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Cassidy A, Bannon N, Wallen M, Dimarco A, Garrity N, Hunter O, Anaby D, Fredrickson E, Cowan H, Knudsen D, Thornton S, Imms C. A stakeholder-involved adaptation of pathways and resources for engagement and participation (PREP) material with young adults with complex disability in Australia: an implementation feasibility study. Disabil Rehabil 2024:1-13. [PMID: 39235070 DOI: 10.1080/09638288.2024.2397083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 08/21/2024] [Accepted: 08/22/2024] [Indexed: 09/06/2024]
Abstract
PURPOSE Pathways and Resources for Engagement and Participation (PREP) is an intervention to optimise individuals' participation by building problem-solving capacity and addressing environmental barriers. We investigated the feasibility of implementing PREP with young adults (18-30 years) with complex disability in Australia. MATERIALS AND METHODS Explanatory sequential mixed methods study in three stages. (i) PREP materials were collaboratively adapted by the research team and consumer research partners. (ii) Steps 1 and 2 of PREP (YA Supplement) were completed with three young adults with disability, and preliminary feasibility explored using qualitative methods. (iii) The feasibility of implementing adapted materials was examined using quantitative and qualitative methods involving four young adults with disability, six support people and two service providers. RESULTS Stage 1: PREP Young Adults Supplement (PREP (YA Supplement)) for use alongside PREP was developed. Stages 2 and 3: findings indicated PREP (YA Supplement) was acceptable, appropriate and feasible. Three themes were identified: setting and achieving goals were associated with challenges and benefits; finding the right time to implement the program was necessary; and PREP (YA Supplement) drives a shift to a participation-focused approach. CONCLUSION PREP delivered alongside PREP (YA Supplement) appears feasible with Australian young adults with complex disability.
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Affiliation(s)
- Annabelle Cassidy
- School of Allied Health, Australian Catholic University, Melbourne, Australia
| | - Natasha Bannon
- School of Allied Health, Australian Catholic University, Melbourne, Australia
| | - Margaret Wallen
- School of Allied Health, Australian Catholic University, North Sydney, Australia
| | - Alessandra Dimarco
- School of Allied Health, Australian Catholic University, North Sydney, Australia
| | | | | | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Emma Fredrickson
- Young Adult Complex Disability Service, St Vincent's Hospital, Melbourne, Australia
| | - Harry Cowan
- School of Allied Health, Australian Catholic University, Melbourne, Australia
| | - Dewa Knudsen
- School of Allied Health, Australian Catholic University, North Sydney, Australia
| | - Scott Thornton
- School of Allied Health, Australian Catholic University, Melbourne, Australia
| | - Christine Imms
- Healthy Trajectories Child and Youth Disability Research Hub, Department of Paediatrics, The University of Melbourne and Murdoch Children's Research Institute, Melbourne, Australia
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Winter JD, Kerns JW, Winter KM, Winter C, Krist A, Etz RS. Lessons learned from CMS's National Partnership to Improve Dementia Care: a thematic synthesis of multiple stakeholder-engaged studies. Psychogeriatrics 2024; 24:1045-1050. [PMID: 38924586 PMCID: PMC11368649 DOI: 10.1111/psyg.13157] [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: 03/04/2024] [Revised: 06/07/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Antipsychotic prescribing in United States nursing homes (NHs) has decreased since the Center for Medicare & Medicaid Service debuted the National Partnership to Improve Dementia Care in Nursing Homes (NP); however, reductions have stalled. To help explain persistent antipsychotic use despite the NP's reduction efforts, the perspectives of diverse NP stakeholders were qualitatively assessed. This study aimed to re-evaluate these individual perspectives in combined thematic synthesis to discover NP improvement opportunities undetectable in single stakeholder assessments. METHODS Thematic synthesis. Through immersive crystallisation, original source coding results were organised into related descriptive themes. Similarities and differences were identified, and descriptive themes were regrouped into new, increasingly abstract, analytical themes. This cycle continued until variances were resolved and analytic themes sufficiently described and explained all initial descriptive themes. RESULTS Three analytic themes emerged regarding NP improvement opportunities. The NP's positive impacts would be augmented by: (i) a deeper and expanded appreciation of stakeholder perspectives; (ii) more urgent and rapid adaptation to unintended adverse outcomes; and (iii) greater recognition of the contextual and environmental factors influencing decisions to prescribe or not prescribe antipsychotic medications. Stakeholder groups described: perspectives they perceived as inadequately considered by the NP; insufficient NP engagement with the stakeholders capable of creating evidenced, affordable, and available non-pharmacologic therapies for dementia symptoms; recognition that dementia interventions effective for a specific individual at a specific time in a specific community may not generalise; and diverse ongoing undesirable outcomes from NP policies that could be mitigated by NP modifications. CONCLUSIONS The NP has done much to advance dementia care in NHs. Notwithstanding, these results suggest the NP would only be improved through increasingly comprehensive inclusion of stakeholder perspectives, enhanced incorporation of individual contextual factors, and a more decisive mechanism for ongoing and continual adaptation.
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Affiliation(s)
- Jonathan D Winter
- VCU-Shenandoah Family Practice Residency, Front Royal, Virginia, USA
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia, USA
| | - J William Kerns
- VCU-Shenandoah Family Practice Residency, Front Royal, Virginia, USA
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia, USA
| | | | - Christopher Winter
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Alex Krist
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Rebecca S Etz
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia, USA
- Larry A. Green Center, Richmond, Virginia, USA
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Lopes JF, Couto AC, Daher A, Fonseca BDP. Strengthening research networks: Insights from a clinical research network in Brazil. PLoS One 2024; 19:e0307817. [PMID: 39088463 PMCID: PMC11293707 DOI: 10.1371/journal.pone.0307817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 07/11/2024] [Indexed: 08/03/2024] Open
Abstract
Clinical Research Networks (CRNs) are means to improve healthcare delivery, quality of care and patient outcomes. The Oswaldo Cruz Foundation (Fiocruz), Latin America's leading health research organization, has established a CRN to promote interaction and collaboration among its clinical research experts. After a decade of operation, a revitalization process was undertaken out of the need to improve its functionality. This study aimed to describe the evaluation process of the Fiocruz Clinical Research Network (RFPC) by gathering the opinions and perspectives of its members and identifying the network structure. The goal was to improve scientific collaboration and member engagement, thereby increasing the integration, effectiveness, and impact of clinical research conducted at the institution. Clinical research professionals at Fiocruz were invited to participate in an online questionnaire to collect information about their professional experience, the benefits and constraints of participating in research networks, relevant discussion topics, and the challenges of complying with Good Clinical Practices (GCP). With the help of social network analysis, a deeper understanding of the dynamics and structure of professional communication networks was obtained. The questionnaire was completed by 122 professionals (response rate 50.4%), with most respondents being principal investigators (PIs) with more than 10 years of professional experience (24.6%). Participation in research networks was considered beneficial, particularly in working groups (48.4%), and as an opportunity to exchange experiences with other professionals (44.3%). Almost half of the participants (48.4%) did not identify any barriers to participating in a network. Topics that required further discussion included data management, biorepositories and biobanks, and ethical and regulatory issues. Challenges to conducting clinical research with GCP standards included strategic support and funding, staffing and training, data management, infrastructure, quality management, and collaboration. Communication within the research network was loosely structured, with the most experienced professionals holding central positions. This analysis provided valuable insights to support the management of the RFPC. It highlighted the internal community's interests and expectations, identified key areas for improvement in GCP implementation, and influential professionals who could improve information sharing and national integration. The findings have far-reaching implications that can be applied in different contexts. They contribute to the ongoing discussion on the establishment and management of research networks.
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Affiliation(s)
- Juliana Freitas Lopes
- Center for Technological Development in Health (CDTS), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Arnaldo Cézar Couto
- Vice Presidency of Research and Biological Collections (VPPCB), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
- Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil
| | - André Daher
- Vice Presidency of Research and Biological Collections (VPPCB), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Bruna de Paula Fonseca
- Center for Technological Development in Health (CDTS), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
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Jull J, Smith M, Carley M, Stacey D, Graham ID. Co-production of a systematic review on decision coaching: a mixed methods case study within a review. Syst Rev 2024; 13:149. [PMID: 38831444 PMCID: PMC11149211 DOI: 10.1186/s13643-024-02563-8] [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: 10/18/2023] [Accepted: 05/16/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Co-production is a collaborative approach to prepare, plan, conduct, and apply research with those who will use or be impacted by research (knowledge users). Our team of knowledge users and researchers sought to conduct and evaluate co-production of a systematic review on decision coaching. METHODS We conducted a mixed-methods case study within a review to describe team co-production of a systematic review. We used the Collaborative Research Framework to support an integrated knowledge translation approach to guide a team through the steps in co-production of a systematic review. The team agreed to conduct self-study as a study within a review to learn from belonging to a co-production research team. A core group that includes a patient partner developed and conducted the study within a review. Data sources were surveys and documents. The study coordinator administered surveys to determine participant preferred and actual levels of engagement, experiences, and perceptions. We included frequency counts, content, and document analysis. RESULTS We describe co-production of a systematic review. Of 17 team members, 14 (82%) agreed to study participation and of those 12 (86%) provided data pre- and post-systematic review. Most participants identified as women (n = 9, 75.0%), researchers (n = 7, 58%), trainees (n = 4, 33%), and/or clinicians (n = 2, 17%) with two patient/caregiver partners (17%). The team self-organized study governance with an executive and Steering Committee and agreed on research co-production actions and strategies. Satisfaction for engagement in the 11 systematic review steps ranged from 75 to 92%, with one participant who did not respond to any of the questions (8%) for all. Participants reported positive experiences with team communication processes (n = 12, 100%), collaboration (n = 12, 100%), and negotiation (n = 10-12, 83-100%). Participants perceived the systematic review as co-produced (n = 12, 100%) with collaborative (n = 8, 67%) and engagement activities to characterize co-production (n = 8, 67%). Participants indicated that they would not change the co-production approach (n = 8, 66%). Five participants (42%) reported team logistics challenges and four (33%) were unaware of challenges. CONCLUSIONS Our results indicate that it is feasible to use an integrated knowledge translation approach to conduct a systematic review. We demonstrate the importance of a relational approach to research co-production, and that it is essential to plan and actively support team engagement in the research lifecycle.
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Affiliation(s)
- Janet Jull
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada.
- Ottawa Hospital Research Institute, Ottawa, ON, Canada.
| | - Maureen Smith
- Cochrane Consumer Network Executive, Ottawa, ON, Canada
| | - Meg Carley
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Dawn Stacey
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Nursing, University of Ottawa, Ottawa, ON, Canada
| | - Ian D Graham
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa, Ottawa, ON, Canada
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Ryan D, Nutting H, Parekh C, Crookes S, Southgate L, Caines K, Dear P, John A, Rehman MA, Davidson D, Abid U, Davidson L, Shire KA, McEachan RRC. Ready, set, co(produce): a co-operative inquiry into co-producing research to explore adolescent health and wellbeing in the Born in Bradford Age of Wonder project. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:41. [PMID: 38689373 PMCID: PMC11060965 DOI: 10.1186/s40900-024-00578-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/22/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Co-production of research with communities and stakeholders is recognised as best practice, but despite this, transparent reporting and reflective accounts on co-producing research is lacking. Born in Bradford Age of Wonder (AoW) is a large longitudinal health research project, following the health trajectories of up to 30,000 young people across the Bradford district; moreover, AoW has been entirely co-produced with teachers, parents, and young people. This paper describes the co-production of the Born in Bradford Age of Wonder (AoW) project and shares general reflections on co-production from peer researchers involved in co-producing AoW. METHODS A co-operative inquiry (CI) approach was used to gather written reflections on co-production from ten peer researchers (one teacher, one parent, eight young people) involved in co-producing the AoW project. Written reflections were collected and rough "themes" were identified using thematic analysis. RESULTS Four key 'themes' were identified: (1) promoting young people's voice and views (2) identifying impacts of co-production, (3) fostering a collaborative ethos, and (4) suggested improvements to the co-production work in AoW. Peer researchers' reflections highlighted how co-production can positively impact research projects such as AoW, whilst also holding broader benefits including giving young people a voice, facilitating their personal development, and fostering a collaborative ethos both within AoW and with partner organisations. Suggested improvements to AoW co-production included supporting greater numbers of young people and researchers to engage in co-production, organising more regular sessions, and establishing clearer communication channels. CONCLUSIONS Peer researchers' reflections highlight positive impacts of engaging in co-production, both for research projects (including AoW) and for peer researchers' personal and professional development. That said, continued efforts are needed in AoW to meet young people's needs and interests, maintain trusting relationships, and foster sustained growth of co-production efforts within and beyond the AoW project. Evaluation of AoW co-production, along with wider partnership building are key to these efforts.
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Affiliation(s)
- David Ryan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK.
| | - Hannah Nutting
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Chloe Parekh
- AllStar, Park View Court, St Pauls Road, Shipley, BD18 3DS, UK
| | - Suzie Crookes
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | | | - Kenzie Caines
- AllStar, Park View Court, St Pauls Road, Shipley, BD18 3DS, UK
| | - Phoebe Dear
- AllStar, Park View Court, St Pauls Road, Shipley, BD18 3DS, UK
| | - Abel John
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Muhammed Adnan Rehman
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Dawn Davidson
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Usayd Abid
- Bradford District Care NHS Foundation Trust, New Mill, Victoria Road, Saltaire, Bradford, BD18 3LD, UK
| | - Lewis Davidson
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Katy A Shire
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Rosemary R C McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
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Ikhile D, Glass D, Frere‐Smith K, Fraser S, Turner K, Ramji H, Gremesty G, Ford E, van Marwijk H. A virtuous cycle of co-production: Reflections from a community priority-setting exercise. Health Expect 2023; 26:2514-2524. [PMID: 37602918 PMCID: PMC10632611 DOI: 10.1111/hex.13851] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/03/2023] [Accepted: 08/05/2023] [Indexed: 08/22/2023] Open
Abstract
INTRODUCTION Co-production is gaining increasing recognition as a good way of facilitating collaboration among different stakeholders, including members of the public. However, it remains an ambiguous concept as there is no definitive or universal model of co-production or clarity on what constitutes a good co-production approach. This paper draws on the reflections of the academic researchers, practitioners and public advisors involved in co-producing a priority-setting exercise. The exercise was conducted by the Primary and Community Health Services (PCHS) Theme of the National Institute for Health and Care Research Applied Research Collaboration for Kent, Surrey and Sussex (NIHR ARC KSS). METHODS We collected data through written and verbal reflections from seven collaborators involved in the PCHS priority-setting exercise. We used Gibbs' model of reflection to guide the data collection. We then analysed the data through an inductive, reflexive thematic analysis. RESULTS A common thread through our reflections was the concept of 'sharing'. Although co-production is inherently shared, we used the virtuous cycle to illustrate a sequence of sharing concepts during the research cycle, which provides the underpinnings of positive co-production outcomes. We identified six themes to denote the iterative process of a shared approach within the virtuous cycle: shared values, shared understanding, shared power, shared responsibilities, shared ownership and positive outcomes. CONCLUSION Our results present a virtuous cycle of co-production, which furthers the conceptual underpinnings of co-production. Through our reflections, we propose that positive co-production outcomes require foundations of shared values and a shared understanding of co-production as a concept. These foundations facilitate a process of shared power, shared responsibilities and shared ownership. We argue that when these elements are present in a co-production exercise, there is a greater potential for implementable outcomes in the communities in which the research serves and the empowerment of collaborators involved in the co-production process. PUBLIC MEMBERS' CONTRIBUTIONS Three members of the public who are public advisors in the NIHR ARC KSS were involved in the priority-setting exercise that informed this paper. The public advisors were involved in the design of the priority-setting exercise and supported participants' recruitment. They also co-facilitated the focus groups during data collection and were involved in the data analysis, interpretation and preparation of the priority-setting report. For this current manuscript, two of them are co-authors. They provided reflections and contributed to the writing and reviewing of this manuscript.
