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Maria Axente - One of the best experts on this subject based on the ideXlab platform.

  • ethics based auditing of automated decision making Systems Intervention points and policy implications
    arXiv: Computers and Society, 2021
    Co-Authors: Jakob Mokander, Maria Axente
    Abstract:

    Organisations increasingly use automated decision-making Systems (ADMS) to inform decisions that affect humans and their environment. While the use of ADMS can improve the accuracy and efficiency of decision-making processes, it is also coupled with ethical challenges. Unfortunately, the governance mechanisms currently used to oversee human decision-making often fail when applied to ADMS. In previous work, we proposed that ethics-based auditing (EBA), i.e. a structured process by which ADMS are assessed for consistency with relevant principles or norms, can (a) help organisations verify claims about their ADMS and (b) provide decision-subjects with justifications for the outputs produced by ADMS. In this article, we outline the conditions under which EBA procedures can be feasible and effective in practice. First, we argue that EBA is best understood as a 'soft' yet 'formal' governance mechanism. This implies that the main responsibility of auditors should be to spark ethical deliberation at key Intervention points throughout the software development process and ensure that there is sufficient documentation to respond to potential inquiries. Second, we frame ADMS as parts of larger socio-technical Systems to demonstrate that to be feasible and effective, EBA procedures must link to Intervention points that span all levels of organisational governance and all phases of the software lifecycle. The main function of EBA should therefore be to inform, formalise, assess, and interlink existing governance structures. Finally, we discuss the policy implications of our findings. To support the emergence of feasible and effective EBA procedures, policymakers and regulators could provide standardised reporting formats, facilitate knowledge exchange, provide guidance on how to resolve normative tensions, and create an independent body to oversee EBA of ADMS.

  • ethics based auditing of automated decision making Systems Intervention points and policy implications
    Social Science Research Network, 2021
    Co-Authors: Jakob Mokander, Maria Axente
    Abstract:

    Organisations increasingly use automated decision-making Systems (ADMS) to inform decisions that affect humans and their environment. While the use of ADMS can improve the accuracy and efficiency of decision-making processes, it is also coupled with ethical challenges. Unfortunately, the governance mechanisms currently used to oversee human decision-making often fail when applied to ADMS. In previous work, we proposed that ethics-based auditing (EBA) – that is, a structured process by which ADMS are assessed for consistency with relevant principles or norms – can (a) help organisations verify claims about their ADMS and (b) provide decision-subjects with justifications for the outputs produced by ADMS. In this article, we outline the conditions under which EBA procedures can be feasible and effective in practice. First, we argue that EBA is best understood as a ‘soft’ yet ‘formal’ governance mechanism. This implies that the main responsibility of auditors should be to spark ethical deliberation at key Intervention points throughout the software development process and ensure that there is sufficient documentation to respond to potential inquiries. Second, we frame ADMS as parts of larger socio-technical Systems to demonstrate that to be feasible and effective, EBA procedures must link to Intervention points that span all levels of organisational governance and all phases of the software lifecycle. The main function of EBA should therefore be to inform, formalise, assess, and interlink existing governance structures. Finally, we discuss the policy implications of our findings. To support the emergence of feasible and effective EBA procedures, policymakers and regulators could provide standardised reporting formats, facilitate knowledge exchange, provide guidance on how to resolve normative tensions, and create an independent body to oversee EBA of ADMS.

Veena Sriram - One of the best experts on this subject based on the ideXlab platform.

  • community participation in health Systems research a systematic review assessing the state of research the nature of Interventions involved and the features of engagement with communities
    PLOS ONE, 2015
    Co-Authors: Asha George, Vrinda Mehra, Kerry Scott, Veena Sriram
    Abstract:

