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Peters S, Guccione L, Francis J, Best S, Tavender E, Curran J, Davies K, Rowe S, Palmer VJ, Klaic M. Evaluation of research co-design in health: a systematic overview of reviews and development of a framework. Implement Sci 2024; 19:63. [PMID: 39261956 PMCID: PMC11391618 DOI: 10.1186/s13012-024-01394-4] [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: 04/01/2024] [Accepted: 08/31/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND Co-design with consumers and healthcare professionals is widely used in applied health research. While this approach appears to be ethically the right thing to do, a rigorous evaluation of its process and impact is frequently missing. Evaluation of research co-design is important to identify areas of improvement in the methods and processes, as well as to determine whether research co-design leads to better outcomes. We aimed to build on current literature to develop a framework to assist researchers with the evaluation of co-design processes and impacts. METHODS A multifaceted, iterative approach, including three steps, was undertaken to develop a Co-design Evaluation Framework: 1) A systematic overview of reviews; 2) Stakeholder panel meetings to discuss and debate findings from the overview of reviews and 3) Consensus meeting with stakeholder panel. The systematic overview of reviews included relevant papers published between 2000 and 2022. OVID (Medline, Embase, PsycINFO), EBSCOhost (Cinahl) and the Cochrane Database of Systematic reviews were searched for papers that reported co-design evaluation or outcomes in health research. Extracted data was inductively analysed and evaluation themes were identified. Review findings were presented to a stakeholder panel, including consumers, healthcare professionals and researchers, to interpret and critique. A consensus meeting, including a nominal group technique, was applied to agree upon the Co-design Evaluation Framework. RESULTS A total of 51 reviews were included in the systematic overview of reviews. Fifteen evaluation themes were identified and grouped into the following seven clusters: People (within co-design group), group processes, research processes, co-design context, people (outside co-design group), system and sustainment. If evaluation methods were mentioned, they mainly included qualitative data, informal consumer feedback and researchers' reflections. The Co-Design Evaluation Framework used a tree metaphor to represent the processes and people in the co-design group (below-ground), underpinning system- and people-level outcomes beyond the co-design group (above-ground). To evaluate research co-design, researchers may wish to consider any or all components in the tree. CONCLUSIONS The Co-Design Evaluation Framework has been collaboratively developed with various stakeholders to be used prospectively (planning for evaluation), concurrently (making adjustments during the co-design process) and retrospectively (reviewing past co-design efforts to inform future activities).
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Affiliation(s)
- Sanne Peters
- School of Health Sciences, The University of Melbourne, Melbourne, Australia.
| | - Lisa Guccione
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Jill Francis
- School of Health Sciences, The University of Melbourne, Melbourne, Australia
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
- Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Stephanie Best
- School of Health Sciences, The University of Melbourne, Melbourne, Australia
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
- Victorian Comprehensive Cancer Centre, Melbourne, VIC, Australia
| | - Emma Tavender
- Emergency Research, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Critical Care, The University of Melbourne , Melbourne, Australia
| | - Janet Curran
- School of Nursing, Faculty of Health, Ottawa, Canada
- Emergency Medicine, Faculty of Medicine, Ottawa, Canada
| | - Katie Davies
- Neurological Rehabilitation Group Mount Waverley, Mount Waverley, Australia
| | - Stephanie Rowe
- School of Health Sciences, The University of Melbourne, Melbourne, Australia
- School of Nursing, Faculty of Health, Ottawa, Canada
| | - Victoria J Palmer
- The ALIVE National Centre for Mental Health Research Translation, The University of Melbourne, Melbourne, Australia
| | - Marlena Klaic
- School of Health Sciences, The University of Melbourne, Melbourne, Australia
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Westerink HJ, Oirbans T, Garvelink MM, van Uden-Kraan CF, Zouitni O, Bart HAJ, van der Wees PJ, van der Nat PB. Barriers and facilitators of meaningful patient participation at the collective level in healthcare organizations: A systematic review. Health Policy 2023; 138:104946. [PMID: 38000333 DOI: 10.1016/j.healthpol.2023.104946] [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: 07/10/2023] [Revised: 10/20/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023]
Abstract
INTRODUCTION Collective patient participation, such as patient participation in policy making, has become increasingly important to achieve high-quality care. However, there is little knowledge on how to let patients participate in a meaningful manner at this level. The aim of this systematic literature review was to provide an overview of barriers, facilitators, and associated impact of collective patient participation. METHODS PubMed and EMBASE were searched until May 2023 for studies that evaluated collective patient participation. Study characteristics, methods for patient participation, barriers and facilitators, and impact (if measured) of patient participation were extracted from the articles. RESULTS We included 59 articles. Identified barriers and facilitators of collective patient participation were grouped into five categories: (1) preconditions for patient participation, (2) strategy for patient participation, (3) preparation of patients and staff for patient participation, (4) support for patients and staff during patient participation, and (5) evaluation of patient participation. Impact of patient participation was reported in 34 included studies at three levels: quality of care and research, the team and organization, and the participants themselves. Only three studies reported quantitative outcomes. CONCLUSION Interestingly, similar challenges were experienced during a period of twenty years, indicating that little progress has been made in structuring patient participation. Our overview of barriers and facilitators will therefore help to improve and structure collective patient participation.
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Affiliation(s)
- Henrike J Westerink
- Department of Value Improvement, St. Antonius Hospital, Nieuwegein, Utrecht, The Netherlands; Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Tom Oirbans
- Department of Value Improvement, St. Antonius Hospital, Nieuwegein, Utrecht, The Netherlands; Department of Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Mirjam M Garvelink
- Department of Value Improvement, St. Antonius Hospital, Nieuwegein, Utrecht, The Netherlands
| | | | - Ouisam Zouitni
- Client Council, St. Antonius Hospital, Nieuwegein, Utrecht, The Netherlands
| | - Hans A J Bart
- Independent patient advocate (former policymaker for the Netherlands Patients Federation, now retired)
| | - Philip J van der Wees
- Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Paul B van der Nat
- Department of Value Improvement, St. Antonius Hospital, Nieuwegein, Utrecht, The Netherlands; Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Nijmegen, The Netherlands
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Bergin RJ, Short CE, Davis N, Marker J, Dawson MT, Milton S, McNamara M, Druce P, Milley K, Karnchanachari N, Skaczkowski G. The nature and impact of patient and public involvement in cancer prevention, screening and early detection research: A systematic review. Prev Med 2023; 167:107412. [PMID: 36592674 DOI: 10.1016/j.ypmed.2022.107412] [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] [Received: 09/16/2022] [Revised: 11/23/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022]
Abstract
Patient and public involvement can produce high-quality, relevant research that better addresses the needs of patients and their families. This systematic review investigated the nature and impact of patient and public involvement in cancer prevention, screening and early detection research. Two patient representatives were involved as members of the review team. Databases (Medline, EMBASE, Emcare, Involve Evidence Library) were searched for English-language studies published 1995-March 2022. Titles/abstracts were screened by two reviewers independently. For eligible studies, data were extracted on study characteristics, patient and public involvement (who, when, how, and impact on research outcomes), and reporting quality using the Guidance for Reporting Involvement of Patients and the Public 2-Short Form. Of 4095 articles screened, 58 were eligible. Most research was from the United States (81%) and examined cancer screening or prevention (82%). Community members/organisations/public were the most involved (71%); fewer studies involved patients and/or carers (14%). Over half reported a high-level of involvement (i.e. partner and/or expert involvement), although this declined in later stages of the research cycle, e.g. data analysis. Common positive impacts included improved study design, research methods and recruitment, although most papers (62%) did not describe methods to determine impact. Reporting quality was sub-optimal, largely due to failure to consider challenges. This review found that high-level involvement of patients and the public in cancer prevention, screening and early detection research is feasible and has several advantages. However, improvements are needed to encourage involvement across the research cycle, and in evaluating and reporting its impact.
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Affiliation(s)
- Rebecca J Bergin
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia; Department of General Practice/Centre for Cancer Research, University of Melbourne, Melbourne, Australia.
| | - Camille E Short
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences and Melbourne School of Health Sciences, University of Melbourne, Melbourne, Australia
| | - Nikki Davis
- Patient representative, Primary Care Collaborative Cancer Clinical Trials Group (PC4) Community Advisory Group, Melbourne, Australia
| | - Julie Marker
- Patient representative, Primary Care Collaborative Cancer Clinical Trials Group (PC4) Community Advisory Group, Melbourne, Australia; Patient representative, Cancer Voices South Australia, Adelaide, Australia
| | | | - Shakira Milton
- Department of General Practice/Centre for Cancer Research, University of Melbourne, Melbourne, Australia
| | - Mairead McNamara
- Department of General Practice/Centre for Cancer Research, University of Melbourne, Melbourne, Australia
| | - Paige Druce
- Department of General Practice/Centre for Cancer Research, University of Melbourne, Melbourne, Australia; Central Clinical School, Monash University, Melbourne, Australia
| | - Kristi Milley
- Department of General Practice/Centre for Cancer Research, University of Melbourne, Melbourne, Australia
| | - Napin Karnchanachari
- Department of General Practice/Centre for Cancer Research, University of Melbourne, Melbourne, Australia
| | - Gemma Skaczkowski
- Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia; School of Psychology & Public Health, La Trobe University, Melbourne, Australia
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The role of personality traits in participation in an Online Cancer Community. ASLIB J INFORM MANAG 2022. [DOI: 10.1108/ajim-05-2022-0242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe purpose of this study was to investigate how personality traits influence participative behaviour in an Online Cancer Community (OCC).Design/methodology/approachQualitative semi-structured interviews were conducted with 42 users of one of the largest OCCs in Australia – Cancer Council Online Community in New South Wales (NSW).FindingsThe results showed that extraversion, emotional stability and agreeableness traits influence posting behaviour, whereas the conscientiousness trait influences lurking behaviour. The openness trait did not affect either posters or lurkers’ online behaviour.Research limitations/implicationsThe research highlights the pivotal role of personality traits in users’ decisions to post or lurk using a multi-theory perspective that combined the social exchange theory and the Five-Factor Model. Future studies should explore personality traits that can benefit from online participation in an OCC to transition only lurkers who may benefit from posting.Practical implicationsInsights from the study inform OCC practitioners and moderators when designing the OCC platform. Except for the openness trait, lurkers and posters exhibited different attitudes, which indicates that integrating these findings in the OCC design can facilitate adopting strategies to elicit more participation by OCC users.Originality/valueThis is the first study that explored the role of personality traits in users’ decisions to participate in an OCC.
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Gutman T, Kelly A, Scholes-Robertson N, Craig JC, Jesudason S, Tong A. Patient and Caregiver Experiences and Attitudes about Their Involvement in Research in Chronic Kidney Disease. Clin J Am Soc Nephrol 2022; 17:215-227. [PMID: 35131928 PMCID: PMC8823931 DOI: 10.2215/cjn.05960521] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 11/16/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND OBJECTIVES Although patient and caregiver involvement in research is widely advocated to improve the relevance and uptake of study findings, barriers and uncertainties in achieving this goal remain. This study aimed to describe patient and caregiver experiences and perspectives of their previous involvement in research, to inform strategies to strengthen patient involvement in research. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Semistructured interviews were conducted with 23 adult patients with CKD and caregivers who had previously been involved in research, from Australia, the United States, the United Kingdom, and Denmark. Transcripts were analyzed thematically. RESULTS We identified six themes: grappling with CKD diagnosis (overwhelmed by the burden of illness, silenced by stigma and shame, absence of advocacy, and awareness), bearing the responsibility for involvement (autonomy in their own care, forced to be proactive to access opportunities, infrastructural support to connect researchers and patients), battling big agendas (struggling in a system of disincentive, changing research culture, becoming equals), seeing the person behind the patient (harnessing broader knowledge, expertise, skills and interests, understanding patient needs, motivations for involvement), sensitivity to complexities of payment (accounting for individual circumstances, denoting value, enabling diverse involvement), and championing the patient voice (links to important stakeholders, drivers of innovation, responsibility to end users). CONCLUSIONS The burden of CKD, limited opportunities, and power asymmetry between patients/caregivers and researchers were challenges to meaningful involvement in research. Building trust, awareness of opportunities, and recognizing the broad expertise and value of patients/caregivers, including and beyond their illness experience, may better support patient and caregiver involvement in research in CKD.
