151
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Blix BH, Hamran T. Brukermedvirkning og representasjon i helse- og omsorgsforskning. TIDSSKRIFT FOR OMSORGSFORSKNING 2021. [DOI: 10.18261/issn.2387-5984-2021-03-07] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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152
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Moreau KA, Eady K, Heath SE. Patient Involvement in Medical Education Research: Results From an International Survey of Medical Education Researchers. J Patient Exp 2021; 8:2374373520981484. [PMID: 34179357 PMCID: PMC8205367 DOI: 10.1177/2374373520981484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
There are demands to involve patients in medical education research (MER). This study surveyed researchers to examine the extent and nature of patient involvement in MER. It obtained 283 completed surveys (response rate of 5%). Of the respondents, 153 (54.1%) indicated that they involve patients in MER. Of these respondents, 102 (66.7%) stated that patients are data sources in MER, 41 (26.8%) noted that patients are involved as advisors and/or reviewers, and/or 22 (14.4%) indicated that patients are involved as team members. These respondents reported that they involve patients to improve the relevance of their MER to patients (n = 99; 64.7%), connect MER to patient outcomes (n = 98; 64.1%), and improve the appropriateness of MER (n = 92; 60.1%). The 130 respondents who do not involve patients in MER do not involve them because they believe that their research topic(s) are irrelevant to patients (n = 68; 52.3%), they have limited resources for patient involvement (n = 40; 30.8%), and/or they do not know how to involve patients (n = 28; 21.5%). Researchers need to consider how they can conduct their MER with patients.
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Affiliation(s)
| | - Kaylee Eady
- Centre for Research on Educational and Community Services, University of Ottawa, Ontario, Canada
| | - Sarah E Heath
- Faculty of Education, University of Ottawa, Ontario, Canada
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153
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Melchior I, van der Heijden A, Stoffers E, Suntjens F, Moser A. Patient and public involvement cultures and the perceived impact in the vulnerable context of palliative care: A qualitative study. Health Expect 2021; 24:456-467. [PMID: 33405359 PMCID: PMC8077136 DOI: 10.1111/hex.13186] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/27/2020] [Accepted: 12/05/2020] [Indexed: 12/05/2022] Open
Abstract
Background Cultural values are crucial to the practice and impact of patient and public involvement (PPI) in research. Objective To understand different PPI cultures among research teams and the impacts of PPI associated with each culture type. Design A participatory action research design. Setting and participants The setting was 10 palliative care research projects. Seventeen patients and members of the public and 31 researchers participated. Intervention A programme consisting of four components: (1) training and coaching of patients and the public to prepare them for participation in research, (2) tailored coaching of the 10 research teams over 12‐18 months, (3) a community of practice, and (4) a qualitative evaluation. Results We identified three cultures types: relationship cultures, task cultures, and control cultures. We identified four areas of impact: the project aim became more relevant to the target audience, methodological reliability increased, the research products were better able to reach the public, and the awareness increased, associated with behavioural changes, among researchers regarding PPI. Discussion A relationship culture appears to be long‐lasting due to impacting the behaviours of the researchers during future projects. Different cultural types require different types of patients and researcher participants, assigned to different tasks. Conclusions Further research remains necessary to investigate the support required by researchers to enable relationship‐ and task‐oriented PPI cultures. Patient or public contribution Patient advocates and representatives contributed to our research team throughout the entire research process, as well as within the 10 implementation projects.
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Affiliation(s)
- Inge Melchior
- Zorgbelang Limburg (currently Burgerkracht Limburg), Sittard, the Netherlands.,Zuyd University of Applied Sciences, Heerlen, the Netherlands.,Maastricht University, Maastricht, the Netherlands
| | | | - Esther Stoffers
- Zorgbelang Limburg (currently Burgerkracht Limburg), Sittard, the Netherlands
| | - Frits Suntjens
- Zorgbelang Limburg (currently Burgerkracht Limburg), Sittard, the Netherlands
| | - Albine Moser
- Zuyd University of Applied Sciences, Heerlen, the Netherlands.,Maastricht University, Maastricht, the Netherlands
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154
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Kaisler RE, Grill C. Enabling Transdisciplinary Collaboration: Stakeholder Views on Working With "Children With Mentally Ill Parents" Research Groups. Front Psychiatry 2021; 12:760716. [PMID: 34887787 PMCID: PMC8649715 DOI: 10.3389/fpsyt.2021.760716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/01/2021] [Indexed: 11/25/2022] Open
Abstract
Working collaboratively and openly together with stakeholders has become a common phenomenon in research. While previous studies have gathered a clear picture on researchers' attitudes, motivations, and barriers for actively involving stakeholders in transdisciplinary research, the stakeholder perspective is yet unknown. Therefore, this paper sets out to identify how stakeholders perceive transdisciplinary collaborations with researchers. This paper in particular reveals the enablers and barriers for such collaborations from the viewpoint of stakeholders. To do so, we look at how stakeholders, who were actively involved in the governance structure of two "children with mentally ill parents" research groups in Austria, perceived their collaboration with researchers. We used a mixed-method, quantitative-qualitative design. We conducted an online survey and interviews with the members of the advisory board and competence group. These stakeholders reported great satisfaction with the transdisciplinary collaboration and emphasized the value of different expertise. As the most important enablers for successful, transdisciplinary collaboration stakeholders emphasized researchers' open-mindedness toward new perspectives and approaches, flexibility to adapt to the research process along the way, and creativity dealing with diverse backgrounds and skills. Stakeholders further underlined the importance of a person facilitating the collaboration process between researchers and stakeholders to resolve any tensions and insecurities. Concluding, researchers' attitudes, and in particular their understanding of the value of stakeholder involvement in research are key enablers for successful transdisciplinary research collaborations.
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Affiliation(s)
- Raphaela E Kaisler
- LBG Open Innovation in Science Center, Ludwig Boltzmann Gesellschaft (LBG), Vienna, Austria
| | - Christiane Grill
- LBG Open Innovation in Science Center, Ludwig Boltzmann Gesellschaft (LBG), Vienna, Austria
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155
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Cui C, Li SZ, Zheng XL, Cheng WJ, Ting W. Participation in healthcare behavior by adolescents with epilepsy and factors that influence it during the transition period: A cross-sectional study in China. Epilepsy Behav 2020; 113:107576. [PMID: 33232895 DOI: 10.1016/j.yebeh.2020.107576] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/16/2020] [Accepted: 10/16/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Given the importance of adolescents' participation in the care of their chronic diseases during their transitional period in the healthcare system, the present study investigated the degree of participation in healthcare behavior by Chinese adolescents with chronic epilepsy and identified factors that should be addressed by health interventions. METHODS The study used a convenience sample of 1238 adolescent patients with epilepsy, who were hospitalized in 17 tertiary A-level children or maternal and child specialty hospitals in China between January 2017 and March 2020. Several scales were used to measure their degree of participation in healthcare behavior and the factors that influence it. Data collection was conducted after uniform training of the investigators. The adolescents who met the inclusion and exclusion criteria could scan the QR code of the questionnaire via a mobile phone. RESULTS The age of the participants ranged from 12.2 to 17.8 years (mean 14.2 years), and the sample had a male-to-female ratio of 1.25:1. The patients' average total score of participation in healthcare behavior was 125.58 (SD = 12.25), which was lower than the norm for China. Their scores on the six dimensions of participation were highest for information interaction, followed in descending order by medical decision-making, treatment and care, appeal, diagnosis and treatment decision-making, and questioning supervision. Multiple linear regression found significant associations between health-care participation and five personal and disease variables (gender, age, course of disease, number of comorbid diseases, type of family structure), self-efficacy, and coping styles (cognitive-palliative and acceptance), which explained 52.1% of the variance in patients' total scores on participating in healthcare behavior. CONCLUSIONS The participation of young Chinese patients with epilepsy in transitional healthcare behavior needs to be improved. Participation was positively associated with being female, a longer course of disease, fewer comorbidities, and living in a nuclear family. Patients who used cognitive-palliative and acceptance coping styles and those who had higher self-efficacy also had significantly higher levels of participation in healthcare behavior. The study provides useful reference points for adolescents with chronic disease to participate in healthcare programs, in order to achieve a smooth transition from childhood to adulthood.
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Affiliation(s)
- Cui Cui
- Department of Nursing, Children's Hospital of Chongqing Medical University, Chongqing, China.
| | - Shuang-Zi Li
- Neurological Medical Center, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xian-Lan Zheng
- Department of Nursing, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Wen-Jin Cheng
- Neurological Medical Center, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Wang Ting
- Neurological Medical Center, Children's Hospital of Chongqing Medical University, Chongqing, China
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156
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Nevola A, Morris ME, Felix HC, Hudson T, Payakachat N, Tilford JM. Improving quality of life assessments for high-need adult Medicaid service users with mental health conditions. Qual Life Res 2020; 30:1155-1164. [PMID: 33211222 DOI: 10.1007/s11136-020-02694-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE There is a lack of consensus on how to evaluate health and social service programs for people with mental health (MH) conditions. Having service users be the primary decision makers in selecting outcome measures can inform a meaningful evaluation strategy. We sought to identify the quality of life (QoL) survey preferences of high-need adult service users with MH conditions. METHODS A systematic review identified generic, self-reported QoL surveys with evidence of validity in MH populations of interest. An advisory panel selected the most promising surveys to assess the success of programs like Medicaid for MH service users. Three groups of high-need, adult service users with MH conditions and one group of direct care staff ranked the surveys from the advisory panel, and generated and ranked characteristics that were desirable or undesirable in a QoL survey. RESULTS Twenty-two surveys met the inclusion criteria. Of the six surveys selected by the advisory panel, groups of service users and direct care staff most preferred the Warwick-Edinburg Mental Well-being Scale (WEMWBS). The WEMWBS best embodied the features prioritized by the groups: to have a user-friendly format and positive focus, to be clearly worded and brief, and to avoid presumptive or unrealistic items. Service user groups appreciated survey topics most amenable to self-report, such as satisfaction with relationships. CONCLUSION Using QoL surveys that service users prefer can reduce the chance that deteriorating QoL is going unchecked, and increase the chance that decisions based on survey findings are meaningful to service users.
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Affiliation(s)
- Adrienne Nevola
- Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham, #820, Little Rock, AR, 72205, USA.
| | - Michael E Morris
- Department of Health Policy, Economics, and Management, University of Texas Health Science Center, 11937 U.S. Highway 271, Tyler, TX, 75708, USA
| | - Holly C Felix
- Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham, #820, Little Rock, AR, 72205, USA
| | - Teresa Hudson
- Psychiatric Research Institute, Division of Health Services Research, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - Nalin Payakachat
- Department of Pharmacy Practice, College of Pharmacy, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - J Mick Tilford
- Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham, #820, Little Rock, AR, 72205, USA
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157
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Natale P, Gutman T, Howell M, Dansie K, Hawley CM, Cho Y, Viecelli AK, Craig JC, Jesudason S, Chapman JR, Johnson DW, Murphy L, Reidlinger D, Crowe S, Duncanson E, Muthuramalingam S, Scholes-Robertson N, Williamson A, McDonald S, Wong G, Teixeira-Pinto A, Strippoli GFM, Tong A. Recruitment and retention in clinical trials in chronic kidney disease: report from national workshops with patients, caregivers and health professionals. Nephrol Dial Transplant 2020; 35:755-764. [PMID: 32240311 DOI: 10.1093/ndt/gfaa044] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Slow recruitment and poor retention jeopardize the reliability and statistical power of clinical trials, delaying access to effective interventions and increasing costs, as commonly observed in nephrology trials. Involving patients in trial design, recruitment and retention is infrequent but potentially transformational. METHODS We conducted three workshops involving 105 patients/caregivers and 43 health professionals discussing patient recruitment and retention in clinical trials in chronic kidney disease. RESULTS We identified four themes. 'Navigating the unknown'-patients described being unaware of the research question, confused by technical terms, sceptical about findings and feared the risk of harm. 'Wary of added burden'-patients voiced reluctance to attend additional appointments, were unsure of the commitment required or at times felt too unwell and without capacity to participate. 'Disillusioned and disconnected'-some patients felt they were taken for granted, particularly if they did not receive trial results. Participants believed there was no culture of trial participation in kidney disease and an overall lack of awareness about opportunities to participate. To improve recruitment and retention, participants addressed 'Building motivation and interest'. CONCLUSIONS Investigators should establish research consciousness from the time of diagnosis, consider optimal timing for approaching patients, provide comprehensive information in an accessible manner, emphasize current and future relevance to them and their illness, involve trusted clinicians in recruitment and minimize the burden of trial participation. Participation in clinical trials was seen as an opportunity for people to give back to the health system and for future people in their predicament.