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Affiliation(s)
- Deborah Ikhile
- Department of Primary Care and Public HealthBrighton and Sussex Medical School, University of SussexBrightonUK
| | - Devyn Glass
- Department of Primary Care and Public HealthBrighton and Sussex Medical School, University of SussexBrightonUK
| | - Kat Frere‐Smith
- Department of Primary Care and Public HealthBrighton and Sussex Medical School, University of SussexBrightonUK
| | - Sam Fraser
- Academic Health Science Network for Kent, Surrey and SussexSurreyUK
| | - Keith Turner
- Primary Care and Community Health Services, NIHR ARC KSS (Applied Research Collaboration Kent, Surrey, and Sussex)SurreyUK
| | - Hasu Ramji
- Primary Care and Community Health Services, NIHR ARC KSS (Applied Research Collaboration Kent, Surrey, and Sussex)SurreyUK
| | - Georgie Gremesty
- National Institute for Health and Care Research Applied Research Collaboration for Kent, Surrey and Sussex (NIHR ARC KSS)SurreyUK
| | - Elizabeth Ford
- Department of Primary Care and Public HealthBrighton and Sussex Medical School, University of SussexBrightonUK
| | - Harm van Marwijk
- Department of Primary Care and Public HealthBrighton and Sussex Medical School, University of SussexBrightonUK
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Bühler F, Leinen A, Schneider-Schelte H, Meyer G, Dichter MN, Köpke S, Wilm S, Bieber A. Exploring stakeholders' perspectives on the adaptation of the Living Lab approach to dementia care: A qualitative study. Geriatr Nurs 2023; 54:184-191. [PMID: 37797546 DOI: 10.1016/j.gerinurse.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/08/2023] [Accepted: 09/08/2023] [Indexed: 10/07/2023]
Abstract
Collaborative research can promote knowledge translation and help to link care practice and research. Academic-practice partnerships enable joint research projects in collaboration between care professionals, researchers, patients, and other stakeholders. This qualitative study was conducted during the adaptation phase of the Living Lab Dementia, an academic-practice partnership for collaborative research on long-term dementia care. The aim was to explore stakeholders' perspectives on linking care practice and research in a sustainable, research-focused partnership. Data were collected in fifteen qualitative interviews with representatives from three stakeholder groups: nursing care professionals, people with dementia, and nursing researchers. Thematic Framework Analysis resulted in five themes: (1) Access, (2) Expectations, (3) Shaping the collaboration, (4) Linking Pins, and (5) Participation. The findings suggest that care professionals expect support in implementing research results into practice. Researchers should take the lead in shaping the collaboration and create opportunities for stakeholders to get involved.
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Affiliation(s)
- Felix Bühler
- Institute for Health and Nursing Science, University Medicine Halle, Medical Faculty of the Martin Luther University Halle-Wittenberg, Magdeburger Strasse 8, Halle (Saale) 06112, Germany.
| | - Andrea Leinen
- Institute of Nursing Science, University of Cologne, Medical Faculty and University Hospital Cologne, Gleueler Strasse 176-178, Cologne 50935, Germany
| | | | - Gabriele Meyer
- Institute for Health and Nursing Science, University Medicine Halle, Medical Faculty of the Martin Luther University Halle-Wittenberg, Magdeburger Strasse 8, Halle (Saale) 06112, Germany
| | - Martin N Dichter
- Institute of Nursing Science, University of Cologne, Medical Faculty and University Hospital Cologne, Gleueler Strasse 176-178, Cologne 50935, Germany
| | - Sascha Köpke
- Institute of Nursing Science, University of Cologne, Medical Faculty and University Hospital Cologne, Gleueler Strasse 176-178, Cologne 50935, Germany
| | - Stefan Wilm
- Institute of General Practice, Heinrich Heine University Düsseldorf, Moorenstrasse 5, Düsseldorf 40225, Germany
| | - Anja Bieber
- Institute for Health and Nursing Science, University Medicine Halle, Medical Faculty of the Martin Luther University Halle-Wittenberg, Magdeburger Strasse 8, Halle (Saale) 06112, Germany
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Munce SE, Steele Gray C, Pomeroy BC, Bayley M, Kokorelias KM, Luong D, Biddiss E, Cave T, Bragge P, Chew-Graham CA, Colquhoun H, Dadich A, Dainty KN, Elliott M, Feng P, Goldhar J, Hamilton CB, Harvey G, Kastner M, Kothari A, Langley J, Jeffs L, Masterson D, Nelson MLA, Perrier L, Riley J, Sellen K, Seto E, Simpson R, Staniszewska S, Srinivasan V, Straus SE, Tricco AC, Kuluski K. Development of the Preferred Components for Co-Design in Research Guideline and Checklist: Protocol for a Scoping Review and a Modified Delphi Process. JMIR Res Protoc 2023; 12:e50463. [PMID: 37902812 PMCID: PMC10644195 DOI: 10.2196/50463] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 07/17/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND There is increasing evidence that co-design can lead to more engaging, acceptable, relevant, feasible, and even effective interventions. However, no guidance is provided on the specific designs and associated methods or methodologies involved in the process. We propose the development of the Preferred Components for Co-design in Research (PRECISE) guideline to enhance the consistency, transparency, and quality of reporting co-design studies used to develop complex health interventions. OBJECTIVE The aim is to develop the first iteration of the PRECISE guideline. The purpose of the PRECISE guideline is to improve the consistency, transparency, and quality of reporting on studies that use co-design to develop complex health interventions. METHODS The aim will be achieved by addressing the following objectives: to review and synthesize the literature on the models, theories, and frameworks used in the co-design of complex health interventions to identify their common elements (components, values or principles, associated methods and methodologies, and outcomes); and by using the results of the scoping review, prioritize the co-design components, values or principles, associated methods and methodologies, and outcomes to be included in the PRECISE guideline. RESULTS The project has been funded by the Canadian Institutes of Health Research. CONCLUSIONS The collective results of this project will lead to a ready-to-implement PRECISE guideline that outlines a minimum set of items to include when reporting the co-design of complex health interventions. The PRECISE guideline will improve the consistency, transparency, and quality of reports of studies. Additionally, it will include guidance on how to enact or enable the values or principles of co-design for meaningful and collaborative solutions (interventions). PRECISE might also be used by peer reviewers and editors to improve the review of manuscripts involving co-design. Ultimately, the PRECISE guideline will facilitate more efficient use of new results about complex health intervention development and bring better returns on research investments. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/50463.
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Affiliation(s)
- Sarah Ep Munce
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Carolyn Steele Gray
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | | | - Mark Bayley
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kristina Marie Kokorelias
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Sinai Health and University Health Network, Geriatrics, Toronto, ON, Canada
| | - Dorothy Luong
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Elaine Biddiss
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | | | - Peter Bragge
- Monash Sustainable Development Institute Evidence Review Service, BehaviourWorks Australia, Monash University, Clayton Campus, Melbourne, Victoria, Australia
| | - Carolyn A Chew-Graham
- School of Medicine, Faculty of Medicine and Health Sciences, Keele University, Newcastle, United Kingdom
| | - Heather Colquhoun
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ann Dadich
- School of Business, Western Sydney University, Sydney, Australia
| | - Katie N Dainty
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- North York General Hospital, Toronto, ON, Canada
| | | | - Patrick Feng
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Ontario College of Art & Design University, Toronto, ON, Canada
| | - Jodeme Goldhar
- International Foundation for Integrated Care, Toronto, ON, Canada
| | - Clayon B Hamilton
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
| | - Gillian Harvey
- Design Studies, Department of Art & Design, University of Alberta, Edmonton, AB, Canada
| | - Monika Kastner
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- North York General Hospital, Toronto, ON, Canada
| | - Anita Kothari
- School of Health Studies, Western University, London, ON, Canada
| | - Joe Langley
- Lab4Living, Sheffield Hallam University, Sheffield, United Kingdom
| | - Lianne Jeffs
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | - Daniel Masterson
- Jönköping Academy for Improvement of Health and Welfare Sweden, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Michelle LA Nelson
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | - Laure Perrier
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - John Riley
- Ontario Strategy for Patient-Oriented Research SUPPORT Unit, Toronto, ON, Canada
| | - Kate Sellen
- Ontario College of Art & Design University, Toronto, ON, Canada
| | - Emily Seto
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Centre for Digital Therapeutics, University Health Network, Toronto, ON, Canada
| | - Robert Simpson
- Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Health and Wellbeing, University of Glasgow, Scotland, United Kingdom
| | - Sophie Staniszewska
- Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Vasanthi Srinivasan
- Ontario Strategy for Patient-Oriented Research SUPPORT Unit, Toronto, ON, Canada
| | - Sharon E Straus
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Li Ka Shing Institute of St. Michael's Hospital, Unity Health, Toronto, ON, Canada
| | - Andrea C Tricco
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Li Ka Shing Institute of St. Michael's Hospital, Unity Health, Toronto, ON, Canada
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Queen's University School of Nursing, Queen's University, Kingston, ON, Canada
| | - Kerry Kuluski
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
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Cazzolli R, Sluiter A, Guha C, Huuskes B, Wong G, Craig JC, Jaure A, Scholes-Robertson N. Partnering with patients and caregivers to enrich research and care in kidney disease: values and strategies. Clin Kidney J 2023; 16:i57-i68. [PMID: 37711636 PMCID: PMC10497378 DOI: 10.1093/ckj/sfad063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Indexed: 09/16/2023] Open
Abstract
Patient and caregiver involvement broadens the scope of new knowledge generated from research and can enhance the relevance, quality and impact of research on clinical practice and health outcomes. Incorporating the perspectives of people with lived experience of chronic kidney disease (CKD) affords new insights into the design of interventions, study methodology, data analysis and implementation and has value for patients, healthcare professionals and researchers alike. However, patient involvement in CKD research has been limited and data on which to inform best practice is scarce. A number of frameworks have been developed for involving patients and caregivers in research in CKD and in health research more broadly. These frameworks provide an overall conceptual structure to guide the planning and implementation of research partnerships and describe values that are essential and strategies considered best practice when working with diverse stakeholder groups. This article aims to provide a summary of the strategies most widely used to support multistakeholder partnerships, the different ways patients and caregivers can be involved in research and the methods used to amalgamate diverse and at times conflicting points of view.
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Affiliation(s)
- Rosanna Cazzolli
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Amanda Sluiter
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Chandana Guha
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Brooke Huuskes
- Centre for Cardiovascular Biology and Disease Research, School of Agriculture, Biomedicine and Environment, La Trobe University, Melbourne, VIC, Australia
| | - Germaine Wong
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Jonathan C Craig
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Allison Jaure
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Nicole Scholes-Robertson
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
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Albert A, Islam S, Haklay M, McEachan RRC. Nothing about us without us: A co-production strategy for communities, researchers and stakeholders to identify ways of improving health and reducing inequalities. Health Expect 2023; 26:836-846. [PMID: 36683204 PMCID: PMC10010091 DOI: 10.1111/hex.13709] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/03/2023] [Accepted: 01/07/2023] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION Co-production with communities is increasingly seen as best practice that can improve the quality, relevance and effectiveness of research and service delivery. Despite this promising position, there remains uncertainty around definitions of co-production and how to operationalize it. The current paper describes the development of a co-production strategy to guide the work of the ActEarly multistakeholder preventative research programme to improve children's health in Bradford and Tower Hamlets, UK. METHODS The strategy used Appreciative Inquiry (AI), an approach following a five-step iterative process: to define (Step 1) scope and guide progress; to discover (Step 2) key issues through seven focus groups (N = 36) and eight in-depth interviews with key stakeholders representing community groups, and the voluntary and statutory sectors; to dream (Step 3) best practice through two workshops with AI participants to review findings; to design (Step 4) a co-production strategy building on AI findings and to deliver (Step 5) the practical guidance in the strategy. RESULTS Nine principles for how to do co-production well were identified: power should be shared; embrace a wide range of perspectives and skills; respect and value the lived experience; benefits should be for all involved parties; go to communities and do not expect them to come to you; work flexibly; avoid jargon and ensure availability of the right information; relationships should be built for the long-term; co-production activities should be adequately resourced. These principles were based on three underlying values of equality, reciprocity and agency. CONCLUSION The empirical insights of the paper highlight the crucial importance of adequate resources and infrastructure to deliver effective co-production. This documentation of one approach to operationalizing co-production serves to avert any misappropriations of the term 'co-production' by listening to service users, stakeholders and other relevant groups, to develop trust and long-term relationships, and build on the learning that already exists amongst such groups. PATIENT OR PUBLIC CONTRIBUTION The work was overseen by a steering group (N = 17) of individuals, both professional and members of the public with experience in undertaking co-production, and/or with some knowledge of the context of the two ActEarly field sites, who provided regular oversight and feedback on the AI process.
