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Morgan C, Clarkson L, Hiscocks R, Hopkins I, Berry K, Tyler N, Wood L, Jacobsen P. What should inpatient psychological therapies be for? Qualitative views of service users on outcomes. Health Expect 2024; 27:e13889. [PMID: 37822299 PMCID: PMC10726158 DOI: 10.1111/hex.13889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/25/2023] [Accepted: 10/03/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND There is limited research on what, when and how outcomes should be measured in psychological therapy trials in acute mental health inpatient wards. OBJECTIVES This study aimed to consider what outcomes service users think are important to measure. METHODS This qualitative study explored the views of 14 participants, who had an inpatient admission within the last year, on outcomes of psychological therapies using semistructured interviews. Data were analysed using thematic analysis from a critical realist perspective with both inductive and deductive coding. RESULTS The 126 outcomes that were important to participants were mapped onto an established taxonomy of outcomes across different health areas and the socioecological framework to consider the wider context and help summarise the outcomes. Most of the outcomes were mapped to the intrapersonal and interpersonal level. In addition to the outcome mapping, three themes were constructed from the qualitative data: (1) I am not a problem I am a person, (2) Feeling cared for and loved, (3) What does getting better look like. CONCLUSIONS Our results highlight the need for patient-reported outcomes which are cocreated with service users, disseminating research and training on preventing dehumanising experiences, enhancing psychological safety and therapeutic relationships and improving access to psychological therapy. PATIENT OR PUBLIC CONTRIBUTION The wider People with Personal Experience Involvement Committee at the University of Bath were consulted which included a focus group during the early planning stages. We also collaborated with a person with personal experience, at every stage of the research. This included developing our research question and aims, protocol, participant documents (e.g., information and debrief forms), advertisement and recruitment strategy, interview topic guide, the codes, the final themes and quotes and reviewing the manuscript. People with lived experience of being admitted to an acute mental health inpatient ward participated in our study.
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Affiliation(s)
- Ceri Morgan
- Department of Psychology, University of Bath, Bath, UK
| | - Lucy Clarkson
- Department of Psychology, University of Bath, Bath, UK
| | | | - India Hopkins
- Department of Psychology, University of Bath, Bath, UK
| | - Katherine Berry
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
- Department of Research and Innovation, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Rawnsley Building Manchester Royal Infirmary, Manchester, UK
| | - Natasha Tyler
- NIHR School for Primary Care Research, University of Manchester, Manchester, UK
| | - Lisa Wood
- Division of Psychiatry, University College London, London, UK
- Research and Development Department, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford, UK
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Wheeler B, Williams O, Meakin B, Chambers E, Beresford P, O'Brien S, Robert G. Exploring Elinor Ostrom's principles for collaborative group working within a user-led project: lessons from a collaboration between researchers and a user-led organisation. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:15. [PMID: 38287410 PMCID: PMC10826181 DOI: 10.1186/s40900-024-00548-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/23/2024] [Indexed: 01/31/2024]
Abstract
BACKGROUND Some research has been undertaken into the mechanisms that shape successful participatory approaches in the context of efforts to improve health and social care. However, greater attention needs to be directed to how partnerships between researchers and user-led organisations (ULOs) might best be formed, practiced, managed, and assessed. We explored whether political economist Elinor Ostrom's Nobel prize winning analysis of common pool resource management-specifically eight principles to enhance collaborative group working as derived from her empirical research-could be usefully applied within a user-led project aiming to co-design new services to support more inclusive involvement of Disabled people in decision-making processes in policy and practice. METHODS Participant observation and participatory methods over a 16-month period comprising observational notes of online user-led meetings (26 h), online study team meetings (20 h), online Joint Interpretive Forum meetings (8 h), and semi-structured one-to-one interviews with project participants (44 h) at two time points (months 6 and 10). RESULTS Initially it proved difficult to establish working practices informed by Ostrom's principles for collaborative group working within the user-led project. Several attempts were made to put a structure in place that met the needs of both the research study and the aims of the user-led project, but this was not straightforward. An important shift saw a move away from directly applying the principles to the working practices of the group and instead applying them to specific tasks the group were undertaking. This was a helpful realisation which enabled the principles to become-for most but not all participants-a useful facilitation device in the latter stages of the project. Eventually we applied the principles in a way that was useful and enabled collaboration between researchers and a ULO (albeit in unexpected ways). CONCLUSIONS Our joint reflections emphasise the importance of being reflexive and responsive when seeking to apply theories of collaboration (the principles) within user-led work. At an early stage, it is important to agree shared definitions and understanding of what 'user-led' means in practice. It is crucial to actively adapt and translate the principles in ways that make them more accessible and applicable within groups where prior knowledge of their origins is both unlikely and unnecessary.
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Affiliation(s)
- Bella Wheeler
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - Oli Williams
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, 57 Waterloo Road, Waterloo, SE1 8WA, UK
| | - Becki Meakin
- Shaping Our Lives National User Network CIC, 30 St Giles', Oxford, OX1 3LE, UK
| | - Eleni Chambers
- Shaping Our Lives National User Network CIC, 30 St Giles', Oxford, OX1 3LE, UK
- School of Allied Health Professions, Nursing and Midwifery, The University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield, S10 2LA, UK
| | - Peter Beresford
- Shaping Our Lives National User Network CIC, 30 St Giles', Oxford, OX1 3LE, UK
- School of Health Sciences, University of East Anglia, Research Park, Norwich, NR4 7TJ, UK
| | - Sarah O'Brien
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, 57 Waterloo Road, Waterloo, SE1 8WA, UK
| | - Glenn Robert
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, 57 Waterloo Road, Waterloo, SE1 8WA, UK.
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Honap S, Buisson A, Danese S, Beaugerie L, Peyrin-Biroulet L. Patient and Public Involvement in Research: Lessons for Inflammatory Bowel Disease. J Crohns Colitis 2023; 17:1882-1891. [PMID: 37220886 PMCID: PMC10673804 DOI: 10.1093/ecco-jcc/jjad090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/05/2023] [Accepted: 05/19/2023] [Indexed: 05/25/2023]
Abstract
Participatory research, also referred to as patient and public involvement, is an approach that involves collaborating with patients affected by the focus of the research, on the design, development and delivery of research to improve outcomes. There are two broad justifications for this: first, that it enhances the quality and relevance of research, and second, that it satisfies the ethical argument for patient inclusion in decisions about them. This synergistic and collaborative effort, which bridges the divide between researchers and participants with the lived condition, is now a mainstream activity and widely accepted as best practice. Although there has been a substantial increase in the literature over the past two decades, little has been published on how participatory research has been used in inflammatory bowel disease [IBD] research and little guidance as to how researchers should go about this. With an increasing incidence and prevalence worldwide, combined with declining study enrolment in an era of perennial unmet need, there are a multitude of benefits of participatory research to IBD patients and investigators, including research output that is informed and relevant to the real world. A key example of participatory research in IBD is the I-CARE study, a large-scale, pan-European observational study assessing the safety of advanced therapies, which had significant patient involvement throughout the study. In this review, we provide a comprehensive overview of the benefits and challenges of participatory research and discuss opportunities of building strategic alliances between IBD patients, healthcare providers and academics to strengthen research outcomes.
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Affiliation(s)
- Sailish Honap
- Department of Gastroenterology, St George’s University Hospitals NHS Foundation Trust, London, UK
- School of Immunology and Microbial Sciences, King’s College London, London, UK
| | | | - Silvio Danese
- Department of Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
| | - Laurent Beaugerie
- Department of Gastroenterology, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Laurent Peyrin-Biroulet
- Department of Gastroenterology and Inserm NGERE U1256, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France
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Belaid L, Sarmiento I, Dion A, Pimentel JP, Rojas-Cárdenas A, Cockcroft A, Andersson N. How does participatory research work: protocol for a realist synthesis. BMJ Open 2023; 13:e074075. [PMID: 37775285 PMCID: PMC10546155 DOI: 10.1136/bmjopen-2023-074075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/20/2023] [Indexed: 10/01/2023] Open
Abstract
INTRODUCTION Participatory research science deals with partnerships underlying research, governance and ownership of research products. It is concerned with relationships behind research objectives and methods. Participatory research has gained significant traction in design of health interventions, contextualising these to local settings and stakeholder groups. Despite a massive increase in participatory research exercises, the field remains undertheorised, and the mechanisms for improving health outcomes remain unclear. This realist review seeks to understand how and under what circumstances participatory research impacts health and social outcomes. METHODS AND ANALYSIS The review will follow four steps: (1) searching for and selecting evidence, (2) assessing the quality of evidence, (3) extracting and categorising data and (4) synthesising the data in the form of context-mechanism-outcomes configurations. The review will follow the Realist And Meta Narrative Evidence Syntheses: Evolving Standards (RAMESES) II guidelines for reporting realist evaluations. We categorise and synthesise data in four steps: (1) identifying outcomes, (2) identifying contextual components of outcomes, (3) theoretical redescription (abduction) and (4) identifying mechanisms. A retroductive analysis will identify mechanisms by moving between empirical data and theories, using inductive and deductive reasoning to explain the outcomes-context matches. The output will generate middle-range theories on how participatory research works, for whom and under what circumstances. ETHICS AND DISSEMINATION This study is a review of a published literature. It does not involve human participants. We will convene a workshop to share and discuss the preliminary results with partners and key stakeholders involved in participatory health research. We will publish the review results in peer-reviewed journals and academic conferences.