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Affiliation(s)
- Talia Gutman
- Sydney School of Public Health, The University of Sydney, Sydney, Australia,Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia
| | - Ayano Kelly
- Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia
| | - Nicole Scholes-Robertson
- Sydney School of Public Health, The University of Sydney, Sydney, Australia,Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia
| | - Jonathan C. Craig
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | | | - Allison Tong
- Sydney School of Public Health, The University of Sydney, Sydney, Australia,Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia
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Hamilton CB, Dehnadi M, Snow ME, Clark N, Lui M, McLean J, Mamdani H, Kooijman AL, Bubber V, Hoefer T, Li LC. Themes for evaluating the quality of initiatives to engage patients and family caregivers in decision-making in healthcare systems: a scoping review. BMJ Open 2021; 11:e050208. [PMID: 34635521 PMCID: PMC8506891 DOI: 10.1136/bmjopen-2021-050208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To identify the key themes for evaluating the quality of initiatives to engage patients and family caregivers in decision-making across the organisation and system domains of healthcare systems. METHODS We conducted a scoping review. Seven databases of journal articles were searched from their inception to June 2019. Eligible articles were literature reviews published in English and provided useful information for determining aspects of engaging patients and family caregivers in decision-making to evaluate. We extracted text under three predetermined categories: structure, process and outcomes that were adapted from the Donabedian conceptual framework. These excerpts were then independently open-coded among four researchers. The subsequent themes and their corresponding excerpts were summarised to provide a rich description of each theme. RESULTS Of 7747 unique articles identified, 366 were potentially relevant, from which we selected the 42 literature reviews. 18 unique themes were identified across the three predetermined categories. There were six structure themes: engagement plan, level of engagement, time and timing of engagement, format and composition, commitment to support and environment. There were four process themes: objectives, engagement approach, communication and engagement activities. There were eight outcome themes: decision-making process, stakeholder relationship, capacity development, stakeholder experience, shape policy/service/programme, health status, healthcare quality, and cost-effectiveness. CONCLUSIONS The 18 themes and their descriptions provide a foundation for identifying constructs and selecting measures to evaluate the quality of initiatives for engaging patients and family caregivers in healthcare system decision-making within the organisation and system domains. The themes can be used to investigate the mechanisms through which relevant initiatives are effective and investigate their effectiveness.
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Affiliation(s)
- Clayon B Hamilton
- Evaluation and Research Services, Fraser Health Authority, Surrey, British Columbia, Canada
- Primary Care Division, Ministry of Health, Victoria, British Columbia, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Arthritis Research Canada, Vancouver, British Columbia, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Maryam Dehnadi
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - M Elizabeth Snow
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Centre for Health Evaluation and Outcomes Sciences, Vancouver, British Columbia, Canada
| | - Nancy Clark
- Faculty of Human and Social Development, University of Victoria, Victoria, British Columbia, Canada
| | - Michelle Lui
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Janet McLean
- Family Caregivers of British Columbia, Victoria, British Columbia, Canada
| | - Hussein Mamdani
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Allison L Kooijman
- Patient Voices Network, BC Patient Safety and Quality Council, Vancouver, British Columbia, Canada
- School of Interdisciplinary Studies, University of British Columbia, Vancouver, British Columbia, Canada
| | - Vikram Bubber
- Patient Voices Network, BC Patient Safety and Quality Council, Vancouver, British Columbia, Canada
| | - Tammy Hoefer
- BC Patient Safety and Quality Council, Vancouver, British Columbia, Canada
| | - Linda C Li
- Arthritis Research Canada, Vancouver, British Columbia, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
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Lowe D, Ryan R, Schonfeld L, Merner B, Walsh L, Graham-Wisener L, Hill S. Effects of consumers and health providers working in partnership on health services planning, delivery and evaluation. Cochrane Database Syst Rev 2021; 9:CD013373. [PMID: 34523117 PMCID: PMC8440158 DOI: 10.1002/14651858.cd013373.pub2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Health services have traditionally been developed to focus on specific diseases or medical specialties. Involving consumers as partners in planning, delivering and evaluating health services may lead to services that are person-centred and so better able to meet the needs of and provide care for individuals. Globally, governments recommend consumer involvement in healthcare decision-making at the systems level, as a strategy for promoting person-centred health services. However, the effects of this 'working in partnership' approach to healthcare decision-making are unclear. Working in partnership is defined here as collaborative relationships between at least one consumer and health provider, meeting jointly and regularly in formal group formats, to equally contribute to and collaborate on health service-related decision-making in real time. In this review, the terms 'consumer' and 'health provider' refer to partnership participants, and 'health service user' and 'health service provider' refer to trial participants. This review of effects of partnership interventions was undertaken concurrently with a Cochrane Qualitative Evidence Synthesis (QES) entitled Consumers and health providers working in partnership for the promotion of person-centred health services: a co-produced qualitative evidence synthesis. OBJECTIVES To assess the effects of consumers and health providers working in partnership, as an intervention to promote person-centred health services. SEARCH METHODS We searched the CENTRAL, MEDLINE, Embase, PsycINFO and CINAHL databases from 2000 to April 2019; PROQUEST Dissertations and Theses Global from 2016 to April 2019; and grey literature and online trial registries from 2000 until September 2019. SELECTION CRITERIA We included randomised controlled trials (RCTs), quasi-RCTs, and cluster-RCTs of 'working in partnership' interventions meeting these three criteria: both consumer and provider participants meet; they meet jointly and regularly in formal group formats; and they make actual decisions that relate to the person-centredness of health service(s). DATA COLLECTION AND ANALYSIS Two review authors independently screened most titles and abstracts. One review author screened a subset of titles and abstracts (i.e. those identified through clinical trials registries searches, those classified by the Cochrane RCT Classifier as unlikely to be an RCT, and those identified through other sources). Two review authors independently screened all full texts of potentially eligible articles for inclusion. In case of disagreement, they consulted a third review author to reach consensus. One review author extracted data and assessed risk of bias for all included studies and a second review author independently cross-checked all data and assessments. Any discrepancies were resolved by discussion, or by consulting a third review author to reach consensus. Meta-analysis was not possible due to the small number of included trials and their heterogeneity; we synthesised results descriptively by comparison and outcome. We reported the following outcomes in GRADE 'Summary of findings' tables: health service alterations; the degree to which changed service reflects health service user priorities; health service users' ratings of health service performance; health service users' health service utilisation patterns; resources associated with the decision-making process; resources associated with implementing decisions; and adverse events. MAIN RESULTS We included five trials (one RCT and four cluster-RCTs), with 16,257 health service users and more than 469 health service providers as trial participants. For two trials, the aims of the partnerships were to directly improve the person-centredness of health services (via health service planning, and discharge co-ordination). In the remaining trials, the aims were indirect (training first-year medical doctors on patient safety) or broader in focus (which could include person-centredness of health services that targeted the public/community, households or health service delivery to improve maternal and neonatal mortality). Three trials were conducted in high income-countries, one was in a middle-income country and one was in a low-income country. Two studies evaluated working in partnership interventions, compared to usual practice without partnership (Comparison 1); and three studies evaluated working in partnership as part of a multi-component intervention, compared to the same intervention without partnership (Comparison 2). No studies evaluated one form of working in partnership compared to another (Comparison 3). The effects of consumers and health providers working in partnership compared to usual practice without partnership are uncertain: only one of the two studies that assessed this comparison measured health service alteration outcomes, and data were not usable, as only intervention group data were reported. Additionally, none of the included studies evaluating this comparison measured the other primary or secondary outcomes we sought for the 'Summary of findings' table. We are also unsure about the effects of consumers and health providers working in partnership as part of a multi-component intervention compared to the same intervention without partnership. Very low-certainty evidence indicated there may be little or no difference on health service alterations or health service user health service performance ratings (two studies); or on health service user health service utilisation patterns and adverse events (one study each). No studies evaluating this comparison reported the degree to which health service alterations reflect health service user priorities, or resource use. Overall, our confidence in the findings about the effects of working in partnership interventions was very low due to indirectness, imprecision and publication bias, and serious concerns about risk of selection bias; performance bias, detection bias and reporting bias in most studies. AUTHORS' CONCLUSIONS The effects of consumers and providers working in partnership as an intervention, or as part of a multi-component intervention, are uncertain, due to a lack of high-quality evidence and/or due to a lack of studies. Further well-designed RCTs with a clear focus on assessing outcomes directly related to partnerships for patient-centred health services are needed in this area, which may also benefit from mixed-methods and qualitative research to build the evidence base.
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Affiliation(s)
- Dianne Lowe
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Rebecca Ryan
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Lina Schonfeld
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Bronwen Merner
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Louisa Walsh
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | | | - Sophie Hill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
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Abstract
The term user involvement is frequently applied in research. Frameworks for patient and informal caregiver participation as coresearchers in studies concerning patients with life-threatening illness are however sparse. The PhD project Dying With Dignity—Dignity-Preserving Care for Older Women Living at Home With Incurable Cancer has implemented a thorough cooperation with patients and informal caregivers from the early stages of the research process. A framework for Patient and Informal Caregiver Participation In Research (PAICPAIR) is suggested—creating a stronger foundation for democracy, equality, and research quality by also promoting active participation among vulnerable people experiencing incurable, life-threatening illness, as coresearchers.
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Halvorsrud K, Kucharska J, Adlington K, Rüdell K, Brown Hajdukova E, Nazroo J, Haarmans M, Rhodes J, Bhui K. Identifying evidence of effectiveness in the co-creation of research: a systematic review and meta-analysis of the international healthcare literature. J Public Health (Oxf) 2021; 43:197-208. [PMID: 31608396 PMCID: PMC8042368 DOI: 10.1093/pubmed/fdz126] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 09/03/2019] [Accepted: 09/17/2019] [Indexed: 12/15/2022] Open
Abstract
Background To investigate and address the evidence gap on the effectiveness of co-creation/production in international health research. Methods An initial systematic search of previous reviews published by 22 July 2017 in Medline, Embase, PsycINFO, Scopus and Web of Science. We extracted reported aims, elements and outcomes of co-creation/production from 50 reviews; however, reviews rarely tested effectiveness against intended outcomes. We therefore checked the reference lists in 13 included systematic reviews that cited quantitative studies involving the public/patients in the design and/or implementation of research projects to conduct meta-analyses on their effectiveness using standardized mean difference (SMD). Results Twenty-six primary studies were included, showing moderate positive effects for community functions (SMD = 0.56, 95%CI = 0.29–0.84, n = 11) and small positive effects for physical health (SMD = 0.25, 95%CI = 0.07–0.42, n = 9), health-promoting behaviour (SMD = 0.14, 95%CI = 0.03–0.26, n = 11), self-efficacy (SMD = 0.34, 95%CI = 0.01–0.67, n = 3) and health service access/receipt (SMD = 0.36, 95%CI = 0.21–0.52, n = 12). Non-academic stakeholders that co-created more than one research stage showed significantly favourable mental health outcomes. However, co-creation was rarely extended to later stages (evaluation/dissemination), with few studies specifically with ethnic minority groups. Conclusions The co-creation of research may improve several health-related outcomes and public health more broadly, but research is lacking on its longer term effects.