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Affiliation(s)
- Alexandra Albert
- Extreme Citizen Science Research Group, Geography Department, University College London, London, UK
| | - Shahid Islam
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Muki Haklay
- Extreme Citizen Science Research Group, Geography Department, University College London, London, UK
| | - Rosemary R C McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
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Zarshenas S, Mosel J, Chui A, Seaton S, Singh H, Moroz S, Khan T, Colquhoun H. Supporting patient and public partners in writing lay summaries of scientific evidence in healthcare: a scoping review protocol. BMJ Open 2022; 12:e062981. [PMID: 36517104 PMCID: PMC9756171 DOI: 10.1136/bmjopen-2022-062981] [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] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Despite growing interest among patient and public partners to engage in writing lay summaries, evidence is scarce regarding the availability of resources to support them. This protocol describes the process of conducting a scoping review to: (1) summarise the source, criteria and characteristics, content, format, intended target audience, patient and public involvement in preparing guidance and development processes in the available guidance for writing lay summaries; (2) contextualise the available guidance to the needs/preferences of patient and public partners and (3) create a patient and public partner-informed output to support their engagement in writing lay summaries. METHOD AND ANALYSIS A scoping review with an integrated knowledge translation approach will be used to ensure the collaboration between patient/public partners and researchers in all steps of the review. To meet objective 1, the English language evidence within a healthcare context that provides guidance for writing lay summaries will be searched in peer-reviewed publications and grey literature. All screening and extraction steps will be performed independently by two reviewers. Extracted data will be organised by adapting the European Union's principles for summaries of clinical trials for laypersons. For objectives 2 and 3, a consultation exercise will be held with patient and public partners to review and contextualise the findings from objective 1. A directed content analysis will be used to organise the data to the needs of the public audience. Output development will follow based on the results. ETHICS AND DISSEMINATION Ethics approval will be obtained for the consultation exercise. Our target audience will be stakeholders who engage or are interested in writing lay summaries. Our dissemination products will include a manuscript, a lay summary and an output to support patient and public partners with writing lay summaries. Findings will be published in a peer-reviewed journal and presented at relevant conferences. OPEN SCIENCE FRAMEWORK REGISTRATION: osf.io/2dvfg.
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Affiliation(s)
- Sareh Zarshenas
- Occupational Science and Occupational Therapy Department, University of Toronto, Toronto, Ontario, Canada
| | - JoAnne Mosel
- Strategy for Patient-Oriented Research-Evidence Alliance, Toronto, Ontario, Canada
| | - Adora Chui
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Samantha Seaton
- Occupational Science and Occupational Therapy Department, University of Toronto, Toronto, Ontario, Canada
| | - Hardeep Singh
- Occupational Science and Occupational Therapy Department, University of Toronto, Toronto, Ontario, Canada
| | - Sandra Moroz
- Strategy for Patient-Oriented Research-Evidence Alliance, Toronto, Ontario, Canada
| | - Tayaba Khan
- Strategy for Patient-Oriented Research-Evidence Alliance, Toronto, Ontario, Canada
| | - Heather Colquhoun
- Occupational Science and Occupational Therapy Department, University of Toronto, Toronto, Ontario, Canada
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MacLeod MLP, Leese J, Garraway L, Oelke ND, Munro S, Bailey S, Hoens AM, Loo S, Valdovinos A, Wick U, Zimmer P, Li LC. Engaging with patients in research on knowledge translation/implementation science methods: a self study. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:41. [PMID: 35941661 PMCID: PMC9358643 DOI: 10.1186/s40900-022-00375-5] [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: 02/05/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND In 2017, the British Columbia (Canada) SUPPORT (SUpport for People and Patient-Oriented Research) Unit created six methods clusters to advance methodologies in patient and public oriented research (POR). The knowledge translation (KT)/implementation science methods cluster identified that although there was guidance about how to involve patients and public members in POR research generally, little was known about how best to involve patients and public members on teams specifically exploring POR KT/implementation science methodologies. The purpose of this self-study was to explore what it means to engage patients and the public in studies of POR methods through the reflections of members of five KT/implementation science teams. METHODS Informed by a collaborative action research approach, this quality improvement self-study focused on reflection within four KT/implementation science research teams in 2020-2021. The self-study included two rounds of individual interviews with 18 members across four teams. Qualitative data were analyzed using a thematic analysis approach followed by a structured discussion of preliminary findings with the research teams. Subsequently, through two small group discussion sessions, the patients/public members from the teams refined the findings. RESULTS Undertaking research on POR KT/implementation science methodologies typically requires teams to work with the uncertainty of exploratory and processual research approaches, make good matches between patients/public members and the team, work intentionally yet flexibly, and be attuned to the external context and its influences on the team. POR methodological research teams need to consider that patients/public members bring their life experiences and world views to the research project. They become researchers in their own right. Individual and team reflection allows teams to become aware of team needs, acknowledge team members' vulnerabilities, gain greater sensitivity, and enhance communication. CONCLUSIONS The iterative self-study process provided research team members with opportunities for reflection and new understanding. Working with patients/public team members as co-researchers opens up new ways of understanding important aspects of research methodologies, which may influence future KT/implementation science research approaches.
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Affiliation(s)
- Martha L. P. MacLeod
- School of Nursing, University of Northern British Columbia, 3333 University Way, Prince George, BC V2N 4Z9 Canada
| | - Jenny Leese
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Centre for Implementation Research, The Ottawa Hospital Research Institute, Ottawa, Canada
- Arthritis Research Canada, Vancouver, BC Canada
| | - Leana Garraway
- Health Research Institute, University of Northern British Columbia, Prince George, BC Canada
| | - Nelly D. Oelke
- School of Nursing, University of British Columbia, Okanagan, Kelowna, BC Canada
- Rural Coordination Centre of BC, Vancouver, BC Canada
| | - Sarah Munro
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC Canada
- Centre for Health Evaluation and Outcome Sciences, Vancouver, BC Canada
| | - Sacha Bailey
- BC Centre for Ability, Vancouver, BC Canada
- Centre for Research on Children and Families, Montreal, QC Canada
| | - Alison M. Hoens
- Arthritis Research Canada, Vancouver, BC Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, BC Canada
| | - Sunny Loo
- Patient Partner, Michael Smith Health Research BC, PaCER Certified, University of Calgary, Calgary, AB Canada
| | - Ana Valdovinos
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC Canada
| | - Ursula Wick
- University of British Columbia, Okanagan, Kelowna, BC Canada
| | - Peter Zimmer
- University of Northern British Columbia, Prince George, BC Canada
| | - Linda C. Li
- Arthritis Research Canada, Vancouver, BC Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, BC Canada
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Etherington C, Lê M, Proulx L, Boet S. Bringing the patient voice into the operating room: engaging patients in surgical safety research with the Operating Room Black Box ®. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:32. [PMID: 35871038 PMCID: PMC9308267 DOI: 10.1186/s40900-022-00367-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 07/12/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Surgery is one of the most common patient experiences in the health care system. Yet, efforts to engage patients in surgical safety research have not matched those of other health care fields. This is a critical issue given the nature of surgery inhibits patients' abilities to advocate for themselves as they are typically under anesthetic when the procedure is performed. We partnered with patients throughout our research program, which uses the Operating Room Black Box® to enhance surgical patient safety through transparent and proactive analysis of human factors to detect and prevent avoidable errors. MAIN BODY In this article, we outline the need for, and our approach to, patient engagement in surgical safety research. Our approach included a series of planned activities and skill development opportunities designed to build capacity and bring together patients, clinicians, and researchers to inform research and practice. We also conducted evaluation surveys during the first year of our program, which have indicated a positive experience by both patient partners and the research team. CONCLUSION We believe our approach can serve as an important first step toward building a model for patient engagement in the surgical safety field and could significantly contribute to improved quality of care and outcomes for surgical patients.
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Affiliation(s)
- Cole Etherington
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Canada
| | | | - Laurie Proulx
- The Ottawa Hospital, Ottawa, Canada
- Canadian Arthritis Patient Alliance, Ottawa, Canada
| | - Sylvain Boet
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.
- Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Canada.
- Department of Innovation in Medical Education, University of Ottawa, Ottawa, Canada.
- Francophone Affairs, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
- Institute du Savoir Monfort, Ottawa, ON, Canada.
- Faculty of Education, University of Ottawa, Ottawa, ON, Canada.
- Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, University of Ottawa, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.
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Meinders MJ, Donnelly AC, Sheehan M, Bloem BR. Including People with Parkinson’s Disease in Clinical Study Design and Execution: A Call to Action. JOURNAL OF PARKINSON'S DISEASE 2022; 12:1359-1363. [PMID: 35404289 PMCID: PMC9198722 DOI: 10.3233/jpd-223190] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The proactive inclusion of patients in the design and execution of clinical studies has been an emerging focus for decades. Such participatory research helps to design studies better, by addressing relevant research questions and defining outcomes that matter to patients. Yet, much remains to be learned about the best methods and exact impacts of patient engagement in research in general, and more specifically, about the specific challenges that come with Parkinson’s disease. Here we present the lived experiences of patient researchers living with Parkinson’s disease, as a motivation for the value of their perspectives in research and as a call to action for empirical research on how to successfully include patient researchers.
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Affiliation(s)
- Marjan J. Meinders
- Center of Expertise for Parkinson & Movement Disorders, Department of Neurology, Radboud University Medical Center, Nijmegen, the Netherlands
- Scientific Centre for Quality of Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Anne C. Donnelly
- The Michael J. Fox Foundation for Parkinson’s Research, Patient Council, New York, NY, USA
| | - Margaret Sheehan
- The Michael J. Fox Foundation for Parkinson’s Research, Patient Council, New York, NY, USA
| | - Bastiaan R. Bloem
- Center of Expertise for Parkinson & Movement Disorders, Department of Neurology, Radboud University Medical Center, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
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Operationalizing Stakeholder Engagement Through the Stakeholder-Centric Engagement Charter (SCEC). J Gen Intern Med 2022; 37:105-108. [PMID: 35349021 PMCID: PMC8994015 DOI: 10.1007/s11606-021-07029-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 07/08/2021] [Indexed: 11/17/2022]
Abstract
There is a need for clear strategies and procedures to operationalize stakeholder engagement in research studies. Clear guidelines that promote shared leadership among study investigators and research stakeholders are important for inclusive and sustainable partnerships. Such guidelines may take the form of a governance charter and can be a means for encouraging the participation and inclusion of stakeholders who may have little to no experience with research or are otherwise underrepresented in research. This perspective article presents the Stakeholder-Centric Engagement Charter (SCEC), one effort to operationalize a stakeholder engagement approach between researchers and an advisory committee as guided by the Patient-Centered Outcomes Research Institute's (PCORI) Research Engagement Principles (i.e., reciprocal relationships, partnerships, co-learning, transparency-honesty-trust). Building on the SCEC can help future investigators develop a study-specific, dynamic, governance document outlining advisory committee and research team preferences in areas such as role expectations, study governance, and decision-making procedures.
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Hurley SL, DeSanto-Madeya S, Fortney CA, Izumi S, Phongtankuel V, Carpenter JG. Building Strong Clinician-Researcher Collaborations for Successful Hospice and Palliative Care Research. J Hosp Palliat Nurs 2022; 24:64-69. [PMID: 34873127 PMCID: PMC8720061 DOI: 10.1097/njh.0000000000000818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Hospice and palliative care research aim to build a knowledge base to guide high-quality care for people with serious illness and improve their quality of life. Considering its focus on patient and family caregiver's experiences, hospice and palliative care research activities primarily take place in real-world clinical settings where seriously ill patients and their family caregivers receive care (eg, nursing homes, clinics, inpatient units). Conducting research in these settings poses many challenges because researchers, clinicians, and administrators may have different priorities-and scientific control is difficult. Therefore, clinician-researcher-administrator collaboration in planning and conducting studies is critical for successful hospice and palliative care research. For an effective collaboration, clinicians, researchers, and site administrators must be considered equal partners. Each collaborator brings their unique expertise, knowledge, and skills that when combined can strengthen scientific rigor, feasibility, and success of the project, as well as have study outcomes that are more translatable to real-world practice. However, little guidance exists to give actionable steps to build collaborative partnerships for hospice and palliative care researchers. The purpose of this article is to describe the process of forming successful clinician-researcher-administrator collaborations through five phases of the research life cycle: idea generation, partnership, proposal writing, research process, and dissemination. Exemplars are drawn from the authors' experiences conducting collaborative research and highlight strategies and resources for successful hospice and palliative care collaborations.
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Hlyva O, Rae C, Deibert S, Kamran R, Shaikh H, Thabane L, Rosenbaum P, Klassen A, Lim A. A Mixed-Methods Feasibility Study of Integrated Pediatric Complex Care: Experiences of Parents With Care and the Value of Parent Engagement in Research. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:710335. [PMID: 36188846 PMCID: PMC9397898 DOI: 10.3389/fresc.2021.710335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 09/15/2021] [Indexed: 11/13/2022]
Abstract
Introduction: Children with medical complexity (CMC) are among the most vulnerable children in society. These children and their families face challenges of fragmented care and are at risk for poorer health outcomes. Families with CMC play a vital role in providing care and navigating the complexities of healthcare systems. It is essential to understand the best ways to engage these families in research to improve the care and optimize the health of CMC.Objectives: This study explored parent engagement within the context of a feasibility study evaluating an Integrated Tertiary Complex Care (ITCC) clinic created to support CMC closer to home. This paper aimed: (1) to understand the family experiences of care and (2) to explore parent engagement in the study.Method: This mixed-methods feasibility study included three components. First, feedback from focus groups was used to identify the common themes that informed interviews with parents. Second, one-on-one interviews were conducted with parents to explore their experience with care, such as the ITCC clinic, using an interpretative description approach. Third, the questionnaires were completed by parents at baseline and 6-months post-baseline. These questionnaires included demographic and cost information and three validated scales designed to measure the caregiver strain, family-centered care, and parental health. The recruitment rate, percentage completion of the questionnaires, and open-ended comments were used to assess parent engagement in the study.Results: The focus groups involved 24 parents, of which 19 (14 women, five men) provided comments. The findings identified the importance of Complex Care Team (CC Team) accessibility, local access, and family-centered approach to care. The challenges noted were access to homecare nursing, fatigue, and lack of respite affecting caregiver well-being. In this study, 17 parents participated in one-on-one interviews. The identified themes relevant to care experience were proximity, continuity, and coordination of care. The parents who received care through the ITCC clinic appreciated receiving care closer to home. The baseline questionnaires were completed by 44 of 77 (57%) eligible parents. Only 24 (31%) completed the 6-month questionnaire. The challenges with study recruitment and follow-up were identified.Conclusion: Family engagement was a challenging yet necessary endeavor to understand how to tailor the healthcare to meet the complex needs of families caring for CMC.