    Background Community participation is a major principle of people centered health Systems, with considerable research highlighting its intrinsic value and strategic importance. Existing reviews largely focus on the effectiveness of community participation with less attention to how community participation is supported in health Systems Intervention research. Objective To explore the extent, nature and quality of community participation in health Systems Intervention research in low- and middle-income countries. Methodology We searched for peer-reviewed, English language literature published between January 2000 and May 2012 through four electronic databases. Search terms combined the concepts of community, capability/participation, health Systems research and low- and middle-income countries. The initial search yielded 3,092 articles, of which 260 articles with more than nominal community participation were identified and included. We further excluded 104 articles due to lower levels of community participation across the research cycle and poor description of the process of community participation. Out of the remaining 160 articles with rich community participation, we further examined 64 articles focused on service delivery and governance within health Systems research. Results Most articles were led by authors in high income countries and many did not consistently list critical aspects of study quality. Articles were most likely to describe community participation in health promotion Interventions (78%, 202/260), even though they were less participatory than other health Systems areas. Community involvement in governance and supply chain management was less common (12%, 30/260 and 9%, 24/260 respectively), but more participatory. Articles cut across all health conditions and varied by scale and duration, with those that were implemented at national scale or over more than five years being mainstreamed by government. Most articles detailed improvements in service availability, accessibility and acceptability, with fewer efforts focused on quality, and few designs able to measure impact on health outcomes. With regards to participation, most articles supported community’s in implementing Interventions (95%, n = 247/260), in contrast to involving communities in identifying and defining problems (18%, n = 46/260). Many articles did not discuss who in communities participated, with just over a half of the articles disaggregating any information by sex. Articles were largely under theorized, and only five mentioned power or control. Majority of the articles (57/64) described community participation processes as being collaborative with fewer describing either community mobilization or community empowerment. Intrinsic individual motivations, community-level trust, strong external linkages, and supportive institutional processes facilitated community participation, while lack of training, interest and information, along with weak financial sustainability were challenges. Supportive contextual factors included decentralization reforms and engagement with social movements. Conclusion Despite positive examples, community participation in health Systems Interventions was variable, with few being truly community directed. Future research should more thoroughly engage with community participation theory, recognize the power relations inherent in community participation, and be more realistic as to how much communities can participate and cognizant of who decides that.

  • community participation in health Systems research a systematic review assessing the state of research the nature of Interventions involved and the features of engagement with communities
    PLOS ONE, 2015
    Co-Authors: Asha George, Vrinda Mehra, Kerry Scott, Veena Sriram
    Abstract:

    Background: Community participation is a major principle of people centered health Systems with considerable research highlighting its intrinsic value and strategic importance. Existing reviews largely focus on the effectiveness of community participation with less attention to how community participation is supported in health Systems Intervention research. Objective: To explore the extent nature and quality of community participation in health Systems Intervention research in low- and middle-income countries. Methodology: We searched for peer-reviewed English language literature published between January 2000 and May 2012 through four electronic databases. Search terms combined the concepts of community capability/participation health Systems research and low- and middle-income countries. The initial search yielded 3092 articles of which 260 articles with more than nominal community participation were identified and included.We further excluded 104 articles due to lower levels of community participation across the research cycle and poor description of the process of community participation. Out of the remaining 160 articles with rich community participation we further examined 64 articles focused on service delivery and governance within health Systems research. Results: Most articles were led by authors in high income countries and many did not consistently list critical aspects of study quality. Articles were most likely to describe community participation in health promotion Interventions (78% 202/260) even though they were less participatory than other health Systems areas. Community involvement in governance and supply chain management was less common (12% 30/260 and 9% 24/260 respectively) but more participatory. Articles cut across all health conditions and varied by scale and duration with those that were implemented at national scale or over more than five years being mainstreamed by government. Most articles detailed improvements in service availability accessibility and acceptability with fewer efforts focused on quality and few designs able to measure impact on health outcomes. With regards to participation most articles supported community’s in implementing Interventions (95% n = 247/260) in contrast to involving communities in identifying and defining problems (18% n = 46/260). Many articles did not discuss who in communities participated with just over a half of the articles disaggregating any information by sex. Articles were largely under theorized and only five mentioned power or control. Majority of the articles (57/64) described community participation processes as being collaborative with fewer describing either community mobilization or community empowerment. Intrinsic individual motivations community-level trust strong external linkages and supportive institutional processes facilitated community participation while lack of training interest and information along with weak financial sustainability were challenges. Supportive contextual factors included decentralization reforms and engagement with social movements. Conclusion: Despite positive examples community participation in health Systems Interventions was variable with few being truly community directed. Future research should more thoroughly engage with community participation theory recognize the power relations inherent in community participation and be more realistic as to how much communities can participate and cognizant of who decides that. Copyright: © 2015 George et al. Open Access.