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Affiliation(s)
- Patrizia Natale
- Sydney School of Public Health, University of Sydney, New South Wales, Sydney, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, New South Wales, Westmead, Australia.,Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Talia Gutman
- Sydney School of Public Health, University of Sydney, New South Wales, Sydney, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, New South Wales, Westmead, Australia
| | - Martin Howell
- Sydney School of Public Health, University of Sydney, New South Wales, Sydney, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, New South Wales, Westmead, Australia
| | - Kathryn Dansie
- Australia and New Zealand Dialysis and Transplant Registry, SA Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Carmel M Hawley
- Australasian Kidney Trials Network, University of Queensland, Brisbane, Queensland, Australia.,Translational Research Institute, Brisbane, Queensland, Australia.,Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Yeoungjee Cho
- Australasian Kidney Trials Network, University of Queensland, Brisbane, Queensland, Australia.,Translational Research Institute, Brisbane, Queensland, Australia.,Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Andrea K Viecelli
- Australasian Kidney Trials Network, University of Queensland, Brisbane, Queensland, Australia.,Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Jonathan C Craig
- Sydney School of Public Health, University of Sydney, New South Wales, Sydney, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, New South Wales, Westmead, Australia.,College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Shilpanjali Jesudason
- Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Kidney Health Australia, Victoria, Melbourne, Australia.,Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Jeremy R Chapman
- Westmead Clinical School, Westmead Institute for Medical Research, New South Wales, Westmead, Australia
| | - David W Johnson
- Australasian Kidney Trials Network, University of Queensland, Brisbane, Queensland, Australia.,Translational Research Institute, Brisbane, Queensland, Australia.,Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Lisa Murphy
- Kidney Health Australia, Victoria, Melbourne, Australia
| | - Donna Reidlinger
- Australasian Kidney Trials Network, University of Queensland, Brisbane, Queensland, Australia.,Translational Research Institute, Brisbane, Queensland, Australia
| | | | - Emily Duncanson
- Australia and New Zealand Dialysis and Transplant Registry, SA Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Shyamsundar Muthuramalingam
- Sydney School of Public Health, University of Sydney, New South Wales, Sydney, Australia.,Australia and New Zealand Dialysis and Transplant Registry, SA Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Nicole Scholes-Robertson
- Sydney School of Public Health, University of Sydney, New South Wales, Sydney, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, New South Wales, Westmead, Australia
| | - Amber Williamson
- BEAT-CKD Consumer Advisory Board, Sydney, New South Wales, Australia.,Kidney Health Australia, Queensland Consumer Consultative Committee, Brisbane, Queensland, Australia
| | - Stephen McDonald
- Australia and New Zealand Dialysis and Transplant Registry, SA Health and Medical Research Institute, Adelaide, South Australia, Australia.,Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Germaine Wong
- Sydney School of Public Health, University of Sydney, New South Wales, Sydney, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, New South Wales, Westmead, Australia.,Westmead Clinical School, Westmead Institute for Medical Research, New South Wales, Westmead, Australia
| | - Armando Teixeira-Pinto
- Sydney School of Public Health, University of Sydney, New South Wales, Sydney, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, New South Wales, Westmead, Australia
| | - Giovanni F M Strippoli
- Sydney School of Public Health, University of Sydney, New South Wales, Sydney, Australia.,Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.,Cochrane Kidney and Transplant, Centre for Kidney Research, Children's Hospital at Westmead, New South Wales, Westmead, Australia
| | - Allison Tong
- Sydney School of Public Health, University of Sydney, New South Wales, Sydney, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, New South Wales, Westmead, Australia
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158
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Bruce C, Harrison P, Giammattei C, Desai SN, Sol JR, Jones S, Schwartz R. Evaluating Patient-Centered Mobile Health Technologies: Definitions, Methodologies, and Outcomes. JMIR Mhealth Uhealth 2020; 8:e17577. [PMID: 33174846 PMCID: PMC7688390 DOI: 10.2196/17577] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 04/11/2020] [Accepted: 10/23/2020] [Indexed: 01/20/2023] Open
Abstract
Several recently published studies and consensus statements have demonstrated that there is only modest (and in many cases, low-quality) evidence that mobile health (mHealth) can improve patient clinical outcomes such as the length of stay or reduction of readmissions. There is also uncertainty as to whether mHealth can improve patient-centered outcomes such as patient engagement or patient satisfaction. One principal challenge behind the “effectiveness” research in this field is a lack of common understanding about what it means to be effective in the digital space (ie, what should constitute a relevant outcome and how best to measure it). In this viewpoint, we call for interdisciplinary, conceptual clarity on the definitions, methodologies, and patient-centered outcomes frequently used in mHealth research. To formulate our recommendations, we used a snowballing approach to identify relevant definitions, outcomes, and methodologies related to mHealth. To begin, we drew heavily upon previously published detailed frameworks that enumerate definitions and measurements of engagement. We built upon these frameworks by extracting other relevant measures of patient-centered care, such as patient satisfaction, patient experience, and patient activation. We describe several definitional inconsistencies for key constructs in the mHealth literature. In an effort to achieve clarity, we tease apart several patient-centered care outcomes, and outline methodologies appropriate to measure each of these patient-care outcomes. By creating a common pathway linking definitions with outcomes and methodologies, we provide a possible interdisciplinary approach to evaluating mHealth technologies. With the broader goal of creating an interdisciplinary approach, we also provide several recommendations that we believe can advance mHealth research and implementation.
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Affiliation(s)
- Courtenay Bruce
- System Quality & Patient Safety, Houston Methodist System, Houston, TX, United States
| | - Patricia Harrison
- System Quality & Patient Safety, Houston Methodist System, Houston, TX, United States
| | | | - Shetal-Nicholas Desai
- Center for Innovation, Houston Methodist Hospital, Houston, TX, United States.,Information Technology Division, Houston Methodist Hospital, Houston, TX, United States
| | - Joshua R Sol
- Center for Innovation, Houston Methodist Hospital, Houston, TX, United States.,Information Technology Division, Houston Methodist Hospital, Houston, TX, United States
| | - Stephen Jones
- Center for Outcomes Research, Houston Methodist Research Institute, Houston, TX, United States.,Department of Surgery, Houston Methodist Hospital, Houston, TX, United States
| | - Roberta Schwartz
- Center for Innovation, Houston Methodist Hospital, Houston, TX, United States
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159
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Newburn M, Scanlon M, Plachcinski R, Jill Macfarlane A. Involving service users in the Birth Timing project, a data linkage study analysing the timing of births and their outcomes. Int J Popul Data Sci 2020; 5:1366. [PMID: 34007886 PMCID: PMC8121135 DOI: 10.23889/ijpds.v5i3.1366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION We report on service user participation in a population-based data linkage study designed to analyse the daily, weekly and yearly cycles of births in England and Wales, the outcomes for women and babies, and their implications for the NHS. Public Involvement and Engagement (PI&E) has a long history in maternity services, though PI&E in maternity data linkage studies is new in the United Kingdom. We have used the GRIPP2 short form, a tool designed for reporting public involvement in research. OBJECTIVES We aimed to involve and engage a wide range of maternity service users and their representatives to ensure that our use of patient-identifiable routinely collected maternity and birth records was acceptable and that our research analyses using linked data were relevant to their expressed safety and quality of care needs. METHODS A three-tiered approach to PI&E was used. Having both PI&E co-investigators and PI&E members of the Study Advisory Group ensured service user involvement was part of the strategic development of the project. A larger constituency of maternity service users from England and Wales was engaged through four regional workshops. RESULTS Two co-investigators with experience of PI&E in maternity research were involved as service user researchers from design stage to dissemination. Four PI&E study advisors contributed service user perspectives. Engagement workshops attracted around 100 attendees, recruited largely from Maternity Services Liaison Committees in England and Wales, and a community engagement group. They supported the use of patient-identifiable data, believing the study had potential to improve safety and quality of maternity services. They contributed their experiences and concerns which will assist with interpretation of the analyses. CONCLUSION Use of PI&E 'knowledge intermediaries' successfully bridged the gap between data intensive research and lived experience, but more inclusivity in involvement and engagement is required. Respecting the concerns and questions of service users provides social legitimacy and a relevance framework for researchers carrying out analyses.
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Affiliation(s)
- Mary Newburn
- School of Health Sciences, City, University of London, Northampton Square, London EC1V 0HB, UK
| | - Miranda Scanlon
- School of Health Sciences, City, University of London, Northampton Square, London EC1V 0HB, UK
| | - Rachel Plachcinski
- School of Health Sciences, City, University of London, Northampton Square, London EC1V 0HB, UK
| | - Alison Jill Macfarlane
- School of Health Sciences, City, University of London, Northampton Square, London EC1V 0HB, UK
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160
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Browne T, Swoboda A, Ephraim PL, Lang-Lindsey K, Green JA, Hill-Briggs F, Jackson GL, Ruff S, Schmidt L, Woods P, Danielson P, Bolden S, Bankes B, Hauer C, Strigo T, Boulware LE. Engaging patients and family members to design and implement patient-centered kidney disease research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:66. [PMID: 33292683 PMCID: PMC7604920 DOI: 10.1186/s40900-020-00237-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 10/07/2020] [Indexed: 06/04/2023]
Abstract
We need more research projects that partner and engage with patients and family members as team members. Doing this requires that patients and family members set research priorities and fully participate in research teams. Models for this patient and family member engagement as research partners can help increase patient centered outcomes research. In this article, we describe how we have successfully engaged patients with kidney disease and family members as Co-Investigators on a 5-year research project testing a health system intervention to improve kidney disease care. Background This article describes a method for successful engagement of patients and family members in all stages of a 5-year comparative effectiveness research trial to improve transitions of care for patients from chronic kidney disease to end-stage kidney disease. Methods This project utilized the Patient-Centered Outcomes Research Institute's conceptual model for engagement with patients and family members. We conducted a qualitative analysis of grant planning meetings to determine patient and family member Co-Investigators' priorities for research and to include these engagement efforts in the research design. Patient and family member Co-Investigators partnered in writing this paper. Results Patients and family members were successfully engaged in remote and in-person meetings to contribute actively to research planning and implementation stages. Three patient-centered themes emerged from our data related to engagement that informed our research plan: kidney disease treatment decision-making, care transitions from chronic to end-stage kidney disease, and patient-centered outcomes. Conclusions The model we have employed represents a new paradigm for kidney disease research in the United States, with patients and family members engaged as full research partners. As a result, the study tests an intervention that directly responds to their needs, and it prioritizes the collection of outcomes data most relevant to patient and family member Co-Investigators. Trial registration NCT02722382 .
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Affiliation(s)
- Teri Browne
- College of Social Work, University of South Carolina, Columbia, SC, USA
| | | | - Patti L Ephraim
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD, USA
| | - Katina Lang-Lindsey
- Present address: Alabama Agriculture & Mechanical University, Huntsville, AL, USA
- Department of Social Work, Alabama A & M University, Huntsville, AL, USA
| | - Jamie A Green
- Department of Nephrology, Geisinger Commonwealth School of Medicine, Danville, PA, USA
- Kidney Health Research Institute, Geisinger, Danville, PA, USA
| | - Felicia Hill-Briggs
- Division of General Internal Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - George L Jackson
- Division of General Internal Medicine, Duke University School of Medicine, 200 Morris Street, 3rd floor, Durham, NC, 27701, USA
| | | | | | | | | | | | | | - Chelsie Hauer
- Center for Clinical Innovation, Institute for Advanced Application, Geisinger, Danville, PA, USA
| | - Tara Strigo
- Division of General Internal Medicine, Duke University School of Medicine, 200 Morris Street, 3rd floor, Durham, NC, 27701, USA
| | - L Ebony Boulware
- Division of General Internal Medicine, Duke University School of Medicine, 200 Morris Street, 3rd floor, Durham, NC, 27701, USA.
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161
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Miah J, Parsons S, Lovell K, Starling B, Leroi I, Dawes P. Impact of involving people with dementia and their care partners in research: a qualitative study. BMJ Open 2020; 10:e039321. [PMID: 33109666 PMCID: PMC7592301 DOI: 10.1136/bmjopen-2020-039321] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES We aimed to evaluate the impact of patient and public involvement (PPI) at each stage of the research cycle in a dementia research programme. DESIGN We used monitoring forms to record the impact of the research programme's PPI at different stages of research and qualitative interviews with all participants to evaluate the impact of PPI. SETTING We evaluated Research User Groups (RUGs-older people with dementia and care partners) which were established to provide PPI support for the research programme in multiple European sites. PARTICIPANTS We purposively sampled RUG members (n=34) and researchers (n=13) who had participated in PPI activities. Inclusion criteria for the study were: (a) RUG members who had participated in the research awareness training and in PPI activities and had the capacity to consent; (b) researchers who involved RUGs in their work. RESULTS Impact on the research: changes to the study conduct were made as a result of the feedback from RUGs. These included prioritisation of clinical recommendations, the wording of study information and recruitment materials, the content and layout of the user interface for a computerised memory test, interpretation of intervention results and advice on dissemination avenues. Impact on RUG members: they reported that involvement had given them a sense of purpose and satisfaction. Their perception of health research changed from being an exclusive activity to one, which lay people, could have meaningful involvement. Impact on researchers: PPI was a new way of working and interacting with PPI members had given them insight into the impact of their work on people living with dementia. CONCLUSIONS PPI can have a substantial impact on dementia research and the people involved in the research. To justify the time and expense of PPI, the advantageous practical impacts of PPI should be systematically recorded and consistently reported.
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Affiliation(s)
- Jahanara Miah
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
- Public Programmes Team, Manchester University NHS Foundation Trust, Manchester, UK
| | - Suzanne Parsons
- Public Programmes Team, Manchester University NHS Foundation Trust, Manchester, UK
| | - Karina Lovell
- The School of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK
| | - Bella Starling
- Public Programmes Team, Manchester University NHS Foundation Trust, Manchester, UK
| | - Iracema Leroi
- School of Medicine, Global Brain Health Institute, Dublin, Ireland
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Piers Dawes
- Manchester Centre for Audiology and Deafness (ManCAD), University of Manchester, Manchester, UK
- Department of Linguistics, Australian Hearing Hub, Macquarie University, Sydney, New South Wales, Australia
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162
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Russell J, Fudge N, Greenhalgh T. The impact of public involvement in health research: what are we measuring? Why are we measuring it? Should we stop measuring it? RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:63. [PMID: 33133636 PMCID: PMC7592364 DOI: 10.1186/s40900-020-00239-w] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/07/2020] [Indexed: 05/20/2023]
Abstract
As public involvement in the design, conduct and dissemination of health research has become an expected norm and firmly enshrined in policy, interest in measuring its impact has also grown. Despite a drive to assess the impact of public involvement, and a growing body of studies attempting to do just this, a number of questions have been largely ignored. This commentary addresses these omissions: What is the impact of all this focus on measuring impact? How is the language of impact shaping the debate about, and the practice of, public involvement in health research? And how have shifting conceptualisations of public involvement in health research shaped, and been shaped by, the way we think about and measure impact? We argue that the focus on impact risks distorting how public involvement in health research is conceptualised and practised, blinding us to possible negative impacts. We call for a critical research agenda for public involvement that [a] considers public involvement not as an instrumental intervention but a social practice of dialogue and learning between researchers and the public; [b] explores how power relations play out in the context of public involvement in health research, what empowerment means and whose interests are served by it, and [c] asks questions about possible harms as well as benefits of public involvement, and whether the language of impact is helpful or not.
