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Bailey K, Allemang B, Vandermorris A, Munce S, Cleverley K, Chisholm C, Cohen E, Davidson C, El Galad A, Leibovich D, Lowthian T, Pillainayagam J, Ramesh H, Samson A, Senthilnathan V, Siska P, Snider M, Toulany A. Benefits, barriers and recommendations for youth engagement in health research: combining evidence-based and youth perspectives. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:92. [PMID: 39223602 PMCID: PMC11370084 DOI: 10.1186/s40900-024-00607-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 07/05/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Youth engagement refers to the collaboration between researchers and youth to produce research. Youth engagement in health research has been shown to inform effective interventions aimed at improving health outcomes. However, limited evidence has identified promising practices to meaningfully engage youth. This synthesis aims to describe youth engagement approaches, frameworks, and barriers, as well as provide both evidence-based and youth-generated recommendations for meaningful engagement. MAIN BODY This review occurred in two stages: 1) a narrative review of existing literature on youth engagement and 2) a Youth Advisory Council (YAC) to review and supplement findings with their perspectives, experiences, and recommendations. The terms 'youth engagement' and 'health research' were searched in Google Scholar, PubMed, Web of Science, Scopus, and PsycINFO. Articles and non-peer reviewed research works related to youth engagement in health research were included, reviewed, and summarized. The YAC met with research team members and in separate youth-only forums to complement the narrative review with their perspectives. Types of youth engagement include participation as research participants, advisors, partners, and co-investigators. Barriers to youth engagement were organized into youth- (e.g., time commitments), researcher- (e.g., attitudes towards youth engagement), organizational- (e.g., inadequate infrastructure to support youth engagement), and system-level (e.g., systemic discrimination and exclusion from research). To enhance youth engagement, recommendations focus on preparing and supporting youth by offering flexible communication approaches, mentorship opportunities, diverse and inclusive recruitment, and ensuring youth understand the commitment and benefits involved. CONCLUSIONS To harness the potential of youth engagement, researchers need to establish an inclusive and enabling environment that fosters collaboration, trust, and valuable contributions from youth. Future research endeavors should prioritize investigating the dynamics of power-sharing between researchers and youth, assessing the impact of youth engagement on young participants, and youth-specific evaluation frameworks.
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Affiliation(s)
- Katherine Bailey
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Brooke Allemang
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada
| | - Ashley Vandermorris
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Adolescent Medicine, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
| | - Sarah Munce
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Kristin Cleverley
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Lawrence S. Bloomberg School of Nursing, University of Toronto, Toronto, ON, Canada
- Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Cassandra Chisholm
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Eva Cohen
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Cedar Davidson
- Neurosciences and Mental Health, SickKids Research Institute, Toronto, ON, Canada
| | - Asil El Galad
- Michael De Groote School of Medicine, McMaster University, Hamilton, ON, Canada
| | | | - Trinity Lowthian
- Department of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | | | | | - Anna Samson
- Patient Partner, Canadian Arthritis Patient Alliance, Toronto, ON, Canada
| | - Vjura Senthilnathan
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | | | | | - Alene Toulany
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Division of Adolescent Medicine, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
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Hudani A, Schwan K, Labonté R, Yaya S. Bounding systems: A qualitative study exploring healthcare coordination between the emergency youth shelter system and health system in Toronto, Canada. PLoS One 2024; 19:e0303655. [PMID: 38905314 PMCID: PMC11192382 DOI: 10.1371/journal.pone.0303655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 04/26/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Several youth staying at emergency youth shelters (EYSs) in Toronto experience poorly coordinated care for their health needs, as both the EYS and health systems operate largely in silos when coordinating care for this population. Understanding how each system is structurally and functionally bound in their healthcare coordination roles for youth experiencing homelessness (YEH) is a preliminary step to identify how healthcare coordination can be strengthened using a system thinking lens, particularly through the framework for transformative system change. METHODS Forty-six documents, and twenty-four semi-structured interviews were analyzed to explore how the EYS and health systems are bound in their healthcare coordination roles. We continuously compared data collected from documents and interviews using constant comparative analysis to build a comprehensive understanding of each system's layers, and the niches (i.e., programs and activities), organizations and actors within these layers that contribute to the provision and coordination of healthcare for YEH, within and between these two systems. RESULTS The EYS and health systems are governed by different ministries, have separate mandates, and therefore have distinct layers, niches, and organizations respective to coordinating healthcare for YEH. While neither system takes sole responsibility for this task, several government, research, and community-based efforts exist to strengthen healthcare coordination for this population, with some overlap between systems. Several organizations and actors within each system are collaborating to develop relevant frameworks, policies, and programs to strengthen healthcare coordination for YEH. Findings indicate that EYS staff play a more active role in coordinating care for YEH than health system staff. CONCLUSION A vast network of organizations and actors within each system layer, work both in silos and collaboratively to coordinate health services for YEH. Efforts are being made to bridge the gap between systems to improve healthcare coordination, and thereby youths' health outcomes.
