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.

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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.

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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.@en

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.@en

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.

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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@en

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.

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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.

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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.@en

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. Check out tudelft.nl/valuesindesign for more information on designing with values in complex projects. Project team: Marina Bos-de Vos, Tom Daamen & Hedwig van der Linden (all TU Delft) Animation by Moniek van Adrichem - Studio Synopsis Funded by: Delft Design for Values Institute & Stichting Kennis Gebiedontwikkeling (SKG)@en

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.@en

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.@en

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.@en

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. Check tudelft.nl/valuesindesign voor meer informatie over ontwerpen met waarden in complexe projecten. Project team: Marina Bos-de Vos, Tom Daamen & Hedwig van der Linden (allen TU Delft) Animatie by Moniek van Adrichem - Studio Synopsis Mogelijk gemaakt door: Delft Design for Values Institute & Stichting Kennis Gebiedontwikkeling (SKG)@en

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.@en

This video allows anybody to teach or practice designing for values in a financially and professionally responsible manner. Creative professionals focusing on designing for client and stakeholder values often struggle to transform their work into sustainable business models that are aligned with their professional identity. Exploiting the results and toolkit of the FuturA project, the video aims to facilitate students and professionals in uncovering, visualizing and reconciling conflicts between creating value and capturing value in their daily work. The tutorial and accompanying Project Value Modelling Blueprint can easily be incorporated into courses or be used by professionals to design and assess their business model for a creative project. @en

Project-based firms have to capture value from the projects in which they engage. This can be challenging as firms need to reconcile project goals and organizational goals while attempting to avoid the slippage of value to other actors. Drawing on interviews with architects and clients, this research reveals how architectural firms used the strategies of postponing financial revenues in a project, compensating for loss of financial revenues across projects and rejecting a project to accept or mitigate the slippage of financial value, and to avoid the potential slippage of professional value in projects. With these strategies firms attempt to enhance their overall benefits. The study contributes to the literature on project business by showing how a more nuanced conceptualization of value slippage is particularly helpful to theoretically explain and practically manage
the value capture of project-based firms through both single project and project portfolio decisions.@en

Professional roles within inter-organizational projects have become increasingly diverse and contested, yet little is known about how professionals react to such threats of marginalization. Drawing on empirical data from interviews with architects, a profession in which historically established role boundaries have become particularly blurred, we analyse how professionals negotiate their roles in
inter-organizational projects. We identified three types of boundary work—reinstating, bending, and pioneering role boundaries—and illustrate their antecedents and effects for project collaboration. These categories exemplify different responses to the threat of marginalization depending upon professionals’ perceptions of what the specific project called for. Our study provides important insights into boundary work practices emerging in the context of inter-organizational projects and how professionals adjust their claims-making to perceived opportunities, thereby triggering incremental as well as more radical changes in the professional role structures.@en

Strategy and identity can work together and enable organizations to reconcile short-term and long-term objectives, but their interplay may easily lead to vicious circles that prevent innovation or jeopardize an organization’s distinctiveness. On the one hand, identity may impede change if the strategic alternatives it allows for do not align with the new problems the organization faces. On the other hand, continuously reconstructing identity along with strategic decisions that are made can result in the organization losing its distinctive, central selling point and potentially even the commitment of the organizational members who identify with it. Previous research has shown how a sustained interplay in which strategy is – over a longer period of time – meaningfully framed by identity and serves to enact identity, may help organizations escape these vicious circles in the long run. Yet, how the day-to-day interactions of groups of organizational members influence the construction and management of a sustained identity-strategy interplay is still underexplored. Consequently, we know little about how organizational members can collectively nourish or compromise a well-balanced relationship between identity and strategy in their organization through their daily interactions. We opted for a process research design that allowed us to observe and compare interactions of multiple groups of organizational members in concentrated modes of strategy-making, thereby viewing process as an ‘activity’. Adopting a rhetoric-based perspective of identity work and strategy work as continuously inter-weaving dynamics, we study the emotionally-laden, rhetorical accounts of 17 groups of architects during project-oriented strategy workshops to see how they collectively give form to identity-strategy interplays when discussing their daily work. Studying group interactions around identity and strategy in contexts where members pursue multiple, possibly competing goals and uphold multiple, possibly competing identities, such as in architectural firms, is particularly relevant, as such complex, dynamic organizational settings are becoming more and more prevalent.@en

‘De toekomstige rol van de architect’ beschrijft de essentie van onze wetenschappelijke verkenning naar nieuwe rolstructuren in de Nederlandse architectenbranche. Deze verkenning is uitgevoerd in het kader van het futurA project, dat verwijst naar future value chains of architectural services. Vier jaar lang hebben we vanuit de Technische Universiteit Delft en Radboud Universiteit Nijmegen in nauwe samenwerking met de BNA onderzoek gedaan naar de toekomstbestendigheid van de rollen die architectenbureaus in het bouwproces vervullen. Het futurA project is één van de 23 projecten die vanuit NWO, de Nederlandse Organisatie voor Wetenschappelijk Onderzoek, binnen het programma CLICK.NL in 2013 tot stand is gekomen om de kennis over en innovatie in de creatieve industrie te versterken. De doelstelling van het project was om veranderingen in het werkveld van de architect ten gevolge van sociaal-maatschappelijke verschuivingen en de financiële crisis te doorgronden en kansen voor de toekomst bloot te leggen. De architect als ondernemer was lange tijd een onderwerp waar weinig aandacht voor was in de bouw. Inmiddels is ondernemerschap in de architectenbranche een gangbaar begrip. Ook de BNA ontplooit veel activiteiten op dit gebied. We zijn als team uitermate trots dat onze promovendi Marina Bos-de Vos en Bente Lieftink, ieder vanuit hun eigen expertisegebied, met veel enthousiasme wetenschappelijke verdieping hebben gezocht in het woud aan interessante praktijkvoorbeelden en persoonlijke ervaringen. We hebben hierdoor zowel gedegen kennis kunnen vergaren op het gebied van het creëren en toe-eigenen van professionele, financiële en gebruikswaarde, als inzicht gekregen in de verschillende rolstructuren in de bouwketen en het bestendigen van veranderingen hierin. Ons onderzoek heeft geleid tot de ontwikkeling van deze ontwerpgids die zijn gebundeld in deze wetenschappelijke ontwerpgids voor het architectenbureau van de toekomst. Naast theoretische inzichten over het bureau en de samenwerking binnen een project wordt een onderscheid gemaakt in vier rolidentiteiten van waaruit de architect in de bouwketen kan acteren: de initiator, de specialist, de productontwikkelaar en de integrator. Het spelbord met kaartjes, dat als bijlage beschikbaar is bij deze publicatie, kan op verschillende manieren gebruikt worden om in gezamenlijkheid na te denken over waar je als bureau met een project heen wilt en welke verdienmodellen en manieren van samenwerken daar het beste bij past. Per rolidentiteit worden de meest cruciale uitdagingen en kansen voor de bedrijfsvoering van architectenbureaus en de samenwerking in de keten weergegeven. Dit maakt het mogelijk om je rol in een project zelf te ontwerpen. Onze taak zit er hiermee op. Het is aan de lezer van het boek en gebruiker van het spel om de opgedane inzichten verder te vertalen in financieel en professioneel duurzame rollen voor de architect van de toekomst. @en