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Affiliation(s)
- Jill Russell
- Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Nina Fudge
- Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Berge I, Barenfeld E, Dahlin-Ivanoff S, Haak M, Lood Q. Challenging oneself on the threshold to the world of research - frail older people's experiences of involvement in research. BMC Geriatr 2020; 20:410. [PMID: 33069211 PMCID: PMC7568390 DOI: 10.1186/s12877-020-01817-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 10/05/2020] [Indexed: 11/10/2022] Open
Abstract
Background User involvement of people outside academia in research is argued to increase relevance of research for society and to empower the involved lay persons. Frail older people can be a hard to reach group for research and thus an underrepresented group in research. There is a lack of knowledge how collaboration with frail older people should be best performed. Therefore, the aim of this study was to explore frail older people’s experiences of involvement in research. Methods In this study we have invited people, 75 years of age or older screened as physically frail and who have previously participated in a study as data sources, to share their experiences by intensive interviewing. Data was collected and analysed in parallel inspired by a constructivist grounded theory approach. Results The results demonstrate how frail older people have different incentives, how their context of ageing and the unusual position of being involved in research altogether influenced how, where and in what way they wished to be involved in research. This is described in three categories: Contributing to making a difference for oneself and others, Living a frail existence and Being on somebody else’s turf. The categories compose the core category, Challenging oneself on the threshold to the world of research, which symbolises the perceived distance between the frail older people themselves and the research world, but also the challenges the frail older people could go through when choosing to be involved in research. Conclusions Frail older people have a varied capacity to participate in research, but in what way and how is difficult to know before they have been involved in the process of research. Our results advocate that it is problematic to exclude frail older people a priori and that there is a potential for new perspectives and knowledge to be shaped in the encounter and in the relationship between the researcher and the frail older person. For research to be able to cater for frail older people’s needs of health services, their voices need to be heard and taken into consideration.
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Affiliation(s)
- Isak Berge
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Gothenburg, Sweden.
| | - Emmelie Barenfeld
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Synneve Dahlin-Ivanoff
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Gothenburg, Sweden
| | - Maria Haak
- Research Platform for Collaboration for Health, Faculty of Health Science, Kristianstad University, Kristianstad, Sweden.,Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Qarin Lood
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Gothenburg, Sweden.,School of Nursing and Midwifery, La Trobe University, Bundoora, Australia
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164
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Lazarou I, Stavropoulos TG, Meditskos G, Andreadis S, Kompatsiaris IY, Tsolaki M. Long-Term Impact of Intelligent Monitoring Technology on People with Cognitive Impairment: An Observational Study. J Alzheimers Dis 2020; 70:757-792. [PMID: 31256141 DOI: 10.3233/jad-190423] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Interactive smart home systems are particularly useful for people with cognitive impairment. OBJECTIVE To investigate the long-term effects of Assistive Technology (AT) combined with tailored non-pharmacological interventions for people with cognitive impairment. METHODS 18 participants (12 with mild cognitive impairment and 6 with Alzheimer's disease) took part in the study that we evenly allocated in one of three groups: 1) experimental group (EG), 2) control group 1 (CG1), and 3) control group 2 (CG2). EG received the system installed at home for 4 to 12 months, during which they received tailored non-pharmacological interventions according to system observations. CG1 received tailored interventions for the same period, but only according to state-of-the-art self-reporting methods. Finally, CG2 neither had a system installation nor received interventions. All groups underwent neuropsychological assessment before and after the observational period. RESULTS After several months of continuously monitoring at home and deployment of tailored interventions, the EG showed statistically significant improvement in cognitive function, compared to the CG1 and CG2. Moreover, EG participants, who received the sensor-based system, have shown improvement in domains such as sleep quality and daily activity, as measured by the multi-sensor system. In addition, the feedback collected from the participants concludes that the long-term use of the multi-sensor system by people with cognitive impairment can be both feasible and beneficial. CONCLUSION Deploying a sensor-based system at real home settings of people with cognitive limitations living alone and maintaining its use long-term is not only possible, but also beneficial for clinical decision making in order to tackle cognitive, functional, and behavioral related problems.
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Affiliation(s)
- Ioulietta Lazarou
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Macedonia, Greece.,1st Department of Neurology, U.H. "AHEPA", Medical School, Faculty of Healthy Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Macedonia, Greece
| | - Thanos G Stavropoulos
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Macedonia, Greece
| | - Georgios Meditskos
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Macedonia, Greece
| | - Stelios Andreadis
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Macedonia, Greece
| | - Ioannis Yiannis Kompatsiaris
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Macedonia, Greece
| | - Magda Tsolaki
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Macedonia, Greece.,1st Department of Neurology, U.H. "AHEPA", Medical School, Faculty of Healthy Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Macedonia, Greece.,Greek Association of Alzheimer's Disease and Related Disorders (GAADRD - Alzheimer Hellas), Thessaloniki, Macedonia, Greece
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165
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Evans BA, Gallanders J, Griffiths L, Harris-Mayes R, James M, Jones S, Joseph-Williams N, Nettle M, Rolph M, Snooks H, Wallace C, Edwards A. Public involvement and engagement in primary and emergency care research: the story from PRIME Centre Wales. Int J Popul Data Sci 2020; 5:1363. [PMID: 33644413 PMCID: PMC7894248 DOI: 10.23889/ijpds.v5i3.1363] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Policy throughout the United Kingdom promotes involvement of patients and public members in research to benefit patient care and health outcomes. PRIME Centre Wales is a national research centre, developing and coordinating research about primary and emergency care which forms 90% of health service encounters. In this paper, we describe our approach to public involvement and engagement in PRIME Centre Wales (hereafter called PRIME), in particular: how this approach has developed; ways in which public members contribute to PRIME activity; the strengths and limitations of our approach, challenges and future opportunities. PRIME ensures work is relevant to service users, carers, the public and policy makers by incorporating comprehensive patient and public involvement in every phase of our work. APPROACH PRIME has policies and processes to enable and promote successful public involvement and engagement across research activities. This ensures public perspectives and patient experiences are integrated throughout research development, implementation and dissemination and in managing and delivering PRIME strategy over a 10 year timescale. A public/patient group called SUPER is a key resource providing wide-ranging perspectives via email and face-to-face discussion. We collect information on processes and experiences to assess value and impact, to guide ongoing involvement and engagement. A funded post provides leadership and support to staff and to public/patient contributors to facilitate collaborations. DISCUSSION A stable, well-resourced structure has provided the timescales to build strong relationships and embed diverse approaches to public involvement and engagement within PRIME. Researchers and public contributors have committed to collaborations, developed knowledge and skills and sustained relationships. Effective approaches incorporate values and actions which, when operating together, strengthen processes and outcomes of public involvement and engagement. CONCLUSION Supportive context, motivation and time are necessary to foster values and practices that enable effective public involvement and engagement. PRIME has embedded public involvement and engagement across research activities and structures. Central is the public/patient group SUPER offering experience-based expertise to add value to the research cycle. This innovative model, aligned with best practice, enhances relevance and quality of primary and emergency care research to benefit patients and the general population.
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Affiliation(s)
- Bridie Angela Evans
- Swansea University Medical School, ILS 2, Singleton Campus, Swansea, SA2 8PP, UK
| | - John Gallanders
- SUPER, c/o Swansea University Medical School ILS 2, Singleton Campus Swansea, SA2 8PP, UK
| | - Lesley Griffiths
- SUPER, c/o Swansea University Medical School ILS 2, Singleton Campus Swansea, SA2 8PP, UK
| | - Robert Harris-Mayes
- SUPER, c/o Swansea University Medical School ILS 2, Singleton Campus Swansea, SA2 8PP, UK
| | - Mari James
- SUPER, c/o Swansea University Medical School ILS 2, Singleton Campus Swansea, SA2 8PP, UK
| | - Sian Jones
- SUPER, c/o Swansea University Medical School ILS 2, Singleton Campus Swansea, SA2 8PP, UK
| | | | - Mary Nettle
- SUPER, c/o Swansea University Medical School ILS 2, Singleton Campus Swansea, SA2 8PP, UK
| | - Martin Rolph
- SUPER, c/o Swansea University Medical School ILS 2, Singleton Campus Swansea, SA2 8PP, UK
| | - Helen Snooks
- Swansea University Medical School, ILS 2, Singleton Campus, Swansea, SA2 8PP, UK
| | - Carolyn Wallace
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, CF37 1DL, UK
| | - Adrian Edwards
- Division of Population Medicine, Cardiff University, Cardiff, Wales, CF10 3AT, UK
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166
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Charalambous M, Kambanaros M, Annoni JM. Are People with Aphasia (PWA) Involved in the Creation of Quality of Life and Aphasia Impact-Related Questionnaires? A Scoping Review. Brain Sci 2020; 10:E688. [PMID: 33003493 PMCID: PMC7600175 DOI: 10.3390/brainsci10100688] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/21/2020] [Accepted: 09/27/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Quality of Life (QoL) questionnaires are used to describe the impact of aphasia on stroke survivors' life. People with aphasia (PWA) are traditionally excluded from research, potentially leading to a mismatch between the factors chosen in the tools and the realistic needs of PWA. The purpose of this review was to determine the direct involvement of PWA in the creation of QoL and aphasia impact-related questionnaires (AIR-Qs). METHODS A scoping review methodology was conducted by an expert librarian and two independent reviewers on health sciences based on the Preferred Reporting Items for Systematic Reviews and Metanalyses extension for Scoping Reviews (PRISMA-ScR) protocol, through a literature search in five databases: Medline Complete, PubMed, PsychINFO, Scopus, and Google Scholar. Search terms included 'stroke', 'people with aphasia', 'communication', 'well-being', and 'quality of life'. RESULTS Of 952 results, 20 studies met the eligibility criteria. Of these, only four AIR-Qs studies (20%) were found reporting the direct involvement of PWA, while no QoL tools did so. Evidence showed involvement in the creation phase of AIR-Q, mainly in a consultation role. CONCLUSIONS There is an absence of a framework for conducting and reporting the involvement of PWA in qualitative participatory research studies, which limits effectiveness to promote equitable best practice in aphasia rehabilitation.
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Affiliation(s)
- Marina Charalambous
- Laboratory of Cognitive and Neurological Sciences, University of Fribourg, CH-1700 Fribourg, Switzerland;
| | - Maria Kambanaros
- Allied Health and Human Performance, University of South Australia, Adelaide SA 5001, Australia;
| | - Jean-Marie Annoni
- Laboratory of Cognitive and Neurological Sciences, University of Fribourg, CH-1700 Fribourg, Switzerland;
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167
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2019 sickle cell disease guidelines by the American Society of Hematology: methodology, challenges, and innovations. Blood Adv 2020; 3:3945-3950. [PMID: 31794603 DOI: 10.1182/bloodadvances.2019000931] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 10/15/2019] [Indexed: 11/20/2022] Open
Abstract
The American Society of Hematology (ASH) convened 5 guideline panels to develop clinical practice recommendations addressing 5 management areas of highest importance to individuals living with sickle cell disease: pain, cerebrovascular complications, pulmonary and kidney complications, transfusion, and hematopoietic stem cell transplant. Panels were multidisciplinary and consisted of patient representatives, content experts, and methodologists. The Mayo Clinic Evidence-Based Practice Center conducted systematic reviews based on a priori selected questions. In this exposition, we describe the process used by ASH, including the GRADE approach (Grades of Recommendations, Assessment, Development and Evaluation) for rating certainty of the evidence and the GRADE Evidence to Decision Framework. We also describe several unique challenges faced by the guideline panels and the specific innovations and solutions used to address them, including a curriculum to train patients to engage in guideline development, dealing with the opioid crisis, and working with indirect and noncomparative evidence.