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Affiliation(s)
- Oksana Hlyva
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Charlene Rae
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Shelby Deibert
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Rakhshan Kamran
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Haniah Shaikh
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Lehana Thabane
- Department of Health, Research Methods, Evidence & Impact, McMaster University, Hamilton, ON, Canada
| | - Peter Rosenbaum
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Anne Klassen
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Audrey Lim
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
- *Correspondence: Audrey Lim
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Tivey A, Huddar P, Shotton R, Cheese I, Daniels S, Lorigan P, J Lee R. Patient engagement in melanoma research: from bench to bedside. Future Oncol 2021; 17:3705-3716. [PMID: 34213356 DOI: 10.2217/fon-2020-1165] [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] [Indexed: 11/21/2022] Open
Abstract
Advances in research have transformed the management of melanoma in the past decade. In parallel, patient advocacy has gained traction, and funders are increasingly prioritizing patient and public involvement. Here we discuss the ways in which patients and the public can be engaged in different stages of the research process, from developing, prioritizing and refining the research question to preclinical studies and clinical trials, then finally to ongoing research in the clinic. We discuss the challenges and opportunities that exist at each stage in order to ensure that a representative population of patients and the public contribute to melanoma research both now and in the future.
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Affiliation(s)
- Ann Tivey
- The Christie NHS Foundation Trust, Wilmslow Road, M20 4BX, UK
- Melanoma Focus, Queen Anne House, Gonville Place, Cambridge, CB1 1ND, UK
| | - Prerana Huddar
- The Christie NHS Foundation Trust, Wilmslow Road, M20 4BX, UK
| | - Rohan Shotton
- The Christie NHS Foundation Trust, Wilmslow Road, M20 4BX, UK
| | - Imogen Cheese
- Division of Cancer Sciences, The University of Manchester, Oxford Road, M13 9PL, UK
- Melanoma Patient Conference, Willow Bank, Prince Crescent, Staunton, Gloucestershire, GL19 3RF, UK
| | - Susanna Daniels
- Melanoma Patient Conference, Willow Bank, Prince Crescent, Staunton, Gloucestershire, GL19 3RF, UK
- Patient Author
| | - Paul Lorigan
- The Christie NHS Foundation Trust, Wilmslow Road, M20 4BX, UK
- Melanoma Focus, Queen Anne House, Gonville Place, Cambridge, CB1 1ND, UK
| | - Rebecca J Lee
- The Christie NHS Foundation Trust, Wilmslow Road, M20 4BX, UK
- Melanoma Focus, Queen Anne House, Gonville Place, Cambridge, CB1 1ND, UK
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Naarding KJ, Doorenweerd N, Koeks Z, Hendriksen RGF, Chotkan KA, Krom YD, de Groot IJM, Straathof CS, Niks EH, Kan HE. Decision-Making And Selection Bias in Four Observational Studies on Duchenne and Becker Muscular Dystrophy. J Neuromuscul Dis 2021; 7:433-442. [PMID: 32925089 PMCID: PMC7902964 DOI: 10.3233/jnd-200541] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Natural history data are essential for trial design in Duchenne (DMD) and Becker muscular dystrophy (BMD), but recruitment for observational studies can be challenging. OBJECTIVE We reviewed reasons why patients or caregivers declined participation, and compared characteristics of participants and non-participants to assess possible selection bias in four observational studies, three on DMD and one on BMD. METHODS Three pediatric DMD studies focused on cross-sectional cognitive function and brain MRI (DMDbrain, n = 35 and DMDperfusion, n = 12), and on longitudinal upper extremity function and muscle MRI (DMDarm, n = 22). One adult BMD study assessed longitudinal functioning (n = 36). Considerations for non-participation were retrospectively reviewed from screening logs. Age, travel-time, DMD gene mutations and age at loss of ambulation (DMDarm and BMD study only), of participants and non-participants were derived from the Dutch Dystrophinopathy Database and compared using nonparametric tests (p < 0.05). RESULTS The perceived burden of the protocol (38.2%), use of MRI (30.4%), and travel-time to the study site (19.1%) were the most frequently reported considerations for non-participation. Only few patients reported lack of personal gain (0.0- 5.9%). Overall, participating patients were representative for the studied sub-populations, except for a younger age of DMDarm study participants and a complete lack of participants with a mutation beyond exon 63. CONCLUSION Optimizing patient involvement in protocol design, improving MRI experiences, and integrating research into clinics are important factors to decrease burden and facilitate participation. Nationwide registries are essential to compare participants and non-participants and ensure representative observational research. Specific effort is needed to include patients with distal mutations in cognitive studies.
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Affiliation(s)
- Karin J Naarding
- Department of Neurology, Leiden University Medical Center (LUMC), Leiden, Netherlands.,Duchenne Center Netherlands
| | - Nathalie Doorenweerd
- C.J. Gorter Center for High Field MRI, Department of Radiology, LUMC, Leiden, Netherlands.,John Walton Muscular Dystrophy Research Centre, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Zaïda Koeks
- Department of Neurology, Leiden University Medical Center (LUMC), Leiden, Netherlands
| | - Ruben G F Hendriksen
- C.J. Gorter Center for High Field MRI, Department of Radiology, LUMC, Leiden, Netherlands
| | - Kinita A Chotkan
- Department of Neurology, Leiden University Medical Center (LUMC), Leiden, Netherlands
| | - Yvonne D Krom
- Department of Neurology, Leiden University Medical Center (LUMC), Leiden, Netherlands.,Duchenne Center Netherlands
| | - Imelda J M de Groot
- Duchenne Center Netherlands.,Department of Rehabilitation, Radboud University Medical Center, Nijmegen, Netherlands
| | - Chiara S Straathof
- Department of Neurology, Leiden University Medical Center (LUMC), Leiden, Netherlands
| | - Erik H Niks
- Department of Neurology, Leiden University Medical Center (LUMC), Leiden, Netherlands.,Duchenne Center Netherlands
| | - Hermien E Kan
- Duchenne Center Netherlands.,C.J. Gorter Center for High Field MRI, Department of Radiology, LUMC, Leiden, Netherlands
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20
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Hoffman A, Crocker L, Mathur A, Holman D, Weston J, Campbell S, Housten A, Bradford A, Agrawala S, Woodard TL. Patients' and Providers' Needs and Preferences When Considering Fertility Preservation Before Cancer Treatment: Decision-Making Needs Assessment. JMIR Form Res 2021; 5:e25083. [PMID: 34096871 PMCID: PMC8218210 DOI: 10.2196/25083] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 02/01/2021] [Accepted: 03/17/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND As cancer treatments continue to improve, it is increasingly important that women of reproductive age have an opportunity to decide whether they want to undergo fertility preservation treatments to try to protect their ability to have a child after cancer. Clinical practice guidelines recommend that providers offer fertility counseling to all young women with cancer; however, as few as 12% of women recall discussing fertility preservation. The long-term goal of this program is to develop an interactive web-based patient decision aid to improve awareness, access, knowledge, and decision making for all young women with cancer. The International Patient Decision Aid Standards collaboration recommends a formal decision-making needs assessment to inform and guide the design of understandable, meaningful, and usable patient decision aid interventions. OBJECTIVE This study aims to assess providers' and survivors' fertility preservation decision-making experiences, unmet needs, and initial design preferences to inform the development of a web-based patient decision aid. METHODS Semistructured interviews and an ad hoc focus group assessed current decision-making experiences, unmet needs, and recommendations for a patient decision aid. Two researchers coded and analyzed the transcripts using NVivo (QSR International). A stakeholder advisory panel guided the study and interpretation of results. RESULTS A total of 51 participants participated in 46 interviews (18 providers and 28 survivors) and 1 ad hoc focus group (7 survivors). The primary themes included the importance of fertility decisions for survivorship, the existence of significant but potentially modifiable barriers to optimal decision making, and a strong support for developing a carefully designed patient decision aid website. Providers reported needing an intervention that could quickly raise awareness and facilitate timely referrals. Survivors reported needing understandable information and help with managing uncertainty, costs, and pressures. Design recommendations included providing tailored information (eg, by age and cancer type), optional interactive features, and multimedia delivery at multiple time points, preferably outside the consultation. CONCLUSIONS Decision making about fertility preservation is an important step in providing high-quality comprehensive cancer care and a priority for many survivors' optimal quality of life. Decision support interventions are needed to address gaps in care and help women quickly navigate toward an informed, values-congruent decision. Survivors and providers support developing a patient decision aid website to make information directly available to women outside of the consultation and to provide self-tailored content according to women's clinical characteristics and their information-seeking and deliberative styles.
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Affiliation(s)
- Aubri Hoffman
- Department of Gynecological Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Laura Crocker
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Aakrati Mathur
- Department of Biostatistics, The University of Texas at Arlington, Arlington, TX, United States
| | - Deborah Holman
- Department of Gynecological Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - June Weston
- Department of Gynecological Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Sukhkamal Campbell
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, United States
| | - Ashley Housten
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Andrea Bradford
- Department of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Shilpi Agrawala
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, United States
| | - Terri L Woodard
- Department of Gynecological Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.,Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, United States
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21
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Combs J, Barzman D, Hemphill R, Osborn A, Sorter M, Decker R. Lessons Learned to Building Stakeholder Engagement during the Initial Stages of Pragmatic Research Development and Implementation. Psychiatr Q 2021; 92:781-791. [PMID: 33057896 DOI: 10.1007/s11126-020-09848-w] [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] [Accepted: 09/17/2020] [Indexed: 02/03/2023]
Abstract
Research does not occur in a vacuum. Effective stakeholder engagement occurs on several levels, including outside influence and cooperation inside the institution. Little guidance around designing and implementing pragmatic mental health research exists. The following paper outlines lessons learned during the initial stages of research design and implementation for a project focused on mental health treatment outcomes.
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Affiliation(s)
- Jennifer Combs
- Cincinnati Children's Hospital and Medical Center, Cincinnati, OH, USA.
- Division of Child and Adolescent Psychiatry, Cincinnati Children's, 3333 Burnet Avenue, MLC 9009, Cincinnati, OH, 45229, USA.
| | - Drew Barzman
- Cincinnati Children's Hospital and Medical Center, Cincinnati, OH, USA
| | - Rosalie Hemphill
- Cincinnati Children's Hospital and Medical Center, Cincinnati, OH, USA
| | - Alexander Osborn
- Cincinnati Children's Hospital and Medical Center, Cincinnati, OH, USA
| | - Michael Sorter
- Cincinnati Children's Hospital and Medical Center, Cincinnati, OH, USA
| | - Reine Decker
- Cincinnati Children's Hospital and Medical Center, Cincinnati, OH, USA
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22
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Torres Roldan VD, Brand-McCarthy SR, Ponce OJ, Belluzzo T, Urtecho M, Espinoza Suarez NR, Toloza FJK, Thota AD, Organick PW, Barrera F, Liu-Sanchez C, Jaladi S, Prokop L, Ozanne EM, Fagerlin A, Hargraves IG, Noseworthy PA, Montori VM, Brito JP. Shared Decision Making Tools for People Facing Stroke Prevention Strategies in Atrial Fibrillation: A Systematic Review and Environmental Scan. Med Decis Making 2021; 41:540-549. [PMID: 33896270 PMCID: PMC8191170 DOI: 10.1177/0272989x211005655] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Shared decision making (SDM) tools can help implement guideline recommendations for patients with atrial fibrillation (AF) considering stroke prevention strategies. We sought to characterize all available SDM tools for this purpose and examine their quality and clinical impact. METHODS We searched through multiple bibliographic databases, social media, and an SDM tool repository from inception to May 2020 and contacted authors of identified SDM tools. Eligible tools had to offer information about warfarin and ≥1 direct oral anticoagulant. We extracted tool characteristics, assessed their adherence to the International Patient Decision Aids Standards, and obtained information about their efficacy in promoting SDM. RESULTS We found 14 SDM tools. Most tools provided up-to-date information about the options, but very few included practical considerations (e.g., out-of-pocket cost). Five of these SDM tools, all used by patients prior to the encounter, were tested in trials at high risk of bias and were found to produce small improvements in patient knowledge and reductions in decisional conflict. CONCLUSION Several SDM tools for stroke prevention in AF are available, but whether they promote high-quality SDM is yet to be known. The implementation of guidelines for SDM in this context requires user-centered development and evaluation of SDM tools that can effectively promote high-quality SDM and improve stroke prevention in patients with AF.