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Affiliation(s)
- Kristoffer Halvorsrud
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK
| | - Justyna Kucharska
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK.,Westminster University, 115 New Cavendich Street, London, W1W 6UW, UK
| | - Katherine Adlington
- East London NHS Foundation Trust, City and Hackney Centre for Mental Health, Homerton Row, London, E9 6SR, UK
| | - Katja Rüdell
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK
| | - Eva Brown Hajdukova
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK
| | - James Nazroo
- Sociology, School of Social Sciences, University of Manchester, Humanities, Bridgeford Street, Oxford Road, Manchester, M13 9PL, UK
| | - Maria Haarmans
- Sociology, School of Social Sciences, University of Manchester, Humanities, Bridgeford Street, Oxford Road, Manchester, M13 9PL, UK
| | - James Rhodes
- Sociology, School of Social Sciences, University of Manchester, Humanities, Bridgeford Street, Oxford Road, Manchester, M13 9PL, UK
| | - Kamaldeep Bhui
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK
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Anderst A, Conroy K, Fairbrother G, Hallam L, McPhail A, Taylor V. Engaging consumers in health research: a narrative review. AUST HEALTH REV 2021; 44:806-813. [PMID: 32780985 DOI: 10.1071/ah19202] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 02/24/2020] [Indexed: 01/30/2023]
Abstract
Objective Consumer and community engagement (CCE) in research is increasingly valued in a contemporary healthcare environment that seeks to genuinely partner with consumers and the wider community. Although there is widespread agreement at research governance levels as to the benefits of CCE in research, there is little available research-based guidance as to how best to proceed with CCE organisationally and how to manage and overcome barriers. The aim of this narrative review was to draw together the available research, review findings and relevant governance-related material and to discuss these in light of a case series among research-engaged consumers in order to chart a practical way forward. Methods A narrative literature review about CCE in research was conducted. Following this, a case series among seven consumers who had been engaged as partners in health research was conducted. Finally, the lived experience of these consumers was explored against the findings of the narrative review. Results In all, 121 papers were identified and reviewed, 37 of which were used to inform the content of this paper. The most important benefits of CCE to both consumers and healthcare researchers were related to improvements in trust between consumer and researchers, and the increased relevance and ethics of research agendas ultimately pursued. Barriers to CCE were found to be pragmatic, attitudinal and organisational. Enabling factors that capitalise on the benefits and help address the barriers to meaningful CCE are outlined and discussed in light of a case series conducted among research-engaged consumers in Australia and internationally. Conclusion Best practice standards, organisational commitments and resources are needed to improve the status quo in Australia and to provide health research end-users with research outcomes that better align with their priorities and needs. What is known about the topic? Consumer and community engagement (CCE) in research is increasing in prevalence and is likely to be beneficial to both consumers and healthcare providers and researchers. What does this paper add? Following review of the available research findings and governance statements about CCE, enabling strategies are presented in light of a case series among Sydney-based research-engaged consumers. What are the implications for practitioners? Barriers to consumer and community engagement can be overcome if well understood and tackled organisationally. The potential benefits of shifting to a fully consumer- or community-engaged healthcare research environment are multifactorial and represent a paradigm shift in favour of evidence-based patient and family-centred care.
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Affiliation(s)
- Ania Anderst
- The George Institute for Global Health, Level 5, 1 King Street, Newtown, NSW 2042, Australia. ; and Corresponding author.
| | - Karena Conroy
- The George Institute for Global Health, Level 5, 1 King Street, Newtown, NSW 2042, Australia. ; and Sydney Local Health District, Level 11, King George V Building, Missenden Road, Camperdown, NSW 2050, Australia. ; ; ;
| | - Greg Fairbrother
- Sydney Local Health District, Level 11, King George V Building, Missenden Road, Camperdown, NSW 2050, Australia. ; ; ; ; and University of Sydney, Faculty of Medicine and Health, Level 11, King George V Building, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Laila Hallam
- Sydney Local Health District, Level 11, King George V Building, Missenden Road, Camperdown, NSW 2050, Australia. ; ; ; ; and The University of Sydney, Centre for Disability Research and Policy (CDRP), 92-94 Parramatta Road, Camperdown, NSW 2050, Australia
| | - Alan McPhail
- Sydney Local Health District, Level 11, King George V Building, Missenden Road, Camperdown, NSW 2050, Australia. ; ; ;
| | - Vicki Taylor
- Sydney Local Health District, Level 11, King George V Building, Missenden Road, Camperdown, NSW 2050, Australia. ; ; ; ; and University of Sydney, Faculty of Medicine and Health, Level 11, King George V Building, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
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11
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Hult A, Lundgren E, Jangland E. Patient representatives: Crucial members of health-care working groups facing an uncertain role and conflicting expectations. A qualitative study. Health Expect 2021; 24:1197-1206. [PMID: 33949054 PMCID: PMC8369119 DOI: 10.1111/hex.13249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/16/2021] [Accepted: 03/18/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Patient representatives (PRs) have been involved for decades in health-care development, and their participation is increasingly sought in health-care working groups (HCWGs) on every level. However, information on how the role could be further developed and teamwork improved remains sparse. OBJECTIVE To explore the role of patient representatives in clinical practice guideline (CPG) monitoring groups, to describe their contributions and identify possibilities of improvement. DESIGN Qualitative design using semi-structured interviews analysed by content analysis. SETTING AND PARTICIPANTS Interviews were conducted with 11 PRs, 13 registered nurses, and 9 physicians, all members of national committees monitoring CPGs for cancer in Sweden. RESULTS Most participants considered the PR role important but mentioned several problems. PRs' contributions were hampered by uncertainties about their role, the low expectations of other group members and their sense that their contributions were often disregarded. Some professionals questioned whether PRs were truly representative and said some topics could not be discussed with PRs present. CONCLUSION This study highlights the fundamental problems that remain to be solved despite the long involvement of PRs in HCWGs. Even though the PR role and teamwork differed between the groups, most PRs need to be empowered to be actively involved in the teamwork and have their engagement and knowledge fully utilized. Enhancing teamwork through clarifying roles and expectations could lead to more inclusive and equal teams able to work more effectively towards the goal of improving health care. PATIENT OR PUBLIC CONTRIBUTION PRs were information givers in data collection.
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Affiliation(s)
- Anna Hult
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Ewa Lundgren
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Eva Jangland
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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12
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Cavens C, Imms C, Drake G, Garrity N, Wallen M. Perspectives of children and adolescents with cerebral palsy about involvement as research partners: a qualitative study. Disabil Rehabil 2021; 44:4293-4302. [PMID: 33779451 DOI: 10.1080/09638288.2021.1900927] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Children and adolescents with cerebral palsy have diverse needs and often engage with healthcare services, including paediatric rehabilitation. Partnering with these children and adolescents on research projects to inform practice has the potential to ensure services continue to remain relevant and appropriate. This study aimed to identify what children and adolescents with cerebral palsy suggest are effective ways for researchers to involve them as partners in research. MATERIALS AND METHODS This qualitative study was guided by interpretive description. Children and adolescents with cerebral palsy between 8 and 18 years participated in semi-structured, activity-based focus groups or interviews. Verbatim transcripts were coded and analysed using thematic analysis. One member of the research team was a young woman with cerebral palsy. RESULTS Seventeen children and adolescents with cerebral palsy from NSW and Victoria (Australia) were involved. Participants were between 8 and 18 years (mean = 12 years), male (n = 11) and female (n = 6). Analysis identified four nested themes: "insider knowledge", "reasons for involvement", "roles in research" and "facilitating partnership". CONCLUSION This study identified perspectives of children and adolescents on their involvement as research partners, and considerations for researchers to facilitate involvement of children and adolescents with cerebral palsy as partners in research.IMPLICATIONS FOR REHABILITATIONThe commitment in healthcare to client-centred practice requires that consumers, including children and young people with cerebral palsy, have opportunities to influence the direction of research which impacts them.Children and young people with cerebral palsy are interested in research partnerships and motivated to be involved in various areas of research.Effective research partnerships with younger populations can be facilitated by researchers acknowledging a child or young person's expertise, and employing strategies relating to open communication, flexibility and support.
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Affiliation(s)
- C Cavens
- School of Allied Health, Australian Catholic University, Sydney, Australia
| | - C Imms
- School of Allied Health, Australian Catholic University, Fitzroy, Australia
| | - G Drake
- School of Allied Health, Australian Catholic University, Strathfield, Australia
| | - N Garrity
- Consumer researcher with lived experience of disability
| | - M Wallen
- School of Allied Health, Australian Catholic University, Sydney, Australia
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Ludwig C, Graham ID, Lavoie J, Gifford W, Stacey D. Ethical considerations for engaging frail and seriously ill patients as partners in research: sub-analysis of a systematic review. RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:8. [PMID: 33517912 PMCID: PMC7849091 DOI: 10.1186/s40900-021-00254-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 01/21/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The commitment to engage patients as partners in research has been described as a political, moral and ethical imperative. Researchers feel ill-equipped to deal with potential ethical implications of engaging patients as partners. The aim of this study is to identify the ethical considerations related to engaging frail and seriously ill (FSI) patients as partners in research. METHODS We conducted a sub-analysis of a prior systematic review of 30 studies that engaged FSI patients as partners in research. Studies were included if they reported ethical considerations associated with partnering. We performed deductive content analysis, data were categorized according to Beauchamp and Childress' Principles of Biomedical Ethics (2019): autonomy, non-maleficence, beneficence, and justice. RESULTS Twenty-five studies were included. Common ethical considerations reported in relation to the principles were: autonomy - promoting desired level of involvement, addressing relational and intellectual power, facilitating knowledge and understanding of research; non-maleficence - protection from financial burden, physical and emotional suffering; beneficence - putting things right for others, showing value-added, and supporting patient-partners; and, justice - achieving appropriate representation, mutual respect for contributions, and distributing risks and benefits. CONCLUSIONS When partnering with FSI patients, research teams need to establish shared values and ensure processes are in place to identify and address ethical issues. Researchers and patients should work together to clarify the intent and outcomes of the partnership, actively address power differentials, recognize and minimize the potential for unintended harm, and strive to maximize the benefits of partnership. SYSTEMATIC REVIEW REGISTRATION The protocol for the original systematic review has been registered with the International Prospective Register of Systematic Reviews PROSPERO (CRD42019127994).
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Affiliation(s)
- Claire Ludwig
- University of Ottawa, Faculty of Health Sciences, School of Nursing, Roger Guindon Hall, 451 Smyth Road, Ottawa, Ontario K1H 8M5 Canada
| | - Ian D. Graham
- University of Ottawa, Faculty of Health Sciences, School of Nursing, Roger Guindon Hall, 451 Smyth Road, Ottawa, Ontario K1H 8M5 Canada
- University of Ottawa, Faculty of Medicine, School of Epidemiology and Public Health, 600 Peter Morand Crescent, Ottawa, K1G 5Z3 Ontario Canada
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, 501 Smyth Road, Ottawa, Ontario K1H 8L6 Canada
| | - Josee Lavoie
- Geriatric Psychiatry Program, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4 Canada
| | - Wendy Gifford
- University of Ottawa, Faculty of Health Sciences, School of Nursing, Roger Guindon Hall, 451 Smyth Road, Ottawa, Ontario K1H 8M5 Canada
| | - Dawn Stacey
- University of Ottawa, Faculty of Health Sciences, School of Nursing, Roger Guindon Hall, 451 Smyth Road, Ottawa, Ontario K1H 8M5 Canada
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, 501 Smyth Road, Ottawa, Ontario K1H 8L6 Canada
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Ocloo J, Garfield S, Franklin BD, Dawson S. Exploring the theory, barriers and enablers for patient and public involvement across health, social care and patient safety: a systematic review of reviews. Health Res Policy Syst 2021; 19:8. [PMID: 33472647 PMCID: PMC7816359 DOI: 10.1186/s12961-020-00644-3] [Citation(s) in RCA: 121] [Impact Index Per Article: 40.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 10/13/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The emergence of patient and public involvement (PPI) in healthcare in the UK can be traced as far back as the 1970s. More recently, campaigns by harmed patients have led to a renewed focus on strengthening PPI. There is a growing awareness of the benefits of PPI in research as well as a need to address power inequities and a lack of diversity and inclusion. This review was undertaken to look at evidence for theories, barriers and enablers in PPI across health, social care and patient safety that could be used to strengthen PPI and address a perceived knowledge and theory gap with PPI in patient safety. METHODS We searched MEDLINE, EMBASE and PsycINFO from inception to August 2018, using both MeSH and free-text terms to identify published empirical literature. Protocols in PROSPERO were also searched to identify any systematic reviews in progress. The extracted information was analysed using a narrative approach, which synthesises data using a descriptive method. RESULTS Forty-two reviews were identified and grouped by key outcomes. Twenty-two papers mentioned theory in some form, 31 mentioned equality and diversity (although with no theory mentioned in this area), and only 19 cited equality and diversity as a barrier or enabler. Thirty-four reviews identified barriers and enablers at different organisational levels: personal/individual; attitudes; health professional; roles and expectations; knowledge, information and communication; financing and resourcing; training; general support; recruitment and representation, PPI methods and working with communities and addressing power dynamics. CONCLUSIONS The review findings suggest that a commitment to PPI and partnership working is dependent on taking a whole system approach. This needs to consider the complex individual and organisational enablers and constraints to this process and address imbalances of power experienced by different groups. Addressing equality and diversity and use of a theory-driven approach to guide PPI are neglected areas. The long tradition of involvement across health and social care can provide considerable expertise in thinking about ways to strengthen approaches to PPI. This is especially important in patient safety, with a much newer tradition of developing PPI than other areas of healthcare.
