Evaluation of the Heart of Birmingham teaching Primary Care Trust (HoBtPCT): My Choice Weight Management Programme:report commissioned by Heart of Birmingham teaching Primary Care Trust

This report details an evaluation of the My Choice Weight Management Programme undertaken by a research team from the School of Pharmacy at Aston University. The My Choice Weight Management Programme is delivered through community pharmacies and general practitioners (GPs) contracted to provide services by the Heart of Birmingham teaching Primary Care Trust. It is designed to support individuals who are ‘ready to change’ by enabling the individual to work with a trained healthcare worker (for example, a healthcare assistant, practice nurse or pharmacy assistant) to develop a care plan designed to enable the individual to lose 5-10% of their current weight. The Programme aims to reduce adult obesity levels; improve access to overweight and obesity management services in primary care; improve diet and nutrition; promote healthy weight and increased levels of physical activity in overweight or obese patients; and support patients to make lifestyle changes to enable them to lose weight. The Programme is available for obese patients over 18 years old who have a Body Mass Index (BMI) greater than 30 kg/m2 (greater than 25 kg/m2 in Asian patients) or greater than 28 kg/m2 (greater than 23.5 kg/m2 in Asian patients) in patients with co-morbidities (diabetes, high blood pressure, cardiovascular disease). Each participant attends weekly consultations over a twelve session period (the final iteration of these weekly sessions is referred to as ‘session twelve’ in this report). They are then offered up to three follow up appointments for up to six months at two monthly intervals (the final of these follow ups, taking place at approximately nine months post recruitment, is referred to as ‘session fifteen’ in this report). A review of the literature highlights the dearth of published research on the effectiveness of primary care- or community-based weight management interventions. This report may help to address this knowledge deficit. A total of 451 individuals were recruited on to the My Choice Weight Management Programme. More participants were recruited at GP surgeries (n=268) than at community pharmacies (n=183). In total, 204 participants (GP n=102; pharmacy n=102) attended session twelve and 82 participants (GP n=22; pharmacy 60) attended session fifteen. The unique demographic characteristics of My Choice Weight Management Programme participants – participants were recruited from areas with high levels of socioeconomic deprivation and over four-fifths of participants were from Black and Minority Ethnic groups; populations which are traditionally underserved by healthcare interventions – make the achievements of the Programme particularly notable. The mean weight loss at session 12 was 3.8 kg (equivalent to a reduction of 4.0% of initial weight) among GP surgery participants and 2.4 kg (2.8%) among pharmacy participants. At session 15 mean weight loss was 2.3 kg (2.2%) among GP surgery participants and 3.4 kg (4.0%) among pharmacy participants. The My Choice Weight Management Programme improved the general health status of participants between recruitment and session twelve as measured by the validated SF-12 questionnaire. While cost data is presented in this report, it is unclear which provider type delivered the Programme more cost-effectively. Attendance rates on the Programme were consistently better among pharmacy participants than among GP participants. The opinions of programme participants (both those who attended regularly and those who failed to attend as expected) and programme providers were explored via semi-structured interviews and, in the case of the participants, a selfcompletion postal questionnaire. These data suggest that the Programme was almost uniformly popular with both the deliverers of the Programme and participants on the Programme with 83% of questionnaire respondents indicating that they would be happy to recommend the Programme to other people looking to lose weight. Our recommendations, based on the evidence provided in this report, include: a. Any consideration of an extension to the study also giving comparable consideration to an extension of the Programme evaluation. The feasibility of assigning participants to a pharmacy provider or a GP provider via a central allocation system should also be examined. This would address imbalances in participant recruitment levels between provider type and allow for more accurate comparison of the effectiveness in the delivery of the Programme between GP surgeries and community pharmacies by increasing the homogeneity of participants at each type of site and increasing the number of Programme participants overall. b. Widespread dissemination of the findings from this review of the My Choice Weight Management Project should be undertaken through a variety of channels. c. Consideration of the inclusion of the following key aspects of the My Choice Weight Management Project in any extension to the Programme: i. The provision of training to staff in GP surgeries and community pharmacies responsible for delivery of the Programme prior to patient recruitment. ii. Maintaining the level of healthcare staff input to the Programme. iii. The regular schedule of appointments with Programme participants. iv. The provision of an increased variety of printed material. d. A simplification of the data collection method used by the Programme commissioners at the individual Programme delivery sites.