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Affiliation(s)
- Victor D Torres Roldan
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Sarah R Brand-McCarthy
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA.,Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Oscar J Ponce
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Tereza Belluzzo
- General Medicine, Charles University in Prague, Medical Faculty of Hradec Králové, Hradec Kralove, Czech Republic
| | - Meritxell Urtecho
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Nataly R Espinoza Suarez
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Freddy J K Toloza
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Anjali D Thota
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Paige W Organick
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Francisco Barrera
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA.,Plataforma INVEST Medicina UANL-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | | | - Soumya Jaladi
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Larry Prokop
- Department of Library-Public Services, Mayo Clinic, Rochester MN, USA
| | - Elissa M Ozanne
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Angela Fagerlin
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.,Salt Lake City VA Informatics Decision-Enhancement and Analytic Sciences (IDEAS) Center for Innovation
| | - Ian G Hargraves
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Peter A Noseworthy
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA.,Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Victor M Montori
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Juan P Brito
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
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23
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Boutin D, Mastine SC, Beaubien L, Berthiaume M, Boilard D, Borja J, Botton E, Boulianne-Gref J, Breton S, Castellano CA, Charpentier G, Counil FP, Cozmano MJ, Dagenais P, Drouin G, Fortier MJ, Francoeur C, Gagné L, Héraud D, Hêtu D, Houde MP, Ladouceur G, Landry M, Leblanc E, Loignon C, Lussier V, Morin A, Ouellet N, Quintin C, Ramnarine A, Wilhelmy C, Svotelis A, Thibault MÈ, Fraser WD, Battista MC. Patient-partner engagement at the Centre de recherche du CHUS in the Province of Québec, Canada: from an intuitive methodology to outreach after three years of implementation. RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:15. [PMID: 33726817 PMCID: PMC7962081 DOI: 10.1186/s40900-021-00258-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 03/03/2021] [Indexed: 05/31/2023]
Abstract
BACKGROUND Medical societies and funding agencies strongly recommend that patients be included as partners in research publications and grant applications. Although this "top-down" approach is certainly efficient at forcing this new and desirable type of collaboration, our past experience demonstrated that it often results in an ambiguous relationship as not yet well integrated into the cultures of either patients' or the researchers'. The question our group raised from this observation was: "How to generate a cultural shift toward a fruitful and long-lasting collaboration between patients and researchers? A "bottom-up" approach was key to our stakeholders. The overall objective was to build a trusting and bidirectional-ecosystem between patients and researchers. The specific objectives were to document: 1) the steps that led to the development of the first patient-partner strategic committee within a research center in the Province of Québec; 2) the committee's achievements after 3 years. METHODS Eighteen volunteer members, 12 patient-partners and 6 clinician/institutional representatives, were invited to represent the six research themes of the Centre de recherche du CHU de Sherbrooke (CRCHUS) (Quebec, Canada). Information on the services offered by Committee was disseminated internally and to external partners. Committee members satisfaction was evaluated. RESULTS From May 2017 to April 2020, members attended 29 scheduled and 6 ad hoc meetings and contributed to activities requiring over 1000 h of volunteer time in 2018-2019 and 1907 h in the 2019-2020 period. The Committee's implication spanned governance, expertise, and knowledge transfer in research. Participation in these activities increased annually at local, provincial, national and international levels. The Patient-Partner Committee collaborated with various local (n = 7), provincial (n = 6) and national (n = 4) partners. Member satisfaction with the Committee's mandate and format was 100%. CONCLUSIONS The CRCHUS co-constructed a Patient-Partner Strategic Committee which resulted in meaningful bilateral, trusting and fruitful collaborations between patients, researchers and partners. The "bottom-up" approach - envisioned and implemented by the Committee, where the expertise and the needs of patients complemented those of researchers, foundations, networks and decision-makers - is key to the success of a cultural shift. The CRCHUS Committee created a hub to develop the relevant intrinsic potential aimed at changing the socio-cultural environment of science.
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Affiliation(s)
- Denis Boutin
- Centre de recherche du CHUS, Sherbrooke, Québec, Canada
| | | | - Luc Beaubien
- Centre de recherche du CHUS, Sherbrooke, Québec, Canada
| | - Maryse Berthiaume
- Centre de recherche du CHUS, Sherbrooke, Québec, Canada
- Direction de la coordination de la mission universitaire, Centre Intégré Universitaire de Santé et des Services Sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | | | - Jaime Borja
- Centre de recherche du CHUS, Sherbrooke, Québec, Canada
| | | | | | - Sylvie Breton
- Centre de recherche du CHUS, Sherbrooke, Québec, Canada
| | | | | | - Francois-Pierre Counil
- Centre de recherche du CHUS, Sherbrooke, Québec, Canada
- Department of Pediatrics, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | | | - Pierre Dagenais
- Centre de recherche du CHUS, Sherbrooke, Québec, Canada
- Department of Medicine, Rheumatology Division, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Guy Drouin
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | | | - Caroline Francoeur
- Direction de la coordination de la mission universitaire, Centre Intégré Universitaire de Santé et des Services Sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Louise Gagné
- Centre de recherche du CHUS, Sherbrooke, Québec, Canada
| | - David Héraud
- Centre de recherche du CHUS, Sherbrooke, Québec, Canada
| | - Denise Hêtu
- Centre de recherche du CHUS, Sherbrooke, Québec, Canada
| | | | | | - Marjolaine Landry
- Centre de recherche du CHUS, Sherbrooke, Québec, Canada
- Department of Nursing, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Elisabeth Leblanc
- Centre de recherche du CHUS, Sherbrooke, Québec, Canada
- Department of Surgery, Orthopedics Division, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Christine Loignon
- Centre de recherche du CHUS, Sherbrooke, Québec, Canada
- Centre de recherche - Charles-Le Moyne - Saguenay - Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Québec, Canada
- Department of Emergency and Family Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Valéry Lussier
- Direction de la coordination de la mission universitaire, Centre Intégré Universitaire de Santé et des Services Sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Annie Morin
- Centre de recherche du CHUS, Sherbrooke, Québec, Canada
| | | | | | | | | | - Amy Svotelis
- Centre de recherche du CHUS, Sherbrooke, Québec, Canada
| | | | - William D Fraser
- Centre de recherche du CHUS, Sherbrooke, Québec, Canada
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Marie-Claude Battista
- Centre de recherche du CHUS, Sherbrooke, Québec, Canada.
- Department of Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Québec, J1H 5N4, Canada.
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Madden JM, Foxworth PM, Ross-Degnan D, Allen KG, Busch AB, Callahan MX, Lu CY, Wharam JF. Integrating Stakeholder Engagement With Claims-Based Research on Health Insurance Design and Bipolar Disorder. Psychiatr Serv 2021; 72:186-194. [PMID: 33167814 DOI: 10.1176/appi.ps.202000177] [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: 11/30/2022]
Abstract
Researchers increasingly recognize that stakeholder involvement enhances research relevance and validity. However, reports of patient engagement in research that relies on administrative records data are rare. The authors' collaborative project combined quantitative and qualitative studies of costs and access to care among U.S. adults with employer-sponsored insurance. The authors analyzed insurance claims to estimate the impacts on enrollee costs and utilization after patients with bipolar disorder were switched from traditional coverage to high-deductible health plans. In parallel, in-depth interviews explored people's experiences accessing treatment for bipolar disorder. Academic investigators on the research team partnered with the Depression and Bipolar Support Alliance (DBSA), a national advocacy organization for people with mood disorders. Detailed personal stories from DBSA-recruited volunteers informed and complemented the claims analyses. Several DBSA audience forums and a stakeholder advisor panel contributed regular feedback on study issues. These multiple engagement modes drew inputs of varying intensity from diverse community segments. Efforts to include new voices must acknowledge individuals' distinct interests and barriers to research participation. Strong engagement leadership roles ensure productive communication between researchers and stakeholders. The involvement of people with direct experience of care is especially necessary in research that uses secondary data. Longitudinal, adaptable partnerships enable colearning and higher-quality research that captures the manifold dimensions of patient experiences.
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Affiliation(s)
- Jeanne M Madden
- Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston (Madden); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston (Madden, Ross-Degnan, Callahan, Lu, Wharam); Depression and Bipolar Support Alliance, Chicago (Foxworth, Allen); McLean Hospital, Belmont, Massachusetts, and Department of Health Care Policy, Harvard Medical School, Boston (Busch)
| | - Phyllis M Foxworth
- Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston (Madden); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston (Madden, Ross-Degnan, Callahan, Lu, Wharam); Depression and Bipolar Support Alliance, Chicago (Foxworth, Allen); McLean Hospital, Belmont, Massachusetts, and Department of Health Care Policy, Harvard Medical School, Boston (Busch)
| | - Dennis Ross-Degnan
- Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston (Madden); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston (Madden, Ross-Degnan, Callahan, Lu, Wharam); Depression and Bipolar Support Alliance, Chicago (Foxworth, Allen); McLean Hospital, Belmont, Massachusetts, and Department of Health Care Policy, Harvard Medical School, Boston (Busch)
| | - Kimberly G Allen
- Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston (Madden); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston (Madden, Ross-Degnan, Callahan, Lu, Wharam); Depression and Bipolar Support Alliance, Chicago (Foxworth, Allen); McLean Hospital, Belmont, Massachusetts, and Department of Health Care Policy, Harvard Medical School, Boston (Busch)
| | - Alisa B Busch
- Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston (Madden); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston (Madden, Ross-Degnan, Callahan, Lu, Wharam); Depression and Bipolar Support Alliance, Chicago (Foxworth, Allen); McLean Hospital, Belmont, Massachusetts, and Department of Health Care Policy, Harvard Medical School, Boston (Busch)
| | - Matthew X Callahan
- Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston (Madden); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston (Madden, Ross-Degnan, Callahan, Lu, Wharam); Depression and Bipolar Support Alliance, Chicago (Foxworth, Allen); McLean Hospital, Belmont, Massachusetts, and Department of Health Care Policy, Harvard Medical School, Boston (Busch)
| | - Christine Y Lu
- Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston (Madden); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston (Madden, Ross-Degnan, Callahan, Lu, Wharam); Depression and Bipolar Support Alliance, Chicago (Foxworth, Allen); McLean Hospital, Belmont, Massachusetts, and Department of Health Care Policy, Harvard Medical School, Boston (Busch)
| | - James F Wharam
- Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston (Madden); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston (Madden, Ross-Degnan, Callahan, Lu, Wharam); Depression and Bipolar Support Alliance, Chicago (Foxworth, Allen); McLean Hospital, Belmont, Massachusetts, and Department of Health Care Policy, Harvard Medical School, Boston (Busch)
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25
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Robert C, Imbert J, Lajnef M, Noûs C, Cabiran G, Robert S, Cabiran F, Mathieu F. [Production of knowledge using data collected by associations of patients: The fibromyalgia example]. Med Sci (Paris) 2021; 37:81-88. [PMID: 33492223 DOI: 10.1051/medsci/2020269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
To respond to the social challenge of medical knowledge democratisation, numerous initiatives have been developed: information, training or consultation of patients or research applications funded by associations of patients. Only a few numbers of collaborations are initiated by the persons directly involved (patients and relatives) or fulfill association research need. We have adopted and tested such an approach with the French fibromyalgia association (Fibromyalgie France). Our work demonstrates the interest to use data collected by associations of patients to answer to their questioning or to rise further relevant research questions. Such participative approach will have a pertinent and significant impact on the knowledge of diseases and on the development of collaborative actions of research, providing a better answer to patient needs, while being methodologically rigorous.
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Affiliation(s)
- Carole Robert
- Fibromyalgie France, 32 rue de Laghouat, 75018 Paris, France
| | | | - Mohamed Lajnef
- Inserm U955, Institut Mondor de recherches biomédicales, Créteil, France
| | | | - Gilbert Cabiran
- Fibromyalgie France, 32 rue de Laghouat, 75018 Paris, France
| | - Serge Robert
- Fibromyalgie France, 32 rue de Laghouat, 75018 Paris, France
| | | | - Flavie Mathieu
- Mission Associations Recherche & Société de l'Inserm, DISC, 101 rue de Tolbiac, 75013 Paris, France
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26
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Heckert A, Forsythe LP, Carman KL, Frank L, Hemphill R, Elstad EA, Esmail L, Lesch JK. Researchers, patients, and other stakeholders' perspectives on challenges to and strategies for engagement. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:60. [PMID: 33042576 PMCID: PMC7539495 DOI: 10.1186/s40900-020-00227-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 08/04/2020] [Indexed: 05/26/2023]
Abstract
BACKGROUND There is growing interest in patient and stakeholder engagement in research, yet limited evidence about effective methods. Since 2012, the Patient-Centered Outcomes Research Institute (PCORI) has funded patient-centered comparative effectiveness research with a requirement for engaging patients and other stakeholders as research partners in study planning, conduct, and dissemination. This requirement, unique among large healthcare research funders in the US, provides an opportunity to learn about challenges encountered and specific strategies used by PCORI-funded study teams. The primary objective of this study is to describe -- from the perspective of PCORI investigators and research partners-the most common engagement challenges encountered in the first two years of the projects and promising strategies to prevent and overcome these challenges. METHODS Descriptive information about investigators, partners, and their engagement was collected from investigators via annual (N = 235) and mid-year (N = 40) project progress reporting to PCORI, and from their partners (N = 260) via voluntary survey. Qualitative data were analyzed using content and thematic analyses. RESULTS Investigators and partners most often described engagement challenges in three domains: (1) infrastructure to support engagement, (2) building relationships, and (3) maintaining relationships. Infrastructure challenges related to financial and human resources, including funding support and dedicated staff, identifying diverse groups of partners, and partners' logistical needs. Challenges for both building and maintaining relationships encompass a variety of aspects of authentic, positive interactions that facilitate mutual understanding, full participation, and genuine influence on the projects. Strategies to prevent or mitigate engagement challenges also corresponded overall to the same three domains. Both groups typically described strategies more generally, with applicability to a range of challenges rather than specific actions to address only particular challenges. CONCLUSION Meaningful engagement of patients and other stakeholders comes with challenges, as does any innovation in the research process. The challenges and promising practices identified by these investigators and partners, related to engagement infrastructure and the building and maintenance of relationships, reveal actionable areas to improve engagement, including organizational policies and resources, training, new engagement models, and supporting engagement by viewing it as an investment in research uptake and impact.
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Affiliation(s)
- Andrea Heckert
- Present Address, Independent Consultant, Portland, OR USA
- Evaluation & Analysis, Patient-Centered Outcomes Research Institute, 1828 L St NW, Suite 900, Washington, DC 20036 USA
| | - Laura P. Forsythe
- Evaluation & Analysis, Patient-Centered Outcomes Research Institute, 1828 L St NW, Suite 900, Washington, DC 20036 USA
| | - Kristin L. Carman
- Public and Patient Engagement, Patient-Centered Outcomes Research Institute, Washington, DC 20036 USA
| | | | - Rachel Hemphill
- Evaluation & Analysis, Patient-Centered Outcomes Research Institute, 1828 L St NW, Suite 900, Washington, DC 20036 USA
| | | | - Laura Esmail
- Present Address, Independent Consultant, Paris, France
- Clinical Effectiveness and Decision Science, Patient-Centered Outcomes Research Institute, 1828 L St NW, Suite 900, Washington, DC, USA
| | - Julie Kennedy Lesch
- Public and Patient Engagement, Patient-Centered Outcomes Research Institute, Washington, DC 20036 USA
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Network Engagement in Action: Stakeholder Engagement Activities to Enhance Patient-centeredness of Research. Med Care 2020; 58 Suppl 6 Suppl 1:S66-S74. [PMID: 32412955 DOI: 10.1097/mlr.0000000000001264] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Stakeholders (ie, patients, policymakers, clinicians, advocacy groups, health system leaders, payers, and others) offer critical input at various stages in the research continuum, and their contributions are increasingly recognized as an important component of effective translational research. Natural experiments, in particular, may benefit from stakeholder feedback in addressing real-world issues and providing insight into future policy decisions, though best practices for the engagement of stakeholders in observational studies are limited in the literature. METHODS The Natural Experiments for Translation in Diabetes 2.0 (NEXT-D2) network utilizes rigorous methods to evaluate natural experiments in health policy and program delivery with a focus on diabetes-related outcomes. Each of the 8 partnering institutions incorporates stakeholder engagement throughout multiple study phases to enhance the patient-centeredness of results. NEXT-D2 dedicates a committee to Engagement for resource sharing, enhancing engagement approaches, and advancing network-wide engagement activities. Key stakeholder engagement activities include Study Meetings, Proposal Development, Trainings & Educational Opportunities, Data Analysis, and Results Dissemination. Network-wide patient-centered resources and multimedia have also been developed through the broad expertise of each site's stakeholder group. CONCLUSIONS This collaboration has created a continuous feedback loop wherein site-level engagement approaches are informed via the network and network-level engagement efforts are shaped by individual sites. Emerging best practices include: incorporating stakeholders in multiple ways throughout the research, building on previous relationships with stakeholders, enhancing capacity through stakeholder and investigator training, involving stakeholders in refining outcome choices and understanding the meaning of variables, and recognizing the power of stakeholders in maximizing dissemination.