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Affiliation(s)
- Josephine Ocloo
- Centre for Implementation Science, Health Services, Population and Research Department, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, UK. .,National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) At King's College Hospital NHS Foundation Trust, London, UK.
| | - Sara Garfield
- Imperial College Healthcare NHS Trust, London, UK.,University College London School of Pharmacy, London, UK
| | - Bryony Dean Franklin
- Imperial College Healthcare NHS Trust, London, UK.,University College London School of Pharmacy, London, UK
| | - Shoba Dawson
- Centre for Academic Primary Care, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
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Moser A, Melchior I, Veenstra M, Stoffers E, Derks E, Jie KS. Improving the experience of older people with colorectal and breast cancer in patient-centred cancer care pathways using experience-based co-design. Health Expect 2021; 24:478-490. [PMID: 33440059 PMCID: PMC8077111 DOI: 10.1111/hex.13189] [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] [Received: 07/20/2020] [Revised: 11/23/2020] [Accepted: 12/08/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Patient and public involvement (PPI) in quality improvement of oncological care pathways for older patients are rare. OBJECTIVES Improve the care pathway experience of older cancer patients and explore lessons learned regarding how to engage this vulnerable group. DESIGN Experience-Based Co-Design. SETTING AND PARTICIPANTS Older cancer patients, their caregivers and healthcare professionals within colorectal and breast cancer care pathways. INTERVENTIONS Co-design quality improvement teams. MAIN OUTCOME MEASURES Colorectal cancer care pathway touchpoints were (a) availability of a contact person during diagnostic, treatment and aftercare phases; (b) collaboration between physicians and different hospital departments; (c) continuous relationship with same physician; (d) respectful treatment; (e) and information transfer with primary care. Breast cancer care pathway touchpoints were (a) comprehensive information package and information provision, (b) care planning based on patient preferences, (c) continuity of patient-professional relationship and (d) specialized care in case of vulnerability. Challenges related to PPI included (a) ability of older cancer patients to be reflective, critical and think at a collective level; (b) gaining support and commitment of professionals; (d) overcoming cultural differences and power inequalities; and (e) involving researchers and facilitators with appropriate expertise and position. CONCLUSION This multidisciplinary quality improvement project revealed several challenges of PPI with older cancer patients and their caregivers. Research teams themselves need to assume the role of facilitator to enable meaningful PPI of older cancer patients. PATIENT OR PUBLIC CONTRIBUTION Patient and caregiver representatives and advocates were involved in the design, conduct, analysis, interpretation of the data and preparation of this manuscript.
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Affiliation(s)
- Albine Moser
- Research Centre for Autonomy and Participation of Chronically Ill People, Zuyd University of Applied Sciences, Heerlen, The Netherlands.,Department of Family Medicine, CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Inge Melchior
- Department of Internal Medicine, Zuyderland Medical Centre, Sittard, The Netherlands.,Research Centre for Integrative Patient Centred Health Care, Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | - Marja Veenstra
- Burgerkracht Limburg (Citizin Power Limburg), Sittard, The Netherlands
| | - Esther Stoffers
- Burgerkracht Limburg (Citizin Power Limburg), Sittard, The Netherlands
| | - Elvira Derks
- Department of Quality Improvement, Zuyderland Medical Centre, Sittard, The Netherlands
| | - Kon-Siong Jie
- Department of Internal Medicine, Zuyderland Medical Centre, Sittard, The Netherlands.,Research Centre for Integrative Patient Centred Health Care, Zuyd University of Applied Sciences, Heerlen, The Netherlands
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Parry M, Bjørnnes AK, Toupin-April K, Najam A, Wells D, Sivakumar A, Richards DP, Ceroni T, Park M, Ellis AK, Gilron I, Marlin S. Patient Engagement Partnerships in Clinical Trials: Development of Patient Partner and Investigator Decision Aids. THE PATIENT 2020; 13:745-756. [PMID: 33026639 PMCID: PMC7655585 DOI: 10.1007/s40271-020-00460-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/19/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND A 2017 systematic review suggested patient engagement in clinical trials has been limited, with little active engagement in trial design or data analysis, interpretation or dissemination. Additionally, there remains limited sex/gender reporting in clinical trial research. OBJECTIVES The overall goal of this project was to disseminate sex/gender knowledge and build capacity for patient engagement in clinical trials. Specific objectives were to (1) create capacity and identify opportunities for patient engagement in clinical trials and sponsor- or investigator-led activities (e.g. clinical trial design and conduct); and (2) enhance new/early investigator sex/gender knowledge and skills related to patient-oriented research (POR). METHODS We used the Canadian Institutes of Health Research Strategy for Patient-Oriented Research (SPOR) Capacity Development Framework and the SPOR Patient Engagement Framework to guide three phases of this project: (1) conduct a scoping review using methods described by the Evidence for Policy and Practice Information (EPPI) and the Coordinating Centre at the Institute of Education (Phase 1); (2) host a 1-day POR consultation workshop (Phase 2); and (3) deliver a new/early investigator POR training day (Phase 3). Six electronic databases (CINAHL, MEDLINE, EMBASE, PsychInfo, the Cochrane Library, and AMED) were searched from 1996 using keywords and Medical Subject Heading (MeSH) terms in accordance with the International Association for Public Participation (IAP2) and the search criteria in the bibliographic databases. Standard approaches were used to search the grey literature. RESULTS A total of 79 studies and over 150 websites were subject to data abstraction by team members, capturing information on sex/gender and SPOR's patient engagement guiding principles of inclusiveness, support, mutual respect, and co-building. Results were presented to 32 key stakeholders at the consultation workshop and input was sought on next steps using nominal group techniques. Based on the plethora of existing POR resources, relevant POR information from the scoping review was collated into two decision aids (patient and investigator) to determine readiness to engage with/as a patient partner in a clinical trial. The decision aids were presented at a POR training day with 88 new/early investigators, clinicians, patient partners and decision makers. The decision aids showed 'good' usability, assessed using the System Usability Scale (SUS). Attendees thought the decision aids were engaging, they increased their understanding of sex/gender, patient engagement and POR, and they would recommend them to others. POR principles and practices were integrated across all phases of the project. Patient partners (1) identified research priorities/search terms; (2) collected/analyzed data; (3) designed the patient partner decision aid; and (4) disseminated the results through presentation. CONCLUSION Our digital patient partner and investigator decision aids are the first to provide information technology to deliver sex/gender, POR knowledge, and decision support beyond the traditional decision aids used for health screening and/or treatment decisions. The decision aids have the potential to make a significant contribution to Canada's Strategy for POR and support the collaborative efforts of patients and investigators to build a sustainable, accessible and equitable health care system.
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Affiliation(s)
- Monica Parry
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, ON, M5T 1P8, Canada.
| | - Ann Kristin Bjørnnes
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Karine Toupin-April
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Adhiyat Najam
- Patient Partner, Diabetes Action Canada, Toronto, ON, Canada
| | - David Wells
- Patient Partner, Diabetes Action Canada, Toronto, ON, Canada
| | - Aditi Sivakumar
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | | | - Tina Ceroni
- Patient Partner, Clinical Trials Ontario, Toronto, ON, Canada
| | - Marianne Park
- Patient Partner, Network of Women with Disabilities, Woodstock, ON, Canada
| | - Anne K Ellis
- Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Ian Gilron
- Departments of Anesthesiology and Perioperative Medicine, Biomedical and Molecular Sciences and School of Policy Studies, Queen's University, Kingston, ON, Canada
| | - Susan Marlin
- Patient Partner, Diabetes Action Canada, Toronto, ON, Canada
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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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Chegini Z, Janati A, Babaie J, Pouraghaei M. Exploring the barriers to patient engagement in the delivery of safe care in Iranian hospitals: A qualitative study. Nurs Open 2020; 7:457-465. [PMID: 31871731 PMCID: PMC6917972 DOI: 10.1002/nop2.411] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 10/01/2019] [Accepted: 10/07/2019] [Indexed: 12/19/2022] Open
Abstract
Aim To investigate barriers to patient engagement in the delivery of safe hospital care. Design Qualitative exploratory study. Methods A qualitative study with 35 Iranian health professionals was conducted from February to April 2019 using semi-structured interviews to elicit their opinions. MAXQDA 11 software was used for data management, and the data were analysed using framework analysis. Results Barriers, which potentially have negative impact on patient engagement in the delivery of safer care, were categorized into four themes. The first category included patient-related barriers such as low levels of health literacy, ineffective education, patient unwillingness and cultural barriers. The second category included staff-related barriers such as the existence of negative attitudes towards engaging patients in matters relating to patient safety, ineffective communication, high workload and the reluctance on the part of physicians to engage with patients. Barriers created by limited resources and inadequate training provided by universities and in the workplace formed the third category and community-related barriers such as the inadequate dissemination of information via the mass media and a lack of community-based services formed the fourth category. Conclusion Results demonstrate the multilayered nature of the significant barriers to the engagement of patients in the delivery of safe care and reflect the need for a collaborative approach between the recipients of care, researchers, care providers and policy makers if these are to be overcome.
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Affiliation(s)
- Zahra Chegini
- Department of Health Services ManagementFaculty of Management and Medical InformaticsTabriz University of Medical SciencesTabrizIran
| | - Ali Janati
- Department of Health Services ManagementFaculty of Management and Medical InformaticsTabriz University of Medical SciencesTabrizIran
- Iranian Center of Excellence in Health ManagementSchool of Management and Medical InformaticsTabriz University of Medical SciencesTabrizIran
| | - Javad Babaie
- Department of Health Services ManagementFaculty of Management and Medical InformaticsTabriz University of Medical SciencesTabrizIran
| | - Mahboub Pouraghaei
- Emergency Medicine Research TeamFaculty of MedicineTabriz University of Medical SciencesTabrizIran
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Virdun C, Luckett T, Gilmore I, Brassil M, Lilian R, Lorenz K, Phillips J. Involving consumers with palliative care needs and their families in research: A case study. Collegian 2019. [DOI: 10.1016/j.colegn.2019.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kebbe M, Perez A, Buchholz A, McHugh TLF, Scott SD, Richard C, Dyson MP, Ball GDC. End-user perspectives to inform policy and program decisions: a qualitative and quantitative content analysis of lifestyle treatment recommendations by adolescents with obesity. BMC Pediatr 2019; 19:418. [PMID: 31699060 PMCID: PMC6839254 DOI: 10.1186/s12887-019-1749-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Accepted: 09/25/2019] [Indexed: 11/12/2022] Open
Abstract
Background Lifestyle modifications represent the first line of treatment in obesity management; however, many adolescents with obesity do not meet lifestyle recommendations. Given that adolescents are rarely consulted during health policy development and in the design of lifestyle interventions, their first-hand experiences, preferences, and priorities may not be represented. Accordingly, our purpose was to explore adolescents’ lifestyle treatment recommendations to inform policy and program decisions. Methods Conducted from July 2017 to January 2018, this study adhered to a qualitative, crosslanguage, patient-oriented design. We recruited 19 13–17-year-old adolescents (body mass index [BMI] ≥85th percentile) seeking multidisciplinary treatment for obesity in geographically and culturally diverse regions of Canada. Adolescents participated in one-on-one, in-person, semi-structured interviews in English or French. Interviews were audio-recorded, transcribed verbatim, managed using NVivo 11, and analyzed using quantitative and qualitative content analysis by two independent researchers. Results Adolescents’ recommendations were organized into five categories, each of which denotes health as a collective responsibility: (i) establish parental support within limits, (ii) improve accessibility and availability of ‘healthy foods’, (iii) limit deceptive practices in food marketing, (iv) improve accessibility and availability of varied physical activity opportunities, and (v) delay school start times. Respect for individual autonomy and decision-making capacity were identified as particularly important, however these were confronted with adolescents’ partial knowledge on nutrition and food literacy. Conclusions Adolescents’ recommendations highlighted multi-level, multi-component factors that influenced their ability to lead healthy lifestyles. Uptake of these recommendations by policy-makers and program developers may be of added value for lifestyle treatment targeting adolescents with obesity.
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Affiliation(s)
- M Kebbe
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton Clinic Health Academy, 11405 - 87 Avenue, Edmonton, Alberta, Canada
| | - A Perez
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton Clinic Health Academy, 11405 - 87 Avenue, Edmonton, Alberta, Canada
| | - A Buchholz
- Centre for Healthy Active Living, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - T-L F McHugh
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - S D Scott
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - C Richard
- Department of Agricultural, Food, and Nutritional Science, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - M P Dyson
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton Clinic Health Academy, 11405 - 87 Avenue, Edmonton, Alberta, Canada
| | - G D C Ball
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton Clinic Health Academy, 11405 - 87 Avenue, Edmonton, Alberta, Canada.