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Affiliation(s)
- Loubna Belaid
- Direction de la recherche et de l'enseignement, École Nationale d'Administration Publique (ÉNAP), Quebec, Quebec, Canada
- Family Medicine (CIET/ PRAM), McGill University, Montreal, Quebec, Canada
| | - Ivàn Sarmiento
- Family Medicine (CIET/ PRAM), McGill University, Montreal, Quebec, Canada
- Grupo de Estudios en Sistemas Tradicionales de Salud, Universidad del Rosario, Bogota, Cundinamarca, Colombia
| | - Anna Dion
- CHEO Research Institute, Ottawa, Ontario, Canada
| | - Juan Pablo Pimentel
- Department of Family Medicine and Public Health, Universidad de La Sabana, Chía, Colombia
| | | | - Anne Cockcroft
- Family Medicine (CIET/ PRAM), McGill University, Montreal, Quebec, Canada
| | - Neil Andersson
- Family Medicine (PRAM), McGill University, Montreal, Quebec, Canada
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Mexico
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Egid B, Ozano K, Hegel G, Zimmerman E, López Y, Roura M, Sheikhattari P, Jones L, Dias S, Wallerstein N. Can everyone hear me? Reflections on the use of global online workshops for promoting inclusive knowledge generation. QUALITATIVE RESEARCH : QR 2023; 23:195-216. [PMID: 37485303 PMCID: PMC10361666 DOI: 10.1177/14687941211019585] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Online research methods have risen in popularity over recent decades, particularly in the wake of COVID-19. We conducted five online workshops capturing the experiences of participatory health researchers in relation to power, as part of a collaborative project to develop global knowledge systems on power in participatory health research. These workshops included predominantly academic researchers working in 24 countries across Africa, Asia, Europe, and the Americas. Here, we reflect on the opportunities, limitations, and key considerations of using online workshops for knowledge generation and shared learning. The online workshop approach offers the potential for cross-continental knowledge exchange and for the amplification of global South voices. However, this study highlights the need for deeper exploration of power dynamics exposed by online platform use, particularly the 'digital divide' between academic partners and community co-researchers. Further research is needed to better understand the role of online platforms in generating more inclusive knowledge systems.
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Affiliation(s)
- Beatrice Egid
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - Kim Ozano
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - Guillermo Hegel
- Institute of Nutrition of Central America and Panama (INCAP), Guatemala
| | - Emily Zimmerman
- Center on Society and Health, Virginia Commonwealth University, VA, USA
| | - Yaimie López
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - Maria Roura
- School of Public Health, University College Cork, Republic of Ireland
| | | | - Laundette Jones
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Sónia Dias
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa & Comprehensive Health Research Center (CHRC), Portugal
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Meeting in the middle: experiences of citizenship in community-engaged psychosis research. JOURNAL OF PUBLIC MENTAL HEALTH 2023. [DOI: 10.1108/jpmh-10-2022-0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Purpose
Previous research has highlighted the importance of engaging people with lived experience (PWLE) in the knowledge creation process. However, diverse approaches to engagement exist. In addition, tensions remain in community-engaged research (CER), including how to address structural inequalities in research settings. This study aims to consider how CER interacts with citizenship within and beyond the research context.
Design/methodology/approach
This study discusses the authors’ experiences as a majority-PWLE of psychosis research team in Canada, including successes and challenges the authors experienced building their team and navigating research institutions. This study also reflects on the authors’ pathways through citizenship, prior to and during the research process. This study discusses divergent models of CER and their applicability to the cyclical process of citizenship and community participation.
Findings
Relationships between academic and peer researchers developed organically over time. However, this study was limited by structural barriers such as pay inequality and access to funding. The authors recognize that there are barriers to full citizenship and acknowledge their resources and privilege of being well supported within their communities. Team members built on a foundation of citizenship to access participation in research. This led to opportunities to engage in community spaces, and for PWLE to participate in research as partners and leaders. This study also found that citizenship is a way of giving back, by building a sense of social responsibility.
Originality/value
Academic and peer researchers can reflect on the authors’ experiences to build more inclusive research teams and communities by using a citizenship approach to research participation.
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Schwedhelm J, Frank M, Conrad I, Seyde T, Steinhart I, Riedel-Heller S, Koschig M, Stengler K. [LeiP#netz - Leipziger Psychiatrie Netzwerk - A Pilot Project to Implement the Functional Basic Model by Steinhart and Wienberg in a Defined Psychiatric Care Region]. PSYCHIATRISCHE PRAXIS 2023; 50:89-97. [PMID: 35320848 DOI: 10.1055/a-1716-1383] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The functional basic model (Steinhart, Wienberg) offers the theoretic ground for a pilot project which emphasis on outpatient treatment in psychiatric care. METHODS The following subgoals were pursued a) networking with providers/institutions/actors located in the study region; (b) evaluation of the offered services for the purpose of mapping psychosocial care. Consequently, a project-based survey instrument was developed and applied for the survey of all care providers. RESULT Merging and networking of all actors was started successfully. All services needed for psychiatric care of severe mentally ill people are provided in the study region. While counselling and prevention tend to be well-maintained structures, there is a lack of access to low-threshold care such as crisis management, retreats alternatives to hospitals and assertive multi-professional complex treatment.
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Affiliation(s)
- Justus Schwedhelm
- Leipzig Heart Institute, Leipzig, Deutschland.,Zentrum für Psychische Gesundheit, Klinik für Psychiatrie und Psychotherapie, UKE, Hamburg, Deutschland
| | - Magdalena Frank
- Zentrum für Seelische Gesundheit, Park Klinikum Leipzig, Deutschland
| | - Ines Conrad
- Medizinische Fakultät, Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig, Deutschland
| | - Thomas Seyde
- Psychiatriekoordinator, Gesundheitsamt der Stadt Leipzig, Deutschland
| | - Ingmar Steinhart
- Institut für Sozialpsychiatrie MV, An-Institut der Universität Greifswald, v. Bodelschwinghsche Stiftungen Bethel, Universität Greifswald, Deutschland
| | - Steffi Riedel-Heller
- Medizinische Fakultät, Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig, Deutschland
| | - Maria Koschig
- Medizinische Fakultät, Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig, Deutschland
| | - Katarina Stengler
- Zentrum für Seelische Gesundheit, Park Klinikum Leipzig, Deutschland
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Baleige A, Guernut M, Denis F. Promouvoir la santé des personnes transgenres et de genre divers au sein des systèmes de santé : une revue systématique de la littérature communautaire. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2023; 34:197-211. [PMID: 37336734 DOI: 10.3917/spub.hs2.0197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
INTRODUCTION Transgender and gender diverse people (TGD) represent a large and growing portion of the general population who face individual and systemic barriers in accessing care. The socio-cultural context and lack of organization of care place them in a vulnerable situation and there is a need to develop sustainable health promotion strategies. PURPOSE OF RESEARCH The aim of this participatory study is to establish an overview of the barriers and opportunities for promoting the health of TGD people. To do so, it relies on the expertise of NGOs and aims to produce a thematic synthesis that will support policy-making. RESULTS We centralized the resources of 18 French and European organizations and included 25 eligible documents following a quality analysis. 3047 data were extracted and coded, then developed into 5 themes that allowed us to model the actions, barriers and opportunities to improve care for the TGD population. CONCLUSIONS Health promotion of TGD people focuses on discrimination, care pathways, access to care, transmission of knowledge and research. The main obstacles are the role of medical specialists, pathologization, epistemic injustice and the low political priority of their health issues. The main opportunities will rely on ensuring that decision-making allows for the implementation of a pragmatic and collaborative health policy in this context.
