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Singh H, Benn N, Fung A, Kokorelias KM, Martyniuk J, Nelson MLA, Colquhoun H, Cameron JI, Munce S, Saragosa M, Godhwani K, Khan A, Yoo PY, Kuluski K. Co-design for stroke intervention development: Results of a scoping review. PLoS One 2024; 19:e0297162. [PMID: 38354160 PMCID: PMC10866508 DOI: 10.1371/journal.pone.0297162] [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: 09/19/2023] [Accepted: 12/29/2023] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Co-design methodology seeks to actively engage end-users in developing interventions. It is increasingly used to design stroke interventions; however, limited guidance exists, particularly with/for individuals with stroke who have diverse cognitive, physical and functional abilities. Thus, we describe 1) the extent of existing research that has used co-design for stroke intervention development and 2) how co-design has been used to develop stroke interventions among studies that explicitly used co-design, including the rationale, types of co-designed stroke interventions, participants involved, research methodologies/approaches, methods of incorporating end-users in the research, co-design limitations, challenges and potential strategies reported by researchers. MATERIALS AND METHODS A scoping review informed by Joanna Briggs Institute and Arksey & O'Malley methodology was conducted by searching nine databases on December 21, 2022, to locate English-language literature that used co-design to develop a stroke intervention. Additional data sources were identified through a hand search. Data sources were de-duplicated, and two research team members reviewed their titles, abstracts and full text to ensure they met the inclusion criteria. Data relating to the research objectives were extracted, analyzed, and reported numerically and descriptively. RESULTS Data sources used co-design for stroke intervention development with (n = 89) and without (n = 139) explicitly using the term 'co-design.' Among studies explicitly using co-design, it was commonly used to understand end-user needs and generate new ideas. Many co-designed interventions were technology-based (65%), and 48% were for physical rehabilitation or activity-based. Co-design was commonly conducted with multiple participants (82%; e.g., individuals with stroke, family members/caregivers and clinicians) and used various methods to engage end-users, including focus groups and workshops. Limitations, challenges and potential strategies for recruitment, participant-engagement, contextual and logistical and ethics of co-designed interventions were described. CONCLUSIONS Given the increasing popularity of co-design as a methodology for developing stroke interventions internationally, these findings can inform future co-designed studies.
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Affiliation(s)
- Hardeep Singh
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- The KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Natasha Benn
- The KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Agnes Fung
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Kristina M. Kokorelias
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- The KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Department of Medicine, Geriatrics Division, Sinai Health System, University Health Network, Toronto, Canada
| | - Julia Martyniuk
- Gerstein Science Information Centre, University of Toronto Libraries, University of Toronto, Toronto, Canada
| | - Michelle L. A. Nelson
- Institute for Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada
| | - Heather Colquhoun
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Jill I. Cameron
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- The KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Sarah Munce
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- The KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Institute for Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Marianne Saragosa
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada
| | - Kian Godhwani
- Department of Psychology, University of Toronto Scarborough, Toronto, Canada
| | - Aleena Khan
- Biological Sciences, University of Toronto, Toronto, Canada
| | - Paul Yejong Yoo
- Division of Neurosciences and Mental Health, The Hospital for Sick Children Research Institute, Toronto, Canada
| | - Kerry Kuluski
- Institute for Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Institute for Better Health, Trillium Health Partners, Toronto, Canada
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Vester LB, Haahr A, Nielsen TL, Bartolomeu S, Portillo MC. A Parkinson care-coordinator may make a difference: A scoping review on multi-sectoral integrated care initiatives for people living with Parkinson's disease and their caregivers. PATIENT EDUCATION AND COUNSELING 2023; 116:107931. [PMID: 37604024 DOI: 10.1016/j.pec.2023.107931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 08/23/2023]
Abstract
OBJECTIVE To identify multi-sectoral integrated care initiatives for people with Parkinson's disease and caregivers. METHOD Following the Matrix Method we created a synthesis of literature across methodological approaches. The search was conducted in four databases until June 2022, and included studies focusing on multi-sectoral integrated care initiatives, and how they helped people with Parkinson's disease and caregivers in everyday living. RESULTS The search yielded 5921 articles of which nine were included. We identified four topics describing characteristics of multi-sectoral integrated care initiatives: 1) Peer-support, 2) Personalised care plan, 3) One-off initiatives limited in time and 4) Presence of a coordinator. And four topics describing how the initiatives helped in everyday living: 1) Confidence, trust and support, 2) Positive changes in health outcomes, 3) Quality of life, coping skills & psychosocial adjustment, and 4) A strengthened multi-agent collaboration and personalised assistance. CONCLUSION Multi-sectoral integrated care initiatives should be ongoing offers, and include a Parkinson care-coordinator, who can enhance multi-sectoral communication and an individualised approach to information about resources responsive to evolving needs at different disease stages. PRACTICE IMPLICATIONS Initiatives should be multidisciplinary, multi-sectoral and aimed at people with Parkinson's disease and caregivers, preferably facilitated by a care-coordinator to promote cross-sectoral communication.
