participants of programs that aim to address wicked, societal problems in urban contexts, such as inequality, malnutrition, and climate change, need to jointly create future value for a diverse set of stakeholders including the natural and urban environment, government institutions, businesses, and citizens. This is challenging as program goals are ambiguous, programs evolve unexpectedly, and participants have diverse backgrounds, organizational interests, and beliefs about what is important for the future. On top of this, participants need to work within the constraints of the physical urban context and existing institutions. Due to the complexity, uncertainty, and messiness involved, the process of joint value creation often remains implicit in program collaborations, resulting in conflicts and uncertainties that can cause delays and suboptimal outcomes in answering pressing societal challenges such as urban inequalities. It is underexplored how joint value creation evolves in programs that aim to address societal challenges in urban contexts, the specific value creation challenges actors are confronted with, how these are dealt with, and the effects this has. This study brings insight into project members' practices to anticipate the creation of future value within the multi-stakeholder collaboration of an urban energy transition project. Drawing on a qualitative, longitudinal case study of a program designed to help transform the local energy system of a neighborhood in Amsterdam, we discuss how actors’ practices of identifying, negotiating, prioritizing, and setting values play a role in defining and progressing the program. We contribute to the existing literature on value creation in projects and programs, by providing detailed insight into how conscious and unconscious value creation can enable or hinder program success, specifically paying attention to the challenge of integrating technological and social innovation. We conclude by proposing a set of guiding principles that can be used by program participants to more consciously manage joint value creation in their programs, and that form the basis for a research agenda on future value creation in project and program management.

In public-private innovation projects that aim to address societal problems like climate change, inequality, and poverty in local contexts, project members have to work towards realizing envisioned possible futures from within existing institutional constraints (Bos-de Vos et al., 2022; Ika & Munro, 2022; Winch & Maytorena-Sanchez, 2020). Project members represent both public and private organizations, often from different sectors. As such, they bring in various – often competing – interests and hold different beliefs about what is important for the future (Martinsuo, 2020). Regardless, they need to jointly create future value with their project for many stakeholders, including stakeholders that are responsible for the project (e.g., project partners from industry, academia and/or government), stakeholders that are interested in the project (e.g., local governments, local businesses), and stakeholders that are impacted by the project (e.g., the local physical and natural environment, residents). […]

Christopher Alexander’s Pattern Language Theory (PLT) has been recognized as a valuable methodology to understand complex systems. It has been applied across domains through a variety of different approaches. This article reviews exist-ing approaches to PLT application and reflects upon the differences between them. We find that application generally differs across four components: artefact, activity, roles and tools, informed by practitioners’ diverging values and needs. We elaborate on how consciously navigating the dimensions that these components consist of can help to broaden the application of PLT in practice. We report on the development of a set of conceptual tools that aim to support this process. The resulting “activity kit” has been applied in a Dutch housing renovation project to support homeowners in communication and decision‐making to illustrate the applicability of our methodology. It can be concluded that the “activity kit” is a promising approach to broaden the use of PLT and contributes to the methodological repertoire of researchers and practitioners to address complexity in today’s societal challenges.

This paper unpacks how actors navigate the multiple organizational, interorganizational and industry contexts that are associated with system transformation programs for addressing wicked, societal problems. Because system transformation programs can only succeed when changes are implemented by multiple organizations, an increased understanding of integrating programs in multiple contexts is needed. We draw on a qualitative field study of an interorganizational program designed to help transform the Dutch healthcare system. We identified three practices of context navigation that actors used to integrate the program into multiple parent organizations and address emerging incongruencies among contexts. These are aligning contexts, prioritizing contexts, and adding contexts. Over time, these navigating practices promoted progress towards program objectives via multiple parallel collaborative paths. Our findings shed new light on the role of breakdowns and decoupled collaborative paths in programs oriented at contributing to system transformation.