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Baleige A, Guernut M, Denis F. Impact of Depsychopathologization of Transgender and Gender Diverse Individuals in ICD-11 on Care Delivery: Looking at Trans Expertise through a Trans Lens. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13257. [PMID: 36293833 PMCID: PMC9603741 DOI: 10.3390/ijerph192013257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/05/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Depsychopathologization of transgender and gender diverse (TGD) individuals in the eleventh revision of the International Classification of Diseases (ICD-11) called for a shift in care delivery models, based on free and informed consent. Public health policies face epistemic and discriminatory challenges and consensus built on evidence-based data is needed. TGD communities were consulted but did not actively participate in ICD-11 and the following public health debates. There is a need for TGD perspective-both in research and practice. This study draws on a peer-led participatory approach and explores TGD participants' recommendations based on unexploited French data from ICD-11, in which 72 TGD gave feedback on public policies. Lexicometric analyses were conducted using the ALCESTE method and resulted in a two-step double Descending Hierarchical Classification. Sex, gender, and health consumption were analyzed as secondary variables. The first classification highlighted five main topics: care pathways, training of professionals, access, literacy, and civil status change, developed into 12 targets in the second classification. While sex and gender appeared to have little impact on discourses, recommendations varied according to received care. This study supports the growing scientific consensus of a public health approach to face TGD health challenges and emphasizes TGD individuals' expertise.
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Affiliation(s)
- Anna Baleige
- EA 75-05 Éducation Éthique Santé, Faculté de Médecine, Université François-Rabelais Tours, 2 Boulevard Tonnellé, 37044 Tours, France
| | - Mathilde Guernut
- UMR 8163 Savoirs, Textes, Langage, Centre National de la Recherche Scientifique, Université de Lille, Rue du Barreau, BP 60149, 59653 Villeneuve d’Ascq, France
| | - Frédéric Denis
- EA 75-05 Éducation Éthique Santé, Faculté de Médecine, Université François-Rabelais Tours, 2 Boulevard Tonnellé, 37044 Tours, France
- Service D’odontologie, Centre Hospitalier Universitaire de Tours, 2 Boulevard Tonnellé, 37044 Tours, France
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Bakolis I, Gupta P, Wykes T. Experience of Inpatient Mental Health Care Assessed With Service User-Developed and Conventional Patient-Reported Outcome Measures. Psychiatr Serv 2022; 73:1132-1139. [PMID: 35473362 DOI: 10.1176/appi.ps.202100470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The goal of this study was to examine and compare the psychometric properties of a patient-reported outcome measure (PROM) generated with patients’ input (Views on Inpatient Care [VOICE]) and a PROM conventionally generated without patients’ input (Service Satisfaction Scale: Residential Services Evaluation [SSS-Res]) for assessing a patient’s perception of psychiatric ward care. METHODS In a stepped-wedge cluster-randomized trial conducted in the United Kingdom, 1,058 participants admitted to 16 wards reported on their perceptions of care via VOICE and SSS-Res before or up to 2 years after the staff training. Exploratory and confirmatory factor analyses were used to investigate the structure of the PROMs and to assess reliability and convergent validity as well as sensitivity to change; the analyses also considered whether study participants had been admitted voluntarily to the ward. RESULTS Two factors emerged from VOICE, labeled “trust” and “involvement,” and from SSS-Res, labeled “environment” and “care,” at baseline. All subscales had high internal consistency and good convergent validity. An ability to detect change in care due to the staff training was observed on the trust subscale of VOICE (N=1,058, mean difference=−0.25, 95% CI=−0.48 to −0.02), but no change was detected on any of the SSS-Res subscales. Patients admitted involuntarily benefited the most from the staff training. CONCLUSIONS VOICE captured patients’ perceptions of ward care better than SSS-Res and was sensitive to changes in aspects of trust, suggesting that participatory approaches for developing PROMs improve patients’ self-reports on the care they received.
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Affiliation(s)
- Ioannis Bakolis
- Centre for Implementation Science, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London (Bakolis, Gupta); Department of Biostatistics and Health Informatics (Bakolis) and Department of Psychology (Wykes), Institute of Psychiatry, Psychology and Neuroscience, King's College London, London; South London and Maudsley National Health Service (NHS) Foundation Trust (Wykes)
| | - Prashant Gupta
- Centre for Implementation Science, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London (Bakolis, Gupta); Department of Biostatistics and Health Informatics (Bakolis) and Department of Psychology (Wykes), Institute of Psychiatry, Psychology and Neuroscience, King's College London, London; South London and Maudsley National Health Service (NHS) Foundation Trust (Wykes)
| | - Til Wykes
- Centre for Implementation Science, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London (Bakolis, Gupta); Department of Biostatistics and Health Informatics (Bakolis) and Department of Psychology (Wykes), Institute of Psychiatry, Psychology and Neuroscience, King's College London, London; South London and Maudsley National Health Service (NHS) Foundation Trust (Wykes)
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Baleige A, Guernut M, Denis F. Trans Expertise and the Revision and Translation of ICD-11: An Analysis of Available French Data from a Trans Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11983. [PMID: 36231284 PMCID: PMC9564459 DOI: 10.3390/ijerph191911983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
Transgender and gender diverse (TGD) individuals' depsychopathologization in the eleventh revision of the International Classification of Diseases (ICD-11) faces systemic discriminations built-in epistemic pipelines. Based on an analysis of unexploited data from ICD-11 and the French translation process, this article addresses power issues in participatory research and systemic discrimination within a socio-cultural context. We used a peer-driven participatory approach to conduct qualitative analyses of the French version of the ICD based on contributions from 72 TGD participants in the French study for ICD-11. The results highlight a major incongruence between participants' propositions and the final official translation. Alternative terms were proposed and discussed by participants in regard to usage and concepts, but also encompassed participation and perceived futility of maintaining pathologization. We found discrepancies in the French publication and translation processes, respectively on gender categorization and back translation. These results question the relevance and implementation of ICD-11 for TGD communities and highlight failures at all three stages of the official French translation. Power issues have an impact on knowledge production and, while mechanisms vary, all relate to epistemic injustice. Involving TGD communities in all stages of medical knowledge production processes would reduce transphobic biases. Individuals with personal stakes involved in politicized research areas appear all the more necessary today.
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Affiliation(s)
- Anna Baleige
- EA 75-05 Éducation Éthique Santé, Faculté de Médecine, Université François-Rabelais Tours, 2 Boulevard Tonnellé, 37044 Tours, France
| | - Mathilde Guernut
- UMR 8163 Savoirs, Textes, Langage, CNRS, Université de Lille, Rue du Barreau, BP 60149, 59653 Villeneuve d’Ascq, France
| | - Frédéric Denis
- EA 75-05 Éducation Éthique Santé, Faculté de Médecine, Université François-Rabelais Tours, 2 Boulevard Tonnellé, 37044 Tours, France
- Service d’Odontologie, Centre Hospitalier Universitaire de Tours, 2 Boulevard Tonnellé, 37044 Tours, France
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12
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Munson MR, Raghavan R, Shimizu R, Rodwin AH, Jaccard J. Methodologies to Advance a "Science of How": Identifying and Engaging Intervention Targets and Outcomes. Psychiatr Serv 2022; 73:1039-1046. [PMID: 35172593 DOI: 10.1176/appi.ps.202100202] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Although implementation science has taken hold in many areas of psychiatric services research, a need remains for developing effective, low-cost interventions for specific subpopulations with mental health conditions. The experimental therapeutics approach has gained momentum as a framework for developing effective interventions. However, few studies have taken steps to rigorously apply experimental therapeutics. This article provides a blueprint for applying this approach. METHODS A focused literature review was conducted to document the frequency of the application of experimental therapeutics among articles published between 2011 and 2021 in some of the American Psychiatric Association's journals. Independently of the review, the authors delineated a four-component approach for applying experimental therapeutics in research and present practical, innovative strategies to advance psychiatric services research. RESULTS The four-component approach includes outlining prerequisites, identifying target mechanisms, proposing intervention strategies to address target mechanisms, and using advanced analytic methods. The strategies described for each component are not exhaustive; rather, they suggest promising avenues for research that can lead to more effective interventions and deeper understanding of how, and for whom, an intervention works. CONCLUSIONS The application of experimental therapeutics in psychiatric services research can lead to increased development, refinement, and implementation of effective interventions for specific populations or conditions.