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Affiliation(s)
- Louise Buus Vester
- Department of Nursing, VIA University College, Randers, Denmark; Research Centre for Health and Welfare Technology, Programme for Rehabilitation, VIA University College, Denmark.
| | - Anita Haahr
- Research Centre for Health and Welfare Technology, Programme for Rehabilitation, VIA University College, Denmark; Department of Nursing, VIA University College, Aarhus, Denmark; Nursing and Healthcare, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Tove Lise Nielsen
- Research Centre for Health and Welfare Technology, Programme for Rehabilitation, VIA University College, Denmark; Department of Occupational Therapy in Aarhus, VIA University College, Aarhus, Denmark
| | - Sandra Bartolomeu
- NIHR Applied Research Collaboration Wessex, School of Health Sciences, University of Southampton, Southampton, UK
| | - Mari Carmen Portillo
- NIHR Applied Research Collaboration Wessex, School of Health Sciences, University of Southampton, Southampton, UK
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Lim S, Morris H, Pizzirani B, Kajewski D, Lee WK, Skouteris H. Evaluating hospital tools and services that were co-produced with patients: A rapid review. Int J Qual Health Care 2021; 32:231-239. [PMID: 32222757 DOI: 10.1093/intqhc/mzaa020] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 02/04/2020] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To describe the process and outcomes of services or products co-produced with patients in hospital settings. DATA SOURCES Database searches on Medline, CINAHL and Business Source between 2008 and 2019. STUDY SELECTION Studies that evaluate the products of co-production in hospital settings. DATA EXTRACTION Primary outcome is the individual and organizational outcomes resulting from co-production. Study characteristics, co-production process, level of engagement and intensity of engagement were also extracted. RESULTS OF DATA SYNTHESIS A total of 13 studies were included. Types of co-produced outputs were health services and care processes, tools and resources, and technology-based products, such as mobile application. Most studies engaged patients at a consultative or involvement level, with only four studies engaging patients as partners. Moderate-to-high acceptability and usability by patients and health services were reported for co-produced outputs. Organizational outcomes were also reported qualitatively as producing various positive effects, such as improved communication and diagnostic process. Positive patient outcomes were reported for co-produced outputs in qualitative (e.g. improved social support) and quantitative results (e.g. reduction of clinic wait time). No patient clinical outcomes were reported. CONCLUSION Co-produced outputs have moderate-to-high acceptability, usability or uptake. There is insufficient evidence on other organizational or patient outcomes due to the lack of reporting of outcomes in co-production. Future research should focus on the outcomes (i.e. effects on patients and health service providers), not just the output of co-production. This is critical to provide feedback to advance the knowledge and implementation of co-production.