A composite framework for the strategic alignment of information systems development

Information systems are corporate resources, therefore information systems development must be aligned with corporate strategy. This thesis proposes that effective strategic alignment of information systems requires information systems development, information systems planning and strategic management to be united. Literature in these areas is examined, breaching the academic boundaries which separate these areas, to contribute a synthesised approach to the strategic alignment of information systems development. Previous work in information systems planning has extended information systems development techniques, such as data modelling, into strategic planning activities, neglecting techniques of strategic management. Examination of strategic management in this thesis, identifies parallel trends in strategic management and information systems development; the premises of the learning school of strategic management are similar to those of soft systems approaches to information systems development. It is therefore proposed that strategic management can be supported by a soft systems approach. Strategic management tools and techniques frame individual views of a strategic situation; soft systems approaches can integrate these diverse views to explore the internal and external environments of an organisation. The information derived from strategic analysis justifies the need for an information system and provides a starting point for information systems development. This is demonstrated by a composite framework which enables each information system to be justified according to its direct contribution to corporate strategy. The proposed framework was developed through action research conducted in a number of organisations of varying types. This suggests that the framework can be widely used to support the strategic alignment of information systems development, thereby contributing to organisational success.

Does stakeholder orientation matter? : empirical evidence about power and influence in local government decision-making

Despite being in the business agenda for almost thirty years, stakeholder management is still an under explored field in the public management context. The investigation presented in this doctoral thesis aims to ensure that stakeholder management is a useful technique able to raise issues about power and interests to public organisation’s strategic management processes. Stakeholder theory is tested in an exploratory study carried out with English Local Authorities whose focus is place on decision-making. The findings derive from two distinct and complementary studies: a cross-sectional survey undertaken with chief executives based on the quantitative approach and a qualitative investigation based on cross-sectional case studies and in-depth interviews of validation. While the first study aimed to produce a reliable and comprehensive list of stakeholders able to raise issues in decision-making, the second study aimed to depict the arena in which decision-making comes about. The findings indicate that local government decision-making is a multistakeholder process in which influences are exerted according to stakeholders’ power and interest. The findings also indicate that local government managers should take into account these tissues to avoid losing resources and legitimacy from its environmental supporters. Another issue raised by the investigation is related to the ethics upon which these types of relationships are based. According to the evidence gathered throughout the investigation, the formal model of accountability does not cover the whole set of stakeholders engaged in the process.

A study of strategy formulation in an automotive manufacturer

The strategies and operations of the Rover Group were investigated using a behaviour based longitudinal examination. The investigating method used was developed from Mintzberg's classical diachronic study approach through the adoption of an observing participant approach supplemented with probes into specific areas of the organisation's activities. The thesis argues, through the use of a future-forward perspective of organisation capability, that an organisation's future capability can be assessed. The thesis questions the periodisation approach normally adopted in longitudinal studies and proposes an alternative method which the author believes generates a better understanding of the operations and future potential of the organisation. This method also produces generalisations which can be readily applied to other organisations. The introduction of a process perspective to behavioural studies has led to the promise of a unified understanding of strategic management and organisation development.

Strategic positioning in voluntary and non-profit organizations in the UK : exploring the experiences of British charitable organizations:Exploring the experiences of British Charitable Organizations

This thesis explores the strategic positioning [SP] activities of charitable organizations [COs] within the wider sector of voluntary and non-profit organizations [VNPOs] in the UK. Despite the growing interest in SP for British COs in an increasingly competitive operating environment and changing policy context, there is lack of research in mainstream marketing/strategic management studies on this topic for charities, whilst the specialist literature on VNPOs has neglected the study of SP. The thesis begins with an extended literature review of the concept of positioning in both commercial [for-profit] and charitable organizations. It concludes that the majority of theoretical underpinnings of SP that are prescribed for COs have been derived from the commercial strategy/marketing literature. There is currently a lack of theoretical and conceptual models that can accommodate the particular context of COs and guide strategic positioning practice in them. The research contained in this thesis is intended to fill some of these research gaps. It combines an exploratory postal survey and four cross-sectional case studies to describe the SP activities of a sample of general welfare and social care charities and identifies the key factors that influence their choice of positioning strategies [PSs]. It concludes that charitable organizations have begun to undertake SP to differentiate their organizations from other charities that provide similar services. Their PSs have both generic features, and other characteristics that are unique to them. A combination of external environmental and organizational factors influences their choice of PSs. A theoretical model, which depicts these factors, is developed in this research. It highlights the role of governmental influence, other external environmental forces, the charity’s mission, organizational resources, and influential stakeholders in shaping the charity’s PS. This study concludes by considering the theoretical and managerial implications of the findings on the study of charitable and non-profit organizations.