Haya R Rubin - One of the best experts on this subject based on the ideXlab platform.

Graham A Colditz - One of the best experts on this subject based on the ideXlab platform.

  • Systems Intervention to promote colon cancer screening in safety net settings protocol for a community based participatory randomized controlled trial
    Implementation Science, 2013
    Co-Authors: Aimee S James, Veronica Richardson, Jean S Wang, Enola K Proctor, Graham A Colditz
    Abstract:

    Background: Colorectal cancer is a leading cause of cancer mortality. Screening can be effective but is underutilized. System- or multi-level Interventions could be effective at increasing screening, but most have been implemented and evaluated in higher-resource settings such as health maintenance organizations. Given the disparities evident for colorectal cancer and the potential for screening to improve outcomes, there is a need to expand this work to include diverse settings, including those who treat economically disadvantaged patients. This paper describes the study protocol for a trial designed to increase colorectal cancer screening in those ‘safety-net’ health centers that serve underinsured and uninsured patients. This trial was designed and is being implemented using a community-based participatory approach. Methods/design: We developed a practical clinical cluster-randomized controlled trial. We will recruit 16 community health centers to this trial. This Systems-level Intervention consists of a menu of evidence-based implementation strategies for increasing colorectal cancer screening. Health centers in the Intervention arm then collaborate with the study team to tailor strategies to their own setting in order to maximize fit and acceptability. Data are collected at the organizational level through interviews, and at the provider and patient levels through surveys. Patients complete a survey about their healthcare and screening utilization at baseline, six months, and twelve months. Outcomes: The primary outcome is colorectal cancer screening by patient self-report, supplemented by a chart-audit in a subsample of patients. Implementation outcomes informed by the Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) conceptual framework will be measured at patient, provider, and practice levels.

  • abstract b04 using cbpr to develop a Systems level colorectal cancer screening Intervention
    Cancer Epidemiology Biomarkers & Prevention, 2012
    Co-Authors: Aimee S James, Meera Muthukrishnan, Matthew Brown, Rebekah R Jacob, Nancy Mueller, Graham A Colditz
    Abstract:

    Introduction: Colorectal cancer (CRC) is a leading cause of cancer death. Despite compelling evidence that screening and early detection reduce CRC incidence and mortality; about 50% of adults are screening adherent. CRC screening rates are low in our region and have been identified by our community partners as a priority. However, many Interventions have only moderate impact, at best. In this study, we used a Community-Based Participatory Research (CBPR) approach to collaborate with community health centers to develop and test a Systems-level Intervention. CBPR assures that those who would benefit from and be affected by research fully participate in and influence decision-making. The resultant Intervention is being tested in a cluster randomized controlled trial. Methods: Using a systematic approach, we reviewed literature for evidence-based recommendations for Systems-Intervention for CRC screening, and worked with our community partners to select Intervention options by assessing acceptability, appropriateness, feasibility, and estimated sustainability. Together, we decided that our Intervention would be a “menu” of Intervention options, thereby allowing more choice for individual sites. Strategic planning with the health center included organizational assessments and interviews with key personnel of the health center to gauge context factors including current health center practices, capacities, and needs. We used snowball sampling to conduct additional interviews with relevant and knowledgeable personnel at each clinic, as well as presentations to group-provider meetings when possible. Results: Based on the literature, Interventions in the following areas were determined to be effective: patient reminders, provider reminder and recall Systems, provider assessment and feedback, and reducing structural barriers. Working with our community partners, we developed an initial Intervention “menu” that included the following: instructional checklists for patients, provider checklists for referring colonoscopy, and a variety of cues and reminders for patients. Partners provided input as every stage of development. Research staff assisted the health center in implementing the chosen Intervention strategies. The outcome evaluation will measure changes in screening rates but also track which strategies were adopted and how they were implemented as well as short-term maintenance of the change once the study has ended. Conclusion: Using CBPR to develop Intervention content and implementation strategies is novel, and has both benefits and challenges. Challenges include the additional time spent and an increased burden placed on our community partners. However, in addition to tapping the expertise of our community partners, having their input and perspective produced an Intervention that may be more sustainable, as it reflects the voice of all stakeholders. Furthermore, the process allowed stakeholders to take ownership of the Intervention, enhancing the relevance and utility of the study. Last, such a process may result in a program that is more likely to be disseminated because it reflects, and works within, the reality of providing healthcare in diverse settings. Although the effort was time consuming, building in the extra time for CBPR allowed for meaningful community involvement and resulted in a more relevant Intervention product. Citation Format: Aimee James, Meera Muthukrishnan, Matthew Brown, Rebekah Jacob, Nancy Mueller, Graham Colditz. Using CBPR to develop a Systems-level colorectal cancer screening Intervention. [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr B04.