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168
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Gohel MS, Heatley F, Liu X, Bradbury A, Bulbulia R, Cullum N, Epstein DM, Nyamekye I, Poskitt KR, Renton S, Warwick J, Davies AH. Early versus deferred endovenous ablation of superficial venous reflux in patients with venous ulceration: the EVRA RCT. Health Technol Assess 2020; 23:1-96. [PMID: 31140402 DOI: 10.3310/hta23240] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Venous ulceration is a common and costly health-care issue worldwide, with poor healing rates greatly affecting patient quality of life. Compression bandaging has been shown to improve healing rates and reduce recurrence, but does not address the underlying cause, which is often superficial venous reflux. Surgical correction of the reflux reduces ulcer recurrence; however, the effect of early endovenous ablation of superficial venous reflux on ulcer healing is unclear. OBJECTIVES To determine the clinical effectiveness and cost-effectiveness of compression therapy with early endovenous ablation of superficial venous reflux compared with compression therapy with deferred endovenous ablation in patients with venous ulceration. DESIGN A pragmatic, two-arm, multicentre, parallel-group, open randomised controlled trial with a health economic evaluation. SETTING Secondary care vascular centres in England. PARTICIPANTS Patients aged ≥ 18 years with a venous leg ulcer of between 6 weeks' and 6 months' duration and an ankle-brachial pressure index of ≥ 0.8 who could tolerate compression and were deemed suitable for endovenous ablation of superficial venous reflux. INTERVENTIONS Participants were randomised 1 : 1 to either early ablation (compression therapy and superficial endovenous ablation within 2 weeks of randomisation) or deferred ablation (compression therapy followed by endovenous ablation once the ulcer had healed). MAIN OUTCOME MEASURES The primary outcome measure was time from randomisation to ulcer healing, confirmed by blinded assessment. Secondary outcomes included 24-week ulcer healing rates, ulcer-free time, clinical success (in addition to quality of life), costs and quality-adjusted life-years (QALYs). All analyses were performed on an intention-to-treat basis. RESULTS A total of 450 participants were recruited (224 to early and 226 to deferred superficial endovenous ablation). Baseline characteristics were similar between the two groups. Time to ulcer healing was shorter in participants randomised to early superficial endovenous ablation than in those randomised to deferred ablation [hazard ratio 1.38, 95% confidence interval (CI) 1.13 to 1.68; p = 0.001]. Median time to ulcer healing was 56 (95% CI 49 to 66) days in the early ablation group and 82 (95% CI 69 to 92) days in the deferred ablation group. The ulcer healing rate at 24 weeks was 85.6% in the early ablation group, compared with 76.3% in the deferred ablation group. Median ulcer-free time was 306 [interquartile range (IQR) 240-328] days in the early ablation group and 278 (IQR 175-324) days in the deferred endovenous ablation group (p = 0.002). The most common complications of superficial endovenous ablation were pain and deep-vein thrombosis. Differences in repeated measures of Aberdeen Varicose Vein Questionnaire scores (p < 0.001), EuroQol-5 Dimensions index values (p = 0.03) and Short Form questionnaire-36 items body pain (p = 0.05) over the follow-up period were observed, in favour of early ablation. The mean difference in total costs between the early ablation and deferred ablation groups was £163 [standard error (SE) £318; p = 0.607]; however, there was a substantial and statistically significant gain in QALY over 1 year [mean difference between groups 0.041 (SE 0.017) QALYs; p = 0.017]. The incremental cost-effectiveness ratio of early ablation at 1 year was £3976 per QALY, with a high probability (89%) of being more cost-effective than deferred ablation at conventional UK decision-making thresholds (currently £20,000 per QALY). Sensitivity analyses using alternative statistical models give qualitatively similar results. LIMITATIONS Only 7% of screened patients were recruited, treatment regimens varied significantly and technical success was assessed only in the early ablation group. CONCLUSIONS Early endovenous ablation of superficial venous reflux, in addition to compression therapy and wound dressings, reduces the time to healing of venous leg ulcers, increases ulcer-free time and is highly likely to be cost-effective. FUTURE WORK Longer-term follow-up is ongoing and will determine if early ablation will affect recurrence rates in the medium and long term. TRIAL REGISTRATION Current Controlled Trials ISRCTN02335796. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 24. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Manjit S Gohel
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.,Department of Surgery and Cancer, Imperial College London, London, UK
| | - Francine Heatley
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Xinxue Liu
- Imperial Clinical Trials Unit, Imperial College London, London, UK
| | - Andrew Bradbury
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Richard Bulbulia
- Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK.,Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.,Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Nicky Cullum
- School of Health Sciences, University of Manchester, Manchester, UK
| | - David M Epstein
- Department of Applied Economics, University of Granada, Granada, Spain
| | | | - Keith R Poskitt
- Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK
| | | | - Jane Warwick
- Imperial Clinical Trials Unit, Imperial College London, London, UK.,Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Alun H Davies
- Department of Surgery and Cancer, Imperial College London, London, UK
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169
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Kylén M, Schmidt SM, Jonsson O, Slaug B, Iwarsson S. Awareness of and Attitudes Toward User Involvement in Research on Aging and Health: Protocol for a Quantitative Large-Scale Panel Study. JMIR Res Protoc 2020; 9:e17759. [PMID: 32955444 PMCID: PMC7536605 DOI: 10.2196/17759] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 05/29/2020] [Accepted: 06/21/2020] [Indexed: 11/29/2022] Open
Abstract
Background User involvement is a requirement of most research funders. There is a growing body of literature exploring the benefits and challenges of user involvement in research, but such studies are scarce in the field of aging and health. Moreover, the majority of such research is qualitative, which limits the generalizability of results. The UserAge panel study will be instrumental in expanding knowledge that will benefit the quality and impact of user involvement in future research. Objective The aim of this study is to determine the awareness and understanding of and attitudes toward user involvement in research among different categories of knowledge users and researchers over time. Methods A panel study will be implemented with 3 different categories of knowledge users (people aged 60 years and older, informal carers, and professionals in health care and architecture) and researchers in aging and health. A professional survey company will collect data from all samples in parallel. Potential participants will be asked to complete the survey via telephone or online, or participants can request a paper survey to be sent to them in the post. A draft set of questions on attitudes and behavioral patterns related to research utilization and user involvement in research was compiled based on existing literature and input from the research team. Using a participatory approach, we engaged a user forum, where 8 older people and 3 researchers jointly refined the survey for time/length to complete, terminology, readability, and context. Data collected via the internet or telephone will be automatically processed, and data collected on paper forms will be entered in machine-readable forms. The survey company will store all data and deliver the quality-controlled database to the university for further storage. Analyses of frequencies and measures of central tendency will be used for descriptive purposes. To compare groups, state-of-the art statistical analyses will be used. Results Data collection for the first study wave started in September 2019 and will be completed in spring 2020. Data will be ready for analysis following cleaning and quality control, which started during summer 2020 and will be completed autumn 2020. We anticipate the data collection for the second study wave to start in September 2021. Conclusions This is the first quantitative large-scale panel study focusing on trends in attitudes toward, awareness of, and knowledge about user involvement in research on aging and health in Sweden. The results will generate new and important knowledge to advance the understanding of user needs and preferences as well as the relevance of user involvement in research on aging and health. International Registered Report Identifier (IRRID) DERR1-10.2196/17759
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Affiliation(s)
- Maya Kylén
- Department of Health Sciences, Lund University, Lund, Sweden
| | | | - Oskar Jonsson
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Björn Slaug
- Department of Health Sciences, Lund University, Lund, Sweden
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170
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Lee BK, Gilbert R, Knighton R. Couple Therapy in Substance Use and Gambling Disorders: Promoting Health System Change. CONTEMPORARY FAMILY THERAPY 2020. [DOI: 10.1007/s10591-020-09536-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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171
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Bourque CJ, Bonanno M, Dumont É, Gaucher N, Lacoste-Julien A, Gomez-Tyo M, Langlet MF, Sultan S. The Integration of Resource Patients in Collaborative Research: A Mixed Method Assessment of the Nesting Dolls Design. PATIENT EDUCATION AND COUNSELING 2020; 103:1830-1838. [PMID: 32418681 DOI: 10.1016/j.pec.2020.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 04/08/2020] [Accepted: 04/10/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES This is a quality assessment of a research design developed for a collaborative study on adolescents and young adults who survived a brain tumor. METHODS A descriptive and critical mixed methods approach was used to assess the design itself, the quality and information power of the database and the integration of collaborators. Project documentation, field notes and transcripts from focus groups interviews(n = 19) were used for the evaluation, which was based on the Consolidated Criteria for Reporting Qualitative Research. RESULTS The design proved to be pertinent to resolve methodological stakes in a "fragile field". The mobilisation of collaborators as members of a "Sherpa team" in all phases of the project helped the team create a progressive focus approach well-adapted for data gathering and analysis as well as produce a high-quality database. CONCLUSION The Nesting Dolls Design including the didactic approach developed along the deployment of the project helped researchers, clinicians and resource patients/parents understand the research procedures and the roles of all collaborators. This fostered a meaningful engagement in the project. PRACTICE IMPLICATIONS Resources and time for training, communication and supervision are necessary to reach the objectives of collaborative research involving novices and are worth the time and efforts.
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Affiliation(s)
- Claude Julie Bourque
- Sainte-Justine University Hospital (CHUSJ) Research Center, Department of Pediatrics, University of Montréal, Montréal, Canada.
| | - Marco Bonanno
- Division of Hematology-Oncology, Sainte-Justine University Hospital, Montréal, Canada
| | - Émilie Dumont
- Department of Psychology, University of Montréal, Montréal, Canada
| | - Nathalie Gaucher
- Department of Pediatrics, University of Montréal, Division of Emergency Medicine, Sainte-Justine University Hospital, Montréal, Canada
| | | | - Mathias Gomez-Tyo
- Leucan (Québec association for parents of children with cancer), Montréal, Canada
| | - Marie-France Langlet
- Patients-Families-Providers Partnership Office, Sainte-Justine University Hospital, Montréal, Canada
| | - Serge Sultan
- Psycho-Oncology Center, Sainte-Justine University Hospital, Montréal, Canada
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Wali N, Renzaho A, Wang X, Atkins B, Bhattacharya D. Do interventions to improve adherence to antiretroviral therapy recognise diversity? A systematic review. AIDS Care 2020; 33:1379-1393. [PMID: 32847386 DOI: 10.1080/09540121.2020.1811198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
People living with HIV (PLWH) are often culturally and linguistically diverse populations; these differences are associated with differing barriers to antiretroviral therapy (ART) adherence. Cultural competence measures the extent to which trial design recognises this diversity. This systematic review aimed to determine whether adherence trial participants represent the diversity of PLWH. Randomised Controlled Trials in Organisation for Economic Co-operation and Development countries to improve ART adherence were eligible. We searched MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews. For all included trials, we searched for their development, testing and evaluation studies. We compared trial participant characteristics with nationally reported PLWH data. We appraised trial cultural competence against ten criteria; scoring each criterion as 0, 1 or 2 indicating cultural blindness, pre-competence or competence respectively. For 80 included trials, a further 13 studies presenting development/testing/evaluation data for the included trials were identified. Only one of the 80 included studies reported trial participants representative of the country's population of PLWH. The median (IQ) cultural competence score was 2.5 (1.0, 4.0) out of 20. HIV adherence trial participants are not reflective of the population with HIV, which may be due to limited adoption of culturally competent research methods.
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Affiliation(s)
- Nidhi Wali
- School of Social Sciences and Psychology, Western Sydney University, Sydney, Australia
| | - Andre Renzaho
- School of Social Sciences and Psychology, Western Sydney University, Sydney, Australia
| | - Xia Wang
- School of Pharmacy, University of East Anglia, Norwich, UK
| | - Bethany Atkins
- School of Pharmacy, University of East Anglia, Norwich, UK
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Conneely M, Boland P, O'Neill A, Byrne D, Cronin S, Quinn D, Trépel D, Leahy S, Salsberg J, Galvin R, Robinson K. A protocol for the establishment and evaluation of an older adult stakeholder panel for health services research. HRB Open Res 2020; 3:1. [PMID: 32760878 PMCID: PMC7374807 DOI: 10.12688/hrbopenres.12979.2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2020] [Indexed: 01/10/2023] Open
Abstract
Background: There has been a policy shift towards public and patient involvement (PPI) in population health and health services research in Ireland and internationally. Despite growing evidence that PPI can have positive impacts on the quality and appropriateness of health research, little is known about the involvement and impact of older adults as research partners. The aim of this study is to 1) describe the process of establishing a PPI panel of older adults, family carers and ageing research academics and 2) to evaluate the impact of this research partnership on all research partners. Methods: A partnership-focused framework will guide the recruitment and establishment of a PPI panel of older adults, family carers and academic researchers. Eight to ten older adults and four to six family carers with experience of using health services will be recruited through gatekeepers in a range of non-governmental, voluntary, and community organisations in the Mid-West region of Ireland. Academic researchers will be recruited through the Ageing Research Centre at the University of Limerick. To evaluating the impact of the research partnership on all members of the PPI panel we propose to record an activity log, maintain a record of all meeting, panel discussions and conduct individual interviews with all members of the research team at key time points. The final plan for evaluation will be negotiated and agreed with all members of the PPI panel. Data will be transcribed, managed in NVivo and analysed using an inductive approach to thematic analysis. Dissemination of research findings will be facilitated by the research partnership team of academics and older adults. Discussion: This study will identify learning about the process of establishing a PPI panel guided by a partnership-focused framework and will evaluate the impact of participation in a PPI panel for all members of the research team.
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Affiliation(s)
- Mairéad Conneely
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
| | - Pauline Boland
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
| | - Aoife O'Neill
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
| | - David Byrne
- HRB Centre for Primary Care Research, Mercer Building, Royal College of Surgeons in Ireland, Dublin 2, Ireland, DO2 YN72, Ireland
| | - Sinéad Cronin
- HRB Centre for Primary Care Research, Mercer Building, Royal College of Surgeons in Ireland, Dublin 2, Ireland, DO2 YN72, Ireland
| | - Dominic Quinn
- HRB Centre for Primary Care Research, Mercer Building, Royal College of Surgeons in Ireland, Dublin 2, Ireland, DO2 YN72, Ireland
| | - Dominic Trépel
- Trinity Institute of Neurosciences, School of Medicine, Trinity College Dublin, Dublin 2, Ireland, DO2 PN40, Ireland
| | - Siobhán Leahy
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
| | - Jon Salsberg
- Graduate Entry Medical School Ireland, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
| | - Rose Galvin
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
| | - Katie Robinson
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
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Network Engagement in Action: Stakeholder Engagement Activities to Enhance Patient-centeredness of Research. Med Care 2020; 58 Suppl 6 Suppl 1:S66-S74. [PMID: 32412955 DOI: 10.1097/mlr.0000000000001264] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Stakeholders (ie, patients, policymakers, clinicians, advocacy groups, health system leaders, payers, and others) offer critical input at various stages in the research continuum, and their contributions are increasingly recognized as an important component of effective translational research. Natural experiments, in particular, may benefit from stakeholder feedback in addressing real-world issues and providing insight into future policy decisions, though best practices for the engagement of stakeholders in observational studies are limited in the literature. METHODS The Natural Experiments for Translation in Diabetes 2.0 (NEXT-D2) network utilizes rigorous methods to evaluate natural experiments in health policy and program delivery with a focus on diabetes-related outcomes. Each of the 8 partnering institutions incorporates stakeholder engagement throughout multiple study phases to enhance the patient-centeredness of results. NEXT-D2 dedicates a committee to Engagement for resource sharing, enhancing engagement approaches, and advancing network-wide engagement activities. Key stakeholder engagement activities include Study Meetings, Proposal Development, Trainings & Educational Opportunities, Data Analysis, and Results Dissemination. Network-wide patient-centered resources and multimedia have also been developed through the broad expertise of each site's stakeholder group. CONCLUSIONS This collaboration has created a continuous feedback loop wherein site-level engagement approaches are informed via the network and network-level engagement efforts are shaped by individual sites. Emerging best practices include: incorporating stakeholders in multiple ways throughout the research, building on previous relationships with stakeholders, enhancing capacity through stakeholder and investigator training, involving stakeholders in refining outcome choices and understanding the meaning of variables, and recognizing the power of stakeholders in maximizing dissemination.
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175
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Perkes S, Bonevski B, Mattes J, Hall K, Gould GS. Respiratory, birth and health economic measures for use with Indigenous Australian infants in a research trial: a modified Delphi with an Indigenous panel. BMC Pediatr 2020; 20:368. [PMID: 32758202 PMCID: PMC7409441 DOI: 10.1186/s12887-020-02255-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 07/23/2020] [Indexed: 01/26/2023] Open
Abstract
Background There is significant disparity between the respiratory health of Indigenous and non-Indigenous Australian infants. There is no culturally accepted measure to collect respiratory health outcomes in Indigenous infants. The aim of this study was to gain end user and expert consensus on the most relevant and acceptable respiratory and birth measures for Indigenous infants at birth, between birth and 6 months, and at 6 months of age follow-up for use in a research trial. Methods A three round modified Delphi process was conducted from February 2018 to April 2019. Eight Indigenous panel members, and 18 Indigenous women participated. Items reached consensus if 7/8 (≥80%) panel members indicated the item was ‘very essential’. Qualitative responses by Indigenous women and the panel were used to modify the 6 months of age surveys. Results In total, 15 items for birth, 48 items from 1 to 6 months, and five potential questionnaires for use at 6 months of age were considered. Of those, 15 measures for birth were accepted, i.e., gestational age, birth weight, Neonatal Intensive Care Unit (NICU) admissions, length, head circumference, sex, Apgar score, substance use, cord blood gas values, labour, birth type, health of the mother, number people living in the home, education of mother and place of residence. Seventeen measures from 1-to 6 months of age were accepted, i.e., acute respiratory symptoms (7), general health items (2), health care utilisation (6), exposure to tobacco smoke (1), and breastfeeding status (1). Three questionnaires for use at 6 months of age were accepted, i.e., a shortened 33-item respiratory questionnaire, a clinical history survey and a developmental questionnaire. Conclusions In a modified Delphi process with an Indigenous panel, measures and items were proposed for use to assess respiratory, birth and health economic outcomes in Indigenous Australian infants between birth and 6 months of age. This initial step can be used to develop a set of relevant and acceptable measures to report respiratory illness and birth outcomes in community based Indigenous infants.