Business information systems:technology, development and management in the E-business

Information technology is at the centre of today’s business environment. The increasing importance of e-commerce and the integration of information systems in all areas of a business means it is crucial for managers to understand and implement IS (information systems). This major text, now in its second edition, provides the skills and knowledge necessary to choose the right systems, and to develop and manage them effectively. Business Information Systems: Technology, Development and Management assumes no prior knowledge of IS or IT, and emphasises the importance of IS to management decision making. It takes a 3 part structure: Part One covers hardware and software technologies; Part Two looks at information systems analysis and design; and Part Three describes the strategic management of IS. This successful format allows each section to be studied alongside individual modules, and enables students to focus clearly on specific areas and use the book for more than one course. This book is suitable for college students, undergraduate degree and postgraduate students taking courses with modules in the practical IT skills of selection, implementation, management and use of BIS. The practical sections are also of use to managers in industry involved in the development and use of IS.

Gaining social values of wireless technology:an interpretive case study in the healthcare institutional context

The existing literature has given little consideration to social values of information technology in general or of wireless technology in particular. The purpose of this paper is thus to shed new light on this issue. Based on an interpretive case study, we examine two healthcare organisations and discover that social values are often manifested beyond, as well as within, organisations. A matrix of social values in relation to technology changes and their interactions with various stakeholders is further discussed. The matrix helps understand how various social values emerge from and revolve around organisations’ strategic management of information technology. The implications of the findings about social values are discussed and future research directions are suggested.

Does the balanced scorecard make a difference to the strategy development process?

A great number of strategy tools are being taught in strategic management modules. These tools are available to managers for use in facilitating strategic decision making and enhancing the strategy development process in their organisations. A number of studies have been published examining which are the most popular tools; however there is little empirical evidence on how their utilisation influences the strategy process. This paper is based on a large scale international survey on the strategy development process, and seeks to examine the impact of a particular strategy tool, the Balanced Scorecard (BSC), upon the strategy process. Recently, it has been suggested that as a strategy tool, the BSC can influence all elements of the strategy process. The results of this study indicate that although there are significant differences in some elements of the strategy process between the organisations that have implemented the BSC and those that have not, the impact is not comprehensive.

Strategic groups, cognitive groups and environmental change in the UK pharmaceutical industry

This chapter explores the relationship between changes in strategy and environmental pressures within the UK Pharmaceutical Industry during a ten- year period. Two stable strategic time periods (SSTPs) were identified each of five years duration. Within each time period seven strategic groups were found but 11 out of 29 firms (37.9%) changed strategic groups membership during the period studied. The break between these two SSTPs was found to coincide with a sharp increase in the substitution of branded pharmaceuticals by cheaper parallel imports. A significant relationship was found between firms that changed groups and both their continent of origin and nationality. Firms whose home markets are more vulnerable to substitution were more likely to switch strategic groups. © 2011 Nova Science Publishers, Inc. All rights reserved.

Electronics:a case study of economic value added in target costing

Whilst target costing and strategic management accounting (SMA) continue to be of considerable interest to academic accountants, both suffer from a relative dearth of empirically based research. Simultaneously, the subject of economic value added (EVA) has also been the subject of little research at the level of the individual firm.The aim of this paper is to contribute to both the management accounting and value based management literatures by analysing how one major European based MNC introduced EVA into its target costing system. The case raises important questions about both the feasibility of cascading EVA down to product level and the compatibility of customer facing versus shareholder focused systems of performance management. We provide preliminary evidence that target costing can be used to align both of these perspectives, and when combined with other SMA techniques it can serve as " the bridge connecting strategy formulation with strategy execution and profit generation" ( Ansari et al., 2007, p. 512). © 2012 Elsevier Ltd.

Institutions, resources, and entry strategies in emerging economies

We investigate the impact of market-supporting institutions on business strategies by analyzing the entry strategies of foreign investors entering emerging economies. We apply and advance the institution-based view of strategy by integrating it with resource-based considerations. In particular, we show how resource-seeking strategies are pursued using different entry modes in different institutional contexts. Alternative modes of entry—greenfield, acquisition, and joint venture (JV)—allow firms to overcome different kinds of market inefficiencies related to both characteristics of the resources and to the institutional context. In a weaker institutional framework, JVs are used to access many resources, but in a stronger institutional framework, JVs become less important while acquisitions can play a more important role in accessing resources that are intangible and organizationally embedded. Combining survey and archival data from four emerging economies, India, Vietnam, South Africa, and Egypt, we provide empirical support for our hypotheses.