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Affiliation(s)
- Michelle R Munson
- Silver School of Social Work, New York University, New York City (Munson, Raghavan, Rodwin, Jaccard); School of Social Work, University of Alaska, Anchorage (Shimizu)
| | - Ramesh Raghavan
- Silver School of Social Work, New York University, New York City (Munson, Raghavan, Rodwin, Jaccard); School of Social Work, University of Alaska, Anchorage (Shimizu)
| | - Rei Shimizu
- Silver School of Social Work, New York University, New York City (Munson, Raghavan, Rodwin, Jaccard); School of Social Work, University of Alaska, Anchorage (Shimizu)
| | - Aaron H Rodwin
- Silver School of Social Work, New York University, New York City (Munson, Raghavan, Rodwin, Jaccard); School of Social Work, University of Alaska, Anchorage (Shimizu)
| | - James Jaccard
- Silver School of Social Work, New York University, New York City (Munson, Raghavan, Rodwin, Jaccard); School of Social Work, University of Alaska, Anchorage (Shimizu)
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13
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Cai HTN, Tran HT, Nguyen YHT, Vu GQT, Tran TP, Bui PB, Nguyen HTT, Pham TQ, Lai AT, Van Nuil JI, Lewycka S. Challenges and Lessons Learned in the Development of a Participatory Learning and Action Intervention to Tackle Antibiotic Resistance: Experiences From Northern Vietnam. Front Public Health 2022; 10:822873. [PMID: 35958847 PMCID: PMC9362799 DOI: 10.3389/fpubh.2022.822873] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 06/22/2022] [Indexed: 12/02/2022] Open
Abstract
Antibiotic use in the community for humans and animals is high in Vietnam, driven by easy access to over-the counter medicines and poor understanding of the role of antibiotics. This has contributed to antibiotic resistance levels that are amongst the highest in the world. To address this problem, we developed a participatory learning and action (PLA) intervention. Here we describe challenges and lessons learned while developing and testing this intervention in preparation for a large-scale One Health trial in northern Vietnam. We tested the PLA approach using community-led photography, and then reflected on how this approach worked in practice. We reviewed and discussed implementation documentation and developed and refined themes. Five main themes were identified related to challenges and lessons learned: understanding the local context, stakeholder relationship development, participant recruitment, building trust and motivation, and engagement with the topic of antibiotics and antimicrobial resistance (AMR). Partnerships with national and local authorities provided an important foundation for building relationships with communities, and enhanced visibility and credibility of activities. Partnership development required managing relationships, clarifying roles, and accommodating different management styles. When recruiting participants, we had to balance preferences for top-down and bottom-up approaches. Building trust and motivation took time and was challenged by limited study team presence in the community. Open discussions around expectations and appropriate incentives were re-visited throughout the process. Financial incentives provided initial motivation to participate, while less tangible benefits like collective knowledge, social connections, desire to help the community, and new skills, sustained longer-term motivation. Lack of awareness and perceived importance of the problem of AMR, affected initial motivation. Developing mutual understanding through use of common and simplified language helped when discussing the complexities of this topic. A sense of ownership emerged as the study progressed and participants understood more about AMR, how it related to their own concerns, and incorporated their own ideas into activities. PLA can be a powerful way of stimulating community action and bringing people together to tackle a common problem. Understanding the nuances of local power structures, and allowing time for stakeholder relationship development and consensus-building are important considerations when designing engagement projects.
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Affiliation(s)
| | - Hang Thi Tran
- Oxford University Clinical Research Unit, Hanoi, Vietnam
| | | | | | | | | | - Huong Thi Thu Nguyen
- Communicable Disease Control and Prevention, National Institute for Hygiene and Epidemiology, Hanoi, Vietnam
| | - Thai Quang Pham
- Communicable Disease Control and Prevention, National Institute for Hygiene and Epidemiology, Hanoi, Vietnam
| | | | - Jennifer Ilo Van Nuil
- Oxford University Clinical Research Unit, Hanoi, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Sonia Lewycka
- Oxford University Clinical Research Unit, Hanoi, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- *Correspondence: Sonia Lewycka
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14
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Jansli SM, Hudson G, Negbenose E, Erturk S, Wykes T, Jilka S. Investigating mental health service user views of stigma on Twitter during COVID-19: a mixed-methods study. J Ment Health 2022; 31:576-584. [PMID: 35786178 PMCID: PMC9612929 DOI: 10.1080/09638237.2022.2091763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background: Mental health stigma on social media is well studied, but not from the perspective of mental health service users. Coronavirus disease-19 (COVID-19) increased mental health discussions and may have impacted stigma. Objectives: (1) to understand how service users perceive and define mental health stigma on social media; (2) how COVID-19 shaped mental health conversations and social media use. Methods: We collected 2,700 tweets related to seven mental health conditions: schizophrenia, depression, anxiety, autism, eating disorders, OCD, and addiction. Twenty-seven service users rated them as stigmatising or neutral, followed by focus group discussions. Focus group transcripts were thematically analysed. Results: Participants rated 1,101 tweets (40.8%) as stigmatising. Tweets related to schizophrenia were most frequently classed as stigmatising (411/534, 77%). Tweets related to depression or anxiety were least stigmatising (139/634, 21.9%). A stigmatising tweet depended on perceived intention and context but some words (e.g. “psycho”) felt stigmatising irrespective of context. Discussion: The anonymity of social media seemingly increased stigma, but COVID-19 lockdowns improved mental health literacy. This is the first study to qualitatively investigate service users' views of stigma towards various mental health conditions on Twitter and we show stigma is common, particularly towards schizophrenia. Service user involvement is vital when designing solutions to stigma.
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Affiliation(s)
- Sonja M Jansli
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Georgie Hudson
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Esther Negbenose
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Sinan Erturk
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Til Wykes
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Sagar Jilka
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK.,Warwick Medical School, University of Warwick, Coventry, UK
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15
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Erturk S, Hudson G, Jansli SM, Morris D, Odoi CM, Wilson E, Clayton-Turner A, Bray V, Yourston G, Cornwall A, Cummins N, Wykes T, Jilka S. Codeveloping and Evaluating a Campaign to Reduce Dementia Misconceptions on Twitter: Machine Learning Study. JMIR INFODEMIOLOGY 2022; 2:e36871. [PMID: 37113444 PMCID: PMC9987190 DOI: 10.2196/36871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/23/2022] [Accepted: 08/15/2022] [Indexed: 04/29/2023]
Abstract
Background Dementia misconceptions on Twitter can have detrimental or harmful effects. Machine learning (ML) models codeveloped with carers provide a method to identify these and help in evaluating awareness campaigns. Objective This study aimed to develop an ML model to distinguish between misconceptions and neutral tweets and to develop, deploy, and evaluate an awareness campaign to tackle dementia misconceptions. Methods Taking 1414 tweets rated by carers from our previous work, we built 4 ML models. Using a 5-fold cross-validation, we evaluated them and performed a further blind validation with carers for the best 2 ML models; from this blind validation, we selected the best model overall. We codeveloped an awareness campaign and collected pre-post campaign tweets (N=4880), classifying them with our model as misconceptions or not. We analyzed dementia tweets from the United Kingdom across the campaign period (N=7124) to investigate how current events influenced misconception prevalence during this time. Results A random forest model best identified misconceptions with an accuracy of 82% from blind validation and found that 37% of the UK tweets (N=7124) about dementia across the campaign period were misconceptions. From this, we could track how the prevalence of misconceptions changed in response to top news stories in the United Kingdom. Misconceptions significantly rose around political topics and were highest (22/28, 79% of the dementia tweets) when there was controversy over the UK government allowing to continue hunting during the COVID-19 pandemic. After our campaign, there was no significant change in the prevalence of misconceptions. Conclusions Through codevelopment with carers, we developed an accurate ML model to predict misconceptions in dementia tweets. Our awareness campaign was ineffective, but similar campaigns could be enhanced through ML to respond to current events that affect misconceptions in real time.