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Affiliation(s)
- Sarah Perkes
- Hunter Medical Research Institute and School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia.
| | - Billie Bonevski
- Hunter Medical Research Institute and School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia
| | - Joerg Mattes
- Hunter Medical Research Institute and School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia
| | - Kerry Hall
- First Peoples Health Unit, (FPHU) Griffith University, Southport, Queensland, 4215, Australia
| | - Gillian S Gould
- Hunter Medical Research Institute and School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia
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Conneely M, Boland P, O'Neill A, Byrne D, Cronin S, Quinn D, Trépel D, Leahy S, Salsberg J, Galvin R, Robinson K. A protocol for the establishment and evaluation of an older adult stakeholder panel for health services research. HRB Open Res 2020; 3:1. [PMID: 32760878 PMCID: PMC7374807 DOI: 10.12688/hrbopenres.12979.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2020] [Indexed: 10/15/2023] Open
Abstract
Background: There has been a policy shift towards public and patient involvement (PPI) in population health and health services research in Ireland and internationally. Despite growing evidence that PPI can have positive impacts on the quality and appropriateness of health research, little is known about the involvement and impact of older adults as research partners. The aim of this study is to 1) describe the process of establishing a PPI panel of older adults, family carers and ageing research academics and 2) to evaluate the impact of this research partnership on all research partners. Methods: A partnership-focused framework will guide the recruitment and establishment of a PPI panel of older adults, family carers and academic researchers. Eight to ten older adults and four to six family carers with experience of using health services will be recruited through gatekeepers in a range of non-governmental, voluntary, and community organisations in the Mid-West region of Ireland. Academic researchers will be recruited through the Ageing Research Centre at the University of Limerick. To evaluating the impact of the research partnership on all members of the PPI panel we propose to record an activity log, maintain a record of all meeting, panel discussions and conduct individual interviews with all members of the research team at key time points. The final plan for evaluation will be negotiated and agreed with all members of the PPI panel. Data will be transcribed, managed in NVivo and analysed using an inductive approach to thematic analysis. Dissemination of research findings will be facilitated by the research partnership team of academics and older adults. Discussion: This study will identify learning about the process of establishing a PPI panel guided by a partnership-focused framework and will evaluate the impact of participation in a PPI panel for all members of the research team.
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Affiliation(s)
- Mairéad Conneely
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
| | - Pauline Boland
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
| | - Aoife O'Neill
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
| | - David Byrne
- HRB Centre for Primary Care Research, Mercer Building, Royal College of Surgeons in Ireland, Dublin 2, Ireland, DO2 YN72, Ireland
| | - Sinéad Cronin
- HRB Centre for Primary Care Research, Mercer Building, Royal College of Surgeons in Ireland, Dublin 2, Ireland, DO2 YN72, Ireland
| | - Dominic Quinn
- HRB Centre for Primary Care Research, Mercer Building, Royal College of Surgeons in Ireland, Dublin 2, Ireland, DO2 YN72, Ireland
| | - Dominic Trépel
- Trinity Institute of Neurosciences, School of Medicine, Trinity College Dublin, Dublin 2, Ireland, DO2 PN40, Ireland
| | - Siobhán Leahy
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
| | - Jon Salsberg
- Graduate Entry Medical School Ireland, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
| | - Rose Galvin
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
| | - Katie Robinson
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
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Roche P, Shimmin C, Hickes S, Khan M, Sherzoi O, Wicklund E, Lavoie JG, Hardie S, Wittmeier KDM, Sibley KM. Valuing All Voices: refining a trauma-informed, intersectional and critical reflexive framework for patient engagement in health research using a qualitative descriptive approach. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:42. [PMID: 32699647 PMCID: PMC7370500 DOI: 10.1186/s40900-020-00217-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 06/30/2020] [Indexed: 05/29/2023]
Abstract
BACKGROUND Critical stakeholder-identified gaps in current health research engagement strategies include the exclusion of voices traditionally less heard and a lack of consideration for the role of trauma in lived experience. Previous work has advocated for a trauma-informed, intersectional, and critical reflexive approach to patient and public involvement in health research. The Valuing All Voices Framework embodies these theoretical concepts through four key components: trust, self-awareness, empathy, and relationship building. The goal of this framework is to provide the context for research teams to conduct patient engagement through the use of a social justice and health equity lens, to improve safety and inclusivity in health research. The aim of this study was to revise the proposed Valuing All Voices Framework with members of groups whose voices are traditionally less heard in health research. METHODS A qualitative descriptive approach was used to conduct a thematic analysis of participant input on the proposed framework. Methods were co-developed with a patient co-researcher and community organizations. RESULTS Group and individual interviews were held with 18 participants identifying as Inuit; refugee, immigrant, and/or newcomer; and/or as a person with lived experience of a mental health condition. Participants supported the proposed framework and underlying theory. Participant definitions of framework components included characterizations, behaviours, feelings, motivations, and ways to put components into action during engagement. Emphasis was placed on the need for a holistic approach to engagement; focusing on open and honest communication; building trusting relationships that extend beyond the research process; and capacity development for both researchers and patient partners. Participants suggested changes that incorporated some of their definitions; simplified and contextualized proposed component definitions; added a component of "education and communication"; and added a 'how to' section for each component. The framework was revised according to participant suggestions and validated through member checking. CONCLUSIONS The revised Valuing All Voices Framework provides guidance for teams looking to employ trauma-informed approaches, intersectional analysis, and critical reflexive practice in the co-development of meaningful, inclusive, and safe engagement strategies. PLAIN ENGLISH SUMMARY Patient engagement in health research continues to exclude many people who face challenges in accessing healthcare, including (but not limited to) First Nations, Inuit, and Metis people; immigrants, refugees, and newcomers; and people with lived experience of a mental health condition. We proposed a new guide to help researchers engage with patients and members of the public in research decision-making in a meaningful, inclusive, and safe way. We called this the Valuing All Voices Framework, and met with people who identify as members of some of these groups to help define the key parts of the framework (trust; self-awareness; empathy; and relationship building), to tell us what they liked and disliked about the proposed framework, and what needed to be changed. Input from participants was used to change the framework, including clarifying definitions of the key parts, adding another key part called "education and communication", and providing action items so teams can put these key parts into practice.
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Affiliation(s)
- P. Roche
- George & Fay Yee Centre for Healthcare Innovation (CHI), 3rd Floor - 753 McDermot Avenue, Winnipeg, Manitoba R3E 0T6 Canada
| | - C. Shimmin
- George & Fay Yee Centre for Healthcare Innovation (CHI), 3rd Floor - 753 McDermot Avenue, Winnipeg, Manitoba R3E 0T6 Canada
| | - S. Hickes
- George & Fay Yee Centre for Healthcare Innovation (CHI), 3rd Floor - 753 McDermot Avenue, Winnipeg, Manitoba R3E 0T6 Canada
| | - M. Khan
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Room S113 – 750 Bannatyne Avenue, Winnipeg, Manitoba R3E 0W3 Canada
| | - O. Sherzoi
- George & Fay Yee Centre for Healthcare Innovation (CHI), 3rd Floor - 753 McDermot Avenue, Winnipeg, Manitoba R3E 0T6 Canada
| | - E. Wicklund
- Canadian Centre on Disability Studies, Unit #10, 226 Osborne Street North, Winnipeg, Manitoba R3C 1V4 Canada
| | - J. G. Lavoie
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Room S113 – 750 Bannatyne Avenue, Winnipeg, Manitoba R3E 0W3 Canada
- Ongomiizwin Research, Indigenous Institute of Health and Healing, Rady Faculty of Health Sciences, University of Manitoba, 715 – 727 McDermot Avenue, Winnipeg, Manitoba R3E 3P4 Canada
| | - S. Hardie
- Canadian Centre on Disability Studies, Unit #10, 226 Osborne Street North, Winnipeg, Manitoba R3C 1V4 Canada
| | - K. D. M. Wittmeier
- Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, Health Sciences Centre, University of Manitoba, CE-208 Children’s Hospital, 840 Sherbrook Street, Winnipeg, Manitoba R3A 1S1 Canada
- Children’s Hospital Research Institute of Manitoba, 656 – 715 McDermot Avenue, Winnipeg, Manitoba R3E 3P4 Canada
| | - K. M. Sibley
- George & Fay Yee Centre for Healthcare Innovation (CHI), 3rd Floor - 753 McDermot Avenue, Winnipeg, Manitoba R3E 0T6 Canada
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Room S113 – 750 Bannatyne Avenue, Winnipeg, Manitoba R3E 0W3 Canada
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Hobbs G, Tully MP. Realist evaluation of public engagement and involvement in data-intensive health research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:37. [PMID: 32612850 PMCID: PMC7325137 DOI: 10.1186/s40900-020-00215-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 06/18/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND High quality public engagement and involvement (PEI) in data-intensive health research is seen as one way of ensuring that social legitimacy, i.e. a social license, is conferred through public acceptance of the need for research use of their data. This is a complex research area, and portfolios of involvement have been suggested, but not yet evaluated, to support the role of public contributors. The study aim was to evaluate if and how membership of a data-intensive research public forum can act as a mechanism for enhancing members' personal development. Our objective was to understand the circumstances and mechanisms that help to explain how, why and for whom involvement with a public forum enhanced those members' personal development. METHOD Qualitative data were collected from 15 current and previous members, via semi-structured interviews, notes from meetings, and consultations with and feedback from members. Data were critically compared, contrasted and reviewed until no new themes could be discerned and then condensed into context-mechanism-outcome (CMO) configurations. Realist evaluation was used to generate a theoretical and empirical appreciation of the contextual circumstances and mechanisms which help to explain the extent to which involvement with a public forum would enhance members' personal development and, if so, how, why, and for whom. RESULTS Three CMO configurations were identified. All of them showed that using the portfolio facilitated growth in forum members' personal development, but only where the members valued using the portfolio. This was particularly so for female members. Members valued the portfolio in one or more of three ways: as a tool to record and evidence activities, to facilitate reflective practice or as a guiding framework. CONCLUSIONS Data analysis and consideration of the three CMO configurations suggests a refined middle range theory that 'The use of a portfolio as a framework for learning in a public forum will facilitate members' personal development if they value its use as a framework for learning'. Further work is needed to confirm these findings both elsewhere in data-intensive health research and in other complex research areas using public forums for PEI. PLAIN ENGLISH SUMMARY Public engagement and involvement in health research is now well established and makes a valuable contribution to the research process. However, little is known about its impact on participants. This article investigates how involvement in a data-intensive health research public forum impacts on public forum members, rather than the research process. Personal involvement portfolios were used to support their involvement work and help evaluate if and how involvement in research activities enhanced members' personal development. Taking a realist evaluation approach, 'Context-Mechanism-Outcome' configurations were used to explore how membership of a public forum might enhance public forum members' personal development. The Context-Mechanism-Outcome configuration refers to an exploration of what influences the extent to which an intervention is successful or unsuccessful in producing positive outcomes and tries to identify the reasons why it is successful for some and unsuccessful for others. However, evidence from this realist evaluation recommends that engagement and involvement should always be underpinned by procedures which ensure that public contributors receive ongoing and tailored guidance and support throughout the process.
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Affiliation(s)
- Georgina Hobbs
- Evidence and Research Manager, Manchester Health and Care Commissioning, Parkway 3, Princess Rd, Manchester, M14-7LU UK
| | - Mary P. Tully
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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Alex J, Ramjan L, Salamonson Y, Ferguson C. Nurses as key advocates of self-care approaches to chronic disease management. Contemp Nurse 2020; 56:101-104. [PMID: 32552496 DOI: 10.1080/10376178.2020.1771191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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180
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Kaisler RE, Missbach B. Co-creating a patient and public involvement and engagement 'how to' guide for researchers. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:32. [PMID: 32566249 PMCID: PMC7301967 DOI: 10.1186/s40900-020-00208-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 06/04/2020] [Indexed: 05/31/2023]
Abstract
PLAIN LANGUAGE SUMMARY Research should benefit society at large. Involving citizens those who are affected by research may not only increase the quality, but can also push research towards generating greater societal benefits and relevant outcomes for citizens. Including citizens in research also has ethical implications, which necessitate structured guidance on 'how to' meaningfully involve them. In our project, we invited a multi-stakeholder group consisting of researchers from multiple disciplines, citizen scientists, youth and patient advocates to co-create a guide on 'how to' meaningfully involve citizens in research. In five consecutive workshops, we discussed how the characteristics of interactions between researchers and citizens (e.g., building trustful relationships and communication) and what a possible project steering structure enabling meaningful public involvement in research could look like. As a result of these workshops, the PPIE 'How to' Guide for Researchers was developed to support the implementation of 'Patient and Public Involvement and Engagement' (PPIE) activities and informed a PPIE Implementation Programme funding public involvement activities in Austria. ABSTRACT Involving citizens in research is not widely utilised across research disciplines and countries. It requires the readiness of researchers and their organisations as well as guides on 'how to' successfully involve citizens in a meaningful way. Including the patient and citizen voice in research activities has been most frequently demonstrated in health research, however, is implemented along various degrees of involvement - from passively receiving information about science to actively involving the citizens in steering projects and research activities. In this commentary, we aim to report a multi-stakeholder co-creation process developing 'Patient and Public Involvement and Engagement' (PPIE) activities across disciplines to provide guidance for researchers and the public. We use Ludwig Boltzmann Society's (LBG) organisational framework as a case study, hence it consists of research institutes ranging from the life sciences to humanities and therefore represents a well-suited research environment for this endeavour. In a co-creation approach - to accomplish a shared understanding of public involvement in research among different stakeholders - a multi-stakeholder group comprising 11 researchers from natural sciences, life sciences, social sciences and humanities, and 13 citizens (such as patient advocates, young people and citizen scientists) were involved. In five consecutive workshops, we co-developed the nature of interactions between citizens and researchers, as well as governance structures enabling meaningful involvement in research. The workshops' content was informed by an initial literature review. As a result of this process, the PPIE 'How to' Guide for Researchers was developed to support the implementation of involvement activities in their research projects according to the public involvement principles. These principles informed assessment criteria for the newly established PPIE Implementation Programme at LBG. It provides funding and support for public involvement activities in research to embed a sustainable and meaningful implementation of public involvement activities in Austria.