An investigation into the adoption of electronic business in Saudi Arabia using technology-organisation-environment framework

Despite the proliferation of e-business adoption by organisations and the world-wide growth of the e-business phenomenon, there is a paucity of empirical studies that examine the adoption of e-business in the Middle East. The aim of our study is to provide insights into the salient e-business adoption issues by focusing on Saudi Arabian businesses. We developed a conceptual model for electronic business (e-business) adoption incorporating ten factors based on the technology-organization-environment framework. Survey data from 550 businesses were used to test the model and hypotheses. We conducted confirmatory factor analysis to assess the reliability and validity of constructs. The findings of the study suggest that firm technology competence, size, top management Support, technology orientation, consumer readiness, trading partner readiness and regulatory support are important antecedents of e-business adoption and utilisation. In addition, the study finds that, competitive pressure and organisational customer and competitor orientation is not a predictor for e-business adoption and utilisation. The implications of the findings are discussed and suggestions for future inquiry are presented.

Advances in global sourcing : models, governance and relationship:7th global sourcing workshop 2013, Val d’Isère, France, March 11-14, 2013, revised selected papers

This book contains 13 papers from the 7th Workshop on Global Sourcing, held in Val d'Isere, France, during March 11-14, 2013, which were carefully reviewed and selected from 40 submissions. They are based on a vast empirical base brought together by leading researchers in information systems, strategic management, and operations. This volume is intended for students, academics, and practitioners interested in research results and experiences on outsourcing and offshoring of information technology and business processes. The topics discussed represent both client and supplier perspectives on sourcing of global services, combine theoretical and practical insights regarding challenges that both clients and vendors face, and include case studies from client and vendor organizations.

The dynamics of global sourcing : perspectives and practices:6th global sourcing workshop 2012, Courchevel, France, March 12-15, 2012, revised selected papers

This edited book is intended for use by students, academics and practitioners who take interest in the outsourcing and offshoring of information technology and business services and processes. The book offers a review of the key topics in outsourcing and offshoring, populated with practical frameworks that serve as a tool kit for practitioners, academics and students. The range of topics covered in this book is wide and diverse, and represents both client and supplier perspectives on sourcing of global services. Various aspects related to the decision making process (e.g., asset transfer), learning mechanisms and organizational practices for managing outsourcing relationships are discussed in great depth. Contemporary sourcing models, including cloud services, are examined. Client dependency on the outsourcing provider, and social aspects, such as identity, are discussed in detail. Furthermore, resistance in outsourcing and failures are investigated to derive lessons as to how to avoid them and improve efficiency in outsourcing. Topics discussed in this book combine theoretical and practical insights regarding challenges that both clients and vendors face. Case studies from client and vendor organizations are used extensively throughout the book. Last but not least, the book examines current and future trends in outsourcing and offshoring, placing particular attention on the centrality of innovation in sourcing arrangements, and how innovation can be realized in outsourcing. The book is based on a vast empirical base brought together through years of extensive research by leading researchers in information systems, strategic management and operations.

Preface

This edited book is intended for use by students, academics and practitioners who take interest in outsourcing and offshoring of information technology and business processes. The book offers a review of the key topics in outsourcing and offshoring, populated with practical frameworks that serve as a tool kit to students and managers. The range of topics covered in this book is wide and diverse. Various governance and coordination mechanisms for managing outsourcing relationships are discussed in great depth and the decision-making processes and considerations regarding sourcing arrangements, including multi-sourcing and cloud services, are examined. Vendors’ capabilities for managing global software development are studied in depth. Clients’ capabilities and issues related to compliance and culture are also discussed in association with various sourcing models. Topics discussed in this book combine theoretical and practical insights regarding challenges that both clients and vendors face. Case studies from client and vendor organizations are used extensively throughout the book. Last but not least, the book examines current and future trends in outsourcing and offshoring, placing particular attention on the centrality of innovation in sourcing arrangements, and how innovation can be realized in outsourcing. The book is based on a vast empirical base brought together through years of extensive research by leading researchers in information systems, strategic management and operations.