We present a framework of stakeholder categories and applied it to the intersection of older adult mobility with the built and social environments. The result was a comprehensive, framework of stakeholder categories that can be used to understand older adult mobility. Furthermore, the novel process of stakeholder identification can be applied across health disciplines in other concept mapping projects to understand various matters of public health concern. For example, one area of research to which our framework may be readily adapted is the growing study of environmental and policy approaches for promoting physical activity [16, 17].
The details of the process of stakeholder identification are of particular value to the literature. The aim of systematic identification of stakeholders is to ensure comprehensive representation of diverse perspectives on an issue. Poorly structured or unsystematic stakeholder identification risks missing valuable perspectives or limiting participation to groups readily known to health researchers. Often marginalized groups and the public’s perspective is lacking from academic literature . Without a framework or structured method of identification, omissions may go undetected. Our framework does not eliminate the risk of omissions, but is a guide to identifying stakeholder groups and helps identify which perspectives may be missing. Our review of stakeholder theory and concept mapping literature suggested three general techniques for stakeholder identification: brainstorming, key informant interviews, and snowball sampling. These techniques broadly capture methods of identifying stakeholders, but they fail to provide a detailed process required to ensure systematic identification of relevant stakeholders. Another approach is to rely on existing frameworks of stakeholder categories to provide a starting point for systematic identification; however such frameworks – particularly as they relate to health – were not commonly cited in literature.
In applying the results of this study to future stakeholder-based projects, we encourage public health researchers and practitioners to use a framework of stakeholder categories to inform their selection of participants. At a minimum, categories of stakeholders add a level of structure to subsequent brainstorming and facilitate the identification of missing groups. The seven categories of stakeholders developed in this study (Public, Policy makers and governments, Research community, Professionals and practitioners, Health and social services providers, Civil society organizations, and Private business) may serve as a template for health-related projects and may be adapted to specific areas of research. Even if all the groups identified are not invited to participate, these missing perspectives may be acknowledged as a limitation of the final results, or justification for their exclusion clearly stated. The process of systematic stakeholder identification can thus increases the methodological rigour of concept mapping and other stakeholder-based projects.
In applying this framework to future research on older adult mobility and the built and social environment, stakeholders identified in Figure 2 can be further specified to reflect the regional context of interest. For example, specific provincial, state, or municipal stakeholders could be identified depending on the scope of study. Initially a national scope was proposed for the concept mapping project that motivated this project. However, as the stakeholder categories of our framework developed, a provincial focus was adopted to provide better context for the stakeholder chart and a more feasible scope for the project.
One of the biggest challenges in developing a framework of stakeholders is representing a complex, intersectional issue in a simplistic model. Distinctions between researchers, professionals, and policy makers, for example, are intuitively convenient but blurred in practice. Many disciplines, and even individual people, fulfill a multiplicity of roles and could be classified under several stakeholder groups. The task of identifying and organizing stakeholder groups within categories thus proved to be a challenging conceptual exercise, and more than mere ‘filling in the blanks’ of a generic framework. It is our intent that this framework and process of stakeholder identification will enable other health researchers to complete the task more effectively.
Which stakeholders should and do participate in any stakeholder-based project depend on a number of factors. Thoughtful identification of stakeholders does not in and of itself guarantee comprehensive participation in public health and concept mapping projects; recruitment and engagement strategies will also be required to ensure participation of desired groups. Prioritization of stakeholders is also often required, and this may limit the breadth of participation. We, like others, caution researchers against prematurely limiting the scope of identified stakeholders, as even remotely affected groups may prove to be important contributors. Concern of identifying too many or irrelevant stakeholders should not inhibit an initial thorough assessment of stakeholder groups. When subsequent boundaries must be drawn, it should be on well-founded, clearly articulated criteria .
This project had an explicit health focus, as older adult mobility was the main outcome of interest. Prioritizing health helped define the scope and refine the analytic approach used to create the framework. Recognizing, as others have , that researchers are often stakeholders in the issues under study, we took steps to enhance objectivity in developing the framework before starting other projects. For example, in order to facilitate a systematic, literature driven process of stakeholder identification, the initial framework was created by a single author (CS) previously external to the project. This process was complemented by feedback from co-authors and external expert informants with diverse expertise to minimize the bias of any one perspective. Although this framework was developed within the regional context of British Columbia, we have provided direction on how it can be generalizable to other settings. We can also attest to the utility of the framework in practice. We relied on it to identify and invite stakeholders from each of the seven categories to participate in our concept mapping project on older adult mobility and the built environment .
As with any review of the literature, our work is limited by its inability to report on newly published articles. Since April 2012 when we conducted our literature search, 13 new citations for “stakeholder analysis” and 56 on “concept mapping” were indexed in Ovid Medline. This increase in concept mapping publications, however, reflects a growing interest in this type of research and provides all the more justification for why a framework of identifying stakeholders is timely and of value.