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Tremblay MC, Bradette-Laplante M, Bérubé D, Brière É, Moisan N, Niquay D, Dogba MJ, Légaré F, McComber A, McGavock J, Witteman HO. Engaging indigenous patient partners in patient-oriented research: lessons from a one-year initiative. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:44. [PMID: 32760594 PMCID: PMC7376932 DOI: 10.1186/s40900-020-00216-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 06/30/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Patient-oriented research (POR) is a specific application of participatory research that promotes active patient engagement in health research. There is a growing concern that people involved in POR do not reflect the diversity of the population such research aims to serve, but are rather those more 'easily' engaged with institutions, organizations and society. Indigenous peoples are among such groups generally underrepresented in POR. The "Indigenous patient partners platform project" was a small-scale initiative aimed to address the issue of the underrepresentation of Indigenous people in patient-oriented research by recruiting, orienting and supporting Indigenous patient partners in Québec (Canada). This article reports on the findings of an evaluation conducted at the end of the project to garner lessons and identify strategies for engaging Indigenous patient partners in patient-oriented research. METHODS The evaluation of this initiative used a case study design hinging on documentary analysis and committee member interviews. Project documents (n = 29) included agendas and meeting minutes, support documents from the orientation workshop and workshop evaluations, and tools the committee developed as part of the project. Interview participants (n = 6) were patients and organizational partners. Thematic analysis was performed by two members of the research team. Patient partners actively contributed to validating the interpretation of result and knowledge translation. RESULTS Results point to four key components of Indigenous patient partner engagement in POR: initiation of partnership, interest development, capacity building and involvement in research. Specific lessons emphasize the importance of community connections in recruiting, sustaining and motivating patient partners, the need to be flexible in the engagement process, and the importance of consistently valuing patient partner contributions and involvement. CONCLUSIONS There is a need to engage Indigenous patient partners in POR to ensure that healthcare practices, policies and research take their particular needs, stories and culture into account. While results of this evaluation are generally consistent with the existing literature on patient engagement, they offer additional insight into how to effectively engage Indigenous patient partners in research, which might also be relevant to the involvement of other marginalized populations who have been historically and systemically disempowered.
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Affiliation(s)
- Marie-Claude Tremblay
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec City, Canada
- Office of Education and Continuing Professional Development, Faculty of Medicine, Université Laval, Québec City, Canada
- VITAM, Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Canada
| | - Maude Bradette-Laplante
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec City, Canada
| | - Danielle Bérubé
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec City, Canada
| | - Élaine Brière
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec City, Canada
| | - Nicole Moisan
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec City, Canada
| | - Daniel Niquay
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec City, Canada
| | - Maman-Joyce Dogba
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec City, Canada
- Office of Education and Continuing Professional Development, Faculty of Medicine, Université Laval, Québec City, Canada
- VITAM, Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Canada
| | - France Légaré
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec City, Canada
- VITAM, Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Canada
| | - Alex McComber
- Department of Family Medicine, Faculty of Medicine, McGill University, Montréal, Canada
| | - Jonathan McGavock
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- The Children’s Hospital Research Institute of Manitoba, Winnipeg, Canada
| | - Holly O. Witteman
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec City, Canada
- Office of Education and Continuing Professional Development, Faculty of Medicine, Université Laval, Québec City, Canada
- VITAM, Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Canada
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Fisher R, Parmar J, Duggleby W, Tian PGJ, Janzen W, Anderson S, Brémault-Phillips S. Health-care Workforce Training to Effectively Support Family Caregivers of Seniors in Care. Can Geriatr J 2020; 23:160-171. [PMID: 32494332 PMCID: PMC7259919 DOI: 10.5770/cgj.23.384] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Introduction Family caregivers (FCGs) play an integral, yet often invisible, role in the Canadian health-care system. As the population ages, their presence will become even more essential as they help balance demands on the system and enable community-dwelling seniors to remain so for as long as possible. To preserve their own well-being and capacity to provide ongoing care, FCGs require support to the meet the challenges of their daily caregiving responsibilities. Supporting FCGs results in better care provision to community-dwelling seniors receiving health-care services, as well as enhancing the quality of life for FCGs. Although FCGs rely upon health-care professionals (HCPs) to provide them with support and services, there is a paucity of research pertaining to the type of health workforce training (HWFT) that HCPs should receive to address FCG needs. Programs that train HCPs to engage with, empower, and support FCGs are required. Objective To describe and discuss key findings of a caregiver symposium focused on determining components of HWFT that might better enable HCPs to support FCGs. Methods A one-day symposium was held on February 22, 2018 in Edmonton, Alberta, to gather the perspectives of FCGs, HCPs, and stakeholders. Attendees participated in a series of working groups to discuss barriers, facilitators, and recommendations related to HWFT. Proceedings and working group discussions were transcribed, and a qualitative thematic analysis was conducted to identify key themes. Results Participants identified the following topic areas as being essential to training HCPs in the provision of support for FCGs: understanding the FCG role, communicating with FCGs, partnering with FCGs, fostering FCG resilience, navigating healthcare systems and accessing resources, and enhancing the culture and context of care. Conclusions FCGs require more support than is currently being provided by HCPs. Training programs need to specifically address topics identified by participants. These findings will be used to develop HWFT for HCPs.
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Affiliation(s)
- Rachel Fisher
- Department of Occupational Therapy, University of Alberta, Edmonton, AB, Canada
| | - Jasneet Parmar
- Department of Family Medicine, University of Alberta, Edmonton, AB, Canada.,Covenant Health-Network of Excellence in Seniors' Health and Wellness, Grey Nuns Community Hospital, Edmonton, AB, Canada
| | - Wendy Duggleby
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | | | - Wonita Janzen
- Faculty of Humanities and Social Sciences, Athabasca University, Athabasca, AB, Canada
| | - Sharon Anderson
- Covenant Health-Network of Excellence in Seniors' Health and Wellness, Grey Nuns Community Hospital, Edmonton, AB, Canada
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Josephs KA, Mackenzie I, Frosch MP, Bigio EH, Neumann M, Arai T, Dugger BN, Ghetti B, Grossman M, Hasegawa M, Herrup K, Holton J, Jellinger K, Lashley T, McAleese KE, Parisi JE, Revesz T, Saito Y, Vonsattel JP, Whitwell JL, Wisniewski T, Hu W. LATE to the PART-y. Brain 2020; 142:e47. [PMID: 31359030 PMCID: PMC6736234 DOI: 10.1093/brain/awz224] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
| | - Ian Mackenzie
- Department of Pathology and Laboratory Medicine, University of British Columbia and Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Matthew P Frosch
- Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Eileen H Bigio
- Feinberg School of Medicine, Northwesterm University, Chicago, IL, USA
| | - Manuela Neumann
- Department of Neuropathology, University of Tübingen and German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Tetsuaki Arai
- Department of Psychiatry, Division of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
| | - Brittany N Dugger
- Department of Pathology and Laboratory Medicine, UC Davis, Sacramento, CA, USA
| | - Bernardino Ghetti
- Pathology and Laboratory Medicine, Indiana University, Indiana, IL, USA
| | - Murray Grossman
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Masato Hasegawa
- Department of Dementia and Higher Brain Function, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Karl Herrup
- Department of Neurology, Alzheimer's Disease Research Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Janice Holton
- UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Kurt Jellinger
- Institute of Clinical Neurobiology, Medical University of Vienna, Vienna, Austria
| | - Tammaryn Lashley
- UCL Queen Square Institute of Neurology, University College London, London, UK
| | | | - Joseph E Parisi
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Tamas Revesz
- UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Yuko Saito
- National Center of Neurology and Pathology Brain Bank, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | | | | | | | - William Hu
- Department of Neurology and Center for Neurodegenerative Diseases Research, Emory University, Atlanta, GA, USA
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Birkeland S, Pedersen SS, Haakonsson AK, Barry MJ, Rottmann N. Men's view on participation in decisions about prostate-specific antigen (PSA) screening: patient and public involvement in development of a survey. BMC Med Inform Decis Mak 2020; 20:65. [PMID: 32252729 PMCID: PMC7132968 DOI: 10.1186/s12911-020-1077-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 03/24/2020] [Indexed: 01/26/2023] Open
Abstract
Background Prostate-Specific Antigen (PSA) screening for early detection of prostate cancer (PCa) may prevent some cancer deaths, but also may miss some cancers or lead to unnecessary and potentially harmful treatment. Therefore, involving patients in decision-making about PSA screening is recommended. However, we know little about the attitude of men regarding participation in decisions about PSA screening and how to assess such attitudes. The purpose of this paper is to describe patient and public participation in the development of a national, web-based case vignette survey for studying men’s view on participation in decision-making about PSA screening. Methods The project group developed a first draft plan for the survey, its vignettes and choice of measurements. This included multiple vignette variants representing various levels of patient participation in decision-making about PSA screening with different outcomes. Additionally, it included questions on respondents’ satisfaction with imagined courses of health care, their propensity to initiate a malpractice complaint, their own health care experiences, socio-demography, personality, and preferences for control regarding health care decision-making. Following feedback from a workshop with academic peers on the draft plan, a group of 30 adult men was engaged to help develop case vignette versions and questionnaire items by providing feedback on structure, comprehension, response patterns, and time required to complete the survey. Furthermore, a panel of three patients with PCa experience was assembled to assist development through a separate review-and-feedback process. Results Based on reviews of survey drafts, the large group made further suggestions about construction of the survey (e.g. clarification and modification of case vignette versions, deletion of items and adjustment of wording, instructions to guide respondents, replacement of technical terms, and optimization of sequence of survey elements). The patient panel ensured fine-tuning of vignette versions and questionnaire items and helped review the internet version of the survey. Conclusions Patient and public involvement during various phases of the survey development helped modify and refine survey structure and content. The survey exemplifies a way to measure health care users’ satisfaction with imagined courses of health care and wish to complain, taking into account their characteristics.
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Affiliation(s)
- Søren Birkeland
- OPEN, Open Patient data Explorative Network, Department of Clinical Research, University of Southern Denmark, J. B. Winsløws Vej 9 a, 3 Floor, DK-5000, Odense C, Denmark.
| | - Susanne S Pedersen
- Department of Psychology, University of Southern Denmark, Campusvej 55, DK-5230, Odense M, Denmark.,Department of Cardiology, Odense University Hospital, J. B. Winsløwsvej 4, DK-5000, Odense C, Denmark
| | - Anders K Haakonsson
- OPEN, Open Patient data Explorative Network, Department of Clinical Research, University of Southern Denmark, J. B. Winsløws Vej 9 a, 3 Floor, DK-5000, Odense C, Denmark
| | - Michael J Barry
- Division of General Internal Medicine, Massachusetts General Hospital & Harvard Medical School, 50 Staniford Street, 9th Floor, Boston, MA, 02114, USA
| | - Nina Rottmann
- Department of Psychology, University of Southern Denmark, Campusvej 55, DK-5230, Odense M, Denmark.,REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care (Odense University Hospital), Winsløwparken 19, 3. sal, DK-5000, Odense C, Denmark.,Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 3. sal, DK-5000, Odense C, Denmark
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Riffin C, Wolff JL, Estill M, Prabhu S, Pillemer KA. Caregiver Needs Assessment in Primary Care: Views of Clinicians, Staff, Patients, and Caregivers. J Am Geriatr Soc 2020; 68:1262-1270. [PMID: 32167573 PMCID: PMC7325837 DOI: 10.1111/jgs.16401] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To understand current practices, challenges, and opportunities for a systematic assessment of family caregivers' needs and risks in primary care. DESIGN Qualitative study consisting of in-depth semi-structured interviews. SETTING Four primary care practices located in urban and rural settings. PARTICIPANTS Primary care clinicians, staff, and administrators (N = 30), as well as older adult patients and family caregivers (N = 40), recruited using purposive and maximum variation sampling. MEASUREMENTS Current experiences, challenges, and opportunities for integrating standardized caregiver assessment into primary care delivery. Interviews were audio-recorded and transcribed; transcripts were analyzed using the constant comparative method of data analysis. RESULTS Participating clinicians had been in practice for an average of 12.8 years (range = 1-36 y). Patients had a mean age of 84.0 years (standard deviation [SD] = 9.7); caregivers had a mean age of 67.0 years (SD = 9.3). There was wide variability in current practices for identifying caregivers' needs and risks, encompassing direct and indirect approaches, when such issues are considered. Participants posited that integrating standardized caregiver assessment into primary care delivery could help improve patient care, enhance clinician-caregiver communication, and validate caregivers' efforts. Barriers to assessment included insufficient time and reimbursement, liability concerns, lack of awareness of community resources, and concerns about patient autonomy. To facilitate future uptake of caregiver assessment, participants recommended brief self-administered assessment tools and post-screen discussions with practice staff. CONCLUSION Identification of caregivers' needs and risks in primary care is highly variable. Integration of standardized caregiver assessment into practice requires coordinated changes to policy, revision of practice workflows, and an interdisciplinary approach to the development of appropriate assessment tools. J Am Geriatr Soc 68:1262-1270, 2020.