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Affiliation(s)
- Alzahra Hudani
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Kaitlin Schwan
- Women’s National Housing & Homelessness Network, Toronto, Ontario, Canada
| | - Ronald Labonté
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
- The George Institute for Global Health, Imperial College London, London, United Kingdom
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Sanchez S, Thorburn R, Rea M, Kaufman P, Schwartz R, Selby P, Chaiton M. A systematic review of theories, models and frameworks used for youth engagement in health research. Health Expect 2024; 27:e13975. [PMID: 39102670 PMCID: PMC10825621 DOI: 10.1111/hex.13975] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 12/09/2023] [Accepted: 01/02/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Youth engagement in research, wherein youth are involved in the research beyond mere participation as human subjects, is growing and becoming more popular as an approach to research. However, systematic and deliberate theory-building has been limited. We conducted a systematic review to identify and synthesize theories, models and frameworks that have been applied in the engagement of youth in health research, including mental health. METHODS Six academic databases (MEDLINE, PsycINFO, Embase, PubMed, Scopus, CINAHL) and the grey literature were searched for relevant studies. Citation tracking was conducted through ancestry and descendancy searches. The final search was completed on 7 February 2023. Findings were summarized in a narrative synthesis informed by principles of hermeneutic analysis and interpretation. Reporting of results is in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) 2020 Statement. RESULTS Of the 1156 records identified, 16 papers were included, from which we extracted named theories (n = 6), implicit theories (n = 5) and models and frameworks (n = 20) used for youth engagement in health research. We identified theories that were explicitly stated and surfaced theories that were more implicitly suggested. Models and frameworks were organized into four categories based on their principal features: power-focused (n = 8), process-focused (n = 7), impact-focused (n = 3) and equity-focused (n = 2). Few frameworks (n = 5) were empirically tested in health-related research. CONCLUSIONS The state of theoretical development in youth engagement in research is still evolving. In this systematic review, we identified theories, models and frameworks used for youth engagement in health research. Findings from this systematic review offer a range of resources to those who seek to develop and strengthen youth engagement in their own research. PATIENT OR PUBLIC CONTRIBUTION Youth engaged as patients in the research were not involved in planning or conducting the systematic review. However, youth researchers in their early to mid-20s led the planning, implementation and interpretation of the review. As part of subsequent work, we formed a youth advisory board to develop a youth-led knowledge mobilization intended for an audience of youth with lived experience of being engaged as patients in research.
