Scott R. Rosas

Introduction: Breast cancer is a leading cause of cancer‐related mortality among young adults (YAs) aged 18–39 years. Although the National Comprehensive Cancer Network recommends that YAs be treated at centers with age‐specific expertise, standardized care pathways are lacking. This study describes a stakeholder‐informed approach to identifying priorities and timing for YA‐specific breast cancer care using group concept mapping . Methods: Breast oncology providers, YA patients, and caregivers from a single comprehensive cancer center participated in a group concept mapping study between July 2025 and January 2026 that used a web‐based platform to: (1) identify priority areas for YA‐specific breast cancer referrals, (2) group priority areas into categories, and (3) rate the importance of referral to delivering high‐value care and the time at which care should be delivered using Likert response scales. Conceptual representations of data were created from multidimensional scaling and hierarchical cluster analyses. Cluster‐level and item‐level ratings for the importance and timing of priorities were compared. Results: Forty‐four participants identified 87 items organized into eight domains reflecting priorities for care: mental health , maintaining relationships , education about surgical treatments , complementary treatments, health maintenance , effect on family and employment , financial navigation , and care coordination for treatment‐related adverse effects . Whereas items related to financial navigation and effect on family and employment were rated as needing early attention, mental health and health maintenance services were more appropriate for referral later in treatment. Conclusions: This stakeholder‐driven framework suggests priorities of care for YAs diagnosed with breast cancer, highlighting both the urgency and importance of specific interventions across the treatment continuum.

Background and Objectives: The Youth Engagement Network (YEN) was a three-year project focused on strengthening meaningful youth engagement in sexual health programs. It sought to answer the question, “What is a useful framework for meaningful youth engagement of vulnerable populations in sexual health programming?” Methods: The YEN chose Group Concept Mapping (GCM) as the approach to answer their learning question. GCM is a mixed-methods process that can be used to integrate the unique perspectives of a group of individuals. The approach entails 1) brainstorming ideas related to a prompt, 2) individual sorting and rating of the ideas, and 3) the application of multi-dimensional scaling (MDS) and hierarchical cluster analysis to integrate the individual sorting information and develop a series of concept maps. Results: Seventy-four young people and adults generated 141 responses to our prompt. These were pared down to 82 statements that were then sorted and/or rated on importance by 113 participants. Our final cluster map focused on 9 concepts: Facilitators, Diversity, Relevance, Access, Connection, Comprehensive Sex Ed, Co-development, and Space. Conclusions: We found GCM to be useful for identifying potential components of a framework to move the field toward more meaningful engagement of young people in sexual health programming.

The literature on entrepreneurial growth cognition insists on the lack of available knowledge to better understand this phenomenon. There has been a paucity of research on the effectiveness of business support providers dedicated to the growth of the young VSE (Very Small Business). However, in practice, differences in collective representations between entrepreneurial actors regarding the implementation of growth-oriented actions constitute a threat to the effectiveness of these types of business support providers. However, a finer understanding of entrepreneurs and business support professionals’ convergent and divergent representations, as they relate to growth-oriented actions as a resource orchestration process, would be relevant to guide entrepreneurial actors facing this challenge. To shed light on this issue, the Group Concept Mapping (GCM) framework coupled with a randomized Procrustes analysis were used. This mixed methods-based and ascending methodological framework is useful to empirically determine the representations of entrepreneurs and business support professionals by isolating their respective spatial correspondence. The empirical results help identify and measure the convergent and divergent representations of growth-oriented actions held by entrepreneurial actors. An epistemological positioning in critical realism (RC) makes possible a theoretical contribution by articulating growth-oriented generative mechanisms extracted from the representations of the entrepreneurial actors. Regarding the managerial contribution of the effort, divergent representations have been established with respect to business support, financing, and risk management growth-oriented actions.

Persistent challenges to public health and well-being are being addressed though complex interventions. Complex interventions are intentional processes designed to shift and realign the form and function of targeted system patterns by changing underlying system dynamics, structures, and conditions. The IM40 initiative was a complex health promotion intervention designed to address adolescent health and well-being through a developmental assets approach. The initiative sought to influence several levels simultaneously (e.g. individual, professional, procedural, and policy), compounding the complexity for implementation and evaluation. The purpose of this case study is to present the development and initiation of an evaluation approach based on systems thinking and complexity science principles, concepts, and methods. We used three systems methods, Group Model Building (GMB), viable systems model (VSM) assessment, and Social Network Analysis (SNA) to identify and examine underlying patterns and structures that influenced system-wide behaviors. Each method focused on a general systems-oriented question and illuminated stakeholder views of the IM40 theory of change, adaptive organization of multiple independent institutions, and relational ties among system actors. Collectively, the methods enabled us to describe systems change over time and examine shifts in boundaries, relationships, perspectives, and dynamics. The implications of this approach relative to typical evaluation activities in public health practice are contrasted and discussed.