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Affiliation(s)
- Catherine Riffin
- Division of Geriatrics & Palliative Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Jennifer L Wolff
- Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Matthew Estill
- Department of Internal Medicine, The Guthrie Clinic, Ithaca, New York, USA
| | - Sheela Prabhu
- Department of Internal Medicine, The Guthrie Clinic, Sayre, Pennsylvania, USA
| | - Karl A Pillemer
- Department of Human Development, Cornell University, Ithaca, New York, USA
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Accoe K, Marchal B, Gnokane Y, Abdellahi D, Bossyns P, Criel B. Action research and health system strengthening: the case of the health sector support programme in Mauritania, West Africa. Health Res Policy Syst 2020; 18:25. [PMID: 32075648 PMCID: PMC7031916 DOI: 10.1186/s12961-020-0531-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 02/04/2020] [Indexed: 05/05/2023] Open
Abstract
Background Access to qualitative and equitable healthcare is a major challenge in Mauritania. In order to support the country’s efforts, a health sector strengthening programme was set up with participatory action research at its core. Reinforcing a health system requires a customised and comprehensive approach to face the complexity inherent to health systems. Yet, limited knowledge is available on how policies could enhance the performance of the system and how multi-stakeholder efforts could give rise to changes in health policy. We aimed to analyse the ongoing participatory action research and, more specifically, see in how far action research as an embedded research approach could contribute to strengthening health systems. Methods We adopted a single-case study design, based on two subunits of analysis, i.e., two selected districts. Qualitative data were collected by analysing country and programme documents, conducting 12 semi-structured interviews and performing participatory observations. Interviewees were selected based on their current position and participation in the programme. The data analysis was designed to address the objectives of the study, but evolved according to emerging insights and through triangulation and identification of emergent and/or recurrent themes along the process. Results An evaluation of the progress made in the two districts indicates that continuous capacity-building and empowerment efforts through a participative approach have been key elements to enhance dialogue between, and ownership of, the actors at the local health system level. However, the strong hierarchical structure of the Mauritanian health system and its low level of decentralisation constituted substantial barriers to innovation. Other constraints were sociocultural and organisational in nature. Poor work ethics due to a weak environmental support system played an important role. While aiming for an alignment between the flexible iterative approach of action research and the prevailing national linear planning process is quite challenging, effects on policy formulation and implementation were not observed. An adequate time frame, the engagement of proactive leaders, maintenance of a sustained dialogue and a pragmatic, flexible approach could further facilitate the process of change. Conclusion Our study showcases that the action research approach used in Mauritania can usher local and national actors towards change within the health system strengthening programme when certain conditions are met. An inclusive, participatory approach generates dynamics of engagement that can facilitate ownership and strengthen capacity. Continuous evaluation is needed to measure how these processes can further develop and presume a possible effect at policy level.
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Affiliation(s)
- Kirsten Accoe
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium.
| | - Bruno Marchal
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium
| | - Yahya Gnokane
- AI-PASS Programme (Institutional Support for Health Sector Strengthening), Enabel - Belgian Development Agency, Nouakchott, Mauritania
| | - Dieng Abdellahi
- AI-PASS Programme (Institutional Support for Health Sector Strengthening), Enabel - Belgian Development Agency, Nouakchott, Mauritania
| | - Paul Bossyns
- Department of Health, Enabel - Belgian Development Agency, Rue Haute 147, 1000, Brussels, Belgium
| | - Bart Criel
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium
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Frisch N, Atherton P, Doyle-Waters MM, MacLeod MLP, Mallidou A, Sheane V, Ward J, Woodley J. Patient-oriented research competencies in health (PORCH) for researchers, patients, healthcare providers, and decision-makers: results of a scoping review. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:4. [PMID: 32055415 PMCID: PMC7011284 DOI: 10.1186/s40900-020-0180-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 01/23/2020] [Indexed: 05/28/2023]
Abstract
PLAIN ENGLISH SUMMARY Background The Canadian Institutes of Health Research funded a program, "patient-oriented research" (POR), to change the way health research is done. POR involves patients and their families/caregivers as equal partners on research teams with researchers, healthcare providers and decision-makers. The authors of this paper work through a unit in British Columbia, Canada that functions to help research teams learn how to do patient-oriented research. We felt that we could not train people if we didn't first understand what others had learned about what competencies (knowledge, skills and attitudes) were helpful for members of these research teams. Method We used a method called a scoping review to search literature on patient-involved research. Our search included papers in academic journals as well as information on websites, training manuals, conference proceedings, governmental documents and statements from health organizations. Findings Writers reported the usefulness of many competencies for researchers and patients, with fewer competencies for healthcare providers or decision-makers. The main competencies for researchers had to do with participation, communication and conflict management; for patients they had to do with research knowledge and skills, cultural competence and participation. It was helpful that all team members want to work as part of a group for the public good. Conclusions We worked with an advisory group of people representing patients and their families/caregivers, researchers, healthcare providers and decision-makers to review our findings. We concluded that our competency statements are helpful for people to determine what they need to know or learn as they join research teams. ABSTRACT Background The Canadian Institutes of Health Research (CIHR) launched an initiative called the Strategy for Patient-Oriented Research (SPOR) encouraging patient-oriented research (POR) that engages patients as equal partners in research teams alongside researchers, healthcare providers and health system decision-makers. Other countries have launched similar initiatives (POR-related work) yet there has never been full review of the competencies needed by individuals engaging in this work. Purpose and methods Our purpose was to summarize existing knowledge on POR and POR-related competencies by conducting a scoping review of peer-reviewed and grey literature. Our objectives were to systematically explore literature, articulate competencies necessary for research team members, identify research gaps and provide recommendations for further research. Using standard health databases and search methods, a total of 2036 sources was retrieved. Data were extracted from 35 peer-reviewed papers and 38 grey literature sources. We used an iterative process to reach consensus on competency statements. Findings and conclusions The main competencies for researchers were in categories of participation, communication and teamwork and conflict/tension management; for patients the main competencies were in research knowledge and skills, cultural competence/context and participation. While fewer competencies were documented for the other stakeholder groups, the need for understanding patient involvement in research and knowledge of the needs that research partners have are noted as competencies for healthcare providers and decision-makers. Attitudes demonstrating inclination to conduct the work were noted for all. The competencies can be used to consider learning needs of research team members and for team members wishing to assess their own readiness to serve on a POR or POR-related research team. Incidentally, we noted the lack of a common vocabulary used to describe patient-involved research, a situation making research and literature review/retrieval quite challenging. Recommendations for future research and for achieving consistency in language are addressed.
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Affiliation(s)
- Noreen Frisch
- School of Nursing, University of Victoria, 3800 Finnerty Rd, Victoria, BC V8P5C2 Canada
- BC SUPPORT Unit, Suite 420 1367 W Broadway, Vancouver, BC Canada
| | - Pat Atherton
- BC SUPPORT Unit, Suite 420 1367 W Broadway, Vancouver, BC Canada
| | - Mary M. Doyle-Waters
- Centre for Clinical Epidemiology and Evaluation, 708 - 828 W. 10Th Avenue, Vancouver, BC Canada
| | - Martha L. P. MacLeod
- University of Northern British Columbia, 3333 University Way, Prince George, BC Canada
| | - Anastasia Mallidou
- School of Nursing, University of Victoria, 3800 Finnerty Rd, Victoria, BC V8P5C2 Canada
| | - Vanessa Sheane
- School of Nursing, University of Victoria, 3800 Finnerty Rd, Victoria, BC V8P5C2 Canada
| | - John Ward
- BC SUPPORT Unit, Suite 420 1367 W Broadway, Vancouver, BC Canada
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Mork M, Laxdal G, Wilkinson G. Patient and family engagement in Alberta's Strategic Clinical Networks. CMAJ 2019; 191:S4-S6. [PMID: 31801751 DOI: 10.1503/cmaj.190596] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Mikie Mork
- Strategic Clinical Networks, Alberta Health Services, Edmonton, Alta.
| | - Garry Laxdal
- Strategic Clinical Networks, Alberta Health Services, Edmonton, Alta
| | - Gloria Wilkinson
- Strategic Clinical Networks, Alberta Health Services, Edmonton, Alta
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Sterling MR, Silva AF, Leung PBK, Shaw AL, Tsui EK, Jones CD, Robbins L, Escamilla Y, Lee A, Wiggins F, Sadler F, Shapiro MF, Charlson ME, Kern LM, Safford MM. "It's Like They Forget That the Word 'Health' Is in 'Home Health Aide'": Understanding the Perspectives of Home Care Workers Who Care for Adults With Heart Failure. J Am Heart Assoc 2019; 7:e010134. [PMID: 30571599 PMCID: PMC6405555 DOI: 10.1161/jaha.118.010134] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Background Home care workers (HCWs) increasingly provide long‐term and posthospitalization care for community‐dwelling adults with heart failure (HF). They observe, assist, and advise these patients, yet few studies have examined their role in HF. As the foundation for future interventions, we sought to understand the perspectives of HCWs caring for adults with HF. Methods and Results We conducted 8 focus groups in partnership with the Home Care Industry Education Fund, a benefit fund of the 1199 Service Employees International Union United Healthcare Workers East, the largest healthcare union in the United States. English‐ and Spanish‐speaking HCWs with HF clients were eligible to participate. Data were analyzed thematically. Forty‐six HCWs employed by 21 unique home care agencies participated. General and HF‐specific themes emerged. Generally, HCWs (1) feel overworked and undervalued; (2) find communication and care to be fragmented; (3) are dedicated to clients and families but are caught in the middle; and, despite this, (4) love their job. With respect to HF, HCWs (1) find it frightening and unpredictable; (2) are involved in HF self‐care without any HF training; and (3) find the care plan problematic. Conclusions Although frequently involved in HF self‐care, most HCWs have not received HF training. In addition, many felt poorly supported by other healthcare providers and the care plan, especially when their clients’ symptoms worsened. Interventions that provide HF‐specific training and aim to improve communication between members of the home health care team may enhance HCWs’ ability to care for adults with HF and potentially lead to better patient outcomes.
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Affiliation(s)
- Madeline R Sterling
- 1 Division of General Internal Medicine Department of Medicine Weill Cornell Medicine New York NY
| | - Ariel F Silva
- 1 Division of General Internal Medicine Department of Medicine Weill Cornell Medicine New York NY
| | - Peggy B K Leung
- 1 Division of General Internal Medicine Department of Medicine Weill Cornell Medicine New York NY
| | - Amy L Shaw
- 2 Division of Geriatrics and Palliative Medicine Department of Medicine Weill Cornell Medicine New York NY
| | - Emma K Tsui
- 3 Department of Community Health and Social Sciences Graduate School of Public Health and Health Policy City University of New York NY
| | | | | | | | - Ann Lee
- 6 1199SEIU - Home Care Industry Education Fund New York NY
| | - Faith Wiggins
- 6 1199SEIU - Home Care Industry Education Fund New York NY
| | - Frances Sadler
- 6 1199SEIU - Home Care Industry Education Fund New York NY
| | - Martin F Shapiro
- 1 Division of General Internal Medicine Department of Medicine Weill Cornell Medicine New York NY
| | - Mary E Charlson
- 7 Division of Clinical Epidemiology and Evaluative Science Research Department of Medicine Weill Cornell Medicine New York NY
| | - Lisa M Kern
- 1 Division of General Internal Medicine Department of Medicine Weill Cornell Medicine New York NY
| | - Monika M Safford
- 1 Division of General Internal Medicine Department of Medicine Weill Cornell Medicine New York NY
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Baker GR, McGillion MH, Gavin F. Engaging with patients on research to inform better care. CMAJ 2019; 190:S6-S8. [PMID: 30404839 DOI: 10.1503/cmaj.180816] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- G Ross Baker
- Institute of Health Policy, Management and Evaluation (Baker), University of Toronto, Toronto, Ont.; School of Nursing, Faculty of Health Sciences (McGillion), McMaster University; Population Health Research Institute (McGillion), Hamilton, Ont.; patient partner (Gavin); Board of Directors, OSSU (Gavin), Toronto, Ont.; and Citizen Engagement Council, CHILD-BRIGHT Network (Gavin), Montréal, Que.
| | - Michael H McGillion
- Institute of Health Policy, Management and Evaluation (Baker), University of Toronto, Toronto, Ont.; School of Nursing, Faculty of Health Sciences (McGillion), McMaster University; Population Health Research Institute (McGillion), Hamilton, Ont.; patient partner (Gavin); Board of Directors, OSSU (Gavin), Toronto, Ont.; and Citizen Engagement Council, CHILD-BRIGHT Network (Gavin), Montréal, Que
| | - Frank Gavin
- Institute of Health Policy, Management and Evaluation (Baker), University of Toronto, Toronto, Ont.; School of Nursing, Faculty of Health Sciences (McGillion), McMaster University; Population Health Research Institute (McGillion), Hamilton, Ont.; patient partner (Gavin); Board of Directors, OSSU (Gavin), Toronto, Ont.; and Citizen Engagement Council, CHILD-BRIGHT Network (Gavin), Montréal, Que
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McIlvennan CK, Morris MA, Guetterman TC, Matlock DD, Curry L. Qualitative Methodology in Cardiovascular Outcomes Research: A Contemporary Look. Circ Cardiovasc Qual Outcomes 2019; 12:e005828. [PMID: 31510771 DOI: 10.1161/circoutcomes.119.005828] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Qualitative research offers unique opportunities to contribute to cardiovascular outcomes research. Despite the growth in qualitative research over the last decade, outcomes investigators in cardiology still have relatively little guidance on when and how best to implement these methods in their investigations, leaving the full potential of these methods unrealized. We offer a contemporary look at qualitative methods, including publication trends of qualitative studies in cardiology journals from 1998 to 2018, novel emerging data collection and analytic methods, and current use and examples of cardiovascular outcomes research that apply qualitative methods such as user-centered design, preimplementation evaluation, implementation evaluation, effectiveness evaluation, and policy analysis.
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Affiliation(s)
- Colleen K McIlvennan
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (C.K.M., M.A.M., D.D.M.), University of Colorado School of Medicine, Aurora.,Division of Cardiology (C.K.M.), University of Colorado School of Medicine, Aurora
| | - Megan A Morris
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (C.K.M., M.A.M., D.D.M.), University of Colorado School of Medicine, Aurora
| | | | - Daniel D Matlock
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (C.K.M., M.A.M., D.D.M.), University of Colorado School of Medicine, Aurora.,Veteran Affairs Eastern Colorado Geriatric Research Education and Clinical Center, Denver, CO (D.D.M.)
| | - Leslie Curry
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.C.).,Yale Global Health Leadership Institute, Yale University, New Haven, CT (L.C.)