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Affiliation(s)
- Sinan Erturk
- Institute of Psychiatry, Psychology & Neuroscience King's College London London United Kingdom
- South London and Maudsley NHS Foundation Trust London United Kingdom
| | - Georgie Hudson
- Institute of Psychiatry, Psychology & Neuroscience King's College London London United Kingdom
- South London and Maudsley NHS Foundation Trust London United Kingdom
| | - Sonja M Jansli
- Institute of Psychiatry, Psychology & Neuroscience King's College London London United Kingdom
- South London and Maudsley NHS Foundation Trust London United Kingdom
| | - Daniel Morris
- Institute of Psychiatry, Psychology & Neuroscience King's College London London United Kingdom
- South London and Maudsley NHS Foundation Trust London United Kingdom
| | - Clarissa M Odoi
- Institute of Psychiatry, Psychology & Neuroscience King's College London London United Kingdom
- South London and Maudsley NHS Foundation Trust London United Kingdom
| | - Emma Wilson
- Institute of Psychiatry, Psychology & Neuroscience King's College London London United Kingdom
- South London and Maudsley NHS Foundation Trust London United Kingdom
| | - Angela Clayton-Turner
- Institute of Psychiatry, Psychology & Neuroscience King's College London London United Kingdom
| | - Vanessa Bray
- Institute of Psychiatry, Psychology & Neuroscience King's College London London United Kingdom
| | - Gill Yourston
- Institute of Psychiatry, Psychology & Neuroscience King's College London London United Kingdom
| | - Andrew Cornwall
- Institute of Psychiatry, Psychology & Neuroscience King's College London London United Kingdom
| | - Nicholas Cummins
- Institute of Psychiatry, Psychology & Neuroscience King's College London London United Kingdom
| | - Til Wykes
- Institute of Psychiatry, Psychology & Neuroscience King's College London London United Kingdom
- South London and Maudsley NHS Foundation Trust London United Kingdom
| | - Sagar Jilka
- Institute of Psychiatry, Psychology & Neuroscience King's College London London United Kingdom
- South London and Maudsley NHS Foundation Trust London United Kingdom
- Warwick Medical School University of Warwick Coventry United Kingdom
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16
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Ennals P, Lessing K, Spies R, Egan R, Hemus P, Droppert K, Tidhar M, Wood T, van Dijk C, Bride R, Asche A, Bendall S, Simmons M. Co-producing to understand what matters to young people living in youth residential rehabilitation services. Early Interv Psychiatry 2022; 16:782-791. [PMID: 34494354 DOI: 10.1111/eip.13222] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 06/03/2021] [Accepted: 08/15/2021] [Indexed: 11/30/2022]
Abstract
AIM Residential group care is an important service for vulnerable young people experiencing mental health, substance abuse and/or behavioural challenges. Yet little is written about specific models and their outcomes, especially from the perspectives of the young people who use these services. This project aimed to explore what matters to young people living in a 12-month voluntary residential program for young people aged 16-25. METHODS This participatory action research study was co-produced with Youth Residential Rehabilitation Service residents and staff as co-researchers. A steering group comprising residents, staff and researchers oversaw all research stages. 18 young people and 17 staff members participated in either individual or group interviews to discuss what was important in Youth Residential Rehabilitation Services. Data analysis drew on grounded theory techniques; subsequent codes and themes were refined in the steering group. RESULTS We identified the 'change work' that young people were expected to do, and the milieu factors that created a supportive environment. As young people were figuring out their directions and learning new skills, they needed to be understood as the developing expert of their own lives. Real relationships with staff and other young people created a culture of belonging, safety and feeling known. These findings are metaphorically captured in the image of an egg. CONCLUSIONS Our study highlights that real relationships between all Youth Residential Rehabilitation Service community members are central to creating the atmosphere of safety and belonging that enables healing and self-development to occur.
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Affiliation(s)
| | | | | | | | | | | | | | - Tom Wood
- Neami National, Preston, Victoria, Australia
| | | | | | | | - Sarah Bendall
- Orygen, National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Magenta Simmons
- Orygen, National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
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17
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The Feasibility and Acceptability of an Experience-Based Co-Design Approach to Reducing Domestic Abuse. SOCIETIES 2022. [DOI: 10.3390/soc12030093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Abstract
One means of reducing violence against people experiencing domestic abuse is to improve the pathway which they use to access help from the police and other services. In this paper we report and reflect on a project which contributes to violence reduction via a participatory approach to service improvement, focusing on this pathway. We describe the four phases of an innovative experience-based co-design (EBCD) project, which involved collaborating with domestic abuse survivors as well as members of the police and domestic abuse organizations. We report on indicators of the acceptability and feasibility of EBCD in this context. We also reflect upon the potential of the EBCD approach for involving communities in collaborating with services to reduce domestic abuse. We discuss the conceptual and methodological implications with regard to adopting participatory and inclusive approaches in contexts where power-sharing may be difficult. We argue that EBCD has considerable potential for use in this setting and we identify several areas where insights from this project could be used to improve the future viability of any such initiatives.
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18
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Brierley-Jones L, Ramsey L, Canvin K, Kendal S, Baker J. To what extent are patients involved in researching safety in acute mental healthcare? RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:8. [PMID: 35227330 PMCID: PMC8886877 DOI: 10.1186/s40900-022-00337-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 01/20/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND There is a growing need to involve patients in the development of patient safety interventions. Mental health services, despite their strong history of patient involvement, have been slow to develop patient safety interventions, particularly in inpatient settings. METHODS A systematic search was undertaken of both academic and grey literature. Whilst no lay member of the team worked directly on the review, they were part of the project steering group which provided oversight throughout the review process. This included people with lived experience of mental health services. From a research perspective the main focus for lay members was in co-producing the digital technology, the key project output. Smits et al.'s (Res Involv Engagem 6:1-30, 2020) Involvement Matrix was used to taxonomise levels of patient involvement. Studies were included if they were set in any inpatient mental health care context regardless of design. The quality of all selected studies was appraised using Mixed Methods Appraisal Methodology (MMAT). RESULTS Fifty-two studies were classified, synthesised and their levels of patient involvement in the research and development of patient safety interventions were taxonomised. Almost two-thirds of studies (n = 33) researched reducing restrictive practices. Only four studies reported engaging patients in the research process as decision-makers, with the remaining studies divided almost equally between engaging patients in the research process as partners, advisors and co-thinkers. Just under half of all studies engaged patients in just one stage of the research process. CONCLUSION Involvement of patients in researching patient safety and developing interventions in an inpatient mental health context seems diverse in its nature. Researchers need to both more fully consider and better describe their approaches to involving patients in safety research in inpatient mental health. Doing so will likely lead to the development of higher quality safety interventions.
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Affiliation(s)
| | - Lauren Ramsey
- Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford, UK
| | | | - Sarah Kendal
- School of Healthcare, University of Leeds, Leeds, UK
| | - John Baker
- School of Healthcare, University of Leeds, Leeds, UK.
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19
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Hudson G, Jansli SM, Erturk S, Morris D, Odoi CM, Clayton-Turner A, Bray V, Yourston G, Clouden D, Proudfoot D, Cornwall A, Waldron C, Wykes T, Jilka S. Investigation of Carers’ Perspectives of Dementia Misconceptions on Twitter: Focus Group Study. JMIR Aging 2022; 5:e30388. [PMID: 35072637 PMCID: PMC8822432 DOI: 10.2196/30388] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 09/24/2021] [Accepted: 11/09/2021] [Indexed: 12/19/2022] Open
Abstract
Background Dementia misconceptions on social media are common, with negative effects on people with the condition, their carers, and those who know them. This study codeveloped a thematic framework with carers to understand the forms these misconceptions take on Twitter. Objective The aim of this study is to identify and analyze types of dementia conversations on Twitter using participatory methods. Methods A total of 3 focus groups with dementia carers were held to develop a framework of dementia misconceptions based on their experiences. Dementia-related tweets were collected from Twitter’s official application programming interface using neutral and negative search terms defined by the literature and by carers (N=48,211). A sample of these tweets was selected with equal numbers of neutral and negative words (n=1497), which was validated in individual ratings by carers. We then used the framework to analyze, in detail, a sample of carer-rated negative tweets (n=863). Results A total of 25.94% (12,507/48,211) of our tweet corpus contained negative search terms about dementia. The carers’ framework had 3 negative and 3 neutral categories. Our thematic analysis of carer-rated negative tweets found 9 themes, including the use of weaponizing language to insult politicians (469/863, 54.3%), using dehumanizing or outdated words or statements about members of the public (n=143, 16.6%), unfounded claims about the cures or causes of dementia (n=11, 1.3%), or providing armchair diagnoses of dementia (n=21, 2.4%). Conclusions This is the first study to use participatory methods to develop a framework that identifies dementia misconceptions on Twitter. We show that misconceptions and stigmatizing language are not rare. They manifest through minimizing and underestimating language. Web-based campaigns aiming to reduce discrimination and stigma about dementia could target those who use negative vocabulary and reduce the misconceptions that are being propagated, thus improving general awareness.