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Hertel E, Cheadle A, Matthys J, Coleman K, Gray M, Robbins M, Tufte J, Hsu C. Engaging patients in primary care design: An evaluation of a novel approach to codesigning care. Health Expect 2019; 22:609-616. [PMID: 31134725 PMCID: PMC6737754 DOI: 10.1111/hex.12909] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 04/18/2019] [Accepted: 04/22/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Recognition is growing that to create truly patient-centred care, health-care organizations need to partner with patients around care design. More research into the benefits of engaging patients and the most effective ways of partnering with them is needed. METHODS This study assessed the process and impact of a collaborative effort to design a new clinic service that balanced the number of patient and clinical provider/staff codesigners involved and recruited patients to represent diverse perspectives. Data sources included interviews with participants, event observation and participant surveys. RESULTS Our evaluation found that including patients as equal partners improved the design process by infusing a real-world, patient perspective. The pre-event orientation and interactive methods used in the event fostered positive collaboration, as well as personal growth for the patient codesigners. CONCLUSION This study demonstrated the feasibility and benefits of including a roughly equal number of patients and clinical providers/staff in design events and ensuring that the patients represent diverse perspectives.
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Affiliation(s)
- Erin Hertel
- Center for Community Health & EvaluationKaiser Permanente Washington Health Research Institute (formerly known as Group Health Research Institute)SeattleWashington
| | - Allen Cheadle
- Center for Community Health & EvaluationKaiser Permanente Washington Health Research Institute (formerly known as Group Health Research Institute)SeattleWashington
| | - Juno Matthys
- Center for Community Health & EvaluationKaiser Permanente Washington Health Research Institute (formerly known as Group Health Research Institute)SeattleWashington
| | - Katie Coleman
- MacColl Center for Healthcare InnovationKaiser Permanente Washington Health Research Institute (formerly known as Group Health Research Institute)SeattleWashington
| | - Marlaine Gray
- Center for Community Health & EvaluationKaiser Permanente Washington Health Research Institute (formerly known as Group Health Research Institute)SeattleWashington
| | - Michele Robbins
- Kaiser Permanente Washington Health Research Institute (formerly known as Group Health Research Institute)SeattleWashington
| | - Janice Tufte
- Kaiser Permanente Washington Health Research Institute (formerly known as Group Health Research Institute)SeattleWashington
| | - Clarissa Hsu
- Center for Community Health & EvaluationKaiser Permanente Washington Health Research Institute (formerly known as Group Health Research Institute)SeattleWashington
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22
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Lowe D, Merner B, Graham-Wisener L, Walsh L, Hill S. The effects of consumers and health providers working in partnership as an intervention for the promotion of person-centred health services. Hippokratia 2019. [DOI: 10.1002/14651858.cd013373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Dianne Lowe
- La Trobe University; Centre for Health Communication and Participation, School of Psychology and Public Health; Bundoora VIC Australia 3086
| | - Bronwen Merner
- La Trobe University; Centre for Health Communication and Participation, School of Psychology and Public Health; Bundoora VIC Australia 3086
| | | | - Louisa Walsh
- La Trobe University; Centre for Health Communication and Participation, School of Psychology and Public Health; Bundoora VIC Australia 3086
| | - Sophie Hill
- La Trobe University; Centre for Health Communication and Participation, School of Psychology and Public Health; Bundoora VIC Australia 3086
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23
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Gremyr I, Elg M, Smith F, Gustavsson S. Exploring the phase for highest impact on radicality: a cross-sectional study of patient involvement in quality improvement in Swedish healthcare. BMJ Open 2018; 8:e021958. [PMID: 30413500 PMCID: PMC6231560 DOI: 10.1136/bmjopen-2018-021958] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Involving patients in quality improvement is often suggested as a critical step for improving healthcare processes. However, this comes with challenges related to resources, tokenism, validity and competence. Therefore, to optimise the use of available resources, there is a need to understand at what stage in the improvement cycle patient involvement is most beneficial. Thus, the purpose of this study was to identify the phase of an improvement cycle in which patient involvement had the highest impact on radicality of improvement. DESIGN An exploratory cross-sectional survey was used. SETTING AND METHODS A questionnaire was completed by 155 Swedish healthcare professionals (response rate 34%) who had trained and had experience in patient involvement in quality improvement. Based on their replies, the impact of patient involvement on radicality in various phases of the improvement cycle was modelled using the partial least squares method. RESULTS Patient involvement in quality improvement might help to identify and realise innovative solutions; however, there is variation in the impact of patient involvement on perceived radicality depending on the phase in which patients become involved. The highest impact on radicality was observed in the phases of capture experiences and taking action, while a moderate impact was observed in the evaluate phase. The lowest impact was observed in the identify and prioritise phase. CONCLUSIONS Involving patients in improvement projects can enhance the quality of care and help to identify radically new ways of delivering care. This study shows that it is possible to suggest at what point in an improvement cycle patient involvement has the highest impact, which will enable more efficient use of the resources available for patient involvement.
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Affiliation(s)
- Ida Gremyr
- Department of Technology Management and Economics, Chalmers University of Technology, Gothenburg, Sweden
| | - Mattias Elg
- Department of Management and Engineering, Linköping University, Linköping, Sweden
| | - Frida Smith
- Department of Technology Management and Economics, Chalmers University of Technology, Gothenburg, Sweden
- Research and Development, Regional Cancer Centre West, Gothenburg, Sweden
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24
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Pii KH, Schou LH, Piil K, Jarden M. Current trends in patient and public involvement in cancer research: A systematic review. Health Expect 2018; 22:3-20. [PMID: 30378234 PMCID: PMC6351419 DOI: 10.1111/hex.12841] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 08/27/2018] [Accepted: 09/16/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Patient and public involvement (PPI) in health research is on the rise worldwide. Within cancer research, PPI ensures that the rapid development of medical and technological opportunities for diagnostics, treatment and care corresponds with the needs and priorities of people affected by cancer. An overview of the experiences, outcomes and quality of recent PPI in cancer research would provide valuable information for future research. OBJECTIVE To describe the current state of PPI in cancer research focusing on the research stages, applied methods, stated purposes and outcomes, and challenges and recommendations. METHODS A search was conducted on PubMed, CINAHL and PsycINFO for literature published from December 2006 to April 2017. Original research studies describing the involvement of cancer patients, stakeholders and carers as active partners at any stage of the research process were included. RESULTS Twenty-seven studies were included, the majority reporting PPI at the early stages of research, that is, during the definition and prioritization of research topics and the development of recruitment strategies. Few studies reported PPI at later stages and across the research process. Challenges and recommendations were only briefly described, and critical reflection on the PPI process was lacking. CONCLUSION PPI needs to be integrated more broadly in the cancer research process. The quality of reporting PPI should be strengthened through greater critical reflections including both positive and negative experiences of the PPI process. This will contribute to the further development of PPI and its potential in cancer research.
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Affiliation(s)
- Kathrine Hoffmann Pii
- Institute of Nursing and Nutrition, Copehagen University College, Copenhagen, Denmark
| | - Lone Helle Schou
- Institute of Nursing and Nutrition, Copehagen University College, Copenhagen, Denmark
| | - Karin Piil
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet Copenhagen, Denmark.,Department of Public Health, Aarhus University, Denmark
| | - Mary Jarden
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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25
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James M, Todd C, Scott S, Stratton G, McCoubrey S, Christian D, Halcox J, Audrey S, Ellins E, Anderson S, Copp I, Brophy S. Teenage recommendations to improve physical activity for their age group: a qualitative study. BMC Public Health 2018; 18:372. [PMID: 29558987 PMCID: PMC5859389 DOI: 10.1186/s12889-018-5274-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 03/08/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is recommended that young people should engage in 60 min of moderate-to-vigorous activity (MVPA) a day for health benefits, but few teenagers actually meet this recommendation. Policy-makers play a vital role in designing physical activity initiatives, but they generally do this with little or no input from the intervention recipients. This study explores the recommendations made by teenagers to improve activity provision, uptake and sustainability of physical activity engagement for both themselves and their peers. METHODS Thirteen focus groups were carried out in seven secondary schools in South Wales, United Kingdom. Participants (n = 78) were recruited from a larger mixed-method randomised control trial, which involved the implementation of a voucher scheme to promote physical activity in teenagers (aged 13-14). Thematic analysis was undertaken to identify key issues from the perspective of the teenage participants. RESULTS Six key recommendations were identified following analysis of the focus groups: i) Lower/remove the cost of activities without sacrificing the quality, ii) Make physical activity opportunities more locally accessible, iii) Improve the standards of existing facilities, iv) Make activities more specific to teenagers v) Give teenagers a choice of activities/increase variety of activity and vi) Provide activities that teenage girls enjoy (e.g., fun, sociable and not competitive sport). Throughout the focus groups, the increased opportunity to participate in unstructured activity was a key recommendation echoed by both boys and girls in all themes. CONCLUSION There is a disconnect between what is available and what teenagers want to do. Policy-makers and those involved in physical activity delivery (e.g., schools, local council and local activity providers) should include young people in designing interventions and facilities to ensure they are meeting the needs of this age group and providing the right opportunities for teenagers to be active. That is unstructured, local, low cost, fun, sociable opportunities and the right facilities to be active.
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Affiliation(s)
- Michaela James
- College of Medicine, Data Science Building, Swansea University, Singleton Park, Swansea, SA2 8PP, UK.
| | - Charlotte Todd
- College of Medicine, Data Science Building, Swansea University, Singleton Park, Swansea, SA2 8PP, UK
| | - Samantha Scott
- College of Medicine, Data Science Building, Swansea University, Singleton Park, Swansea, SA2 8PP, UK
| | - Gareth Stratton
- College of Engineering, Bay Campus Swansea University, Fabian Way, Crymlyn Burrows, Skewen, Swansea, SA1 8EN, UK
| | - Sarah McCoubrey
- , City and Council of Swansea, Room 153, Guildhall, Swansea, SA1 4PE, Swansea, UK
| | - Danielle Christian
- Department of Sport and Physical Activity, Edge Hill University, St Helens Road, Ormskirk, Lancs, L39 4QP, Wolverhampton, UK
| | - Julian Halcox
- Swansea University, Singleton Park, Swansea, SA2 8PP, UK
| | - Suzanne Audrey
- , Office Room 4.02, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | | | - Samantha Anderson
- Birchgrove Comphrehensive School, Birchgrove Rd, Birchgrove, Swansea SA7 9NB, Swansea, UK
| | - Isabel Copp
- , Cefn Hengoed Community School, 60 Caldicot Rd, Bon-y-maen, Swansea SA1 7HW, Swansea, UK
| | - Sinead Brophy
- College of Medicine, Data Science Building, Swansea University, Singleton Park, Swansea, SA2 8PP, UK
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26
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Hall AE, Bryant J, Sanson-Fisher RW, Fradgley EA, Proietto AM, Roos I. Consumer input into health care: Time for a new active and comprehensive model of consumer involvement. Health Expect 2018; 21:707-713. [PMID: 29512248 PMCID: PMC6117488 DOI: 10.1111/hex.12665] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2017] [Indexed: 11/28/2022] Open
Abstract
Background To ensure the provision of patient‐centred health care, it is essential that consumers are actively involved in the process of determining and implementing health‐care quality improvements. However, common strategies used to involve consumers in quality improvements, such as consumer membership on committees and collection of patient feedback via surveys, are ineffective and have a number of limitations, including: limited representativeness; tokenism; a lack of reliable and valid patient feedback data; infrequent assessment of patient feedback; delays in acquiring feedback; and how collected feedback is used to drive health‐care improvements. Objectives We propose a new active model of consumer engagement that aims to overcome these limitations. This model involves the following: (i) the development of a new measure of consumer perceptions; (ii) low cost and frequent electronic data collection of patient views of quality improvements; (iii) efficient feedback to the health‐care decision makers; and (iv) active involvement of consumers that fosters power to influence health system changes.