It is no news that it is challenging to run a financially successful architecture business. Clients do not always need or value the full spectrum of services an architect wishes to provide, making it increasingly hard to negotiate a profitable fee. It is not only market conditions that lead to challenges. Challenges also originate from within the business model of the architecture firm itself. This short article unravels some of these challenges by looking at the value that is created and captured by architecture firms. It was written for a themed issue around architect labour of Architecture Ireland, the Journal of the Royal Institute of Architects of Ireland. A digital version of the entire issue is available here: https://www.riai.ie/discover-architecture/architecture-ireland-digital/issue-323

Changing a specific health behaviour can be highly com- plex and is often influenced by many personal, social, and environmental factors. Therefore, interventions that aim at behaviour change cannot be one-size-fits-all solutions, and no behaviour change technique is effective for everyone. One potential solution could be to support individuals in finding interventions through self-experimentation. This research explored the requirements for an explorative self- experimentation intervention and developed tools that sup- port users in the process, complementing developments in quantitative self-experimentation. Based on a research through design approach, we developed three different prototypes for supporting a change in health-related behaviour, which were used and evaluated by fourteen par- ticipants over a four-week period. A thematic analysis of interviews with participants led to seven themes, which can be used as a starting point when designing for explorative self-experimentation.

This chapter positions designers as actors in multidisciplinary collaboration within municipal, commercial or educational settings. It supports designers and those working with designers by triggering reflection on empathy as a work-related yet subjective issue in such contexts. The chapter considers empathy as being a social construction emerging through human interactions, incorporating cognitive, affective and other dimensions. It discusses challenges of designer empathy work and suggests linking designer empathy work with identity work and boundary work. Empathic and communicative coping strategies are suggested to be relevant for designers’ professional development. Holism is connected to empathising: service designers, for example, constructed their occupational mandate by expanding their role boundaries through holism, empathy and cocreation.

Prenatal nutrition is a key predictor of early-life development. However, despite mass campaigns to stimulate healthy nutrition during pregnancy, the diet of Dutch pregnant women is often suboptimal. Innovative technologies offer an opportunity to develop tailored tools, which resulted in the release of various apps on healthy nutrition during pregnancy. As midwives act as primary contact for Dutch pregnant women, the goal was to explore the experiences and perspectives of midwives on (1) nutritional counselling during pregnancy, and (2) nutritional mHealth apps to support midwifery care. Analyses of eleven in-depth interviews indicated that nutritional counselling involved the referral to websites, a brochure, and an app developed by the Dutch Nutrition Centre. Midwives were aware of the existence of other nutritional mHealth apps but felt uncertain about their trustworthiness. Nevertheless, midwives were open towards the implementation of new tools providing that these are trustworthy, accessible, user-friendly, personalised, scientifically sound, and contain easy-digestible information. Midwives stressed the need for guidelines for professionals on the implementation of new tools. Involving midwives early-on in the development of future nutritional mHealth apps may facilitate better alignment with the needs and preferences of end-users and professionals, and thus increase the likelihood of successful implementation in midwifery practice.

Overweight, obesity and cardiometabolic diseases are major global health concerns. Lifestyle factors, including diet, have been acknowledged to play a key role in the solution of these health risks. However, as shown by numerous studies, and in clinical practice, it is extremely challenging to quantify dietary behaviors as well as influencing them via dietary interventions. As shown by the limited success of ‘one-size-fits-all’ nutritional campaigns catered to an entire population or subpopulation, the need for more personalized coaching approaches is evident. New technology-based innovations provide opportunities to further improve the accuracy of dietary assessment and develop approaches to coach individuals towards healthier dietary behaviors. Pride & Prejudice (P&P) is a unique multi-disciplinary consortium consisting of researchers in life, nutrition, ICT, design, behavioral and social sciences from all four Dutch Universities of Technology. P&P focuses on the development and integration of innovative technological techniques such as artificial intelligence (AI), machine learning, conversational agents, behavior change theory and personalized coaching to improve current practices and establish lasting dietary behavior change.

Project Value Modelling helps to discuss how values in design projects can be created and captured. For a particular project, value-related questions are answered that, step by step, generate an overview of important relationships, tensions, and opportunities. This allows you to make well-informed decisions on project selection, contract negotiation, and collaboration.

