Gabriela Beirão

Abstract
The recent pandemic crisis has greatly impacted startups, and some changes are expected to be long-lasting. Small businesses usually have fewer resources and are more vulnerable to losing customers and investors, especially during crises. This study investigates how startups’ business processes were affected and how entrepreneurs managed this sudden change brought by the COVID-19 outbreak. Data were analyzed using qualitative research methods through in-depth interviews with the co-founders of eighteen startups. Results show that the three core business processes affected by the COVID-19 crisis were marketing and sales, logistics and operations, and organizational support. The way to succeed is to be flexible, agile, and adaptable, with technological knowledge focusing on digital channels to find novel opportunities and innovate. Additionally, resilience, self-improvement, education, technology readiness and adoption, close relationship with customers and other stakeholders, and incubation experience seem to shield startups against pandemic crisis outbreaks.

Abstract
Background: Over the past few years, various new types of technologies have been introduced, which have been tailored to meet the specific needs of older adults by incorporating gerontological design principles (i.e., "gerontechnologies"). However, it has been difficult to motivate older adults to adopt and use these new technologies. Therefore, it is crucial to better understand not only the role of personal drivers but also the family influences on older adults. Objective: This research goes beyond traditional technology acceptance theories by investigating the role of personal (e.g., inherent novelty seeking) and interpersonal drivers (e.g., influence of family) in stimulating older adults to use gerontechnologies. Nine hypotheses, building on traditional and new technology acceptance theories, were developed and tested. Methods: This research applies a cross-sectional study design. Therefore, a face-to-face survey instrument was developed building on a qualitative pilot study and validated scales. Three hundred and four older adults (minimum age = 70 years) were willing to participate as well as one of their family members. Structural equation modeling was applied to analyze the hypothesized conceptual model. Results: Our results extend the seminal technology acceptance theories by adding personal (i.e., inherent novelty seeking p = 0.017) and interpersonal drivers. More specifically, it was found that the attitude toward gerontechnologies was influenced by family tech savviness (i.e., people who often use technology), as this relationship is fully mediated through the social norms of older adults (p = 0.014). The same was found for older adults' trust in the family member's technology knowledge (p = 0.001). Here, the relationship with older adults' attitude toward gerontechnologies was partially mediated by the older adults' trust in technology. Conclusion: This study identified important personal and interpersonal drivers that influence attitudes toward and intentions to use gerontechnologies. To foster technology acceptance among older adults, it was found that it is important to strengthen the trust in and the attitude toward gerontechnologies. Furthermore, family members' knowledge and beliefs in technology were the keys to promoting the actual use of gerontechnologies among older adults. Furthermore, the families' trust in gerontechnologies and the provision of access to technology can improve their attitudes toward technology and usage intentions for the older relative.

Abstract

Abstract
Purpose - The purpose of this paper is to understand value cocreation in service ecosystems from a multilevel perspective, uncovering value cocreation factors and outcomes at the micro, meso, and macro levels. Design/methodology/approach - A Grounded Theory approach based on semi-structured interviews is adopted. The sample design was defined to enable the ecosystem analysis at its different levels. At the macro level was the Portuguese Health Information ecosystem. Embedded meso level units of analysis comprised eight health care organizations. A total of 48 interviews with citizens and health care practitioners were conducted at the micro level. Findings - Study results enable a detailed understanding of the nature and dynamics of value cocreation in service ecosystems from a multilevel perspective. First, value cocreation factors are identified (resource access, resource sharing, resource recombination, resource monitoring, and governance/institutions generation). These factors enable actors to integrate resources in multiple dynamic interactions to cocreate value outcomes, which involve both population well-being and ecosystem viability. Study results show that these value cocreation factors and outcomes differ across levels, but they are also embedded and interdependent. Practical implications - The findings have important implications for organizations that are ecosystem actors (like the Portuguese Ministry of Health) for understanding synergies among value cocreation factors and outcomes at the different levels. This provides orientations to better integrate different actor roles, technology, and information while facilitating ecosystem coordination and co-evolution. Originality/value - This study responds to the need for a multilevel understanding of value cocreation in service ecosystems. It also illuminates how keystone players in the ecosystem should manage their value propositions to promote resource integration for each actor, fostering resource density and ecosystem viability. It also bridges the high-level conceptual perspective of Service-Dominant logic with specific empirical findings in the very important context of health care.

Abstract
Purpose - The purpose of this paper is to explore the concept of value co-creation in complex value networks with many actors. Electronic health records (EHRs) are innovations that warrant deep study to properly introduce such a complex system. Design/methodology/approach - The paper describes a qualitative study based on Grounded Theory to understand value co-creation from multiple actors' perspectives in a National EHR Service Project: the Portuguese Health Data Platform. Findings - Study results enabled further development of the value co-creation concept in complex environments with multiple actors. More specifically they allowed: operationalizing the value co-creation concept by identifying its factors and outcomes, understanding how value co-creation factors and outcomes are interconnected, and understanding of how value co-creation for each actor depends on his/her own actions and the actions of other actors, in a complex set of interactions and interdependencies. Practical implications - The findings have implications for service managers seeking to understand how actors participating in the network integrate resources and interact to co-create value. The study highlights the need for designing and managing services to co-create value, not only by enabling dyadic interactions between the customer and the service provider, but also by supporting and enabling value co-creation interactions among different actors in the network. Originality/value - This study responds to the need for empirical research on value co-creation in many-to-many contexts and for operationalizing the value co-creation concept.