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Affiliation(s)
- Georgie Hudson
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Sonja M Jansli
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Sinan Erturk
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Daniel Morris
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Clarissa M Odoi
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Angela Clayton-Turner
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Vanessa Bray
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Gill Yourston
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Doreen Clouden
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - David Proudfoot
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Andrew Cornwall
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Claire Waldron
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Til Wykes
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Sagar Jilka
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
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20
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Pickard H, Pellicano E, den Houting J, Crane L. Participatory autism research: Early career and established researchers' views and experiences. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:75-87. [PMID: 34088215 PMCID: PMC8750139 DOI: 10.1177/13623613211019594] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LAY ABSTRACT 'Participatory autism research' refers to ways of involving autistic people and their allies (e.g. family members) in making decisions about research. These decisions can include what research gets done, how it gets done and how research findings are used. While there is more and more interest in participatory autism research, we know little about how researchers at different stages of their careers use this approach. To find out more, we discussed these issues with 25 researchers. Fourteen of these were at an early stage of their careers, and 11 were more senior researchers. We spoke to people in individual interviews or in groups. We then used a technique called thematic analysis to analyse our data, which involved us looking for common topics or 'themes' discussed by our participants. What did we find? Our participants told us that participatory autism research was a flexible approach, meaning that autistic people can be involved in research in many different ways. While people viewed this flexibility in a positive way, it also caused some confusion about what does or does not 'count' as participatory research. Our participants also spoke about how important it was to build relationships with those involved in their research, but they also said it could be difficult to communicate well with diverse groups of people who may not have much experience of research. Finally, our participants said it was hard to do participatory research when there was not much time, funding or support available to researchers. In this article, we discuss these findings, focusing on what needs to change to ensure that autistic people and their allies are meaningfully involved in autism research.
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Affiliation(s)
| | | | - Jacquiline den Houting
- Macquarie University,
Australia
- Cooperative Research Centre for
Living with Autism, Australia
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21
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Egid BR, Roura M, Aktar B, Amegee Quach J, Chumo I, Dias S, Hegel G, Jones L, Karuga R, Lar L, López Y, Pandya A, Norton TC, Sheikhattari P, Tancred T, Wallerstein N, Zimmerman E, Ozano K. 'You want to deal with power while riding on power': global perspectives on power in participatory health research and co-production approaches. BMJ Glob Health 2021; 6:e006978. [PMID: 34764147 PMCID: PMC8587355 DOI: 10.1136/bmjgh-2021-006978] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 10/23/2021] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Power relations permeate research partnerships and compromise the ability of participatory research approaches to bring about transformational and sustainable change. This study aimed to explore how participatory health researchers engaged in co-production research perceive and experience 'power', and how it is discussed and addressed within the context of research partnerships. METHODS Five online workshops were carried out with participatory health researchers working in different global contexts. Transcripts of the workshops were analysed thematically against the 'Social Ecology of Power' framework and mapped at the micro (individual), meso (interpersonal) or macro (structural) level. RESULTS A total of 59 participants, with participatory experience in 24 different countries, attended the workshops. At the micro level, key findings included the rarity of explicit discussions on the meaning and impact of power, the use of reflexivity for examining assumptions and power differentials, and the perceived importance of strengthening co-researcher capacity to shift power. At the meso level, participants emphasised the need to manage co-researcher expectations, create spaces for trusted dialogue, and consider the potential risks faced by empowered community partners. Participants were divided over whether gatekeeper engagement aided the research process or acted to exclude marginalised groups from participating. At the macro level, colonial and 'traditional' research legacies were acknowledged to have generated and maintained power inequities within research partnerships. CONCLUSIONS The 'Social Ecology of Power' framework is a useful tool for engaging with power inequities that cut across the social ecology, highlighting how they can operate at the micro, meso and macro level. This study reiterates that power is pervasive, and that while many researchers are intentional about engaging with power, actions and available tools must be used more systematically to identify and address power imbalances in participatory research partnerships, in order to contribute to improved equity and social justice outcomes.
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Affiliation(s)
- Beatrice R Egid
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - María Roura
- School of Public Health, University College Cork, Cork, Ireland
| | - Bachera Aktar
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Jessica Amegee Quach
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Ivy Chumo
- Urbanisation and Wellbeing Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Sónia Dias
- NOVA National School of Public Health, Public Health Research Centre, Universidade Nova de Lisboa and Comprehensive Health Research Centre, Lisboa, Portugal
| | - Guillermo Hegel
- INCAP Research Center for Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala
| | - Laundette Jones
- School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Robinson Karuga
- Department of Research and Strategic Information, LVCT Health, Nairobi, Kenya
| | - Luret Lar
- Department of Community Medicine, University of Jos, Jos, Nigeria
| | - Yaimie López
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Apurvakumar Pandya
- Parul Institute of Public Health, Faculty of Medicine, Parul University, Vadodara, Gujarat, India
| | | | - Payam Sheikhattari
- School of Community Health and Policy, Prevention Sciences Research Center, Morgan State University, Baltimore, Maryland, USA
| | - Tara Tancred
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Nina Wallerstein
- Center for Participatory Research, College of Population Health, University of New Mexico, Albuquerque, New Mexico, USA
| | - Emily Zimmerman
- Center on Society and Health, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Kim Ozano
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
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Beeker T, Glück RK, Ziegenhagen J, Göppert L, Jänchen P, Krispin H, Schwarz J, von Peter S. Designed to Clash? Reflecting on the Practical, Personal, and Structural Challenges of Collaborative Research in Psychiatry. Front Psychiatry 2021; 12:701312. [PMID: 34305686 PMCID: PMC8292740 DOI: 10.3389/fpsyt.2021.701312] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 06/04/2021] [Indexed: 11/13/2022] Open
Abstract
Background: In the field of mental health research, collaborative and participatory approaches in which mental health service users actively contribute to academic knowledge production are gaining momentum. However, concrete examples in scientific literature that would detail how collaborative research projects are actually organized, and how they deal with the inherent challenges are rare. This paper provides an in-depth description of a three-year collaborative project that took place in the wider context of a mixed-method process evaluation of innovative models of psychiatric care in Germany. Methods: The in-depth description we provide here draws on a vast body of notes and records that originated from numerous meetings and sessions. The research group continuously and systematically reflected on their collaboration itself using the interpretative method of "interactive interviewing," which included that also the personal memories of the researchers were collectively re-discussed before and during the process of writing. Our concrete experiences as a group were then contextualized with and analyzed in the light of more general challenges that are central to collaborative research in general. Results: Performing collaborative research requires unconventional thinking and improvisation in order to find creative solutions for practical problems and to overcome the structural obstacles inherent to the process of academic knowledge production. An atmosphere of mutual trust and respect within the group is crucial, and continuous self-reflection or supervision can be largely beneficial. Challenges mainly originate from the vast heterogeneity that characterizes the researchers, usually including large differences in economic, cultural, and social capital. Conclusion: Collaborative research in the field of psychiatry is designed to bring together researchers with widely diverse backgrounds. Emerging conflicts are important parts of knowledge production but also exceptional opportunities to negotiate research ethics, and potential vehicles for personal growth and transformation. Success or failure of collaborative research largely depends on how divergences and conflicts are articulated, mediated, and reflected. This also holds true in the light of the power asymmetries within the research team and the structural power inherent to the engines of academic knowledge production.