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Affiliation(s)
- Alix E Hall
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW, Australia
| | - Jamie Bryant
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW, Australia
| | - Rob W Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW, Australia
| | - Elizabeth A Fradgley
- Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW, Australia.,Hunter Cancer Research Alliance, Waratah, NSW, Australia
| | - Anthony M Proietto
- Hunter Cancer Research Alliance, Waratah, NSW, Australia.,Cancer Services and Cancer Network, Hunter New England Local Health District, Newcastle, NSW, Australia
| | - Ian Roos
- Youth Research Centre, Melbourne Graduate School of Education, University of Melbourne, Parkville, Vic., Australia
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Shiu C, Kim HJ, Fredriksen-Goldsen K. Health Care Engagement Among LGBT Older Adults: The Role of Depression Diagnosis and Symptomatology. THE GERONTOLOGIST 2017; 57:S105-S114. [PMID: 28087800 DOI: 10.1093/geront/gnw186] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 11/14/2016] [Indexed: 01/10/2023] Open
Abstract
PURPOSE OF THE STUDY Optimal engagement in health care plays a critical role in the success of disease prevention and treatment, particularly for older adults who are often in greater need of health care services. However, to date, there is still limited knowledge about the relationship between depression and health care engagement among lesbian, gay, bisexual, and transgender (LGBT) older adults. DESIGN AND METHODS This study utilized data from Aging with Pride: National Health, Aging, Sexuality/Gender Study, from the 2014 survey with 2,450 LGBT adults 50 years old and older. Multiple-variable regression was utilized to evaluate relationships between three indicators of health care engagement and four depression groups after controlling for background characteristics and discrimination in health care. Health care engagement indicators were "not using preventive care," "not seeking care when needed," and "difficulty in adhering to treatments." Depression groups were defined by depression diagnosis and symptomatology, including Diagnosed-Symptomatic group (Diag-Sympt), Diagnosed-Nonsymptomatic group (Diag-NoSympt), Nondiagnosed-Symptomatic group (NoDiag-Sympt), and Nondiagnosed-Nonsymptomatic group (NoDiag-NoSympt). RESULTS Depression groups displayed different patterns and levels of health care engagement. The Diag-Sympt group displayed the highest "difficulty in adhering to treatments." Diag-NoSympt group displayed the lowest "not using preventive care." The NoDiag-Sympt group reported the highest "not using preventive care" and "not seeking care when needed." The NoDiag-NoSympt group had the lowest "not seeking care when needed" and "difficulty in adhering to treatments." IMPLICATIONS Depression diagnosis and symptomatology are jointly associated with health care engagement among LGBT older adults. Interventions aiming to promote health care engagement among this population should simultaneously consider both depression diagnosis and symptomatology.
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Brett J, Staniszewska S, Simera I, Seers K, Mockford C, Goodlad S, Altman D, Moher D, Barber R, Denegri S, Entwistle AR, Littlejohns P, Morris C, Suleman R, Thomas V, Tysall C. Reaching consensus on reporting patient and public involvement (PPI) in research: methods and lessons learned from the development of reporting guidelines. BMJ Open 2017; 7:e016948. [PMID: 29061613 PMCID: PMC5665282 DOI: 10.1136/bmjopen-2017-016948] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 07/18/2017] [Accepted: 08/09/2017] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Patient and public involvement (PPI) is inconsistently reported in health and social care research. Improving the quality of how PPI is reported is critical in developing a higher quality evidence base to gain a better insight into the methods and impact of PPI. This paper describes the methods used to develop and gain consensus on guidelines for reporting PPI in research studies (updated version of the Guidance for Reporting Patient and Public Involvement (GRIPP2)). METHODS There were three key stages in the development of GRIPP2: identification of key items for the guideline from systematic review evidence of the impact of PPI on health research and health services, a three-phase online Delphi survey with a diverse sample of experts in PPI to gain consensus on included items and a face-to-face consensus meeting to finalise and reach definitive agreement on GRIPP2. Challenges and lessons learnt during the development of the reporting guidelines are reported. DISCUSSION The process of reaching consensus is vital within the development of guidelines and policy directions, although debate around how best to reach consensus is still needed. This paper discusses the critical stages of consensus development as applied to the development of consensus for GRIPP2 and discusses the benefits and challenges of consensus development.
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Affiliation(s)
- Jo Brett
- Department of Midwifery, Community and Public Health, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, Oxfordshire, UK
| | - Sophie Staniszewska
- Division of Health Sciences, RCN Research Institute, Warwick Medical School, University of Warwick, Coventry, UK
| | - Iveta Simera
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, EQUATOR Network, Centre for Statistics in Medicine, University of Oxford, Oxford, Oxfordshire, UK
| | - Kate Seers
- Division of Health and Social Care Research, RCN Research Institute, Warwick Medical School, University of Warwick, Coventry, UK
| | - Carole Mockford
- Division of Health Sciences, RCN Research Institute, Warwick Medical School, University of Warwick, Coventry, UK
| | - Susan Goodlad
- Centre for Research in Psychology, Behaviour and Acheivement, University of Coventry, Coventry, UK
| | - Doug Altman
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, EQUATOR Network, Centre for Statistics in Medicine, University of Oxford, Oxford, Oxfordshire, UK
- Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, Centre for Statistics in Medicine, Oxford, UK
| | - David Moher
- Ottawa Hospital Research Institute, School of Epidemiology, Public Health, and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Rosemary Barber
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Simon Denegri
- INVOLVE, National Institute of Health Research (NIHR), University of Southampton, Southampton, UK
| | | | | | - Christopher Morris
- Peninsula Cerebra Childhood Disability Research Unit (PenCRU), University of Exeter Medical School, Exeter, UK
| | | | - Victoria Thomas
- Patient and Public Involvement Unit, Public Involvement Programme, National Institute for Health and Clinical Excellence, London, UK
| | - Colin Tysall
- UNTRAP, University of Warwick, Coventry, Warwicks, UK
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30
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Coon JT, Gwernan-Jones R, Moore D, Richardson M, Shotton C, Pritchard W, Morris C, Stein K, Ford T. End-user involvement in a systematic review of quantitative and qualitative research of non-pharmacological interventions for attention deficit hyperactivity disorder delivered in school settings: reflections on the impacts and challenges. Health Expect 2016; 19:1084-97. [PMID: 26389784 PMCID: PMC5053289 DOI: 10.1111/hex.12400] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The benefits of end-user involvement in health-care research are widely recognized by research agencies. There are few published evaluations of end-user involvement in systematic reviews. OBJECTIVES (i) Describe end-user involvement in a complex mixed-methods systematic review of ADHD in schools, (ii) reflect on the impact of end-user involvement, (iii) highlight challenges and benefits experienced and (iv) provide suggestions to inform future involvement. METHODS End-users were involved in all stages of the project, both as authors and as members of an advisory group. In addition, several events were held with groups of relevant end-users during the project. RESULTS End-user input (i) guided the direction of the research, (ii) contributed to a typology of interventions and outcomes, (iii) contributed to the direction of data analysis and (iv) contributed to the robustness of the syntheses by demonstrating the alignment of interim findings with lived experiences. Challenges included (i) managing expectations, (ii) managing the intensity of emotion, (iii) ensuring that involvement was fruitful for all not just the researcher, (iv) our capacity to communicate and manage the process and (v) engendering a sense of involvement amongst end-users. CONCLUSIONS End-user involvement was an important aspect of this project. To minimize challenges in future projects, a recognition by the project management team and the funding provider that end-user involvement even in evidence synthesis projects is resource intensive is essential to allow appropriate allocation of time and resources for meaningful engagement.
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Affiliation(s)
- Jo Thompson Coon
- NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter, Exeter, UK.
| | | | - Darren Moore
- NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter, Exeter, UK
| | - Michelle Richardson
- Health Service and Population Research Department, Kings College London, London, UK
| | - Catherine Shotton
- Child Health Group, University of Exeter Medical School, University of Exeter, Exeter, UK
| | | | | | - Ken Stein
- NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter, Exeter, UK
| | - Tamsin Ford
- Child Health Group, University of Exeter Medical School, University of Exeter, Exeter, UK
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31
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Johnson KE, Mroz TM, Abraham M, Figueroa Gray M, Minniti M, Nickel W, Reid R, Sweeney J, Frosch DL, Ness DL, Hsu C. Promoting Patient and Family Partnerships in Ambulatory Care Improvement: A Narrative Review and Focus Group Findings. Adv Ther 2016; 33:1417-39. [PMID: 27352378 PMCID: PMC4969329 DOI: 10.1007/s12325-016-0364-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Indexed: 01/17/2023]
Abstract
Introduction Ambulatory practices that actively partner with patients and families in quality improvement (QI) report benefits such as better patient/family interactions with physicians and staff, and patient empowerment. However, creating effective patient/family partnerships for ambulatory care improvement is not yet routine. The objective of this paper is to provide practices with concrete evidence about meaningfully involving patients and families in QI activities. Methods Review of literature published from 2000–2015 and a focus group conducted in 2014 with practice advisors. Results Thirty articles discussed 26 studies or examples of patient/family partnerships in ambulatory care QI. Patient and family partnership mechanisms included QI committees and advisory councils. Facilitators included process transparency, mechanisms for acting on patient/family input, and compensation. Challenges for practices included uncertainty about how best to involve patients and families in QI. Several studies found that patient/family partnership was a catalyst for improvement and reported that partnerships resulted in process improvements. Focus group results were concordant. Conclusion This paper describes emergent mechanisms and processes that ambulatory care practices use to partner with patients and families in QI including outcomes, facilitators, and challenges. Funding Gordon and Betty Moore Foundation. Electronic supplementary material The online version of this article (doi:10.1007/s12325-016-0364-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | - Marie Abraham
- Institute for Patient- and Family-Centered Care, Bethesda, MD, USA
| | | | - Mary Minniti
- Institute for Patient- and Family-Centered Care, Bethesda, MD, USA
| | - Wendy Nickel
- American College of Physicians, Philadelphia, PA, USA
| | - Robert Reid
- Trillium Health Partners, Mississauga, ON, Canada
| | - Jennifer Sweeney
- National Partnership for Women and Families, Washington, DC, USA
| | | | - Debra L Ness
- National Partnership for Women and Families, Washington, DC, USA
| | - Clarissa Hsu
- Group Health Research Institute, Seattle, WA, USA
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Abstract
BACKGROUND Existing evidence suggests that a person-centred approach can improve coordination and access to health care and services. OBJECTIVES This overview sought to: (1) identify and define components of person-centred care; (2) explore nursing and health-care provider behaviours that are person-centred; and (3) identify systems level supports required to enable person-centred care. METHODS An overview of reviews was conducted to locate synthesized literature published between June 2005 and April 2014. Two independent reviewers screened, extracted data and quality appraised the sources. Results were synthesized narratively. RESULTS A total of 46 articles were deemed relevant to this overview. This paper synthesizes the results of 43 of the 46 articles. A universal definition of person-centred care was not found, however; common components, associated health-care provider behaviours and the organizational supports required for person-centred care are discussed. CONCLUSIONS Key findings from this review outline that health-care providers and organizations need to promote person-centred care by engaging persons in partnerships, shared decision-making, and meaningful participation in health system improvement.
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Affiliation(s)
- Tanvi Sharma
- a International Affairs & Best Practice Guidelines Program , Registered Nurses' Association of Ontario , 158 Pearl Street, Toronto , ON , Canada M5H 1L3
| | - Megan Bamford
- a International Affairs & Best Practice Guidelines Program , Registered Nurses' Association of Ontario , 158 Pearl Street, Toronto , ON , Canada M5H 1L3
| | - Denise Dodman
- b Bluewater Health , 89 Norman Street, Sarnia , ON , Canada N7T 6S3
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Lawn S. What researchers think of involving consumers in health research. Aust J Prim Health 2016; 22:483-490. [DOI: 10.1071/py15089] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 09/28/2015] [Indexed: 11/23/2022]
Abstract
Involving consumers in research enhances its quality and appropriateness, and is required within many research funding schemes. While the rationale for consumer involvement is understood, its implementation is unclear. The researcher investigated views of a group of Australia’s leading researchers (n=38) about the role of consumers in their research using a brief survey administered at the Australia National Health and Medical Research (NHMRC) Translation Conference in 2014. Interpretive content analysis was used for data analysis. Respondents noted the importance of consumer involvement in the planning and design of research, to ensure its relevance to the community as end-users of research outcomes. Therefore, consumers were seen as central to research translation by the respondents. Many respondents perceived empathy for the experiences of others as a fundamental researcher skill. Despite strong acknowledgement of the benefits of consumer involvement in research, gaps exist between the rhetoric and practice of consumer involvement beyond consultative roles. Power over decisions made about research processes and ownership of research are continuing barriers to greater consumer involvement in research. Structural changes to how research is funded, evaluated and reported provide a means of addressing these gaps. NHMRC leadership is needed to promote these changes.