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Affiliation(s)
- Raphaela E. Kaisler
- Ludwig Boltzmann Gesellschaft (LBG), LBG Open Innovation in Science Center, Nussdorferstraße 64/2, 1090 Vienna, Austria
| | - Benjamin Missbach
- Ludwig Boltzmann Gesellschaft (LBG), LBG Open Innovation in Science Center, Nussdorferstraße 64/2, 1090 Vienna, Austria
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Luna Puerta L, Bartlam B, Sun HLS, Smith HE. Perspectives on public involvement in health research from Singapore: The potential of a supported group model of involvement. Health Expect 2020; 23:1074-1085. [PMID: 32520434 PMCID: PMC7696133 DOI: 10.1111/hex.13058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 03/09/2020] [Accepted: 03/14/2020] [Indexed: 11/28/2022] Open
Abstract
Background Singapore is an international research hub, with an emphasis on translational clinical research. Despite growing evidence of the positive impact of public involvement (PPI) in research, it remains rare in Singapore. Aims To investigate Singaporean public perspectives around the rationale, role and scope for being involved in health research To identify the potential, challenges, facilitators and strategies for implementing PPI in Singapore.
Design Semi‐structured qualitative interviews with members of the public, analysed using thematic framework analysis. Results Twenty people participated. Four main themes emerged: potential benefits; challenges; facilitators; and strategies for implementation. Whilst initially unfamiliar with the concept, all interviewees recognized potential benefits for the research itself and those involved, including researchers. PPI was seen to offer opportunities for public empowerment and strengthening of relationships and understanding between the public, academics and health professionals, resulting in more impactful research. Challenges included a Singaporean culture of passive citizenship and an education system that inculcates deferential attitudes. Facilitators comprised demographic and cultural changes, including trends towards greater individual openness and community engagement. Implementation strategies included formal government policies promoting involvement and informal community‐based collaborative approaches. Conclusion Given the socio‐political framework in Singapore, a community‐based approach has potential to address challenges to PPI and maximize impact. Careful consideration needs to be given to issues of resource and support to enable members of the public to engage in culturally sensitive and meaningful ways that will deliver research best placed to effectively address patient needs.
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Affiliation(s)
- Lidia Luna Puerta
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Bernadette Bartlam
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Hsiao-Li Shirley Sun
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore.,School of Social Sciences, Nanyang Technological University Singapore, Singapore, Singapore
| | - Helen E Smith
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore.,Division of Public Health and Primary Care, Brighton and Sussex Medical School, Brighton, UK
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182
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Hoekstra F, Mrklas KJ, Khan M, McKay RC, Vis-Dunbar M, Sibley KM, Nguyen T, Graham ID, Gainforth HL. A review of reviews on principles, strategies, outcomes and impacts of research partnerships approaches: a first step in synthesising the research partnership literature. Health Res Policy Syst 2020; 18:51. [PMID: 32450919 PMCID: PMC7249434 DOI: 10.1186/s12961-020-0544-9] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 02/21/2020] [Indexed: 01/12/2023] Open
Abstract
Background Conducting research in partnership with stakeholders (e.g. policy-makers, practitioners, organisations, patients) is a promising and popular approach to improving the implementation of research findings in policy and practice. This study aimed to identify the principles, strategies, outcomes and impacts reported in different types of reviews of research partnerships in order to obtain a better understanding of the scope of the research partnership literature. Methods This review of reviews is part of a Coordinated Multicenter Team approach to synthesise the research partnership literature with five conceptually linked literature reviews. The main research question was ‘What principles, strategies, outcomes and impacts are reported in different types of research partnership approaches?’. We included articles describing a literature review of research partnerships using a systematic search strategy. We used an adapted version of the Revised Assessment of Multiple Systematic Reviews tool to assess quality. Nine electronic databases were searched from inception to April 2018. Principles, strategies, outcomes and impacts were extracted from the included reviews and analysed using direct content analysis. Results We included 86 reviews using terms describing several research partnership approaches (e.g. community-based participatory research, participatory research, integrated knowledge translation). After the analyses, we synthesised 17 overarching principles and 11 overarching strategies and grouped them into one of the following subcategories: relationship between partners; co-production of knowledge; meaningful stakeholder engagement; capacity-building, support and resources; communication process; and ethical issues related to the collaborative research activities. Similarly, we synthesised 20 overarching outcomes and impacts on researchers, stakeholders, the community or society, and the research process. Conclusions This review of reviews is the first that presents overarching principles, strategies, outcomes and impacts of research partnerships. This review is unique in scope as we synthesised literature across multiple research areas, involving different stakeholder groups. Our findings can be used as a first step to guide the initiation and maintenance of research partnerships and to create a classification system of the key domains of research partnerships, which may improve reporting consistency in the research partnership literature. Trial registration This study is registered via Open Science Framework: 10.17605/OSF.IO/GVR7Y.
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Affiliation(s)
- F Hoekstra
- School of Health & Exercise Sciences, University of British Columbia, Kelowna, Canada.,International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
| | - K J Mrklas
- Strategic Clinical Networks™, System Innovation and Programs, Alberta Health Services, Calgary, Alberta, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - M Khan
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - R C McKay
- School of Health & Exercise Sciences, University of British Columbia, Kelowna, Canada.,International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
| | - M Vis-Dunbar
- Library, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - K M Sibley
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.,George & Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - T Nguyen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,CanChild Centre for Childhood Disability Research, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - I D Graham
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | | | - H L Gainforth
- School of Health & Exercise Sciences, University of British Columbia, Kelowna, Canada. .,International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada.
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183
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Luger TM, Hamilton AB, True G. Measuring Community-Engaged Research Contexts, Processes, and Outcomes: A Mapping Review. Milbank Q 2020; 98:493-553. [PMID: 32428339 PMCID: PMC7296434 DOI: 10.1111/1468-0009.12458] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Policy Points Community‐engaged research (CEnR) engenders meaningful academic‐community partnerships to improve research quality and health outcomes. CEnR has increasingly been adopted by health care systems, funders, and communities looking for solutions to intractable problems. It has been difficult to systematically measure CEnR's impact, as most evaluations focus on project‐specific outcomes. Similarly, partners have struggled with identifying appropriate measures to assess outcomes of interest. To make a case for CEnR's value, we must demonstrate the impacts of CEnR over time. We compiled recent measures and developed an interactive data visualization to facilitate more consistent measurement of CEnR's theoretical domains.
Context Community‐engaged research (CEnR) aims to engender meaningful academic‐community partnerships to increase research quality and impact, improve individual and community health, and build capacity for uptake of evidence‐based practices. Given the urgency to solve society's pressing public health problems and increasing competition for funding, it is important to demonstrate CEnR's value. Most evaluations focus on project‐specific outcomes, making it difficult to demonstrate CEnR's broader impact. Moreover, it is challenging for partnerships to identify assessments of interest beyond process measures. We conducted a mapping review to help partnerships find and select measures to evaluate CEnR projects and to characterize areas where further development of measures is needed. Methods We searched electronic bibliographic databases using relevant search terms from 2009 to 2018 and scanned CEnR projects to identify unpublished measures. Through review and reduction, we found 69 measures of CEnR's context, process, or outcomes that are potentially generalizable beyond a specific health condition or population. We abstracted data from descriptions of each measure to catalog purpose, aim (context, process, or outcome), and specific domains being measured. Findings We identified 28 measures of the conditions under which CEnR is conducted and factors to support effective academic‐community collaboration (context); 43 measures evaluating constructs such as group dynamics and trust (process); and 43 measures of impacts such as benefits and challenges of CEnR participation and system and capacity changes (outcomes). Conclusions We found substantial variation in how academic‐community partnerships conceptualize and define even similar domains. Achieving more consistency in how partnerships evaluate key constructs could reduce measurement confusion apparent in the literature. A hybrid approach whereby partnerships discuss common metrics and develop locally important measures can address CEnR's multiple goals. Our accessible data visualization serves as a convenient resource to support partnerships’ evaluation goals and may help to build the evidence base for CEnR through the use of common measures across studies.
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Affiliation(s)
- Tana M Luger
- VA Greater Los Angeles Healthcare System, Health Services Research and Development Center for the Study of Healthcare Innovation, Implementation and Policy
| | - Alison B Hamilton
- VA Greater Los Angeles Healthcare System, Health Services Research and Development Center for the Study of Healthcare Innovation, Implementation and Policy.,David Geffen School of Medicine, University of California, Los Angeles
| | - Gala True
- Southeast Louisiana Veterans Healthcare System, South Central Mental Illness Research, Education, and Clinical Center.,Louisiana State University School of Medicine, Section of Community and Population Medicine
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184
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Laustsen CE, Petersson P, Westergren A, Haak M. Exploring health professionals´ experiences of being involved in a research project. KNOWLEDGE MANAGEMENT RESEARCH & PRACTICE 2020. [DOI: 10.1080/14778238.2020.1762253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - Pia Petersson
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Albert Westergren
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Maria Haak
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
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185
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Blakey EP, Durante A, Malfait S, Panayiota K, Thilo FJS, O'Connor S. Involving older people in gerontological nursing research: A discussion of five European perspectives. Int J Older People Nurs 2020; 15:e12311. [PMID: 32413241 DOI: 10.1111/opn.12311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 12/16/2019] [Accepted: 01/18/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Emma Pascale Blakey
- Oxford Brookes University, Oxford, UK.,Oxford University NHS Foundation Trust, Oxford, UK
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186
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Martineau JT, Minyaoui A, Boivin A. Partnering with patients in healthcare research: a scoping review of ethical issues, challenges, and recommendations for practice. BMC Med Ethics 2020; 21:34. [PMID: 32393230 PMCID: PMC7216517 DOI: 10.1186/s12910-020-0460-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 02/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Partnering with patients in healthcare research now benefits from a strong rationale and is encouraged by funding agencies and research institutions. However, this new approach raises ethical issues for patients, researchers, research professionals and administrators. The main objective of this review is to map the literature related to the ethical issues associated with patient partnership in healthcare research, as well as the recommendations to address them. Our global aim is to help researchers, patients, research institutions and research ethics boards reflecting on and dealing with these issues. METHODS We conducted a scoping review of the ethical issues and recommendations associated with partnering with patients in healthcare research. After our search strategy, 31 peer reviewed articles published between 2007 and 2017 remained and were analyzed. RESULTS We have identified 58 first-order ethical issues and challenges associated with patient partnership in research, regrouped in 18 second-order ethical themes. Most of the issues are transversal to all phases and stages of the research process and a lot of them could also apply to patient-partnership in other spheres of health, such as governance, quality improvement, and education. We suggested that ethical issues and challenges of partnered research can be related to four ethical frameworks: 1) Research ethics; 2) Research integrity; 3) Organizational ethics, and 4) Relational ethics. CONCLUSIONS We have identified numerous ethical issues associated with the recent approach of patient-partnership in research. These issues are more diverse than the issues associated with a more traditional research approach. Indeed, the current discussion on how we address ethical issues in research is anchored in the assumption that patients, as research participants, must be protected from risk. However, doing research with, and not on, the patient involves changes in the way we reflect on the ethical issues associated with this approach to research. We propose to broaden the ethical discussion on partnered research to not only rely on a research ethics framework, but to also frame it within the areas of research integrity, organizational ethics and relational ethics.
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Affiliation(s)
- Joé T Martineau
- Department of Management, HEC Montreal, 3000 chemin de la Cote-Ste-Catherine, Montreal, QC, H3T2A7, Canada.
| | | | - Antoine Boivin
- Canada Research Chair in Patient and Public Partnership, CHUM Research Center (CRCHUM) and University of Montreal, Montreal, Canada
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187
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Aubin D, Hebert M, Eurich D. The importance of measuring the impact of patient-oriented research. CMAJ 2020; 191:E860-E864. [PMID: 31387956 DOI: 10.1503/cmaj.190237] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Affiliation(s)
- Diane Aubin
- Career Development in Methods and Health Services Research (Aubin, Hebert, Eurich), Alberta SPOR SUPPORT Unit; School of Public Health (Aubin, Eurich), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (Hebert), Cumming School of Medicine, University of Calgary, Calgary, Alta.
| | - Marilynne Hebert
- Career Development in Methods and Health Services Research (Aubin, Hebert, Eurich), Alberta SPOR SUPPORT Unit; School of Public Health (Aubin, Eurich), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (Hebert), Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Dean Eurich
- Career Development in Methods and Health Services Research (Aubin, Hebert, Eurich), Alberta SPOR SUPPORT Unit; School of Public Health (Aubin, Eurich), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (Hebert), Cumming School of Medicine, University of Calgary, Calgary, Alta
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188
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Pratt B. Towards inclusive priority-setting for global health research projects: recommendations for sharing power with communities. Health Policy Plan 2020; 34:346-357. [PMID: 31168568 DOI: 10.1093/heapol/czz041] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2019] [Indexed: 11/12/2022] Open
Abstract
Global health research priority-setting is dominated by funders and researchers, often from high-income countries. Engaging communities that are considered disadvantaged and marginalized in priority-setting is essential to making their voices and concerns visible in global health research projects' topics and questions. However, without attention to power dynamics, their engagement can often lead to presence without voice and voice without influence. Global health research priority-setting must be designed to share power with such communities to ensure that research projects' topics and questions reflect the health care and system inequities they face. To better understand what sharing 'power over' priority-setting requires, 29 in-depth, semi-structured interviews and one focus group were undertaken with researchers, ethicists, community engagement practitioners and community-based organization staff. The study shows that, before moving ahead with priority-setting for global health research projects, it is vital to assess whether contextual factors necessary for meaningful engagement between researchers and marginalized communities are present or can be built in the research setting. Study findings describe several such contextual factors and 12 features of priority-setting that affect how processes are run, who participates in them, and who influences their outputs. During priority-setting for global health research projects, it is essential to implement ways of sharing power with communities in relation to these features. Study findings describe a multitude of such strategies that are employed in practice. After priority-setting, it is important to demonstrate respect and accountability to communities.