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Affiliation(s)
- Timo Beeker
- Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Immanuel Klinik Rüdersdorf, Rüdersdorf, Germany
| | - Rosa Kato Glück
- Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Immanuel Klinik Rüdersdorf, Rüdersdorf, Germany
| | - Jenny Ziegenhagen
- Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Immanuel Klinik Rüdersdorf, Rüdersdorf, Germany
- ExPEERienced – Experience With Mental Health Crises – Registered Non-profit Organization, Berlin, Germany
| | - Lena Göppert
- Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Immanuel Klinik Rüdersdorf, Rüdersdorf, Germany
| | - Patrick Jänchen
- Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Immanuel Klinik Rüdersdorf, Rüdersdorf, Germany
| | - Helene Krispin
- Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Immanuel Klinik Rüdersdorf, Rüdersdorf, Germany
| | - Julian Schwarz
- Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Immanuel Klinik Rüdersdorf, Rüdersdorf, Germany
| | - Sebastian von Peter
- Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Immanuel Klinik Rüdersdorf, Rüdersdorf, Germany
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Friesen P, Lignou S, Sheehan M, Singh I. Measuring the impact of participatory research in psychiatry: How the search for epistemic justifications obscures ethical considerations. Health Expect 2021; 24 Suppl 1:54-61. [PMID: 31854081 PMCID: PMC8137501 DOI: 10.1111/hex.12988] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/05/2019] [Accepted: 10/02/2019] [Indexed: 11/28/2022] Open
Abstract
CONTEXT Both within politics and practice, the field of psychiatry is undergoing a significant transformation, as increasing emphasis is placed on the importance of involving those with lived experience in research. In response to this participatory turn, a push towards measuring the impact of patient involvement is also growing, seeking to identify how participation can improve research. OBJECTIVE This paper examines the recent push towards measuring impact in relation to justifications underlying the democratization of research in psychiatry, revealing a disconnect between the two, and harms that could result from a singular focus on measuring impact. DISCUSSION While those promoting and regulating participatory research tend to focus on the epistemic benefits of such research, many have pointed to both epistemic and ethical justifications underlying participatory research. The ethical reasons for involving service users loom especially large in psychiatry, given its unique history of abuse, the ways diagnoses can be utilized as tools for oppression, and the prevalence of coercion. The current focus on measuring the impact of involvement can be harmful, in that it obscures ethical reasons in favour of epistemic ones, potentially exacerbating issues common to participatory research, such as role confusion and ineffective, tokenistic participatory efforts. CONCLUSIONS We argue that to take the ethical reasons behind involvement in mental health research seriously will involve looking beyond impact and towards sharing power. We suggest three ways this can be done: measuring more than impact, building service user capacities and sharing power in realms outside of research.
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Affiliation(s)
- Phoebe Friesen
- Department of Population HealthEthox CentreUniversity of OxfordOxfordUK
| | - Sapfo Lignou
- NEUROSECDepartment of PsychiatryUniversity of OxfordOxfordUK
| | - Mark Sheehan
- Department of Population HealthEthox CentreUniversity of OxfordOxfordUK
| | - Ilina Singh
- NEUROSECDepartment of PsychiatryUniversity of OxfordOxfordUK
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Papoulias SC, Callard F. 'A limpet on a ship': Spatio-temporal dynamics of patient and public involvement in research. Health Expect 2021; 24:810-818. [PMID: 33745192 PMCID: PMC8235890 DOI: 10.1111/hex.13215] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 12/15/2020] [Accepted: 02/02/2021] [Indexed: 11/27/2022] Open
Abstract
Objective To understand how current funding expectations that applied health research is undertaken in partnership with research institutions, health service providers and other stakeholders may impact on patient and public involvement (PPI). Background While there is considerable research on the potential impact of PPI in health research, the processes of embedding PPI in research teams remain understudied. We draw on anthropological research on meetings as sites of production and reproduction of institutional cultures and external contexts to investigate how these functions of meetings may affect the potential contributions of patients, carers and the public in research. Methods We present an ethnography of meetings that draws from a larger set of case studies of PPI in applied health research settings. The study draws on ethnographic observations, interviews with team members, analysis of documents and a presentation of preliminary findings through which feedback from informants was gathered. Results We identified four means by which the oversight meetings regulated research and constrained the possibilities for PPI: a logic of ‘deliverables’ and imagined interlocutors, the performance of inclusion, positioning PPI in an ‘elsewhere’ of research, and the use of meetings to embed apprenticeship for junior researchers. Conclusions PPI is essentially out of sync from the institutional logic of ‘deliverables’ constituting research partnerships. Embedding PPI in research requires challenging this logic.
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Lignou S, Singh I. Pharmaceutical industry, academia and people with experience of mental illness as partners in research: a need for ethical guidance. Wellcome Open Res 2021. [DOI: 10.12688/wellcomeopenres.16166.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Several social and policy developments have led to research partnerships in mental health research, which depart from traditional research models. One form of such partnerships is among Research institutions, Industry (pharmaceutical and biotech) and People with lived experience of mental illness (RIPs) in the NIHR services. There are several benefits but also challenges in such partnerships. An ethics-based approach to anticipating and addressing such problems is lacking. Given the expansion of RIPs in treatment development for mental health illness, guidance to support ethical and effective collaborations in NIHR-funded mental health research is essential. Methods: To develop a moral framework for evaluating the ethics of RIPs, we systematically searched PubMed for peer-reviewed literature discussing good practices in research partnerships. Searches were also conducted in websites of known organizations supporting patient engagement with industry in mental health research and in the references of short-listed articles. Following application of exclusion criteria, remaining articles were critically examined and summarised to synthesise principles for ethical RIPs and inform clear guidance and practices. Results: Critical analysis and synthesis of the short-listed articles highlighted the need for two sets of principles to guide ethical RIPs: principles for (a) RIPs as a trustworthy enterprise and (b) fair RIPs. We discuss the application of these principles in problem-solving strategies that can support best practice in establishing fair and effective research partnerships among research institutions, industry and people with lived experience of mental illness in the NIHR services. Conclusions: Ethical guidance is needed to prevent and address challenges in RIPs and to promote the scientific and social benefits of these new research partnership models in mental health research in the NIHR services. We show how the proposed moral framework can guide research partners in designing, sustaining and assessing ethical and effective mental health research collaborations.
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26
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If not now, when? COVID-19, lived experience, and a moment for real change. Lancet Psychiatry 2020; 7:1008-1009. [PMID: 32822563 PMCID: PMC7434480 DOI: 10.1016/s2215-0366(20)30374-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 07/28/2020] [Accepted: 08/06/2020] [Indexed: 11/30/2022]
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Lignou S, Singh I. Pharmaceutical industry, academia and people with experience of mental illness as partners in research: a need for ethical guidance. Wellcome Open Res 2020. [DOI: 10.12688/wellcomeopenres.16166.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Several social and policy developments have led to research partnerships in mental health research, which depart from traditional research models. One form of such partnerships is among research institutions, industry (pharmaceutical and biotech) and people with lived experience of mental illness (RIPs). There are several benefits but also ethical challenges in RIPs. An ethics-based approach to anticipating and addressing such ethical issues in mental health research is lacking. Given the expansion of RIPs in treatment development for mental health illness, guidance to support ethical and trustworthy collaborative mental health research projects is essential. Methods: To develop a moral framework for evaluating the ethics of RIPs, we systematically searched PubMed for peer-reviewed literature discussing good practices in research partnerships. Searches were also conducted in websites of known organizations supporting patient engagement with industry in mental health research and in the references of short-listed articles. Following application of exclusion criteria, remaining articles were critically examined and summarised to synthesise principles for ethically acceptable RIPs and inform clear guidance and practices. Results: Critical analysis and synthesis of the short-listed articles highlighted the need for two sets of principles to guide ethical RIPs: principles for (a) RIPs as a trustworthy enterprise (e.g. public accountability, transparency) and (b) fair RIPs (e.g. effective governance, respect). We discuss the application of these principles in problem-solving strategies that can support best practice in establishing fair and successful mental health research partnerships among research institutions, industry and people with lived experience of mental illness. Conclusions: Ethical guidance is needed to prevent and address challenges in RIPs and to promote the scientific and social benefits of these new research partnership models in mental health research. We show how the proposed moral framework can guide research partners in designing, sustaining and assessing ethical and trustworthy collaborative mental health research projects.
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Wusinich C, Lindy DC, Russell D, Pessin N, Friesen P. Experiences of Parachute NYC: An Integration of Open Dialogue and Intentional Peer Support. Community Ment Health J 2020; 56:1033-1043. [PMID: 32036517 DOI: 10.1007/s10597-020-00556-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 01/24/2020] [Indexed: 10/25/2022]
Abstract
Guided by the principles of Open Dialogue and Intentional Peer Support (IPS), Parachute NYC was designed to provide a "soft landing" for people experiencing psychiatric crisis. From 2012 to 2018, Parachute's teams of clinicians and peer specialists provided home-based mental health care to enrollees and their networks (family, friends), seeking to engage and improve their natural support networks. This qualitative study examined the experiences of enrollees and network members who participated in Parachute. Participants reported that they valued the accessibility and flexibility of Parachute as well as their relationships with, and the lack of hierarchy within, the Parachute team. Responses to the structure of network meetings and Parachute's approach to medication were mixed, with a few participants struggling with what they felt was a lack of urgency and others experiencing the approach as holistic. Many enrollees and network members reported that Parachute improved their self-understanding and relationships with each other.