How can we better cope with value dynamics in complex projects as designers?

Some people look at what is being created in a project, others look at what drives people in a projects. Industrial Design Engineering, TU Delft researcher Marina Bos-de Vos argues it should be about both. It’s about internal values that drive you, and the external values you create. As designer, it is your role to grasp and connect all these values to make it a success.

This short movie is intended to be used in education, but can also be used in practice as a conversation starter on values. [...]

Hoe kunnen ontwerpers beter omgaan met waarden in complexe projecten?

Sommige mensen kijken naar wat er gecreëerd wordt in een project, anderen juist naar wat mensen in deze projecten motiveert. Industrieel Ontwerpen, TU Delft onderzoeker Marina Bos-de Vos stelt dat het om allebei gaat: de interne waarden die jou en je partners motiveren, en de externe waarden die je samen realiseert. Het is jouw rol als ontwerper om al deze waarden in beeld te krijgen, met elkaar te verbinden en daarmee een succesvol project te realiseren.

Deze korte animatie is bedoeld voor gebruik in onderwijs, maar is ook geschikt om het gesprek te starten over waarden in complexe projecten. [...]

In dit hoofdstuk staan de verschillende aspecten van de rol van een bouwkundig ingenieur centraal. Allereerst wordt ingegaan op de verschillende rollen die een bouwkundige ingenieur vervult in het projecten netwerk, over het algemeen als medewerker binnen een private of publieke organisatie, zoals gemeentes, architectenbureaus, ingenieursbureaus, ontwikkelaars, bouwbedrijven en projectmanagement bureaus.

Preventing or decreasing chronic health conditions by healthy eating is increasingly seen as a shared responsibility. Defining what is healthy is person-specific, depending amongst others on a person’s health and responses to food. Supermarkets, which are considered highly influential in shaping the diet of customers, are starting to serve customers based on their health needs. This study explores how supermarkets can tailor their service provision to the dietary needs of individual customers and what business and design implications this involves. Through a service design approach involving participants with elevated blood glucose levels, thoughts and emotions during the process of dietary change were translated into a customer journey that reveals multiple opportunities for service delivery to support healthy eating. The customer journey can be used by supermarkets to shed new light on their positioning and customer segments. The study also provides inspiration for how supermarkets and other organizations can support customers with specific health needs to eat healthy via group-based and personalised services.

Open innovation initiatives in the health sector are considered spaces that can fuel systemic change. However, it is not clear yet how these initiatives contribute to the transition to a sustainable healthcare system. This research explores how actors in open innovation health initiatives contribute to a sustainable transition in healthcare by implementing the Quadruple Aim. The Quadruple Aim is a practical framework that helps organizations to innovate in healthcare. It consists of four aims: improving the health of the population, improving the work-life of care providers, enhancing patients’ experience and reducing health cost. Sixteen interviews with professionals from different backgrounds working in health initiatives in the Netherlands, highlight that 1) improving the health of the population is the main aim, 2) not all initiatives are considering all four aims, 3) solutions to one aim can cause new problems, and 4) the Quadruple Aim is not assessed in a structured way. This indicates that the implementation of the Quadruple Aim is highly challenging. A suggestion for future research is to focus on how design can facilitate the implementation of the Quadruple Aim in open innovation health initiatives.

Designers increasingly collaborate with other actors to deliver designs that address diverse stakeholder needs. Such multidisciplinary design processes revolve around integrating various, often divergent values, including the ideals that collaborating actors have, and the different kinds of worth that they attempt to realize. As values are multidimensional and continuously in flux, the process of designing for divergent values requires conscious action. Existing theories of values and methods for integrating diverse, possibly competing values are still scattered across disciplines, leaving designers with little overview and handles for what they have to deal with. Synthesizing insights from workshops with architects and literature from a wide range of scholarly domains, this paper presents a first step towards an integrative framework that can help designers and design students to effectively discuss and reconcile divergent values in multidisciplinary settings.