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Affiliation(s)
- Sherald Sanchez
- Institute of Medical Science, Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- Ontario Tobacco Research Unit, Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Rachel Thorburn
- Department of Applied Psychology and Human DevelopmentUniversity of TorontoTorontoOntarioCanada
- Centre for Addiction and Mental HealthInstitute for Mental Health Policy ResearchTorontoOntarioCanada
| | - Marika Rea
- Centre for Criminology and Sociolegal StudiesUniversity of TorontoTorontoOntarioCanada
| | - Pamela Kaufman
- Ontario Tobacco Research Unit, Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
- Centre for Addiction and Mental HealthInstitute for Mental Health Policy ResearchTorontoOntarioCanada
| | - Robert Schwartz
- Ontario Tobacco Research Unit, Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
- Centre for Addiction and Mental HealthInstitute for Mental Health Policy ResearchTorontoOntarioCanada
| | - Peter Selby
- Institute of Medical Science, Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- Centre for Addiction and Mental HealthInstitute for Mental Health Policy ResearchTorontoOntarioCanada
- Department of Family and Community MedicineUniversity of TorontoTorontoOntarioCanada
| | - Michael Chaiton
- Institute of Medical Science, Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- Ontario Tobacco Research Unit, Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
- Centre for Addiction and Mental HealthInstitute for Mental Health Policy ResearchTorontoOntarioCanada
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Nicholls SG, Fox G, Monfaredi Z, Poole E, Garritty C, Maybee A, Presseau J, Shea B, Fergusson DA. The impact of patient engagement on trials and trialists in Ontario, Canada: An interview study with IMPACT awardees. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:50. [PMID: 36071496 PMCID: PMC9450365 DOI: 10.1186/s40900-022-00381-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 08/28/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND A key component of patient-oriented research is the engagement of patients as partners in the design and conduct of health research. While there is now national infrastructure and networks to support the engagement of patients as partners, there remain calls for promising practices and success stories. In particular, there remains a keen interest in evaluating the impact that patient engagement has on health research studies. We aimed to investigate the impact that patient engagement had on health research conducted in Ontario, Canada. METHODS Our sampling frame was studies that were awarded funding by the Ontario SPOR SUPPORT Unit. Semi-structured interviews were conducted with 10 principal investigators, members of research teams, and patient partners. Interviews explored the role of patient partners, the perceived impact of the patient engagement on the study, challenges faced, and advice for other researchers considering patient engagement. Data were analysed using the thematic analysis method with transcripts coded independently by two members of the study team. All coding and subsequent theme generation were discussed until consensus was achieved. RESULTS There was variation in the methods used to engage patients and other stakeholders, the roles that patients and stakeholders occupied, and where they had input. Interviewees discussed two major areas of impact of patient engagement on research: impact on the study about which they were being interviewed, which tended to relate to improved relevancy of the research to the study population, and impact on themselves which led to changes in their own practice or approaches to future research. Identified challenges to patient engagement included: identifying and reaching patient advisors or patient partners, time-related challenges, and maintaining engagement over the course of the research. CONCLUSIONS There remains a need to further build out the concept of relevancy and how it may be operationalised in practice. Further, the longer-term impacts of patient engagement on researchers and research teams remains under-explored and may reveal additional elements for evaluation. Challenges to patient engagement remain, including identifying and maintaining engagement with partners that reflect the diversity of the population of interest.
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Affiliation(s)
- Stuart G. Nicholls
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON Canada
| | - Grace Fox
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Zarah Monfaredi
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Evelyn Poole
- Faculty of Arts and Science, Queen’s University, Kingston, Canada
| | - Chantelle Garritty
- Global Health and Guidelines Division, Public Health Agency of Canada, Ottawa, Canada
| | | | - Justin Presseau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Beverley Shea
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Dean A. Fergusson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
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Hawke LD, Sheikhan NY, Jones N, Slade M, Soklaridis S, Wells S, Castle D. Embedding lived experience into mental health academic research organizations: Critical reflections. Health Expect 2022; 25:2299-2305. [PMID: 35999670 PMCID: PMC9615091 DOI: 10.1111/hex.13586] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/26/2022] [Accepted: 08/10/2022] [Indexed: 11/29/2022] Open
Abstract
Background As part of a growing emphasis on engaging people with lived experience of mental health conditions in mental health research, there are increasing calls to consider and embed lived experience throughout academic research institutes. This extends beyond the engagement of lay patients and also considers the potential roles of academic researchers with lived experience. When the lived experience of academic researchers is applied to academic work, there is the potential to improve the relevance of the research, while destigmatizing mental illness within academia. However, there are different and often contrasting perspectives on the way a lived experience academic researcher initiative should be implemented. Objectives This article describes some of the key issues to be considered when planning an initiative that leverages and values the lived experience of academic researchers, including the advantages and disadvantages of each potential approach. Discussion & Recommendations Institutions are encouraged to reflect on the ways that they might support and value lived experience among academic researchers. In developing any such initiative, institutions are encouraged to be transparent about their objectives and values, undertake a careful planning process, involve researchers with lived experience from the outset and consistently challenge the stigma experienced by academic researchers with lived experience. Patient or Public Contribution Multiple authors are academic researchers with lived experience of mental health conditions.
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Affiliation(s)
- Lisa D Hawke
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Natasha Y Sheikhan
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Nev Jones
- School of Social Work, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mike Slade
- School of Health Sciences, University of Nottingham, Nottingham, UK.,Faculty of Medicine & Health Sciences, Nord University, Namsos, Norway
| | - Sophie Soklaridis
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Education Services, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Samantha Wells
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - David Castle
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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