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Affiliation(s)
- Christina Wusinich
- Visiting Nurse Service of New York, Community Mental Health Services, 286 Lenox Ave., New York, NY, 10027, USA.
| | - David C Lindy
- Visiting Nurse Service of New York, Community Mental Health Services, 286 Lenox Ave., New York, NY, 10027, USA.,College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, New York, NY, 10032, USA
| | - David Russell
- Center for Home Care Policy & Research, Visiting Nurse Service of New York, 5 Penn Plaza, 12th Floor, New York, NY, 10001, USA.,Department of Sociology, Appalachian State University, 209 Chapell Wilson Hall, 480 Howard Street, Boone, NC, 28608, USA
| | - Neil Pessin
- Visiting Nurse Service of New York, Community Mental Health Services, 286 Lenox Ave., New York, NY, 10027, USA
| | - Phoebe Friesen
- Visiting Nurse Service of New York, Community Mental Health Services, 286 Lenox Ave., New York, NY, 10027, USA.,Biomedical Ethics Unit, Social Studies of Medicine, McGill University, 3647 Peel St., Montreal, QC, H3A 1X1, Canada
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Lambley R. Small talk matters! Creating allyship in mental health research. QUALITATIVE RESEARCH IN PSYCHOLOGY 2020. [DOI: 10.1080/14780887.2020.1769239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Ruth Lambley
- Converge, York Saint John University, York, United Kingdom of Great Britain and Northern Ireland
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Williams O, Sarre S, Papoulias SC, Knowles S, Robert G, Beresford P, Rose D, Carr S, Kaur M, Palmer VJ. Lost in the shadows: reflections on the dark side of co-production. Health Res Policy Syst 2020; 18:43. [PMID: 32380998 PMCID: PMC7204208 DOI: 10.1186/s12961-020-00558-0] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 04/02/2020] [Indexed: 11/30/2022] Open
Abstract
This article is a response to Oliver et al.'s Commentary 'The dark side of coproduction: do the costs outweigh the benefits for health research?' recently published in Health Research Policy and Systems (2019, 17:33). The original commentary raises some important questions about how and when to co-produce health research, including highlighting various professional costs to those involved. However, we identify four related limitations in their inquiry, as follows: (1) the adoption of a problematically expansive definition of co-production that fails to acknowledge key features that distinguish co-production from broader collaboration; (2) a strong focus on technocratic rationales for co-producing research and a relative neglect of democratic rationales; (3) the transposition of legitimate concerns relating to collaboration between researchers and practitioners onto work with patients, service users and marginalised citizens; and (4) the presentation of bad practice as an inherent flaw, or indeed 'dark side', of co-production without attending to the corrupting influence of contextual factors within academic research that facilitate and even promote such malpractice. The Commentary's limitations can be seen to reflect the contemporary use of the term 'co-production' more broadly. We describe this phenomenon as 'cobiquity' - an apparent appetite for participatory research practice and increased emphasis on partnership working, in combination with the related emergence of a plethora of 'co' words, promoting a conflation of meanings and practices from different collaborative traditions. This phenomenon commonly leads to a misappropriation of the term 'co-production'. Our main motivation is to address this imprecision and the detrimental impact it has on efforts to enable co-production with marginalised and disadvantaged groups. We conclude that Oliver et al. stray too close to 'the problem' of 'co-production' seeing only the dark side rather than what is casting the shadows. We warn against such a restricted view and argue for greater scrutiny of the structural factors that largely explain academia's failure to accommodate and promote the egalitarian and utilitarian potential of co-produced research.
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Affiliation(s)
- Oli Williams
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, 4th Floor, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, United Kingdom.
- THIS Institute, Cambridge, United Kingdom.
| | - Sophie Sarre
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, 4th Floor, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, United Kingdom
| | | | | | - Glenn Robert
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, 4th Floor, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, United Kingdom
| | | | - Diana Rose
- Service User Research Enterprise, King's College London, London, United Kingdom
| | - Sarah Carr
- University of Birmingham, Birmingham, United Kingdom
| | - Meerat Kaur
- NIHR ARC Northwest London, London, United Kingdom
| | - Victoria J Palmer
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, 4th Floor, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, United Kingdom
- The University of Melbourne, Melbourne, Australia
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The Challenges and Opportunities of Energy-Flexible Factories: A Holistic Case Study of the Model Region Augsburg in Germany. SUSTAINABILITY 2020. [DOI: 10.3390/su12010360] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Economic solutions for the integration of volatile renewable electricity generation are decisive for a socially supported energy transition. So-called energy-flexible factories can adapt their electricity consumption process efficiently to power generation. These adaptions can support the system balance and counteract local network bottlenecks. Within part of the model region Augsburg, a research and demonstration area of a federal research project, the potential, obstacles, effects, and opportunities of the energy-flexible factory were considered holistically. Exemplary flexibilization measures of industrial companies were identified and modeled. Simulations were performed to analyze these measures in supply scenarios with advanced expansion of fluctuating renewable electricity generation. The simulations demonstrate that industrial energy flexibility can make a positive contribution to regional energy balancing, thus enabling the integration of more volatile renewable electricity generation. Based on these fundamentals, profiles for regional market mechanisms for energy flexibility were investigated and elaborated. The associated environmental additional expenses of the companies for the implementation of the flexibility measures were identified in a life-cycle assessment, with the result that the negative effects are mitigated by the increased share of renewable energy. Therefore, from a technical perspective, energy-flexible factories can make a significant contribution to a sustainable energy system without greater environmental impact. In terms of a holistic approach, a network of actors from science, industry, associations, and civil society organizations was established and actively collaborated in a transdisciplinary work process. Using design-thinking methods, profiles of stakeholders in the region, as well as their mutual interactions and interests, were created. This resulted in requirements for the development of suitable business models and reduced regulatory barriers.
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Wallerstein N, Muhammad M, Sanchez-Youngman S, Rodriguez Espinosa P, Avila M, Baker EA, Barnett S, Belone L, Golub M, Lucero J, Mahdi I, Noyes E, Nguyen T, Roubideaux Y, Sigo R, Duran B. Power Dynamics in Community-Based Participatory Research: A Multiple-Case Study Analysis of Partnering Contexts, Histories, and Practices. HEALTH EDUCATION & BEHAVIOR 2019; 46:19S-32S. [PMID: 31549557 DOI: 10.1177/1090198119852998] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
Community-based participatory research has a long-term commitment to principles of equity and justice with decades of research showcasing the added value of power-sharing and participatory involvement of community members for achieving health, community capacity, policy, and social justice outcomes. Missing, however, has been a clear articulation of how power operates within partnership practices and the impact of these practices on outcomes. The National Institutes of Health-funded Research for Improved Health study (2009-2013), having surveyed 200 partnerships, then conducted seven in-depth case studies to better understand which partnership practices can best build from community histories of organizing to address inequities. The diverse case studies represented multiple ethnic-racial and other marginalized populations, health issues, and urban and rural areas and regions. Cross-cutting analyses of the qualitative results focus on how oppressive and emancipatory forms of power operate within partnerships in response to oppressive conditions or emancipatory histories of advocacy within communities. The analysis of power was conducted within each of the four domains of the community-based participatory research conceptual model, starting from how contexts shape partnering processes to impact short-term intervention and research outputs, and contribute to outcomes. Similarities and differences in how partnerships leveraged and addressed their unique contexts and histories are presented, with both structural and relational practices that intentionally addressed power relations. These results demonstrate how community members draw from their resilience and strengths to combat histories of injustice and oppression, using partnership principles and practices toward multilevel outcomes that honor community knowledge and leadership, and seek shared power, policy, and community transformation changes, thereby advancing health equity.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Ihsan Mahdi
- New Mexico Department of Health, Santa Fe, NM, USA
| | - Emma Noyes
- Washington State University-Spokane, WA, USA
| | - Tung Nguyen
- University of California San Francisco, CA, USA
| | - Yvette Roubideaux
- National Congress on American Indians Policy Research Center, Washington, DC, USA
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