According to the WHO, healthcare in Europe requires ‘systemic change through innovation’ if it is to respond to the demographic, epidemiological, environmental and technological challenges the region is facing. However, top-down methods of innovation in healthcare, driven by the macro levels of the system, have been struggling to impact the healthcare system at the scale that is required to drive meaningful and sustainable change. It has been widely acknowledged that frontline-led, employee-driven innovation will be the main driver to ensure that innovation in healthcare is human-centred and prioritises the needs of the patients.

This study protocol presents a research project designed to evaluate the experiences of frontline innovators supported by the Irish Health Service Executive’s HSE Spark Innovation programme. The purpose of this research is threefold. First, the findings will further strengthen the provision of support for frontline healthcare professionals, ensuring that they can continue to address the challenges they experience in providing care. Second, the research will provide insight into the structures required to support frontline innovation within the public healthcare sector, forming a starting point for other public sector organisations interested in establishing their own support system for frontline innovation. Finally, it will highlight the impact supporting frontline clinicians to innovate has on service users, staff and the wider healthcare organisation.

A qualitative research design, situated in a phenomenological framework, will be adopted for this research. ‘Participants’ in this study will include staff from the Irish public healthcare system who have obtained innovation support (either funding or human centred design support) from HSE Spark. The participants will be invited to share their experiences of the innovation support they received from HSE Spark, as well as their understanding of the impact of this support on their professional development, their service and the wider healthcare organisation. A stratified purposive sampling approach will be used to ensure the sample provides information-rich representations of individuals’ experiences engaging innovation initiatives supported by HSE Spark. One-to-one, semistructured interviews will be conducted with participants. Transcripts from these interviews will be analysed through a thematic approach, using the data analysis software NVivo. Themes will be derived from the data and used to understand the healthcare professionals’ experiences of engaging with innovation projects and with the support provided to them by HSE Spark. These themes will be used to identify the unspoken needs of innovators within healthcare, the support they need to continue innovating in this sector, and the impact supporting frontline innovation has on the service users, staff and the healthcare organisation.

We used the Standards for Reporting Qualitative Research (SRQR) reporting guideline to draft this manuscript, and the SRQR reporting checklist when editing.

Ethics approval for this study has been obtained from HSE Regional Ethics Committee (No. 20251650-RDMLRREC) and Maynooth University Social Sciences Research Committee (Approval Number: SRESC-2025-40031). Dissemination of results will be via journal articles, conference presentations and proceedings. Study findings will be disseminated in peer-reviewed journals and through conference presentations. Lay summaries of the findings will also be prepared for distribution in internal Irish Health Service publications. Other dissemination activities include the preparation of a book of case studies and key findings on the challenges of integrating human-centred design into public services, to be presented to the Irish Department of Public Expenditure and Reform.

To examine the longitudinal impact of time-varying factors on US youth’s trajectories of initiation and use of e-cigarettes and cigarettes during the transition from adolescence to young adulthood.

Longitudinal.

Nationally representative US survey, the Population Assessment of Tobacco and Health (PATH) Study.

2682 US youth (aged 16–17) at wave (W)1 of the PATH Study across six waves (2013–2020) into young adulthood (aged 22–23).

Unweighted longitudinal latent class analyses identified trajectory classes of e-cigarette and cigarette use, separately. Nationally representative weighted multinomial logistic regression analyses examined time-varying harm perceptions, substance use problems and tobacco product first tried as predictors of these trajectory classes.

Five e-cigarette classes (2013–2020; 41.5% Persistent Never Use, 12.6% W5 Initiation, 19.9% W3 Initiation, 15.2% Prior Initiation, 10.8% High Frequency Past 30-Day (P30D) Use) and five cigarette classes (2013–2019; 58.6% Persistent Never Use, 11.5% W4 Initiation, 10.9% W2 Initiation, 9.6% Prior Initiation, 9.5% High Frequency P30D Use) were identified. Time-varying harm perceptions and substance use problems were associated with trajectories of initiation and use for both products. Cigarettes, cigarillos, other combustibles and any smokeless tobacco as first product tried were associated with e-cigarette initiation and/or progression to high frequency use. E-cigarettes and hookah as first product tried were associated with later cigarette initiation. High Frequency P30D Cigarette Use was less likely if the first product tried was e-cigarettes, cigarillos, hookah or any smokeless tobacco product.

Results reinforce the need for identification and intervention of early substance use among younger adolescents and targeted public health messaging to address changing harm perceptions and prevent initiation among older adolescents.