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Forbat L, Hubbard G. Service user involvement in research may lead to contrary rather than collaborative accounts: findings from a qualitative palliative care study. J Adv Nurs 2015; 72:759-69. [DOI: 10.1111/jan.12865] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Liz Forbat
- Clare Holland House Hospice; Calvary Health and Australian Catholic University; Canberra Australian Capital Territory Australia
| | - Gill Hubbard
- Cancer Care Research Centre; University of Stirling; Inverness UK
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Safaei J. Deliberative democracy in health care: current challenges and future prospects. J Healthc Leadersh 2015; 7:123-136. [PMID: 29355181 PMCID: PMC5740990 DOI: 10.2147/jhl.s70021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND There is a vast body of literature on deliberative, participative, or engaged democracy. In the area of health care there is a rapidly expanding literature on deliberative democracy as embodied in various notions of public engagement, shared decision-making (SDM), patient-centered care, and patient/care provider autonomy over the past few decades. It is useful to review such literature to get a sense of the challenges and prospects of introducing deliberative democracy in health care. OBJECTIVE This paper reviews the key literature on deliberative democracy and SDM in health care settings with a focus on identifying the main challenges of promoting this approach in health care, and recognizing its progress so far for mapping out its future prospects in the context of advanced countries. METHOD Several databases were searched to identify the literature pertinent to the subject of this study. A total of 56 key studies in English were identified and reviewed carefully for indications and evidence of challenges and/or promising avenues of promoting deliberative democracy in health care. RESULTS Time pressure, lack of financial motivation, entrenched professional interests, informational imbalance, practical feasibility, cost, diversity of decisions, and contextual factors are noted as the main challenges. As for the prospects, greater clarity on conception of public engagement and policy objectives, real commitment of the authorities to public input, documenting evidence of the effectiveness of public involvement, development of patient decision supports, training of health professionals in SDM, and use of multiple and flexible methods of engagement leadership suited to specific contexts are the main findings in the reviewed literature. CONCLUSION Seeking deliberative democracy in health care is both challenging and rewarding. The challenges have been more or less identified. However, its prospects are potentially significant. Such prospects are more likely to materialize if deliberative democracy is pursued more systematically in the broader sociopolitical domains.
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Affiliation(s)
- Jalil Safaei
- Department of Economics, University of Northern British Columbia, Prince George, BC, Canada
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Lord L, Gale N. Subjective experience or objective process: understanding the gap between values and practice for involving patients in designing patient-centred care. J Health Organ Manag 2015; 28:714-30. [PMID: 25420353 DOI: 10.1108/jhom-08-2013-0160] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Patient-centred care and patient involvement are increasingly central concepts in health policy in the UK and elsewhere. However, there is little consensus regarding their definition or how to achieve "patient-centred" care in everyday practice or how to involve patients in service redesign initiatives. The purpose of this paper is to explore these issues from the perspective of key stakeholders within National Health Service (NHS) hospitals in the UK. DESIGN/METHODOLOGY/APPROACH Semi-structured interviews, covering a range of topics related to service redesign, were conducted with 77 key stakeholders across three NHS Trusts in the West Midlands. In total, 20 of these stakeholders were re-interviewed 18 months later. Data were managed and analysed using the Framework Method. FINDINGS While patient-centred care and patient involvement were regularly cited as important to the stakeholders, a gap persisted between values and reported practice. This gap is explained through close examination of the ways in which the concepts were used by stakeholders, and identifying the way in which they were adapted to fit other organizational priorities. The value placed on positive subjective experience changed to concerns about objective measurement of the patients as they move through the system. RESEARCH LIMITATIONS/IMPLICATIONS Increased awareness and reflection on the conceptual tensions between objective processes and subjective experiences could highlight reasons why patient-centred values fail to translate into improved practice. ORIGINALITY/VALUE The paper describes and explains a previously unarticulated tension in health organisations between values and practice in patient centred care and patient involvement in service redesign.
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Cupertino AP, Saint-Elin M, de Los Rios JB, Engelman KK, Greiner KA, Ellerbeck EF, Nápoles AM. Empowering Promotores de Salud as partners in cancer education and research in rural southwest Kansas. Oncol Nurs Forum 2015; 42:15-22. [PMID: 25542317 PMCID: PMC4349504 DOI: 10.1188/15.onf.15-22] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To describe community-based participatory processes used to develop promotore training on cancer research, and to assess the feasibility of training promotores from rural communities to disseminate cancer research information. DESIGN Prospective, cohort design. SETTING Rural communities in the state of Kansas. SAMPLE 34 Spanish-speaking promotores attended an information session; 27 enrolled and 22 completed training. METHODS With input from a community advisory board, the authors developed a leadership and cancer curriculum and trained Spanish-speaking promotores to disseminate information on cancer research. Promotores completed pretraining and post-training surveys in Spanish to assess demographic characteristics and changes in knowledge of cancer, cancer treatment and cancer research studies, and intent to participate in cancer research. MAIN RESEARCH VARIABLES Cancer knowledge, awareness of cancer clinical trials, interest in participating in cancer clinical research studies. FINDINGS Compared to pretraining, after training, promotores were more likely to correctly define cancer, identify biopsies, describe cancer stages, and report ever having heard of cancer research studies. CONCLUSIONS Completion rates of the training and willingness to participate in cancer research were high, supporting the feasibility of training promotores to deliver community-based education to promote cancer research participation. IMPLICATIONS FOR NURSING Nursing professionals and researchers can collaborate with promotores to disseminate cancer education and research among underserved rural Latino communities in Kansas and elsewhere. Members of these communities appear willing and interested in improving their knowledge of cancer and cancer clinical trials.
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Affiliation(s)
- Ana Paula Cupertino
- Department of Preventive Medicine and Public Health, Kansas University Medical Center (KUMC)
| | | | | | | | | | | | - Anna M Nápoles
- Department of Medicine, University of California, San Francisco
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Oliver S, Liabo K, Stewart R, Rees R. Public involvement in research: making sense of the diversity. J Health Serv Res Policy 2014; 20:45-51. [PMID: 25228453 DOI: 10.1177/1355819614551848] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This paper presents a coherent framework for designing and evaluating public involvement in research by drawing on an extensive literature and the authors' experience. The framework consists of three key interrelated dimensions: the drivers for involvement; the processes for involvement and the impact of involvement. The pivotal point in this framework is the opportunity for researchers and others to exchange ideas. This opportunity results from the processes which bring them together and which support their debates and decisions. It is also the point at which research that is in the public interest is open to public influence and the point at which the interaction can also influence anyone directly involved. Judicious choice of methods for bringing people together, and supporting their debate and decisions, depends upon the drivers of those involved; these vary with their characteristics, particularly their degree of enthusiasm and experience, and their motivation.
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Affiliation(s)
- Sandy Oliver
- Professor of Public Policy, Social Science Research Unit, Institute of Education, University of London, UK
| | - Kristin Liabo
- Research Fellow, Social Science Research Unit, Institute of Education, University of London, UK
| | - Ruth Stewart
- Senior Research Officer, Social Science Research Unit, Institute of Education, University of London, UK Associate Professor, Evidence-Informed Policy Team, Centre for Anthropological Research, University of Johannesburg, South Africa
| | - Rebecca Rees
- Senior Lecturer in Evidence Informed Policy and Practice, Social Science Research Unit, Institute of Education, University of London, UK
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van Bekkum JE, Hilton S. UK research funding bodies' views towards public participation in health-related research decisions: an exploratory study. BMC Health Serv Res 2014; 14:318. [PMID: 25056498 PMCID: PMC4115156 DOI: 10.1186/1472-6963-14-318] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 07/16/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A challenge facing science is how to renew and improve its relationship with society. One potential solution is to ensure that the public are more involved in the scientific process from the inception of research plans to scientific dissemination strategies. However, to date, little is known about how research funding bodies view public participation in research funding decisions, and how they involve the public into their strategies and practices. This paper provides insights into how key representatives working in the UK non-commercial research funding sector perceive public participation in health-related research funding decisions and the possible implications of these. METHODS We conducted qualitative semi-structured interviews with 30 key stakeholders from 10 UK non-commercial research funding bodies that either partially or exclusively fund health-related research. The findings were written up in thematic narrative form. RESULTS The different disciplines that encompass health research, and their differing frames of 'science and society', were found to influence how research funding bodies viewed and implemented public participation in research funding decisions. Relevant subsets of the public were more likely to be involved in research funding decisions than lay public, which could be linked to underlying technocratic rationales. Concerns about public participation stemmed from the highly professionalised scientific environment that the public were exposed to. Additionally, from a more positivist frame, concerns arose regarding subjective views and values held by the public that may damage the integrity of science. CONCLUSION Underlying assumptions of technocracy largely appear to be driving PP/PE within the research grant review process, even in funding bodies that have overtly democratic ideals. Some conceptions of technocracy were more inclusive than others, welcoming different types of expertise such as patient or research-user experiences and knowledge, while others suggested taking a narrower and more positivist view of expertise as techno-scientific expertise. For research to have its maximum impact when translated into healthcare, health policies and health technologies, there needs to be sensitivity towards multiple frames of knowledge, expertise and underlying values that exist across science and society.
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Affiliation(s)
| | - Shona Hilton
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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A Systematic Review of the Impact of Patient and Public Involvement on Service Users, Researchers and Communities. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2014; 7:387-95. [DOI: 10.1007/s40271-014-0065-0] [Citation(s) in RCA: 354] [Impact Index Per Article: 35.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Paterson C, Jones M, Rattray J, Lauder W. Identifying the self-management behaviours performed by prostate cancer survivors: a systematic review of the evidence. J Res Nurs 2014. [DOI: 10.1177/1744987114523976] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Purpose Prostate cancer survivors are keen to engage as active partners in the management of their condition but have voiced a number of unmet support needs that make effective self-management problematic. Identifying self-management behaviours and evaluating how self-management changes over time may provide valuable insights into how men can be better supported to self-manage. Our systematic review aimed to identify the self-management behaviours for prostate cancer survivors and to evaluate whether these change over time. Methods Using the PRISMA statement we performed a systematic review of studies that identified the self-management behaviours of prostate cancer survivors. Databases searched included: DARE, CDSR, Medline, CINAHL, PsycINFO and ASSIA. Studies were classified by levels of evidence and quality assessment. Results 111 publications were retrieved from the search and 5 publications were included. Men performed a variety of self-management behaviours for psychological and physical problems. Only one study assessed changes in self-management behaviours over time and was limited to men treated by radiotherapy. Conclusion Despite the recent political drive for cancer survivors to self-manage, this review has demonstrated the evidence base is under-developed and a wide range of research is needed to address the unmet supportive care needs of prostate cancer survivors. Practically, this review has identified that Dodd’s Self-Care Log was found to have the strongest psychometric properties for additional research in this area.
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Affiliation(s)
- Catherine Paterson
- Research Fellow (RAII) in Cancer Care, Faculty of Health and Medical Sciences, School of Health and Social Care, University of Surrey, UK
| | - Martyn Jones
- Professor of Healthcare Research in School of Nursing and Midwifery, University of Dundee, UK
| | - Janice Rattray
- Reader in Acute and Critical Care Nursing, School of Nursing and Midwifery, University of Dundee, UK
| | - William Lauder
- Professor of Nursing at the University of Stirling, UK; Visiting Professor at the University of South Florida, USA
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Supporting cancer survivors' participation in peer review: perspectives from NCI's CARRA program. J Cancer Surviv 2013; 8:114-20. [PMID: 24214497 DOI: 10.1007/s11764-013-0318-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 10/04/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE Including cancer survivors in the peer review of cancer-related research is increasingly valued as a strategy for bringing the "patient perspective" to discussions of research merit and human subject protection. Because integrating lay stakeholders into peer review poses challenges, this qualitative study explored the perspectives of experienced patient advocates to identify programmatic supports for survivors' participation. METHODS Semi-structured telephone interviews were conducted with a purposive sample of 19 cancer survivors and 6 administrators involved in the National Cancer Institute's Consumer Advocates in Research and Related Activities program. Audio-recorded interviews were transcribed verbatim and analyzed via thematic content analysis. Participants were highly educated and included survivors of breast, prostate, and blood-related cancers. RESULTS Interviewees emphasized the importance of adequately preparing survivors to serve as advocates. Given the intellectual challenge of peer review, interviewees noted the need for intensive and ongoing training on how to review proposals, and they identified mock reviews and peer mentoring as effective strategies to complement didactic instruction. Participants also stressed the need to address social challenges inherent in advocate-scientist encounters. In addition to training for both advocates and scientists, participants reported that opportunities for informal social interaction were important for facilitating collaboration. Finally, participants recommended structuring advocates' role so as to give them a voice via equal voting privileges and protected opportunities to speak. CONCLUSIONS Programs that seek to include cancer survivors in peer review can prepare advocates for the intellectual and social challenges of working with scientists through careful attention to training, networking, and programmatic design. IMPLICATIONS FOR CANCER SURVIVORS Cancer survivors have been leaders in developing a role for patient advocates in the peer review of research. As the concept of patient-centered outcomes continues to gain currency, lessons learned from early programs for patient inclusion in peer review can help to inform future efforts aimed at giving patients a voice in shaping agendas for health-related research.
