A key determinant and outcome of successful environmental education is ‘pro-environmental behavior’, i.e., behavior that involves conscious action to mitigate adverse environmental impacts at personal or community level, e.g., reducing resource consumption and waste generation, avoiding toxic substances, and organizing community awareness initiatives. However, some theorists have sought to move away from rationalist models of behavioral modification, towards holistic pedagogical initiatives that seek to develop action competence. In light of the global push towards achievement of the Sustainable Development Goals (SDGs), emerging evidence suggests that education initiatives should foster action competence so students may be equipped to contribute to sustainable development as part of their education. The UNESCO Education for Sustainable Development (ESD) Roadmap 2030 has also identified key priority areas to strengthen ESD in formal curricula. This article reports two informal environmental education initiatives for promoting action competence and pro-environmental behaviors in school-aged children. The authors recommend that formal education settings (e.g., schools) should incorporate self-directed, free-choice project-based learning to augment environmental education programs and promote students’ action competence for contribution to attainment of SDGs. To this end, we propose a Free-Choice Project-based Learning for Action Competence in Sustainable Development (ACiSD) Curriculum, comprising six implementation dimensions, namely: (1) project duration and teaming arrangements, (2) topic selection, (3) student support, (4) teacher support, (5) learning environments, and (6) digital access and equity. For each implementation dimension, we recommend action steps to help educators implement this curriculum in their own educational settings, with the aid of an illustrative worked example.

Background: It is widely accepted that the COVID-19 pandemic has accelerated the era of online health care delivery, including within community palliative care. This study was part of a larger project involving a collaboration between universities, health care services, government agencies, and software developers that sought to enhance an existing telehealth (video call) platform with additional features to improve both patient and health care professional (HCP) experience in a palliative care context. Objective: The aim of this study was to understand palliative care patients’ and HCPs’ experiences of telehealth delivery in a palliative care context in Victoria, Australia. For the purposes of this study, telehealth included consultations by both video and telephone calls. By better understanding users’ experiences and perceptions of telehealth, we hoped to determine users’ preferences for new telehealth enhancement features. Methods: A total of 6 health care professionals and 6 patients were recruited from a major tertiary hospital network’s palliative care unit in Victoria, Australia. Participants were asked to generate 3‐5 photographs depicting their telehealth experiences. These photographs were used as visual aids to prompt discussion during subsequent one-on-one interviews. Intertextual analysis was conducted to identify key themes. Results: A total of 3 overarching themes emerged: comfort (or lack thereof) afforded by telehealth, connection considerations in telehealth, and care quality impacts of telehealth. Patients (n=6) described telehealth as supporting their physical and psychological comfort and maintaining connection with HCPs, yet there were specific situations where it failed to meet their needs or impacted care quality and delayed treatment. HCPs (n=6) recognized the benefit of telehealth for patients but reported several limitations of telehealth, in particular due to lack of physical examination opportunities. Participants indicated that 2 types of connection were imperative for effective telehealth delivery: technical connection (eg, good internet connectivity or clear phone line) and interpersonal connection (ie, good rapport and therapeutic alliance between the HCPs and patients). Often technical connection issues impeded the development of interpersonal connection between the HCPs and patients in telehealth. Conclusions: The findings presented in this study combined with other co-design activities, which are outside the scope of this paper, indicated the potential value of a telehealth enhancement feature that generates patient-facing clinical consultation summaries. Our team has developed a video telehealth enhancement feature (or “add-on”), which will enable clinicians to distill key actionable advice and self-management guidance discussed during teleconsultations for a take-home summary document for patients. The add-on’s prototype has also been subjected to an initial simulation study, which will be reported in a future publication.

Background: Brain tumors are characterized by the high burden of disease that profoundly impacts the quality of life in patients and their families. Digital health tools hold tremendous potential to enhance supportive care and quality of life for patients with brain tumors and their caregivers. Objective: This study aims to generate ideas and concepts, through a co-design paradigm, to inform the development of a digital health tool to address the unmet needs of people affected by brain tumors. Methods: Patients with brain tumors, caregivers, and health professionals from 2 large public tertiary hospitals in Victoria, Australia, were invited to complete a qualitative interview discussing their unmet needs of care. Overall, 35 qualitative interviews focusing on unmet needs and concepts for a digital health tool were conducted with 13 patients, 11 caregivers, and 11 health professionals. Interviews were audio recorded and transcribed, and a 5-step framework analysis approach was used to analyze data. Results: Four themes of unmet supportive care needs emerged: (1) emotional and psychological, (2) information, (3) physical and practical, and (4) social connectedness. Participants expressed the desire for early and proactive mental health intervention, noted the importance of providing mental health support to caregivers, and emphasized the need for positive stories and affirmative language. From an information perspective, participants noted a sense of information overload, especially at the beginning. They also underscored the variety of information needed on an ongoing basis, including life after treatment, and comprehensive care assistance to maintain quality of life. Participants also described unmet supportive care needs relating to symptom burden, and practical and administrative support to facilitate the logistics of accessing treatment and accomplishing daily life tasks. Finally, they expressed the desire for greater social connectedness and safe spaces to engage with other people in a similar situation. Our findings are consistent with previous research on this subject and were integrated into the development of a web-based platform. Conclusions: Participants’ perspectives informed the development of content for a web-based digital health platform called “Brain Tumours Online.” The platform comprises three pillars—(1) “LEARN”: a repository of vetted information about a range of biomedical and psychosocial care topics; (2) “CONNECT”: a digital peer support community with a health care professional interface; and (3) “TOOLBOX”: an emerging library of validated digital therapeutics for symptom management.

Background: Implementation challenges of digital health solutions (DHSs) comprise complexities of behavioural change, resource limitation, inertia in existing systems, and failure to include consumer preferences. Understanding the factors which contribute to successful implementation of DHS is essential. We report the development of an implementation strategy for Brain Tumours Online (BT Online), a digital supportive care platform for patients with brain tumours, their carers and healthcare professionals. Aim: To develop an evidence-informed implementation strategy for BT Online, considering the specific barriers and facilitators to implementing DHS for adults with a brain tumour and their carers and healthcare professionals. Methods: A rapid review methodology was used to summarise factors relevant to implementation of DHS for people affected by cancer. Themes from the review were supported by implementation guidelines for DHS and the combined evidence informed the implementation strategy. Each theme was matched with specific steps for implementing BT Online. Results: The rapid review identified 10 themes, namely, awareness of the new digital platform; institutional integration and support; data security, the quality, usability and accessibility of the platform; belief in the benefit of the platform; the need for holistic and tailored features; the timing of introducing the platform; engagement of healthcare professionals; and the re-definition of roles and workload. The themes were matched with 51 concrete implementation steps. Discussion: The purpose of the strategy was to minimise risk of implementation failure, consider the specific context of care and generate a reference framework to evaluate BT Online prior to upscaling to use outside the research context. Our method contributes a novel approach of developing an evidence-informed rigorous implementation strategy if existing implementation frameworks do not apply.