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Affiliation(s)
- Bridget Pratt
- Centre for Health Equity, School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, Victoria, Australia
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189
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Khayatzadeh-Mahani A, Wittevrongel K, Petermann L, Graham ID, Zwicker JD. Stakeholders' engagement in co-producing policy-relevant knowledge to facilitate employment for persons with developmental disabilities. Health Res Policy Syst 2020; 18:39. [PMID: 32303228 PMCID: PMC7164207 DOI: 10.1186/s12961-020-00548-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 03/17/2020] [Indexed: 11/24/2022] Open
Abstract
Background Persons with developmental disabilities (PWDD) face a number of individual, environmental and societal barriers when seeking employment. Integrated knowledge translation (IKT) involves ongoing and dynamic interactions between researchers and stakeholders for the purpose of engaging in mutually beneficial research to address these types of multi-faceted barriers. There is a knowledge gap in the IKT literature on effective stakeholder engagement strategies outside of the dissemination stage to inform policy. In this paper, we report on a number of engagement strategies employed over a 2-year period to engage a wide range of stakeholders in different stages of an IKT project that aimed to investigate the ‘wicked’ problem of employment for PWDD. Method Our engagement plan included multiple linked strategies and was designed to ensure the meaningful engagement of, and knowledge co-production with, stakeholders. We held two participatory consensus-building stakeholder policy dialogue events to co-produce knowledge utilising the nominal group technique and the modified Delphi technique. A total of 31 and 49 stakeholders engaged in the first and second events, respectively, from six key stakeholder groups. Focused engagement strategies were employed to build on the stakeholder dialogues for knowledge mobilisation and included a focus group attended only by PWDD, a stakeholder workshop attended only by policy/decision-makers, a webinar attended by human resources professionals and employers, and a current affairs panel attended by the general public. Results Our findings suggest that the level of engagement for each stakeholder group varies depending on the goal and need of the project. Our stakeholder dialogue findings highlight the inherent challenges in co-framing and knowledge co-production through the meaningful engagement of multiple stakeholders who hold different ideas and interests. Focused outreach is needed to foster relationships and trust for meaningful engagement. Conclusions In addition to providing guidance on how to implement adaptable meaningful engagement strategies, these findings contribute to discussions on how IKT projects are planned and funded. More studies to explore effective mechanisms for engaging a wide range of stakeholders in IKT research are needed. More evidence of successful engagement strategies employed by researchers to achieve meaningful knowledge co-production is also key to advancing the discipline.
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Affiliation(s)
- Akram Khayatzadeh-Mahani
- School of Public Policy, University of Calgary, Downtown Campus, 906 8th Avenue S.W., 5th Floor, Calgary, Alberta, T2P 1H9, Canada.,Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Krystle Wittevrongel
- School of Public Policy, University of Calgary, Downtown Campus, 906 8th Avenue S.W., 5th Floor, Calgary, Alberta, T2P 1H9, Canada
| | - Lisa Petermann
- Libin Cardiovascular Institute of Alberta, Calgary, Canada
| | - Ian D Graham
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Jennifer D Zwicker
- School of Public Policy, University of Calgary, Downtown Campus, 906 8th Avenue S.W., 5th Floor, Calgary, Alberta, T2P 1H9, Canada.
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190
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Seeralan T, Härter M, Koschnitzke C, Scholl M, Kohlmann S, Lehmann M, Eisele M, Braunschneider LE, Marx G, Scherer M, Löwe B, Magaard JL, Brütt AL. Patient involvement in developing a patient-targeted feedback intervention after depression screening in primary care within the randomized controlled trial GET.FEEDBACK.GP. Health Expect 2020; 24 Suppl 1:95-112. [PMID: 32286005 PMCID: PMC8137500 DOI: 10.1111/hex.13039] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 01/31/2020] [Accepted: 02/05/2020] [Indexed: 11/28/2022] Open
Abstract
Background Patient and public involvement (PPI) is increasingly required in mental health services research. To empower patients to actively address depression, the GET.FEEDBACK.GP study evaluates a patient‐targeted feedback intervention after depression screening using the Patient Health Questionnaire (PHQ‐9). Objective To refine the patient‐targeted feedback from a previous study within a participatory research team (PRT) by conducting workshops to investigate patients' needs and preferences for feedback. To evaluate the process and outcome of PPI. Design Patient and public involvement was carried out on the levels of collaboration and consultation. A PRT of patient partners and researchers planned and conducted three workshops with patients. Patients' needs were investigated using a focus group. Participants prioritized needs, discussed feedback drafts and evaluated two drafts using cognitive debriefings. Researchers of the PRT communicated the results at project level. PPI was evaluated using the Public and Patient Engagement Evaluation Tools (PPEET). Setting and Participants A purposeful sampling of N = 12 patients with experiences of depression participated in at least one workshop. Results Relevant content‐related needs about feedback (eg no distinction between severe and moderate symptoms), recommendations for action and patient‐relevant information were considered. Needs for comprehensible, valuing, nonstigmatizing language and design elements (eg dimensional bar) were implemented. Workshops and PRT were positively evaluated. Discussion and Conclusions Patient and public involvement influenced the content, wording and design of the feedback. Strengths include two levels of PPI, methodical diversity and purposeful sampling. Limitations include the lack of inclusion of patients who are unaware of their depression. The evaluated PPI concept can be useful for future studies.
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Affiliation(s)
- Tharanya Seeralan
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Member of the Participatory Research Team, Hamburg, Germany
| | - Martin Härter
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Michael Scholl
- Member of the Participatory Research Team, Hamburg, Germany
| | - Sebastian Kohlmann
- Department of Psychosomatic Medicine and Psychotherapy, Center for Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marco Lehmann
- Department of Psychosomatic Medicine and Psychotherapy, Center for Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marion Eisele
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lea-Elena Braunschneider
- Department of Psychosomatic Medicine and Psychotherapy, Center for Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gabriella Marx
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, Center for Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Luise Magaard
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Member of the Participatory Research Team, Hamburg, Germany
| | - Anna Levke Brütt
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Member of the Participatory Research Team, Hamburg, Germany.,Department for Health Services Research, Faculty of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
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191
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Todd S, Coupland C, Randall R. Patient and public involvement facilitators: Could they be the key to the NHS quality improvement agenda? Health Expect 2020; 23:461-472. [PMID: 32022356 PMCID: PMC7104637 DOI: 10.1111/hex.13023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 11/26/2019] [Accepted: 12/17/2019] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE Research into patient and public involvement (PPI) has not examined in detail patient and public involvement facilitators' (PPIFs) roles and activities. This study analysed PPIFs' roles using qualitative data gathered from three different UK health-care organizations. DESIGN Thematic analysis was used to examine cross-sectional data collected using a mixed-methods approach from three organizations: a mental health trust, a community health social enterprise and an acute hospital trust. The data set comprised of 27 interviews and 48 observations. FINDINGS Patient and public involvement facilitators roles included the leadership and management of PPI interventions, developing health-care practices and influencing quality improvements (QI). They usually occupied middle-management grades but their PPIF role involved working in isolation or in small teams. They reported facilitating the development and maintenance of relationships between patients and the public, and health-care professionals and service managers. These roles sometimes required them to use conflict resolution skills and involved considerable emotional labour. Integrating information from PPI into service improvement processes was reported to be a challenge for these individuals. CONCLUSIONS Patient and public involvement facilitators capture and hold information that can be used in service improvement. However, they work with limited resources and support. Health-care organizations need to offer more practical support to PPIFs in their efforts to improve care quality, particularly by making their role integral to developing QI strategies.
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Affiliation(s)
- Sarah Todd
- Centre for Professional Work & SocietySchool of Business & EconomicsLoughborough UniversityLoughboroughUK
| | - Christine Coupland
- Centre for Professional Work & SocietySchool of Business & EconomicsLoughborough UniversityLoughboroughUK
| | - Raymond Randall
- Centre for Professional Work & SocietySchool of Business & EconomicsLoughborough UniversityLoughboroughUK
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192
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Cognitive behavioral therapy for suicide prevention in youth admitted to hospital following an episode of self-harm: A pilot randomized controlled trial. J Affect Disord 2020; 266:686-694. [PMID: 32056945 DOI: 10.1016/j.jad.2020.01.178] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/29/2019] [Accepted: 01/28/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Self-harm (SH) is among the strongest risk factors for eventual suicide death yet there are limited data on which interventions are most effective for treating SH in youth. METHODS This single-blind, pilot randomized controlled trial examined brief cognitive behavioral therapy (BCBT) for suicide prevention vs. minimally-directive supportive psychotherapy in youth (aged 16-26) hospitalized following SH. Both therapies included 10 acute sessions over 15 weeks with three booster sessions occurring at three month intervals thereafter. The primary feasibility outcome was ≥70% retention at study endpoint. Efficacy measures, including repeat SH, were secondary outcomes. RESULTS Twenty-four subjects were enrolled (12 per group) with one BCBT subject and two controls dropping out prior to the first therapy session. Five (45%) of the remaining BCBT subjects and seven (70%) control subjects completed all 10 acute therapy sessions. All subjects who completed five sessions went on to complete 10. There were significantly fewer instances of repeat SH in BCBT subjects (7 of 62 weeks of acute follow-up; 11%) compared to control subjects (24 of 79 weeks; 30%)(OR 0.34, 95%CI:0.13-0.92). Three subjects, all in the control condition, made a total of five suicide attempts during the study. LIMITATIONS This study had a modest sample size and retention rate. CONCLUSIONS This study failed to achieve its primary feasibility retention goal for BCBT. However, it did demonstrate that initial adherence to follow-up predicted study completion. Despite small numbers, it also found a significant reduction in repeat SH in the BCBT group, a finding which requires replication.
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193
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Stuhlfauth S, Knutsen IR, Foss C. Users' and researchers' construction of equity in research collaboration. Health Expect 2020; 23:296-305. [PMID: 31960555 PMCID: PMC7104651 DOI: 10.1111/hex.13026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 11/26/2019] [Accepted: 12/21/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Equity is described as an ideal in user involvement in research and is mentioned in the health service literature and in several guidelines. However, equity is described as being difficult to obtain and the concept is rarely clarified or concretized. Equity can be socially constructed. OBJECTIVE This study explored users' and researchers' constructions of equity in research processes. DESIGN AND METHOD The study had a qualitative research design. Constructions of equity were analysed through the lens of positioning theory. Two focus group interviews consisting of both users and researchers were conducted. FINDINGS The thirteen users and four researchers considered 'equity' as an important part of user involvement in research. Storylines about norms, responsibility, language, knowledge and usefulness evolved in the discussions. These storylines elucidated unequal access to rights and duties. DISCUSSION AND CONCLUSION Users and researchers constructed equity in user involvement differently, but the difference was masked by an apparent agreement. Users and researchers drew on different storylines. The researchers emphasized the scientific discourse and although users acknowledged this discourse, they attempted to oppose this dominant discourse by drawing on a lay discourse. The identified constructions and negotiations of equity may contribute in new understandings of an equal collaboration in user involvement in research.
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Affiliation(s)
- Susanne Stuhlfauth
- Department of Nursing ScienceFaculty of MedicineUniversity of OsloOsloNorway
| | - Ingrid Ruud Knutsen
- Department of Nursing and Health PromotionFaculty of Health ScienceOslo Metropolitan UniversityKjellerNorway
| | - Christina Foss
- Department of Nursing ScienceFaculty of MedicineUniversity of OsloOsloNorway
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194
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Nguyen T, Graham ID, Mrklas KJ, Bowen S, Cargo M, Estabrooks CA, Kothari A, Lavis J, Macaulay AC, MacLeod M, Phipps D, Ramsden VR, Renfrew MJ, Salsberg J, Wallerstein N. How does integrated knowledge translation (IKT) compare to other collaborative research approaches to generating and translating knowledge? Learning from experts in the field. Health Res Policy Syst 2020; 18:35. [PMID: 32228692 PMCID: PMC7106699 DOI: 10.1186/s12961-020-0539-6] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 02/07/2020] [Indexed: 11/24/2022] Open
Abstract
Background Research funders in Canada and abroad have made substantial investments in supporting collaborative research approaches to generating and translating knowledge as it is believed to increase knowledge use. Canadian health research funders have advocated for the use of integrated knowledge translation (IKT) in health research, however, there is limited research around how IKT compares to other collaborative research approaches. Our objective was to better understand how IKT compares with engaged scholarship, Mode 2 research, co-production and participatory research by identifying the differences and similarities among them in order to provide conceptual clarity and reduce researcher and knowledge user confusion about these common approaches. Methods We employed a qualitative descriptive method using interview data to better understand experts’ perspectives and experiences on collaborative research approaches. Participants’ responses were analysed through thematic analysis to elicit core themes. The analysis was centred around the concept of IKT, as it is the most recent approach; IKT was then compared and contrasted with engaged scholarship, Mode 2 research, co-production and participatory research. As this was an iterative process, data triangulation and member-checking were conducted with participants to ensure accuracy of the emergent themes and analysis process. Results Differences were noted in the orientation (i.e. original purpose), historical roots (i.e. disciplinary origin) and partnership/engagement (i.e. role of partners etc.). Similarities among the approaches included (1) true partnerships rather than simple engagement, (2) focus on essential components and processes rather than labels, (3) collaborative research orientations rather than research methods, (4) core values and principles, and (5) extensive time and financial investment. Core values and principles among the approaches included co-creation, reciprocity, trust, fostering relationships, respect, co-learning, active participation, and shared decision-making in the generation and application of knowledge. All approaches require extensive time and financial investment to develop and maintain true partnerships. Conclusions This qualitative study is the first to systematically synthesise experts’ perspectives and experiences in a comparison of collaborative research approaches. This work contributes to developing a shared understanding of collaborative research approaches to facilitate conceptual clarity in use, reporting, indexing and communication among researchers, trainees, knowledge users and stakeholders to advance IKT and implementation science.