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Shippee ND, Domecq Garces JP, Prutsky Lopez GJ, Wang Z, Elraiyah TA, Nabhan M, Brito JP, Boehmer K, Hasan R, Firwana B, Erwin PJ, Montori VM, Murad MH. Patient and service user engagement in research: a systematic review and synthesized framework. Health Expect 2013; 18:1151-66. [PMID: 23731468 DOI: 10.1111/hex.12090] [Citation(s) in RCA: 405] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2013] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND There is growing attention towards increasing patient and service user engagement (PSUE) in biomedical and health services research. Existing variations in language and design inhibit reporting and indexing, which are crucial to comparative effectiveness in determining best practices. OBJECTIVE This paper utilizes a systematic review and environmental scan to derive an evidence-based framework for PSUE. DESIGN A metanarrative systematic review and environmental scan/manual search using scientific databases and other search engines, along with feedback from a patient advisory group (PAG). ELIGIBLE SOURCES English-language studies, commentaries, grey literature and other sources (including systematic and non-systematic reviews) pertaining to patient and public involvement in biomedical and health services research. DATA EXTRACTED Study description (e.g. participant demographics, research setting) and design, if applicable; frameworks, conceptualizations or planning schemes for PSUE-related endeavours; and methods for PSUE initiation and gathering patients'/service users' input or contributions. RESULTS Overall, 202 sources were included and met eligibility criteria; 41 of these presented some framework or conceptualization of PSUE. Sources were synthesized into a two-part framework for PSUE: (i) integral PSUE components include patient and service user initiation, reciprocal relationships, colearning and re-assessment and feedback, (ii) sources describe PSUE at several research stages, within three larger phases: preparatory, execution and translational. DISCUSSION AND CONCLUSIONS Efforts at developing a solid evidence base on PSUE are limited by the non-standard and non-empirical nature of much of the literature. Our proposed two-part framework provides a standard structure and language for reporting and indexing to support comparative effectiveness and optimize PSUE.
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Affiliation(s)
- Nathan D Shippee
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA
| | - Juan Pablo Domecq Garces
- Knowledge Synthesis Program, Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA.,Henry Ford Hospital, Detroit, MI, USA
| | - Gabriela J Prutsky Lopez
- Knowledge Synthesis Program, Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA.,Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine/Detroit Medical Center, Detroit, MI, USA
| | - Zhen Wang
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Tarig A Elraiyah
- Knowledge Synthesis Program, Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Mohammed Nabhan
- Knowledge Synthesis Program, Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA.,Saint Joseph Mercy Hospital, Ann Arbor, MI, USA
| | - Juan P Brito
- Endocrinology Division, Mayo Clinic, Rochester, MN, USA
| | - Kasey Boehmer
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Rim Hasan
- Knowledge Synthesis Program, Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Belal Firwana
- Knowledge Synthesis Program, Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | | | - Victor M Montori
- Mayo Clinic, Rochester, MN, USA.,Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
| | - M Hassan Murad
- Mayo Clinic, Rochester, MN, USA.,Knowledge Synthesis Program, Mayo Clinic, Rochester, MN, USA
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Chiu CG, Mitchell TL, Fitch MI. From patient to participant: enhancing the validity and ethics of cancer research through participatory research. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2013; 28:237-46. [PMID: 23605172 DOI: 10.1007/s13187-013-0464-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Participatory health research involves a wide spectrum of participation from the population of study. We describe the participatory research processes of a large mixed method study on the psychosocial impact of dragon boating in individuals with breast cancer. In particular, we discuss the involvement of a Community Advisory Group (consisting of five breast cancer patients/survivors) in the development of the research study, data collection and analysis, and dissemination of the study results. We also outline the elements of a research workshop, in which 13 breast cancer patients/survivors were involved in the development of a provincial survey for the study. The purpose of this article is to share our experience of engaging cancer patients/survivors in a participatory research study. We discuss the value-based elements of participatory research (power sharing, voice and respect, reciprocity, and mutual benefit), and provide a case-based example of how these participatory elements were employed to potentially increase the validity of the survey instrument, to enhance the ethics of working with a cancer population, and ultimately contributed to a high survey response rate.
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Affiliation(s)
- Connie G Chiu
- Surgical Oncology, John Wayne Cancer Institute, 2200 Santa Monica Boulevard, Santa Monica, CA, 90404, USA.
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Lam CG, Cohen KJ, Roter DL. Coping Needs in Adolescents with Cancer: A Participatory Study. J Adolesc Young Adult Oncol 2013. [DOI: 10.1089/jayao.2012.0011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Catherine G. Lam
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Kenneth J. Cohen
- Division of Pediatric Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
| | - Debra L. Roter
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Developing, testing, and sustaining rehabilitation interventions via participatory action research. Arch Phys Med Rehabil 2013; 94:S30-42. [PMID: 23260776 DOI: 10.1016/j.apmr.2012.10.025] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Revised: 10/01/2012] [Accepted: 10/09/2012] [Indexed: 11/21/2022]
Abstract
Few published intervention studies in the rehabilitation literature have included consumers in the research process other than as study participants. This lack of consumer involvement in intervention research may contribute to the challenges encountered developing, translating, disseminating, and sustaining evidence-based rehabilitation interventions in clinical practice. The overall objective of this article is to promote the integration of participatory action research (PAR) into rehabilitation intervention research as a mechanism for addressing these gaps. First, we outline essential components of a PAR model across 5 key phases of intervention research, specifically: agenda setting, methods, implementation, diffusion/dissemination, and sustainability. Second, we describe the use of PAR in rehabilitation intervention research within each of these phases by reviewing relevant literature and by providing an illustrative research example from a randomized controlled trial that integrated PAR throughout the research process. Finally, we conclude with a discussion of 5 specific recommendations for promoting the integration of PAR into rehabilitation intervention research.
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Ti L, Tzemis D, Buxton JA. Engaging people who use drugs in policy and program development: a review of the literature. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2012; 7:47. [PMID: 23176382 PMCID: PMC3551750 DOI: 10.1186/1747-597x-7-47] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 11/08/2012] [Indexed: 11/14/2022]
Abstract
Health policies and programs are increasingly being driven by people from the community to more effectively address their needs. While a large body of evidence supports peer engagement in the context of policy and program development for various populations, little is known about this form of engagement among people who use drugs (PWUD). Therefore, a narrative literature review was undertaken to provide an overview of this topic. Searches of PubMed and Academic Search Premier databases covering 1995–2010 were conducted to identify articles assessing peer engagement in policy and program development. In total, 19 articles were included for review. Our findings indicate that PWUD face many challenges that restrict their ability to engage with public health professionals and policy makers, including the high levels of stigma and discrimination that persist among this population. Although the literature shows that many international organizations are recommending the involvement of PWUD in policy and program development, our findings revealed a lack of published data on the implementation of these efforts. Gaps in the current evidence highlight the need for additional research to explore and document the engagement of PWUD in the areas of policy and program development. Further, efforts to minimize stigmatizing barriers associated with illicit drug use are urgently needed to improve the engagement of PWUD in decision making processes.
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Affiliation(s)
- Lianping Ti
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, Canada
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Wilson MG, Lavis JN, Guta A. Community-based organizations in the health sector: a scoping review. Health Res Policy Syst 2012; 10:36. [PMID: 23171160 PMCID: PMC3511187 DOI: 10.1186/1478-4505-10-36] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Accepted: 09/25/2012] [Indexed: 11/28/2022] Open
Abstract
Community-based organizations are important health system stakeholders as they provide numerous, often highly valued programs and services to the members of their community. However, community-based organizations are described using diverse terminology and concepts from across a range of disciplines. To better understand the literature related to community-based organizations in the health sector (i.e., those working in health systems or more broadly to address population or public health issues), we conducted a scoping review by using an iterative process to identify existing literature, conceptually map it, and identify gaps and areas for future inquiry. We searched 18 databases and conducted citation searches using 15 articles to identify relevant literature. All search results were reviewed in duplicate and were included if they addressed the key characteristics of community-based organizations or networks of community-based organizations. We then coded all included articles based on the country focus, type of literature, source of literature, academic discipline, disease sector, terminology used to describe organizations and topics discussed. We identified 186 articles addressing topics related to the key characteristics of community-based organizations and/or networks of community-based organizations. The literature is largely focused on high-income countries and on mental health and addictions, HIV/AIDS or general/unspecified populations. A large number of different terms have been used in the literature to describe community-based organizations and the literature addresses a range of topics about them (mandate, structure, revenue sources and type and skills or skill mix of staff), the involvement of community members in organizations, how organizations contribute to community organizing and development and how they function in networks with each other and with government (e.g., in policy networks). Given the range of terms used to describe community-based organizations, this scoping review can be used to further map their meanings/definitions to develop a more comprehensive typology and understanding of community-based organizations. This information can be used in further investigations about the ways in which community-based organizations can be engaged in health system decision-making and the mechanisms available for facilitating or supporting their engagement.
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Affiliation(s)
- Michael G Wilson
- McMaster Health Forum, McMaster University, Hamilton, ON L8S 4L6, Canada.
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Mosconi P, Satolli R, Colombo C, Villani W. Does a consumer training work? a follow-up survey of the PartecipaSalute training programs. Health Res Policy Syst 2012; 10:27. [PMID: 22938140 PMCID: PMC3464673 DOI: 10.1186/1478-4505-10-27] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Accepted: 08/06/2012] [Indexed: 11/14/2022] Open
Abstract
Background When properly trained through training programs on epidemiology, clinical research and healthcare policy, members of patients’/consumers’ organizations could be helpful for a patient-oriented healthcare system. Since 2006 the not for profit project PartecipaSalute has organized periodic editions of a training program for representatives of citizens’/patients’ organizations. After five editions of this training program, a survey of the long-term satisfaction and the impact on activities has been carried out. Methods A 17-questions follow-up questionnaire has been developed. The sample comprised 99 people who had taken part in at least one program edition. Results The overall response rate was 89% (89 responders/99 participants). About 98% of participants expressed general satisfaction with the training program and with the knowledge gained. Medical and informative topics were rated better than technical ones for their usefulness (96% versus 86%). The results of the survey showed a strong impact of the training course on single participants, while a weak outcome on the activities of the organizations was reported. Conclusions The training program was positively rated, and improvements in personal knowledge were reported. Less impact was reported on organizations’ activities. Participants showed a remarkable willingness to get more involved in healthcare decisions, and to boost their knowledge of health and research issues. The results show the importance of follow-up to understand the real value of training program and to better organize future programs.
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Affiliation(s)
- Paola Mosconi
- Laboratory of Medical Research and Consumer Involvement, Mario Negri Institute for Pharmacological Research, Via La Masa 19, Milan, 20156, Italy.
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Lancaster K, Ritter A, Stafford J. Public opinion and drug policy in Australia: Engaging the ‘affected community’. Drug Alcohol Rev 2012; 32:60-6. [DOI: 10.1111/j.1465-3362.2012.00497.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 07/25/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Kari Lancaster
- Drug Policy Modelling Program; National Drug and Alcohol Research Centre; University of New South Wales; Sydney; Australia
| | - Alison Ritter
- Drug Policy Modelling Program; National Drug and Alcohol Research Centre; University of New South Wales; Sydney; Australia
| | - Jennifer Stafford
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney; Australia
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