Jakob Mokander - One of the best experts on this subject based on the ideXlab platform.

  • ethics based auditing of automated decision making Systems Intervention points and policy implications
    arXiv: Computers and Society, 2021
    Co-Authors: Jakob Mokander, Maria Axente
    Abstract:

    Organisations increasingly use automated decision-making Systems (ADMS) to inform decisions that affect humans and their environment. While the use of ADMS can improve the accuracy and efficiency of decision-making processes, it is also coupled with ethical challenges. Unfortunately, the governance mechanisms currently used to oversee human decision-making often fail when applied to ADMS. In previous work, we proposed that ethics-based auditing (EBA), i.e. a structured process by which ADMS are assessed for consistency with relevant principles or norms, can (a) help organisations verify claims about their ADMS and (b) provide decision-subjects with justifications for the outputs produced by ADMS. In this article, we outline the conditions under which EBA procedures can be feasible and effective in practice. First, we argue that EBA is best understood as a 'soft' yet 'formal' governance mechanism. This implies that the main responsibility of auditors should be to spark ethical deliberation at key Intervention points throughout the software development process and ensure that there is sufficient documentation to respond to potential inquiries. Second, we frame ADMS as parts of larger socio-technical Systems to demonstrate that to be feasible and effective, EBA procedures must link to Intervention points that span all levels of organisational governance and all phases of the software lifecycle. The main function of EBA should therefore be to inform, formalise, assess, and interlink existing governance structures. Finally, we discuss the policy implications of our findings. To support the emergence of feasible and effective EBA procedures, policymakers and regulators could provide standardised reporting formats, facilitate knowledge exchange, provide guidance on how to resolve normative tensions, and create an independent body to oversee EBA of ADMS.

  • ethics based auditing of automated decision making Systems Intervention points and policy implications
    Social Science Research Network, 2021
    Co-Authors: Jakob Mokander, Maria Axente
    Abstract:

    Organisations increasingly use automated decision-making Systems (ADMS) to inform decisions that affect humans and their environment. While the use of ADMS can improve the accuracy and efficiency of decision-making processes, it is also coupled with ethical challenges. Unfortunately, the governance mechanisms currently used to oversee human decision-making often fail when applied to ADMS. In previous work, we proposed that ethics-based auditing (EBA) – that is, a structured process by which ADMS are assessed for consistency with relevant principles or norms – can (a) help organisations verify claims about their ADMS and (b) provide decision-subjects with justifications for the outputs produced by ADMS. In this article, we outline the conditions under which EBA procedures can be feasible and effective in practice. First, we argue that EBA is best understood as a ‘soft’ yet ‘formal’ governance mechanism. This implies that the main responsibility of auditors should be to spark ethical deliberation at key Intervention points throughout the software development process and ensure that there is sufficient documentation to respond to potential inquiries. Second, we frame ADMS as parts of larger socio-technical Systems to demonstrate that to be feasible and effective, EBA procedures must link to Intervention points that span all levels of organisational governance and all phases of the software lifecycle. The main function of EBA should therefore be to inform, formalise, assess, and interlink existing governance structures. Finally, we discuss the policy implications of our findings. To support the emergence of feasible and effective EBA procedures, policymakers and regulators could provide standardised reporting formats, facilitate knowledge exchange, provide guidance on how to resolve normative tensions, and create an independent body to oversee EBA of ADMS.