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Affiliation(s)
- Tram Nguyen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada. .,CanChild Centre for Childhood Disability Research, Faculty of Health Sciences, McMaster University, Hamilton, Canada.
| | - Ian D Graham
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Kelly J Mrklas
- Strategic Clinical Networks™, System Innovation and Programs, Alberta Health Services, Calgary, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Sarah Bowen
- Applied Research and Evaluation Consultant, Nova Scotia, Canada
| | - Margaret Cargo
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Canberra, Australia
| | - Carole A Estabrooks
- Canada Research Chair, Faculty of Nursing, University of Alberta, Edmonton, Canada
| | - Anita Kothari
- Faculty of Health Sciences, School of Health Studies, Western University, London, Canada
| | - John Lavis
- Canada Research Chair in Evidence-Informed Health Systems, McMaster Health Forum, Centre for Health Economics and Policy Analysis, Department of Health Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Ann C Macaulay
- Participatory Research at McGill, Department of Family Medicine, McGill University, Montreal, Canada
| | - Martha MacLeod
- School of Nursing, University of Northern British Columbia, Prince George, Canada
| | - David Phipps
- Research and Innovation Services, York University, Toronto, Canada
| | - Vivian R Ramsden
- Department of Academic Family Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Mary J Renfrew
- Mother and Infant Research Unit, School of Nursing and Health Sciences, University of Dundee, Dundee, United Kingdom
| | - Jon Salsberg
- Graduate Entry Medical School and Health Research Institute, University of Limerick, Limerick, Ireland
| | - Nina Wallerstein
- Center for Participatory Research, College of Population Health, University of New Mexico, Albuquerque, USA
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195
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Warren M, Leamon T, Hall A, Twells L, Street C, Stordy A, Majumdar K, Breault L, Fiest K, Rasiah J, Santana M, Etchegary H. The Role of Patient Advisory Councils in Health Research: Lessons From Two Provincial Councils in Canada. J Patient Exp 2020; 7:898-905. [PMID: 33457517 PMCID: PMC7786741 DOI: 10.1177/2374373520909598] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
This article describes two patient advisory councils (PACs) in Canada in order to contribute to the limited evidence base on how they might facilitate patient engagement in health research. Specifically, members of PACs from Newfoundland and Labrador and Alberta describe their councils’ governance structure, primary functions, creation and composition, and recount specific research-related activities with which they have been involved. Key challenges of these councils and facilitators of their use are also presented. Finally, members from both councils recount lessons learned and offer suggestions for others interested in advisory councils as a mechanism for patient engagement in any health research project. Members believe patient engagement can result in better quality research and encourage decision makers and researchers to utilize patients’ valuable input to inform health system changes and drive priorities at a policy level.
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Affiliation(s)
- Mike Warren
- NL Support Unit, Newfoundland and Labrador, Canada
| | - Toni Leamon
- NL Support Unit, Newfoundland and Labrador, Canada
| | - Amanda Hall
- NL Support Unit and Primary Healthcare Research Unit, Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - Laurie Twells
- NL Support Unit, and School of Pharmacy and Clinical Epidemiology, Memorial University, St. John's NL, Newfoundland and Labrador, Canada
| | | | | | | | - Lorraine Breault
- AbSPORU and Department of Critical Care Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
| | - Kirsten Fiest
- AbSPORU and Department of Critical Care Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
| | - Jananee Rasiah
- AbSPORU Platform and Faculty of Health Disciplines, Athabasca University, Faculty of Nursing, University of Alberta, AbSPORU Platform and Departments of Pediatrics and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Maria Santana
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Holly Etchegary
- Clinical Epidemiology, Faculty of Medicine, Memorial University, St. John's, NL and NL Support, Newfoundland and Labrador, Canada
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Top ten priorities for anesthesia and perioperative research: a report from the Canadian Anesthesia Research Priority Setting Partnership. Can J Anaesth 2020; 67:641-654. [PMID: 32157588 PMCID: PMC7214488 DOI: 10.1007/s12630-020-01607-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 12/19/2019] [Accepted: 12/20/2019] [Indexed: 10/25/2022] Open
Abstract
PURPOSE The purpose of the Canadian Anesthesia Research Priority Setting Partnership (CAR PSP) was to identify a top ten list of shared priorities for research in anesthesia and perioperative care in Canada. METHODS We used the methods of the James Lind Alliance to involve patients, caregivers, healthcare professionals, and researchers in determining the research priorities in Canada. In a first survey, participants submitted questions that they want research to answer about anesthesia and perioperative care. We summarized those responses into a longlist of questions. We reviewed the literature to see if any of those questions were already answered. In a second survey, participants chose up to ten questions from the longlist that they thought were most important to be answered with research. From that list, the highest ranking questions were discussed and assigned a final rank at an in-person workshop. RESULTS A total of 254 participants submitted 574 research suggestions that were then summarized into 49 questions. Those questions were checked against the literature to be sure they were not already adequately addressed, and in a second survey of those 49 questions, participants chose up to 10 that they thought were most important. A total of 233 participants submitted their priorities, which were then used to choose 24 questions for discussion at the final workshop. At the final workshop, 22 participants agreed on a top ten list of priorities. CONCLUSION The CAR PSP top ten priorities reflect a wide variety of priorities captured by a broad spectrum of Canadians who receive and provide anesthesia care. The priorities are a tool to initiate and guide patient-oriented research in anesthesia and perioperative care.
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197
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Informing the model of care for an academic integrative healthcare centre: a qualitative study exploring healthcare consumer perspectives. BMC Complement Med Ther 2020; 20:58. [PMID: 32070328 PMCID: PMC7076816 DOI: 10.1186/s12906-019-2801-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 12/17/2019] [Indexed: 01/24/2023] Open
Abstract
Background In response to high demand and the growing body of evidence for traditional and complementary therapies, the practice of integrative medicine and integrative healthcare has emerged where these therapies are blended with conventional healthcare. While there are a number of academic integrative healthcare centres worldwide, there are none in Australia. Western Sydney University will soon establish an academic integrative healthcare centre offering evidence-informed traditional and complementary therapies integrated with conventional healthcare in a research-based culture. The aim of this study was to explore healthcare consumers’ views about the perceived need, advantages, and disadvantages of the proposed centre and its relevance to community-defined problems and health and service needs. Methods Qualitative methods, informed by community-based participatory research, were used during 2017. Focus groups supplemented with semi-structured interviews were conducted with healthcare consumers. Participants were recruited through paid advertisements on Facebook. Thematic coding, informed by an integrative healthcare continuum, was used to analyse and organise the data. Analysis was augmented with descriptive statistics of participant demographic details. Results Three main themes emerged: (i) the integrative approach, (i) person-centred care, and (iii) safety and quality. Participants proposed a coordinated healthcare model, with perspectives falling along a continuum from parallel and consultative to fully integrative models of healthcare. The importance of multidisciplinary collaboration and culturally appropriate, team-based care within a supportive healing environment was emphasised. A priority of providing broad and holistic healthcare that was person centred and treated the whole person was valued. It was proposed that safety and quality standards be met by medical oversight, evidence-informed practice, practitioner competency, and interprofessional communication. Conclusions Our findings demonstrate that participants desired greater integration of conventional healthcare with traditional and complementary therapies within a team-based, person-centred environment with assurances of safety and quality. Findings will be used to refine the model of care for an academic integrative healthcare centre in Western Sydney.
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[Implementation and participatory design of digital health interventions]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:145-152. [PMID: 31938837 DOI: 10.1007/s00103-019-03079-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
There are dynamic interactions between (digital) technologies and society. Digital technologies have a (re-)structuring effect on social relationships and social innovations in a variety of ways. Because of these characteristics, technological innovations affect our individual lifestyles and living environments. In particular, the development and implementation of interventions with digital (health) technologies is attracting increasing national and international attention (e.g. telematics GP consultations and app-supported patient education programs).Digital health technologies enable new forms of interaction and knowledge-based reproduction in the field of health. The integration of potential users in the development process of digital health technologies and interventions requires the discussion of new research approaches. The interests, needs, and requirements of users may influence the nonuse of digital health technologies. It is above all the successful implementation, involving potential users, that can have an influence on acceptance and integrative use in the later course of care. The discourse on the participatory development and implementation of interventions with digital health technologies in the field of digital public health presents itself as a complex process characterized by various theoretical approaches and methodological procedures and requiring representation, evaluation, and classification.
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Frisch N, Atherton P, Doyle-Waters MM, MacLeod MLP, Mallidou A, Sheane V, Ward J, Woodley J. Patient-oriented research competencies in health (PORCH) for researchers, patients, healthcare providers, and decision-makers: results of a scoping review. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:4. [PMID: 32055415 PMCID: PMC7011284 DOI: 10.1186/s40900-020-0180-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 01/23/2020] [Indexed: 05/28/2023]
Abstract
PLAIN ENGLISH SUMMARY Background The Canadian Institutes of Health Research funded a program, "patient-oriented research" (POR), to change the way health research is done. POR involves patients and their families/caregivers as equal partners on research teams with researchers, healthcare providers and decision-makers. The authors of this paper work through a unit in British Columbia, Canada that functions to help research teams learn how to do patient-oriented research. We felt that we could not train people if we didn't first understand what others had learned about what competencies (knowledge, skills and attitudes) were helpful for members of these research teams. Method We used a method called a scoping review to search literature on patient-involved research. Our search included papers in academic journals as well as information on websites, training manuals, conference proceedings, governmental documents and statements from health organizations. Findings Writers reported the usefulness of many competencies for researchers and patients, with fewer competencies for healthcare providers or decision-makers. The main competencies for researchers had to do with participation, communication and conflict management; for patients they had to do with research knowledge and skills, cultural competence and participation. It was helpful that all team members want to work as part of a group for the public good. Conclusions We worked with an advisory group of people representing patients and their families/caregivers, researchers, healthcare providers and decision-makers to review our findings. We concluded that our competency statements are helpful for people to determine what they need to know or learn as they join research teams. ABSTRACT Background The Canadian Institutes of Health Research (CIHR) launched an initiative called the Strategy for Patient-Oriented Research (SPOR) encouraging patient-oriented research (POR) that engages patients as equal partners in research teams alongside researchers, healthcare providers and health system decision-makers. Other countries have launched similar initiatives (POR-related work) yet there has never been full review of the competencies needed by individuals engaging in this work. Purpose and methods Our purpose was to summarize existing knowledge on POR and POR-related competencies by conducting a scoping review of peer-reviewed and grey literature. Our objectives were to systematically explore literature, articulate competencies necessary for research team members, identify research gaps and provide recommendations for further research. Using standard health databases and search methods, a total of 2036 sources was retrieved. Data were extracted from 35 peer-reviewed papers and 38 grey literature sources. We used an iterative process to reach consensus on competency statements. Findings and conclusions The main competencies for researchers were in categories of participation, communication and teamwork and conflict/tension management; for patients the main competencies were in research knowledge and skills, cultural competence/context and participation. While fewer competencies were documented for the other stakeholder groups, the need for understanding patient involvement in research and knowledge of the needs that research partners have are noted as competencies for healthcare providers and decision-makers. Attitudes demonstrating inclination to conduct the work were noted for all. The competencies can be used to consider learning needs of research team members and for team members wishing to assess their own readiness to serve on a POR or POR-related research team. Incidentally, we noted the lack of a common vocabulary used to describe patient-involved research, a situation making research and literature review/retrieval quite challenging. Recommendations for future research and for achieving consistency in language are addressed.
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Affiliation(s)
- Noreen Frisch
- School of Nursing, University of Victoria, 3800 Finnerty Rd, Victoria, BC V8P5C2 Canada
- BC SUPPORT Unit, Suite 420 1367 W Broadway, Vancouver, BC Canada
| | - Pat Atherton
- BC SUPPORT Unit, Suite 420 1367 W Broadway, Vancouver, BC Canada
| | - Mary M. Doyle-Waters
- Centre for Clinical Epidemiology and Evaluation, 708 - 828 W. 10Th Avenue, Vancouver, BC Canada
| | - Martha L. P. MacLeod
- University of Northern British Columbia, 3333 University Way, Prince George, BC Canada
| | - Anastasia Mallidou
- School of Nursing, University of Victoria, 3800 Finnerty Rd, Victoria, BC V8P5C2 Canada
| | - Vanessa Sheane
- School of Nursing, University of Victoria, 3800 Finnerty Rd, Victoria, BC V8P5C2 Canada
| | - John Ward
- BC SUPPORT Unit, Suite 420 1367 W Broadway, Vancouver, BC Canada
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Santana MJ, Zelinsky S, Ahmed S, Doktorchik C, James M, Wilton S, Quan H, Fernandez N, Anderson T, Butalia S. Patients, clinicians and researchers working together to improve cardiovascular health: a qualitative study of barriers and priorities for patient-oriented research. BMJ Open 2020; 10:e031187. [PMID: 32034018 PMCID: PMC7044837 DOI: 10.1136/bmjopen-2019-031187] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 12/09/2019] [Accepted: 01/14/2020] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES The overall goal of this study is to identify priorities for cardiovascular (CV) health research that are important to patients and clinician-researchers. We brought together a group of CV patients and clinician-researchers new to patient-oriented research (POR), to build a multidisciplinary POR team and form an advisory committee for the Libin Cardiovascular Institute of Alberta. DESIGN This qualitative POR used a participatory health research paradigm to work with participants in eliciting their priorities. Therefore, participants were involved in priority setting, and analysis of findings. Participants also developed a plan for continued engagement to support POR in CV health research. SETTING Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Canada. PARTICIPANTS A total of 23 participants, including patients and family caregivers (n=12) and clinician-researchers (n=11). RESULTS Participants identified barriers and facilitators to POR in CV health (lack of awareness of POR and poor understanding on the role of patients) and 10 research priorities for improving CV health. The CV health research priorities include: (1) CV disease prediction and prevention, (2) access to CV care, (3) communication with providers, (4) use of eHealth technology, (5) patient experiences in healthcare, (6) patient engagement, (7) transitions and continuity of CV care, (8) integrated CV care, (9) development of structures for patient-to-patient support and (10) research on rare heart diseases. CONCLUSIONS In this study, research priorities were identified by patients and clinician-researchers working together to improve CV health. Future research programme and projects will be developed to address these priorities. A key output of this study is the creation of the patient advisory council that will provide support and will work with clinician-researchers to improve CV health.
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Affiliation(s)
- Maria-Jose Santana
- Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Pediatrics, University of Calgary, Calgary, AB, Canada
| | - Sandra Zelinsky
- Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Sadia Ahmed
- Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Pediatrics, University of Calgary, Calgary, AB, Canada
| | - Chelsea Doktorchik
- Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Matthew James
- Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Medicine, University of Calgary, Calgary, AB, Canada
| | - Stephen Wilton
- Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Medicine, University of Calgary, Calgary, AB, Canada
- Cardiac Sciences, University of Calgary, Calgary, AB, Canada
| | - Hude Quan
- Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Medicine, University of Calgary, Calgary, AB, Canada
| | - Nicolas Fernandez
- Family and Emergency Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Todd Anderson
- Medicine, University of Calgary, Calgary, AB, Canada
- Cardiac Sciences, University of Calgary, Calgary, AB, Canada
| | - Sonia Butalia
- Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Medicine, University of Calgary, Calgary, AB, Canada
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