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Thomas A, D Gruppen L, van der Vleuten C, Chilingaryan G, Amari F, Steinert Y. Use of evidence in health professions education: Attitudes, practices, barriers and supports. MEDICAL TEACHER 2019; 41:1012-1022. [PMID: 31050311 DOI: 10.1080/0142159x.2019.1605161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Introduction: Health professions educators are increasingly called upon to apply an evidence-informed approach to teaching and assessment practices. There is scant empirical research exploring educators' attitudes, practices, and perceived barriers and supports to using research evidence in educational practice. Methods: We conducted a survey of AMEE members to explore three domains related to evidence-informed health professions education: (1) attitudes; (2) practices; and (3) supports and barriers. Analyses involved descriptive statistics to characterize participants' responses per domain, exploratory factor analysis, and multivariate regression analyses. Results: Three hundred ninety-six (∼10%) participants representing health professions educators (HPEs) and non HPEs (e.g. PhDs) and different roles (e.g. teacher, administrator) completed the survey. Attitudes toward evidence-informed HPE were generally favorable. Several barriers preclude participants from engaging in evidence-informed approaches to health professions education (HPE). Discussion: This study provides preliminary evidence on the attitudes toward and perceived barriers and supports of research use in HPE from different groups of HP educators, clinicians, and administrators. The findings for each of the three domains require additional exploration using qualitative methodologies. Conclusion: Targeted interventions designed to increase the uptake of research in HPE should consider different stakeholder groups' perceptions regarding these approaches, current vs. best practices, and factors that may impede evidence-informed approaches.
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Affiliation(s)
- Aliki Thomas
- School of Physical and Occupational Therapy, Institute of Health Sciences Education, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, McGill University , Montreal , Canada
| | - Larry D Gruppen
- Medical School, University of Michigan , Ann Arbor , MI , USA
| | - Cees van der Vleuten
- Department of Educational Development and Research, Maastricht University , Maastricht , the Netherlands
| | - Gevorg Chilingaryan
- Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal , Laval , Canada
| | - Fatima Amari
- School of Physical and Occupational Therapy, McGill University , Montreal , Canada
| | - Yvonne Steinert
- Department of Family Medicine, Institute of Health Sciences Education, McGill University , Montréal , Canada
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Learning From Others: Lessons for Improving Collaborations Between Stakeholders and Researchers. Med Care 2019; 56 Suppl 10 Suppl 1:S9-S10. [PMID: 30074944 PMCID: PMC6143207 DOI: 10.1097/mlr.0000000000000952] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tambor E, Shalowitz M, Harrington JM, Hull K, Watson N, Sital S, Al Naber J, Miller D. Engaging patients, clinicians, and the community in a Clinical Data Research Network: Lessons learned from the CAPriCORN CDRN. Learn Health Syst 2019; 3:e10079. [PMID: 31245603 PMCID: PMC6508783 DOI: 10.1002/lrh2.10079] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 11/08/2018] [Accepted: 12/07/2018] [Indexed: 11/29/2022] Open
Abstract
Engaging patients, clinicians, and community members in the development of a research network creates opportunities and challenges beyond engagement in discrete learning activities. This paper describes our experiences establishing and maintaining a stakeholder engagement infrastructure for the Chicago Area Patient-Centered Outcomes Research Network (CAPriCORN) and highlights important lessons learned over the first 4 years. During this time, the CAPriCORN Patient and Community Advisory Committee (PCAC) appointed patient, clinician, and community representatives to governance and advisory groups throughout the network, developed a process and criteria for patient- and clinician-centered review of research proposals, and evolved from a large, diverse group to a smaller yet still diverse, more actively engaged group with connections to the broader community. Key challenges faced by the PCAC have included determining the optimal size and composition of the group, understanding the complex structure of the network as a whole, coordinating with other network entities and functions, and integrating the patient and community voice into the research review process. Efforts to engage stakeholders in clinical data research networks should anticipate and develop solutions to address these challenges.
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Affiliation(s)
- Ellen Tambor
- Center for Medical Technology PolicyBaltimoreMDUSA
| | | | | | - Kevin Hull
- West Side Institute for Science and Education, at the Jesse Brown VA Medical CenterChicagoILUSA
| | - Natalie Watson
- Center for Community Health and VitalityUniversity of Chicago MedicineChicagoILUSA
| | - Shelly Sital
- Chicago Area Patient‐Centered Outcomes Research Network (CAPriCORN)ChicagoILUSA
| | | | - Doriane Miller
- Center for Community Health and VitalityUniversity of Chicago MedicineChicagoILUSA
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Lochmüller H, Ambrosini A, van Engelen B, Hansson M, Tibben A, Breukel A, Sterrenburg E, Schrijvers G, Meijer I, Padberg G, Peay H, Monaco L, Snape M, Lennox A, Mazzone E, Bere N, de Lemus M, Landfeldt E, Willmann R. The Position of Neuromuscular Patients in Shared Decision Making. Report from the 235th ENMC Workshop: Milan, Italy, January 19-20, 2018. J Neuromuscul Dis 2019; 6:161-172. [PMID: 30714970 DOI: 10.3233/jnd-180368] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In the era of patient-centered medicine, shared decision-making (SDM) - in which healthcare professionals and patients exchange information and preferences and jointly reach a decision - has emerged as the gold standard model for the provision of formal healthcare. Indeed, in many geographical settings, patients are frequently invited to participate in choices concerning the design and delivery of their medical management. From a clinical perspective, benefits of this type of patient involvement encompass, for example, enhanced treatment satisfaction, improved medical compliance, better health outcomes, and maintained or promoted quality of life. Yet, although the theory and enactment of SDM in healthcare are well-described in the literature [1-3], comparatively less attention has been devoted to contextualizing questions relating to if, when, and how to include patients in decisions within medical research. In this context, patient involvement would be expected to be potentially relevant for and applicable to a wide range of activities and processes, from the identification of research priorities and development of grant applications, to the design of patient information and consent procedures, formulation of interventions, identification and recruitment of study sample populations, feasibility of a clinical trial, identification, selection, and specification of endpoints and outcomes in clinical trials and observational studies, data collection and analysis, and dissemination of results. To this end, 45 clinicians, healthcare professionals, researchers, patients, caregivers, and representatives from regulatory authorities and pharmaceutical companies from 15 different countries met to discuss the level of involvement of patients with neuromuscular diseases, specifically in the following settings of medical research for neuromuscular diseases: i) registries and biobanks; ii) clinical trials; and iii) regulatory processes. In this report, we present summaries of the talks that were given during the workshop, as well as discussion outcomes from the three topic areas listed above.
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Affiliation(s)
- Hanns Lochmüller
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Canada and Division of Neurology, Department of Medicine, The Ottawa Hospital, Ottawa, Canada; Department of Neuropediatrics and Muscle Disorders, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | | | - Baziel van Engelen
- Department of Neurology, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Aad Tibben
- Centre for Human and Clinical Genetics, Leiden University Medical Centre, Leiden, the Netherlands
| | | | | | | | - Ingeborg Meijer
- Centre for Science and Technology Studies (CWTS), University of Leiden, Leiden, the Netherlands and Spierziekten Nederland, Baarn, the Netherlands
| | - George Padberg
- Centre for Human and Clinical Genetics, Leiden University Medical Centre, Leiden, the Netherlands
| | - Holly Peay
- RTI International, Research Triangle Park, NC, USA
| | | | | | | | - Elena Mazzone
- Department of Child Neurology, Catholic University, Rome, Italy
| | - Nathalie Bere
- Public Engagement, European Medicines Agency, London, UK
| | | | - Erik Landfeldt
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; and Icon plc, Stockholm, Sweden
| | - Raffaella Willmann
- Swiss Foundation for Research on Muscle Diseases, Cortaillod, Switzerland
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ANI Emerging Leaders Project: Supporting and Elevating Clinical Informatics Research Through Academic-Practice Partnership. Comput Inform Nurs 2018; 36:576-578. [PMID: 30531257 DOI: 10.1097/cin.0000000000000501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kendall C, Fitzgerald M, Kang RS, Wong ST, Katz A, Fortin M, Dionne E, Kuluski K, O'Brien MA, Ploeg J, Crowe L, Liddy C. "Still learning and evolving in our approaches": patient and stakeholder engagement among Canadian community-based primary health care researchers. RESEARCH INVOLVEMENT AND ENGAGEMENT 2018; 4:47. [PMID: 30524753 PMCID: PMC6276251 DOI: 10.1186/s40900-018-0132-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 11/14/2018] [Indexed: 05/15/2023]
Abstract
PLAIN ENGLISH SUMMARY Increasingly, health researchers are conducting their research in partnership with non-researchers such as patients and caregivers, advocacy groups, clinicians, and policymakers. The idea behind this partnership is to make research more relevant and appropriate. However, so far there is not much evidence about how this partnership or engagement actually affects research. We conducted an online survey of 12 teams in Canada that have engaged patients and other stakeholders in community based health research, partly as a requirement to obtain funding. We found that in many cases, the teams have engaged a wide variety and large number of stakeholders, and have involved them in many different stages of their research. Teams reported that their overall experience of this approach to research has been positive, but some challenges have been encountered along the way. Some teams found that it was difficult to communicate appropriately with all the stakeholders, and to keep them informed when research was going slowly. Other teams had trouble finding government representatives to work with. Several teams noted that engagement is time-consuming, and requires a lot of effort. Nevertheless, all teams reported that they had learned from the experience, and found it valuable. As a result, Canadian health care researchers are better positioned to engage with patients and other stakeholders in the future. ABSTRACT Background Patient and other stakeholder engagement in research is increasingly important, but there is limited evidence of its impact. In 2013, the Canadian Institutes of Health Research launched a five-year Community Based Primary Health Care (CBPHC) initiative that funded 12 teams for innovative approaches to primary health care involving engagement with patients, communities, decision-makers, and clinicians across jurisdictions in Canada. The present study examines the extent of engagement by these teams, and the factors that affected it, either as challenges or opportunities. Methods We conducted a cross-sectional web-based survey across the 12 CBPHC Innovation Teams, in which we were also participants. We used a data collection tool developed by the Patient Centered Outcomes Research Institute that included both closed and open-ended questions. Results The quantitative data showed that the CBPHC Innovation teams have engaged with diverse stakeholders at different levels and in different stages of research. Almost all teams surveyed engaged with policymakers, most with clinicians and health system representatives, and more than half with patients, mostly at the level of consultation or collaboration. There were very few instances of stakeholder-led research reported. There was a near universal recognition of the importance of communications processes/tools in facilitating engagement, whereas time was the most commonly identified challenge. In almost all cases, challenges encountered were partially if not fully resolved.The qualitative findings showed that each team's engagement was contextualized by factors such as the jurisdictions and geographic scope of the project, the number and type of stakeholders engaged and their level of involvement. These intersected with the researchers' motivations for engagement, to give rise to diverse experiences, but ones that the CBPHC teams assessed positively as an approach to research. Conclusions Over the past five years, primary health care researchers in Canada have been actively engaging with patients and other stakeholders. The wide range, extent and nature of that engagement shows that these researchers have anticipated developments in this approach to research and are thus in a position to support and strengthen future efforts to understand the impact of this engagement on health care outcomes.
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Affiliation(s)
- Claire Kendall
- 1C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, ON Canada
- 2Department of Family Medicine, University of Ottawa, Ottawa, ON Canada
- 3Institute for Clinical Evaluative Sciences (IC/ES), Toronto, ON Canada
- 4Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON Canada
- 5Ottawa Hospital Research Institute, Ottawa, ON Canada
| | - Michael Fitzgerald
- 1C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, ON Canada
| | | | - Sabrina T Wong
- 7School of Nursing, University of British Columbia, Vancouver, BC Canada
- 8Centre for Health Services and Policy Research, University of British Columbia, Vancouver, BC Canada
| | - Alan Katz
- 9Manitoba Centre for Health Policy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB Canada
- 10Department of Family Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB Canada
- 11Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB Canada
| | - Martin Fortin
- 12Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Chicoutimi, QC Canada
- Centre Intégré Universitaire de Santé et de Services Sociaux du Saguenay-Lac St-Jean, Chicoutimi, QC Canada
| | - Emilie Dionne
- 14St. Mary's Research Centre & Department of Family Medicine, McGill University, Montreal, QC Canada
| | - Kerry Kuluski
- 15Bridgepoint Collaboratory of the Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON Canada
- 16Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada
| | - Mary Ann O'Brien
- 17Department of Family and Community Medicine, University of Toronto, Toronto, ON Canada
| | - Jenny Ploeg
- 18School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON Canada
- 19Department of Health, Aging and Society, Faculty of Social Sciences, McMaster University, Hamilton, ON Canada
- 20McMaster Institute for Research on Aging, McMaster University, Hamilton, ON Canada
- 21Aging, Community and Health Research Unit, McMaster University, Hamilton, ON Canada
| | - Lois Crowe
- 1C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, ON Canada
| | - Clare Liddy
- 1C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, ON Canada
- 22Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON Canada
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Gustavson AM, Boxer RS, Nordon-Craft A, Marcus RL, Daddato A, Stevens-Lapsley JE. Advancing Innovation in Skilled Nursing Facilities through Academic Collaborations. PHYSICAL THERAPY JOURNAL OF POLICY, ADMINISTRATION, AND LEADERSHIP 2018; 18:5-16. [PMID: 35747320 PMCID: PMC9217103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
There is growing recognition that acute hospitalization contributes to marked functional decline in older adult populations. Nearly 20% of all hospitalized older adults in the United States are discharged to skilled nursing facilities (SNFs) to address these functional deficits. However, current approaches to care in SNFs may not adequately restore function, which may contribute to low community discharge rates and high hospital readmission rates. Barriers to rehabilitation innovation in SNFs include management, staff, patient, and researcher-level factors. This clinical commentary builds upon clinical innovation strategies in other health care settings by describing barriers in the context of the SNF environment. Fostering collaboration between academic clinical researchers and SNFs may be the answer to advancing rehabilitation practices and care delivery, thereby improving outcomes in this vulnerable population.
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Affiliation(s)
- Allison M. Gustavson
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO
| | - Rebecca S. Boxer
- Division of Geriatric Medicine, Department of Medicine, University of Colorado, Aurora, CO
- Veterans Affairs Geriatric Research, Education and Clinical Center, Denver, CO
| | - Amy Nordon-Craft
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO
| | - Robin L. Marcus
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT
| | - Andrea Daddato
- Division of Geriatric Medicine, Department of Medicine, University of Colorado, Aurora, CO
| | - Jennifer E. Stevens-Lapsley
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO
- Veterans Affairs Geriatric Research, Education and Clinical Center, Denver, CO
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