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Affiliation(s)
- Siew Lim
- Monash Centre for Health Research and Implementation, Monash University, 43-51 Kanooka Grove, Clayton, Melbourne, VIC 3168, Australia
| | - Heather Morris
- Monash Centre for Health Research and Implementation, Monash University, 43-51 Kanooka Grove, Clayton, Melbourne, VIC 3168, Australia
| | - Bengianni Pizzirani
- Monash Centre for Health Research and Implementation, Monash University, 43-51 Kanooka Grove, Clayton, Melbourne, VIC 3168, Australia
| | - Duncan Kajewski
- Monash Centre for Health Research and Implementation, Monash University, 43-51 Kanooka Grove, Clayton, Melbourne, VIC 3168, Australia
| | - Wai Kit Lee
- Monash Centre for Health Research and Implementation, Monash University, 43-51 Kanooka Grove, Clayton, Melbourne, VIC 3168, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, Monash University, 43-51 Kanooka Grove, Clayton, Melbourne, VIC 3168, Australia
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Zidaru T, Morrow EM, Stockley R. Ensuring patient and public involvement in the transition to AI-assisted mental health care: A systematic scoping review and agenda for design justice. Health Expect 2021; 24:1072-1124. [PMID: 34118185 PMCID: PMC8369091 DOI: 10.1111/hex.13299] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 04/07/2021] [Accepted: 05/26/2021] [Indexed: 12/16/2022] Open
Abstract
Background Machine‐learning algorithms and big data analytics, popularly known as ‘artificial intelligence’ (AI), are being developed and taken up globally. Patient and public involvement (PPI) in the transition to AI‐assisted health care is essential for design justice based on diverse patient needs. Objective To inform the future development of PPI in AI‐assisted health care by exploring public engagement in the conceptualization, design, development, testing, implementation, use and evaluation of AI technologies for mental health. Methods Systematic scoping review drawing on design justice principles, and (i) structured searches of Web of Science (all databases) and Ovid (MEDLINE, PsycINFO, Global Health and Embase); (ii) handsearching (reference and citation tracking); (iii) grey literature; and (iv) inductive thematic analysis, tested at a workshop with health researchers. Results The review identified 144 articles that met inclusion criteria. Three main themes reflect the challenges and opportunities associated with PPI in AI‐assisted mental health care: (a) applications of AI technologies in mental health care; (b) ethics of public engagement in AI‐assisted care; and (c) public engagement in the planning, development, implementation, evaluation and diffusion of AI technologies. Conclusion The new data‐rich health landscape creates multiple ethical issues and opportunities for the development of PPI in relation to AI technologies. Further research is needed to understand effective modes of public engagement in the context of AI technologies, to examine pressing ethical and safety issues and to develop new methods of PPI at every stage, from concept design to the final review of technology in practice. Principles of design justice can guide this agenda.
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Affiliation(s)
- Teodor Zidaru
- Department of Anthropology, London School of Economics and Political Science (LSE), London, UK
| | | | - Rich Stockley
- Surrey Heartlands Health and Care Partnership, Guildford and Waverley CCG, Guildford, UK.,Insight and Feedback Team, Nursing Directorate, NHS England and NHS Improvement, London, UK.,Surrey County Council, Kingston upon Thames, UK
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Lloyd N, Kenny A, Hyett N. Evaluating health service outcomes of public involvement in health service design in high-income countries: a systematic review. BMC Health Serv Res 2021; 21:364. [PMID: 33879149 PMCID: PMC8056601 DOI: 10.1186/s12913-021-06319-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 03/26/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Internationally, it is expected that health services will involve the public in health service design. Evaluation of public involvement has typically focused on the process and experiences for participants. Less is known about outcomes for health services. The aim of this systematic review was to a) identify and synthesise what is known about health service outcomes of public involvement and b) document how outcomes were evaluated. METHODS Searches were undertaken in MEDLINE, EMBASE, The Cochrane Library, PsycINFO, Web of Science, and CINAHL for studies that reported health service outcomes from public involvement in health service design. The review was limited to high-income countries and studies in English. Study quality was assessed using the Mixed Methods Appraisal Tool and critical appraisal guidelines for assessing the quality and impact of user involvement in health research. Content analysis was used to determine the outcomes of public involvement in health service design and how outcomes were evaluated. RESULTS A total of 93 articles were included. The majority were published in the last 5 years, were qualitative, and were located in the United Kingdom. A range of health service outcomes (discrete products, improvements to health services and system/policy level changes) were reported at various levels (service level, across services, and across organisations). However, evaluations of outcomes were reported in less than half of studies. In studies where outcomes were evaluated, a range of methods were used; most frequent were mixed methods. The quality of study design and reporting was inconsistent. CONCLUSION When reporting public involvement in health service design authors outline a range of outcomes for health services, but it is challenging to determine the extent of outcomes due to inadequate descriptions of study design and poor reporting. There is an urgent need for evaluations, including longitudinal study designs and cost-benefit analyses, to fully understand outcomes from public involvement in health service design.
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Affiliation(s)
- Nicola Lloyd
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Amanda Kenny
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Nerida Hyett
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
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